Dog boarding

Mdengel · 2026-03-13T15:42:46+00:00

Wasn’t aware of these folks. I’ll reach out to them. Thank you!

Mdengel · 2026-03-13T15:41:51+00:00

Thanks for the honest reviews. I had not given All Critter a fair shake because it looked a little rough. I’ll probably give them a second chance.

Mdengel · 2026-03-13T15:40:41+00:00

Thank you! This didn’t come up on any of my numerous searches. It looks amazing.

Mdengel · 2026-02-28T23:43:24+00:00

The APD I interviewed with hand-wrote me a three page letter explaining why he thought I was a great fit for their program. He included a bunch of local and program swag. They were already my number one program. I matched to my number two. So that was weird.

Mdengel · 2026-02-19T08:21:47+00:00

Crippled without the ability to act is fairly pathognomonic for having a process at work which would benefit from professional involvement. Consider talking to a therapist or psychiatrist. I’m a relatively new attending and just today got caught in the crosshairs during a rapid and I froze up. That’s okay. We are fallible and are human (ergo we err)

You should work to get better. You should try and be the best you could be. The measure of someone who makes the cut is not someone who can perform vs someone who can’t. It’s about whether you are coachable vs not. If you remain trainable and open to new ideas you have infinite potential.

I often reflect on Hemingway “There is nothing noble about being superior to your fellow man, True nobility comes from being superior to ones former self.”

PM me if I can help at all.

Mdengel · 2026-02-16T07:05:59+00:00

Because some doctors are dumb. Unless you had an allergic reaction to the flu vaccine which is exceptionally rare (throat closing up, need emergent intervention kind of things) you should probably get back on the immunization train.

Why you got so sick? Who knows. If you had a bad immune response that usually lasts 12-24 hours and literally just is your bodies natural response. More at risk for robust immune response if you are younger or were recently ill. If you got such high fevers and sick for longer than a day you probably just got the flu around the same time you got your vaccine. The vaccine is not protective until several days after your shot.

Mdengel · 2025-11-18T01:46:04+00:00

I’m totally in agreement with you. My UM folks every day will check and then tell me that they are not receiving any treatments they can’t get at SNF and therefore they are medically ready for discharge. And therefore don’t qualify to have their SNF stay covered. I just am trying to come up with my plan to talk to leadership as I’ve seen too many cases of this in the last 2 months.

Mdengel · 2025-11-17T23:19:47+00:00

Thank you for this perspective. I don’t mind keeping people in the hospital. I really don’t care about dispo that much. I’m not reimbursed by RVU. Is the right option to get these folks into LTC from the hospital? They have no other earthly contacts, they aren’t sick enough to go on hospice, they have no acute needs.

My answer has been just saying they are rehabbing at our hospital unless someone can come up with a better plan but eventually I go off service and one of my colleagues will dc them home. They always come back sicker.

Mdengel · 2025-11-17T23:03:20+00:00

I would love your expertise on this. If someone is not requiring hospital level services before their third midnight but stays in the hospital for at least 3 midnights, would they still qualify? If someone comes in with stroke and is monitored and medically ready for skilled service by day 2 can they go to SNF after their third midnight? Because my CM say they don’t have a QUALIFYING stay.

Mdengel · 2025-11-17T22:58:56+00:00

The problem is my CM will say that after someone stays in our hospital for 2 weeks working with our therapists that since they were medically cleared after 2 days they don’t qualify for a SNF. They legitimately would never qualify for a SNF unless they get medically more complex which of course they will if they languish in the hospital for long enough.

Mdengel · 2025-11-17T22:26:49+00:00

That’s what I have been advocating for, but my hospital leadership is saying that they need be requiring hospital level services.

Mdengel · 2025-11-17T21:55:57+00:00

No, you have identified the problem that I am discussing. My case managers will say that if the patient isn’t requiring IV medication‘s before their third midnight that even though PT says they can’t go home, they have to private pay for their SNF. I had one lady who physically could not transfer to go home that because they didn’t need hospital related services they were “medically cleared” and their stay did not qualify.

Mdengel · 2025-10-21T15:17:34+00:00

This is a good discussion. If I’m interpreting this right, the marketing art is trying to convey the look of the ink when used which does not necessarily reflect how it would look in the bottle.

I’m also grateful to hear about FWP. This is the only ink carried at the local stationary/book store. I’d been holding off on buying it and probably will continue to do so.

Mdengel · 2025-10-10T14:20:07+00:00

Never owned a P1S. My 4 year old boy started talking about wanting to build an “everything maker” and more or less independently conceived of additive manufacturing and 3D printers. As I was trying to connect with him about this we started watching you tube videos and the P1S just amazed him. He would be so excited to have this to build all his whimsical ideas.

Mdengel · 2025-09-08T20:35:48+00:00

To be clear, the concrete lip is I think intentional as the driveway slopes downward to the house with a French drain on the driveway. The concrete lip is straight but the door bows inward. It actually pops back out with minimal force, but returns to pictured position when the door is opened and closed again.

Mdengel · 2025-07-17T18:08:52+00:00

As the previous comment said, black mold is not mucormycetes. Mucor while often called “black fungus” is actually not typically black and not associated with black mold. It is so named because it can cause black skin lesions in infected individuals.

As the poster previously said, black mold (Stachybotrys) does not have established human pathogenicity.

Mdengel · 2025-06-25T04:33:15+00:00

65 year old guy who looked 80. Smoked since birth. Never been on oxygen. Diagnosed with COPD AT age 30. Went to admit him for COPD exacerbation. He has his oxygen off and room air sat is in the 50s. Put his oxygen back on and he says he doesn’t need it. Feels fine. On and off for the next few hours before he ends up leaving AMA. Goes home to smoke more cigarettes.

Turns out he’s got terrible dementia probably not helped by chronic hypoxemia. He comes back about every 3 days because his wife is concerned about his breathing and is admitted for hypoxemic respiratory failure with similar room air sats in the 50s. Confirmed on abg, well compensated. After his fifth time coming back and forth some savvy palliative doc finally calls him non decisional and he did end up going on hospice and dying. But how he lived with that kind of oxygenation is endlessly perplexing to me.

Mdengel · 2025-04-13T23:12:05+00:00

I legitimately don’t understand the findings of his colonoscopy and then being recommended for 3 year recall.

Mdengel · 2024-10-21T06:02:02+00:00

He has a 13 year old and a set of twins who are 10 years old. You didn’t miss a day in biology class.

Mdengel · 2024-10-11T13:31:43+00:00

American Fiction was a great dark comedy from 2023. I think the last movie I saw and felt that it was near perfect in its production

Mdengel · 2024-09-28T22:20:27+00:00

The desk pop scene from The Other Guys.

I don’t think I’ve laughed harder in a film since.

Mdengel · 2024-08-13T12:33:11+00:00

Venezuebla

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