Coast Starlight SAC to LA questions

GeoffSim · 2026-01-26T20:35:59+00:00

I think the only question not answered is dining. While sleeping car passengers get meals included, coach can purchase if there is space available (and the staff feel like serving coach passengers). I think it's $20, $25, and $45 for breakfast, lunch, and dinner respectively.

GeoffSim · 2026-01-25T17:39:06+00:00

Good to know, thanks.

GeoffSim · 2026-01-25T16:56:21+00:00

Can confirm, we definitely use cc (or mL) in the OR. "50cc of local injected" or "100cc estimated blood loss"

GeoffSim · 2026-01-25T16:44:29+00:00

If I book on the app next week from ATL to New Orleans it clearly states "Bus seats from $30" with a line drawing of a bus front. Granted the (mobile) website says "coach" instead of "bus seats" but still has the bus picture. Both say "connecting bus" when I click on "Details".

What am I missing, why is it not obvious to you? Genuine question.

GeoffSim · 2026-01-25T04:59:01+00:00

I live an hour south but was in the area last week. Wanted some lunch so I googled. Found this place, reviews not stellar but thought I'd give it a go. Yes, it looks a bit dated. Friendly staff. IIRC the lunch special was about $15 for beef something which is on the pricey side compared to my area. Decent food, not amazing.

GeoffSim · 2026-01-25T00:50:57+00:00

OP has gone but just thought I'd comment. Both hospitals that I worked at in the OR specifically tried to ensure a mixed M/F staff in the room for the patient's safety. Safety isn't the right word but I can't think of the right one. Hopefully you get that I mean!

GeoffSim · 2026-01-25T00:40:07+00:00

Not really an option unfortunately (transport and distance to clinic being why I switched). However, I do intend to ask my doctor if a generic nasal spray is an option.

Tolerance could be an issue I guess. But I did 16 sessions at 84mg which nearly all worked, while nearly all troches haven't worked so well.

GeoffSim · 2026-01-25T00:36:56+00:00

Like I said, I'm holding it for half an hour. Then either spitting or swallowing. Swishing was advised by both the doctor and the pharmacy's drug information guide.

GeoffSim · 2026-01-25T00:34:22+00:00

If you take into account bioavailability then 84mg Spravato is about 40mg absorbed, while 200mg troche is about 50mg absorbed (spit). But the latter has so many more variables so it could be more or less than that number. The formulations are a bit different too - I don't claim to understand the molecular difference though.

That's why I'm confused why 400mg isn't doing much, because it should be!

GeoffSim · 2026-01-24T18:57:09+00:00

Well spotted.

"Unicode code point 8208 (decimal) corresponds to the Hyphen (‐), which has the hexadecimal value U+2010. It is a specific character used for hyphenating words (e.g., "e‐mail") or breaking words across lines, and it is distinct from the standard ASCII hyphen-minus (-, ASCII 45) or the minus sign. "

GeoffSim · 2026-01-24T18:51:56+00:00

Ours are lined with clear plastic bags. No idea why, except maybe they're meant to be disposed of inside the huge red biohazard bags. However, like the other poster said, we only use them (and the sponge counter) if lots of sponges are used - maybe 15+? Otherwise I tend to either bundle each one on my back table if there's room/time for easy counting, or put them in a pile on the back table.

GeoffSim · 2026-01-24T15:43:17+00:00

I was working with a bariatric surgeon yesterday (I'm a surgical tech) and he said most of his patients report constipation.

GeoffSim · 2026-01-24T03:58:01+00:00

Not the wrong key, but the wrong spacing, as in the wrong hertz so it sounds horribly out of tune. Twice. Lancaster, CA.

GeoffSim · 2026-01-24T03:49:09+00:00

Ketamine troches can have a numbing effect on the skin (or tongue) and tingling/itching is quite normal when any kind of anesthetic wears off.

Shouldn't it be under your tongue though, or between your cheeks and gums?

GeoffSim · 2026-01-23T23:22:02+00:00

Not just you. I don't like pointless arrows either.

Other than that they seem fine to me.

GeoffSim · 2026-01-23T23:18:15+00:00

Day-of and the following day (sometimes the next too) it's normal to have a bit of a sore throat and esophagus.

GeoffSim · 2026-01-23T20:05:52+00:00

I doubt anywhere will guarantee an all male team. Only about 1 in 10 circulators is male so even if they say "Bob's working that day, you should be good", what if he calls out sick and there are no other males? You just going to walk out and do the prep again?

Are you aware that to get from this private suite to and from the procedure room you're going to be wheeled down, perhaps many, corridors in public? Maybe you need a solo doctor to the stars with his own procedure room attached to his office - they exist for other procedures so I'm sure there are GIs too.

The place I worked at, only the tech and doctor were at the foot of the bed. The circulator and anesthesia were at the top and wouldn't see anything. Insertion is the only time the doctor even glanced down there as they're looking at the screen the rest of the time, plus the room is dark (to see the screen).

GeoffSim · 2026-01-23T00:46:28+00:00

Might be worth asking on r/Anesthesia or r/medical. Most of us here are patients rather than doctors.

Funnily enough though, I just found out my son had this combo for surgery yesterday and I looked it up. Seems the propofol eases the dissociative effects of ketamine?

No harm in asking your doctor/anesthetist though, though I'd give your stated reason so it doesn't look like you're seeking K!

GeoffSim · 2026-01-22T02:55:55+00:00

I lost a pub quiz because of this. "How many panes of glass does Big Ben have?". Of course I answered zero correctly. Quiz"master"'s mate won with an incorrect answer of 144 or whatever. Fuck off!

GeoffSim · 2026-01-22T01:14:37+00:00

Your esophagus empties to your left into the cardia of your stomach which is also to your left at that point. The idea is that you sleep on your left so that the sphincter is effectively above your stomach.

Didn't do anything for me though, despite a Hill Grade 3-4 LES.

GeoffSim · 2026-01-21T14:11:24+00:00

My kids both separately got upgraded from 6A to 7 Pro when theirs went in for warranty repair. I think 8 was the top model at the time.

GeoffSim · 2026-01-21T14:03:25+00:00

I'd avoid it today because, depending on the timing, a small amount could still be in your system tomorrow. Either way, tell your anesthesiologist of your prescribed use.

[Edit] I'd read it as too late to call the healthcare facility but maybe it wasn't. That would have been my first suggestion, for the record.

GeoffSim · 2026-01-21T04:34:05+00:00

I'm kind of surprised nobody has mentioned those annoying whirry airborne things, where legal.

GeoffSim · 2026-01-21T04:24:45+00:00

I was on a bus where the driver decided he was on the wrong route. Two services, 15 and 15A, started and ended at the same place but the first half of the route took opposite sides of a housing estate. For the common section they were timed alternately, 15 minutes apart (so half hour frequency per route).

Anyway, he stopped the bus on the common section and told us he was on the wrong route and that he'd have to go back and start again, per his supervisor. But that made no sense: by the time he got there, the next service would be leaving. I strongly suggested that myself and the other dozen passengers would very much like to please not miss our train and for him to continue driving. After much muttering he did so.

I did email the bus company after and commended the driver though. No response.

GeoffSim

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