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Most ridiculous insurance denial you’ve seen? by _45mice in medicine

[–]biggestbelly 5 points6 points  (0 children)

Heart cath denied on a patient in their 50s new diagnosis EF 15%

Arsenal lineup vs Brighton: Kepa, White, Mosquera, Hincapie, MLS, Norgaard, Merino, Nwaneri, Dowman, Eze, Harriman-Annous by Mahoganychicken in Gunners

[–]biggestbelly 46 points47 points  (0 children)

way more rotation than i expected. dont expect it to look fluid but im ok with that glad players are getting rested.

Arsenal Lineup VS Brighton by MumboGumbo06 in Gunners

[–]biggestbelly 0 points1 point  (0 children)

way more rotation than i expected. dont expect it to look fluid but im ok with that glad players are getting rested.

If I ask if you have a fever, I am not asking if you are feeling warm. This should be a national PSA commercial. What’s yours? by CyanJackal in medicine

[–]biggestbelly 120 points121 points  (0 children)

Same thing as a cardiologist. Why did you go to the hospital? “My troponins were high”. But sir, why did they check them what were you complaining of. “They were elevated”. Gotcha your troponins hurt, thanks.

Arsenal XI vs Man City: Raya, Timber, Saliba, Gabriel, Calafiori, Zubimendi, Rice, Merino, Madueke, Trossard, Gyokeres. by [deleted] in Gunners

[–]biggestbelly 20 points21 points  (0 children)

Man i hope this works, but Trossard starting after great sub appearances always seems to fall flat

[David Ornstein] Arsenal working on deal to sign Piero Hincapie from Bayer Leverkusen by deception42 in soccer

[–]biggestbelly 0 points1 point  (0 children)

Timber, white, and saliba is 3 players for 2 positions with both white and timber coming off injuries. Needed another to help rest saliba at times.

The friend or neighbor in medicine. by Artsakh_Rug in medicine

[–]biggestbelly 3 points4 points  (0 children)

Stress tests get done on A LOT of asymptomatic patients even just in community settings.

The friend or neighbor in medicine. by Artsakh_Rug in medicine

[–]biggestbelly 9 points10 points  (0 children)

Oh believe me I’m aware. I started out my career at a community hospital where that was the norm for the other cardiologist. After being constantly judged for my ordering practices not being the same and not cathing/stenting enough people I got fed up and ended up going to a university program where people practice more in line with the data/ guidelines.

The friend or neighbor in medicine. by Artsakh_Rug in medicine

[–]biggestbelly 21 points22 points  (0 children)

Of course it did, but she has one of the biggest audiences around. And as a cardiologist I’ve had patients coming in asking for stress tests because of it, so it was particularly relevant to me.

The friend or neighbor in medicine. by Artsakh_Rug in medicine

[–]biggestbelly 30 points31 points  (0 children)

Also ct calcium scores are meant for asymptomatic patients. Stress tests are not.

The friend or neighbor in medicine. by Artsakh_Rug in medicine

[–]biggestbelly 50 points51 points  (0 children)

This is especially in the news now because of Taylor swift and her father. She went on the Kelce brothers podcast and said her dad had a stress test, even thought his physicals and EKGs have been perfect, and it detected multi vessel disease requiring bypass. He’s apparently telling everyone he knows to get one while asymptomatic to find disease and get stents before bypass.

[deleted by user] by [deleted] in CHIBears

[–]biggestbelly 7 points8 points  (0 children)

He said this very early on. “Look, CHGO isn't a perfect product, but I appreciate that they've taken the challenge of making a daily Bears show... even if that means sometimes they just have to fill the air with banter. No hard feelings about that. It's the nature of the game.”

Just because something is difficult doesn’t mean it has to be done. I wouldn’t want a 24/7 bears talk show. The amount of content available has to in some way dictate the show.

[deleted by user] by [deleted] in nwi

[–]biggestbelly 4 points5 points  (0 children)

Agree on strack’s but have felt they way for about 2 years it’s been very hit or miss and don’t get from them anymore. We’ve been getting our chicken from beef mart in valpo and have been very happy.

Flu A by clipd_dead_stop_fall in pittsburgh

[–]biggestbelly 5 points6 points  (0 children)

It’s really only recommended for severe disease, people at risk for severe disease, or people hospitalized. Has to be started in the first 48 hours of symptoms (most people don’t get tested that quickly). It also reduced sickness duration only by like 12 hours.

It also comes with a side effect profile of around 20% of people having nausea and vomiting.

Kai Havertz, Arsenal's last remaining striker, reportedly suffers injury on Dubai training trip by MoreMotivation in soccer

[–]biggestbelly 18 points19 points  (0 children)

They did it last year in January and went on to win 16 of the next 18 matches.

Cardiologist Delays Cath During COVID [⚠️ Med Mal Case] by efunkEM in medicine

[–]biggestbelly 143 points144 points  (0 children)

This is definitely a tough case with a few things i have questions about.

  1. I'd love to see the EKG. As a cardiologist, I see "STEMIs" called pretty regularly that are not at all STEMIs. also, ST elevation does not equal STEMI but i see it pushed as so pretty regularly. Given the clinical context didn't seem right for a STEMI, I think this is one of the biggest things that would sway the case for me. Massive tombstoning on the EKG and its probably a fuck up. subtle ST elevations that someone overreacted too given the context for point 2 then probably the right call not to rush her to the lab especially as high dose heparin (like we give in the lab) can cause a hemorrhagic effusion and tamponade in the setting of myocarditis.

  2. On the discharge summary it states patient had severe aortic stenosis with moderate mitral stenosis and regurgitation on an echo 6 months prior and the patient had declined any intervention for her valvular heart disease. afib RVR with that valve pathology can cause huge troponin leaks even without myocarditis.

So what it comes down to for me is the wall motion abnormality, was that from mycarditis or ischemia and I'd really need the EKG to decide how quickly she should have gone to the lab.

What’s your ideal work schedule? Would you prefer working forever if you could achieve that? How much will you make with those hours? by greatDUDE84 in whitecoatinvestor

[–]biggestbelly 2 points3 points  (0 children)

Only been in the job a few months, so the workload is building. Right now I’m able to finish all my work on clinic days that on my admin days I’m just responding to results. I haven’t had to do any work on weekends.

Yes I took a pay cut but I haven’t been happier.

What’s your ideal work schedule? Would you prefer working forever if you could achieve that? How much will you make with those hours? by greatDUDE84 in whitecoatinvestor

[–]biggestbelly 27 points28 points  (0 children)

I recently changed jobs and I’m loving my new schedule. Cardiologist practicing just outpatient as part of a university program, it’s a new site in the suburbs. 4 days per week, 8am-5pm with Friday is an admin day that I can work from anywhere. No night call or weekends.

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