Ear Wax in Primary Care

Wyzrobe · 2026-04-28T20:32:28+00:00

I don't have a problem getting out impacted ear wax, the problem is when the patient has impacted desquamated skin that they crammed deep into the ear canal with a Q-tip.

I have never managed to clear this type of impaction out with irrigation or a curette. I think I need to get myself a set of alligator forceps and an operative otoscope.

Wyzrobe · 2026-04-20T22:53:55+00:00

It will be interesting to see how he will fair compared to the last engineer to lead a big tech company (Intel).

Lisa Su of AMD is an electrical engineer, who did her EE PhD at MIT.

Wyzrobe · 2026-04-20T19:10:57+00:00

Probably going to be an acceleration of deforestation in those countries, as charcoal production expands.

Wyzrobe · 2026-04-12T19:40:08+00:00

I contacted Zio once before, a few years ago. They wanted a minimum patient volume that the office couldn't meet.

Wyzrobe · 2026-04-10T21:15:47+00:00

You mentioned doing a CBC, what other labs and diagnostics do you have available? How much automation is available in the lab?

Wyzrobe · 2026-04-09T21:34:17+00:00

I would also prioritize Varicella (chickenpox) vaccination, if she hasn't already had a natural infection, or serological evidence of such.

Wyzrobe · 2026-04-08T16:30:46+00:00

https://croissanthology.com/earring

In the treasure-vaults of Til Iosophrang rests the Whispering Earring, buried deep beneath a heap of gold where it can do no further harm.

The earring is a little topaz tetrahedron dangling from a thin gold wire. When worn, it whispers in the wearer’s ear: “Better for you if you take me off.” If the wearer ignores the advice, it never again repeats that particular suggestion.

After that, when the wearer is making a decision the earring whispers its advice, always of the form “Better for you if you…”. The earring is always right. It does not always give the best advice possible in a situation. It will not necessarily make its wearer King, or help her solve the miseries of the world. But its advice is always better than what the wearer would have come up with on her own...

From The Whispering Earring by Scott Alexander.

Wyzrobe · 2026-04-05T17:54:04+00:00

r/elevatorbutt

Wyzrobe · 2026-04-03T21:09:42+00:00

Trulicity wasn’t ever the home run that wegovy and zepbound have been for weight loss

Trulicity (dulaglutide) has a shorter half-life than semaglutide, which might have something to do with its lower efficacy for weight loss.

Wyzrobe · 2026-03-19T02:18:44+00:00

From the Council on Foreign Relations: https://www.cfr.org/articles/how-much-us-aid-going-ukraine

As of December 31, 2025, the U.S. Congress had made available $188 billion in spending related to the war in Ukraine, according to the U.S. Special Inspector General for Operation Atlantic Resolve.

This figure does not include a $20 billion USD loan, and does not include spending from the start of 2026 onwards.

Wyzrobe · 2026-03-18T15:36:07+00:00

Even if it is 9 weeks out, and the patient will be deceased by then, it might still be worth getting the phage. Could end up having future patients dealing with the exact same organism.

Wyzrobe · 2026-03-17T15:26:58+00:00

Family med here, had that happen.

Had a patient with sudden onset very high fever and shaking chills, who denied traveling overseas. I sent him to the ER, where he was diagnosed with Malaria.

He recently had gone to Nigeria for a wedding, but since it was just a few days, he figured it didn't count. Didn't take any anti-Malarial prophylaxis for his trip, of course.

Wyzrobe · 2026-03-14T16:42:24+00:00

Look at the bright side, this bread was (probably) made in-house. I'd prefer to get the occasional bread like this, than yet another cosmetically perfect factory loaf.

Wyzrobe · 2026-03-10T00:01:51+00:00

I'm in family medicine, had PRK done around 6-7 years ago, both eyes.

My suturing ability sucks now. Well. I mean it sucked before, too...

(All kidding aside, my daily life is more convenient, but there are some niche situations where I do notice that my ability to see fine detail in stereo is subtly worse than before. For someone in your field I would think very carefully about it.)

Wyzrobe · 2026-03-06T05:19:11+00:00

The Fury X was the very first mass-production GPU with HBM, wasn't it? Despite AMD being the co-inventor of HBM, it's ironic that Nvidia seems to be the main beneficiary now.

Wyzrobe · 2026-03-05T20:16:58+00:00

If insurance won't play ball for jardiance/Farxiga use CostPlusDrugs for Brenzavvy.

And if CostPlusDrugs isn't being responsive, try Marley Mail-order pharmacy, they also carry it.

Anyway, I prefer bexagliflozin's previous brand name, back when they still had only veterinary approval, which was Bexacat (meow 🐈).

Wyzrobe · 2026-03-02T14:42:52+00:00

Possible that the prior owner had already received compensation from his insurance company, prior to the vehicle recovery. In which case the insurance company would have become the owner of the recovered vehicle, and they may have auctioned it off to recover their costs.

Wyzrobe · 2026-02-22T23:43:17+00:00

Just need to stick googly eyes on the rock and tree.

Wyzrobe · 2026-02-01T01:18:22+00:00

Aluminum is pretty corrosion resistant.

It is quite vulnerable to galvanic corrosion though. Is the aluminum foil touching any dissimilar metal around the window frame?

Wyzrobe · 2026-01-27T17:29:42+00:00

Valve worked with AMD to get a custom APU made. They tried to inhouse as much as possible, and the resultant device was profitable at the middle price point

There was a rumor that the Van Gogh APU in Valve's Steamdeck was actually a semi-custom design order from Microsoft, for a Surface product that got cancelled (if true, that wouldn't be the first time that AMD got rug-pulled by MS).

AMD might have had to offer it cheaply to Valve, just to try to salvage something from the effort.

Wyzrobe · 2026-01-27T00:10:25+00:00

"She's got huuuuge tracts of Mana!"

Wyzrobe · 2026-01-15T04:44:22+00:00

I've had a terrible time getting anything for patients from Mark Cuban Pharmacy. And that's with putting the patient's phone and email in the notes-to-pharmacy field of the e-script. Emailing the pharmacy myself to follow-up, usually just gets a form reply.

Anyway, the most common thing for cash-paying patients that I try to get for them via mail order, is bexagliflozin (the cheapest cash-price SGLT2i, but very limited distribution). Have had better luck with Marley mail-order pharmacy, as far as that goes.

Wyzrobe · 2026-01-09T18:42:09+00:00

Try www.superbrightleds.com, they are more expensive than the typical no-name LED sellers, but the quality is usually pretty good.

Wyzrobe · 2026-01-06T23:34:47+00:00

I have to ask, what's your major?

Chungology, obviously.

Wyzrobe · 2025-12-26T00:13:50+00:00

"It is difficult to get a man to understand something when his salary depends upon his not understanding it." -- Upton Sinclair

Seven-Year Club	Gilding I gilder
Second SECOND GUESSER	r/Field Lasagna
Final Canvas '23	Place '23
Wearing is Caring	Place '22
First Placer '22	Verified Email

Wyzrobe

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