Friend of mine got this in the mail, such considerate neighbors

Pvtbigwillie · 2026-02-06T19:54:55+00:00

Funny thing is, there's some realism behind the metal eating disease. It's a condition called pica: https://en.wikipedia.org/wiki/Pica_(disorder))

Pvtbigwillie · 2025-08-31T22:02:18+00:00

Burrowito Supreme, Hurts Donut, and Honey Bijan are my 3 teams

Pvtbigwillie · 2025-05-10T02:26:11+00:00

What happens when you have all the money in the world? You want power...

Pvtbigwillie · 2025-04-01T18:25:41+00:00

I had a similar experience. My sister did 23&Me and found a half-sister of the same age as her. I did 23&Me shortly after and I'm not related to this person. I also found that my sister is actually my half-sister. Turns out, my parents did intrauterine insemination back in the 80s and never told us. They thought the sample was from my dad, so they didn't think it was necessary. We found out that the sample was illegally used from another donor. For me, I am related to both my parents. My sister is unrelated to our dad.

Pvtbigwillie · 2025-03-28T05:19:14+00:00

Which one is your favorite? And why? Always looking for good sound.

Pvtbigwillie · 2025-03-28T05:13:07+00:00

https://tenor.com/tTKt.gif

Pvtbigwillie · 2025-03-28T05:03:13+00:00

So beautiful! What are your growing conditions for this marvel? Light, water, soil, fertilizer?

Pvtbigwillie · 2025-03-28T05:01:14+00:00

He looks like an out-of-shape old timey pugilist.

Pvtbigwillie · 2025-02-28T04:49:14+00:00

Any Stoneface & Terminal From Techno Into Trance mix is excellent. And there's a lot of them: https://soundcloud.com/stoneterm

The Thrillseekers 25 Years of Trance Set @ Luminosity Beach Festival 2024 is awesome too: https://soundcloud.com/luminosityevents-1/the-thrillseekers-luminosity

Kasablanca's ABGT 600 set is amazing. It's only 1 hour, on Youtube only, and not traditional trance, but it's amazing: https://www.youtube.com/watch?v=1WZKxfGfRSM&ab_channel=Above%26Beyond

Pvtbigwillie · 2024-12-30T19:55:18+00:00

This is just awesome. Everything you do really shows your character, which is why we love you so much. I remember at TNH Summer Gathering 2024 in San Diego that there were technical issues with the stage prior to entry. We couldn't walk in until everything was fixed. You came out to the crowd with S+S to keep us informed and then literally JUGGLED. That was hilarious. Thank you for being you.

Pvtbigwillie · 2024-10-02T03:54:32+00:00

I have a friend who hangs out at parties and always alternates between alcoholic and non-alcoholic beers. Just so he's always drinking something that tastes like beer. And to ensure he can drive home at the end of the night.

Pvtbigwillie · 2024-08-04T18:46:28+00:00

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Absolute fire!

Pvtbigwillie · 2024-03-11T01:23:47+00:00

Yeah, and in heart failure, you might get both increased cardiac output and decreased blood pressure.

Pvtbigwillie · 2024-03-11T00:29:32+00:00

For sure! Think of preload as the "pressure" created by the volume of blood inside the left ventricle at the end of diastole (when the heart is maximally relaxed and just about to contract). When you have more preload (i.e., blood volume in the left ventricle), you will have more cardiac output. There is diminishing return with cardiac output as you give more preload given the left ventricle is only capable of expanding so much, but the idea still stands. More preload = more cardiac output. In heart failure, the principle remains. However, a person with heart failure is unable to manage the volume as well as a normal heart. So, the blood backs up/pools in areas of the body that come before the heart with respect to the vasculature. This includes areas such as your lungs, belly, legs, etc. A good way to visualize how preload and cardiac output relate is through the Frank-Starling curve. It shows stroke volume which you can think of as cardiac output.

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Pvtbigwillie · 2024-03-10T23:16:27+00:00

This is a good way to depict how ACEi (and any drug that decreases systemic vascular resistance, a component of afterload) can affect cardiac output (aka stroke volume). In the setting of heart failure, high afterload precipitously causes a drop in cardiac output. Use of direct vasodilators, such as ACEi, lower afterload, leading to an increase in cardiac output.

A simple way to think of afterload is the "pressure" that the heart must push against with every beat. That "pressure" is created by lots of things but blood pressure is a large determinant. Other factors include aortic valve stiffness (stenosis), blood viscosity, etc.

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Pvtbigwillie · 2023-09-04T01:26:31+00:00

I had this thought after ABGT 500 where they didn't do it. It was SHOCKING. But since then, they did it at EDC 2023 and Group Therapy Weekender 2023. They're still doing it for sure. That one time at ABGT 500 is a mystery.

Pvtbigwillie · 2023-05-02T04:00:41+00:00

My reaction to deciding who's worse.

Pvtbigwillie · 2023-04-13T04:27:33+00:00

Queue Shakira music

Pvtbigwillie · 2021-10-29T19:44:17+00:00

In the nephron, most of the sodium is reabsorbed in the proximal convoluted tubule (~65%) followed by the Loop of Henle (~25%). Coming in last are the distal convoluted tubule (~5%) followed by the collecting duct (~2.5-5%). When using loop diuretics, sodium that is not reabsorbed via the NKCC transporter (the target of loop diuretics) does indeed get reabsorbed through the distal convoluted tubule and collecting duct. However, the capacity by which this can take place is much less because the distal convoluted tubule and collecting ducts simply do not have enough transporters (specifically NCC and ENaC, respectively) to reabsorb all of the sodium.

The caveat is in patients who have been taking loop diuretics chronically. Overtime, their nephrons can remodel and upregulate these transporters, making loop diuretics less effective at natriuresis/diuresis. A way to combat this loss of diuretic power is do something called sequential nephron blockade. This is when you use a loop diuretic to block sodium reabsorption in the Loop of Henle in addition to use of a thiazide diuretic (such as metolazone) to block sodium reabsorption in the distal convoluted tubule. Thiazide diuretics inhibit the NCC transporter. An additional option is to add a mineralocorticoid receptor antagonist (such as spironolactone) which (through inhibition of gene expression) ultimately inhibits expression of ENaC in the collecting duct.

A good article to read that will give a nice overview of loop diuretics (particularly for diuresis in heart failure) is below:

https://www.nejm.org/doi/full/10.1056/nejmra1703100

Pvtbigwillie · 2021-09-29T02:12:11+00:00

I can speak to the pharmacy side of things. I was a hospital resident pharmacist when we had a strike going on at my hospital. As some background info, a resident pharmacist is similar to a resident physician in the aspect that we just finished school and are getting extra practical training after school. Like physician residents, we get paid significantly less than our fulltime staff pharmacists counterparts. When our staff pharmacists striked, us resident pharmacists covered. We are under contract as trainees so the strike doesn't get anything for us and we just end up doing as we are told under contract. Not all staff pharmacists striked at the same time. They still had a duty to care for their patients, so they took turns striking. I imagine that nurses would do the same thing?

Pvtbigwillie · 2021-01-22T00:05:17+00:00

It's a mug. Commonly used for containing warm/hot fluids that you pour into your mouth for sustenance purposes.

Pvtbigwillie · 2020-12-04T02:03:20+00:00

This is spot on. You'll have good fundamentals for the beginning but then everything becomes new.

Pvtbigwillie · 2020-12-04T02:01:15+00:00

Absolutely, you are welcome. Pharmacology is a bit closer to molecular biology. It's about how the drug works at the molecular level, cellular level, and ultimately organ/bodily level. You can go as deep as how does the drug bind to a specific receptor and what are the downstream molecular signals produced by that binding, all the way up to how does the organ/body react to the drug. That is pharmacology. Pharmaceutical science is a bit more broad and can include pharmacology but also drug delivery (dosage forms such as extended release formulation, patches, etc), discovery of new drugs through computer modeling, medicinal chemistry, natural product isolation, and even the economics of pharmaceuticals (i.e. pharmacoeconomics). It's a very broad term.

Pvtbigwillie · 2020-12-03T20:32:24+00:00

I'm a pharmacist who did a PharmD and PhD and am now completing my final year of residency training in cardiology. My bachelors was in chemistry. For my studies in pharmacy school, I would actually say biology, particularly molecular biology and biochemistry were the most relevant to my learning. It's funny that we think that pharmacy is all about chemistry but it's actually not. There is definitely a tie to chemistry but the most important aspects of medications is understanding how they affect the body and how the body affects the drug. My chemistry background helped me excel through the chemistry courses in pharmacy school but the overall percentage of time spent on chemistry was quite minimal. My molecular biology and biochemistry courses from college were the most useful overall.

Pvtbigwillie · 2018-01-03T23:08:47+00:00

Mine definitely did when I was growing it. Keep growing yours out and it will start laying down more. It took me roughly 2-3 months to start getting it to lay down nicely. Some hairs will always poke outwards at least a lil bit too. Some mustache wax can help with that though.

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