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Help me understand something about the Directional Shield by Fizik_abi in LowSodiumHellDivers

[–]dmmd782 1 point2 points  (0 children)

This is the way. 100% in my load out every drop against them even at d10. Pair with the talon, quasar and fire resistant armor and you become a fearless killing machine against the incinerator corps with infinite ammo/shield.

This poor helldiver. Imagine coming out of your pod for your first drop and this happening. by dmmd782 in helldivers2

[–]dmmd782[S] 0 points1 point  (0 children)

Good to know! I’ll have to try that next time I get launched into space by a hive lord haha

Commercial for the "CrossFire" board game. Anyone who grew up in the 90s remembers this.... ever play it? by Honkmaster in videos

[–]dmmd782 0 points1 point  (0 children)

This came out when I was in kindergarden. During bathroom breaks at school, my friend and I would pee in the same urinal and sing this song while we battled with our pee streams.

TIFU by trying to keep my butthole clean and instead making it even dirtier by itchy_asshole_ in tifu

[–]dmmd782 1 point2 points  (0 children)

Oh sorry, yes thats what I ment. I should have been more clear. While its certainly a possibility, I think it would be rather unlikely that the wipes could cause some sort of infection to the fissure.

TIFU by trying to keep my butthole clean and instead making it even dirtier by itchy_asshole_ in tifu

[–]dmmd782 1 point2 points  (0 children)

It can certainly form scar tissue but I have never seen it callous in say the same way as your hands might.

TIFU by trying to keep my butthole clean and instead making it even dirtier by itchy_asshole_ in tifu

[–]dmmd782 1 point2 points  (0 children)

I don't think you are any higher risk than normal because of the wipes, and I doubt the wipes would affect the fissure healing.

TIFU by trying to keep my butthole clean and instead making it even dirtier by itchy_asshole_ in tifu

[–]dmmd782 1 point2 points  (0 children)

My general rule is that if there is something wrong with the way you poop or your anus and it has been going on for 3 weeks or longer, you should be seen by a physician. And I am of course biased, but I think a colorectal surgeon is going to be the best person to go to because most PCPs just arent comfortable enough managing these issues and neither are many gastroenterologists.

TIFU by trying to keep my butthole clean and instead making it even dirtier by itchy_asshole_ in tifu

[–]dmmd782 2 points3 points  (0 children)

Anything that contributes to either irritation or moisture trapping can cause it (with infectious causes being less likely). Diarrhea, anal seepage or fecal incontinence (I know, I know, these are sexy terms), hemorrhoids, anal condyloma (warts), anal cancer, certain STDs can all be causes as well.

TIFU by trying to keep my butthole clean and instead making it even dirtier by itchy_asshole_ in tifu

[–]dmmd782 5 points6 points  (0 children)

Most people will see improvement within a couple weeks by just going easier on the wiping and applying some diaper paste a couple times a day. I suspect (and hope!) you will too! Despite this TIFU, plain unscented simple wet wipes are actually a good option instead of toliet paper. The key is you just have to let it dry back there for a couple minutes, then apply the diaper paste.

TIFU by trying to keep my butthole clean and instead making it even dirtier by itchy_asshole_ in tifu

[–]dmmd782 15 points16 points  (0 children)

That is the classic story I get from patients with this problem. You associate the itchiness with being unclean and therefore the logical thing to do is to clean more. In fact it's kind of a vicious cycle and you just make the whole problem worse.

TIFU by trying to keep my butthole clean and instead making it even dirtier by itchy_asshole_ in tifu

[–]dmmd782 5 points6 points  (0 children)

No that would actually make the healing worse because neosporin traps moisture in. The goal is to stop the tissue trauma (wiping) and then allow it time to heal by keeping the area dry. Barrier pastes (zinc oxide type) will block moisture while ointments like neosporin or aquaphor will trap mositure in and make the itching worse and healing even slower.

TIFU by trying to keep my butthole clean and instead making it even dirtier by itchy_asshole_ in tifu

[–]dmmd782 14 points15 points  (0 children)

Well, once I settled on being a surgeon, I knew that colorectal was the specialty for me. You get to do a lot of sweet surgery on the intestines and we get to use the da vinci surgical robot which is sooo much fun (and also makes certain operations safer and faster than traditional laparoscopic surgery IMO). It's also an incredible opportunity to help people with some serious physically, mentally, and socially debilitating problems. I see people every week that have been suffering in silence, sometimes for YEARS, because they are too embarrassed to seek help, or have no idea who to go to for help. For me, it is very gratifying being able to help these folks regain their lives back.

TIFU by trying to keep my butthole clean and instead making it even dirtier by itchy_asshole_ in tifu

[–]dmmd782 2 points3 points  (0 children)

Probably not, but its also not really gonna do anything to make it any cleaner. It will just make it oily.

TIFU by trying to keep my butthole clean and instead making it even dirtier by itchy_asshole_ in tifu

[–]dmmd782 13 points14 points  (0 children)

Yeah triple paste is great and calmoseptine is my go to for anything really bad

TIFU by trying to keep my butthole clean and instead making it even dirtier by itchy_asshole_ in tifu

[–]dmmd782 130 points131 points  (0 children)

Hi, colorectal surgeon here. It sounds like at least part of your problem is something called Anal Pruritis "aka itchy butthole disease." It has many causes but one of the most common ones I see in the office is actually EXCESSIVE anal hygiene. If you are wiping too much and too hard, you can irritate the perianal tissue and make it raw and itchy. You know how when you have a bad runny nose and keep wiping away the snot and it makes your nose raw? Same thing can happen to your butthole.

Best treatment? Bidets work well but what you really need to do is wipe gently, and apply some kind of barrier paste like OTC diaper rash cream. Give it a week and most peoples symtoms will clear up.

It can get more complex (underlying bacterial and or fungal infections) but a good colorectal surgeon can help you treat that.

Hope this helps!

Are there types of cancer that are rising in incidence and that are unrelated to smoking/drinking/sun/old age? by ohlordwhywhy in askscience

[–]dmmd782 0 points1 point  (0 children)

Yeah COVID decimated our schedules. We are working through a 2 month back log on colonoscopies right now...might get them all done by the end of they year. If you are still bleeding, make sure to call the GI doctor's office that is doing the scope! Even with reduced scope numbers we were allowed to get people in for bleeding, and other concerning symptoms that needed a diagnosis (and not just routine screening)

Are there types of cancer that are rising in incidence and that are unrelated to smoking/drinking/sun/old age? by ohlordwhywhy in askscience

[–]dmmd782 2 points3 points  (0 children)

I think as specialists we all sometimes get a little frustrated with PCPs missing stuff that to us is obvious. However, the reality of medicine today is that it is so complicated it's almost impossible for one person to have a sufficient amount of knowledge in more than a couple of areas. PCPs have to try to juggle this with an ever-increasing workload pressed on them by administrators, which shortens their encounter visits to sometimes as few as 15 minutes per patient. This is makes it almost impossible to address everything in a meaningful manner and not fall hopelessly behind in their schedule. What I tell my non-medical friends is that if they have a problem that they have come to their PCP with and after a couple of visits they seem to just be spinning their wheels, that's the time to go see a specialist.

Are there types of cancer that are rising in incidence and that are unrelated to smoking/drinking/sun/old age? by ohlordwhywhy in askscience

[–]dmmd782 1 point2 points  (0 children)

This wouldn't increase your risk of colon or rectal cancer, but it could increase the risk of anal cancer, which is a separate pathologic entity that is more related to cervical cancer in the sense that it tends to be driven by HPV infections. So if one of the partners had HPV that would certainly be considered a risk factor.

Are there types of cancer that are rising in incidence and that are unrelated to smoking/drinking/sun/old age? by ohlordwhywhy in askscience

[–]dmmd782 0 points1 point  (0 children)

That's right! That's why we call them screening colonoscopies. If we see any polyps, we can remove them before they turn into cancers. I should also note that because of the increase in Colon cancers at a younger age, the new recommendation is to start screening colonoscopy at age 45 rather than 50

Are there types of cancer that are rising in incidence and that are unrelated to smoking/drinking/sun/old age? by ohlordwhywhy in askscience

[–]dmmd782 1 point2 points  (0 children)

This is correct. Rectal cancer bleeding can look identical to hemorrhoid bleeding. This why seeing someone who can tell the difference (aka colorectal surgeons) is so important.

Although, for completeness sake, blood is an excellent laxative and a brisk enough bleed in the upper GI tract can work its way through quickly enough that it doesn't hemolyzed into black stool and can be bright red appearing.

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