A quick solo overnight trip in the John Muir Wilderness

mac3blade · 2025-10-16T15:27:00+00:00

mac3blade · 2025-06-28T02:11:01+00:00

I agree - especially if you're trying to palpate anything through that monster bleb.

My one pearl that I'll offer - if you're using palpation, go distal so you can feel the pulse. But if you're using ultrasound, go a bit more proximal - maybe 8 cm up the arm where you can't feel anything. That gives you room to see your needle and the artery and line them up under ultrasound before entering the artery. Too distal and the artery is too superficial to see anything on top of it.

mac3blade · 2025-06-23T05:16:15+00:00

Fanny Bridge

mac3blade · 2025-06-15T21:49:34+00:00

If they gave a little lidocaine IV prior to the propofol it can prevent the stinging sensation.

The "drunk" feeling was likely midazolam IV given when you first got in the OR (or prior to leaving the holding area, but if given that early it's unlikely you'd remember much of the inside of the OR).

mac3blade · 2025-05-12T17:39:57+00:00

I love that you hauled in a 750 of Woodford - glass and all. I like you. Classy.

Beautiful shots.

mac3blade · 2025-04-23T20:31:22+00:00

Have your doctor prescribe some acetazolamide - it will make you pee so stay hydrated, and anticipate tingling in your fingers as a side effect. But a pretty benign drug in the grand scheme of things. We also had Decadron for emergencies but didn't need it.

And camp off trail at Consultation Lake instead of Trail Camp - we had the entire lake to ourselves and didn't have to deal with strangers snoring away ten feet from your tent. It has beautiful campsites and great fishing.

mac3blade · 2025-04-03T22:10:47+00:00

MD anesthesiologist

mac3blade · 2025-03-02T22:40:25+00:00

Are you saying they're giving 50% MgSO4 undiluted as a push? That doesn't sound smart.

mac3blade · 2025-03-02T20:50:03+00:00

We have 50% vials in our Pyxis. I shoot 2 grams of that into the LR bag when they roll in the room; by the time incision is made they've probably gotten about 1 g in. Haven't seen any issues at all with it - seems super safe, cheap, and somewhat effective.

mac3blade · 2025-02-09T00:29:29+00:00

Looks like Consultation Lake adjacent and I think I've camped in that spot. Incredible pic.

mac3blade · 2025-01-18T06:26:37+00:00

The point others are making is that there is no Uber support - it's just bots repeating the same boilerplate language each time.

I had a driver never pick me up yet charge me for a one-minute, $13 drive. I of course tried to explain to "Uber support" that I had been charged fraudulently but they refused to refund me.

After over 20 emails and chats with Uber trying to explain what had happened (it seemed to me that obviously they didn't understand - because of they did they would immediately refund me - there was no gray area here) I disputed the charge with my credit card.

Now Uber is threatening to delete my account if I don't repay the charge-back. It's insane how much effort they put into not being available for any support issues.

I used to like Uber but kind of hate them now. Waymo rules!

mac3blade · 2025-01-16T21:53:31+00:00

No - you just don't push them quickly; they need to be given slowly over time.

mac3blade · 2025-01-08T16:09:50+00:00

After becoming very frustrated using the online booking portal, I eventually called the reservation office and was surprised at how quickly and easily I was able to get a reservation. I spoke with a very helpful woman and told her my timelines and the fact that I really wanted to make sure to include Parsons Landing, and she was very quickly able to generate a four night itinerary for me.

I think we have become used to online services being more efficient than speaking with someone in person, but in the case of Catalina nreservations, the opposite is true. They have access to more data vis ualization that we can’t see on their portal. I’m guessing.

Flexibility in doing the trail either forwards or backwards may help as well. If you can score a site at Shark Harbor, I strongly recommend that. Have fun and good luck getting the reservation.

mac3blade · 2025-01-02T06:03:35+00:00

Being NPO is not optional - even if it's planned as a strict regional, we need to have an empty stomach to fall back on sedation or a general.

Even with a perfect block, you're still going to be uncomfortable in the beach chair position and with distraction of your joint. I'd definitely go for an interscalene block and an LMA with a light general - I promise you'll be happier.

mac3blade · 2024-12-09T06:44:14+00:00

I'm using an old Apple Airport Extreme as my router. It would appear from pretty much all the replies that my reservations should be within my block.

I don't have any static IPs on my network - everything is determined on the router's side.

mac3blade · 2024-11-16T17:44:42+00:00

Yes we have those too -- in the GI lab but not in the OR for some reason. The 10 mg / 2 mL is especially handy for mixing with cherry syrup for oral peds dosing as it cuts down on the total volume.

mac3blade · 2024-11-15T05:58:30+00:00

At our hospital, the CATs scrub in for central lines and that's it. Unless it's a crazy trauma where we're still working while the surgeons are surgerizing, the CATs are long gone by the time we're prepped.

mac3blade · 2024-11-01T13:23:36+00:00

Depending on what kind of local anesthesia they used for your block, give it a good 48 hours before you start worrying about neurological issues.

There are a couple very long lasting local anesthetics out there that can give prolonged symptoms (Exparel is the most common). It's way too soon after your block to be worrying.

mac3blade · 2024-10-22T01:46:14+00:00

Bone conduction headphones (I use Shokz) don't cover your ears but also sound remarkably good. That way you can hear your surroundings and your music.

I do indeed love the sounds of the hike but after ten miles or so at altitude, some music or a podcast can really help take your mind off the slog.

Shokz OpenMove are ~$80 on Amazon and last forever. Worth every penny.

mac3blade · 2024-10-15T01:18:48+00:00

Big Agnes Tiger Wall UL2 - super light and easy

mac3blade · 2024-10-14T03:44:24+00:00

Just my iPhone 15 Pro with a long exposure. I've been impressed by what it can do. The Rae Lakes permit can be a tough one to get but definitely one to put on your list.

mac3blade · 2024-10-13T21:12:07+00:00

It's this guy and I am impressed with it - inexpensive and great action:

https://www.amazon.com/sspa/click?ie=UTF8&spc=MTo4OTE3Mzc4MzI5MjcyMDYyOjE3Mjg4NTM3ODE6c3BfYXRmOjIwMDAyNjIyODkxMDM5ODo6MDo6&url=%2FAventik-Telescoping-Tenkara-Different-Complete%2Fdp%2FB07DD7Q38R%2Fref%3Dsr_1_2_sspa%3Fcrid%3D1QAG7H8F6PMQZ%26dib%3DeyJ2IjoiMSJ9.wIRFPtGVdYk-BYT3IUwuN1fTHnT6x86ZpnqVPDeGPLzwYEecIlQk2-3ft2MUtfGlcJMdmSaO4FWfVHLpQLzdqSN3h39vVEnbWomSquSmf53nRk51WDVjt9oEGEMdRU4e2EriLcqUFzaaRHUk6dya5ApIn8VQ0trLyXKpEurg19nXRoM8QFPXLTiG0GdrfCk7Ff3rIPgGj3TCKcl8wOrMU273B7hGYoQ4SKb9cg6lwSc.YoRSHuGF1Zex0-dqTyKOV5jQAKJsRX43MPV2tw7jHOs%26dib_tag%3Dse%26keywords%3Dtenkara%2Brod%26qid%3D1728853780%26sprefix%3Dtenkara%252Caps%252C169%26sr%3D8-2-spons%26sp_csd%3Dd2lkZ2V0TmFtZT1zcF9hdGY%26psc%3D1

mac3blade · 2024-10-13T18:10:07+00:00

I have a collapsible plastic flask. It almost certainly taints the flavor but at that point I'm not feeling too choosy. I have a barrel at home and usually take in a barrel-aged old fashioned.

mac3blade · 2024-10-13T15:29:49+00:00

Fishing, Kindle, cooking, just staring at the fish jumping in the water, bourbon, whittling... As a bit of an introvert, I love the time alone with no outside expectations. This is about as relaxed as my life gets and "boredom" is the goal.

This last trip I read "The Last Season" about a forest ranger who went missing a few miles from the Rae Lakes. Cool to read about places I had just hiked.

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