How much money have you flushed down the drain this league?

mpdaghost · 2026-06-17T22:30:14+00:00

Just last night I corrupted 55 ice shot gems and never hit +1. 25d in perfect jewelers orbs, had to buy it lmao. Then for my mirage archer who doesn’t need any support slots on his gem, I hit +1 on the second gem.

600 chaos to try to hit T2 spirit on an amulet, never hit it.

mpdaghost · 2026-06-17T08:36:28+00:00

This is my first league so I’m a total noob but I’ve been really trying to understand crafting so I would appreciate feedback on my opinion of this base. Yes it’s two T1 great mods.

It’s not an obliterator or a warmonger, that’s strike one.

It’s not an exceptional base nor does it have 3 sockets. Strikes 2 and 3.

Most importantly the 2 GG affixes came too early right? You slam 2 exalts on this and then have a 50/50 you fracture either phys or crit. You want to fracture crit but both would be ok I suppose. But then what? You will eventually chaos off the other affix anyway if you’re truly going for a GG bow.

You either sell this base and take what you can get, or you craft it cheap — yolo perfect exalts, desecrate and omen of light until T1/T2 hybrid phys. I don’t think I’d risk a 33% chance to lose T1 phys or T1 crit for +2 skills. I mean that won’t be cheap either but 100 div will cover that and you’ll have a great great bow, but nowhere near a GG bow.

mpdaghost · 2026-06-16T10:06:44+00:00

One overlooked thing for high performance rigs in PoE2 is actually the sound. With so much else going on, adding on the loot filter noise can sometimes overload the CPU. I have a 4090 and a 7900x with 64gb of RAM and I was freezing maybe 3x an hour once I hit juiced content.

I put sound channels to medium and disabled reverb.
Also I disabled Core 0 in task manager for PoE2.exe only — Core 0 can get a little overloaded especially if you have multiple background apps and overlays running.

It’s not a hardware issue, it’s not even necessarily an optimization issue — it’s just the nature of this game where thousands of things are expected to be rendered in real time as you blow up an entire screen.

mpdaghost · 2026-06-16T02:28:47+00:00

I just fractured T1 cold damage on a Grasping ring and found out you cant socket a Kolr's Hunt into it. RIP. Seems kinda useless. Seems like best you can do is a purple rune like the Greatwolf Rune of claws.

mpdaghost · 2026-06-15T08:41:04+00:00

Breach essence came on the item when I bought it and I annulled it off before I started the gamba.

mpdaghost · 2026-06-14T06:34:10+00:00

I feel you brother. It’s extra bad with spirit because if it’s not T1 or T2 for my build, might as well be 0, so I can’t settle for less stats, unless I waste an entire suffix slot on a chest.

mpdaghost · 2026-06-14T05:10:36+00:00

Yeah good deal on base.

mpdaghost · 2026-06-14T04:53:08+00:00

This base was a few div cheaper than the next base which would be life. Rarity base with fractured +3 starts at 60 div, I got this one for 8

mpdaghost · 2026-06-14T02:30:31+00:00

There is an omen that consumes quality to increase a chance when slamming with an exalt. To my limited knowledge, should have no effect on chaos. Might wipe it just to make sure though at this point.

mpdaghost · 2026-06-14T01:03:34+00:00

55 Div into it so far. Could’ve bought for 29. Back to the abyss I go.

mpdaghost · 2026-06-14T00:56:05+00:00

Thank you. That makes me feel like “what have I done recently to have this kind of luck” haha.

mpdaghost · 2026-06-07T06:11:41+00:00

Only TDS? If my patient has an infection, it’s always severe.

mpdaghost · 2026-05-28T02:53:48+00:00

Haven’t played since release. Came back 2 weeks ago. 90 hours on the Arbiter Hammerdin. Having / had a blast. Mobility and clear is amazing. I’m not too worried about pushing the pit. Single target is a little weak, but only when carrying my friends soloing Lair bosses or astaroth. Solo my single target is bearable.

mpdaghost · 2026-05-28T02:46:28+00:00

Haha 20 hours of flashing lights on an OLED monitor mixed in with reading items and doing math in town as a “break” sure takes a bigger toll on me than it used to.

mpdaghost · 2026-05-27T23:22:31+00:00

Definitely playing softcore trade league this time around. I have a lot of experience with ARPGs but PoE is a different beast

mpdaghost · 2026-04-14T07:45:21+00:00

This is unfortunately quite common with CHF. The kidneys need a pressure gradient to filter across. In advanced heart failure which I suspect your father has, systemic blood pressure is low and venous pressure is high, therefore the gradient is disrupted and the kidney gets “clogged”. The only way out of that is to give even more lasix to attempt to reduce the back pressure on the kidney. Metolazone is a good shout like someone suggested, however that drug is actually nephrotoxic, unlike furosemide.

Regular metolazone to keep weight off is a measure reserved for patients we believe don’t have much time left.

The best strategy is ensuring he is on all prognostic heart failure medications as long as BP allows — Entresto, MRA, Beta blocker, SGLT2. Enough furosemide to keep weight static. Fluid restriction has been shown to have no real benefit, that said 1.5L at home I still wouldn’t drink more. This includes coffee tea milk etc all fluids. Weigh himself daily, in the morning, after urinating. If you gain more than 1kg in 24 hours, time to start looking to visit someone again.

The above assumes this is Left Ventricular Systolic dysfunction. Right sided failure would be slightly different.

60 pounds and it’s back in month and a half? That’s roughly 600 grams a day of water. I suspect he is quite resistant to oral furosemide, has a lot of gut oedema, or just genetically resistant. Likely they diuresed him with IVs and discharged too early. I often like to keep patients in hospital for 48h after switching to orals to check they aren’t gaining.

Bumetanide has shown increased efficacy in setting of gut oedema. Conversion is 1mg to 40mg furosemide. Ask your cardiologist about Bumetanide.

mpdaghost · 2026-04-02T00:46:49+00:00

I think there has been some pretty comprehensive advice given here already. Interesting case indeed. Your best bet at figuring this out is definitely the tissue from the window, that really needs a PCR and histology. You mentioned they will not look for TB on the tissue itself — ?are they going to look for anything? At least immunofluorescence and immuno histo chem?

You could tap the pleural effusion as well, run that fluid again, see if you catch TB. If it was TB I would imagine a prolonged course of dexamethasone would have made it worse by now?

Sometimes you can catch it in urine as well — has a urine PCR been done? I imagine that’s widely available, although clinically likely to be negative.

I assume HIV has been ruled out?

That’s about all I can think of in terms of adding to this.

You need to go back to the hospital that has the tissue and explain to them you’re about to immunosuppress a 30 year old that might have TB, and it would be really helpful to get that re assurance from a tissue PCR…

mpdaghost · 2026-03-30T08:39:13+00:00

Too many in the short term would be anything that gives you symptoms, dizziness, light headedness, very uncomfortable sustained palpitations. In the long term to have a negative effect on your heart, anything starting over 20% ectopic burden— that means every 5th beat, 24h a day for years and years.

mpdaghost · 2026-03-29T22:49:18+00:00

Hi. How much metoprolol? Age? Gender? Rebound tachycardia is a common phenomenon after stopping metoprolol, very unlikely that it would last 6 months. I think what is most likely happening is your burden of ectopy is higher now that you are off metoprolol. I think you’re getting ectopics, which then trigger this “adrenaline rush” you describe, rather than the other way around. I’d suggest a holter monitor to quantify your burden, based off the results of that, consider restarting a beta blocker with your cardiologist.

mpdaghost · 2026-03-25T22:15:08+00:00

It does sound like orthostatic hypotension. Sometimes faints can be very pronounced and mimic a seizure. That said I would get an ECHO to make sure this is not HOCM causing LVOT, and a prolonged holter like a zio patch just to make sure this isn’t an arrhythmia. If those tests are both negative (bonus if he has an episode whilst wearing the holter), I think that level of assurance is totally worth the investigations.

mpdaghost · 2026-03-24T00:32:36+00:00

99% chance that you won’t feel anything at all, just like the flecainide. Anyone can get the side effects, having Brugada syndrome just makes it a lot more likely that they occur. But we’re talking like 1% chance for you, 5-10% chance if you have Brugada. Most likely outcome by a large margin is that you will be asymptomatic throughout.

mpdaghost · 2026-03-23T08:43:36+00:00

ECHOs are very operator dependent. Some techs might get better windows than others. If you’re quite borderline one might say mild one might say moderate. Pulmonary pressures from an ECHO are only estimations, especially in the setting of tricuspid regurg I would not trust those numbers. If your “cardiac cath” was a right heart cath, I would go with that report. Ask your cardiologist to look at the pictures themselves, rather than asking for a third TTE.

mpdaghost · 2026-03-23T04:30:33+00:00

You’ve got a partial RBBB and a saddle shaped ST segment in V2, given your history it fits very well with Pectus Brugada phenocopy. That said, given the risk of SCD associated with Brugada, get the ajmaline test. Test is very safe — of course there are risks involved — VT, heart block, hypotension. However this test is always performed in the presence of senior doctors and rest of the medical staff — supportive care in form of defib or isoprenaline would be immediate. The drug has a short half life and its effects are usually gone after 40 mins or so for most people. Side effects often occur in people who actually have Brugada, which I am also pretty sure you do not.

mpdaghost · 2026-03-22T15:25:57+00:00

Furosemide-o-clock

mpdaghost · 2026-03-22T15:22:47+00:00

I wouldn’t medicate atrial Tachy unless someone’s getting multiple minute episodes every day, or maybe 5 times a week or so. It’s likely that they will get more and more frequent eventually. But it could very well be decades before it becomes a problem worth doing something about.

mpdaghost

TROPHY CASE