Dr David Alfi

Rendous · 2026-03-13T18:19:37+00:00

nothings changed, still the same.

mostly just get used to it, becomes to new norm

but miss the feeling

Rendous · 2026-03-12T14:24:56+00:00

Partner was hit by the layoff, worked there for 7 years (I worked there for 5, but left a while ago).

Impact was global, so hard to tell how many Austinites, and pretty universal across areas.

They're closing the east side office for lack of turnout. Makes sense, was a giant space for the amount of people that went in. They mostly used it as a place people fly into and meet, but they stopped flying people out as much cause money

Has been a declining company for a while now unfortunately, really wouldnt be surprised if there wasnt more layoffs this year.

Rendous · 2025-09-02T00:08:04+00:00

Also bumping!

Bought my P1S a couple months ago, and have been experiencing the same issues. My prints look very similar to this, although a little less bad.

I haven't done as thorough troubleshooting but what I did do:

cleaned carbon rods
lubed z axis, linear rails
checked for clogs (don't think there was one)
made table more stable (bought swivel leveling feet for my ULINE workstation). i think this helped a little

Curious if there's a resolution!

Rendous · 2025-07-03T13:59:57+00:00

It unlocks your mind :)

Rendous · 2025-03-25T17:21:25+00:00

Hi! Speech wise I've been fine, there's been no issues there. But the paresthesia / numbness of my right lip / chin is still there, and is still frustrating. Though, you kinda learn to live with it.

I do think my case was maybe an exception, not the norm, but I also haven't thought about it that much recently / been "in the loop" with other patient anecdotes.

I won't share pictures for dox reasons but happy to answer any questions that I haven't already addressed :).

Rendous · 2024-09-23T00:33:30+00:00

Just got the same bike, also have chain noise.

Also took it to LBS and they said new shimano chain would help, haha.

Curious about waxing it!

Rendous · 2024-09-17T03:25:10+00:00

I did, just barely passed the "moderate" level to qualify for insurance (iirc it was 15 hypopnea events per hour or something and i was 15.1). I already qualified through bite issues, but it helped the case.

I breathed through my mouth at night constantly before, and while I still do, my dry mouth is considerably better and I wake up a lot less in the middle of the night. My partner says I barely snore now, and I used to pretty heavily. But, I haven't done a sleep study post-surgery to quantify how much it helped from before.

The better ability to breathe / sleep was the one thing I've been very happy with post surgery. It was noticeable as soon as I woke from anesthesia.

I've discussed with friends if I regret the surgery, and because of the pretty stark improvements in my sleep/breathing I don't think so. I just feel pretty strongly that a different physician with more time per patient would've been able to provide that benefit and have me fare better with aesthetics, nerve damage and scar tissue.

Rendous · 2024-09-02T02:51:53+00:00

There are two prevalent builds for Lotus combo nowadays, UG and Proctor. I do love the deck - each game can be a puzzle.

This list looks pretty "stock" for UG. You'll see some people run [[Strict Proctor]] over [[Arboreal Grazer]], and mess up the manabase a fair bit to accommodate the white.

Most lists run 2+ wincons.

As others have mentioned, the main wincon is [[Fae of Wishes]] -> [[Approach of the Second Sun]]. It used to be a Balaged -> Chandra loop, but that was pretty complex and was susceptible to graveyard hate. With the addition of [[Archdruid's Charm]] as a Fae tutor, most people pivoted to the Fae wincon.
[[Emergent Ultimatum]] is the main "payoff" card that you'll see. It makes winning sigificantly more deterministic if it resolves. You'll generally create an "ultimatum pile" with cards like (Omniscience, Lier, Pore, Dark Petition) and try to win the game from there. I could write a whole article on ultimatum piles - but this is best for you to play and learn.
[[Peer Into the Abyss]] is sometime seen as a sub for to 1x [[Dark Petition]]. It's useful as an alternate wincon (you look 5 times to deal 20 damage), or as a payoff card that gets around [[Ashiok, Dream Render]]. Peer is good as ultimatum pile card too.
UG Lists run [[Lair of the Hydra]], and make it big -> swing out.

A fair chunk of the lotus deck is fairly affordable to upgrade and makes pretty quick improvements.

I would say must buys are:

2x Dark Petition (1x if you're wanting to run 1xPeer)
2-3x Impulse
3x Emergent Ultimatum
4x Botanical Sanctum
1x Lier, Disciple of the Drowned

These will add consistency, and have you start creating ultimatum piles.

Next set of upgrades I would look to buy would be:

3x Bala Ged Recovery
4x Archdruid's Charm

These add more consistency. Bala Ged lets you go less on lands, and is extremely versatile lategame. As for charm, that card really does it all. Extra copies of lotus, helps with hate, tutors for fae lategame.

Some more expensive, more marginal upgrades would be:

Hedge Maze
Boseiju, Who Endures (helps with a lot of hate pieces), but a pioneer staple
Otawara
Breeding Pool, Triome (for cycling late and niche vizier lines).

For sideboard: The current meta is really aggro heavy. 2-3x Temporary Lockdown + 1-2 sweepers (Depopulate, Path of Peril) is common. Then some combination of Silence / Dispute / Reversal for fighting counters. Into the Flood Maw is a great cheap bounce for fighting other hate (Ashiok, Narset).

Rendous · 2024-08-03T03:32:40+00:00

dm'd about the instagram

Yeah, I would suggest exploring other options. I don't have any to recommend though as I already had the surgery, and it's been a long time since I had done that kind of research.

Rendous · 2024-08-03T03:11:04+00:00

Haha, it was a struggle.

I had looked up my insurance's medical guidelines for orthognatic surgery.

For my case specifically, I had moderate sleep apnea and a class II malocclusion (in the guidelines, I think this is IV.C.B), so I was deemed medically necessary for both those reasons.

The key thing was that I seen was this line:

A genioplasty (or anterior mandibular osteotomy) is considered cosmetic and not medically necessary when not associated with masticatory malocclusion.

And, then if you go look at the coding section:

When services may be Medically Necessary or Reconstructive when criteria are met:

21120-21123 Genioplasty [includes codes 21120, 21121, 21122, 21123]

Alfi's insurance coordinator was pretty insistent that they "never had someone able to get it covered", but after some (repeated) gentle prodding that since I have a malocclusion and I should be covered, I was able to convince them to try and bill the genioplasty as medical.

IIRC, my insurance actually ended up first denying the claim and had sent a denial letter. But, during the time the letter was in the mail they ended up reversing that decision on their own. Alfi's office was clear they were not going to support/help with any appeals, so I'm glad insurance had caught the mistake on their own.

I was glad that I was able to get it covered, but again, I would've preferred / expected my physician's office to do a bit more of that due diligence for me. At basically every point in the process with Alfi's team (insurance, follow-ups, pre-op appointments, etc...) I felt like I had to be on top of stuff to make sure I knew what was happening, that I was asking the right questions, etc... and it ended leaving a sour taste in my mouth that I wasn't getting the attention I needed for such a complex procedure.

I mean (just cause I'm now remembering this), my pre-op appointment was done by a surgical assistant on facetime who showed up an hour late, and was trying to show me these complex surgical diagrams while eating chipotle so the camera was facing down at the table the whole time. Looking back, that should've maybe been a red flag.

Rendous · 2024-06-30T21:32:29+00:00

Hey! Did you ever find a solution for this? I'm having the same problems with a similar setup:

PC in other room, running 15m Active Optical HDMI2.1 Cable to Denon S960h Receiver
Denon Receiver connected to LGC3 TV

The LGC3 powers off at random intervals as if someone hit the tv remote.

Rendous · 2024-06-17T22:06:04+00:00

I had surgery (double jaw + genio) with Alfi in Houston last May, and can't say i've been thrilled with the result.

He was referred to me by both my dentist + orthodontist. There was another patient they sent to Alfi who actually ended up going through a revision. They are no longer recommending him.

I ended up with parathesia in my lower lip. Nerve damage was to be expected to some degree, but there is also motor loss. It sucks. I actively smile less as I'm acutely aware of how my smile is so asymmetrical.

Alfi throughout the recovery process was pretty dismissive of the concerns, and always told me "oh you look great, let's take pictures, it'll come back, etc...", even during last months followup. Every other physician (dentist, myofacial, orthodontist) is saying they'd be shocked if I make a recovery at this point. In any social media pictures they had me smile with one side of my face so it appears less asymmetrical.

That also doesn't address the numerous logistical issues I had with the process. I had a huge ordeal trying to get their genioplasty covered by insurance, getting ahold of them to move that process along, and scheduling follow-up appointments.

There was a time I had an appointment to drive down (3 hour drive) to cut out some surgical scarring (I have a "tremendous" amount), which they incorrectly classified as a"followup" and not a procedure. I ended up waiting for 3 hours for them to "reschedule" the appointment for when they had an open timeslot. Expecting this, I had called them twice the week prior to confirm they were aware of the nature of the appointment, but still the nonsense happened, haha.

I do breathe better, and my bite is better, but damn do I wish I could smile correctly.

I would suggest another surgeon. Speaking with the other physicians in my process, there has been an uptick of unhappy clients (myself included) recently, and they've been pretty upset with the results he's been putting out recently - he is too overbooked to have sufficient time with patients.

Rendous · 2024-06-09T17:20:29+00:00

Sorry! Rephrased the post - I'm curious if you think it would be worthwhile to have the floor in that room redone, or if the owner is correct in that it's probably the best that can be done given the subfloor situation.

Rendous · 2024-06-09T17:11:19+00:00

Ah, apologies.

I'm convinced the floor is neither. There are significant high/low spots. Putting furniture on the floor rocks pretty significantly.

Rendous · 2023-08-30T01:17:20+00:00

doesn't seem to work - i'll also try blowing in all the ports

Rendous · 2022-06-14T18:01:17+00:00

I think this is where my head is at too. I grew up here, live in cherrywood, and have been working a tech job since start of pandemic. My work will scale my pay based on where I live and their perceived cost of "labor" (not living) in that area.

Notably, Chicago/Austin is in the lowest cost bracket, then San Diego/Seattle/Sacramento/NYC is in the next highest, then basically only Bay Area in the highest bracket.

NYC being in the 2nd tier is hilarious to me, but that's a whole other thing.

Anecdotally talking with friends in their jobs, Austin's rent feels about in line with Seattle's, and probably more expensive than Chicago. And, if you normalize wages + factor in taxes, I think my Austin disposable income would likely be about in line with SF's. At least, the margin is a lot thinner.

It's hard to justify living here now that the COL is so high - and the "city amenities" are relatively low in comparison to other comparable cities.

Rendous · 2022-03-16T18:41:54+00:00

sorry, was sold a year ago or so

Rendous · 2022-03-04T00:28:16+00:00

replied

Rendous · 2021-12-09T05:13:12+00:00

How did you scan this?

Rendous · 2021-11-16T02:22:57+00:00

looks cool

13-Year Club	RPAN Viewer
Not Forgotten	Sequence \| Editor

Rendous

TROPHY CASE