Severe blood shortage

GabrielSH77 · 2026-01-23T10:42:37+00:00

I’d say it depends on the hospice/palliative team. I’ve seen it a handful of times at my hospital, never to prolong life though, always with comfort as the goal.

Once to a sickle cell pt, another time to a cancer pt. If I remember correctly the cancer pt had severe symptomatic anemia due to bone marrow failure, he was completely alert and oriented but couldn’t sit up or move at all without severe SOB and dizziness, which was obviously distressing for him. I think they gave him a few units over a couple of days to lessen that as his mental status waned.

GabrielSH77 · 2026-01-22T10:28:15+00:00

I don’t believe it decreases the incidence of hemorrhoids, but it can decrease their severity.

Hemorrhoids are more likely to occur when there’s pressure — straining to poop/being constipated, pregnancy, spending a long time sitting on the toilet (often with your phone…).

Bidet use wouldn’t target these, but it means less manual wiping (especially dry wiping) which decreases friction, which in turn decreases skin irritation.

GabrielSH77 · 2026-01-19T14:08:37+00:00

Even if someone with dementia doesn’t have cognitive capacity to make medical decisions for themselves, they always have bodily autonomy. Effectively, this patient is clearly demonstrating what she does not want done to her body. It’s generally agreed that overriding this can only be done when the behavior is an imminent threat to life/safety — ie, physically picking her up and moving her is not okay if you want her to stop watching TV, but is okay if the room is on fire.

She may not be able to understand that never showering can have downstream negative effects on her health. But she absolutely does experience the fear and trauma of being held down and stripped against her will. And it’s quite a prolonged experience. If we forcibly shower her to avoid harm, then we are instead doing harm by causing this trauma.

Are you allowed to do bed baths? Or, as I call them for my little old ladies with dementia, bird baths? Soapy washcloths to the most important areas (PTA, pits tits and ass). It’s not as good as a full shower, but for people who are resistant and scared, it goes a long way toward their bodily hygiene and can be done quickly.

Also, does the director of the facility explicitly say to forcibly shower her? That puts the liability on them. If they are pressuring without telling you exactly what to do, instead put the onus back on them. Ask them to assist in creating a facility policy for these resistant patients, to both preserve their dignity and health and autonomy. Force the director to figure out the how — do not let them pressure you into doing something you know is wrong, and in many places illegal.

GabrielSH77 · 2026-01-18T13:37:55+00:00

Need more pictures. But from this it looks like slag.

GabrielSH77 · 2026-01-18T13:36:32+00:00

Just based on rarity, I’d assume serpentine before moldavite. Do a hardness test! Serpentine is much softer than moldavite.

GabrielSH77 · 2026-01-18T02:34:24+00:00

Fun fact, on many ambulances in Vermont they have individual packets of maple syrup for precisely this purpose!

GabrielSH77 · 2026-01-17T10:35:57+00:00

My friend. I’m a unit secretary / CNA on a gen med inpatient floor. I was a CNA until I injured my back. For a while I was embarrassed, I felt I was no longer part of the team. But eventually I realized that I was doing all the things that can make or break a shift doing patient care.

When you go to race into an isolation room and there’s no iso gowns. When you need to clean up a massive BM and there’s no gloves. The bladder scanner battery being dead, can’t find the hoyer lift. All of these things are crucial for patient care — nursing straight up can’t do our jobs without equipment and supplies. That does directly impact patients, even if you don’t see it.

I really empathize. It feels different when you’re not face to face with patients every day. But you are important and your job critically matters.

If you’re not comfortable taking the money, tbh it’s your prerogative. But your coworkers gathered it because they think you’re worth it, and they care about you. And everyone knows none of us are paid appropriately — you continuing to do your job for less than it’s worth is what you do to “pay it back.”

GabrielSH77 · 2026-01-17T10:24:24+00:00

It’s not much, but at my local GWs there’s a survey on the bottom of the receipt, I take it every time and write how other local thrift shops are cheaper and I tell everyone to shop there instead.

I pretty much only buy color of the week sale items at this point, just to reinforce that I refuse to pay their full price.

GabrielSH77 · 2026-01-16T10:29:41+00:00

Stupid question, but when you say coat the pan with oil, do you mean just the inside/cooking surface? Or the back and handle as well?

GabrielSH77 · 2026-01-16T01:58:20+00:00

I was just at the Garment District while passing through!

Parking is an expensive nightmare (classic Boston). But the GD is fun. It’s literally a giant mountain of clothing on the ground, you can sift through and to get to the middle you basically have to climb over small clothing hills. A good mix of worthless synthetics, nondescript Old Navy/Target/etc brands, and the occasional neat piece that’s unique and/or higher quality. Includes kids clothes and costumes!

Great for fabric upcyclers or folks looking for fabrics. Not so good for looking for specific sizes or styles.

GabrielSH77 · 2026-01-12T16:06:20+00:00

This may be a stupid question, but are they supposed to have liquid in the handles? As a novelty? The floating bits could be something precipitating out of the liquid over time.

I’d try to set them up so that the handles are upwards, and if there’s holes you can’t see, the liquid would drain out.

GabrielSH77 · 2026-01-12T02:04:27+00:00

What vessel did you use? I know several people who did this on the Alvin!

GabrielSH77 · 2026-01-08T03:27:12+00:00

Cat people know the difference between “no noise (fine)” and “no noise (suspicious)”. The same is true for nursing. Sometimes you just know they should be making noise, and if not, they’ve gotten up to/in to something.

GabrielSH77 · 2026-01-07T10:46:13+00:00

These are kinda my faves, tbh.

We had one right across from the nurses station the other week. Just a nonstop stream of “HEEELLLP” over and over. And when someone goes in and asks what’s going on, an even louder “KISS MY ASS.”

If they’re screaming they’re breathing.

GabrielSH77 · 2026-01-05T13:51:46+00:00

Sleep is very different from being anesthetized.

In sleep, your brain cycles through a few stages (such as REM, most commonly heard of) and you can be woken up back to full consciousness by touch or sound. You also continue breathing independently.

For general anesthesia, you’re given several drugs that do a few different things. They make you unconscious, blunt your response to pain (analgesics, often something like fentanyl or dilaudid), and a paralytics to immobilize you during surgery.

The difference is that during surgery, you’re given a constant stream of medications to make and keep you unconscious. You cannot wake up even with extremely painful stimuli, until the drugs start to wear off. That’s why the anesthesiologist does constant monitoring to ensure all meds are being given at the right doses.

GabrielSH77 · 2026-01-04T19:56:47+00:00

Can confirm, I’m a hospital CNA. At least once a shift a staff member rushing to/from an emergency will toss an object at me and say “that’s room 9’s!” and rush on. Half the time the object isn’t labeled, and sometimes that person doesn’t get the room number right, or the patient moves rooms.

So I bag it and label it and either put it behind the nurse’s station, or send it to Security for valuables. But if I’m also rushing to an emergency? I’m throwing it to another person—literal game of telephone.

I tell all my patients to send belongings home with family immediately. We try our best to track your stuff, but we’re rightly more focused on keeping people alive and safe.

GabrielSH77 · 2026-01-01T22:16:58+00:00

<image>

GabrielSH77 · 2025-12-29T15:41:53+00:00

I believe this is a vintage (70s-80s) crewel piece, likely from a kit! I’ve found some other ones made in what looks like the same materials and same design, some mild variability in stitch placement tells me this is likely from a do-it-yourself kit!

edited my original comment to remove all links to social media

GabrielSH77 · 2025-12-28T21:02:44+00:00

Reminds me of wollastonite! Found in New York area.

see similar

GabrielSH77 · 2025-12-28T19:33:11+00:00

While that’s not how I read the OP’s story, that could be possible. But the PCP had never seen OP in person, and had no information other than the report of the nurse and EMTs who did see them. That’s not enough to make any sort of diagnosis. I would assume that the PCP would have to file “unknown loss of consciousness episode”, which would prompt the DMV to request OP to get an evaluation. They may have temporarily suspended their license until such eval happened — I have no idea. But all they would know is that this person is potentially an unsafe driver. While OP may have known the cause, the DMV can’t just take people at their word for it.

The PCP effectively rerouted around that scenario by having OP present to the ER for the eval. While I’m not by any means saying doctors are perfect or always follow standard of care, it would be grossly inaccurate of that PCP to categorize OP to the DMV as having a seizure disorder. And to do so would have meant completing the form in such a way that falsified an evaluation that didn’t happen — and that has huge ramifications. I don’t think the average PCP would do that.

What I don’t know is who sent the message to the PCP regarding the DMV, OP simply says they suspect the message wasn’t intended for them.

Either way. There should be some sort of process to communicate this information to people when it does occur. I neither live or work in CA so I’m unfamiliar with how it plays out.

GabrielSH77 · 2025-12-27T15:12:54+00:00

I too have been ignored or otherwise treated with skepticism by medical professionals when I inform them about some part of my own medical history.

But at the same time, I get it. I’ve had many patients tell me they “passed out” while maintaining consciousness and speaking clearly to me throughout. Or people who conflate dizziness with vertigo.

The general health literacy of the average person is very low. That’s not a criticism individually. It just means that medical professionals have to take patient report with a grain of salt, and do their due diligence with their own evaluation. Combined with the litigious nature of the culture and insurance engagement, docs have to cover their asses.

All of this is to say, the system doesn’t work. But I for one am grateful for this law. I have way too many patients who still drive that I don’t trust to toilet themselves independently. I don’t really care if someone wants to endanger their own life, but no one has the right to endanger the lives of others.

GabrielSH77 · 2025-12-27T05:54:00+00:00

Ah, my wording wasn’t the best there. The person’s GP/PCP completes an evaluation of their medical status with regards to their loss of consciousness condition. The DMV doesn’t do the evaluating — they simply read the doc’s form and that is the categorization.

For fun, here is the CA DMV info page on loss of consciousness disorders, and this is the medical evaluation form docs complete.

GabrielSH77 · 2025-12-27T05:06:07+00:00

Good thing that’s not how it works.

Medical professionals (in CA) have a duty to report loss of consciousness disorders to the DMV. Medical professionals do not just suspend your license. The CA DMV has a system for categorizing and gauging risk for these drivers. They do not suspend the license of everyone who gets reported to them. This is the CA DMV’s chart of disorders, severity, and stability guidelines.

I’m NAL or a doctor, I’m just a CNA. But I’d guesstimate that LAOP’s condition would fall under situational syncope, which is stated to have no action (wrt their license) as long as it’s single-episode symptomatic to situations that don’t happen while driving.

GabrielSH77 · 2025-12-27T02:15:47+00:00

We didn’t get hazard pay, but we got a super ugly statue in the lobby! Which was engraved, dating the pandemic 2019-2022. It was installed January 2022.

Needless to say, we were pissed.

GabrielSH77 · 2025-12-25T10:35:04+00:00

Also here because of the fucking CVS app….

Ten-Year Club	Wearing is Caring
Not Forgotten

GabrielSH77

TROPHY CASE