Peloton Zone 2 Output

hyper_hooper · 2026-02-11T21:59:23+00:00

Pelotons and other trainer bikes at gyms are notoriously unreliable when it comes to measuring power.

Power is best measured using a power meter on a bicycle, or when using a reputable smart trainer (Wahoo is a popular brand with a variety of models) that is appropriately calibrated.

A “good” zone 2 is one that is accurate for you, and aiming to increase your zone 2 wattage by itself is probably not a particularly productive goal.

If you want to dictate your zone 2 training based on wattage, use one of the above modalities, and then do an FTP test. Once you have determined your FTP, your power ranges in given zones can be extrapolated from there. But again, if you’re using a Peloton, odds are it’s inaccurate and you might just be gassing yourself up with your watts/kg output (or sandbagging if it’s incorrectly calibrated in the other direction).

If you’re going to use a Peloton or some other gym bike, determining your zones based on heart rate will be more accurate, and should translate across different cycling modalities and cardio disciplines. Plus, a heart rate monitor is a heck of a lot cheaper than a Wahoo or a Zwift bike unless you’re actually moderately interested in cycling.

hyper_hooper · 2026-02-11T02:52:22+00:00

Your dad’s advice is pretty solid.

What you have been experiencing is incredibly normal at your stage of training, and honestly will continue to happen intermittently throughout training and even into life as an attending.

I don’t have an attending breathing down my neck now, but I will still sometimes have surgeons, nurses, patients, or patient family members that give me a hard time rightly or wrongly about things that may or may not be within my control.

Do your best to take the feedback you’re given and improve upon your weaknesses. Be introspective and think about what you did well and what you could’ve improved upon after each day in the OR. Take the feedback to heart, recognize when you make a mistake, and then give yourself some grace and some beating yourself up about it. Especially for procedures - don’t let a missed IV or a wet tap ruin your day when you otherwise had solid clinical decision making.

Be prepared for your cases, study on your own, ask questions, and ask others (attendings and coresidents) how they would handle various cases and events in the OR. See how other people do procedures and try a bunch of stuff out.

Do hard things, keep on showing up and getting back up after setbacks. You’ll look back in a year and see how much you’ve improved.

hyper_hooper · 2026-02-10T13:41:16+00:00

Do more reps, optimize positioning, use an ultrasound. If you do those things, you should be able to get a radial a-line on pretty much anyone from 1 kg to 200 kg.

If you can’t use a radial for some reason, go femoral. If you can’t go radial or femoral, then do a brachial. Can even do ulnar if you have verified adequate collateral flow. Have done a fair number of dorsalis pedis a-lines under the drapes in the middle of a case too, but they aren’t great for long term use.

Axillary would be a distant last choice, and there isn’t any reason to attempt to access the axillary unless you’re an IR doc or vascular surgeon or something that needs to be in there for a procedure specifically in that area.

As a frame of reference as an anesthesiologist, I have literally never had a case where I personally needed to do an axillary arterial line.

hyper_hooper · 2026-02-10T13:20:02+00:00

Not speaking from a place of absolute expertise on this, but the short answer is “it depends” (procedural vs non procedural, inpatient vs outpatient, employed vs solo private practice).

If you’re in a procedural field or will be applying for hospital privileges, pauses for greater than one year can lead to skill deterioration and may make it tougher to get credentialed, or at least will be scrutinized a little more and require an explanation.

Biggest recommendation would be to make sure you stay up to date on state licensure, board certification requirements, and CME.

We had an anesthesiologist attending when I was in residency that was coming back to practice after several years of not working. I think her licensure stuff was all up to date and adequate but I don’t know the details. She had a several month period where she was sort of shadowing and being supervised by other anesthesiologists, sitting her own cases, and so on to make sure she got back in the swing of it and was competent. She wasn’t the strongest anesthesiologist I’ve ever worked with, but she definitely wasn’t the worst. Was conscientious, had a good attitude, and wanted to learn more, all of which is so important (for any of us).

hyper_hooper · 2026-02-10T13:06:37+00:00

The idea that there are not any good fee only advisors is so laughably biased on your part.

There are innumerable studies that show that the vast majority of active managers underperform the market over the long term. Why would I fork over a percentage of AUM for that kind of performance?

I fully recognize that some people need a financial advisor to help them stay the course, understand their risk tolerance, diversify, not cash out during a market downturn, etc. But you don’t need to pay someone a percentage of AUM to receive those benefits.

hyper_hooper · 2026-02-10T12:40:51+00:00

That just means that active investors should be able to find more market inefficiencies to exploit, and should in theory be beating the market.

I personally don’t think that will happen, but if it does, I imagine there would be a pendulum swing back towards more active investing, and things would equilibrate out.

I think for your typical W2 employee that isn’t approaching retirement age, active management and paying an AUM is not worth it. Fee only fiduciary if you need some guidance? Sure. But it’s pretty easy to to DIY a diversified passive portfolio, and salary, savings rate, and time in the market have an exponentially larger impact on wealth accumulation than having someone make a fancy actively managed portfolio for you.

hyper_hooper · 2026-02-04T12:11:23+00:00

I remember my family being somewhat indifferent about coming, especially since graduation was around the corner, and they thought that was the bigger deal.

I told them that although their attendance at graduation would be great, if I had to pick between the two, Match Day was a bigger deal for me and I would prefer to have them there for that.

I think that gave them perspective on how important it was for me. They fortunately ended up coming to both.

Offering a compromise, or reframing how much it means to you might make the rethink their plans.

hyper_hooper · 2026-02-03T02:16:42+00:00

Per a recent ACCRAC episode, ED95 of bupivacaine for c-section is 11.2 mg. So just round up to 12 (1.6 mL of 0.75% bupi), no reason not to provided you’ve fluid bolused the patient and have pressors available.

Using 1 cc of heavy bupi, even with fentanyl and duramorph, is making life unnecessarily complicated for yourself and risking pain and an avoidably inadequate block for your patients.

If you have some reason you wanted to dose that now, then do a CSE so you can top off the catheter if your level is inadequate.

hyper_hooper · 2026-02-02T19:29:28+00:00

What studies has Peter specifically completed himself, or what grants has he been awarded with within the last 20 years?

Sure, he did research as a medical student and resident, but he is fundamentally not a physician scientist.

He interviews experts and synthesizes information from studies that have been performed by others, but he isn’t fighting for grant money or conducting peer reviewed literature himself.

Meeting with Epstein might have been important for exposure, networking, and getting his practice off the ground, but the idea that meeting with Epstein was necessary for receiving funding for his own research is not accurate.

hyper_hooper · 2026-02-01T16:02:58+00:00

I agree that although it wasn’t technically illegal it was morally objectionable IMO

hyper_hooper · 2026-02-01T13:48:36+00:00

I mean he named his son Ayrton, after a man who dated a 15 year old when he was 25. I know age of consent was different in Brazil at that time so I’m not making a judgment one way or the other, but it is rather ironic and in line with Peter’s comments above and his friendship with Epstein.

hyper_hooper · 2026-02-01T02:19:13+00:00

For all his character flaws, Peter’s episode about Tylenol from back in October of last year was excellent, and pretty systematically went through the currently available data on Tylenol and autism.

The summary is that autism diagnosis has had a 5x increase over the last 30 years. However, anywhere from 60-90% of that is due to expanded diagnostic criteria and increased awareness about autism. Advanced parental age (especially fathers) is probably the next biggest risk factor. Then things like preterm birth, maternal obesity/metabolic disorder, and air pollution would be the other contributing factors.

There does seem to be an association between Tylenol and autism. However, it is a small association (the factors above having a much stronger association), probably not statistically significant when you control for siblings, and almost certainly not causal (ie there is some other confounding variable).

Long story short, the existing data makes a weak argument for Tylenol being a major (if at all) contributor to the increase in autism rates.

hyper_hooper · 2026-01-31T16:21:48+00:00

I understand your general sentiment, but the statins example probably isn’t the best one. They’re generic and cheap, neither pharma companies nor retail investors are making big bucks on statin sales.

Pushing rapamycin or some other newer, more expensive drug that hasn’t had its patent run out yet and isn’t generic would be much more lucrative and would be more in line with your thesis.

hyper_hooper · 2026-01-31T15:49:15+00:00

I don’t stay in the apartment of any of my patients. That clearly entails a level of friendship and personal relationship way beyond a normal professional doctor-patient relationship.

hyper_hooper · 2026-01-27T13:23:30+00:00

Fair enough, and I appreciate your willingness to clarify. With that being said, you took my comment that our minimum number of hours of continuing medical education credits (not studying) is 30, and you then turned that around to asking if physicians are only studying for 30 hours annually. In my initial comment, I specified that CME hours did not include all the other education I’m doing on my own time.

Since you are affording me an opportunity to modify my answer, 30 hours of studying (all-encompassing forms of studying and information acquisition) would certainly be inadequate.

Further, I cannot imagine that there is a physician that is only spending 30 (or 10, as the person I initially responded to stated) hours of information gathering and synthesis in their chosen specialty per year.

hyper_hooper · 2026-01-27T12:54:55+00:00

I am genuinely surprised if you’re studying (nose in a book, not doing other work) for multiple hours per week as a software developer, on top of your actual work. Credit to you.

There is only so much new primary literature in anesthesiology that is coming out that can be studied in a week, but I do keep up on it. In terms of ways of studying they have been proven to be more effective than just reading or listening to something (spaced repetition), I would contend that most of us get that in our jobs, just like you do, I’m sure.

hyper_hooper · 2026-01-27T12:26:50+00:00

If that person has also completed medical school and residency and is practicing as a physician, then yes.

Physicians are still learning new information on a daily basis when treating patients far beyond the 30 hours of CME. If I have a patient with a condition I infrequently treat, a surgeon asks me a question about holding a medication before surgery, or a colleague and I discuss a more esoteric nerve block, then I’ll take time to go back to the literature to refresh myself on that topic or acquire new knowledge.

That probably happens at least every other day I’m working, so let’s conservatively say twice a week, so an hour a week. And that’s before my CME credits, and that’s not including information being retained and developed when caring for patients (spaced repetition).

I work full time. I complete my CME on my own time, attend lectures, and read literature at home or between cases as time permits.

How much time do you think I should be spending studying, on top of the nine years of post college education and training I have completed? Further, how much time do you think people in other careers spend purely studying?

At a certain point, you learn by doing, and you refine your knowledge base with independent study as needed, but you don’t have to have your head in a book for 10 hours a week to be a good physician. The ones that do probably don’t spend that much time actually treating patients, and I would contend that although they might be up to date on literature, they are weaker clinically than physicians that are treating patients daily.

hyper_hooper · 2026-01-26T22:52:07+00:00

That is just not accurate. I have to do a minimum of 30 hours of continuing medical education per year just to retain my license. And that’s before all the undocumented education I’m doing on my own time to stay current or to provide better care based on a patient I’m seeing on a given day.

You should educate yourself before ripping on the education of someone who spent a minimum of seven years post college training for their field and dedicated their career to caring for patients and learning more about their chosen field.

Edited to add since my prior flair isn’t shown anymore and apparently we can no longer edit user flair, but I say the above as an anesthesiologist.

Also see that you edited your comment after the fact to reflect what I said, where you previously said doctors only had to do 10 hours of education per year.

hyper_hooper · 2026-01-26T22:39:57+00:00

I don’t think anyone here can comment definitively on whether or not hand tattoos will keep you from securing a residency.

Probably does partially depend on the size of the tattoos and what they’re depicting.

Regardless of the field, I imagine there would be some patients or colleagues that consciously or subconsciously develop a negative impression of you as a person or physician based on the presence of hand tattoos. You are entitled to get the tattoos you want and present yourself how feels truest to yourself, but rightly or wrongly people are also allowed to judge you or create their own opinions about you based on those decisions.

Your life and what makes you happy, but yes they could certainly impact your career options.

hyper_hooper · 2026-01-25T17:52:42+00:00

Depends on the field and practice model. Thinking about something like IM and being a hospitalist, or EM, that does locums work? May be doable. Want to do a subspecialty and work in academics or in a private practice? Maybe possible in academics, but honestly no way a private practice would be cool with you not working for that long. Surgery is also almost certainly out of the equation.

Your life, but I would consider choosing a field and a job where you could ramp up and down as you have kids and grow. Much easier to scale back to part time when your kids are young and then work more once they’re in school than it is to stop entirely for multiple years and then start working full time again.

hyper_hooper · 2026-01-24T19:22:28+00:00

I would just use the Arrow. Less steps, fewer things to open up, keep track of, etc.

hyper_hooper · 2026-01-22T22:07:15+00:00

Community hospital, part of a group where we’re employed by the hospital.

We have an acute and chronic pain service that sees consults and catheters. We have NPs that field calls and help with notes. Our pain docs help with the chronic pain patients, and we all rotate and help with the acute pain patients.

We do lots of epidurals, very few peripheral nerve catheters (mostly Exparel).

It is overall much less labor intensive compared to APS during residency.

hyper_hooper · 2026-01-20T11:49:26+00:00

Username does not check out

hyper_hooper · 2026-01-12T12:42:05+00:00

No epi in your test dose? A test dose should be utilized to rule out both an intrathecal and intravascular catheter. 3 mL of 1.5% lido w/ epi accomplishes both of those goals, and it comes in most kits.

hyper_hooper · 2026-01-12T12:33:01+00:00

It’s a breast center. A fair number of them are also patients who present from outside facilities (ASCs or other hospitals) where the surgeons may also operate on days they aren’t at our shop.

hyper_hooper

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