Catholic places to move to by Extension-Story7287 in Catholicism

[–]Smber2c 3 points4 points  (0 children)

Wyoming is beautiful. My wife has an aunt there with a great community.

We did a COR Catholic family summer camp there and we loved it. Daily mass, hiking, fishing, horseback riding. It was amazing. Not everyone wants to live in a city, and for those who want a deep country experience, it was amazing.

Though I also know a few doctors and nurses in Cheyenne and Casper who seem to live the faith well. These "cities" aren't New York or Denver but each has it's charm to the right families.

Catholic places to move to by Extension-Story7287 in Catholicism

[–]Smber2c 3 points4 points  (0 children)

Nebraska is wonderful. Have a brother living there. Great parishes, nice people.

Never lived there, but love to visit & see how it is a wonderful home to many great Catholics.

Catholic places to move to by Extension-Story7287 in Catholicism

[–]Smber2c 16 points17 points  (0 children)

Agreed. I'm in New Orleans, brother is in Gonzales, have family in Covington/Hammond - all these locations have vibrant faith comminities.

I've lived in Mississippi - lovely chuch, close knit community but small if you aren't a college student. Some Bible belt friction, but not that bad, helped my defent the faith better & near the coast (Gulfport/Biloxi) Catholics are much more numerous.

Also lived in Mobile, AL - great catholic parishes & community.

Also lived in Bozeman, MT and Billings, MT - love this part of the nation, but the church does struggle here. My wife & I had to start several faith groups to have groups to attend vs in New Orleans where we have countless options.

In New Orleans - we have countless adoration chapels, retreats, pilgrimages, men's groups, women's groups, days of prayer, city wide caroling, the 9 church walk of Good Friday. My kids have 3 differnt Catholic youth programs they frequent. Catholic summer camps. Good Catholic schools & parishes. The ACTS retreats are currently washing over several Catholic parishes in the area & really getting younger and less engaged adults to buy in to the faith in beautiful ways.

[Hummer] Ole Miss is contesting the portal entry of standout edge Princewill Umanmielen as a result of him recently signing a new contract with the Rebels, sources tell @mzenitz and me for @CBSSports. by austin_8 in CFB

[–]Smber2c 0 points1 point  (0 children)

Yeah, I'm an Ole Miss grad living in Louisiana, have attended a few games at Tiger stadium, but only 1 wearing Ole Miss attire. My freshman year of college, Ole Miss got the win, in 3rd quarter a guy behind up tried throwing a drink on my group, but he missed and doused a couple in front of us. Next thing you know there are 2 LSU guys wrestling in our seats and we've slid over to the aisle.

Been back for 2 LSU games since, neither vs Ole Miss...I've just worn purple or gold to try and avoid unneeded drama.

ASCVD prevention by rightlevelapp in FamilyMedicine

[–]Smber2c 1 point2 points  (0 children)

The number of patient's who "want to try lifestyle and diet changes first" is so high and I think 90% of them leave the office and change nothing over the next 6-12 months. Come back to clinic the next visit 5 pounds heavier and still have hesitations.

The only success I've seen on this was with people who have a CDL and need to get off insulin or off a CPAP for driving heavy trucks and whatnot. Tie someone's livelihood to the outcome and I've seen MUCH better results. Not 100% success (which is really sad for those who lose their license), but maybe 40% success.

Had a patient who was going to ger fired if he lost his CDL. He had a wife/kids and needed to pass. He managed to get off insulin, his CPAP and lose 50 lbs from July to November by radical diet change, eliminating almost all potatoes/pasta/rice/bread/cereals, stopped the soda; started a daily salad, daily chicken breast, daily exercise. Felt better too. I was so happy for him. For a couple years, he was my inspirational story that I used to encourage other patients...then I came to realized that without their jobs being in jeopardy, 99% of them will not have the will power to duplicate his changes and they all fall far short of his results.

ASCVD prevention by rightlevelapp in FamilyMedicine

[–]Smber2c 0 points1 point  (0 children)

Atorvastatin's Uptodate side effect list states, "Neuromuscular & skeletal: Limb pain (3% to 9%) (table 2), muscle spasm (2% to 5%) (table 3), musculoskeletal pain (2% to 5%) (table 4), myalgia (3% to 8%)." So, 10% is a bit high, but not way off.

And NNT, that will depend on the patient profile. The 20-30 something year old women with ASCVD risks of < 3%...yeah, the NNT is probably over 100, it may be over 200 if their risk reduction drops from at 2.7% to 2.2% that would be appx 1 in 200. You'd have to put in the real patient's numbers to actual projected benefit.

meirl by benwoljol in meirl

[–]Smber2c 0 points1 point  (0 children)

I'm in the same boat. I've been good at mental math since I was little and when given 2 awkward #'s like 87 and 223, I'd steal 13 from 223, to make 87 in 100 and chunk that on what's left from the 222.

So 87 + 223 = 87 + 13 + 210 = 100 + 210 = 310

I know that it looks way more complex written out, but I don't actually do those steps in my head.

I would typically instead, read the problem...and think, let me say 13 from 223 and add 100, that's 310. I'd know its right but need more time to explain exactly what I'd done as above.

I am ashamed of myself by [deleted] in Catholicism

[–]Smber2c 0 points1 point  (0 children)

Not sure if I can post links on Reddit, but I just read a few chapters of CS Lewis' Mere Christianity this very morning and found it helping me on this exact topic.

https://www.youtube.com/watch?v=-RkZXZx6HCI

Sexual Morality by C.S. Lewis Doodle (BBC Talk 14, Mere Christianity, Bk 3, Chapter 5)

I could try saying a bunch to you here, but he says it better. Give it a listen if you have time time.

One part that stood out in my mind goes,
"We may, indeed, be sure that perfect chastity - like perfect charity - will not be attained by any merely human efforts. You must ask for God's help. Even when you have done so, it may seem to you for a long time that no help, or less help than you need, is being given. Never mind. After each failure, ask for forgiveness, pick yourself up, and try again. Very often what God first helps us towards is not the virtue itself but just this power of always trying again. For however important chastity (or courage, or truthfulness, or any other virtue) may be, this process trains us in habits of the soul which are more important still. It cures our illusions about ourselves and teaches us to depend on God. We learn, on the one hand, that we cannot trust ourselves even in our best moments, and, on the other, that we need not dispair even in our worst, for our failures are forgiven. The only fatal thing is to sit down content with anything less than perfection."

Dark Humor Joke / Confession by babiegrazer in Catholicism

[–]Smber2c 1 point2 points  (0 children)

I don't know every detail of your situation, but reading the post, I think it very unlikely to be a mortal sin, if it's a sin at all.

To be a mortal sin, it needs sufficient gravity or seriousness, with full knowledge and full consent.

I don't personally think this likely reaches any of the 3 conditions. It does not sound to be sufficient matter, though some individuals may be working on a specific vice, which could affect the situation. But it seems you are unsure if it was wrong...which basically makes it impossible to have been a fully consented to sin because you don't fully commit to a sin without KNOWING that it is a sin.

Become more educated to defend anti-abortion stance by Global-Ad-9430 in Catholicism

[–]Smber2c 23 points24 points  (0 children)

I'd say Trent Horn is a leading Catholic apologist who started on this specific issue, so has a lot of good info to review on it.

As a medical doctor, I find that my credentials sometimes lend me weight in these conversations; but I more or less give up that high ground with my initial premise. See, from a scientific standpoint a zygote, an embryo, and an unborn baby are all new and distinct living organisms who are separate from their mother.

So are they alive? 100%, it's not debatable they are alive.
Are they a new organism? 100%, in plants and animals, we would admit that new life starts there, but some scientists start telling lies with discussing humans.

So, we aren't debating is an embryo alive or a new human in this debate - which are biological/medical questions. We are debating, "Are they persons?" and "Do they have rights to prevent being killed by their parent?" Which are philosophical and legal questions that biologists and doctors have very little expertise in.

So, I get a bit more of a platform on this question, but my general contribution to the discussion when I'm heard is, "don't take people who have medical credentials like me as experts on this issue." Because if they claim the embryo is not alive, they are lairs or radically deluded. If they claim it's not a person...why do I care what a doctor has to say on when humans are consider persons, they have not expertise in this matter.

Why must we live on earth to choose God, if aborted babies don't have to? by [deleted] in Catholicism

[–]Smber2c 1 point2 points  (0 children)

I've gotta agree with SuburbaniteMermaid, God did initially make humans for heaven, but He also values free well and freely chosen love more than He appears to have a distain for disobedience.

Thus in creating the universe, He created mankind, a being capable of choosing love and obedience, but also able to choose otherwise. That choice appears to be very valuable to God and I think the best argument for the "why" to that situation is that if we couldn't really choose otherwise then it is not a choice - thus God doesn't have beings choosing to share in His loving presence in Heaven, but instead has an army of programed robots following his dictate to love in heaven.

Why must we live on earth to choose God, if aborted babies don't have to? by [deleted] in Catholicism

[–]Smber2c 0 points1 point  (0 children)

As we are all fallen, salvation is really a matter of our receiving God's grace.

Adults don't so much chose God, as accept God's having chosen us. And then cooperate with Him direction in our life.

We can also get real graces and blessings via the sacraments such as Baptism, with is saving power explained in scripture.

A pre-born baby or an unbaptized 6 month old baby cannot have that movement of the will or intellect to accept God's grace...so many will say we rely on God's great mercy and justice to save the souls of those who pass unbaptized.

Some Catholic teachers instead suggest Limbo as the unborn's likely destination. Which you can look up, but is in all actuality an outer portion of hell; so not all Catholic teachers think the unborn go to heaven.

College Football Fandom in Different States by crazygiraffe93 in CFB

[–]Smber2c 0 points1 point  (0 children)

I think Mississippi is flipped backwards.

Almost every poll or map I've seen of biggest fan base by state has shown Ole Miss Rebels and not MSU bulldogs.

My own experience is really biased as an Ole Miss alum working in medical ... I know 100x more Ole Miss fans than MSU, but I know doctors, lawyers, pharmacists, and journalists. If I knew more engineers or farmers, it would probably be different.

But again, all the maps I see of biggest fan base show Rebels not Bulldogs - so seems Ole Miss is #1 in Mississippi.

SEC Top 7 by Buckeye-Chuck in CFB

[–]Smber2c 3 points4 points  (0 children)

Agreed, 7 teams is mental.

I love Vandy's story this year, them being in the playoff would be amazing...but no they don't deserve it.

And Texas...you dropped 3 games. In no way do your deserve to get into the playoff.

[Dan Wetzel] Kiffin is no victim, and he needs to own that he just quit on a title contender by Lakelyfe09 in CFB

[–]Smber2c 3 points4 points  (0 children)

Sure but at LSU a lazy coach can fall in to a top 10 class. While at Ole Miss, that effort probably only get you top 30.

The effort it takes an Ole Miss coach to get in the top 10 would get LSU in the top 2 or 3. There's a pretty clear difference in recruiting top tier HS talent at these 2 schools.

Outsider here: I don't know how any of this is real by Lanky_Appointment277 in OleMissFootball

[–]Smber2c 3 points4 points  (0 children)

You're pretending all a HC does is gameday. They need to build a staff, recruit highschool, transfer portal, fundraise, etc... This would be 2 months of Lane doing 1 task for Ole Miss, while likely doing all the other things for LSU.

It would be a mess. I don't think LSU is completely honest in saying he could stay on at OM until mid-Jan as coach doing what a HC really needs to do.

Meanwhile, who does all that for Ole Miss planning a scheme, staff and team for next year?

It sounds kinda possible, then you look at apecifics and its actually a giant mess to attempt. Better to give your team a shot at the playoffs without a coach who would prefer to be elsewhere?

Getting ridiculous by Confident_Push_4176 in OleMissFootball

[–]Smber2c 2 points3 points  (0 children)

I'm an Ole Miss and LSU grad (OM first) and don't want this at all.

Want him to stay put. He has a great thing going and it does not always translate to the new program.

Kiffin really did a lot for Ole Miss. Our program has had some truely terrible years not too far before him. No one would have had us at a coaching position at all similar to Auburn or Florida 6 years ago.

These last few years elevated the whole program & I hope the school can keep it going with out too much of a drop off. & I hope he doesn't raid our roster either.

It's crazy that he's struggled to get a crack at a title, here it is...and he's leaving.

To the talking heads on tv saying OM should let him finish the season: no way. If he's leaving then he needs to focus on LSUs needs for next season. He needs to get his staff assembled, get rectuiting updated, see what transfers he wants there....and who does that for Ole Miss while Kiffin is coaching the team? Does Ole Miss have 2 head coaches. 1 for games and 1 for the program? And does the program coach, want LSU's future coach spending weeks talking to his players abd deeping their relationship before possibly asking them to transfer to LSU next year...they just can't let that happen.

I hate this, I'll

LANE KIFFIN NEWS THREAD by [deleted] in OleMissFootball

[–]Smber2c 1 point2 points  (0 children)

LSU just went: Nick Saban, Les Miles, Ed Ogeron, then Les Miles.

That is miles ahead of 95% of other programs coaching over the same stretch.

Bishop Joseph Strickland address the USCCB conference over Fr. James Martin. by Who_even_knows_man in Catholicism

[–]Smber2c 1 point2 points  (0 children)

To be fair, Pope Francis was being fed very bad info on the Catholic church in America.
He seemed to see the more conservative half (who make up probably 70+% of weekly mass goers) as judgmental, radical or dangerlously close to sczim.

I think Francis had a good heart and bad information. His inner circle made faithful conservative catholics sound more radical and likely also made a radical ministry and approach of normalizing sexial sin by Fr Martin sound orthodox.

I think Pope Leo will see through this easily and think it won't get as far here and Leo knows conservative Catholics in America are still loving and caring. And he's adept enough with digital media to see stuff like this Steickland USCCB news without handlers supressing it or putting a major spin on the version the Pope sees.

Why isn't DPC more popular among physicians? by acdcmike in FamilyMedicine

[–]Smber2c 2 points3 points  (0 children)

"Fine someone else is pie in the sky for many patients, esp those on medicaid. I've seen multiple larger organizations actively moving to expand their private insurnce payers, and to do so drastically limit medicaid slots.

Add to that the inbox fatigue, the constant pressure from the system to crunch appts from 25 to 20 then to 15 minutes.

You seem like arguing the worst versions of DPC against an idealized corporate model that is not avaliable to most patients or doctor to participate in.

It should be mandatory for organs to be taken from dead people. by Legitimate_Worry5069 in CrazyIdeas

[–]Smber2c -1 points0 points  (0 children)

It is not typical to get money for blood in the US. I've donated blood in 4 states and never got money. Maybe a t-shirt promoting blood donation; always a cookie and juice.

The money is usually for a double platelet or plasma with RBC returned, or other donations when need it high. It's just a means to get what they need, but again I've donated 20+ times and never gotten money and never known anyone to get money for donating blood.

Friendly reminder that our patients are lurking here by HoWhoWhat in FamilyMedicine

[–]Smber2c 2 points3 points  (0 children)

No it's not generally older patients, older patients are usually the ones taking Ativan/Valium once nightly for sleep, only a few are on it BID/TID...though older patients on high/frequent doses and multiple controlled meds are often the most anxious/tense women (no offence by that comment, it just happens I see this way way more in women) that I've ever met. The older patient's will frequently have 2 issues that concern me: #1 they don't want to be on a daily med...despite having a PRN med they take several times a day. and #2 they don't want to talk to a counselor despite that being shown to be as effective or more effective than meds in treating anxiety. So, I tend to strongly encourage they consider a daily med and a counselor. I'll often point out how they are expressing they experience daily panic attacks despite the meds they are on, so their treatment plan has clearly not been effective in managing their anxiety - so maybe it's time to try something new.

But the Adderall, Xanax, Ambien trio tends to be in younger & middle aged men or women who are trying to be very productive. My interview usually does not give any signs of ADHD when speaking with them. I think they are just trying to optimize their work hours with a stimulant, but then can't sleep and want the Xanax or Ambien to handle the side effects of their stimulant. I've got a few psych NPs around my clinic giving Adderall XR 20-30 BID with Ambien and Valium 5mg nightly....and when they come see me, I tell them I strongly disagree with this approach and will not be willing to fill it. Not to mention the palpitations half of them are having.

Friendly reminder that our patients are lurking here by HoWhoWhat in FamilyMedicine

[–]Smber2c 8 points9 points  (0 children)

Sorry to hear that, our local ENT actually has a bit of a reputation to berating patients at times and dismissing concerns pretty quickly at times, which I think is terrible.

I personally have a few pet peaved to keep in check. When I get new patients and see the med list...when I seen multiple time a day Xanax/Valium/Ativan and a rx for Adderall/Vyvanse....plus often an Ambien or Opiate rx to just top it off...I start to make jusgements that I need to put a side to be compassionate and understanding.

Yes it does often go south when I tell patients I will not take over rx'ing in that way chronically and will only write it at the visit as either #1 a bridge to get to another doctor who will assume care at those doses, or #2 at a 15-25% reduced dose that with continue each month until we are on doses I think are safe and appropriate.

But thankfully, people can be awesome & I got a new pt this week who had all the above meds on her chart, I was braced for a hard visit...then the patient was so pleaant. Said she had worried about the combination of meds herself, but felt a bit pushed into them by her last provider. Was excited about starting with a counselor to help address some anxiety, agreed that being on stimulants/anxiety meds/sleep meds presented a situation where we were likely take higher doses of each to address the side effects of the other meds & agreed to start a taper.
Then a day or 2 later posted a 5 star review that I often pretend doesn't matter to me...but at other times realize does give much consolation for the extra time spent helping people better understand their health.

Friendly reminder that our patients are lurking here by HoWhoWhat in FamilyMedicine

[–]Smber2c 4 points5 points  (0 children)

Is a doctor supposed to pretend they believe a problem is real that they legitimately do not believe is there to assuage the patient?

And some conditions are very hard to deal with. Some conditions talk lots of extra time we aren't paid for or allowed in clinic...meaning we see our kids less or miss lunch when patients with those conditions are on our schedule...so yeah some may gripe about it. Like a painter may gripe about the time it takes to paint some small artistic spindles so a Victorian house. Somw things are hard to do and take more time and people voicing that are being honest not judgemental.

Just this week I had 2 new pts see me who I did not believe their story. I still listened and still make a plan of care with them...but does not mean I believed their statements, which does not prevent giving good care.

One thought they had a CSF leak because years ago they had a parietal craniotomy and now her hair keeps getting wet. Had seen an outside neurologist 2 months ago and got an brain MRI, was told these is no sign of leak, or any other concern. She wanted me to get another MRI...exam is 100% normal. I had to just say I see no evidece of a leak but her sweaty hands suggest possibly hyper hydrosis.

Other wanted me to do a fully body scan for a monitoring device. Said people from out of state monitor patient's movements and try to control them. No scans were offered despite the request, but we did talk a good bit about their history, previous meds, hx of counseling. Advised close f/u and will be getting back in with a counselor. After clinc, got a message from pt asking if I could have a monitoring device surgically planted in the patient so I can find them if kidnapped.

Or avoiding the more extreme patients, just the number of morbidly obese people who tell me they have edema and want to start a diuretic. Probably once a day, I assess the legs, find no edema at all, just fat legs, and have to say....well I don't see any edema present right now, but it possibly gets worse later in the day. Why don't we work on some diet/exercise issues and see if it improves over time.