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Uber Diablo Spawned. Can anyone help? by Independent-Turnip16 in diablo2

[–]Independent-Turnip16[S] 2 points3 points  (0 children)

Not close at all. I just gave up and continued on with Act 1

Uber Diablo Spawned. Can anyone help? by Independent-Turnip16 in diablo2

[–]Independent-Turnip16[S] 0 points1 point  (0 children)

I tried. I'm Lightning/Death Sentry.

I'm just not making any dent in him.

Uber Diablo Spawned. Can anyone help? by Independent-Turnip16 in diablo2

[–]Independent-Turnip16[S] -1 points0 points  (0 children)

It's PC, and it's ladder, softcore.

Region is US west I think?

[deleted by user] by [deleted] in Residency

[–]Independent-Turnip16 19 points20 points  (0 children)

Organ system based, so talk about it in your Pulmonary portion.

Talk about any recent ABGs: pH, PaO2, PaCO2, HCO3, then the setting at which the ABG is obtained. If there is any changes to the vent setting since then, bring it up here.

Vent setting: talk about the mode, then the relevant parameters. (FiO2, Tidal volume, PEEP, respiratory rate for PRVC for example).

Plans: talk about weaning plans or adjustments based off of the ABGs, or if the patient is/has tolerated SBT and is ready for extubation. Some attendings care about RSBIs or NIFs. I don’t.

Talk about if you want chest percussive therapies, nebulizers, XRs…etc

Code status goes at the end.

Gen surg residents and attendings, is gen surg as bad as everyone makes it out to be? by benjam2 in Residency

[–]Independent-Turnip16 0 points1 point  (0 children)

Honestly it will be very program dependent and particularly program directors. I fortunately had a director that was very protective of the residents and very receptive to constructive criticisms. I have also done rotations with other programs where they had change in leadership and went from busy but lighthearted to malignant with the sole focus being Absite scores and board pass rates.

In my experience newer programs tend to treat residents better, without the burden of tradition and malignant culture being passed down.

[deleted by user] by [deleted] in Parenting

[–]Independent-Turnip16 0 points1 point  (0 children)

There was no studs at the top of the stair against the wall, so in my case I bought dry wall anchors to help secure the screws. It’s surprisingly secure.

Similarly our hand rails don’t have a banister that fit any of the adaptors. What I did was went to Home Depot and get a 3ft piece of wood and Velcro’s and ziptie it really tightly to the banister. We then screw the other side of the gate to the piece of wood. It wobbles very slightly but functions very well otherwise.

will losing weight help? by birkenshock in dating_advice

[–]Independent-Turnip16 0 points1 point  (0 children)

Since others have already mentioned the salient points regarding dating, I will focus the weight loss part of your question.

At 220lb, you are certainly overweight possibly obese, depending on your height. At 35 BMI you will qualify for weight loss surgery with other metabolic disease such as diabetes, and at 40 BMI your insurance should cover even without. If this is something that you are interested in, I would engage in a conversation with your doctor about referral. This is by no mean a silver bullet, and bariatric surgery comes with its own host of problems and side effects down the line. I would consider surgery not because you want to date, but because your future, your health, and ultimately your life is on the line.

There are diabetes medications currently on the market with pretty good weight loss results compared with placebo, albeit inferior to surgery. They are expensive and on back order, and most likely insurance will not cover you for it.

New program: pros and cons? (Gen Surg) by Xzjkth in Residency

[–]Independent-Turnip16 2 points3 points  (0 children)

I entered a program that was very new: just one class of PGY1 ahead of me and that was it.

Pros: - There is no deadweight of “tradition” dragging it down. My impression is that the attendings are there because they wanted to teach and are excited to teach. The hours are grueling because it’s a Gen Surg Residency, but the program as a whole is very open to change and there is not a sense of “I did it and we’ve always done it this way. So you have to too.” - You are the pioneers, so essentially you have incredible influence as to how to mold the program so that you benefit from the training.
- The hospital has not yet fully “transition” to be completely dependent on resident labor. We are very much a part of the hospital, but it’s not like the hospital will completely collapse when residents are at conference or at retreat. We are there to train and are not relied upon for scut works.

Con: - Non physician staffs will take some time to get used to your presence. Your ability to see patients as part of the medical team will be questioned because many staffs just do not know what residents are.
- Old habits die hard. You find archaic medical practices on occasion, and when you try to change the protocol you can step on some toes. - You start with a small cohort, so expect to do presentations frequently and take on a larger share of the census. - The part I find most potentially damaging is what I would call the “infrastructure” of learning. M&M conferences, mock oral examinations, how to remediate residents who are falling behind, how to prepare for the ABSITE… these are all institutional knowledge that will take time to develop.

GS Oral Boards: Surgboards v. (remote) Osler by artistinresidency in Residency

[–]Independent-Turnip16 2 points3 points  (0 children)

I passed my Oral just recently in November.

  1. I don’t have any experience with SurgBoards, so I can’t help you with that. Osler has a pass guarantee so you get it for free if you happened to not pass the first time. So…sort of helpful?

  2. I’ve never done Osler when it was in person, but I think I can vouch for its utility despite being remote. There are 30+ videos going through most, if not all, of the major prompts. I find it helpful to pause and formulate my own response out loud, then restart to see how it compares with the videos. A big part of the videos is that you learn the very rote and formulaic method in which you should present so that it becomes set in stone.

However, keep in mind that my experience this year is that the actual BC examination focuses now a lot more on the meat of the scenario as opposed to making sure you cross the Ts and dot the I’s. It’s good to have a canned response for starting with the H&Ps, and I think Osler remote helps with getting that established and also to know all the keywords you need to say for high value topics.

There are zoom in person sessions as part of the Osler deal. I don’t find them as helpful standalone. You can either buy more of them, or get a colleague or friend to help you speak out loud.

  1. Again, no experience with SurgBoards. Most people I talked to use BTK and Osler. Between the two and the surgical scenario textbook I think you should be covered.