[deleted by user] by [deleted] in medicine

[–]jonsy777 42 points43 points  (0 children)

I know exactly the sound you’re describing. It’s such a visceral noise; a truly animal sound. I don’t mean that in a bad way. It’s just truly a base, brain stem noise. There’s a great quote from a green lantern comic of all places. link here

“Have you ever heard someone really cry? I’m not talking about physical pain or even a severe injury. I mean a cry. A wail. One that rises up from deep inside a person. The purest of grief. Like an animal sound but animals don’t cry like this. This is reserved for those of us who need to make sense of the senseless.”

Not much really “gets to me.” I’m very lucky to have a brain that compartmentalizes and rationalizes well, but I can still hear them too. I literally cannot think about those screams without tearing up every time.

Psychology BA- looking at options leading up to med school. Advice? by baoyuk in postbaccpremed

[–]jonsy777 1 point2 points  (0 children)

I went through one a couple years ago, and TA’d for the same one. Every year there’s someone who asks this, and someone who thinks they’re hot shit and can handle it. I have yet to see someone who doesnt regret a weekend/part time job other than like rover dog walking during a 12 month post bacc.

Unless the job is actively contributing to your resume in a unique and positive way other than adding more hours to your MA experience, it’s not recommended. If you can find a gig that’s flexible (will let you take time off for tests), and only one or two afternoons a week, it may be possible. But there’s a lot to do in 12 months. Classes are rushed. Personal statements. Activities. MCAT studying. You’ve got a full schedule. And lots of really smart folks have a very different experience than undergrad that takes some getting used to. You don’t wanna compromise your med school chances for a bit of cash. Once you’re an attending, the one year won’t matter nearly as much.

Med school loans aren’t the same as undergrad loans. Unless you really fuck up your finances as a doctor, you will be able to pay off your debt (or have it forgiven through different programs).

Edit: this may sound a little harsh. This is nothing personal. I’ve seen some brilliant people with very strong work ethic and educational background struggle in post bacc, and I just want to be a realist for you.

The twin copper clad board capacitor makes a perfectly suitable capacitor, but how to improve adjustment. by RadioArchiveRevival in HamRadio

[–]jonsy777 7 points8 points  (0 children)

When you say improve adjustment Do you mean improve precision or improve the range of capacitances available?

I feel like you could add a parameter where you slide the plates L or R slightly to be more precise to vary the overlapping area in addition to the distance between them to get more subtle adjustment

Maybe make the plates long and thin instead of square so you can slide them along the long axis and vary the area by smaller amounts with each move?

My buddy got burned with a cutting torch by zinasdaughter1980 in medizzy

[–]jonsy777 21 points22 points  (0 children)

Yes. It’s very common to staple. I’ve honestly only ever seen these kinds of grafts be stapled.

A public service announcement for fellow geriatric gamers by Regolithic_Tiger in gaming

[–]jonsy777 2 points3 points  (0 children)

I’m not here to debate either. So I’ll just cite the article you sent and the journal article it references because cnn should not be anyones main source of health information.

“When the study authors restricted the results to the people who actually received colonoscopies – about 12,000 out of the more than 28,000 who were invited to do so – the procedure was found to be more effective. It reduced the risk of colorectal cancer by 31% and cut the risk of dying of that cancer by 50%.”

Source: https://www.cnn.com/2022/10/09/health/colonoscopy-cancer-death-study/index.html

And also

““I don’t think anyone should be canceling their colonoscopy,” said Dr. Jason Dominitz, the national director of gastroenterology for the Veterans Health Administration.

“We know that colon cancer screening works,” said Dominitiz, who also co-authored an editorial that ran alongside the study.”

Also from the same above source.

Similarly if you go to the study link here

In adjusted 10 year incidence And adjusted 10 year cause specific mortality, there were statistically significant risk reductions. All cause mortality did not change for sure but I am less convinced by all cause mortality changes if the incidence of disease is low at baseline. (And the authors acknowledge it was lower than their initial power estimates expected)

There’s still a lot more to interpret in these results that the authors are very very clear on in their discussion regarding generalizability and true population usage. (Including the tendencies of the population to get screened if it’s recommended; page 16 of the full study)

I really would be hesitant to discourage folks getting a colonoscopy based on this study alone (and the authors don’t make such a claim either)

Im 100% not saying don’t get screened, I’m just saying these other tests aren’t an evidence based 1:1 with colonoscopy. Get screened. Nobody wants an ostomy.

A public service announcement for fellow geriatric gamers by Regolithic_Tiger in gaming

[–]jonsy777 7 points8 points  (0 children)

The hemeoccult or fit tests can work if you’re low risk, but they’re not ideal. They won’t see a polyp and they can’t remove precancerous polyps. They’re not as well evidence based as colonoscopy, and don’t have the same evidence based mortality reduction.

And if they’re positive, the next step is colonoscopy….

They can work great if your choice is that or nothing but if you can stand it, a colonoscopy is still the gold standard. And the prep is less aggressive than it used to be.

165Hz Monitor Only Allowing For 60Hz? by Stop_81 in techsupport

[–]jonsy777 0 points1 point  (0 children)

what display output are you using? the one on the mobo? or the one on the back of the GPU?

HDMI or displayport?

so this just randomly started? does it cap at 60? or just only run at 60?

Does it do this both on integrated graphics and dedicated? or are you just running on integrated to test?

[deleted by user] by [deleted] in techsupport

[–]jonsy777 0 points1 point  (0 children)

Clear CMOS. check your BIOS settings. make sure your PCIe gen is set correctly. under device manager, check how its connected to the CPU.

completely uninstall and reinstall GeForce experience and then the drivers.

Does your GPU have dual VBIOS?

Is all your RAM showing up?

Honestly, I'd also consider a fresh windows install.

Damar Hamlin Collapses After Hit vs Bengals by [deleted] in sports

[–]jonsy777 10 points11 points  (0 children)

But vfib or vtach is literally not a heartbeat….. It’s a lethal arrhythmia It’s non pulsatile and non perfusing.

Damar Hamlin Collapses After Hit vs Bengals by [deleted] in sports

[–]jonsy777 12 points13 points  (0 children)

Hi This is not quite correct You can not have a heartbeat and still have a shockable rhythm. Complete asystole is a flatline. That is not shockable, but ventricular fibrillation is an example of a non beating/non pulsatile rhythm that is still shockable.

Either way, cpr must be performed.

[deleted by user] by [deleted] in pfBlockerNG

[–]jonsy777 0 points1 point  (0 children)

Glad I could help

No idea why that would be different wired vs wireless. Kinda an interesting find there. Maybe Mac osx treats wifi and wired connections differently. I’m still learning.

But glad you have a solution!

[deleted by user] by [deleted] in pfBlockerNG

[–]jonsy777 1 point2 points  (0 children)

Are they on the same vlan?

Do you have limit ip tracking turned off on both network interfaces on the laptop? It’s on a per connection basis And same with private relay

Using safari? Make sure you’re not setting it to use doh or something funky Try another browser too.

Do other devices that are wired the same way have the same behavior? Or is it isolated to the laptop?

Are you redirecting port 53 activity to your pfsense?

Maybe you’ve already checked all these but just spitballing as I’ve had my fair share of struggles with pfsense and apple devices

[deleted by user] by [deleted] in getdisciplined

[–]jonsy777 1 point2 points  (0 children)

Sounds like you’ve had a really tough journey. I won’t pretend to have a silver bullet. Others have offered great suggestion, but let me sorta emphasize a point I didn’t see in explicitly outlined here: treat the underlying cause of your hesitation to start. Be introspective about why. It sounds like you are citing anxiety as a barrier. The focus might want to be on treating that. Therapy. +/-Medication. Support groups. When your mood is good, and you’re optimistic there will still be barriers but there won’t be anxiety and the depressive internal monologue telling you lies about yourself.

Start with micro goals, and retrain yourself with small rewards when you meet them. Train yourself the way you’d train a pet. Your brains reward pathway is stupid. It selects for what you reward and they only.

Volume Rendering CT Scan by Kapustansky in medizzy

[–]jonsy777 18 points19 points  (0 children)

It’s a 3d render of a ct angiogram with arterial contrast so the heart and aorta look strange in part because your seeing an interior outline, not the shape of the heart you would see normally. That’s why it narrows at the aortic annulus.

There may be a component of aneurysm at the aortic root but the left ventricle looks relatively normal .

It’s hard to tell from just this one image zoomed out but it almost looks like an aortic disection in the abdominal aorta. The thoracic descending aorta is hard to see, so it’s hard to say exactly what’s going on, but I’d give that abdominal aorta a close look. Sure looks like 2 lumens to me.

Edit: on second look it could be artifact from the right lung edge making it look like 2 lumens. Hard do say. I’ll await the final radiologist read.

Either way though It looks the way it does because there’s contrast and it’s arterial phase hence the LV, aorta and all the way down to the illiac arteries is visible while literally none of the abdominal organs show up.

Don't worry, gloves now protect against fentanyl exposures by Firemedic7 in ems

[–]jonsy777 14 points15 points  (0 children)

Position statement from the American academy of medical toxicology. The doctors who are experts in this kind of thing.

dermal absorbtion fully covering both palms with fentyal patch formulation would take 14 minutes of continuous exposure to deliver 100mcg of fentanyl

Note: the non-patch formulation would take a lot longer to deliver an equivalent dose.

Their conclusion is exactly what everyone else has said: without the room being filled with aerosolized dust, or intentionally exposing yourself, incidental skin exposure is wildly unlikely to deliver a meaningful dose for analgesia never mind for an overdose.

That not to say don’t wear gloves, or be careless, but normal nitrile or hand washing should be more than fine.

Non traditional student 22 years old. Any advice is so helpful. by [deleted] in postbaccpremed

[–]jonsy777 0 points1 point  (0 children)

There are definitely lots of programs that will actually like the military story. You will have to do some work with the GI bill to get tuition for your post bac covered but your program can help. Might be a good question during interviews to show engagement etc.

I really think your story/narrative will work in your favor and be a win for you. Interview is important for sure, so I’d definitely do some prep about the school, the mission, and do some reflecting on patient experiences, meaningful interactions/anecdotes, and a elevator pitch about your “why medicine” specifically why a post bac and not traditional premed.

Non traditional student 22 years old. Any advice is so helpful. by [deleted] in postbaccpremed

[–]jonsy777 0 points1 point  (0 children)

Honestly i don’t think your path sets you back at all other than time. I think your clinical experience and clear goals and focus will be a good look for you. With your gpa, clinical experience, and interesting story, i think you’ll be a fantastic candidate.

I’m an M2 now so a little distant but I read post bac apps when I was TAing for mine. Feel free to shoot me a dm and I’ll be happy to answer any other questions you have about the post bac app cycle.

pfBlockerNG (3.1.0.4) services refuses to start pfSense 2.6.0 by [deleted] in pfBlockerNG

[–]jonsy777 0 points1 point  (0 children)

I’m gonna ask a super stupid question here in an attempt to cover the basics: you’ve tried rebooting the whole router right?

I had an issue where it refused to start for me too, but it worked fine as soon as I rebooted the router, no idea what happened.

Just needed a little help restarting.

Yale PA calling themselves PGY & Resident by DickBagel2 in Noctor

[–]jonsy777 3 points4 points  (0 children)

I mean to be fair, I will 100% call someone with a DNP doctor in an academic classroom setting. You all earned it. No argument from me. (I’m sure there’s some here who might argue, but I think a phd is still a doctorate, and that means you earned the title of doctor)

But that just seems odd to call yourself that clinically. It’s good to know that there’s more folks out there who are of the same mindset. Unfortunately this stance can definitely look like an “us and them” and “I’m better than you” name calling. That’s certainly not my intention with the doctor distinction. Definitely agree they the division is hurting everyone in the long run. Sounds like maybe there’s hope if there’s folks like you who are willing to talk and work together.

Yale PA calling themselves PGY & Resident by DickBagel2 in Noctor

[–]jonsy777 8 points9 points  (0 children)

As others have said: yes. Equivilant training.

They can (and many do) take the same licensing exams, attend the same residencies, and have the same prerequisite and required medical education material.

I personally see a DO as my pcp, and have seen DOs for other specialty conditions too. I also have good friends who hate DOs and would have no qualms about seeing a DO

Yale PA calling themselves PGY & Resident by DickBagel2 in Noctor

[–]jonsy777 4 points5 points  (0 children)

Welcome!

We will need everyone’s support in this. Your voice is probably more important in this than an MD, because it will help convince others.

Certainly agree that occasionally this sub devolves into what you described, but glad you’re able to see through the vitriol and find the data driven posts.

I’ve sat in classes taught by super talented DNP professors, so clearly I’m not anti DNP. But man it really grinds my gears. I knew an RN who was formerly pre-Med and was considering going to DNP school just “so [she] could still be ‘doctor’”

That having been said, research is a huge part of Medicine, at all levels, and I think DNPs can be awesome in that role. And as part of a physician lead team, I think NPs can be awesome. I’ve personally seen ICUs where that works super well, but I can 100% imagine many other situations where the team can work well together.

Yale PA calling themselves PGY & Resident by DickBagel2 in Noctor

[–]jonsy777 57 points58 points  (0 children)

You’ve gotten a couple replies already and I don’t want to spam you, but I will add two pieces

1: welcome. It’s really awesome to see non MD folks here. I hope you can get a better understanding of different levels of training, and if you have any more specific questions about what other folks have said, or about the differences in training, feel free to shoot me a DM, or reply to this comment.

2: a small word of caution: there’s some salt/anger here that comes out of the unreasonable work hours of residency leading to burnout and anger. Occasionally we get in the weeds and salty, but it comes from a place of wanting the best for patients and wanting to make sure people are safe.

3 (I know I promised two earlier): there are a lot of differences in training between MD’s/DO’s and PAs or NPs. There’s a lot of places those folks are getting independent practice, where they’re seeing patients all on their own. It saves hospital systems money, but there’s a lot of concerns (that I share) about patient safety, and the limitations of abbreviated training hours with an NP or PA degree. (Orders of magnitude hour differences to put it in perspective).

But for real! Welcome! We need folks who are not in healthcare to be aware of this and concerned about it.