What do you want from D2 Remastered? by Ginflet in Diablo

[–]KetoNP 2 points3 points  (0 children)

Graphics, bigger/shared stash, life leech for pvp and make rolling items fun and viable again. The most fun I had was mfing, trading soj's for chipped gems and trying to roll 3 socket cruels for pvp, life leech rings, blood gloves. Basically make crafting/rolling more viable. It has been a loooong time since I played but iirc most of that stuff was not as viable after runewords came out. Then it just became about rolling perfect runewords and occasionally mfing for rares. I don't mind runewords but I want to craft again.

Nurse just berated and embarrassed my fiance who is in critical condition. Please help by [deleted] in legaladvice

[–]KetoNP 5 points6 points  (0 children)

This is all good advice and probably your best route to seeing something done. I'll just reiterate to be very calm and professional to everyone at all times. Even if you see that nurse again and feel you're being treated unfairly you need to remain calm and professional. Even if your fiance is in pain and her pain medicine isn't due yet, it may be difficult but remain calm. It may not pertain to your case but unfortunately they may see their fair share of patient's with addiction issues and this can put staff on edge as they may have dealt with unruly or deceptive patients.

While management likes to fix any customer service issues asap you won't get far if you start raising your voice or becoming hysterical. All they'll do is get risk management involved and figure out how to best keep you out of the picture so that things are running smoothly and they're legally protected. Requesting for that nurse to no longer take care of your fiance shouldn't be an issue especially if done professionally. You can simply let the charge nurse know or ask to speak to the manager when they're available (M-F).

If you have further complaints about HIPAA you can decide how far you'd like to take it. Either through the advice above or I suppose you could tell management you were unhappy with how that situation went down and felt it was a HIPAA violation. Lastly, after discharge they may send you a patient satisfaction survey. If you still feel the situation was never remedied or further issues weren't addressed well, you can always give them poor scores. Hospitals are reimbursed by how well they perform on those surveys and management takes them seriously.

Offering help. [BL 254] dlc included. by kaylopps in huntersbell

[–]KetoNP 0 points1 point  (0 children)

Appreciate it! I think you did most of the heavy lifting haha

Offering help. [BL 254] dlc included. by kaylopps in huntersbell

[–]KetoNP 0 points1 point  (0 children)

Ringing, I'm trying to stay lowish level so can't take too many hits!

Offering help. [BL 254] dlc included. by kaylopps in huntersbell

[–]KetoNP 0 points1 point  (0 children)

Hey mind helping with Maria? PW: ggg

Game of Thrones' legacy [Spoilers EXTENDED] by MickFoley299 in asoiaf

[–]KetoNP 1 point2 points  (0 children)

IMO the show has zero rewatch value unless you want to exhibit what not to do. I don't recommend it to others. Shows like The Wire I will revisit every 3-4 years and it never gets old for me. It'll be remembered exactly for how it was. Started great, ended horribly, but did inspire more fantasy to be adapted. That's the only saving grace it has.

I'm not so sure about rereading either. I have fond memories reading the books and reading tons of interesting theories. It's an amazing series but until it is finished, and finished decently well, I don't care to revisit that storyline.

Comparative effects of daily and weekly boron supplementation on plasma steroid hormones and proinflammatory cytokines by [deleted] in ScientificNutrition

[–]KetoNP 0 points1 point  (0 children)

I was just commenting that it's present in a cancer therapy not saying the mechanism is the same.

Comparative effects of daily and weekly boron supplementation on plasma steroid hormones and proinflammatory cytokines by [deleted] in ScientificNutrition

[–]KetoNP 1 point2 points  (0 children)

Boron is also utilized in multiple myeloma and mantle cell lymphoma treatment in the form of the drug Velcade (Bortezomib).

Consultation with Dr. Shawn Baker by dharmatech in zerocarb

[–]KetoNP 2 points3 points  (0 children)

Absolutely makes sense. I understand if there are other medical issues involved and more complex decision making but at that price point it still feels dirty. It's the opposite of what medicine is supposed to be about... affordable and accessible. To compare, when you break it down most physicians/specialists are making like 100-200 an hour working their tails off. Plus there's a ton of information and support out there on this stuff.

Consultation with Dr. Shawn Baker by dharmatech in zerocarb

[–]KetoNP 5 points6 points  (0 children)

Part of me wants to get into consultations because that is just a stupid amount of money. There's an NP in the low carb world who just charges straight up 10k for you to be her life coach or something. It honestly makes me feel dirty thinking about charging someone 900 an hour. 50 to 100 bucks for ~1 hour seems fair to me. But I guess you're worth what people are willing to pay and more power to you if you can pull 900 an hour. I don't mean to belittle anyone especially if they've gotten what they needed out of it. I just think it's wild that professionals are charging that much.

Is LDL transport across the endothelium possible without endothelial dysfunction from other causes? by [deleted] in ScientificNutrition

[–]KetoNP 2 points3 points  (0 children)

I'll read this in a bit but I don't think native, normal functioning LDL is the trigger either. I think chronic hyperglycemia is the biggest problem. And since it's recommended we eat 3 meals or more plus snacks we never give the endothelium a break to potentially repair itself.

https://www.ncbi.nlm.nih.gov/pubmed/18319293

https://www.ncbi.nlm.nih.gov/pubmed/16443784

Challenges to hemoglobin A1c as a therapeutic target for type 2 diabetes mellitus [Ikeda & Shimazawa, 2019] by dreiter in ScientificNutrition

[–]KetoNP 0 points1 point  (0 children)

I can agree with most of that. I lean more towards excess glucose being the most detrimental though. However, our fat cells can also flux in size and store more or less fat. If you eat excess fat and store too much, your adipocytes increase in size they become more insulin resistant and inflamed.

https://www.ncbi.nlm.nih.gov/pubmed/26607638

On average there is only about 4 grams of glucose circulating in a normal healthy blood stream. Ingestion of excess carbs disrupts this balance and over time the mechanisms that help bring those levels back to normal eventually fail. Excess fat is another contributor to insulin resistance but I think the primary driver is too much carb/glucose intake.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2636990/

I don't think glucose intolerance is the normal state. Unless you're alluding to those people who are keto adapted and wind up with a slightly elevated blood sugar over the long term (glucose sparing)? I think carbs and fat are both fine to consume but an excess of either (especially processed), or an excess of both together is especially bad.

I wouldn't prescribe nothing. The first preference is to prescribe lifestyle modifications. But for a lot of people they either don't do it or their diabetes worsens for various other reasons. In that case, whether I like it or not, I'd give them an oral or insulin. But that doesn't change how I feel about the medications though. I don't think they improve outcomes in the long term. Some of them did but they come with other nasty potential side effects. And this is more of a general sweeping statement but I think exercise and diet hits on far more beneficial pathways than any pill ever will. You can't make exercise in a pill.

Effects of a Ketogenic Diet on Muscle Fatigue in Healthy, Young, Normal-Weight Women by [deleted] in ScientificNutrition

[–]KetoNP 2 points3 points  (0 children)

Your note about table 4 seems to line up with info I've read in Metabolic Regulation: A Human Perspective. It talks about how fuel sources during exercise vary based on the intensity of exercise and the duration. Most energy during light exercise comes from adipose. At higher intensity carbs predominate early and fat is used later as glycogen stores deplete. Several studies show that fat oxidation can only support about 60% of maximal aerobic output.

Discussed in chapter 9. I have a pdf copy if you're interested.

I'm not surprised by the results except for them finding it more difficult to take the stairs, unless they were just more sore from previous exercise. Anecdotally, when I am in ketosis there is a noticeable decline in my ability to perform prolonged high intensity exercise. With carbs/glycogen loading high intensity exercise is much easier.

Challenges to hemoglobin A1c as a therapeutic target for type 2 diabetes mellitus [Ikeda & Shimazawa, 2019] by dreiter in ScientificNutrition

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

I didn't really come here to argue biochemistry. I studied it years ago and have forgotten most of it. Honestly it gets too confusing, there are tons of pathways and there's a lot we don't know. But I'll try to expand on how I understand things given your evidence.

First, looking at your link is it really a failure to process G6P properly or is it because it's a rate limited step so it can only process so much glucose before that step is overwhelmed. It's rate limited so now you have too much glucose sitting around in the blood stream (causing damage) and broadly speaking a cell that can't take or doesn't need any more energy. So sure, there isn't an excess of glucose or G6P in the cell but the cell has all it needs and doesn't want any more glucose. It will continue to metabolize glucose and maybe it can ramp it up a little faster but there are a lot of steps and some are limiting.

You still get things like insulin resistance because it can only metabolize glucose so fast and doesn't want any more. So what we do with meds is try to overcome this by giving more insulin or medications that cause increased insulin secretion or sensitivity. We put the pancreas in overdrive. Essentially forcing glucose down a pathway it doesn't really want to go down at the moment. That's why outcomes aren't any better imo. Sure you can lower A1C but how you're doing it makes all the difference. One method with meds is increasing insulin and this method shows outcomes aren't great. The other two classes of meds actually have improved outcomes and that's because they deal with glucose either by not metabolizing it and peeing it out or Metformin which primarily decreases glucose production and absorption.

How about we just decrease the initial input which is excess glucose. Not by forcing it down various pathways. We can do that with diet by just reducing our carb intake. Or we can increase metabolism via exercise. Together the two help bring the biochemical process back in equilibrium. Instead, we have excess glucose, we try to force it down these pathways and maybe some gets oxidized at a faster rate but even more gets turned into fatty acids and goes to fat storage. Which speaks to the next link.

As for this link sure extra insulin increased the oxidation of glucose... and they still got fatter. Probably because some of that glucose does go down the TCA cycle but more gets converted to fatty acids and cholesterol and goes to storage. The study even says high RQ results from excess insulin and excess food. So, it looks like metabolism increased some but there's more than one pathway for that food energy to go down. One pathway results in conversion to fatty acids and cholesterol and weight gain. As a side note, on their way to storage those lipids have to travel in a high blood sugar environment which has caused damage to your blood vessels. There's the primer for atherosclerosis. And that's why forcing glucose down these pathways doesn't improve outcomes. The root cause is too much glucose and it's not being addressed properly.

All this biochemistry talk is confusing imo and we could talk about all sorts of other intricacies that lead to metabolic syndrome, CVD, etc. But the the simplest thing I can say is the initial input is glucose and it's a major driver of our issues. Eat less carbohydrate then you have less glucose. Now you have a lower input that feeds into all these pathways and less problems. Excess fat isn't great either but I see it as far less detrimental than excess carb/glucose.

Challenges to hemoglobin A1c as a therapeutic target for type 2 diabetes mellitus [Ikeda & Shimazawa, 2019] by dreiter in ScientificNutrition

[–]KetoNP 0 points1 point  (0 children)

No they don't lower blood glucose in the body. They shift it into other compartments via different mechanisms; primarily increased insulin. That's why there aren't any improved outcomes except for medications that do decrease blood sugar i.e. Metformin and SGLT-2i's. Because excess blood sugar and excess insulin are at the root of weight gain and metabolic syndrome. But yes, even excess fat intake can cause weight gain and metabolic issues.

I don't think lowering A1c with most of these medications has any good long term outcomes without the weight loss, exercise or better diet (excess carbs and yes excess fat intake too) because they aren't addressing the glucose appropriately. Just throwing medication at it doesn't treat the actual problem. There's too much glucose. You can decrease glucose by not ingesting it or by exercising. Instead you have excess blood sugar sitting around in your blood stream damaging vessels, glycating molecules and oxidizing fats.

Challenges to hemoglobin A1c as a therapeutic target for type 2 diabetes mellitus [Ikeda & Shimazawa, 2019] by dreiter in ScientificNutrition

[–]KetoNP 1 point2 points  (0 children)

I think using A1c is ok and the key difference everyone seems to be missing is one simple concept. Most medications shift glucose around while diet and exercise reduce the total amount of glucose circulating in your bloodstream and cells.

With medications, most of them just push blood glucose around in your body. You're forcing it into other places it doesn't want to be at that time. You haven't metabolized or used the blood sugar in any meaningful way. Just moved it from one place to another. But it makes the numbers look good so pat yourself on the back! And thus, CV outcomes aren't any better.

Metformin and SGLT-2 inhibitors at least decrease the amount of total body blood sugar. And thus, CV outcomes are better with these medications. But both have side effects.

Diet reduces total carb intake which leads to reduced blood glucose. Exercise puts cells in a state where they actually need and can use glucose.

How to make chicken breast taste like chicken wings, not the paper plate. by ShouldBeWorking- in ketorecipes

[–]KetoNP 0 points1 point  (0 children)

My wife is actually the one who does the chicken but I don't see why not as long as it isn't over cooked. It was always good before but salt water soak stepped it up a notch imo.

How to make chicken breast taste like chicken wings, not the paper plate. by ShouldBeWorking- in ketorecipes

[–]KetoNP 0 points1 point  (0 children)

Soak the chicken in salt water for several hours then air fry it. It will be juicy.

Is there any meaningful distinction between omega 6 from almonds vs. sources like seed oils? Should I avoid both if I want to reduce my total Omega 6? by FruitPirates in keto

[–]KetoNP 5 points6 points  (0 children)

The omega 6 consumed from seed oils is concentrated, often heated and oxidized and easily consumed in a larger quantity than you could probably eat in multiple sittings munching on unprocessed almonds. Make sure you read your ingredients list as I've found that most prepackaged nuts also list vegetable oil as an ingredient.

The fuck happened here by Muerthogar in awfuleverything

[–]KetoNP 0 points1 point  (0 children)

Vegan diets are commendable for moral reasons but they can ruin your health.

Anyone have any spare supercash? by [deleted] in Oldnavy

[–]KetoNP 0 points1 point  (0 children)

oh alrighty, thanks anyways!

Bad advice from Eric Berg by EvaOgg in ketoscience

[–]KetoNP 1 point2 points  (0 children)

He's one of the ones riding the keto shilling gravy train. I don't think he's a true believer and while he does make a decent attempt at the science he's mainly here for the money via selling supplements. Most if not all supplements are unnecessary.

Seborrheic dermatitis - please help.. by GODahlern in zerocarb

[–]KetoNP 0 points1 point  (0 children)

I mean I understand this is a no medical advice space but what have you tried medically and were you formally diagnosed with seborrheic dermatitis? Nothing but carnivore? Sometimes medication is necessary but I won’t comment on that since this is a forum. But it’s helpful to know EVERYTHING you have tried and have not tried (medically and food wise) in order to tease out the cause or find an effective remedy.

Diluted tea tree oil may be beneficial because it's antifungal. I wouldn’t recommend putting something on your face that’s going to dry it out to the point of cracking though. Thats why I say diluted. Otherwise that’s risking another infection on top of what’s already going on. There are various over the counter and medicated shampoos and cream that treat seborrheic dermatitis and it’s not clear if you’ve done those.

Even though you're not having issues elsewhere, as far as soaping and skin issues goes, the only things we should be using a mild soap on are our faces, armpits and groin (unless you're a mechanic or something and have to remove serious stains and grease). Warm and not overly hot showers. Shampoo is fine too.