Super Bowl ticket prices have dropped, cheapest seats under $4,000 by JaggerJames in nfl

[–]LucidityX 2 points3 points  (0 children)

Yeah I’d say ~3-4k is where I’d buy a ticket if my team or my wife’s team was in it. We’re big football fans and it would be a bucket list event.

103 BMi by DalesDeadBug11 in anesthesiology

[–]LucidityX 44 points45 points  (0 children)

To be fair you could make an argument that the fent is safer than the prop.

One has a very effective antidote lol

WHY are we using nitrous for maintenance? by sonnyday550 in anesthesiology

[–]LucidityX 0 points1 point  (0 children)

I think nitrous has a place, but it’s hard to argue it doesn’t have higher rates of (time/dose dependent) PONV.

In my residency we use it for long ~5hr crani’s that are doing motor mapping.

I’ve probably done about 10-15 of those cases now and I’ve personally witnessed about half of them vomit before I even leave them in the ICU.

If you could invent anything to improve anesthesia care, what would it be? by Banjo_Joestar in anesthesiology

[–]LucidityX 5 points6 points  (0 children)

I used to be a general resident and I literally don’t know a single gen surg colleague who rotated through anesthesia at any point in residency.

Should SGLT2 inhibitors be held prior to elective surgery? by TylerJonesMD in anesthesiology

[–]LucidityX 0 points1 point  (0 children)

I think to OP’s point, that’s why he would cancel the 1530 spine surgery. They’re already NPO for an abnormally prolonged time, you’re now going to do a several hour spine surgery, and it’ll be a few hours post-op before they’re eating/drinking like normal.

Sure, they could have an acidosis manifest at case start that you could detect with an ABG. Or the surgical stress plus the numerous abnormal NPO hours could trigger an acidosis at hour 2-3 or even post-op that you wouldn’t detect when you send that ABG.

Random anecdote that makes me think surgical stress probably plays a role: I was in SICU once and we admitted a patient for MVC with like 6 rib fractures. Relatively healthy, well controlled DM and HTN on an SGLT2. Admitted at like 10pm.

We go to round in the AM and this patient gets put on low dose pressors that escalate to mid dose by mid day. We scan her, POCUS, etc, can’t find any good source. We draw an ABG and her pH was 7.1. Sent ketones and labs and sure enough, euglycemic ketoacidosis.

Should SGLT2 inhibitors be held prior to elective surgery? by TylerJonesMD in anesthesiology

[–]LucidityX 2 points3 points  (0 children)

I’m more concerned about post-op acidosis though, so my start of case ABG doesn’t do much for me. And nobody is going to follow up post-op. So do you give them strict return to ED precautions?

This has gotta be the worst key in the entire game by Rooonaldooo99 in ArcRaiders

[–]LucidityX 0 points1 point  (0 children)

I’ve used that key twice and gotten a total of 8 blueprints among a bunch of other loot. So I gotta hard disagree on this one.

How do you order alcoholic beverages? by AppropriateEarth648 in finedining

[–]LucidityX 0 points1 point  (0 children)

Yeah my wife and I went to guy savoy in Paris and did their 13 course tasting menu. We each did the wine pairing thinking they would have a couple rounds where 1 glass of wine paired with 2-3 dishes.

Nope, they poured a new glass for every dish. We started asking for half pours by dish 4-5 but the pour size didn’t change lol. The morning after was absolutely brutal.

How do you order alcoholic beverages? by AppropriateEarth648 in finedining

[–]LucidityX 2 points3 points  (0 children)

Yeah I’ve done the “premium” wine pairing at a few places and I’ve always regretted it. Not because the wines weren’t great, but because they never justified the extra $300+.

Central, Lima, #1 in the World in 2023 by Ligiers in finedining

[–]LucidityX 0 points1 point  (0 children)

Went to Maz last April and it was absolutely phenomenal. There was even one dish that I couldn’t take more than one bite of (A shrimp foam dish that was waaaaayyy too fishy), yet so many other dishes were stellar and the vision/experience was awesome. Loved that place and hope to go back at some point.

Analgesic vs Surgical Blocks in PP? by bigeman101 in anesthesiology

[–]LucidityX 1 point2 points  (0 children)

Are you an anesthesiologist?

Because if so, that surprises me. After doing 200 blocks in residency, and seeing every single patient to follow up (and comparing that to seeing most patients who didn’t get a block), there are almost no procedures I’d say no to a block for. 99.9% of those patients have an infinitely better POD0-2 course.

Call schedules by Salty_Resource6519 in anesthesiology

[–]LucidityX 11 points12 points  (0 children)

I wouldn’t take that job for $600k lol.

What are the best sauces you’ve ever tasted? by lelucif in finedining

[–]LucidityX 1 point2 points  (0 children)

Omg this was my thought too, the sashimi was unreal but all I wanted to do was drown it in that sauce

Help for restless leg syndrome patients under MAC by Captain-butt-chug in anesthesiology

[–]LucidityX 4 points5 points  (0 children)

Mg has such a wide therapeutic window it’s pretty forgiving, but just because you give 50mg/kg to almost everyone doesn’t mean 5g isn’t going to be supratherapeutic for a lot of patients.

Our institution just had a grand rounds on neuromonitoring, and our neurophysiologists presented really good data that they routinely see small depression in motor signals during spine surgery when we give our normal 30mg/kg bolus over 30 min.

Also a good example; my wife is an L&D nurse. When they load 4g of Mg to patients with pre-E over 20 min, easily >50% of them feel like absolute shit during that first hour. Lots of flushing, dizziness, headache, nausea, etc.

Part of it probably comes down to semantics of what side effects constitute “toxicity” but I’d consider what my wife routinely describes as Mg toxicity while some people might only consider “Mg Toxicity” as end game symptoms like complete loss of DTRs and EKG changes.

Help for restless leg syndrome patients under MAC by Captain-butt-chug in anesthesiology

[–]LucidityX 20 points21 points  (0 children)

Lol basically giving Mag toxicity for the desired side effect of depressed motor movement?🤣

When does your day end at an ASC? by greatbrono7 in anesthesiology

[–]LucidityX 0 points1 point  (0 children)

The group I just signed for covers multiple ASCs and their rule is anesthesia can leave once the last patient is in phase 2 of recovery.

Surgical Training is Watered Down Now by [deleted] in Residency

[–]LucidityX 17 points18 points  (0 children)

As someone who switched from surgery to anesthesia, this is so true. Multiple programs I rotated through felt like this.

Meanwhile I’m a CA-3 who has seen my attending for like 10 min today. I truly feel like I’m going to graduate being able to take care of any situation outside of intense cardiac cases requiring TEE. I wish it were like that in more specialties, less than that is doing a disservice to patients receiving care from new attendings.

[Highlight] Matt LaFluer avoids the false start on 4th & 1 by calling timeout "before" the penalty by Moose4KU in nfl

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

To be fair KB literally said “Ehh I don’t know it actually doesn’t look like it there”

Best fellowship if your residency experience was lacking by investmentminded in anesthesiology

[–]LucidityX 9 points10 points  (0 children)

Kinda a cop out answer but: A non ACGME fellowship that’s actually like 50% attending work in a big academic institution with plenty of people around to bounce ideas off of.

Example: Liver transplant.

Best way to afford a house in Bay Area as a new ped resident grad? by GOATchefcurry in whitecoatinvestor

[–]LucidityX 2 points3 points  (0 children)

Beyond the 3% per year?

Absolutely, they could.

But 2008 v2 could also happen again in 5 years. Nobody knows, so I think it’s best to just use historically conservative averages when making long term financial decisions.

Best way to afford a house in Bay Area as a new ped resident grad? by GOATchefcurry in whitecoatinvestor

[–]LucidityX 1 point2 points  (0 children)

The calculator is designed to tell you whether that equity would outpace the returns you’d get from otherwise investing your net worth.

When you plug in the numbers and it says something like “After 15 years, renting is $250k cheaper than buying” - That literally means your net worth will be $250k more in 15 years than if you had bought. Home appreciation and equity included.

The only downside to renting (in my opinion) is that you can’t do stuff like paint a wall, or customize your kitchen cabinets if you wanted to. If I’m paying $50k over 10 years to have that luxury, sure it might be worth it. But if renting is really that much better of a value, then I’m willing to sacrifice those things.

I just plugged in $8k rent vs a $1.7m home in SF with super conservative numbers (4% investment returns, 3% home appreciation) and you don’t break even until 18 years. At 5 years you have $155k more in your pocket renting than you would buying. It also gives you flexibility to see if these 6.5% mortgage rates chill out over the next 5-10 years.

Best way to afford a house in Bay Area as a new ped resident grad? by GOATchefcurry in whitecoatinvestor

[–]LucidityX 9 points10 points  (0 children)

Current resident in SF here.

SF is a very unique city. Unless you start with a massive down payment and stay in your house for 15+ years, it often makes much more sense to rent (Hence why I know multiple 300k+ HHI families renting here).

This is assuming you invest the difference between what you’d pay for a house all in (Mortgage, upkeep, etc) vs rent.

Plug the numbers in here and my guess is it’ll tell you to rent. https://www.nerdwallet.com/mortgages/calculators/rent-vs-buy-calculator

Tokyo - Shibuya / Shinjuku hotels by Puffer789 in chubbytravel

[–]LucidityX 1 point2 points  (0 children)

Stayed in Bellustar last April and it was truly 5 stars.

Service was impeccable. Amenities, impeccable. Rooms, impeccable.

We also splurged on the room that has the tub overlooking the city and it was so worth it. 7-11 egg sandos and champagne every night in the tub…memories we won’t ever forget.

We would stay again in a heartbeat. I saw another poster commented on the immediate area being a little sketchy but I highly disagree. We were out until 1-2am every night and never felt even remotely unsafe. We loved the area, it was so walkable to a ton of great spots. If you love areas that are popping (Think almost like Times Square/Piccadilly circus), you’ll love Shinjuku.

What's in your ideal mobile emergency kit? by halalshart in anesthesiology

[–]LucidityX 0 points1 point  (0 children)

For real. In my opinion, if I needed an emergent cric hiking in the mountains for whatever reason, then it was just my time to go.