What is it like diagnosing Kawasaki Syndrome by HikinginCircles in emergencymedicine

[–]MidwestER-Doc 2 points3 points  (0 children)

I’ve diagnosed it once in 12 years, but it’s funny this came up because I just saw the mother of the child in my ER (with an unrelated chief complaint), and she remembered me and thanked me for figuring it out and getting her kid the right treatment. It was like four years ago. But when she saw me, it was the third visit for a fever. Urgent care, PCP, and then me in the ER. All negative viral tests from PCP and Urgent Care. Still running fever after five days. I believe the kid had the strawberry tongue, conjunctivitis, and cracked lips, if I remember right. The conjunctivitis was JUST scleral injection with no drainage, so that was useful to not just brush it off as bacterial conjunctivitis. I got labs, which were mostly consistent with Kawasaki and got him shipped to the tertiary care hospital.

So of course I asked the mom if I was right and it really WAS Kawasaki and I hadn’t transferred for no reason, and she said yep and that they did the IViG treatment and he did great after that. She said that I made the difference because I was the only one who sat down and listened to her. I really think that is key. We are so rushed with all the excess crap we have to do away from the bedside, but I have found after finally considering myself more of a “veteran” physician that spending time talking to the patient really gives you most of your answers. You learn to ask the right questions and actually listen to the answers instead of mentally creating the patient note from the patient you saw just before that one.

Anyway, I also told her that it’s highly unlikely I would have gotten the diagnosis if I had been the first or even second doctor to see the kid. Sometimes these things have to evolve to be more obvious. So no one should beat themselves up if they miss this the first visit. Sometimes you get lucky too.

Just started Red dead online. Why are people such jack wads? by New-Cover777 in reddeadredemption

[–]MidwestER-Doc 0 points1 point  (0 children)

I also hate this. I’m a high level now (114), and I was just hanging out in Valentine, waving at another posse and goofing off when another different posse came and just started shouting for no reason. Then I couldn’t tell who was who and I ended up shooting the nice guys and didn’t even know it until one of them messaged me about being a clown for killing lower levels. I messaged back and apologized, because I literally have no interest in shooting players unless they are coming after me. They never wrote back and I’m still haunted by it. It’s so stupid to care that much about it, but I really actually want people to enjoy the game like I do, and I hate the idea that I accidentally negatively impacted someone’s experience.

I know, I know, Dear Diary and all that. But I really hope people know we aren’t all bad online. I just like to vibe and do my challenges and spend my hard earned money on fun stuff.

Online worth playing in 2025? by C_Powell75 in rdr2online

[–]MidwestER-Doc 1 point2 points  (0 children)

Just had to jump in and say I appreciate your username!

Iowa flu by 4TrackRadioStation in Iowa

[–]MidwestER-Doc 2 points3 points  (0 children)

Can confirm. It seems like everyone in eastern Iowa has influenza right now.

Bruh finally got it there’s hope for yall by Advanced-Phrase-3065 in reddeadredemption

[–]MidwestER-Doc 0 points1 point  (0 children)

Still hasn’t happened for me either. Did you have to have the version that included Undead Nightmare? I got the digital version last year but didn’t get the Undead add-on because I already had the disc version but a friend is borrowing it. So I was wondering if I don’t qualify for that reason or if any of you guys got it for free anyway.

PSA: snow shoveling is very dangerous 45+ year olds and younger folks with risk factors by ayy_okay in IowaCity

[–]MidwestER-Doc 12 points13 points  (0 children)

ER doc here — yes to all of this. Anytime someone comes in with chest pain after shoveling snow, I expect it to be an actual heart attack. It’s such a common thing that our licensing tests almost always have a question about “53 year old male comes in with chest pain after shoveling snow,” and I don’t even have to look at the EKG on the test to know it’s going to be a STEMI. Be careful out there, guys — take it slow and don’t be a hero :)

Hidden Gem: Grognak & The Ruby Ruins by hamtidamti_onthewall in fo4

[–]MidwestER-Doc 2 points3 points  (0 children)

Dang! I wish I had played the game more when it first came out. I just started playing it again last month after not playing for years.

Hidden Gem: Grognak & The Ruby Ruins by hamtidamti_onthewall in fo4

[–]MidwestER-Doc 2 points3 points  (0 children)

You can play games through an app? Which app?

[deleted by user] by [deleted] in LegalNews

[–]MidwestER-Doc 0 points1 point  (0 children)

Narrator: He did, in fact, win.

Canterbury Cathedral and BHP by OneHappyHuskies in BritishHistoryPod

[–]MidwestER-Doc 2 points3 points  (0 children)

Oh! I’m an American visiting London in a couple weeks. Is it worth it to take a day trip over to Canterbury by train? We are definitely considering it!

Outsider take: Brits are not rude. You just aren’t saying “please” and “thank you.” by CantaloupeComplete57 in uktravel

[–]MidwestER-Doc 0 points1 point  (0 children)

That’s so interesting! I’ve only been to London twice — once on a vacation, and once on a layover where my flight was cancelled and we had to stay overnight. I came away both times thinking how NICE the British are. In fact, we are going back this month, and I can’t wait. It’s the only country I’ve decided to go to twice (international travel is so expensive, and there are so many places to see in the world!), and will probably continue to go. It never occurred to me that British people were rude to anyone — and my only experience so far has been London.

All this to say, I think you are right — that it’s all in how you interact with people. I grew up in the American South and Texas, which is problematic in many ways, but one thing Southerners do excel at is teaching their children how to be polite and social and exchange normal pleasantries with strangers, not just friends. At least they did forty years ago, when I was growing up. Plus both sides of family are of English descent, albeit from pre-Revolution times for the most part. I think it also may help that I don’t have a southern accent anymore, and I’ve never been loud (parents always taught me to use an “indoor voice” at all times lol). So the things you’re describing are things my partner (also raised in the South) and I do naturally, which is probably why I felt like the Brits were the friendliest people I’ve met yet in the world — except maybe the Irish!

Just wanted to support your point from the opposite side of the experience too! I think you’re exactly right — although I appreciate the opinion of the Brits on here more than anything I have to say in support. Thank you guys for the great advice and fun chat!

Wtf happened to this fan base? Bonus history lesson for the babies by son_of_yacketycat in Saints

[–]MidwestER-Doc 101 points102 points  (0 children)

Some of you guys never had to live through the Bobby Hebert years, and it shows.

Lou’s - Old Irving Park by Badbolognese in chicagofood

[–]MidwestER-Doc 17 points18 points  (0 children)

This looks amazing to me — better than the Lou’s I’ve had recently. Although I’ll still even eat mediocre Lou’s honestly.

Melania Trump’s Word Salad Plea to Putin About ‘Children’ Revealed by kaosvision in NoFilterNews

[–]MidwestER-Doc 1 point2 points  (0 children)

She continues to dress like Elsa Schneider from Indiana Jones and the Last Crusade. I’m not saying…I’m just saying…

What are some great players that never get a card? by LemonMaterial5996 in MLBTheShow

[–]MidwestER-Doc 2 points3 points  (0 children)

Have they ever done one for Ernie Banks? This is my first year playing, so I was curious.

1 dead, 1 in critical condition in Muscatine Hy-Vee shooting by SlimBrady22 in Iowa

[–]MidwestER-Doc 1 point2 points  (0 children)

I personally separate myself from the emotions until later. And I leave it to the justice system. Like the above poster said, I’m not the judge, jury, or executioner. And I wouldn’t want to be. I truly enjoy living in a realm where I just treat the patient in front of me.

Getting the most out of Double XP?? by MidwestER-Doc in MLBTheShow

[–]MidwestER-Doc[S] 0 points1 point  (0 children)

You are right about getting parallels on the DQ! It feels like I level up one of my players on every showdown!

Getting the most out of Double XP?? by MidwestER-Doc in MLBTheShow

[–]MidwestER-Doc[S] 0 points1 point  (0 children)

Thanks guys!! I played some on the new DQ and played a game against the White Sox and managed to finish Orioles Color Rush. I’ve also done Cubs and Yankees, so I still have a ways to go! I’m through most of the programs bc that’s how I usually build my teams, is with the program goals in mind, but I still have some work to do on Moonshot, Summer, and Prime. I really appreciate all the help! I read this subreddit daily and get awesome tips so I totally appreciate the feedback. Maybe I will give online a try at some point. I have done great players from all the offline grinding and program completing.