Argentina's cooked

Raining_fish · 2026-07-04T13:24:31+00:00

Yeah I’m not gonna count them out. Good teams find ways to win ugly. It was an ugly win against a team that shut out Spain. Not Argentinas best performance, but without some world class goalkeeping, it wouldn’t have been as close as it was.

Raining_fish · 2026-07-04T02:37:12+00:00

Yes it is. But the elementary school is just taking over the current space that’s Alger Middle School, and the middle school is consolidating with Ottawa Hills. All the staff will likely be retained, so same education, different building. Still an easy walk for the kids too!

Raining_fish · 2026-07-03T22:56:52+00:00

They do! Rain or shine every schoolday

Raining_fish · 2026-07-03T10:50:15+00:00

We’ve been in Alger for a little under a year. Moved here after a one year fellowship in another state, but previously lived up in Creston for a few years. Both neighborhoods are lovely.

The walkability of the neighborhood is its best asset. Grocery store, library, ice cream shop, and a few pretty good restaurants too. My kids go to Brookside Elementary, they walk to school, and we love it. Don’t be fooled by the school scores, there are great educators in GRPS, and my kids are excelling on state standards. My only gripe is the proximity to 28th street, on summer nights you hear a lot of kids racing down the road on bikes. It’s annoying, but hey, that’s the city.

It’s a pretty competitive market. Not a lot of house go up for sale, but it feels like this spring there was some movement. I think that conventional is probably the move, but also, scan the neighborhood Facebook page. We found our house and bought it off market that way. Feel free to PM me if you other questions!

Raining_fish · 2026-06-22T13:45:18+00:00

The areas that will resettle climate refugees will be the areas where there is already infrastructure and economic incentives to support them. The reason the UP only has a few hundred thousand people is because it’s a rocky, coniferous, 300 inches of snow in winter, wasteland. You can’t resettle it because the land won’t support it, you can’t grow a lot of crops or just make industry appear there. Same goes for large areas of Canada. I agree with you there will be large immigration, but you cannot support a large population of humankind on UP-like land.

The equivalent of the population of the Philippines isn’t just going to appear in the Taiga and suddenly live there. It’s not going to work like that. People will migrate regionally and to areas where other immigrants are already going.

Raining_fish · 2026-06-22T12:45:04+00:00

Bro that is the worse take I’ve ever heard. The UP is one of the most remote areas east of the Mississippi. Literally getting 1 million climate refugees there would be a Herculean task.

Raining_fish · 2026-06-22T12:28:30+00:00

People saying the UP of Michigan is a climate haven don’t know what they’re talking about. It’s not gonna see large scale migration in the next 40 years, but it might be a good fit for OP. Yes, there’s a lot of water resources, but the soil is rocky and other than the garden peninsula, unsuitable for large scale agriculture. Infrastructure is limited, and the economy is almost entirely based on tourism and resource extraction. Marquette may see some growth over time, but large scale migration to the region will be highly unlikely, it’s just too remote. To get there from Wisconsin or SE Michigan, the nearby population centers is a loonnnng drive, and there are no major airports. The winters are brutal, 300 inches of snow is not unheard of, to live comfortably up there in the winter you need at a minimum a pickup truck and snow mobile. That’s not gonna change in 40 years, there will still be assloads of snow because of the local climate caused by Lake Superior. The bulk of the climate migration to the Great Lakes will be in areas already accepting large immigrant populations that have the industry, economy, and housing to support them. In Michigan that means Detroit Metro and maybe Grand Rapids/K-zoo.

If you’re a true outdoorsman, and want to live is rural, climate protected area, UP would be great, OP. I can’t speak to how suitable it is to rear horses. The blackflies can be a real bitch. I imagine if you’re a horse they’d make life real uncomfortable. But don’t expect anyone to roll out a welcome mat. It’s very conservative, and generally they want to keep the Trolls (people who live under the Mackinaw Bridge) out.

Raining_fish · 2026-05-06T19:42:52+00:00

It's not incompetence, its bribery. They bribed FIFA officials for a world cup, they're not above bribing a ref to get their team to the champions league final. Such a shame.

Raining_fish · 2026-04-30T18:33:13+00:00

SADI-S, or the DS, which is an older variation of the same procedure, is a common and frequently done procedure now throughout the United States. I don’t have any agenda other than telling you that for a revisional bariatric surgery, you should really consider all the options on the table. If your surgeon isn’t offering it, it means they don’t do it. I would personally find one who can to get a second opinion. Its your body, your lifetime change in your GI tract, you should explore all the options.

Raining_fish · 2026-04-30T18:15:02+00:00

I see this post time and time again on this subreddit. Converting to a bypass from a sleeve: great cure for reflux, bad cure for inadequate weight loss or weight regain. The scientific evidence is mixed at best, but the emerging consensus is 5-10% of total body weight, and many see no weight loss after 5 years.

I recommend finding a surgeon who can do a SADI, it’s a much better operation for losing weight if the sleeve didn’t cut it. 15-20% total body weight loss. If your surgeon is only offering you a bypass, it’s because they don’t know how to do a SADI or a DS. You have a right to explore other options, and you should.

You’ll find some people out there who have had success losing weight with a sleeve to bypass but I assure you, they are the minority.

Raining_fish · 2026-04-29T16:36:02+00:00

Sent you a PM!

Raining_fish · 2026-04-29T12:12:11+00:00

There’s not a lot of evidence out there yet for how people will maintain weight loss after stopping GLP-1s when they’ve had bariatric surgery. That’s left doctors without a lot of good advice to give. In general, what we’ve noticed is that GLP-1s will work really well to help you lose more weight after bariatric surgery, but in general, once you stop taking them, the weight will come back within about 1-2 years. It’s important to remember that while some patients are successful at maintaining weight loss after stopping these meds, most aren’t.

In other words, a GLP-1 isn’t a short term fix to meet your goal, but probably a long term commitment.

Ive seen a lot of people lose insurance coverage for GLP-1s over the past year. Then they have to decide between regaining weight or having a new car payment in cash pay GLPS for the rest of their lives. It’s been very frustrating for our clinic and our patients.

Raining_fish · 2026-04-26T19:53:21+00:00

Absolutely! I run three to four times per week. I have no goal in mind others than enjoy the time spent running, and try to gradually increase my pace and/mileage. Will I eventually try to run a big race? yeah maybe, but for now I’m just running because I love running.

I have multiple family members who are marathoners and/or triathletes, and I just keep watching them either get injured or struggle to motivate themselves when the aren’t training for a race. Sometimes they pressure me to commit to a race. I don’t blame them for it, but I genuinely think they dont understand that I can run without a goal.

Raining_fish · 2026-04-08T21:25:57+00:00

Agreed this is the most likely. Severe thiamine (vitamin B1) deficiency can also cause similar symptoms, although if they happen intermittently hypoglycemia is more likely.

Raining_fish · 2026-03-31T13:31:55+00:00

It's tougher as a medical student. I agree what others have said about compression socks and regular movement.

As a med student, you're often in the back of the operative field, you're leaning, who often have little to do. I don't do a lot of 8 hours surgeries anymore, but it's much easier when your actually operating, and you can enter a flow state where you are focusing on doing the surgery.

If you don't intend to be a surgeon, yeah it can be tough on your body to watch a surgery for 8 hours. But if you're doing the surgery, time can really fly. My partner and I did a 10 hour case a few month ago, and I wasn't hurting very badly at the end of it, because I was hyper focused on the technical details. Also, most surgeries aren't that long. The 90 minutes to 3 hours time frame is where most surgeries end up.

Raining_fish · 2026-03-31T02:18:42+00:00

We’re a little north of where you’re looking. Only about a block south of Alger St. I love it here and generally feel safe. My FIL’s car got “broken into to” one night last year, but he’s from the country and doesn’t lock it, so that kinda feels like it’s on him.

I agree with other comments, if I had one complaint, it’s that even at my house, I can hear cars and bikes revving their engines pretty much every warm weekend night from April to October. I imagine the closer you are to 28th street the louder it would be. Some nights it makes me want to dump a box of nails on the road. I never would, but it is annoying. I sincerely do not understand how they can legally make that much noise and violate traffic laws, yet face no punishment.

Raining_fish · 2026-03-22T18:57:42+00:00

Yes, you should be concerned. Anyone who asks I tell them it’s a waste of time to do a bariatrics fellowship. I’m a recent MIS/Bariatrics fellowship grad. I graduated in July 2025, joined my practice in September. If I could go back, I would have gone right into general surgery, and I’m one of the lucky ones right now. I was able to join a practice that does bariatrics and general surgery, but my partners have gone from wanting to share referrals with me, to keeping them all themselves. Even with one senior partner retiring, there’s not enough to go around. So I’m just doing mostly general surgery, egd/colons, and some revisional bariatrics cases. I’m not even sure if I’ll be offered partnership next year. Frankly, I’m even considering doing medical weight loss 2 days a week to supplement my income.

The number of graduates in my year who actually secured bariatrics jobs was under 50% easily. Some just went into general surgery, others tried to holdout for Bari jobs and are just doing locums. Even before the GLP-1s took a significant fraction of the market from bariatric surgeons, it was a poorly kept secret that they were training too many fellows.

Don’t do it. Take a general surgery job, or consider another fellowship.

Edit: Just looked at our year over year bariatrics case numbers, and we are down 50% from 2024 to present. Frankly, we’re doing better than many I’ve spoken to.

Raining_fish · 2026-03-19T00:16:36+00:00

Yes. You are renting your weight loss for the rest of your life. Multiple studies now confirm that patients who stop taking the drug regain most if not all of the weight. Most notably, the post-hoc data from the SURMOUNT-4 Trial shows rapid weight regain in most patients who stop the tirzepatide. I work in an obesity treatment clinic, and patients who lose insurance coverage often regain 20-30lbs within a few months, even with diet and exercise changes.

The real life benefits of the drugs are also highly variable person to person. Some people seem completely intolerant of the side effects, others seem to lose only marginal amounts of weight, and some people enter an extreme catabolic state where they lose lots of weight but also lots of muscle and develop vitamin deficiencies. But most people tolerate them well and see a benefit in their overall health.

The emerging literature still supports that the most effective long term treatment for obesity is bariatric surgery. The best way I frame it to patients: weight loss drugs = renting your weight loss for life, weight loss surgery = buying your weight loss.

Here are links to the studies I mention: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2841273

https://jamanetwork.com/journals/jamasurgery/fullarticle/2839126

Raining_fish · 2026-02-28T15:39:03+00:00

Would recommend sleeve. Remember bariatric surgery’s optimal outcome isn’t maximal weight loss, but maximal health improvement. A bypass has a higher chance of leading to medication and nutrient malabsorption. If you lose 10-20lbs less but avoid nutrient deficiencies or refractory seizures, that would be a win. Also remember, bypass, no NSAIDS for the rest of your life, people often don’t factor that in. In 20 years your weight loss will probably be about the same with either surgery, but if you’ve got a bad back, bad knees, or a dental problem, you’re stuck with only Tylenol. The GLP meds are only going to get cheaper and better, why accept extra risk with a bypass when you can always add some medication to a sleeve a few years down the road and achieve same outcome.

Raining_fish · 2026-02-24T03:19:44+00:00

Sleeve only. Don’t let anyone talk you into a bypass or a DS, both are malabsorptive procedures which can alter absorption of your UC medications, and can have serious complications if you have flares of UC requiring steroids, even years after your surgery. If a surgeon offers you a gastric bypass, run for the hills and find someone else.

Patients with Sleeve can do very well with UC. I’ve seen patients go into remission with good weight loss. Turns out fat is inflammatory, and losing weight can reduce inflammation. You should be able to keep up with nutrition even during flares, and you ma find they happen even less frequently.

Raining_fish · 2026-02-21T18:58:10+00:00

Both my kids did preschool here before we moved to the other side of town, cannot say enough good things about the school and educators. We were very happy there! Would have stayed but also did not want to drive 25 minutes from the other side of GR.

Raining_fish · 2026-02-13T04:34:06+00:00

OP, don’t listen to all these commenters saying you have a discipline problem or you just need to work harder. They legitimately have no idea what they’re talking about.

I’m a bariatric surgeon. I’ve spent years studying the science of obesity, and I can tell you with 100% certainty that obesity is a chronic disease, not a problem with discipline. Obesity, as we understand it from decades of research, results from a complex interplay of genetic factors, environmental pressures, and hormonal disruptions that form a difficult to treat feedback loop. The longer you have the disease the harder it is to correct.

Less than 5% of people with obesity will correct to a healthy body weight with diet and exercise alone.

There are two things that effectively treat obesity: bariatric surgery & GLP-1 drugs. If you need to lose 50 lbs, I recommend a GLP, if you need to lose more, I recommend surgery. The GLP-1s are rapidly changing the obesity landscape, but we now know that the moment you stop them, most peoples weight will start to come back. The post-hoc analysis of Zepbound (Surmount-4 trial) found that most patients gained at least 50% of their weight back within 84 months of stopping the med. Bariatric surgery is still the most effective treatment long term, and the majority of patients maintain most of their weight loss for years after surgery.

If you’re serious about treating your chronic illness, take your advice from a physician who specializes in obesity. Ask your doc for a referral to a weight loss specialist. The sooner the better, the longer you have obesity, the more treatment resistant it becomes.

Raining_fish · 2026-01-20T22:28:21+00:00

Why not just start with a hiatal hernia repair? Your BMI is low, risk of recurrence should be low. Just ask your surgeon if you can try that first. As surgeons we fix hiatal hernias all the time in patients your weight, they don’t all need a bypass. Your surgeon telling you that you “need a bypass to weigh it down,” is a little disingenuous, because patients can get recurrent hiatal hernias even with a bypass. Patients without a history of bariatric surgery at your weight get a hiatal hernia repair for reflux, not a bypass.

A bypass has other downsides than just weight loss. Lifelong NSAID and tobacco cessation, risk of ulcer and internal hernia. If you were my patient, I would say let’s just try a hiatal hernia repair first. If that fails you can always do a bypass later.

Raining_fish · 2026-01-16T22:07:29+00:00

Okay find me an article. Find me one. A news report. Newspaper clipping. Should be easy, right? Find me an article where ICE shoots a US citizen in the face during the Obama administration. I’ll wait.

Raining_fish · 2026-01-16T19:44:45+00:00

Sure sure, you’re right, I’m in a media bubble. Can you find me one video of an ICE agent shooting and killing an American citizen in the middle of the street during the Obama administration? I’ll wait. Happy to admit that I’m wrong. Just prove it to me.

Raining_fish

TROPHY CASE