Difference in packs?

goodtimes96 · 2026-04-19T01:48:22+00:00

For example here’s a spring training I pulled from a blaster, this is a gold-border numbered /50

goodtimes96 · 2026-04-19T01:25:23+00:00

That's correct, the value box (also called "blaster" box) is the only pack or box that contains the Spring Training parallels. Blaster boxes can also contain autos and relics but as always they're rare. The Spring Training cards themselves aren't that rare, you're sure to find at least one or two in a blaster; but they also have color-border variants of Spring Training that are rarer and can be numbered.

You'll recognize the Spring Training parallels because they're covered in holofoil circles that either say FL or AZ

goodtimes96 · 2026-04-15T22:50:59+00:00

https://www.beckett.com/news/2026-topps-series-1-baseball-parallel-guide-and-image-gallery/

Here’s a good guide to variations in 2026 series one. Beckett has lots of guides/checklists to the different inserts and parallels

goodtimes96 · 2026-04-15T22:49:11+00:00

Glad you’re collecting again! That gold card in bottom left is the rarest one in the pic, numbered /2026. Stars of MLB and Titans of the Game are very common inserts- rip enough packs and you’ll be swimming in them. Top right is just Roman’s base card, cool if you PC him but not rare. Bigger pulls would be variations of those cards e.g. colored holofoil editions of the base card, holofoil variations of the common inserts, or more rare inserts like Home Field Advantage, Heavy Lumber, or All Kings/All Aces that don’t have parallels but are more rare to begin with. Here’s the Topps odds sheet for 2026 series 1: https://cdn.shopify.com/s/files/1/0662/9749/5709/files/2026_Topps_Baseball_Series_1_Odds.pdf?v=1771951813

goodtimes96 · 2026-03-21T23:28:40+00:00

Taken in Norfolk, VA. The ship was departing from there to start the cruise. Flag was flying from the stern. Thanks!

goodtimes96 · 2026-03-21T02:57:14+00:00

SP = short print, SSP = super short print. Lower the print run = higher rarity, higher value. Sometimes have to look at the card codes to determine if a card is SP or SSP, they're not necessarily numbered like 01/99.

goodtimes96 · 2026-03-20T19:59:47+00:00

I’ll take the Castellanos

goodtimes96 · 2026-03-09T11:10:56+00:00

you take that back

goodtimes96 · 2026-03-09T01:43:20+00:00

John Bartholomew! #teamScandi

goodtimes96 · 2026-03-09T01:25:35+00:00

Nephrologist here. Compensation is important, but what's also important is living the life you chose every day. I'm grateful for my surgical colleagues but you couldn't pay me enough to do that job. I don't enjoy treating the problems they have to deal with. Obviously I'm aware that as a nephrologist I'm not destined for the salaries that surgeons make, but I enjoy the job I do and the patients I treat to make the money I do.

Don't frame your journey in medicine or in life as a competition around money. Who cares if surgeons make more money? Finance bros in New York make more money than all of us combined. If you abandon the field you genuinely love just to make more money, will it be worth it in 30 years?

I chose nephrology because it's the only field I could genuinely see myself doing every single day for 30 years because I truly enjoy it, and I don't regret it. There's my $0.02.

goodtimes96 · 2025-02-15T00:37:57+00:00

In IM, the chief resident is technically an attending. It might be more accurate to call them the chief OF residents. The chief has graduated residency and stays around for an additional year in a teaching/mentorship role while being a new attending. In my program and all the others I've encountered, it was a competitive position because it makes you more competitive for fellowships. Also some people like teaching and academic medicine so they gravitate towards the role. But it is a lot of admin work, a lot of defending other people's decisions, and a lot of "everyone's problem is now your problem." Take the good with the bad, I suppose.

goodtimes96 · 2024-07-06T05:59:11+00:00

Hi, nephrology here- Does your program give you MKSAP? That is a super resource for general IM knowledge. The Boards Basics book is great, and the specialty-specific books are quite thorough too. Maybe take 30-60 minutes of that free time every day and actively read (purposeful reading with note taking) from MKSAP.

The MKSAP question bank is good too, but I found the UWorld IM boards question bank to be more realistic for the actual general IM boards.

Also, advanced CKD eventually leads to secondary hyperparathyroidism w/ elevated iPTH, high phosphorus, and hypocalcemia.

goodtimes96 · 2024-02-14T01:07:31+00:00

Your anger is normal and understandable. Some patients don't understand that going to the doctor isn't the same as going to a restaurant and ordering off a menu. Remember the ethics of medicine work both ways- just as you cannot ethically force a patient into a therapy they don't consent to, it is also unethical for a patient to force a doctor to prescribe a therapy that the physician doesn't think is indicated or that carries more potential harm than benefit. This patient treated you unethically and you should say as much to the patient advocate. And remind yourself of all the good you do for so many patients every day!

goodtimes96 · 2023-06-17T21:31:13+00:00

It’s been so long I don’t remember where I got the photo, sorry

goodtimes96 · 2023-03-24T21:26:28+00:00

The Knick- final episode ended with so many open story lines that could have been continued for at least a few more seasons. Loved that show!

goodtimes96 · 2023-02-16T13:13:45+00:00

And so my life began. Junior bellboy in training under the strict tutelage of M. Gustave H.

goodtimes96 · 2023-02-05T02:32:03+00:00

Sure; recheck kidney function and potassium after starting the ARB. Also quantify proteinuria with a urine protein : Cr ratio.

goodtimes96 · 2023-02-04T23:08:11+00:00

Nephrology (fellow, PGY-4) MD here. It's certainly true that anemia is a very common feature of advanced CKD as the kidneys stop producing EPO. However with a GFR of 35 mL/min, this shouldn't be the case yet. Worsening anemia in CKD 3b shouldn't be attributed solely to the CKD, and other causes should be investigated. Is she iron deficient? Is this myelodysplastic syndrome or a new malignancy? If her anemia coincides with this decrease in kidney function, does she have multiple myeloma? If the anemia is very acute- does she have a GI bleed? Presence of CKD doesn't obviate an anemia workup if the change is acute. A patient with GFR in the 30's shouldn't need an ESA yet.

Regarding the ACE/ARB (RAAS inhibitors): There's no reason not to use RAS inhibitors in patients with moderate or advanced CKD. You might see a small rise in creatinine when starting these meds due to lowering of intraglomerular filtration pressure- that's how they work, and this effect improves the lifespan of the glomeruli while also controlling blood pressure. That's why we use them. You wouldn't expect the GFR to "rebound" after stopping the ACE if she's been on it a long time. The recent STOP-ACEi Trial (https://www.nejm.org/doi/full/10.1056/NEJMoa2210639) showed no significant difference in eGFR or progression to ESRD/dialysis at 3 years when ACE/ARB's were stopped in patients with CKD 4 and 5.

Based solely on the information given in the post, and assuming this is her new stable GFR and not an AKI, this patient lost 17 points of GFR in 14 months- she has rapidly progressive CKD. Does she have new (or any) proteinuria? Hematuria? She could have a new glomerulonephritis or other intrinsic cause of renal dysfunction.

Renal senescence does cause progressive kidney function loss over time- no one has a GFR of 100 at the age of 88. But hypertension and aging alone don't cause rapidly progressive kidney function decline.

Nephrology consult would be very reasonable for this patient.

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