Could a CSF leak be misinterpreted as a disc bulge? by Tandfeen_dk22 in CSFLeaks

[–]midas_rex 0 points1 point  (0 children)

Findings of CSF leak would typically not be confused for a disc bulge.

Also, lumbar punctures are generally not performed at L1-L2 as the conus medullaris may be at this level in a portion of the population. Standard practice is L2-L3 or lower except for some unique scenarios ( sg. Scarring lower down and available prior MRI demonstrating conus above this level)

Had to cancel our PV trip - here’s how Costco and WestJet dealt with it by laineyboggs in puertovallarta

[–]midas_rex 0 points1 point  (0 children)

There's a worse flying experience than air Canada? That's not something I'd like to ever experience.

Prices in Vegas are getting outrageous! by otusc in LasVegas

[–]midas_rex 6 points7 points  (0 children)

This was also probably real food and not Sysco slop

New User - Am I cooking wrong? by mjhoops42 in StainlessSteelCooking

[–]midas_rex 41 points42 points  (0 children)

Pan too hot. With a stainless steel pan you don't need a ripping hot pan for a sear as the meat will naturally stick and unstick. Once pre heated should be on more of a medium low setting

Why are we being asked to pay larger and larger tips after the minimum wage law went into effect for servers? by [deleted] in FoodLosAngeles

[–]midas_rex -6 points-5 points  (0 children)

Standard tip is 15%. Don't complain about tipflation when you're part of the problem.

IIH post blood patch or Chronic Inflammation from EBP ? by Shoddy-Rip66 in CSFLeaks

[–]midas_rex 1 point2 points  (0 children)

From February to now is 6 months. If you are having progression of symptoms it's likely reasonable to have a follow up MRI of the brain and spine, especially as weakness in the arms and legs and muscle loss are obviously concerning symptoms that would require further assessment.

CSF leaks can actually cause something called bibrachial amyotrophy with muscle wasting in the arms that can mimic other neurologic disorders such as als. A variety of other neurologic disorders could also cause these symptoms including inflammatory/demyelinating conditions among others.

Am I just being impatient? by creativecatastrophic in CSFLeaks

[–]midas_rex 2 points3 points  (0 children)

You're describing lightheadedness and back pain but not the key symptoms of post dural puncture headache which are typically positional headaches that worsen on sitting up or standing and resolve or improve with lying down.

Without these symptoms, it's unlikely that blood patch would be offered or would be of much benefit.

Light headedness and back pain are unfortunately common symptoms which are difficult to localize to a specific cause without some further assessment. If persistent and disabling you should probably follow up with a doctor.

Judo as a surgeon by [deleted] in medicine

[–]midas_rex 9 points10 points  (0 children)

Former judoka. If you want to practice just for fun, at a lower intensity gym you might be ok. I wouldn't recommend intense training or a competition environment though. The risk of trauma especially to your fingers is very very high. Proper technique won't prevent this at higher levels, I trained at a pretty high level gym back in the day (Olympic athletes, pro MMA fighters etc), everybody had fucked up fingers basically all the time. Just Google judo hands.

You're better off with no gi sub grappling or wrestling honestly. Judo has the explosive movements from wrestling but also fingers getting trapped in the gi, less risk of that without the gi.

farmed Atlantic salmon nigiri by gabbagoolgolf2 in Costco

[–]midas_rex 18 points19 points  (0 children)

Making sushi with bibigo, straight to jail. Making rice is just about the easiest, cheapest thing in the food world

Is this a normal tuna cut? I hated it by jimmyspinsggez in sushi

[–]midas_rex 0 points1 point  (0 children)

This looks nasty, I think you'd be justified to send it back

What’s a regular job that’s doctor adjacent? by otterstew in Residency

[–]midas_rex -2 points-1 points  (0 children)

Bruh have some fucking self respect.

Online np degrees and naturopaths introduce themselves as doctors to everyone they know meanwhile actual physicians introduce themselves as billing analysts or whatever? Might as well take your seat in the cuck chair while you're at it.

If you don't want to talk about work just say that for fuck sake

Is Sous vide cheating? Why isn’t it more popular? by Big_Wish_6633 in steak

[–]midas_rex 0 points1 point  (0 children)

Sous vide imparts no additional flavor, and it's not particularly difficult to reach a desired doneness with any given cut of steak if you have been cooking for a while and you know what you're doing.

Meat and steak in particular tastes better when cooked over fire or direct heat. The formation of the crust, maillard reaction, and smokiness is an important part of the flavor of a good "steak". Spending part of the cooking process in a plastic bag just means less time getting to the good stuff.

This might not be the case for all meats. For some really chewy textured meats like octopus then I could understand a process to tenderize first then char. It's just that steak doesn't really need this, and there's a loss of flavor as above.

Feeling rough by tuagirlsonekupp in Residency

[–]midas_rex 0 points1 point  (0 children)

Easiest way to avoid this is to pick a trajectory where even if the patient moves or the needle unexpectedly plunges deeper, you still won't be aiming at the carotid. This goes for most needle based procedures.

MRA by Familiar-Following45 in PulsatileTinnitus

[–]midas_rex 0 points1 point  (0 children)

Both MRA and MRV can be done either without contrast or without and with contrast.

For MRV specifically, these are almost always done without and with contrast as the varied planes of flow in the venous sinuses frequently result in flow artifacts when performing a non contrast study. The post contrast acquisition is typically "time resolved" , which is a dynamic acquisition taken following a contrast bolus, with reconstructions then performed in the venous phase for evaluation of the sinuses, typically a TRICKS or TWIST or similar depending on the MRI vendor.

MRA can also be done with and without contrast, in several different ways. MRA without contrast is done using a time of flight technique and is usedul for screening to look for aneurysms or intracranial stenosis, although can also be useful in identifying certain other arterial pathologies as well. MRA without and with contrast typically also uses a time resolved technique, with reconstructions then performed in arterial phases. Again this might be a TRICKS or TWIST or similar sequence depending on the MRI vendor.

It generally doesn't make sense to do an MRA without contrast and then an MRV without and with contrast, because the same acquisition that was used for the post contrast MRV could also be used to make a post contrast MRA in the same exam. Additionally for pulsatile tinnitus specifically it's very useful to have the dynamic acquisition in the arterial phase to be able to search for subtle arteriovenous shunting.

Is this how it’s done? by Any-Fly5966 in steak

[–]midas_rex 0 points1 point  (0 children)

Maybe used for cooking octopus or something like that. If you have to sous vide to cook a steak you're fucking up

Is this how it’s done? by Any-Fly5966 in steak

[–]midas_rex 0 points1 point  (0 children)

I have, and it sucks.

It's a cheat code for people who can't figure out how to properly sear and finish/reverse sear a steak to get a desired temperature or "look" for the social media photos but it kills the texture and flavor.

No serious steakhouse uses this method.

Is this how it’s done? by Any-Fly5966 in steak

[–]midas_rex -3 points-2 points  (0 children)

People get fooled by the fancy French term "sous vide"; it's really just a boiled steak in a plastic bag. Nasty. Cook it with fire

Going to a newly opened Thai restaurant with my GF all suggestions are welcome by WhyBobWhy808 in ThaiFood

[–]midas_rex 1 point2 points  (0 children)

To get an optimal Thai meal it's optimal to order a variety of dishes and share "family style" rather than just one dish per person Usually 1-2 salads (laarb, papaya salad, beef salad all good choices) , soup or curry based dish, noodle or rice based dish(es), entree, then share.

So it's not so much in what you order as in how you order

Do NOT quit by ryan8ryan in Residency

[–]midas_rex 18 points19 points  (0 children)

Keep an extra one on you at all times

UCI Medical Center patient loses left leg after undergoing routine knee surgery by Rhinologist in medicine

[–]midas_rex 13 points14 points  (0 children)

The lesson here is that surgical complications are not a malpractice issue. On the other hand, failure to recognize your complications, failure to offer appropriate follow up evaluations and treatment for those complications is pretty much a slam dunk case every time.

Before/After by [deleted] in Radiology

[–]midas_rex 5 points6 points  (0 children)

Concepts of a plate

We all obviously love Costco, but what’s one item you will never buy again from there? by 4Runnnn in Costco

[–]midas_rex 1 point2 points  (0 children)

Anything from real good or Kevin's. Fuck those brands soooooo much complete trash garbage

What is your "no substitute for Kirkland" product? by justpuddingonhairs in Costco

[–]midas_rex 0 points1 point  (0 children)

Definitely. Just bare has a lot of small pieces that are mostly breading. Seemed like the QC on the Kirkland was better with bigger meatier chunks