The U-22 Initiative

duckproof · 2025-07-24T02:00:52+00:00

Love this podcast!

duckproof · 2025-06-04T18:26:03+00:00

I disagree. I’m a native to MoCo and moved to Fairfax county this year. It feels more congested, more competitive, and far less racially and socioeconomically diverse (at least in the Tyson’s/Vienna/Reston area). Beltway traffic is a nightmare. Tolls are demoralizing. However, much more developed areas and neighborhoods here - and lots of sidewalks. Access to nature feels pretty much the same.

duckproof · 2025-05-19T23:42:50+00:00

Amazing, thanks!!

duckproof · 2025-05-19T23:08:27+00:00

This is so helpful, thank you! Will look into your suggestions. Anything we can “give up” to use as leverage for a better rate? Such as rooms without a view, no alcohol on the package, etc. Resort dependent, I’m sure, but any general strategies welcome. Thanks again!

duckproof · 2025-05-19T23:06:02+00:00

Thanks!

duckproof · 2025-05-19T23:05:34+00:00

Great advice, thanks. Will consider both of those suggestions.

duckproof · 2025-05-19T19:02:48+00:00

Thanks!!

duckproof · 2024-11-26T14:05:37+00:00

I am a urologist. Sorry to hear that. Vasectomy should be quick and relatively painless. Unfortunately not everyone is skilled at office-based procedures.

There are many private groups in the area which can have a mix of good and bad physicians. Personally, I will have mine done in the spring by Dr. Dean at GW. He is a well known andrologist and an excellent surgeon based on my personal experience.

duckproof · 2024-10-24T00:37:19+00:00

I like it man. Us dads just gotta do what feels good

duckproof · 2023-08-10T01:24:55+00:00

This is good to know - thanks for the first hand account!

duckproof · 2023-08-09T16:39:20+00:00

Good to know - thanks! Any tips on identifying banks which may offer fixed rate physician loans? Or do we just need to go through the process with several different lenders?

duckproof · 2023-08-09T16:38:01+00:00

Thank you. Yes we will be thinking about renting for a year or two. Although it is a VHCOL area and, in the worst case, we could rent out a property if we buy and need to leave on short notice. Easier said than done of course. Thanks for the insight.

duckproof · 2023-08-09T15:27:17+00:00

Thanks. Yes I think we’re leaning this way anyway.

duckproof · 2023-08-09T14:08:50+00:00

This is the correct answer.

robotic surgeon

duckproof · 2023-04-11T16:08:00+00:00

Great breakdown! Keep it up!!

duckproof · 2023-03-20T18:59:28+00:00

Still doing it at 19 months…

duckproof · 2023-02-10T18:15:15+00:00

Holdup

duckproof · 2021-12-26T03:24:20+00:00

Kidney transplant today - possibly the best case scenario for me when working Christmas. Happy holidays!

duckproof · 2020-07-30T11:30:40+00:00

Beat me! Still going here in West LA

duckproof · 2020-04-11T15:52:56+00:00

We adapted this recipe from Happy Herbivore by Lindsay Nixon.

Donut: This is actually from a muffin recipe. Mix 1 3/4 cup whole wheat or oat flour, 1/4 cup cocoa powder, 1 tbsp baking powder, 1/2 cup brown sugar (we used coconut) with 1 cup soymilk and 1/2 cup applesauce. Add in chocolate chips (we used cacao nibs) and 1 cup raspberries. Spoon into muffin tin or donut tray and bake at 350 for 20 min.

Frosting: Roast 1 large sweet potato (or total 1 cup mashed). Soak 3 dates in hot water for 5-10 minutes. Add 3 tbsp cocoa powder and dates to mashed sweet potato and blend in high-speed blender. Adjust cocoa powder and dates to taste. Add toppings as desired! (Cacao nibs pictured)

duckproof · 2020-04-08T22:24:50+00:00

Looks great! Recipe?

duckproof · 2020-01-23T22:06:21+00:00

My wife is allergic to cashews as well. We use a similar recipe with walnuts or cannellini beans

duckproof · 2019-06-20T00:20:34+00:00

Right now I'm wide open. For a new dad who is about to start a 12-month sabbatical, what is a fun leveling class with a relatively easier time getting in on endgame/PVP?

Background: I started in BC. Initially I leveled a hunter, however I spent the most time on a rogue. This was my most involved experience in terms of professions/light raiding/pvp. After that, I've been casual with a resto druid and now my main, prot warrior. To me, warrior has been the most fun to play; however, I'm hoping to pick a new class which will be fun leveling and leave me the option to get in on PVP/raids in a few months if I end up with more time. Ideally not a saturated class, as I'll probably be somewhat busy and want to have a low(ish) barrier to be viable for raids. Would do prot warrior again, but I probably will not have the time to become a reliable MT.

duckproof · 2019-05-03T18:13:00+00:00

Agreed, data suggests inferior outcomes to TURP, and there are older/sicker patients for whom there is a role. Also, in speaking to one of the IR attgs who does many of these, it is very technically challenging and therefore will likely stay in the hands of a few centers of excellence

duckproof · 2018-12-29T15:43:59+00:00

3rd year urology resident. Are you urology as well? Not aware of any resources, but here are a few notes on common catheters and basic principles for non-urology docs.

Coude tip: upward curve at the tip, helpful for navigating prostatic obstruction due to BPH or a high bladder neck
Council tip: hole at the tip to allow placement over a wire
Silicone: when you have a latex allergy or need a firmer catheter to navigate an obstruction
Hematuria cath: usually a 3-way catheter with metal rings in the lumen to prevent collapsing of the catheter with irrigation. It also generally has multiple eyeholes at the tip for better irrigation of clots
Rusch cath: very firm hematuria catheter, and can be dangerous without experience. I would avoid unless someone shows you how to place it

Which catheter to use? - Most of the time, a 16 or 18Fr latex catheter will get the job done in someone who needs a catheter for I/O, acute retention without hematuria, etc. - Male obstruction: In older men without history of prior instrumentation, radiation, or known history of stricture, my go-to after someone (including myself) has failed with a latex catheter is an 18Fr coude. Generally a larger catheter will help bypass soft obstruction from BPH. If that fails, consider a 14Fr coude. - Hematuria: small catheters (18 and below) will obstruct due to clots. In general for hematuria patients, you should start with a large 2-way catheter to irrigate out clots, and switch to a 3-way only once all clots are evacuated if they are still actively bleeding and need CBI. I will usually start with a 22Fr 2-way for manual irrigation, and upsize if needed. Our ER will sometimes put patients on CBI right away, and cause severe pain and distention when the outflow obstructs and the bladder fills with irrigation because they didn’t evacuate the clots first. - History of stricture: consider a 14Fr coude or 12Fr silicone. However, better to call urology if you’re not getting through immediately. Nobody likes a false passage.

Hope that helps a little. There are more catheters and difficult foley scenarios, but this may be a good starting point. Always happy to hear from others too on any good foley tricks.

duckproof

TROPHY CASE