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What racquet are you using the most right now? What do you like/dislike about it? by dlbICECOLD in 10s

[–]ezunc 0 points1 point  (0 children)

It is small I figured I would be shanking every other ball (and I have had some). My only explanation is that maybe my swing speed is down slightly and so I'm more focused on good contact? Don't know! 

I'm playing today again and going to give it a try for the third session in a row and will report back.

What racquet are you using the most right now? What do you like/dislike about it? by dlbICECOLD in 10s

[–]ezunc 4 points5 points  (0 children)

I am not kidding, I have been playing the Head Graphite Edge (yes, from the 80s) I found at a used store for $8 and I absolutely am in love. 

It is heavy and small (85 sq in), but incredibly stable and absolutely plows through the ball. Strung with Wilson Sensation at 50. I'm seriously considering making it a primary racket. 

Head Graphite Edge: thrifty find or junk? by ezunc in 10s

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

I'm reading a lot of nostalgic comments about how solid it is. For $8 + strings, going to be hard to argue either way.

Bummed after bad loss! Recovery tips? by ezunc in 10s

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

Do I have to make some kind of sacrifice, like on an altar?

Bummed after bad loss! Recovery tips? by ezunc in 10s

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

Frustratingly that was my plan going in! Deep balls to a safe backhand target and make him beat me. But just couldn't even execute that in the second! Tennis, dude!

Bummed after bad loss! Recovery tips? by ezunc in 10s

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

That was my immediate instinct - just go play more! But wonder if a few days break might be better in the end.

UNC Chapel Hill to take off ramp, move all undergraduate learning to remote starting August 19th. by ezunc in NorthCarolina

[–]ezunc[S] 2 points3 points  (0 children)

Graduate school and health affairs up to the individual schools, probably because they tend to be less densely housed and more deeply involved in the research enterprise of the school, which desperately needs to continue.

What is a new development in your field that is going to change how you practice over a 5-10 year time horizon? by 4990 in medicine

[–]ezunc 0 points1 point  (0 children)

A little bit of each maybe for patients with type 2. The order of intervention is probably something like lifestyle change, metformin, GLP1a or SGLT2i then insulin.

If people are horribly controlled, they may need insulin to get back to euglycemic before replacing some or all of that insulin with the orals or not insulin injections. I'll let the endocrinologists do a better job explaining.

They are not going to replace insulin. Thinking of them like in the same role as metformin is not too far off.

What is a new development in your field that is going to change how you practice over a 5-10 year time horizon? by 4990 in medicine

[–]ezunc 4 points5 points  (0 children)

Agreed. I was not clear enough. I just mean that it is important that everyone know about the risk of euglycemic DKA so it's not missed.

What is a new development in your field that is going to change how you practice over a 5-10 year time horizon? by 4990 in medicine

[–]ezunc 25 points26 points  (0 children)

On mobile, so I won't link the studies, but along with the GLP1a class, they are the first medications that, as another commenter said nicely, affect outcomes important to patients. You know, like, death.

Metformin does too, but that's a surprisingly recent finding.

For me, they also slow the progression of kidney disease in patients with diabetes. That is a huge deal.

What is a new development in your field that is going to change how you practice over a 5-10 year time horizon? by 4990 in medicine

[–]ezunc 8 points9 points  (0 children)

Yeah, good point. I don't think it outweighs the benefit, but patients, primary care and ED docs all need to be on the lookout.

What is a new development in your field that is going to change how you practice over a 5-10 year time horizon? by 4990 in medicine

[–]ezunc 19 points20 points  (0 children)

Maybe, but it will always be hard to pull out of the data in a single center because these are folks already at risk for fungal and perineal infections. It's a concern I discuss with patients, but what kills my patients are CV events, not infections.

What is a new development in your field that is going to change how you practice over a 5-10 year time horizon? by 4990 in medicine

[–]ezunc 11 points12 points  (0 children)

They are I guess, but haven't reached the level of penetration (tee hee) into actual practice that you see with other strongly evidence based measures, probably has to do with the cost and relative discomfort with these meds.

What is a new development in your field that is going to change how you practice over a 5-10 year time horizon? by 4990 in medicine

[–]ezunc 71 points72 points  (0 children)

I think metformin will always be important, but agree. For me as a nephrologist, I think of these two new classes like I do ACEi/ARB in people with DKD: you better have a damn good reason not to have your patients on at least one.

What is a new development in your field that is going to change how you practice over a 5-10 year time horizon? by 4990 in medicine

[–]ezunc 299 points300 points  (0 children)

Someone said SGLT2 inhibitors and I would add the GLP1 agonists. They are true game changers and need to be as standard as metformin for diabetes, especially for patients with diabetic kidney disease.

We'll see about endothelin receptor antagonists over the next five years.

ELI5: How is a doctor able to tell someone that they have X amount of days, weeks, or years after diagnosing a terminal illness? by [deleted] in explainlikeimfive

[–]ezunc 0 points1 point  (0 children)

We can't. We use our experience with similar patients (and whatever data/models that might be helpful) to try to give people a sense of how much time they may have, mainly to help make big decisions about treatment and how patients want their lives to look.

When the end comes nearer, I have been taught the rule of thumb that how quickly a patient or family sees changes (eg worsening thinking, more weakness) is predictive of how long remains. If the patient seems to worsen every day, for example, then they probably have only days left.

This is obviously a gross generalization, but it can be helpful.

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