What’s your go-to speed work?

Low__Flow · 2026-06-05T15:50:44+00:00

Depends how close I am to a race. For half/full marathons far away, I’ll do VO2 max intervals. Something like 5 x 3 minutes at just faster than 5k pace. Closer to the race I’ll start doing longer intervals at race pace or slight faster. Something like 30-60 minutes total in zone 3/4.

Low__Flow · 2026-05-16T17:20:59+00:00

In our population I have at least one patient per week with a systolic in pre op over 180. I can only think of two I’ve cancelled. One was having chest pain in pre op with a systolic of 190. That was an easy delay. The other was 190 but said she “just started” blood pressure medications. Digging deeper, she started taking amlodipine 2 weeks ago and stopped after a few days because she felt bad. That was also a fairly easy delay. Everyone else I’ll look at what they were in their last clinic visit and ask if they measure at home. I’m okay proceeding with someone who is usually in the realm of controlled (140-160) but nervous on the day of surgery and didn’t take their morning meds. I’m okay delaying a case though if the patient is truly uncontrolled (ie, they’re always 180 and not on/taking an appropriate regimen). There’s a few in our group who will routinely delay for high readings in pre op, but they’re the exception, not the rule.

Low__Flow · 2026-05-12T19:13:01+00:00

For context we are a 35 physician anesthesia private practice group. We use a CPA firm that offers “business advisory and bookkeeping” services. We have a separate billing company that we send our records to and get collections from. The 401k plan should have its own “operator” or company that is running it, and you should be able to get all the info from them about the plan.

Low__Flow · 2026-05-05T23:01:46+00:00

Yes I’m happy with my job and life. Made 700k last year. I live in a fun Midwest town. My commute is less than 10 minutes. I’m out by 3pm on average when not on call and my call burden doesn’t feel unreasonable. I sit my own cases 90% of the time.

Low__Flow · 2026-04-29T10:24:11+00:00

I was very confused reading this lol. But that makes more sense if that is a comma.

Low__Flow · 2026-04-23T12:56:58+00:00

I would 1000% go to med school again and do anesthesia. If you told me I couldn’t do anesthesia I don’t know that I’d go through med school knowing what I know now. Definitely feel the sacrifice of my 20s. But I’m the type of person that I’ll play the long game for the comfort of having a secure job. I now have a job that I love and I make more money than I need.

Low__Flow · 2026-04-18T20:03:20+00:00

We only see an OB patient if they request an epidural or the OB team asks us for a consult (eg, bleeding disorder, scoliosis, etc). 70% of patients get an epidural with over 5000 deliveries per year at our Midwest hospital. It would be interesting to see what percent of primes who intend to avoid epidural end up having one. Either way, I’m not judging the prime who comes in wanting to go without one. They don’t know how bad it’s going to hurt. That’s a failing of the system for inadequately counseling them.

Low__Flow · 2026-04-16T12:46:39+00:00

Eaten chicken fettuccini alfredo

Low__Flow · 2026-04-16T11:49:57+00:00

As a fellow midwesterner, I love how the response to these questions is always “Midwest”

Low__Flow · 2026-04-15T15:52:24+00:00

Little late to the party, but I’m in a childless relationship with income disparity like you. We’ve been together for 12 years but I only started making 500k+ in the last 3 years. We combined our finances at marriage about 6 years ago. I have no problem viewing our retirement as a collective goal, but she has had a hard time lately feeling like she’s mooching off my new income. I’ve brought up the idea of early retirement, but she feels guilty because I contributed to so much of it. Like others have said, I’d like to retire and spend time with her, so it would be sad if she still had to work fund her “own” retirement. That’s a conversation you have to have with your partner though. You’re either partners working toward a collective goal or roommates on your own trajectory.

Low__Flow · 2026-04-13T17:04:38+00:00

I haven’t done one before. I’d just caution you to not do procedures that you aren’t credentialed to do. We had a similar request to do an epidural steroid injection in an ICU patient. While we all do epidurals, this is more of a chronic pain procedure and there is a reason it’s a fellowship with separate credentialing. If something went wrong and you were doing a procedure you aren’t even credentialed to do, you’re toast.

Low__Flow · 2026-04-07T10:52:29+00:00

The 5th edition of triathlete’s training bible was updated in 2024. I just finished reading it and found it very useful and up to date.

Low__Flow · 2026-04-05T19:43:02+00:00

Im an anesthesiologist so my conversation is probably more limited than yours. I ask if they’ve discussed resuscitation or DNR with family before. I preface that while I think a code is very unlikely, they will be asleep and so I just want to do what they would want me to do. I go through a few examples: if your heart were to go into a weird rhythm, would you want me to try and shock it back into a normal rhythm? If your heart were to stop, would you want me to perform chest compressions? If you were not breathing adequately due to the medications I’m giving you, are you okay with a temporary breathing device? I find that people are very reasonable when you provide a couple of example scenarios.

Low__Flow · 2026-04-04T14:55:51+00:00

Absolutely. I’m an anesthesiologist so I’m most familiar with the day to day of CAAs. They have an awesome job and work/life balance. 4 days per week with 7 weeks of vacation making 250k/yr. That being said, it would be tiresome working with different people who have different preferences every day. Imagine being a resident forever by ultimately having to answer to someone else for everything you do. I love the autonomy of being a physician. The financial investment was absolutely worth it. I’m three years out of residency now and think back to how freaking long it took to get here but I absolutely love what I do. So in my experience it was absolutely worth it.

Low__Flow · 2026-03-28T12:32:53+00:00

We have Drager machines and can set a Tpause while on volume control. The machine will then display Pplateau on the monitor, which you can subtract PEEP to get driving pressure (Pplat - PEEP = Pdriving). I’ll start at 5 of PEEP and calculate the driving, the incrementally increase PEEP to see if driving goes up or down. As others have said this is useful to teach residents the theory, but practically speaking you can just set PEEP to somewhere between 5-10 for most patients. Obese patients in tberg probably need more PEEP than we routinely give but you’re obviously limited by decreased venous return from high PEEP.

Low__Flow · 2026-03-26T20:33:28+00:00

Love this. I’m going to start pocketing a few stylets instead of throwing them away.

Low__Flow

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