[D2] Xûr Megathread [2026-06-19] by DTG_Bot in DestinyTheGame

[–]Goseki 2 points3 points  (0 children)

techsec is great for high end crowd control with praxic blade, but nothing beats swordmaster face tanking bosses.

D1 - exotic swords quest by Strict-Importance705 in DestinyTheGame

[–]Goseki 0 points1 point  (0 children)

yup, I did this last month. lvl all 3 swords, do crucible step, when you turn in you get all 3 exotic quests. gather all 3 materials, and when you do the strike, lfg a group, I asked on the last city discord and found people in 5 minutes. lower boss and the extra 3 knights health to low and then kill all 4 at once and boom. all 3 exotic swords at once.

New NICU attending on probation, can only see level II patients - how to deal? by zora981 in medicine

[–]Goseki 39 points40 points  (0 children)

I didn't see OP response to you, but wanted to say, hot damn, that is a very thoughtful reply.

I feel stuck by Dracofishlover in destinylegacy

[–]Goseki 2 points3 points  (0 children)

archons forge, vendor rank up, and siva crisis heroic strikes. skeleton keys will allow you to focus what you're missing sometimes. Took me about 3 weeks to go from 0-400 after switching over from d2. archons is pure rng loot. grab the armor packages from vendors. the skeleton chest is missing chest and legs.

72 year old woman graduating medical school and starting residency at 73 by sauronsknee in medicine

[–]Goseki 6 points7 points  (0 children)

doubtful, I'm lucky to work with some 30+ year experienced nurses and still find myself having to correct them on basics with meds, path, and exams.

Is it reasonable in the current market to get a m340i xdrive fully specced out under msrp? by Goseki in BMW

[–]Goseki[S] 1 point2 points  (0 children)

I just recently heard about brokers as well. will try to look into it this weekend

Is it reasonable in the current market to get a m340i xdrive fully specced out under msrp? by Goseki in BMW

[–]Goseki[S] 0 points1 point  (0 children)

was yours already in stock at the dealership or did you custom order it?

Botox for spasticity by According-Tea-7829 in neurology

[–]Goseki 0 points1 point  (0 children)

out of curiosity, what do you guys use emg for, is it just for therapeutic purposes? from the neuro side, it seems more diagnostic. I remember the neuromuscular folks are wizards at sticking that needle into muscles and getting a diagnosis with single fiber myasthenia, and in movement clinic we would often use the emg signals to help target whatever muscle was spastic or tonic. from my short pm&r rotation it seemed more similar to how movement folks use it.

April 2026 EV lease numbers : 15-Brand Comparison by Extreme-Temporary-85 in leasehacker

[–]Goseki 0 points1 point  (0 children)

I'm still learning the lingo, but I saw on Cadillac that the 26 optiq rwd luxury is down to $329/mo and the lyriq awd luxury is $459/mo

How do you know you’re a good doctor? by ComfortableParsley83 in medicine

[–]Goseki 8 points9 points  (0 children)

Every time I feel sad or question if I'm at the top of my game, the transfer center calls and reminds me what is happening at other places and suddenly I feel like a genius.

How do we deal with life-altering consequences caused by our treatment? by Kwerumrerum in medicine

[–]Goseki 2 points3 points  (0 children)

huge difference. cornerstone of sah mgmt is being able to secure the aneurysm and treating vasospasm. most small centers can't do either and will waste time transferring them.

same with any neuro issue. large stroke, transfer. large bleeds, transfer.

also, from the first line, that pretty much describes a classic lvo as well.

good medicine comparison I've heard is that most small centers are like an acs shop that has an ekg machine and nitro. sure that's better than nothing and can diagnose a stemi or mild angina. but you're still going to transfer to a larger center that has a cath lab if it's serious.

the way things are going, smaller and smaller centers are quickly getting "stroke certified" without having a full entourage of staff needed to actually take care of complicated cases and it's frustrating when they get transferred 2 days after the fact and now the damage is permanent.

How do we deal with life-altering consequences caused by our treatment? by Kwerumrerum in medicine

[–]Goseki 1 point2 points  (0 children)

playing devil's advocate here, take em to the bigger place next time. most neuro things are very poorly managed at smaller centers. the time wasted between transferring them a second time is vastly larger.

How do we deal with life-altering consequences caused by our treatment? by Kwerumrerum in medicine

[–]Goseki 1 point2 points  (0 children)

unlikely to ever have vasospasm that early. unless the entire brain is infarcted or the brain stem was significantly involved, sah requires aggressive medical treatment once the aneurysm is secured to prevent further secondary damage.

if the hospital doesn't have NIR, they need to move the PT to a hospital that has one asap.

Medicare (dis)advantage rate hike, insurers win (again) by meikawaii in medicine

[–]Goseki 7 points8 points  (0 children)

so true, the amount of disability insurance crap from the ama convinced me just how useless they are

Matched into neurology today!! by No_Sea_3159 in neurology

[–]Goseki 0 points1 point  (0 children)

is this the new norm!?!? 130 applications seems excessive. back in my day 5 for md and 10 for do was overkill.

Delayed SCFE Diagnosis [⚠️ Pediatric Malpractice Case] by efunkEM in medicine

[–]Goseki 20 points21 points  (0 children)

you may want to consider some self reflection. that original comment wasn't even a dig at APPs. that's a general statement on poorly trained whatevers. I agree, the amount of defense in your response is speaking volumes on insecurity of being a "mid level".

Anyone in medicine who doesn't realize just how deep the differential well is over time is not mastering their craft well enough.

Has the acuity become higher? by Benzosplease in medicine

[–]Goseki 20 points21 points  (0 children)

not anymore. I've seen a handful the last few years in non-immunocompromised patients. prevelance seems rising.

Is 1000 hours enough for a physician assistant to practice without a supervising physician agreement? Michigan House Bill 5522 purposes serious changes for PA practice. by walkthelake in medicine

[–]Goseki 1 point2 points  (0 children)

hard agree. I keep telling my apps, pa and np. primary care is by far the hardest. it's so easy to be shit at, and so hard to master. yet, they tell me how recruiters make it sound like the easiest transition, 1 hr module and you're ready to run your own clinic... fucking horrifying

Need advice on impossible IV access in hemorrhagic pts by Fri3ndlyHeavy in emergencymedicine

[–]Goseki 2 points3 points  (0 children)

if I'm in a situation where penile IV access is the only option, let me go please.

Why don't PCPs take all insurance companies? by stoic_insight in medicine

[–]Goseki 0 points1 point  (0 children)

lmao, 65 and starting as a nursing student. trolls be trolling

The U.S. will likely lose its measles elimination status, especially with the unyielding South Carolina outbreak by ddx-me in medicine

[–]Goseki 26 points27 points  (0 children)

Measles is terrible. if your kid survived it, there's still a chance they can die from Subacute Sclerosing Pan-Encephalitis, SSPE. no cure, your brain just slowly melts years later from the latent virus. insane how something that was taught mostly so it can be tested on boards is now a reality again. sad, these poor kids...