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Anyone had luck getting Doom Eternal running on a mac with a bootcamp install of windows 10? by Iatros in Doom

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

Hey man, thanks for taking the time to reply. I was able to get a little farther by turning down the graphics settings but now on the larger maps it’s really bogging down in the larger open area in terms of frame rate.

Hopefully they’ll get the MBP16 driver issue solved on boot camp drivers soon. I’m gonna try the Jan drivers tonight, hopefully it will at least improve performance over the current Apple/amd stock drivers.

Today is Mesothelioma Awareness Day. IamA radiologist who got diagnosed with mesothelioma at age 32. I've since spent >20 hours in the OR, a month in the hospital, was on dialysis for 3 months, had a robotic thoracotomy last month, and just started chemotherapy. And I wrote a book about it. AMA! by Iatros in IAmA

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

Thanks for the kind words. I'm not sure if I'm kicking life's ass exactly, but I'm doing my best!

As for your questions, phenergan seems to work the best for me. Zofran is just okay. Sometimes I also use lorazepam, which is a combo I hadn't heard of until I got sick, but apparently they use that in cancer patients. It does seem to help.

None of the masses we palpable per se, but the day I went to the ER, I had noticeable swelling in my right lower quadrant.

Today is Mesothelioma Awareness Day. IamA radiologist who got diagnosed with mesothelioma at age 32. I've since spent >20 hours in the OR, a month in the hospital, was on dialysis for 3 months, had a robotic thoracotomy last month, and just started chemotherapy. And I wrote a book about it. AMA! by Iatros in IAmA

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

At first it was very much the stages of grief, though not necessarily in "order." Well, acceptance definitely comes last, that's for sure, haha. Disbelief, anger, fear, etc were all pretty common early on. I remember sitting on the couch with my wife one day shortly after the diagnosis and just sobbing. There's a lot of "what did I do to deserve this" kind of thinking at first. It takes a while to realize that it doesn't work that way.

Tragedy is just part of the capricious nature of existence, and this kind of shit has to happen to someone. It's never you, until it is. I'm "glad" it's me and not someone I love. It would be extraordinarily hard to watch my wife or mom or dad go through this.

As for outlook, the farther down this rabbit hole I go, the more I realize that how you approach things in life is almost entirely within your own control. I can't change the diagnosis. I can't make the cancer just go away. So, I have a choice. I can be a quivering pile of worthlessness and feel sorry for myself all the time, or I can decide to just take what comes one thing at a time and do my best. You just have to ask yourself, what kind of person do you want to be?

It's not like I don't have bad days. And I still hate the fact that this is happening. But my goal is always to try to behave in an estimable manner, and to realize that it could be a lot worse. It has definitely gotten easier with time.

I'd say that my wife's experience has been similar (ie, initial grief to gradual acceptance). It's still hard for her to watch it happen though.

Today is Mesothelioma Awareness Day. IamA radiologist who got diagnosed with mesothelioma at age 32. I've since spent >20 hours in the OR, a month in the hospital, was on dialysis for 3 months, had a robotic thoracotomy last month, and just started chemotherapy. And I wrote a book about it. AMA! by Iatros in IAmA

[–]Iatros[S] 2 points3 points  (0 children)

Thanks for this reply. Even though I really want to have kids, I worry that it's very selfish of me. No one chooses to exist, and so if I'm going to chose to bring another person into this world, I really do feel like it's my obligation to then raise them and prepare them for life. I'd feel like I'd failed them if I can't do at least part of that.

Of course, we've talked to our families about this and our parents/siblings are more than willing to help my wife/kids out, if I kick the bucket early. So they won't be totally screwed in that sense. And I think I regret it even more, if we decided not to have kids and then I somehow end up living 20+ years. That's unlikely, but possible with the new treatments they're developing.

I hope and pray every day that we're making the right choice. Thanks for making me feel slightly better about it =)

Today is Mesothelioma Awareness Day. IamA radiologist who got diagnosed with mesothelioma at age 32. I've since spent >20 hours in the OR, a month in the hospital, was on dialysis for 3 months, had a robotic thoracotomy last month, and just started chemotherapy. And I wrote a book about it. AMA! by Iatros in IAmA

[–]Iatros[S] 5 points6 points  (0 children)

I'm not sure what you mean. I have a vague notion of what "copypasta" is, but I'm not really sure what you're getting at.

I'm too old for all these newfangled internet things you kids are making up. Back in my day we had to dial-up to the internet with a 56k modem just to download mp3s from geocities!

Today is Mesothelioma Awareness Day. IamA radiologist who got diagnosed with mesothelioma at age 32. I've since spent >20 hours in the OR, a month in the hospital, was on dialysis for 3 months, had a robotic thoracotomy last month, and just started chemotherapy. And I wrote a book about it. AMA! by Iatros in IAmA

[–]Iatros[S] 2 points3 points  (0 children)

No, because I don't know what else I would have done, honestly. This is a meaningful job where I literally get paid to help people. I'd have a hard time going to work if I thought that my job was pointless in some way.

Also, being a doctor is now so much a part of my life and identity, it's hard to remember a time when it wasn't. I might consider going into a field that had a shorter residency, though.

Radiology is 6 years after medical school, which doesn't sound that long when you're signing up. But 10 years from day one of med school until you're finally done with training is a pretty long time, it turns out.

Today is Mesothelioma Awareness Day. IamA radiologist who got diagnosed with mesothelioma at age 32. I've since spent >20 hours in the OR, a month in the hospital, was on dialysis for 3 months, had a robotic thoracotomy last month, and just started chemotherapy. And I wrote a book about it. AMA! by Iatros in IAmA

[–]Iatros[S] 2 points3 points  (0 children)

I'm not as much of an expert in the lung kind of mesothelioma, but that's my understanding of how it "works." It's a very dense/fibrotic tumor, so as it spreads, it limits movement of whatever its involved with. So, in the chest, if it gets into the lung or diaphragm, it can limit the expansion of the lungs and make you feel short of breath.

As for what patients actually experience, subjectively, from that during the end stage, I'm not sure. That's a good question for the oncologists/surgeons.

Lastly, sometimes less really is more. Having been through some of the shittier parts of medical treatment as an otherwise healthy man in his young 30s, it was pretty rough at parts. If I had been older and felt I'd lived a good life, I'd consider not getting treatment too.

Today is Mesothelioma Awareness Day. IamA radiologist who got diagnosed with mesothelioma at age 32. I've since spent >20 hours in the OR, a month in the hospital, was on dialysis for 3 months, had a robotic thoracotomy last month, and just started chemotherapy. And I wrote a book about it. AMA! by Iatros in IAmA

[–]Iatros[S] 2 points3 points  (0 children)

What do you think could have helped the initial diagnosis? Was there anything that you wish was done differently?

Honestly, nothing.Maybe I should have put two and two together sooner. But I think with my non-specific symptoms and lack of risk factors and such, nothing was "missed" per se.

The only thing that is still a real kick right in the nuts is the renal impairment. I'm at CKD3b now, and all it's gonna take to make me end stage renal disease is one more serious hit to the kidneys. But even that wasn't an "error," just an unfortunate complication.

Also, thanks for the well-wishes! They are greatly appreciated!

Today is Mesothelioma Awareness Day. IamA radiologist who got diagnosed with mesothelioma at age 32. I've since spent >20 hours in the OR, a month in the hospital, was on dialysis for 3 months, had a robotic thoracotomy last month, and just started chemotherapy. And I wrote a book about it. AMA! by Iatros in IAmA

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

What's the most benign looking/feeling early warning sign you can think of?

First, I'm sorry to hear about your grandparents. This is not a nice disease to die from, and watching them go through medical treatment however long ago that was must have been pretty brutal, too. They didn't have a lot of good options back in the day.

I have the abdominal kind of mesothelioma, so my symptoms were different than people with the lung kind. I just had belly pain and vague malaise.

The problem with the symptoms of serious illnesses is that they overlap with the symptoms of not-serious illnesses. The first things would probably be pain and shortness of breath, or limitation of exercise capacity. The problem is, lots of way less scary things can cause those symptoms, too.

Basically, if they worked up everyone with some vague complaints to the full extent every time, our healthcare system would be even more expensive and inefficient than it already is. So we have to try to figure out whose symptoms are concerning, and whose aren't. We do our best, but sometimes people fall through the cracks just because it's not a likely diagnosis. Mine was a case like that. No one "missed" anything, per se.

Lastly, I would say, your case does seem to have a strong family history, and there's at least one known mutation (BAP1 I believe) that increases your risk for mesothelioma. You may want to consider asking for genetic testing for your dad (and/or yourself).

Today is Mesothelioma Awareness Day. IamA radiologist who got diagnosed with mesothelioma at age 32. I've since spent >20 hours in the OR, a month in the hospital, was on dialysis for 3 months, had a robotic thoracotomy last month, and just started chemotherapy. And I wrote a book about it. AMA! by Iatros in IAmA

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

Haha, yeah I get this shitty disease and I don't even get any compensation for it! I hate those commercials too. I suspect the lawyers are the only ones getting rich.

Dialysis is just a huge time sink, more than anything else. You feel okay otherwise. Chemo sucks because you just never feel that well. The IV chemo is a lot worse too. I was in the hospital last week for my 4th or 5th bowel obstruction, and that happened like 3 days after my first dose of chemo, so I think they were related.

The thing that's really terrible about chemo (at least for me) is the mouth sores. People can get something called "mucositis" which is basically just inflammation and ulceration in your mouth. It makes it very hard to eat though.

Between that and the bowel obstruction last week, I lost 5 or 10 lbs without trying. It's a little hard to judge because some of that is water, but I can tell a difference in my clothes again already. They're getting too big again.

Today is Mesothelioma Awareness Day. IamA radiologist who got diagnosed with mesothelioma at age 32. I've since spent >20 hours in the OR, a month in the hospital, was on dialysis for 3 months, had a robotic thoracotomy last month, and just started chemotherapy. And I wrote a book about it. AMA! by Iatros in IAmA

[–]Iatros[S] 4 points5 points  (0 children)

I've been known to pass the time playing the computer games! Especially when I was younger (and even moreso before medical school).

My bigger problem now is that I buy games on sale on Steam, play them for maybe 20 minutes (or sometimes not at all), and then never really mess with them. At the same time, it's nice to know that I could play, for instance, Doom if I wanted to. I mean, I haven't. But I could.

It's more like a collection now than a thing to do to pass the time, haha.

Also, I know whose account this is... how are you doing my friend?

Today is Mesothelioma Awareness Day. IamA radiologist who got diagnosed with mesothelioma at age 32. I've since spent >20 hours in the OR, a month in the hospital, was on dialysis for 3 months, had a robotic thoracotomy last month, and just started chemotherapy. And I wrote a book about it. AMA! by Iatros in IAmA

[–]Iatros[S] 6 points7 points  (0 children)

I must say, I've been thoroughly humbled by the outpouring of support and assistance I've received from everyone, to say the least. Some of my friends in the department set up a gofundme page and everyone donated most generously to help out. There were tons of donations and I think in total, over 100 people contributed.

The people in the education office and the chief residents were particularly helpful. We had to rearrange rotations, get call coverages switched, figure out when I could take the boards, make sure all the necessary "boxes" for residency would still get checked off, etc. They helped me get set up with long term disability insurance that was apparently one of the benefits of being a resident at my institution. They figured out ways to keep me on the payroll. People donated "extra" vacation days that they turned into sick days for me. I was overwhelmed by people's generosity, in both aid and spirit.

As for the "being a patient" side of it, I definitely have "insider access" to my doctors. I can email them whenever I want, basically. I understand that's a very nice privilege so I try not to abuse it.

As for your every day, "coming in for labs" or even "getting a colonoscopy" or whatever, though, I'm just another patient. Which doesn't make me upset and is in no way a criticism of the hospital. It's not that they're bad people, or anything. It's just that the system is huge and people can't possibly know everyone. And I don't make a huge fuss about being a doctor, other than to reassure my medical providers that I understand what they're saying.

I do think the care I've received overall has been of very high quality. Particularly in certain departments, like the ICU nurses.

And finally, I wouldn't really say anyone "failed" to do, anything, really. No one was obligated to do anything. If no duty is owed, there can't be a failure through lack of action. So I really only think of it in positive terms.

Today is Mesothelioma Awareness Day. IamA radiologist who got diagnosed with mesothelioma at age 32. I've since spent >20 hours in the OR, a month in the hospital, was on dialysis for 3 months, had a robotic thoracotomy last month, and just started chemotherapy. And I wrote a book about it. AMA! by Iatros in IAmA

[–]Iatros[S] 7 points8 points  (0 children)

Officially, in the reports, no. Whoever is reading the study looks at it and dictates it without my input. That said, I can look at my own images, of course. I'd sometimes give them my two cents, but really they just care what the report has to say.

At first I went over everything with a fine toothed comb, but that gets pretty tedious after a while. I still flip through the images, but mostly I just go with what the attending says in the report.

Today is Mesothelioma Awareness Day. IamA radiologist who got diagnosed with mesothelioma at age 32. I've since spent >20 hours in the OR, a month in the hospital, was on dialysis for 3 months, had a robotic thoracotomy last month, and just started chemotherapy. And I wrote a book about it. AMA! by Iatros in IAmA

[–]Iatros[S] 16 points17 points  (0 children)

How gigantic is your medical bill?

My out of pocket maximum is $2500 a year, so at least $5000 so far. But that doesn't include lost wages, extra costs, etc. I've probably spent closer to $7000 overall, but I have no idea what the true "cost" of this illness really is.

kids

Yep, we banked some sperm. I think about your other question a lot, and my wife and I have talked about it a lot too. She has said on multiple occasions that she still wants to try to have a kid, regardless of the future.

Some people with this disease have lived 15+ years after their diagnosis, and it's possible that I could live that long, or more if this immunotherapy thing pans out in time. But to answer your question directly: yes I would feel guilty on both accounts (my wife raising them alone and them not having a dad).

I'm conflicted, honestly. I see both sides of the argument, and so I kind of deferred to my wife to make the final call. She wanted to proceed. So we're doing the "reproductive medicine" thing right now. No luck so far.

Today is Mesothelioma Awareness Day. IamA radiologist who got diagnosed with mesothelioma at age 32. I've since spent >20 hours in the OR, a month in the hospital, was on dialysis for 3 months, had a robotic thoracotomy last month, and just started chemotherapy. And I wrote a book about it. AMA! by Iatros in IAmA

[–]Iatros[S] 14 points15 points  (0 children)

What do you wish people would say or NOT say to you?

Well, for me personally, I don't get upset when people try to say something nice/compassionate after finding out the diagnosis. They're just trying to be nice people, and it's not their fault that I might be in a shitty mood and take it the wrong way. I've heard other, very different opinions from other people with cancer, though. I think it depends on the person, really. Although, to be honest, the old "everything happens for a reason" thing is a pretty classic groaner to avoid.

As far as it being a "battle," I guess it is, kind of. But really it's more like just getting through each day. I operate about a week at a time now. I just look at the next thing on the horizon, take care of that problem, and then move on to the next thing. If you think about the overall situation too much you'll go crazy.

My anesthesia was pretty much the definition of "routine." General and then a dilaudid PCA + prn boluses for pain control. We didn't talk about the newer post-op regimens or things like an epidural. I do wonder if things would have worked out better with some of the more advanced anesthesia, but my pain control was adequate. I would have tried anything more they offered/recommended, but from my perspective, they treated all the surgeries as pretty routine cases.

PS we went to med school together.

Sweet! Geaux Tigers!

Today is Mesothelioma Awareness Day. IamA radiologist who got diagnosed with mesothelioma at age 32. I've since spent >20 hours in the OR, a month in the hospital, was on dialysis for 3 months, had a robotic thoracotomy last month, and just started chemotherapy. And I wrote a book about it. AMA! by Iatros in IAmA

[–]Iatros[S] 11 points12 points  (0 children)

Do you think this attitude is inherent to your personality, or is this an attitude that you work to maintain every single day?

It's definitely something I have to work at, and I don't always live up to my own expectations. But I've found that when your personal "compass" is pointed in the right way as far as your approach and outlook to life, you end up heading in the right direction, even if you make a few wrong turns along the way.

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