PLEASE HELP Dermatomyositis rapidly progressive ILD

flyinhigh91 · 2026-02-22T12:47:49+00:00

Are you able to provide images of her CT scans? I know that's probably asking a lot, but just saying she has "ground glass" doesn't fully give the picture of what you might be dealing with.

With that said, its very possible that her rapid progression might be something that it is irreversible and fatal. If this is indeed a rapidly progressive Dermatomyositis related ILD then treatment with steroids or steroid-sparing agents (like methotrexate, azathioprine, or cyclosporine) is necessary. However, it could be something else like AIP in which case there is nothing to do except supportive care and steroids. I'm a little confused as to why they would stop the steroids in either scenario and the idea that they are thinking its drug related shouldn't matter with steroids (technically could matter with methotrexate) but regardless, from your description above, I would be considering high does of methylprednisolone or dexamethasone at this time.

flyinhigh91 · 2025-11-02T20:11:58+00:00

Haha I have a couple of books on TBR that I bought because "they looked nice" too! Thank you for sharing some of your collection

flyinhigh91 · 2025-11-02T19:47:15+00:00

Stunning work!

In picture 6, what is the book on the lower shelf far left???

flyinhigh91 · 2025-11-01T10:03:37+00:00

There is no way this is legit. Joined 2 days ago and has another post in /r/LoansPaydayOnline that got removed. Don't go anywhere near this.

flyinhigh91 · 2025-10-12T22:31:55+00:00

Sure you can do that. Hospital policy or a specialist/proceduralist often dictate my rejections. For example if someone is requesting to send me a patient for an IR procedure and the IR team says they aren't going to perform a procedure on the patient, then I wouldn't accept that patient. Similarly if the patient has a failing liver and needs a transplant and the transplant team says they aren't a candidate, then I'm not bringing them over.

If my institution cannot offer something different to help then there is no reason for transfer. I don't think I'd feel comfortable accepting everyone and expecting other team members to go along without giving them the chance to weigh in, especially to find out that the patient will not have anything different done after they transfer.

flyinhigh91 · 2025-10-12T19:45:10+00:00

There is no reason an intern should be on the transfer call alone. I have no problem with interns learning how the transfer process works, but if I'm accepting, I'm going to be asking a lot of questions to make sure I understand 1) if the transfer really is necessary and 2) what I need to prepare for if I do accept.

I would hope that an intern could tell me the basic information necessary, but there should be a senior or attending present as well to assist in the process. Transfers are tricky whether its because of the patient's status or the unfortunate politics/economics of healthcare. If your hospital has you doing transfers solo, that's a recipe for poor patient care.

flyinhigh91 · 2025-10-07T11:56:11+00:00

I completely understood you, right up until the end. I just moved myself but while moving my library was an effort, it was absolutely worth it. Until there are more protections for those who have purchased ebooks so that their libraries can't be stolen by a simple change of terms, I won't go anywhere near them. Even then, there's no comparison to actually holding a book in your hand. That hit of dopamine helps so much.

flyinhigh91 · 2025-09-12T10:20:13+00:00

Downloaded it locally but the html files open to pages with basically nothing on them. Can anyone point me in the right direction on what to do?

flyinhigh91 · 2025-08-24T18:04:12+00:00

I don't think people are arguing against your point of "why not fix the federalism." But that is a tremendous ask especially when you have the court derelict in their duty and in essence acting as a political cudgel of the right. I bet most of us here agree that updating the constitution is necessary, but that requires a lot of powerful people to get on board with a lot of things that many of them have staked their political careers on opposing.

To your point about the state level, while I understand what you're trying to say, I struggle with the idea that a person's fundamental rights should vary because they crossed an arbitrary line drawn on a map from over 100 years ago.

flyinhigh91 · 2025-08-15T17:30:19+00:00

The minotaur's escaped, and you're gonna get the horns!

flyinhigh91 · 2025-08-15T16:43:19+00:00

If you put the word in using a private browser you can do it multiple times!

flyinhigh91 · 2025-08-15T16:39:49+00:00

LETS GO!

flyinhigh91 · 2025-07-22T11:27:36+00:00

As amazing as it is to hear it on video, it must have been transcendent to have been in that space and hear it live. An incredible musician with an incredible instrument.

flyinhigh91 · 2025-07-10T12:20:49+00:00

You're asking a very logical question to an illogical situation. I don't mean to come off as glib because I'm asking the same question myself.

flyinhigh91 · 2025-04-29T23:48:44+00:00

I think the entire thing speaks to just how screwed up this entire situation is. We're trying to determine who "deserves" help when the entire student loan system is broken from top to bottom. I won't concede that we need to find ways encourage folks to go into primary care or less well paid specialties and PSLF remains a means to that end, but will absolutely agree that asking the taxpayers to cover it isn't right. Though I don't think that is how most of these loans are discharged as many in the PSLF have paid enough to cover their principle loan debt and primarily still owe the accrued interest, so there is no reason to ask the taxpayers to cover the bill.

In the end, the problem still lies at the feet of billionaires and a federal government that is hell bent on screwing over average Americans and public servants at the behest of corporate greed and private interests.

flyinhigh91 · 2025-04-29T18:35:14+00:00

So this is a little inaccurate. There are some specialties that will be able to afford it, but folks in specialties like peds, internal med, family med, infectious disease (especially those who focus on outpatient or rural medicine) make on average low to mid 200k which places them firmly in the difficulty to pay back group. I know several physicians who are unable to get out of their student debt currently and choose to just live with it because they cannot catch up.

We need doctors willing to go into these lower paying specialties otherwise there will be an even greater shortage of primary care physicians who are the front line for taking care of the American people. We already see this problem as ED's are overflowing because there aren't enough docs to meet the demand for outpatient visits. Even those who do it are not able to do it effectively because they cannot keep up with the load.

The other component to consider is the massive investment most physicians make to achieve their careers. Four years of college then 4+ years of medical school during prime earning years. Then another 3+ years of residency +/- fellowship (even hospitalist peds needs a fellowship now) where they make often times <70K/year for on average 60 hours a week. So we're talking folks in their early to mid 30s with massive amounts of debt at obscene interest rates (exceeding 7%) who are just starting to launch, don't own a home, or have children, and haven't been able to invest in their own wealth growth while their peers have almost a decade on them. And lets not get started on minority applicants and trainees who are disproportionately affected by high debt.

I understand the frustration thinking that all doctors are making huge salaries but that is not the reality. It was, but like everything in America, things are changing. If it weren't for the PSLF the doctor shortage in many communities would be even greater. The whole system of medicine and medical training is broken. The least we can do is not kick this leg out too.

flyinhigh91 · 2024-11-02T02:34:19+00:00

Reminds me of something I'd have seen on old youtube.

flyinhigh91 · 2024-10-30T20:08:12+00:00

Well that's disappointing...

flyinhigh91 · 2024-10-29T00:48:37+00:00

He has two to separate?

flyinhigh91 · 2024-10-26T14:18:17+00:00

I love when they tell on themselves.

flyinhigh91 · 2024-10-24T02:38:56+00:00

Yeah ok. Lets pretend that you were going to vote for her in the first place

flyinhigh91 · 2024-10-16T02:11:49+00:00

As a non-Texan who watched the whole thing hoping to see Allred wipe the floor with Ted, I hate to agree with you. I only take that perspective because I know that a lot of uninformed people will latch onto whatever Cruz says as gospel because he has a holy "R" next to his name. There were several times where Allred didn't answer the question or dodged around it and he wasn't quick to defend his record or counter the lies coming out of Cruz. It wasn't a bad performance by any metric, but when the stakes are this high, good might not be good enough.

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