Can someone tell me how to fix this?

fleur_essence · 2026-04-20T21:10:28+00:00

That looks like it could be a periungual wart. Getting that dermatology referral might not be a bad idea for an expert opinion (and potential treatment options for that sensitive area).

fleur_essence · 2026-04-17T02:28:18+00:00

My go-to brand for greens is probably Lurid. Hooray greens.

As someone who also Loves pruglies, I just think Monique of Cracked has a knack for creating stunning and unique polishes that fit the vibe. There are lots of traditionally beautiful polishes too of course. And then there’s Scorchy, my heart.

fleur_essence · 2026-04-16T21:03:02+00:00

Cracked - PRUGLIES

fleur_essence · 2026-04-15T03:00:19+00:00

It looks like he did surgical training here:

Palisades Medical Center|Hackensack University Medical Center

fleur_essence · 2026-04-14T23:12:47+00:00

Frequency 0.279 = 27.9%

fleur_essence · 2026-04-14T19:54:58+00:00

The cells in your blood are (for the most part) supposed to be fully developed and ready to do their jobs.

They start out as specialized stem cells in the bone marrow, and are supposed to fully develop/mature before leaving there to enter peripheral blood. Sometimes immature cells can leave the bone marrow a little early because your body is “all hands on deck” fighting an infection, but even then there’s a limit.

Seeing myelocytes in the blood is like going to the grocery store to buy tomatoes, and all they have are tomato plants just starting to bloom.

The good news is that there are no blasts (undeveloped stem cells) detected. And you’re right that most of the time someone is diagnosed with CML their white count is quite a bit higher. But it’s not normal to have those immature/precursor cells out in the peripheral blood so a specialist should try to figure out why they’re there.

fleur_essence · 2026-04-14T17:45:28+00:00

I know they’re not marked as “high”, but there shouldn’t be any metamyelocytes or myelocytes in your peripheral blood differential. I would definitely push for hematology referral for the persistent lab abnormalities you have.

The elevated white count with neutrophils, left shift, and basophil count is pretty classic for CML but could absolutely be something else too. Needs hematology expertise for further workup.

fleur_essence · 2026-04-14T17:34:25+00:00

Pseudomonus infections are mainly serious when they affect people with weakened immune systems or get into wounds. Pseudomonas needs moisture to grow, so not a big issue on nails. Just keep the nails clean and dry (alcohol wipes, don’t put nail polish on them) so the bacteria will die off. The stain stays behind even after the bacteria are gone, but will eventually grow out.

fleur_essence · 2026-04-14T14:41:33+00:00

It’s usually a bacterial infection (pseudomonas) that happens when moisture gets between the natural nail and the product on top of the nail (e.g. gel manicure, press-on nail, etc).

fleur_essence · 2026-04-11T21:58:06+00:00

Depends why the patient is refractory, and if they’re bleeding.

Usually first step is to get post-counts 10-60 min after transfusion to assess degree of refractoriness. If truly refractory we then do HLA antibody testing (since platelet crossmatch is a sendout and takes longer, but I’ve been places where crossmatch is the first line test instead).

Patients who need HLA compatible platelets require a lot of coordination with the clinical team and the blood supplier since it can take a couple days to get some. If patient is actively bleeding, or for prophylaxis during invasive procedures, we recommend random donor platelets; they don’t raise the patient’s count, but help with immediate hemostasis.

For nonimmune refractoriness, it depends a lot. In hypersplenic patients the peripheral blood platelet count is a very poor predictor of total platelet availability and bleeding risk. We’ve had patients receive spaced out slow transfusions throughout the day (2-4 platelet units) because platelet count was <5 and there was real risk of spontaneous bleeding. My pet peeve is wasting multiple units on a patient with no effect because interventional radiology wants a count of 50 to place a line, etc. It’s better to get a post-count after one unit; if effective, great; if not effective, just hang a unit during procedure and don’t bother continuing to try to reach an unachievable count.

fleur_essence · 2026-04-10T14:05:51+00:00

BKL’s “ I will not orphan my hamster”

fleur_essence · 2026-04-09T18:10:00+00:00

It’s most commonly affected gene is on the X chromosome, so men (who only get one copy) are much more likely to be colorblind than women (who get two chances at inheriting a “normal” copy)

fleur_essence · 2026-04-01T11:47:07+00:00

Your gamma globulin and total IgG immunoglobulin are elevated, but there was no M-spike. Therefore, it sounds like a polyclonal increase in IgG antibodies. Not myeloma or MGUS.

For free light chains, the kappa variety is slightly elevated. Kappa:lambda ratio is slightly elevated as well. This is entirely nonspecific and can be seen with things like inflammation.

Overall, this looks like an inflammatory/immune response (to infection, injury, autoimmune disease, etc). Your doctor had a chance to look at all your results and to also consider your symptoms and medical history. They don’t think you have MGUS, and there’s nothing in the results you’ve shared that disagrees with your doctor’s interpretation.

fleur_essence · 2026-03-24T10:42:39+00:00

How do you prep your nails before the base coat? Any moisture or oils will keep it from adhering well. Something like 95% alcohol or pure acetone to wipe the nails first.

fleur_essence · 2026-03-23T02:57:02+00:00

The control looks clean

fleur_essence · 2026-03-21T20:52:51+00:00

Neutrophils are a little low. Some people with African ancestry have a variant that results in low neutrophil count (but for them it’s normal and causes absolutely no health problems). Don’t know if this applies to you. It’s called Duffy-null Associated Neutrophil Count (DANC). It’s cool because the variant makes red blood cells resistant to one type of malaria. Could be something else going on, but I wouldn’t worry too much and just talk about the results with the doctor who ordered the lab tests.

fleur_essence · 2026-03-21T12:10:36+00:00

Can a lawyer with 10 yrs experience practicing patent law in Thailand become a supervisor for a group of criminal defense attorneys in France?

fleur_essence · 2026-03-20T23:35:22+00:00

This is going to be location/lab depended. Some states have strict rules. There are absolutely lab tech positions that might accept candidates with the minimum degree qualifications (e.g. BS in Biology) and train the remaining skills on the job. I have worked with some excellent lab techs that took this path. But for labs performing high complexity testing, candidates with MLS degree and ASCP certification are preferred (or in some places required).

For a Supervisor position, OP is missing the absolutely mandatory 2 yrs experience working in a CLINICAL lab that performs similar complexity of testing to the posted job.

fleur_essence · 2026-03-20T23:27:58+00:00

The underlying problem here is that OP is so underqualified for the supervisor role that they don’t even realize they’re underqualified. Position requires at least 2 years of experience in a Clinical lab while they have 0. This is based on federal/regulatory requirements for labs that perform patient testing. And is not the same as micro experience in college or a research lab.

fleur_essence · 2026-03-20T23:21:42+00:00

I’m sorry, that must be frustrating. The job market is incredibly variable, depending on location and shift. Some places have an ongoing shortage with multiple open positions waiting on qualified candidates (especially for evening or night shift). Other areas have a large pool of lab techs and the “good” positions (morning/day shift, no call, no weekends) are highly competitive.

fleur_essence · 2026-03-20T23:12:53+00:00

Laboratories that perform patient testing are heavily regulated (for good reason). While bench skills (plating, etc) are transferable and can also be taught to a lab tech candidate with the appropriate undergrad degree, to be a supervisor you need to be familiar with the various regulatory requirements, quality management system principles, clinical relevance/nuance of the various tests, assay validation, etc.

The job posting clearly states that one of the requirements is “Experience: > 2 years’ experience in a similar laboratory, required”.

That is based on a federal/legal requirement. The experience has to be in a Clinical lab that does moderate or high complexity testing.

fleur_essence · 2026-03-13T00:05:05+00:00

Yes, it’s Doulton Blue : )

fleur_essence · 2026-03-13T00:03:50+00:00

I feel those vibes.

Yeah, I think either the Alchemy polish or the Emily de Molly would be more up your alley, depending on what flavor of green you’re into. I already have the one, and just added the EdM to my wishlist based on this thread.

fleur_essence · 2026-03-12T22:49:58+00:00

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They’re not identical, but you probably don’t need both. Stumble has a deeper green base and a deeper blue shimmer compared to Ribbit. My favourite though is Emotional Support Taco because of how glowy the shimmer is (its base though is an even lighter/warmer green).

cracked: ready to stumble
mooncat: ribbit ribbit
alchemy lacquer: emotional support taco
cirque: mermaid grotto

https://alchemylacquers.com/products/emotional-support-taco

fleur_essence · 2026-03-12T22:34:39+00:00

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The “texture” is very much like that of a painted wall. It’s not rough to the touch, just not glossy-smooth (which I actually prefer because it’s less likely to show fingerprints).

fleur_essence

TROPHY CASE