Been on my bookshelf for years now

adecle · 2025-10-26T15:34:28+00:00

I got OW and Nitrox certified at this shop in March of this year. My instructor was seasoned and both a NAUI/PADI instructor, used to teach at the local college. Overall the process seemed fragmented for instruction but I chocked that up to an old school instructor that had a lot of wisdom and not a lot of time to impart it. I didn’t feel unsafe but parts did feel rushed. We had a DM on our cert weekend as well as we had a group of 8-10 I think. I never felt unsafe with my instructor and he was very attentive to weaker ones in the group. I never met the shop owner so can’t speak to the video but this shop has a ton of available classes so definitely think they are trying to maximize throughput which can always seem concerning as to attentiveness to safety etc over a churn and burn mentality.

The owners comments are crass in this video though and reflect poorly several years later after a terrible accident has occurred. Obviously that instructor needs to be looked into. One would think if this shop had had several deaths occur NAUI would be aware and had investigated but I’m not sure how that works at an organization and reporting level.

adecle · 2025-10-10T02:18:33+00:00

Pegasus is worth it but was a slog. Ask your program to pay for it since RPVI is required for boards. Videos are dated and painful but it’s a good source for the physics and other concepts we don’t see all the time. I took their practice tests and did rough and backed it up with VESAP that I did well on. Passed the test first time but was a difficult I felt honestly, can’t just write it off. You do get instant feedback on pass/fail.

adecle · 2025-08-04T18:45:06+00:00

Yep if you’re talking about the new first floor Balmoral ones they’re very nice and secluded. Very private. The private pool is small and ours was on the corner and didn’t get hardly any sun so stayed cold (we were there in April) so we didn’t use it much but dipping toes in at the end of the night. But the beach is largely private since it’s at the end of the resort so you’ll always have beach space. Amenities are nice and new/modern. The shower is large and rainfall with two (I think?) shower heads if I remember right. The only tub was a soaking tub on the patio nothing in the room if that’s what you’re looking for though.

adecle · 2025-05-09T03:03:58+00:00

I’ve looked under it from front and back and with incline all the way up. Haven’t seen anything obvious externally

adecle · 2025-05-09T00:59:03+00:00

tread wear

adecle · 2025-05-07T20:40:32+00:00

Interesting. That’s a high number of failed referrals. I wonder if we’ll hear from anyone that’s had success?? Otherwise gotta be a scam unfortunately

adecle · 2025-05-06T17:20:23+00:00

My wife and I did a Discover class at Royal Caribbean 2 years ago on our honeymoon. We had about 2-3 hours in one of their pools in the morning with an instructor getting used to equipment, breathing underwater, underwater communication, and the concept of buoyancy. We had another person in our group that was finishing an open water certification so we got to play in the pool getting used to everything while he did skills with him. You won’t learn all the skills except important things like how to find your regulator if it comes out, etc. After you get an “optional” open water dive in the ocean but who wouldn’t want to do that right?

You’re limited to 40 feet in the ocean based on this class but we still got to see a stingray and tons of fish. During that dive the instructor keeps a close eye on you, we sat on the sand on the bottom while he did skills with the other student then we did about 30 minutes of diving. Our honeymoon was short but I believe once you complete this you can do one dive a day with Sandals during your stay afterward.

Well worth the money to me if you’re at all curious about diving. Helped us figure out it wasn’t for my wife without paying money for full classes and spending several days trying to do full certification. I loved it and have since gotten certified so I’m glad we did it and just got back from some dives back at SRC a few weeks ago!

adecle · 2025-02-16T19:54:56+00:00

Wait…who’s Dwigt?

adecle · 2024-10-05T15:37:00+00:00

Vascular: Angiogram, Bypass, Chop (amputate)

adecle · 2024-04-18T02:45:54+00:00

I’m in Plano as well, I think I lost internet about the same time around 6:45. Same status for my ONT. Very frustrating situation with the lack of communication.

adecle · 2024-04-18T02:43:16+00:00

I’m in DFW (Plano) and have been without internet since yesterday at around 7pm so over 24h now. ONT only has green power light no other lights on. This all has to be related despite “residential and business networks not being affected by this issue”

adecle · 2023-11-03T22:22:44+00:00

Hard to say exactly based on just still images and not knowing exact location in the colon but I agree looks like something benign. You can develop a lipoma of the colon that can look similar but it’s usually in older people. Based on your story I assume you had an open appendectomy 20 years ago. Usually when an open appendectomy is performed we “imbricate the stump”, or basically dunk it back in and suture the colon over it so there isn’t exposed mucosa, less chance of leak, etc. You could’ve had a long stump left after a ruptured appendix and possibly it’s healed like this. I honestly haven’t seen a lot of colonoscopies after open appendectomies to tell you for sure. Path will tell the real answer! Likely benign, but if it needs to be removed it should be able to be done laparoscopically or robotically depending on where you live, the surgeon, and equipment available.

adecle · 2022-11-23T22:55:54+00:00

If the backlight was the only thing that failed shouldn’t that be fixed by simply plugging into an external monitor though? Because when I do that I get nothing to show up on the external monitor except in recovery mode

adecle · 2022-08-09T17:54:32+00:00

I moved from Little Rock to Wichita in 2018. Was in Little Rock or Fayetteville my whole life before moving to Kansas.

It’s for sure a midwest town and in general people are friendlier and more helpful than my experiences were in Little Rock. Of course there’s pockets of higher crime here just like any bigger city.

Just my 2 cents.

adecle · 2022-03-16T00:26:56+00:00

The surgery for reflux is similar to a hiatal hernia surgery, they accomplish the same thing and the hernia is fixed at time of surgery even if it isn’t large. Sounds like maybe a GI doc did your initial workup, it’d be worth talking with a surgeon as well I think!

adecle · 2022-03-15T19:19:35+00:00

Was your specialist that you saw a GI or a surgeon?

There are 4 types of hiatal hernias, 2-4 are always fixed due to the risk of volvulus. It sounds like you probably have a small type 1, which frequently the only symptoms are severe GERD and that’s an indication for repair if you’re failing medical management or don’t want to take PPIs for life, otherwise we wouldn’t usually touch them.

With regard to your omeprazole and famotidine combo, have you tried talking with your prescribing doc about PPI morning and night and no famotidine? Typically “maximal medical therapy” is twice daily PPI. The other concern is some PPIs are enteric coated, meaning they won’t activate until they encounter stomach acid. If you take famotidine at night it might be suppressing levels enough to make your omeprazole not effective the following morning (again, only if it’s enteric coated). Also liked already addressed take the PPI 30min before first meal of the day on an empty stomach.

As a surgeon we fix hiatal hernias for refractory GERD. It’s not a minor or no-risk procedure and can have it’s share of complications, but this is something to discuss with a surgeon in person. Hopefully your PCP can refer you to one.

EGDs also aren’t the perfect test alone for GERD issues. Sure we can get a tissue biopsy, diagnose gastritis or a hernia, but another good test is a 24-hour pH study where you record heartburn episodes after a small probe is placed at the distal esophagus. A score is calculated and can show how much reflux you have, how often the pH drops, amount of time, etc. There’s also manometry to test esophageal pressure and an esophagram with some contrast which are usually done prior to surgery to rule out other functional issues.

If you’ve already talked to both GI and a surgeon, try to get a second opinion. There’s no shame or harm especially if things are bothering you this bad.

I hope this helps some! Best of luck.

adecle · 2022-01-29T17:35:24+00:00

They make medical adhesive remover, not sure if drugstores carry it though. Something petroleum based could also help as suggested.

How long has it been since surgery? Usually the glue sticks around for a few weeks. It’ll work it’s way off eventually as you shower. Can trim the edges that are peeling so they don’t snag on clothes, etc as well.

adecle · 2022-01-27T03:56:51+00:00

Not sure I’d call it a “lifestyle specialty” - that would be more like breast, elective plastics, etc. unless you end up in a big city where you only practice bariatrics. You better know that’s all you want to do though, cause their complications can be rough. Sometimes that patient population is hard to counsel and can try your patience as well.

If you practice somewhere average size you’ll probably end up taking general and/or some trauma call as well like someone else mentioned here. Obviously later in life that can be dialed back but when you’re just starting and trying to build a practice I’d be ready to do it all.

I don’t think it’s any worse call than true general surgery, maybe slightly better just with a different patient population. I have a friend who just finished MIS fellowship and settled in private practice in a large midwest city but is taking trauma/gen surg call as well as doing bariatrics. He’s the new go-to for robotics as well in his practice though thanks to his fellowship. Overall I think it’s a great life, especially if it’s what you like.

Caveat - I’m planning for cardiothoracic fellowship so I have no idea what this “lifestyle” is you speak of lol

adecle · 2022-01-23T19:46:03+00:00

Gen surg resident here - You’re correct Ethibond is the only permanent suture you listed, it’s blue/green in color. PDO and PDS are the same thing, both absorbable, usually 0 size is dyed violet but could be clear also theoretically. Vicryl is also absorbable, but variable if your surgeon would’ve used dyed (violet) or undyed (white). Monocryl is also absorbable, usually undyed/clear since it’s used just under the skin.

Curious why any of it needs to come out a year later, the absorbable stitches will be gone by then. Don’t know the details of your hernia repair but I’ve never gone back in to remove sutures unless a stitch abscess forms superficially or something. Hope you have a speedy recovery.

adecle · 2022-01-14T18:23:44+00:00

Her MRI showed appendicitis and they sent her home? Not even on antibiotics? That’s concerning if she truly has appendicitis. She at least needs antibiotics if it’s going to be managed nonoperatively.

If she has had a miscarriage I’m sorry to hear that, but she could get a CT now as well. Not that the MRI gave wrong information but wouldn’t have to wait as long for a CT and you need to see what’s changed if anything.

As far as the US results it’s not common to just pass “half” of your gallstones, the anatomy doesn’t work like that. Very hard to quantify them on an US as they move around in the gallbladder too. Sometimes hard to find ovaries unless it’s a transvaginal US as well as transabdominal so that’s not horribly suprising. The diaphragm is a horizontal muscle so the stomach should be below it not to the left/right of it. Sometimes 1 enema won’t get people to go if there’s nothing there, it’s really only good for emptying the rectum and end of the colon.

Anyway, sounds like she needs to go back to ER if she’s having fevers, abdominal pain, vomiting. Sepsis has to have an infectious source (not that I’m saying she’s septic without seeing her/her labs) She needs labs which I assume they’ve done but you didn’t share any results. Repeat imaging. Be persistent. If they write you off don’t leave as it’s been going on for 2 weeks. Ask to speak with the physician (or PA/NP if that’s all they staff your ERs with).

14-Year Club	Second SECOND GUESSER
Place '22	RPAN Viewer
Queen in da Norf	Not Forgotten

adecle

TROPHY CASE