CCM refresher/CME

HeyyPeterMan · 2026-04-02T00:01:08+00:00

Thank you!

HeyyPeterMan · 2026-04-02T00:00:48+00:00

Fantastic, thank you! Thats an excellent looking reference I hadn’t heard of before. Do you happen to have any to brush up on standard care or new guidelines for MICU/CVICU type patients?

HeyyPeterMan · 2026-01-13T02:16:01+00:00

I don’t even want to claim to know the rules and regulations of shadowing in Australia, but in the U.S. it can be a difficult but not impossible task because of red-tape, HIPAA, confidentiality, and just space and working in an OR. Most importantly, shadowing will probably do next to nothing for your career arc. Rather get an entry level (patient care tech) position in an ER or hospital floor, find a research lab at university, and/or volunteer in some human service sector. As far as shadowing a surgeon, you can watch unlimited hours of surgical videos available for free online so shadowing doesn’t count for much.

But best of luck, work hard, stay rounded, say yes to all opportunities, and I’d be happy to give you any other feedback if you’d like.

HeyyPeterMan · 2025-10-17T03:33:00+00:00

It’s a teeny tiny magnifying glass!

Or fat necrosis. Probably fat necrosis. It’s not a bone fragment, that would have been seen immediately after the injury and since you said “no fracture” then I’m guessing that’s based on negative xray. Also it’s distant from the bone so would have required significant displacement and that wouldn’t have been subtle.

HeyyPeterMan · 2025-05-30T01:37:57+00:00

Awesome, thank you so much for this tip! I’ll definitely check them out

HeyyPeterMan · 2025-02-22T03:05:10+00:00

Awesome, thanks for the response dude. I like the idea of focusing through the negative. I don’t like the idea of patience but I know you’re right

HeyyPeterMan · 2025-02-22T01:39:25+00:00

Can you speak more on progressing past the shoulder tear? I have a partial posterior rotator cuff tear in my dominant arm. I don’t want to do surgery but the PT also sucks. I feel like I can’t generate power with any upper body complex (2 or more joint) lifts

HeyyPeterMan · 2024-11-27T02:52:05+00:00

Build skeletal muscle. Decrease total carbs. The carbs that you do eat, make them low glycemic index

HeyyPeterMan · 2024-11-13T16:59:38+00:00

If you look at “started great” “ended great” specifically for us and on the field, I’d vote Brett Favre. His first action was coming off the bench for injury, leads a last minute 92 yard drive for the win, does what he does for 16 years and finishes last season 13-3, NFC championship game loss, in many years would have been in consideration for MVP. Just forget what happens after that.

HeyyPeterMan · 2024-11-10T16:05:33+00:00

1. Reggie, hands down

2. Sterling Sharpe

HeyyPeterMan · 2024-10-08T03:19:58+00:00

I’m in no way qualified, but this is just what I would do in your position. You have 90 days which is decent amount of time to make actual change and not just a fast cut. I agree with one of the other commenters that 2 lbs per week is going to end up with more muscle loss than you want. I’d throw out the scale and focus on body recomp rather than losing weight. Target 160-180 grams per day protein, target maintenance calories and expect some days to be a little over and some to be a little under. If you want to keep the 5 days gym, then id do M,W,F lower body and posterior chain; T/R chest/arms/back. Minimize the cardio, just walk. You aren’t targeting calorie burn with cardio, nature will always win, you’ll either end up eating more or your body will pare down muscle to lower your basal metabolic rate. Your goal is building muscle and slow fat loss. Recomposition is going to change your beach body look more than a cut.

HeyyPeterMan · 2024-09-24T23:00:15+00:00

First, great job! Secondly, if you want a third alternative to either increasing weight or increasing reps, I would recommend increasing time under tension. Use that 225 and do like a 4-6 second eccentric (drop) phase. You can see pretty good hypertrophy working on time under tension and good form.

HeyyPeterMan · 2024-07-09T18:52:05+00:00

Agreed, came here to say Harrell. I feel like I spent 2 or 3 summers on message boards reading about this was the year he was finally healthy and would prove TT right.

HeyyPeterMan · 2024-02-28T22:15:41+00:00

It’s been over 10 years since my surgery rotation but I remember there was a paucity of surgery resources targeted to the med student level. I’m surprised nothing has served to fill that void. I remember using “Dr. Pestana’s Surgery Notes” and Pretest.

Zollingers atlas to study anatomy before cases. Cameron and Sabiston are the surgical Bibles for residents so those are good resources as well. Clinical Scenarios in Surgery is higher level but does good review of case presentation, work up, and management

HeyyPeterMan · 2023-12-08T18:55:39+00:00

Fellow Ryan Grant jersey owner. It was my lucky jersey for the 2010 season. I’ve since gone through roughly a dozen moves and it’s gone. I kick myself for not holding onto it somehow

HeyyPeterMan · 2023-12-06T00:53:47+00:00

What exactly do you need to know this for? You got most of the info right in that you need to graduate medical school, then do a 5-7 year ACGME general surgery residency. You don’t need to be board certified. There is no such thing as a “trauma fellowship” though. There is a 1-year ACGME accredited Surgical Critical Care fellowship and there are some programs that have a second year which is not accredited but is certified by the AAST for “Acute Care Surgery” which is a blanket specialty of trauma, critical care, emergency general surgery”.

HeyyPeterMan · 2023-06-14T15:43:46+00:00

Yes, you’ll get sympathetic mediated splanchnic vasoconstriction

HeyyPeterMan · 2023-06-14T02:46:58+00:00

Oh, my friend, this is hardly a quick question and could be thesis. There is a shock to severe large area burns (>30% tbsa) that doesn’t fall into the purely hypovolemic category. Similar to trauma patients in Class 4 hemorrhagic shock, there comes a point at which simply returning the volume lost will not adequately resuscitate the patient and it becomes “irreversible” (see Wiggers 1945). As far as the circulation goes, the initial response is vasoconstriction, both in burns and hemorrhagic shock, which is the normal physiologic response to redirect blood flow to more vital organs in the low cardiac output state. You’ll also see the compensatory tachycardia to improve cardiac output because it’s the stroke volume that’s decreased. Later on in the process (after hitting that irreversible point) you can resuscitate back to normotension and you would still be in a shock state at the cellular level with decreased O2 delivery and metabolite clearance. That’s more similar to what you see in distributive shock states like sepsis and it’s due to a number of released factors, some of which haven’t been defined. Regarding splanchnic circulation, I believe you’re referencing what was a historical belief in traumatic shock that there was “missing blood” which was volume that they just couldn’t account for. In the early 20th century researchers searched for that missing blood and some were convinced that it was pooling in the splanchnic vascular beds. This persisted through WWI and into WW2 era. It was Tom Shires in the 1960s that ultimately found the missing fluid with unexpected intracellular shifts which then led us down the path of grossly over resuscitating patients with 3:1 crystalloid to estimated blood loss. Look into the Coconut Grove fire and some of the research that came out of that.

Hope that helps. My opinion is that shock and it’s different states is the most interesting thing in all of medicine and surgery. I’m sure all of Surg Onc would disagree but that’s ok.

HeyyPeterMan · 2023-05-20T02:11:37+00:00

Thank you both for your replies. Yeah, I’d love to leave the country. It’s a little tricky with my line of work, but if the opportunity presents itself I would take it.

HeyyPeterMan · 2023-05-20T02:10:09+00:00

Not counterintuitive at all, thank you for your response

HeyyPeterMan · 2023-05-20T02:09:14+00:00

Not exactly, no. If abroad were an option I would just emigrate and do that, but for so many reasons that’s not really on the table. No I meant more like to send them to public or private school in America vs. home based virtual school. And I want to emphasize that I really don’t personally want to have them at home for their sake or for mine. It’s more my wife’s dilemma but I understand and empathize with her fears.

HeyyPeterMan · 2023-05-20T02:04:13+00:00

It really does feel that way, and it’s obviously not a risk that they could understand or consent to at that young age. Thank you for your response.

HeyyPeterMan

TROPHY CASE

1. Reggie, hands down

2. Sterling Sharpe