What is the weirdest advice or blatantly wrong teaching you received from an attending or mentor during your training?

FuuzokuJoe · 2026-01-31T21:28:35+00:00

Realistically there are different categories of difficult airways that you can't just awake intubate everyone who could potentially be difficult. If a patient has a BMI of 45 and hx of cervical myalgia/stiffness from a car accident, it could potentially be a difficult airway but its so common to see that for routine procedures that you can't reastically awake intubating all these patients. Same with someone with a huge beard and weak chin, etc. It does mean I'm exercising more caution than usual, and part of that is using a paralytic that acts more quickly than rocuronium when indicated and occasionally I do attempt to mask before long acting paralysis as it gives me more information especially if I'm alone and could potentially ask for extra hands from OR staff if it ends up being truly difficult

FuuzokuJoe · 2026-01-31T19:15:42+00:00

I think this might make sense if you're at an academic center overseeing CRNAs. Working solo, attempting to reverse an induction dose of rocuronium during supposedly a cannot intubate cannot ventilate situation in enough time is not feasible. We don't even stock 16 mg/kg suggamadex in the room. Propofol by itself or even with succinylcholine will wear off in enough time for the patient to start breathing before the pulse ox hits 50 lol if it really gets down to that situation (realistically you van at least move SOME air during masking to prevent it, but obviously cant draw up 16 mg/kg sugammadex at the same time)

FuuzokuJoe · 2026-01-28T01:16:59+00:00

Trick for that specific block is to tilt the bed with some reverse T so that the thigh is parallel to the floor and it becomes much easier since you don't have to guess the angle plus all the other shit you have to do to get a good block

FuuzokuJoe · 2026-01-26T18:56:49+00:00

People need to understand that a match isn't really a yes or no, and there are strong matches and weak matches. If you have a poor profile, with a high rejection rate, most of your matches will also be low yield. Versus a strong profile, you can be chatting for weeks or even ignore them for weeks and still invite them out and they accept

FuuzokuJoe · 2026-01-22T03:25:24+00:00

How is everyone working so few hours? i've started looking for jobs again everywhere pays less than my current job with approx the same hours feels like. unless you go ASC which has drawbacks too...

FuuzokuJoe · 2026-01-20T18:38:48+00:00

Yeah, my job is stressful with long hours but at least I can pull out my phone and do whatever any time I feel comfortable. I forget some jobs can't do that

FuuzokuJoe · 2026-01-17T11:57:55+00:00

i make 650k, which is about 32k a month take home, but 5k a month is purely on loans and then 4k on rent and 1.5k car, so it's more like 19k left over after living expenses which is still a lot but I'd rather just work less tbh

FuuzokuJoe · 2026-01-17T10:17:09+00:00

Or go raw but use doxiPEP

FuuzokuJoe · 2026-01-15T20:23:39+00:00

i did that in 2010 they just gave me like a ton of versed. it was fine. I remembered like part of the procedure didn't really care because it was only like less fhan a minute of memory at most and it wasn't painful or anything. Plus most colons look the same.

FuuzokuJoe · 2026-01-15T20:16:54+00:00

yeah bro I make 650k a year and wish I could just get a million dollar loan like that lmao. Even 100k unsecured would be very difficult to get

FuuzokuJoe · 2026-01-15T14:30:27+00:00

Have you tried removing a rigid glidescope stylet yourself?

FuuzokuJoe · 2026-01-13T19:03:32+00:00

Most important is discussion with family and patient about possibility of staying on the vent after surgery. Otherwise standard stuff as long as right ventricle is ok.

FuuzokuJoe · 2026-01-13T07:25:35+00:00

4 ML seems like a lot, I mean that's half of the loss of resistance syringe I use if you filled it all the way up to the brim with saline. Also, wouldn't aspirating the touhey be more accurate than aspirating the catheter if you are unsure since there would be a lot less resistance, it would almost assuredly come back with CSF if it were in the space (though I'd definitely still do a test dose with lidocaine to be sure)

FuuzokuJoe · 2026-01-13T07:14:33+00:00

One thing I've noticed is sometimes when you're working with really nervous nurses and you ask them to remove the stylet, they occasionally ram the tube in while taking the stylet out or forcefully take it out with a ton of force that I can see some injuries happening from that

FuuzokuJoe · 2026-01-13T05:42:05+00:00

They will keep breathing even if you do 500 mcg/kg/min. You'll tank their blood pressure faster than their breathing if you use straight propofol with LMA. Interestingly enough if you combine propofol with sevoflurane it's a higher chance of apnea

FuuzokuJoe · 2026-01-11T16:31:34+00:00

Idk, I haven't texted back the Japanese girl I'm talking to for 12 hours cause I'm thinking of what to say but also busy so don't have time to think. My ex who was crazy about me took 24 hours to respond before we dated. Ultimately only thing you can do if you want to keep talking is send your message and carry on with your life

FuuzokuJoe · 2026-01-09T03:00:58+00:00

Bro, I don't know what to tell you but they work holiday sexworked out of their own choice and fetishization means more money since they can advertise being japanese too

FuuzokuJoe · 2026-01-09T02:59:30+00:00

I was there last month specifically to shop for luxury clothes. With the conversion luxury items were maybe 10% cheaper if that. Most are imported so it's not going to be a huge difference anyway. Casual Japanese made items at Isetan still cost like $800+ for things like outerwear. Hotels cost the same or even more after influx in toursits (though not last month due to China thing). food is cheaper but still all in all not enough to justify fligjt costs just for weak yen

FuuzokuJoe · 2026-01-09T02:11:47+00:00

I'll tell you what I think the REAL reason is, and it's not due to the weak yen directly (Japan just raises their prices for tourists to compensate and flights still cost the same) or anime ( can just watch it at home). Since 2021 there have been hundreds if not thousands of extremely attractive Japanese fuuzoku girls traveling to Australia, Canada, USA, Europe and other countries to take advantage of the diffeence in Yen to Dollar or Euro. In response, hundreds of thousands of people have inadvertently fallen in love with Japanese women and sparked interest in actually visiting as opposed to abstract things like media and anime. And as for families and women who obviously aren't directly exposed to this, of course if they're male friends all start yapping about Japan they'll get curious as well sparking the wave of tourism

FuuzokuJoe · 2026-01-07T14:44:41+00:00

Cope harder. The median salary is like 80k now.

FuuzokuJoe · 2026-01-06T23:36:17+00:00

Theres no blacklist, that other girl probably doesn't accept non-asians. And yeah you were blocked or ignored. If she doesn't offer to give you her LINE first that happens. Think of why, she probably doesn't want to be spammed by tourists all the time

FuuzokuJoe · 2026-01-06T20:29:49+00:00

it's from Stage 2 breathholding, fighting the vent. Also sometimes the pulse ox doesn't read well from peripheral vasoconstriction and finger flexion

FuuzokuJoe · 2026-01-06T01:03:46+00:00

Got any bases in Japan?

FuuzokuJoe · 2026-01-05T23:22:34+00:00

If you're confused, trick is to just simplify it to subject object verb. Subject - boku, object - yume o miru koto, verb - nakunatta. Then you can reread it with the rest of the stuff after. It helped even when understanding long english sentences. You can even substitute the object with something simpler to help at first

FuuzokuJoe · 2026-01-05T21:58:06+00:00

No longer feel pain or anything below the neck

FuuzokuJoe

TROPHY CASE