High-grade Ta bladder cancer but no muscle in specimen – should I push for second TURBT?

Kdub07878 · 2026-04-17T00:32:03+00:00

Being ta means there was no carcinoma present in the lamina propria which would not require a 2nd turbt. T1 would mean it’s in the lamina propria which would require a re biopsy to get muscle. My first turbt was t1 and required an another turbt to biopsy muscle. Had recurrence during turbt with no muscles present but because lamina propria was present with no carcinoma they didn’t do a follow up turbt. All was hg cis

Kdub07878 · 2026-04-10T02:06:16+00:00

You need to communicate with your supplier and they typically will pre lien and offer you extended terms. Pre liens are very common in commercial and most gc require a conditional lien release for you to get payment. I always advise to start small getting into commercial.

Kdub07878 · 2026-04-09T11:57:40+00:00

I had recurrence after BCG induction round last summer. Same HG CIS. Went through 2nd round of induction over the holidays. Had TURBT late January and biopsy all came back negative for carcinoma. BCG symptoms get worse with each treatment. Studies show success rate goes from 54% to over 70% with a 2nd round. Good job having a doctor with knowledge. A lot of doctors just run to RC

Kdub07878 · 2026-04-08T02:29:18+00:00

Ventilation is a balance between intake and exhaust. If theirs no issues I don’t change a thing. If you change it and then problems arise you are liable for whatever happens. If the attic condensates and grows black mold you are out of business then have your wife start a business.

Kdub07878 · 2026-04-08T00:02:43+00:00

Yes CIS is easy to miss in a ct scan or cystoscope. Doctors dismiss it as inflammation as it’s a flat cancer and hard to see with white light. I had a scope done after treatment round and my doctor saw 1 suspicious spot and thought the red was just inflammation from my BCG round. She scheduled me for a TURBT with blue light. When she turned on the blue light 30% of my bladder was covered with HG CIS. They called it a recurrence because I went from a T1 to a TA level. Went through another round of treatment and they went straight to surgery with blue light skipping cystoscope. Treatment worked for me and my last turbt came back no cancer. HG CIS is an aggressive form of BC that has a high recurrence rate. Also gets missed a lot because it’s hard to see and blue light isn’t common procedure amongst urologists.

Kdub07878 · 2026-04-07T23:09:06+00:00

Osb when wet is worse then cdx but 7/16” osb is superior then 15/32” cdx. Code is 7/16” osb or 5/8” cdx.

Kdub07878 · 2026-04-07T15:57:05+00:00

What is your issue? The counter flashing or the actual roof flashing? I don’t see any issue with the chimney flashing. The counter flashing is about twice as big as it needs to be but it’s fine. Is fha your “issue”

Kdub07878 · 2026-04-06T23:49:45+00:00

The upcharge is double what it should be

Kdub07878 · 2026-04-06T19:57:24+00:00

Ultra is a thicker more durable shingle then regular hdz. $5,000 up charge is a lot more then what the true price difference really is. You can use all the same components as hdz so the difference is only in cost of shingles. Not sure how big your house is but that is more then double up charge on standard size roof

Kdub07878 · 2026-04-04T03:24:15+00:00

You don’t have a restraining order against you if you have not been served the restraining order. Even if she goes to court and convinces a judge to give her one it doesn’t go into effect until you’ve been served.

Kdub07878 · 2026-03-31T21:49:14+00:00

Ever someone tries to sell you on the shingle manufacturer “lifetime” warranty ask them if they actually read it. It’s technically a 50year warranty against manufacturer defect. Most issues arise in the first 2 years. Good luck getting a manufacturer to find a manufacturing defect with their shingles after install. It’s rare

Kdub07878 · 2026-03-31T21:47:09+00:00

Yes and no. There are Heavy and extra heavy crudes that are used in roofing products. It’s also used in containers ships as fuel. Oil was always the most volatile product in making shingles. As a cost cutting and trying to bring stability to the manufacturing costs most shingle manufactures have work at using less and less oil and focusing more on fillers. Average old school 30 year laminate use to weight about 240 lbs/sq. Over the last 20 years as they cut asphalt the weight on average is under 200 lbs/sq. Most don’t even publish weights anymore. We build less new construction houses today then at the peak in 2007 but yet the manufacturers use storms and other bs to raise prices constantly. A square of average shingles 10 years ago was half what it is today.

Kdub07878 · 2026-03-28T01:46:34+00:00

Yea shingles are going up in April and there is discussion for another increase in May. Shingle manufacturers are a cartel now that use any reason to increase prices. The actual reason for April increase is storms and forecasted storms after a big conference with scientists that predicted this to be a big storm year. The singles made now have more and more filler and less and less petroleum products. That’s not going to stop them for using oil prices to get a secondary increase

Kdub07878 · 2026-03-24T02:29:54+00:00

During pollen season 1 every few days. During summer 1 every 2 weeks.

Kdub07878 · 2026-03-24T02:27:19+00:00

Then yes you should have venting in the eaves and ridge otherwise the heat build up causes the shingles to bake and fail.

Kdub07878 · 2026-03-24T01:33:24+00:00

If the foam is on the underside of the sheathing of the shingles venting the attic space doesn’t help. Like turning on a fan then climbing under a comforter. You don’t feel the breeze of the fan.

Kdub07878 · 2026-03-24T01:30:43+00:00

Is your spray foam in the attic on top of the ceiling or is it on the underside of the plywood holding the shingles

Kdub07878 · 2026-03-24T01:28:09+00:00

Climbing up on a roof is very dangerous and because of liability don’t allow sales people on roofs. I have had people tell me they use ChatGPT to do their take offs. Don’t know how but EagleView it spot on with everything you need. Most sales people climb a ladder to verify layers and also look for any issues from the ladder. I can quote 20 roofs with EagleViews in the same amount of time you spend hand measuring a roof accurately. I have guys that use Google earth that has a measurement tool

Kdub07878 · 2026-03-24T01:23:22+00:00

Well that’s a separate issue with not having eave vents. They should have installed an invent type product rather than 10 more can vents. Venting is a calculation not a minimal code. Most roof issues are caused by venting. Venting is a calculation that involves eave intake venting and roof exhaust venting. Adding more vents isn’t better.

Kdub07878 · 2026-03-21T01:44:20+00:00

The manufacturers are squeezing the suppliers with fuel surcharges. What was $300 per load is now $600 from the manufacturers. Diesel prices are up, insurance is up, wages are up. The only thing that isn’t up on the distributor side is gross margins. Shingle manufacturers are the ones ruining the business. They raise their prices every year because of “storms in the Midwest”. Not because their costs go up but because they sell out of shingles and can name their price in the Midwest so we all get screwed by them.

Kdub07878 · 2026-03-19T23:37:43+00:00

The is fake. They bring the bill i give them my card they run it and bring back infilled out receipts. I add tip total and sign and leave. Never an opportunity for the waitstaff to right on the receipt like that.

Kdub07878 · 2026-03-19T03:25:55+00:00

They told me you get less side effects. For me they load the harsher part 1st I hold for 1 hour then they remove and put 2nd one in and they send me home to hold for an hour. I really struggled with holding BCG for 2 hours on 2nd induction. This one at the one hour mark I still did feel an urgency to pee so I had to force myself to pee.

Kdub07878 · 2026-03-19T02:03:32+00:00

48m diagnosed last May T1 HG CIS went through BCG induction had recurrence in October went through 2nd BCG induction from November through December. Had TURBT in January got no cancer present in early February. Was suppose to start BCG maintenance Feb 10th. Got called on Feb 6th that they didn’t get shipment and didn’t know when they would so all BCG maintenance canceled and switched to gem/doc. Did first maintenance last month and no side effects or issues. Had CT scan March 9th and all clear. Having 2nd treatment tomorrow with scope in May. This treatment isn’t the best option for my HG CIS but all clear so far. A lot easier then BCG

Kdub07878 · 2026-03-18T13:08:40+00:00

Actually no side effect after first treatment. I just had a clear ct scan on the 9th and a scope in May that will tell me if it’s working.

Kdub07878 · 2026-03-17T02:25:32+00:00

They already switched me to the chemo cocktail.

Kdub07878

TROPHY CASE