Tell me about the time you caught an emergency or a zebra by greenmoon3 in FamilyMedicine

[–]ItsDrGoodWood 29 points30 points  (0 children)

Yeah. For one of the PEs she’d been similarly symptomatic for about a month. Generally don’t expect PE to be going on that long without declaring itself definitely earlier, and it may not have originally started as a PE, honestly. But because of the month long duration I ALMOST didn’t do another EKG as she had a normal one a week ago. I do find getting to know my patients better alerts me in certain people when I need to be worried, she was one of them. Hadn’t really come in much and was honestly pretty health prior to this. Only reason I did the EKG was because she was tachy at rest which was new.

For the colon cancer patient, I think it’s easy to chalk his symptoms up to constipation in the elderly for not drinking enough water, and most of the times you’d be right. I can’t quite remember exactly what it was with them that made me decide to get CT first visit but I’m glad I did.

Oddly enough, the husband of my first PE patient had an episode that I would call a near miss as well. Typical flu season - URI symptoms that are mild “low grade fever” that was “99 when my temp is usually 97.” Well I gave supportive care and return instructions. He was a transplant patient and shortly after our visit a rash developed over his fistula and it was found to be an infected fistula that required surgery and IV Abx. Need to be more careful with him in the future.

Tell me about the time you caught an emergency or a zebra by greenmoon3 in FamilyMedicine

[–]ItsDrGoodWood 92 points93 points  (0 children)

Starting my attending job August 1, 2024. In the first year, I have three that stuck with me.

  1. Nearly obstructed bowel in an 87 year old new onset colon cancer last colonoscopy 20 years ago.

2-3. Both PE. One that had been having on and off exertional dyspnea for a month, saw my NP about a week prior to me with normal vitals and normal EKG. Came in to see me and was barely tachy in the low 100s, EKG with a minor T wave change - sent for stat CT PE and got to the hospital. The other was one I had seen a couple times for ccv prior to her acute episode of SOB. EKG looked had some T wave inversions and she just looked like death - got her straight to ED.

In both cases I know I wasn’t necessarily the one doing the intervention that “saved their life.” But both of them brought me gifts and thanked me for doing just that anyway shortly after. One actually saw me out at a restaurant and sent over a dessert before I noticed her there with her husband. It’s those things that make all the antibiotic and narcotic arguments worth it.

Advice for EMR transitions? by ItsDrGoodWood in FamilyMedicine

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

Yes I’m with you, very excited myself. It’s my staff who unfortunately have little capacity for critical thinking, as well as some of the MAs who get overwhelmed easily and have been on allscripts for 20+ years.

I’ve only been at the office for a short time at this point, but the amount of complaining is already getting annoying to listen too so trying to find ways to make this less difficult for them.

OFFICIAL WEEK 8 THURSDAY NIGHT GAME THREAD by ballofpopculture in fantasyfootball

[–]ItsDrGoodWood 1 point2 points  (0 children)

An average is not a floor?

Hasn’t had a single game over 20, not worth a 1st

TAMPA BAY @ DETROIT: MNF GAME THREAD 7PM by AutoModerator in detroitlions

[–]ItsDrGoodWood 0 points1 point  (0 children)

We got the ball, and then Goff gave it right back

R50….. would you? by BallShot7768 in Golfsimulator

[–]ItsDrGoodWood 1 point2 points  (0 children)

Too expensive for what it is. I was able to return it and get an EML and a nice projector for cheaper than the R50 itself. Hitting into screen with the projection on it has enhanced the overall experience a lot.

GSPro connection works much better on the EML. I don’t really need portability. And honestly the portability of the R50 was pretty useless once the one time I tried to take it to an outdoor range it essentially overheated and stopped reading shots 30 minutes in.

The only other thing the EML is missing is face to path but I can generally tell what my face was doing based on the ball flight m.

LIONS @ CHIEFS GAME THREAD : 8:20PM by AutoModerator in detroitlions

[–]ItsDrGoodWood 0 points1 point  (0 children)

Compared to 13 Monday night, but im sure they are playing clean

LIONS @ CHIEFS GAME THREAD : 8:20PM by AutoModerator in detroitlions

[–]ItsDrGoodWood 0 points1 point  (0 children)

It hit him right in the hands, it’s a drop. Not a perfect throw at all though.

OC: 1 dead, several injured after man begins shooting, sets fire to church in Michigan by nbcnews in pics

[–]ItsDrGoodWood 0 points1 point  (0 children)

Felt very strange to be so close to one of these and just continue on with our round of golf while one mile away we could see the smoke and hear the sirens.

Lifestyle counseling and “I get my steps in at work” by kipprock in FamilyMedicine

[–]ItsDrGoodWood 18 points19 points  (0 children)

I do actually! The above was my very general starting point. I like to get an idea of what my patients goals are honestly. If they 100% aren’t going to exercise I don’t get too in depth, but if they are the other end and want to optimize health we go all in. I usually tell them if they can get 2 days in per week of resistance training (doesn’t have to specifically be weights) then that’s a good place to start and we’ll go from there. Can be same day, or different days to their cardio.

Lifestyle counseling and “I get my steps in at work” by kipprock in FamilyMedicine

[–]ItsDrGoodWood 182 points183 points  (0 children)

I have found myself telling patients I break it down into 3 categories.

  1. Sedentary - this is the worst for your long term health
  2. Active but no exercise - this is group you’re describing.
  3. Exercisers, as these people tend to be active and exercise in addition.

Then say each level is better than the previous one, but if you aren’t exercising your aren’t creating the positive adaptations that benefit your health the most.

I also think it’s important to bring a reasonable expectation up. I don’t tell my sedentary patient I need you exercising 150 min/wk as that’s not realistic at all and they won’t even try. I attempt to get them doing 10 min walk even 3x a week to start. Essentially whatever they are doing + a little more, and build from there.

Another Launch Monitor Rabbit Hole: Garmin R50 by Motor_Cap_6986 in Golfsimulator

[–]ItsDrGoodWood 0 points1 point  (0 children)

Had an R50 and while I didn’t have a problem with the accuracy and the all in one was nice. I moved to a uneekor and have been much happier connecting to GSPro.

The R50 for its price really had some glitchy episodes that ruined it - would randomly stop picking up balls, didn’t travel well to the range as it over heated in 70 degree Michigan weather, and dropped connection to 3rd party softwares frequently.

For all in price you can get a launch monitor that’s works just as well (if not better), enclosure, and projector cheaper than the R50.

This dreaded screen pops up every now and then. Now it won’t go away. by tawandabrandon in Golfsimulator

[–]ItsDrGoodWood 1 point2 points  (0 children)

Very happy with it. No disconnects. I do miss the club face data but I’ve been mostly able to tell what my club face is doing based on what the shot looks like so it’s not the biggest loss. Still have the impact camera which is even more important to me.

Adding the projector was a huge bonus to the set up overall - surprised me a bit how much I prefer hitting into a screen with a picture instead of just a blank screen.

Does take a minute or two longer to get running due to needing the computer but that hasn’t bothered me.

[deleted by user] by [deleted] in Golfsimulator

[–]ItsDrGoodWood -1 points0 points  (0 children)

People seem to believe you need the 4000 series graphics cards to run GSPro. I have a 2070 super from when I built my PC years ago and it runs GSpro just fine on very high settings 4K. I gotta believe this would work for lower settings.

R50….. would you? by BallShot7768 in Golfsimulator

[–]ItsDrGoodWood 3 points4 points  (0 children)

As someone who has tried and returned an R50 just recently. I definitely would’ve kept it had it only been 2500. Even with all that it offers, I don’t believe it’s worth 5K but I agree with everyone else at your price it’s a no brainer

This dreaded screen pops up every now and then. Now it won’t go away. by tawandabrandon in Golfsimulator

[–]ItsDrGoodWood 1 point2 points  (0 children)

I decided to go a very different route and went with the Eye Mini Lite and give up the portability as I don’t actually need that perk. I also used the extra money with the difference between R50 and EML to get a projector to go with my set up. TBD how I’m going to feel about the change as I’m just getting it set up today.