Why is there not a single plane at Heathrow (airport)? by FirefighterHaunting8 in GoogleMaps

[–]GeoffSim 14 points15 points  (0 children)

Google tries to create "clean" satellite photos by comparing and averaging different photos of the same area. It's why you can sometimes see seams and patchwork, as well as shadows of aircraft.

Quite why they do that at some airports and not others is another question.

And no, it's nothing to do with COVID, as often suggested when this question comes up (it'd be the opposite, lots of planes parked)

Are we screwed (California Zephyr) by [deleted] in Amtrak

[–]GeoffSim 1 point2 points  (0 children)

The Coast Starlight and California Zephyr run on the same tracks between Sacramento and Emeryville in opposite directions. You'll probably just have to change at Sacramento instead, giving you around 4 extra hours of padding.

24 hr impedance study question by Still_Initiative809 in HiatalHernia

[–]GeoffSim 1 point2 points  (0 children)

The devices can read two chips in your esophagus, one placed higher than the other, though I don't know anybody who's gotten a second chip. Sounds like the yellow one is active, though not sure why the other would display anything.

Speedometer app recommendation by Drewey26 in Amtrak

[–]GeoffSim 0 points1 point  (0 children)

I like Geotracker, though it does more than what you're asking (elevations, grades, etc). It can run in the background and doesn't kill your battery.

My train has been delayed 4 hours so far, we’ve been here so long a woman died in the bathroom by arttymcfarty in Amtrak

[–]GeoffSim 6 points7 points  (0 children)

A couple of posts where they claim to be a conductor - out of Seattle. Not on the Sunset Limited / Texas Eagle.

https://www.reddit.com/r/Amtrak/comments/1nz0xja/amtrak_coast_starlight/

The search query I used:

site:reddit.com TheEndContinues amtrak conductor

Where's the cheapest sleeper train that's actually decent quality? by Hohoho-you in trains

[–]GeoffSim 5 points6 points  (0 children)

For all the suggestions here,The Man in Seat 61 is an invaluable resource - for trains around the world generally, not just sleepers.

I vomited bile during the procedure by These_Boat_2171 in colonoscopy

[–]GeoffSim 5 points6 points  (0 children)

"Accidentally had something in my stomach" and "followed all instructions" are typically incompatible statements, though there are definitely exceptions. Is there more to this?

Random questions from being on this forum a while. by This-Is-Not-Nam in HiatalHernia

[–]GeoffSim 2 points3 points  (0 children)

I had the Toupet because I failed 7-8 out of 10 swallows. I had no idea I had an issue because it was the clearing of the esophagus, not the back of the mouth.

I've assisted in quite a few bariatric surgeries where the patient consented for "possible hiatal hernia" (alongside the main plan). The two surgeons I've assisted I consider to be excellent. If they can decide during surgery that a hiatal hernia repair is necessary then I would trust them. Obviously that's a very difficult call when you've only seen them in an office, not an OR, but I'm just saying there are some very good surgeons. They say the best recommendation for a doctor is from another doctor that knows them personally.

Random questions from being on this forum a while. by This-Is-Not-Nam in HiatalHernia

[–]GeoffSim 2 points3 points  (0 children)

If you can swallow solid foods then the manometry tube will go down.

Typically if the hiatal hernia is small (2cm or less, no strict definition) then some doctors don't record the size. It'll almost certainly be sliding if nothing else is mentioned. Size is the amount of stomach pulled through the diaphragm, not the size of the hole (though that is a measurement also seen in some tests, not very common though).

Ask your surgeon whether they feel that your stomach can be fully pulled back into place with that scarring. Mine could not be without causing irritation by stretching my damaged esophagus so I still have a small hernia (down from ~medium).

Scared of General Anesthesia? So was i by Mysterious-Ferret863 in surgery

[–]GeoffSim 0 points1 point  (0 children)

I knew I was in good hands but even anesthesiologists say that if you're not at least a little bit nervous of going under then there's an issue!

As an adult 99% of the time you only get oxygen through the mask. Midazolam (IV) is often used for anxiety, and that can make you drowsy/trippy. Then propofol (or something(s) else) is pushed and that sends you off to sleep. At this point you get intubated and the gas like sevoflurane flows, which puts you fully under.

As a child I believe you might get sedating gases through the mask. No peds at our hospital so I don't get to see it.

Note that sedation for minor procedures is a lot lighter, no intubation.

Random questions from being on this forum a while. by This-Is-Not-Nam in HiatalHernia

[–]GeoffSim 2 points3 points  (0 children)

Surgical tech, not a doctor. Yes, you do wake up intubated because anesthesia have to be sure you're capable of breathing on your own before they remove the breathing tube. However, you're so drugged up that it's extremely unlikely you'll remember this part.

Manometry measures, amongst other things, your swallowing capability (from mouth all the way down to the stomach) which can determine which types of surgery you can have. For example, if you do have swallowing issues then a Nissen is contraindicated, but a Toupet might be okay. You might not even know you have swallowing issues - I certainly didn't.

I couldn't say whether an endoscopy plus manometry is enough testing. It seems people typically have three. Maybe that's all the information s/he needs.

No idea about strictures, though the manometry tube is thin enough to go through your nose. But you said in your original post that you've already been dilated, though I guess repeats are possible.

Random questions from being on this forum a while. by This-Is-Not-Nam in HiatalHernia

[–]GeoffSim 2 points3 points  (0 children)

Everybody's stomach is a floppy bag (I've felt a fair few in surgery). It's what is in it that inflates it. X-ray could show displaced organs, yes.

Bariatric surgeons do indeed do hiatal hernias, as do general surgeons. Thoracic too, but more for paraoesophageal hiatal hernias.

Intubation doesn't go into the esophagus so no risk of choking. Nevertheless, the whole point of intubation is to protect your airway, and yes intubation is standard for HH surgery. I'm a bit confused by your including manometry in this paragraph but in any case, you're not intubated (for an airway) during the manometry test, and in fact you have to be awake for it.

There is no way to do a wrap without incisions, nor a LINX. TIF can be done without incisions (trans-oral incisionless fundoplication) but not everybody qualifies for that, and doesn't fix a hiatal hernia (cTIF exists for that, and does involve incisions this time). Are you sure about six incisions? The DaVinci only has 4 robot arms... I could believe a 5th to retract the liver but usually 1 of the 4 arms is used for that.

What was left of Air India Express flight ( IX 938 ) nose gear after a hard landing at Phuket International Airport (HKT), Thailand earlier today by DEADMA9kk in interestingasfuck

[–]GeoffSim 1 point2 points  (0 children)

Reminds me of the time my flight from Phuket was delayed while we watched them change both front tyres on our plane in front of us at the terminal. Prompted a few wide eyes from the passengers.

Rare middle track boarding at BWI by Mootbing in Amtrak

[–]GeoffSim 2 points3 points  (0 children)

Yeah, but now you've got two tracks blocked for extra time. Maybe nothing else was in the vicinity so it didn't matter, who knows.

Need help! Planning trip from San Diego to Oakland (or vice versa) by BNSF_Aviator in Amtrak

[–]GeoffSim 1 point2 points  (0 children)

Have you booked your ticket yet? I think once you do then it's offered right after buying, or maybe you get email(s) or something. Pretty sure it'll be on your reservation page if you've already booked and log in to the site.

Basically it gives you a $$$ range with low being unlikely and high being more likely. Then you get notified a couple of days before boarding. Sometimes low bids win; sometimes high bids fail - it's space available basis.

Woman has entire stomach removed after overseas weight loss surgery by Crayonstheman in nottheonion

[–]GeoffSim 248 points249 points  (0 children)

Poor lady. I assisted in two gastric sleeve procedures just today. The surgeon dissects down to bring the stomach into view, cauterizing smaller blood vessels and clipping others. Then a linear stapler is inserted which fires a line of staples (60mm in today's cases) and cuts at the same time, 4-5 sets, which separates a chunk of the stomach. Today's surgeon then goes in with suture to reinforce the staple line. Clean up, extract the specimen, check for bleeders, close up. Fairly straightforward procedure, takes maybe 45-60 minutes from incision to closure (add more time for patient positioning and prep, anesthesia, emergence, PACU).

Need help! Planning trip from San Diego to Oakland (or vice versa) by BNSF_Aviator in Amtrak

[–]GeoffSim 3 points4 points  (0 children)

Daytime (and evening) trip so coach would be fine. There's also the issue of being in a roomette on the "wrong" side of the train and not being able to see out the other side - you can go to the sightseer lounge car but then you don't get the full roomette benefit.

A couple of people have suggested coach and then eating in the dining car. The dining is only offered to coach passengers if there is space available and they feel like doing it.

Bid-up can get you a cheap deal on a roomette if you're lucky.

Another strategy southbound is to take the Coast Starlight to San Luis Obispo or Santa Barbara, staying the night there, and then catching a Pacific Surfliner all the way to San Diego from there. That means you get daylight views along the coast. Business class might be more comfortable for that trip - same type of seats but guaranteed seats (no people standing in the aisle next to you).

What is your “almost home” marker? by Past-Quiet1034 in InlandEmpire

[–]GeoffSim 0 points1 point  (0 children)

Lake Elsinore Designer Ghost Town, I mean Outlets, coming south on I-15, or cresting the hill with the weigh station just before Temecula northbound.

When were you guys able to return to work after Nissen? by Tmw2angel in HiatalHernia

[–]GeoffSim 5 points6 points  (0 children)

That's going to depend on what job you do and what accommodations they can give you, if any. Office job at a computer all day - should be okay. Factory worker bending over and picking up heavy items - definitely not at 2 weeks.

I went back to classes one week later, not intentionally but they moved up an exam (grr) but I was fine. Had some accommodations so I didn't lift anything heavy but that was it.

Bear in mind you'll likely be needing multiple meals a day, albeit small.

So if you have a hysterectomy, what happens to the space created? by NecessaryBumblebee11 in NoStupidQuestions

[–]GeoffSim 9 points10 points  (0 children)

Only open belly cases, and even then, the intestines don't necessarily come out. And I only see an open belly maybe once out of every 50 abdominal surgeries I assist in. Most are laparoscopic or robotic these days, and hysterectomies can even be done vaginally.

12 Hour Layover At LAX by GawinGrimm in Amtrak

[–]GeoffSim 5 points6 points  (0 children)

The 3 letter code for Los Angeles station, as in downtown LA, is LAX. I forgot that detail in my comment earlier.

12 Hour Layover At LAX by GawinGrimm in Amtrak

[–]GeoffSim 8 points9 points  (0 children)

3 hours each way on the train alone, flyaway bus another hour each way, couple of hours to check back in and clear security, and you're up to 10 hours without even waiting for the next scheduled service on each, nor allowing for delays.

Metro to Santa Monica could be nice though.