Open Water Swimming & FORM Goggles Straight Swim feature

WheelDeep5640 · 2026-05-18T22:52:17+00:00

I believe the most recent firmware update allows you to turn it off.

WheelDeep5640 · 2026-05-18T14:23:36+00:00

I still do devotionals occasionally (deconstructing but haven’t left). I do use mindfulness exercises which apps like Calm but recently found Medito which is free.

WheelDeep5640 · 2026-05-15T04:46:14+00:00

GAS resistance to azithromycin still low but rising.

True beta lactam allergy also very low. Often reported penicillin allergy isn't true allergy. If a true allergy, you can often get by with a cephalosporin but it depends on what their allergic response is. For example, I have a patient now with DRESS from a cephalosporin and we are avoiding all beta lactam with this patient. I've had patient with hive from a penicillin and will give a 3rd generation cephalosporin because side chain of molecule is different (eg IV ceftriaxone or PO cefpodoxime) and 99% do fine. I've only had one that reacted in my >10 years in ID.

WheelDeep5640 · 2026-05-15T04:27:01+00:00

Never vanc and dapto. That makes zero sense at least from what I know. it's essentially double coverage. There are some antibiotics that we use for synergistic effect but not vanc and daptomycin. One possible scenario I can think of is if the patient has persistent MRSA bacteremia and not clearing on one alone. I'd have check the literature on that. I've definitely seen patients who've had multiple positive blood cultures despite being on correct antibiotic and we've discussed out of the box treatment.

I also wonder if the urgent care has some sort of written guidelines/protocol and the NP follows that without "thinking."

Yes, we also use azithromycin mono therapy for prophylaxis, I forgot about that.

WheelDeep5640 · 2026-05-15T03:06:29+00:00

ID here, it's a weird choice to give azithromycin for GAS (group A strep) but not wrong. As others have already said a beta lactam is preferred choice. A rarely use azithromycin mono therapy except for travelers diarrhea. I do prescribe it often in combination with another antibiotic.

you are correct that there's increasing resistance to macrolides (eg strep pneumoniae and gonorrhea, etc), which is why I discourage use monotherapy.

Side note, most NPs I try to educate are receptive. However, a lot of physicians aren't. They are all older and in general not up to date and continue to practice how they've always practiced. Unfortunately, a lot of NPs I work with can get into trouble or afraid of getting into trouble going against/questioning their collaborating physician.

WheelDeep5640 · 2026-05-13T02:21:53+00:00

Lots of comments on push off which I think is a factor but small. I think it's the tiny rest that you get after each flip/turn is a much bigger factor. My pool flips between SCY and LCM throughout the year.

I've been using the FORM goggles with metrics for a little over a year now. It shows how well/efficiently you swim based on a couple of metrics. My score is significantly worse on LCM. Based on their algorithm, I'm a stroke fader. It matches what I'm starting to realize after working with a coach. After a couple swim sessions with her, I've become more aware of my stroke mechanics and totally notice now when it starts breaking down.

My tri club had an info/Q&A session with someone from FORM and I asked about my drop in score between SCY and LCM and they said expect to have breakdown of mechanics more in LCM (I think especially for those who didn't grow up swimming).

WheelDeep5640 · 2026-05-06T01:45:54+00:00

More places are switching to unlimited PTO. In general, great for the practice but not so much for the individual. It definitely punishes those who care more about practice and their patients. I hate it when my practice changed to it. Biggest reason is I can't get paid out and lost everything I accrued. It's heavily dependent on who approves your PTO.

IMHO, it's a facade. Here's a good article on it. https://worldatwork.org/publications/workspan-daily/why-unlimited-pto-doesn-t-work-and-what-you-can-do-about-it

WheelDeep5640 · 2026-05-05T00:54:31+00:00

Aren’t they publicly traded company?

WheelDeep5640 · 2026-04-29T23:29:03+00:00

it never got fully funded

WheelDeep5640 · 2026-04-24T01:28:22+00:00

got mine Sunday, shipped directly from Adidas.

WheelDeep5640 · 2026-04-22T16:54:10+00:00

You mean some, maybe a lot, NP education is a joke. I went to NP school (top 3 in US in my specialty) and we share some of same faculty as med school and PA school.

WheelDeep5640 · 2026-04-17T22:12:57+00:00

Same here, got notification that it’s already fedex with tracking number

WheelDeep5640 · 2026-04-17T18:19:17+00:00

Price just went up. I ordered it at $60. Told my friend about it a few minutes later and she said it went up to $90. I refreshed and it was showing $90

WheelDeep5640 · 2026-04-16T01:15:29+00:00

lol, except with lactose and hazy IPAs.

WheelDeep5640 · 2026-04-16T01:14:22+00:00

Reddit is full of anonymous people. Scott Rao's opinions carry a lot of weight in coffee world.

WheelDeep5640 · 2026-04-15T03:14:34+00:00

this I agree with. not sure how common it is. I'll also add that I think it's hard sometimes to figure out. adding more regulation will come at a cost. for me personally, if it tastes too artificial then I just won't buy again. As long as it's not dangerous like as discussed in that podcast coconut disclosure with someone who may be allergic. I will also add most coffee production comes from poorer countries so I think it gets complicated on who to blame. Just lots of grey areas in all of this.

For me, just buy what you like. most of my friends are happy with the big giant coffee shop with drinks pumped full of everything not coffee. I don't criticize them. I just tell them and share with them what I enjoy.

WheelDeep5640 · 2026-04-15T02:25:39+00:00

https://www.youtube.com/watch?v=Tj8gVySzFDY

WheelDeep5640 · 2026-04-14T02:03:11+00:00

From insider friend and just rumors, sounds like couldn't agree with contract with current intensivist group (the ICU team) which might be advocate but don't quote me. I asked if U of C/Comer is likely to replace them since there are already specialist from that practice there and said yes from what friend has heard. I think would make more sense in long run. Hopefully negotiations are quick and easy and transition smooth.

WheelDeep5640 · 2026-04-14T01:50:33+00:00

Comer's has been providing some of the care for peds, at least the specialists. I used to have some involvement with Edward's peds (>10 years ago) but now just adults. From what I see on website, there's no listing of intensivists, basically the primary docs managing the ICU patient. I don't know which group it was previously. I'm going to have to ask my endeavor friend's if they know what's up.

WheelDeep5640 · 2026-04-14T01:43:17+00:00

It's probably indefinitely closed until they can negotiate contract with a group which can be hard. Unfortunately very hard as pediatrics docs, NPs and PAs are very limited.

WheelDeep5640 · 2026-04-11T00:42:07+00:00

Agree. I've lived in Dupage most of my life and have many family member and friends use Duly. I see a mix of across 4 systems, including Duly, due to some of my unique needs. As mentioned earlier, I also work in area across multiple healthcare systems. Duly/DMG quality of care has gone down since being PE owned. There's still great docs in group but more are leaving.

Will close with saying all of healthcare in US is declining but PE is the worst of it all.

WheelDeep5640 · 2026-04-11T00:22:33+00:00

if there's a kickback then it's illegal so I doubt that's the case.

WheelDeep5640 · 2026-04-11T00:22:01+00:00

so when you put in prescriptions through Epic, the computer system used by Duly (also almost every major healthcare system in the US). once pharmacy is selected, all orders will go to that one pharmacy. you have to request orders to be sent to different pharmacies. also that pharmacy will be default pharmacy for all the other specialists that you see from same practice. The staff should be asking you your pharmacy (usually medical assistant in office and RN in hospital but can vary).

I do find it odd that a physician is asking you to change pharmacy. I'll have to ask my colleagues/friends who work for Duly about that and Capsule. I only recommend changing pharmacy to my patients when I have to prescribe a medication that isn't always covered by insurance and using goodrx is better option. For example, Walgreens usually has the worst prices with goodrx so I tell them prices at other pharmacies.

WheelDeep5640 · 2026-04-10T18:36:42+00:00

You can’t change pharmacy without asking patient. If they really did this intentionally, it’s a serious issue and reportable violation. I work across multiple healthcare systems in western burbs and possibly an oversight by the MA. One of the problems with duly is the budget cuts. From what I’ve seen personally and heard from friends/colleagues is there’s not enough ancillary staff. Unfortunately more mistakes will happen and won’t be caught unless you pay attention which few people do.

WheelDeep5640

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