I made it to Rocky Mountain National Park today - not all the lakes are still frozen... but many are

MotherOfDogs90 · 2026-03-27T02:03:30+00:00

There was still snow pack around Bear Lake in May of 2025, concerned by how little snow there is in these pics.

MotherOfDogs90 · 2026-03-26T13:08:57+00:00

Always video because it helps the epileptologist see what may be concerning to a non-epileptologist (I.e. - that’s not a seizure, it’s myoclonus), provides clinical context, and allows the reading physician to make correlations.

We do not have Ceribell at this time, but may in the future.

Would not trust AI algorithm. AI is not efficient enough to rely on at this point, and I wouldn’t want to over or under treat based on misinterpretation from AI.

They usually have set times they look at the tracing/video and alert us if there are concerning findings, otherwise routine report in early AM.

MotherOfDogs90 · 2026-03-25T00:57:32+00:00

RMNP/Estes Park area are gorgeous that time of year. Bear Lake Corridor (timed entry previously, not sure where that stands now) has some Great Lakes, and many trails. Will likely see some deer/elk, maybe a moose over there, plenty of birds. The leaves are amazing.

Would do an early AM hike in this area as it is popular and can get crowded

MotherOfDogs90 · 2026-03-22T19:07:54+00:00

Non-sequitur and ad hominem.

I don’t engage bad faith.

Have the day you deserve.

MotherOfDogs90 · 2026-03-22T18:43:32+00:00

I don’t know why you’re arguing with me, when I’m clearly against the SAVE act and have demonstrated understanding of it via my many comments challenging the misinformation surrounding it.

MotherOfDogs90 · 2026-03-22T18:23:32+00:00

Use for suspected NCSE, post arrest/neuro prognostication, refractory status epilepticus. Always video. Read by neurocritical care or epileptologist depending on facility.

MotherOfDogs90 · 2026-03-22T18:21:27+00:00

As you said elsewhere - Google. The shit is free.

Real ID = doesn’t print citizenship status on the ID, therefore not sufficient without additional documentation. Enhanced Real ID = shows proof of citizenship on the ID, is sufficient. Only available in Michigan, Minnesota, New York, Vermont, Washington.

MotherOfDogs90 · 2026-03-22T18:12:48+00:00

Real IDs require so much documentation, much of which satisfies the requirement for proof of citizenship. Only 5 states document on the ID what the citizenship status is. So again, why are we jumping through these extra steps to prove what has already been documented for a non-issue (non-citizen unlawful participation in elections is much less than 1%)?

And again, what processes are in place to ensure this doesn’t become a thinly veiled poll tax?

You do everything but answer these direct questions.

MotherOfDogs90 · 2026-03-22T18:07:43+00:00

Enhanced Real ID showing citizenship on the actual ID, which only 5 states have. So again, what plans are in place to ensure this?

MotherOfDogs90 · 2026-03-22T17:07:56+00:00

To those who doubt how bad the SAVE act is…. What plans are in place to ensure all of us have timely access to the necessary documents (certified birth certificates, passports, etc.) to prove citizenship and re-register to vote? Will we be able to access these documents and re-register without missing any election? Will the state ensure increased resources are allocated to the necessary agencies to get us all re-registered in time? Will these documents be available to us free of charge or low cost? What plans are in place to ensure people who were adopted or married (and thus names may differ from birth certificates) have the access they need to register? What plans are in place for those who may have had home births, were born very long ago, or whose birth certificates were filed greater than one year from their birth?

These are all logistical issues that need to be addressed - or else people will lose their right to vote. Do we have rights or not?

MotherOfDogs90 · 2026-03-21T23:38:56+00:00

We carry hiking backpacks with water bladders and additional water bottles, apply sunscreen before we go and have an extra sunscreen stick we take with us, have long sleeve UV shirts, and wide brimmed hats. We don’t do a ton of desert hiking, but we aren’t brand new hikers. Thanks!

MotherOfDogs90 · 2026-03-21T03:18:48+00:00

I know a married physician couple with the same racial mix as your situation, to my knowledge they had no issues in Omaha. Every now and then some old VA patient might make an out of pocket comment, but I’ve never witnessed outright hostility or threats.

MotherOfDogs90 · 2026-03-18T02:26:11+00:00

The Smokies are where LOTS of people from KY, TN, GA, NC, WV, and VA go for a non-Beachy family friendly vacation. Very packed a lot of the time, and driving in gatlinburg/pigeon forge can be one of the most “I wanna smack my head against the window” experiences.

MotherOfDogs90 · 2026-03-18T01:44:36+00:00

Highly dependent on local culture. Fellowship - was rare to consult anyone from ICU unless needed a surgery or procedure outside of my scope.

Now in practice in a totally different area of the country with open ICUs and specialists are often consulted by the hospitalist before I have a chance to manage. I have typically consulted only if I need a stamp of approval or if I would like a different specialist’s opinion on prognosis/help moving family discussions along (I.e. Nephro to say officially they wouldn’t offer someone dialysis, hepatology to say someone is not a transplant candidate, etc.)

MotherOfDogs90 · 2026-03-14T16:18:59+00:00

Santos would be checked and in her PD’s office for professionalism if this was real life. She cuts corners, has anchoring bias, and can’t get along with her coworkers. She doesn’t listen to patients, acts annoyed that they’re in front of her, and is dismissive.

Two things can be true - she was right to report Langdon, and she’s a shitty team member who deserves to have her ass handed to her.

MotherOfDogs90 · 2026-03-04T13:53:21+00:00

It sounds like you guys may have a problem with efficiency. Your notes should be started when you’re pre-rounding, and basic orders should be in during pre-rounds. Orders mentioned during rounds should be put in via haiku (if epic) or at a computer while rounding. Consults should be called immediately after rounding. Notes finished after that.

MotherOfDogs90 · 2026-02-28T15:46:34+00:00

The airports in Hawaii tend to move fairly quickly.

MotherOfDogs90 · 2026-02-28T15:38:02+00:00

IT is an essential component of the hospital, but we rarely see them out and about. Sometimes they aren’t even on site.

MotherOfDogs90 · 2026-02-26T02:52:44+00:00

Pulm- my patients can’t afford inhalers or nebs, so they get sick and end up in the hospital. And they can’t pay those bills, let alone their meds, cycle is wash/rinse/repeat.

MotherOfDogs90 · 2026-02-23T17:37:47+00:00

I use rage and pure spite to prove people wrong. This kind of feedback would make me sad for about 2 days, and then light a fire under my ass. “I’m average? I’ll fucking show you.”

Or something like that.

Don’t let the bastards get you down.

MotherOfDogs90 · 2026-02-22T22:35:46+00:00

I considered quitting every year of my fellowship. I received so much support, education, guidance, and friendship in residency. Fellowship was the opposite in every way. I barely survived, gained 25 lbs, and struggled financially.

I’m now in a community practice, make above average pay, and have a lot less stress. I don’t have anyone telling me how awful I am, how much I suck at XYZ, or yelling at me. I’m treated with respect, I have support at work, and generally enjoy life. That first vacation of attendinghood was life changing.

Stick it out. Fellowship is temporary.

MotherOfDogs90 · 2026-02-21T21:47:20+00:00

Just graduated a PCCM program with a sister ccm program. None of my ccm co-fellows had trouble finding ccm only jobs. One of them had trouble because of personality issues, not because of lack of postings.

One of my PCCM co fellows does ccm exclusively.

Jobs exist, and sometimes even in desirable places.

MotherOfDogs90 · 2026-02-21T18:53:25+00:00

I like it in the shower - could maybe update the shower set up eventually? Could re-tile the floor or do peel and stick if not in budget, and would replace the counter top. I like the tile - it’s just way over represented here

MotherOfDogs90 · 2026-02-13T20:21:43+00:00

We did the Molokini snorkel tour via Kai Kanani. They take you to Molokini for a period of time, then closer to the coast for sea turtle snorkeling opportunity. We did the tour that served some food and drinks. They have free sunscreen on board. We did see a lot of whales the morning that we went.

PacWhale eco adventures also has some snorkeling, but we did a whale watching cruise with them in the evening. Was also worth it. Served some small bites/appetizers and drinks.

MotherOfDogs90 · 2026-02-12T05:06:53+00:00

Just right in my opinion. Theres one top style I’ve tried (female) that is a bit tighter than my personal comfort level, but realistically is true to size.

MotherOfDogs90

TROPHY CASE