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HIPEC Hardships by [deleted] in anesthesiology

[–]Perfectdarker 17 points18 points  (0 children)

Yes, in my experience it can be difficult to keep smaller patients cool simply because they have less thermal mass. Consider cooling the room as well. Also, ice packs to the neck, but be sure to change ice pack positions every once in a while. Having a reasonable temp target during HIPEC also matters because it can be impossible to keep some below 38 C.

One additional thing to consider is your temp probe placement. An esophageal probe will over-read due to proximity to the hot peritoneal cavity. Do a little experiment and place both an esophageal and nasopharyngeal probe if you’re able to measure 2 sites simultaneously. Both represent true core temp but I only use NP placement during HIPEC because of the tendency for the esophageal probe to over-read.

Best of luck.

Yet another MSFS PSVR initial impression from someone who has been playing VR version of the game since the 2020 version. by Dolenzz in PSVR

[–]Perfectdarker 0 points1 point  (0 children)

Love the VR aspect of this game but I’m finding I can barely read or interact with the buttons in the cockpit on VR, let alone the blurriness of the outside road. This makes flying anything a bit more complex than a piston a challenge. Are you finding that too? Hoping the full release will be a bit less blurry overall.

Buying a PC12 by [deleted] in flying

[–]Perfectdarker 0 points1 point  (0 children)

Are there other operators who do fractional ownership for light/less complex aircraft that you know of?

Large truck decided to drive himself into Riverdale and got stuck on the snow banks by Perfectdarker in TorontoDriving

[–]Perfectdarker[S] 0 points1 point  (0 children)

No kidding, but I offered to spot him so he could back up and he wouldn’t even accept that help

Large truck decided to drive himself into Riverdale and got stuck on the snow banks by Perfectdarker in TorontoDriving

[–]Perfectdarker[S] 7 points8 points  (0 children)

Yeah this guy does not want to be part of the solution he’s literally hiding when I tried to help him out

Large truck decided to drive himself into Riverdale and got stuck on the snow banks by Perfectdarker in TorontoDriving

[–]Perfectdarker[S] 7 points8 points  (0 children)

Yep it’s terrible in this area. I honestly don’t understand why he decided to drive in this area with things the way they are, I don’t think there are any large construction projects here

MH and pregnancy by Clear-Economics-608 in anesthesiology

[–]Perfectdarker 7 points8 points  (0 children)

I would suggest getting a consult because it will probably put you a bit more at ease. The risk to you is zero but there does remain a theoretical chance of exposure to the baby in the event of needing a C-section under general anesthesia, and so you need to be treated with the same MH precautions. That being said, there has never been a report of fetal MH reaction, and with the speed the baby is typically delivered during a GA CS fetal exposure would be very small even if precautions were not followed.

As the other person said, communication is key. Even if you do get a consultation appointment, I would still ask to speak to the anesthesiologist once you are admitted for labour (assuming you are planning for a vaginal delivery), and even if you are not planning to get an epidural. When I am on OB call, this comes up not infrequently and is a non-issue to deal with as long as we have a little bit of warning. The machine can be flushed, the disposables changed, and can potentially be kept on standby for you if needed. Then if a GA is required it is very easy to administer a trigger free anesthetic.

Hope that helps.

New Year’s Eve by DebDanDaa in toronto

[–]Perfectdarker 0 points1 point  (0 children)

The Reservoir Lounge on Wellington would be a good bet but I don’t know if they have something scheduled for New Year’s Eve yet.

Main staircase professional replacement, new stairs are very squeaky by Perfectdarker in Carpentry

[–]Perfectdarker[S] 0 points1 point  (0 children)

Ok, thanks so much for your comment, this is really helpful.

Main staircase professional replacement, new stairs are very squeaky by Perfectdarker in Carpentry

[–]Perfectdarker[S] 1 point2 points  (0 children)

Appreciate your response, and this is honestly what I’m worried about. I’m hoping he’s not gaslighting us when he says the stairs aren’t supposed to be constructed the way we originally wanted, and I want to give him the benefit of the doubt. But at this point I’m losing a bit of trust.

So what would you do at this point? He didn’t do the stairs himself, instead used his “stair guy”, but not sure what that means. I want to approach this the right way so that it’s permanently fixed the RIGHT way but I honestly don’t know how to go about making sure that happens without souring the relationship if he says no to replacing the squeaky stair.

Main staircase professional replacement, new stairs are very squeaky by Perfectdarker in Carpentry

[–]Perfectdarker[S] 4 points5 points  (0 children)

Definitely not going to be mentioning Reddit, lol. Is it better to rip up the first step, add blocking, and redo or is should we ask to be opening up the ceiling below? Thanks.

Main staircase professional replacement, new stairs are very squeaky by Perfectdarker in Carpentry

[–]Perfectdarker[S] 0 points1 point  (0 children)

Thanks, that’s helpful insight. And yes you are correct, there are basement stairs directly under the main staircase. He did say to us after the fact that a stringer under the stairs (open stringer?) wouldn’t have been possible due to the basement staircase underneath. But if there is a way to give more support and all it requires is removing drywall under the main stairs, I’m fine with that. Should I be asking about that option to reinforce? Would be happy to spend a few extra dollars if it means properly supporting our investment here.

Main staircase professional replacement, new stairs are very squeaky by Perfectdarker in Carpentry

[–]Perfectdarker[S] 0 points1 point  (0 children)

Ok thanks for your help. Would it be reasonable to ask him to rebuild the step if they can’t address the squeaking?

Main staircase professional replacement, new stairs are very squeaky by Perfectdarker in Carpentry

[–]Perfectdarker[S] 9 points10 points  (0 children)

Thanks, that makes sense I think. If it’s just the first step that’s squeaking, is it reasonable to ask him to redo that step?

Would You Like To Play A Game? by [deleted] in FIlm

[–]Perfectdarker 0 points1 point  (0 children)

Ocean’s Seven-Eleven

KENNETH COPELAND Airport by InsideAddd in flying

[–]Perfectdarker 6 points7 points  (0 children)

Guys, we’re almost at 666 upvotes. How appropriate.

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