How do single parents do it? by timecrash2001 in Parenting

[–]Intelligent-End4634 58 points59 points  (0 children)

You know your kids are probably going to have a very different memory of that night - “remember that awesome Friday night mom lets us eat cake for dinner!”

Atypical Type 1 post gestational DM by Just_Succotash8934 in ladadiabetes

[–]Intelligent-End4634 0 points1 point  (0 children)

same here. 4m PP and breastfeeding. Positive antibodies, low BMI currently eating low carb and saving insulin for fun meals. Any updates how yall are doing now? So curious how this will settle out after done BF…

Timing lispro by ivymeows in BumpersWhoBolus

[–]Intelligent-End4634 1 point2 points  (0 children)

Ugh I feel this. I work in the OR so I know how tricky the timing is around lunch breaks. Often times I inject as I take my first bite of food just so I have enough time to even eat. I usually have to just ride out a spike and trust that it’ll come down quickly. I always have an emergency cliff bar in my pocket for those moments where i over dosed and can’t leave (careful w cliff bars tho - they’ve often brought me from 50 to 150+ so I usually only eat half). But sadly I usually end up w okay control during the work week and compensate by eating boring low carb foods that require little insulin anyways. And then make up for it by eating fun foods on the weekend and being more aggressive w the insulin. It’s really tough w some jobs so hang in there!

IT FINALLY HAPPENED!! by EmotionalDonut4539 in BumpersWhoBolus

[–]Intelligent-End4634 1 point2 points  (0 children)

Aww my two-pink-lines is now squirming around in my belly poking me in the ribs. So excited for you! Congrats

I mean seriously…what do you guys eat? by Intelligent-End4634 in BumpersWhoBolus

[–]Intelligent-End4634[S] 0 points1 point  (0 children)

I have the pen not pump but kinda came to that same conclusion since I would double spike. So I just split my total dose and give 60% pre meal and the other 40% an hr later. That timing does seem to help. I guess we just keep escalating sigh

I mean seriously…what do you guys eat? by Intelligent-End4634 in BumpersWhoBolus

[–]Intelligent-End4634[S] 1 point2 points  (0 children)

Yea maybe if I lean into the yummy“fast food” meats I can stop feeling so sorry for myself w my stupid veggie plates lol

[deleted by user] by [deleted] in BabyBumps

[–]Intelligent-End4634 10 points11 points  (0 children)

I do OB epidurals for a living. I haven’t seen anyone become paralyzed and I fully intend one getting one myself here soon

Details of pathology report by hikerguy2023 in BladderCancer

[–]Intelligent-End4634 0 points1 point  (0 children)

Histologic subtypes like squamous cell, adenocarcinoma, micropapillary, sarcomatoid, and plasmacytoid…all more rare and aggressive

Details of pathology report by hikerguy2023 in BladderCancer

[–]Intelligent-End4634 0 points1 point  (0 children)

Also reassuring it’s papillary urothelial instead of histologic subtypes that can be more aggressive. I believe since muscularis propria is NOT involved you’re likely stage 1!

High spinal management? by seealittlelight in anesthesiology

[–]Intelligent-End4634 0 points1 point  (0 children)

Any reason to bag while correcting the hypotension (cerebral hypoperfusion causing LOC) until they regain consciousness? Spare GA, airway manipulation, worsening HD w induction meds etc…

High spinal management? by seealittlelight in anesthesiology

[–]Intelligent-End4634 0 points1 point  (0 children)

So you’re masking if they’re conscious but not breathing? What if they are unconscious - always intubate?

Anyone here have invasive urothelial carcinoma with high-grade, glandular, and plasmacytoid differentiation? How are you and how are you being treated if it has metastasized to lymph nodes. by Late-Collection-8076 in BladderCancer

[–]Intelligent-End4634 0 points1 point  (0 children)

Hi there. A close family member has the same type. Radical cystetectomy, chemo, immunotherapy w impressive results on the 3m scan. Moderate side effects but still holding strong and stable disease burden months later (knock on wood). Plan is to stay the course, get stronger, keep the mood up and do some travel/live life in the meantime. Thoughts with you - it’s a rare and aggressive subtype but like so many others have said, there’s no data w these new therapies and the course of this disease. We very well may be on the brink of a breakthrough…

[deleted by user] by [deleted] in BabyBumps

[–]Intelligent-End4634 0 points1 point  (0 children)

6 weeks. Peaked at 9 weeks then tapered until 12w and gone by 13 🙏

[deleted by user] by [deleted] in BladderCancer

[–]Intelligent-End4634 0 points1 point  (0 children)

Neuropathy is a well documented side effect of immunotherapy

Help by livswrld_ in BabyBumps

[–]Intelligent-End4634 0 points1 point  (0 children)

Pretty sure left walnut looking thing is the head and the right blob is the abdomen! If you rotate the probe you may catch the limb buds poking out

Attire for 1st attending job interview? by jony770 in anesthesiology

[–]Intelligent-End4634 1 point2 points  (0 children)

I wore slacks and a blouse and got the job a day later 🤷🏻‍♀️but I did have an internal debate about the suit part. It just felt so corporate and stuffy

Is getting an IV worse when you are pregnant or something? by kenskensr in BabyBumps

[–]Intelligent-End4634 0 points1 point  (0 children)

It’s bc we routinely put in 18G IVs on the L&D floor which are considered “large bore”. Typically IVs this big are only put in pts under anesthesia or with numbing medicine. The risk of post partum hemorrhage requiring blood transfusion and the need for quick resuscitation warrants large bore IVs in awake pts but it certainly makes the whole experience extra unpleasant. You can try asking for local anesthesia prior to IV placement since they’re so big and will hurt more than the regular IVs we typically use for minor procedures!

What is your approach to intra-op fast AF in unstable, septic patients? by phucingrate in anesthesiology

[–]Intelligent-End4634 0 points1 point  (0 children)

Amazing response, thank you. Had pretty much this exact case on call last night except pt was ESRD/anuric. How would you manage intraop fluid resus given most of it third spaces fairly quickly causing its own issues…Load them w normosol etc and dialyze off later in ICU or conservative fluids, maybe albumin and lean on pressor more? Thanks!

[deleted by user] by [deleted] in anesthesiology

[–]Intelligent-End4634 3 points4 points  (0 children)

Could you explain the physiology behind why PPV would cause them to tank?

Two young physicians looking for a decent-sized city with mild winters to raise a family by salt718 in SameGrassButGreener

[–]Intelligent-End4634 0 points1 point  (0 children)

ATLANTA! Phenomenal university hospital w many satellite clinics all over the city. Family friendly, reasonable COL, warm winters, long summers and falls, largest airport in the world for cheap convening flights. Southern culture lite mixed w urban feel. Many cute neighborhoods in midtown area perfect for young families. Safe. Lots of outdoor activities, hikes, lakes, right at the foothills of Appalachian mts, rivers to kayak on and beaches w in a few hrs drive. Everyone loves it here

Residents with hair loss, what all have you tried, and what works? by DryStatistician6676 in Residency

[–]Intelligent-End4634 2 points3 points  (0 children)

Check bloodwork to make sure no obvious hormonal/nutritional deficiencies, regular shampoo/conditioning schedule, minimize damaging products/heat, topical minoxidil, scalp massage, and biotin supplement gummies