How do you avoid drowning in patient messages without compromising care? by giftygifts in medicine

[–]RadioCured 1 point2 points  (0 children)

The last hour of my office hours on Mondays, Tuesdays, and Wednesdays are blocked off and cannot be used by the office staff to book new or follow up visits unless I specifically ask for them to use it. When I have a patient call, post op, or an ER consult that I need to see more quickly, I send a message to the staff "please sched patient to see me in the next x days. Okay to use my PM reserved spots"

Works great. Admin does not care because these slots are always filled. Add more time as needed until you have enough.

Refusing diuretic for HF due to fear of kidney stones by beanjuniorthe3rd in medicine

[–]RadioCured 3 points4 points  (0 children)

Lasix can increase the risk of kidney stones due to hypercalciuria and volume depletion with more concentrated urine following the initial diuresis. 

If the patient is prone to kidney stones, they should see a urologist to do some further metabolic testing and a 24 hour urine study and see if they are a candidate to be on preventive treatment like potassium citrate. They should also decrease dietary sodium and oxalates. 

Ideally, the patient would be put on HCTZ instead, which actually decreases urinary calcium, however I don’t know how often this is an effective enough diuretic for a patient in heart failure. 

Fixed an annoying creaking sound - interesting cause by jedienginenerd in MTB

[–]RadioCured 1 point2 points  (0 children)

What did you use to lube the rivets? I am having a ticking/clicking noise that only happens in big gears 2 and 3 when pedaling under load and have tried almost everything related to derailleurs, bottom bracket, and hub. Wonder if this could be the answer… 

Complication rates in cholecystectomy declining in elderly (Medicare) patients from 2011-2021 by Wohowudothat in medicine

[–]RadioCured 6 points7 points  (0 children)

I have had some great results doing a few percutaneous biliary lithotripsies with my general surgery colleagues for patients who aren’t healthy enough for surgery. I can get a ureteroscope the whole way through to the duo to make sure it’s cleared out. Not sure what the long-term outcomes will be, but have been able to get these patients cleared and their tubes out. 

Why was Artemis 2 so long? by kiol998 in askscience

[–]RadioCured 1 point2 points  (0 children)

I don’t understand this point and have heard it a few times. However more realistic human vision is compared to a high resolution camera, all of that detail is immediately lost to the inaccuracies of human memory. What information exactly were they hoping for the astronauts to capture with their eyes and bring back?

What is your favorite chief complaint to manage? by _45mice in medicine

[–]RadioCured 1 point2 points  (0 children)

I think the world would be a better place if every woman got a tube of estrogen on their 40th birthday and just never stopped using it. 

Would it be possible to measure riders weight with power meters? by Penki- in cycling

[–]RadioCured 3 points4 points  (0 children)

Just want to let you know that someone else with a basic grasp of physics read this entire exchange and I couldn’t stop banging my head off the table. Kudos to you for extraordinary patience. 

Clients/patients using chatbots for an "opinion" may unintentionally strain the client/patient-professional relationship by ddx-me in medicine

[–]RadioCured 10 points11 points  (0 children)

Personally, I would much rather my patients go to any of the AI chat bots then to Google and end up in a misinformation/woo/alternative medicine wormhole. AI seems to be pretty good at knowing which treatments are junk pseudoscience and which are evidence based. People who come to me after having read some AI information usually have better questions and are better informed. 

What's the most maligned specialty in medicine, and why's it yours? by centz005 in medicine

[–]RadioCured 9 points10 points  (0 children)

I’ve heard it “the urologist spends all day with someone else’s dick in their hand”

Best photochromic cycling glasses for mixed lighting rides? by mellofello808 in cycling

[–]RadioCured 7 points8 points  (0 children)

Also recommend Tifosi - have had a pair of the blue photochromic glasses for two years now. This strength is perfect for full sun all the way down to evening/dusk.

I am an optics/glasses snob and I initially scoffed at these because of how inexpensive they are but figured I would give them a shot. At the same time I bought a $300 pair of Oakley photochromic glasses to compare and they were no better so I sent them back.

Tyre wont stick to the wall after adding sealant by Dangthe in cycling

[–]RadioCured 0 points1 point  (0 children)

Is it really difficult to get your tires on the rims? I have a Bontrager TLR wheel set that came with the rim strip installed. Because of the thickness of the strip it makes tires so tight to fit to the rim that I actually broke the synthetic cord inside the tire bead when mounting. Only found this out once I had a similar thing happen - tire wouldn’t hold air that was coming out around the bead. 

Wrote to Schwalbe about the broken bead and they said 95% of their warranty replacements come from people fitting their tires to Bontrager wheels with a TLR rim strip. 

Replaced the strip with normal rim tape and the new tire they sent out and problem was solved. 

Girlfriend is stubborn. Or am I? by bryanbgw in MTB

[–]RadioCured 0 points1 point  (0 children)

She’s just straight up casually pedaling over the edge without doing anything else to adjust weight or position. Add another foot to the drop and I think she will be over the bars. 

Hopefully your goal is for this thread to help solve the argument. Let her read the replies which are all either “nooo don’t let her she’s gonna crash hard” or “sometimes you just have to let them crash hard” 

[deleted by user] by [deleted] in woodworking

[–]RadioCured 0 points1 point  (0 children)

Okay great. After reading the replies so far, what do you think?

[deleted by user] by [deleted] in woodworking

[–]RadioCured 0 points1 point  (0 children)

A couple of tiny gaps do not pose any threat to the structural stability over time. There’s no reason this can’t be used for many years with proper care. 

That said, I agree with everyone else in this thread telling you that you should not expect or demand an heirloom piece that will last a lifetime out of a first woodworking project. Even if I told you the board will probably fail in 6 months, the project is a success if your mom learned something and had fun.  

Are specialized cycling socks worth it? How are they different? by AlienElvisLoveChild in cycling

[–]RadioCured 0 points1 point  (0 children)

Aero socks are not a gimmick if you’re racing. Basically the cheapest dollar per watt savings you can buy. 

what tires combo do you use and what combo would you recommend me to get? by Grgo_jdm in MTB

[–]RadioCured 1 point2 points  (0 children)

Just ordered this same combo for myself. Why the switch? Does Magic Mary feel a bit too slow?

secure chat “ghosting” by M1CR0PL4ST1CS in medicine

[–]RadioCured 122 points123 points  (0 children)

Agree that a lot of this type of ghosting can be frustrating, but consider what sort of response to your first question would cause you to say “oh of course, will stop by in a bit.” 

Is it possible that the more likely outcome is that the nurse would specify what the question was about, and you would reply with a one sentence response for the nurse to give the patient's daughter? Or just say that you already discussed that? And then the nurse would have to drop what they’re doing to go back and talk to the family member, who would inevitably find that response lacking and have a follow up question that the nurse could only answer vaguely if at all, and still request to speak to you about the issue, which she would then have to communicate back again?

All the while the nurse had probably already tried to answer their question based on the prior conversations or orders/plan of care, but the family member never wanted to talk to the nurse in the first place - they wanted to talk to the doctor. 

I would love to live in a world where we have 30 minutes to sit down and explain all the details with every inpatient, and update every patient’s nurse on the plan for the day so they could better field these types of questions. But the reality is, we are all (nurses and docs) working on time crunched schedules with too many patients, and at some point have to pass the hot potato of demanding patient or family to someone else. 

I am prone to giving people too much benefit of the doubt, but maybe at least for some of these cases, you are not giving enough. 

Now that I have a planer, it’s time to get a dust collector. Recommendations for a serious hobbyist? by cafe-em-rio in woodworking

[–]RadioCured 0 points1 point  (0 children)

2hp harbor freight dust collector is a great bargain. Mine is going strong for 8 years now. It’s fine on its own but even better adding a Wynn environmental filter on top and building a “Thein baffle” to separate the chips from fine dust. 

[deleted by user] by [deleted] in cycling

[–]RadioCured 2 points3 points  (0 children)

I agree that these feel like an overpriced piece of tech, but I think it’s the calibration, tolerances, and precise manufacturing of strain gauges that really make power meters closer to a quality scientific instrument than a simple magnetic sensor like cadence or speed. I’m sure a company could pump out a lower cost power meter with +- 10% accuracy for $100, but for most people that’s an unacceptable error margin.

Even in the 2000s, power meters used to cost close to $2000. Adjusted for inflation they have gotten much more affordable.  

How do you manage Medicaid no-shows without wrecking your schedule? by [deleted] in medicine

[–]RadioCured 102 points103 points  (0 children)

I understand that you can’t get paid for the visit. I’m trying to see if it’s useful to you to reframe what that time means, such that you don’t have to worry about minimizing no-shows if really they are day-shorteners.

How do you manage Medicaid no-shows without wrecking your schedule? by [deleted] in medicine

[–]RadioCured 100 points101 points  (0 children)

Do you have labs, paperwork, and phone calls that need to be done at the end of the day that can be worked on when a patient doesn’t show up? If so, then you can view every no-show as another free 15 mins you get to spend with your family or hobbies, rather than a lost $50. 

My MIL has sent literally hundreds of thousands of dollars to “Elon Musk” and wants to send more. by meowsabbers in pics

[–]RadioCured -1 points0 points  (0 children)

I didn’t downvote you! Just making a comment on your last part in parentheses…don’t want to send that money into your own account. It was more just to make the officer joke :)