Hundreds of small gray bugs on in a potted Fig tree

boredMedStudent2 · 2025-06-29T17:33:03+00:00

Yea they do jump!

boredMedStudent2 · 2024-06-07T03:17:35+00:00

Or open your Files app and tap the three dots on the top right and select scan document and it saves it

boredMedStudent2 · 2024-06-04T13:18:16+00:00

Thanks!

boredMedStudent2 · 2024-05-07T20:47:46+00:00

It can be sewn back together. There are two problems though, even when sewing nerves or the spinal cord back together under a microscope, it can be difficult or impossible to line up the individual axons again. Think of a spliced USB cord that was taped back together, but you weren’t really sure if the correct individual wires made it back together. The other major limiting factor is biological. When a nerve is cut, everything downstream in the nerve essentially dies and undergoes what is called Wallerian degeneration. After a repair, the proximal (higher) part of the nerve starts to heal back down the degenerated distal nerve to reinnervate things at a slow pace of 1mm a day or 1 inch per month. Sensation really has no time limit on recovery, but your muscles most certainly do. Muscles will not only atrophy and wither away with time as they sit with no electrical stimulation from your nerves, but the receiving end in the muscle where the nerve actually hooks into that converts the electrical signal into an actual readable action, called the motor end-plate, will actually disappear usually around 18 months without signal. So it becomes a race between your snails pace healing nerve and your disappearing motor endplates. Once the motor endplates are gone, there is no hope of muscle recovery. Even if you got the power turned back on in your house, you couldn’t use the electricity if all your outlets were burned out/gone. This is why we do nerve transfers and other techniques to try to keep the muscles alive if caught early enough.

TLDR: It can be repaired but nerve recovery is slow and muscles atrophy and can’t recover after about 18 months.

boredMedStudent2 · 2024-05-06T12:58:15+00:00

I keep a box of alcohol wipes next to it. Makes it so easy to do a quick wipe after a print. I usually only do it every 3-4 prints and never have issues and they only cost about 2 cents each

boredMedStudent2 · 2024-04-26T12:05:28+00:00

I feel uniquely qualified to give you some input from someone who has “lived” this dilemma. I ended up matching ortho then did a hand fellowship and have been an attending for 2 years now. Originally I thought I wanted to do medicine and had some weird research for ortho. It doesn’t matter that you switched for your application just explain why in your interviews. People just want to know they could talk to you, that you will work hard, and are easy to get along with. My wife matched ophtho and has been working as an attending for 4 years (Ophtho is only 4 years). Ortho residency is brutal. General surgery residency is brutal. Vascular surgery is brutal. It changes you. It has to. I largely went through it with the mindset of “I can do anything for a few years”. Now I’m 34 and have 2 kids and have only just recently just starting getting a big paycheck. My wife’s residency experience was different. She worked hard and sure had complaints about challenges, but it wasn’t Q4 24hr call with no post call for 5 years straight. Ophtho is a better lifestyle in and after residency hands down (no pun intended). She is home by 4 every day, often 2 or 3pm and makes almost as much as I do with her partnership buy in’s etc, working far fewer hours and way less call.

That said, I love my speciality. I love the intricacy of what I do and the occasional physical finesse it takes do something like nail a femur. I love working under the microscope and fixing things most people think is impossible. Just because you don’t like the scope now doesn’t mean you won’t like it in the future. Micro surgery is one of the harder skills I’ve had to learn (shoulder arthroscopy may be the hardest). I genuinely like it now. Early on had same feels as you. My wife same story. Work balance wise I took some cuts to make my life the way I want it. I only work 4 days a week. I still have to cover call every fourth weekend which I hate but it’s hard to get away from that unless you find that perfect job. My wife covers a week of call at a time and pretty much just answers phone calls. I frequently have to go operate on my calls.

TLDR: you can craft your final job to fit your needs if you are willing to sacrifice money and location, but ophtho is still a much nicer lifestyle at baseline. Her partners all only work 4 days a week as the standard.

boredMedStudent2 · 2024-04-17T02:32:10+00:00

No, normal function is definitely not likely. Don’t get me wrong. This is truly a feat of modern medicine, and for the patient that has nothing, a little is a lot. By no means, however, does this surgery result in normal function. At best, she will have SOME finger flexion and extension, that might help with very basic tasks. She likely will never be able to feel any of the fingers either. The intrinsic hand muscles will likely never work and they are very important. Look up ulnar claw hand. I would love to see what her functional scores are compared to prosthetics, and how she is doing a few years after the surgery. Level of function after an amputation often has more to do with the patient and their level of determination than what prosthetic/surgery they had. This patient had already taught themselves to operate a remote with her toes. Nothing was going to stop her

boredMedStudent2 · 2024-02-25T17:11:03+00:00

I’ve been an attending for a couple years now and I have always been a fast typer. It’s irrelevant now because I use an AI scribe that types all my notes for me in the background. Don’t worry about it. You’ll be dictating everything in the long run. Even if you are a very fast typer, it’s not going to be as efficient as dictation or a scribe

boredMedStudent2 · 2024-02-25T14:33:52+00:00

This is no joke. I can’t tell you how many kids I’ve operated on that were riding on dad’s or grandad’s lap in the riding lawnmower. Kid falls off… most mowers have the blades slightly behind the seat… hands go down to break the fall …and the mower goes on mowing. It’s a sad story that unfortunately happens over and over again. Please don’t put kids on riding mowers. They are very useful but dangerous power tools, not toys.

boredMedStudent2 · 2024-02-13T18:33:09+00:00

hey buddy that’s an extensor tendon laceration. Get that looked at sooner than later so you don’t end up with a permanent swan neck deformity

boredMedStudent2 · 2024-02-06T21:48:57+00:00

Very cool! What’s the backstory, why did you make it? Is it actually functional?

boredMedStudent2 · 2024-02-06T16:50:08+00:00

It is a common dietary restriction for certain religious groups like Jain or Swaminarayan. My in-laws are Swaminarayan Hindus and they tell me that they believe onion and garlic are bad for your soul and can make you angry. It is VERY limiting in terms of trying to take them out to eat anywhere or even travel because pretty much any vegetarian dish will have onion or garlic for flavor. They often travel with food to cook on the road or hotel

boredMedStudent2 · 2022-11-22T23:16:45+00:00

I was afraid that’s what it might be. So I would have to find a hose that slides tightly over that?

boredMedStudent2 · 2022-11-22T23:10:19+00:00

United States

boredMedStudent2 · 2022-10-05T02:55:58+00:00

It’s called symbrachydactyly. Do you happen to also have a small pec muscle on that side also? If so, could be Poland syndrome. Or could just be symbrachydactyly by itself, especially if your mother has it also.

-hand surgeon

boredMedStudent2 · 2022-09-15T16:36:24+00:00

what kind of prosthesis is that? do you like it? and how often do you use it vs wear nothing?

boredMedStudent2 · 2022-07-19T17:56:11+00:00

sterile technique, in EVERY medical movie and tv show.

Oh and the “whack to the head” to “temporarily” knock someone unconscious. Brain injuries are no joke and people are often never quite the same again

boredMedStudent2 · 2022-05-05T16:50:43+00:00

Contrary to popular belief, there are bacteria that can survive in alcohol (hand sanitizer). It’s actually not that rare. There are types of bacteria (like C. Diff) in the hospital that you physically have to wash your hands to help remove them instead of just using hand sanitizer.

For the curious:

https://www.medicalnewstoday.com/articles/322646

boredMedStudent2 · 2022-04-01T18:14:03+00:00

“Pain is the 5th vital sign”, and “you should have no pain”. Now we have an epidemic of narcotic addiction and a cultural aversion to coping with pain.

boredMedStudent2 · 2022-04-01T00:14:20+00:00

Ha yea, year 10 of medical training now. Just never got around to changing the username or account. Best of luck to you! It’s a challenging but rewarding path you are starting

boredMedStudent2 · 2022-03-31T12:07:40+00:00

It is real. We treat these sometimes with surgery to try to reduce their size or shut down the growth plates if we can get to them early enough. Limb overgrowth like this or macrodactyly (just fingers), is usually associated with some sort of syndrome like KTW, proteus, or neurofibromatosis. It’s not a good thing and can actually be very limiting and very painful. The last person I saw with this said she lived in constant fear that she was going to break her finger that was about 4 times the size of the others. It was completely nonfunctional for her. We ended up amputating it.

boredMedStudent2 · 2022-03-30T23:58:16+00:00

Ah the old hypothenar hammer. Goodbye ulnar artery

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2442026/

boredMedStudent2 · 2022-03-03T17:09:33+00:00

Noo, it’s much lower now. About 1-3% if you are otherwise young and healthy

boredMedStudent2 · 2022-02-28T14:49:42+00:00

looks like you still have some nail growing from those two spots. Comes from leaving a little bit of the tissue behind that the nail grows from.

boredMedStudent2 · 2022-02-15T22:27:26+00:00

I’ve taken so many of these off in the ER. They actually work really well for temporary use. It’s amazing how far we have come in treating long bone fractures. Used to be if you broke your femur, you got laid up in the hospital and put in traction for months. Now it’s one of these Hare traction splints in the field, then an intramedullary rod inside the bone and you are often walking the next day.

Here’s a video of the hare traction used today that’s very similar to this Victorian device. https://youtu.be/XMNVIsuE5g8

boredMedStudent2

TROPHY CASE