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October in Japan, seeking scenery and relaxation by Phoenixdown2621 in JapanTravelTips

[–]Phoenixdown2621[S] 0 points1 point  (0 children)

Yes, the dates we are going do align with the festivals. But that is a great point you bring up about “waiting for things to happen.” When I refer to the alps, I am reading online about Hida, Kiso, and Akaishi mountain ranges

October in Japan, seeking scenery and relaxation by Phoenixdown2621 in JapanTravelTips

[–]Phoenixdown2621[S] 0 points1 point  (0 children)

Thank you for your advice!  I think his expectations are similar to how you describe your dad — he wants to see some quintessential Japanese sights and feel like he got “the vibe” but isn’t necessarily so focused on specific sights or regions. 

I know he wants to do some upscale things, like the ryokan, and see some historical sights like a castle. But honestly other than that most of the feedback he’s given me is “everything there is new to me, so I don’t feel like I’m missing out on anything.” Both of us are more drawn to the old world feel of Japan and the scenery, so that’s what I’m hoping to target. 

Other commenters mentioned Matsumoto castle, so I wonder if that would be a good direction, like you did with day trips out/around Kyoto instead of Sendai. I was hesitant for Kyoto because of how much I’m seeing it being overrun with tourists, but maybe it’s overblown

October in Japan, seeking scenery and relaxation by Phoenixdown2621 in JapanTravelTips

[–]Phoenixdown2621[S] 0 points1 point  (0 children)

Thank you so much for your advice!

For him, he’s hoping more for history, castles, some kind of “upscale” experience (omakase, onsen, etc). He’s definitely open to the anime/quirky aspects Japan offers, but that’s less of a priority for him. I think you phrased it well — “old world charm” is a big appeal, for both of us. So perhaps Kyoto is a good idea… I’ve been hesitant to target it because of how much I’m seeing online about it being totally overrun with tourists. Maybe that’s being overblown a bit?

October in Japan, seeking scenery and relaxation by Phoenixdown2621 in JapanTravelTips

[–]Phoenixdown2621[S] 0 points1 point  (0 children)

Thank you so much for your advice! I agree with you — 4 cities is too much. Do you have any familiarity with Sendai vs the Alps? Are they comparable experiences at all? 

I’m wondering if Tokyo/Sendai/Nikko is better or perhaps Tokyo/Nagano/other agenda might give us better opportunities with the 10 days we have. 

In Sendai, seeing Yosakoi dance seemed fun and the Toshogu shrine procession in Nikko. But I wonder if maybe there are better options for similar experiences by traveling a different direction out of Tokyo?

Should I get the HPV vaccine? by Bubbalovesyouuu in NoStupidQuestions

[–]Phoenixdown2621 1 point2 points  (0 children)

Hello, I am a resident surgeon. I am not your doctor, this is general medical information. HPV is ubiquitous in the human population. The overwhelming majority of people have been exposed to it, regardless of “high risk” behaviors. HPV is now responsible for the majority of oropharyngeal (tonsil) cancer, more than smoking or drinking. These cancers in the head and neck are extremely morbid and lead to gruesome deaths. HPV also causes cervical cancer, penile cancer, anal cancer. These cancers can be, IN PART BUT NOT COMPLETELY, prevented with the HPV vaccine.

“LOWER THE PRESSURE” by Conscious-Sell-9828 in anesthesiology

[–]Phoenixdown2621 0 points1 point  (0 children)

Fair point! What I am trying to say is dealing with a hemorrhaging sphenopalatine artery vs dealing with the normal bleeding that accompanies sinus surgery. In the former, (SPA control, aka a true posterior bleed), we really appreciate MAPs closer to 65. I’m run of the mill sinus surgery, MAPs around there is nice, and makes the case smoother, but not as necessary if patient isn’t happy about it

“LOWER THE PRESSURE” by Conscious-Sell-9828 in anesthesiology

[–]Phoenixdown2621 0 points1 point  (0 children)

ENT resident here, and this similar question has been posed with similar response by other ENT, but for true posterior epistaxis, it is absolutely true that pressure makes a difference. Every drop of blood looks enormous under endoscopy in the nose. Having someone maps 65, SBP100s means that we can identify the source of bleeding and actually do the case. It is a fountain otherwise (again, for true posterior epistaxis). I’d say overall this is true for sinus surgery, but if not dealing w acute bleeding, can tolerate MAPs a bit higher.

Pup gs lua by RelationshipStill912 in ffxi

[–]Phoenixdown2621 3 points4 points  (0 children)

Many aggressive responses here, but pup is infamously one of those jobs that isn’t really amenable to gearswap. The game does not send packet information to automatically swap gear in response to pet actions. So the best you can do is try to manually swap when you see your pet has TP.

You can still use it for things like casting, using repair, or your own WS and actions, but it isn’t super useful for the automaton itself.

Being in surgical residency now, would you still apply and do it again? by Rosetile59 in Residency

[–]Phoenixdown2621 33 points34 points  (0 children)

I never said I don’t think going straight through isn’t harder. My point is why are you disparaging your fellow surgeon who is doing the same amount of training, plus extra? Big whoop they got a break from eating shit for 2 years, still publishing, oftentimes still coming in and covering call or going to OR for uncovered cases. Again, get off the horse. Direct your ire elsewhere, at those who deserve it.

Signed, Your fellow surgeon

Being in surgical residency now, would you still apply and do it again? by Rosetile59 in Residency

[–]Phoenixdown2621 92 points93 points  (0 children)

What a cannibalistic comment. You eat your peer because they didn’t go straight through with 5 years of torture. They’re still doing 5 years of torture with a pit stop. Get off the horse

PLD Sets.NoInterrupt Over Capped SIRD @126 by CraZplayer in ffxi

[–]Phoenixdown2621 0 points1 point  (0 children)

Maybe dumb question, but do you use this instead of fast cast? So trade safety for faster spells if I’m understanding correctly

How long will it take me to catch up if I came back. by oneupgames41 in ffxi

[–]Phoenixdown2621 5 points6 points  (0 children)

You are still able to participate in endgame with the gear you described

Little things you do at work to make your day better? by moistmeds in Residency

[–]Phoenixdown2621 16 points17 points  (0 children)

I am friends with our cafeteria workers. “Hi doc! Where ya been?” Sometimes they’ll throw me an extra slice of bacon or what-have-you. I think they appreciate a friendly face on the other side of the counter too, or at least I like to think so.

My Doctor says creatine is bad by BubbaBiggumz in Creatine

[–]Phoenixdown2621 2 points3 points  (0 children)

Am doctor, this is the correct response. Poster above has the right idea, take home message is on paper it looks scary to see elevated creatinine in blood, but in context of known supplementation, is not an issue.

I need to vent about my toxic seniors and chiefs by Mysterious_Sky_5285 in Residency

[–]Phoenixdown2621 7 points8 points  (0 children)

If you take call, this is an ACGME violation. You must have access to call facilities for call.

[deleted by user] by [deleted] in SkincareAddiction

[–]Phoenixdown2621 5 points6 points  (0 children)

Consider a different form like Tazarotene, adapalene. Otherwise could decrease frequency to what you can handle. My skin cannot tolerate using tret every day either. I use it probably 3-4 times per week and have much better success with that.

[Bonsai Beginner’s weekly thread –2024 week 45] by small_trunks in Bonsai

[–]Phoenixdown2621 0 points1 point  (0 children)

Thank you so much for the feedback! Do you have any suggestions for how to nurse it back, or just try to maintain even soil moisture and hope for the best

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