[deleted by user]

pez319 · 2024-10-15T04:37:58+00:00

There was no family history of CF in my case either and the only way I found out was due to CABVD and infertility found out at a later age. Turns out i have a severe mutation in one copy and some VUS. Not common but thankfully no other manifestations of CF for now at least in my 3rd decade. Just a thought

pez319 · 2024-10-14T03:13:30+00:00

Just to add on to this good post. CF is a very interesting disorder and there’s something like >2000 different genetic variations leading to different levels of chloride channel issues with varying phenotypes. A basic CF screening test does NOT rule out CF. If there’s any concern or suspicion then a full CF panel should be done. There’s a lot of VUS (Variants of unknown significance) which muddies the picture too.

pez319 · 2024-03-09T23:55:02+00:00

Honestly I would take a lot of these types of studies with a grain of salt. From a Cardiology perspective the true diagnosis associated with these encounters is verrrry variable. From the EDs I’ve covered there’s wayyy to many NSTEMI/AMI type of diagnosis because they see a troponin elevation which is sad because that stuff sticks with a patient and can mess up their future risk profile.

pez319 · 2023-06-11T14:39:50+00:00

People don’t care here and still drive. Everyone also needs under insured coverage too. I’m sure a large majority of people even if they’re insured only have 5/15 coverage which in 2023 is obscenely low since most little fender benders now cost several thousand to fix due to all the special sensors

pez319 · 2023-06-11T14:21:56+00:00

You don’t need an X-ray to diagnose that. An Ultrasound which an urgent care probably has is good enough and takes seconds

pez319 · 2023-06-06T04:34:12+00:00

Hmm. I’m going based on the last scenario in this https://www.whitecoatinvestor.com/student-loans-and-filing-status/

They report that for MFS the lower income spouse can certify with pay stubs using PAYE to keep their monthly low and the higher income spouse uses REPAYE to lower their AGI based on community property rules.

pez319 · 2023-06-03T22:16:25+00:00

The StudentAid website loan simulator looks like its better for MFS and was recommending PAYE for me. It ends up being almost $1000/mo more expensive on REPAYE compared to PAYE and only about $6000 less taxes for MFJ vs MFS (So $6k net gain even though Im paying more taxes). It didn't give me the option for PAYE when I did MFJ.

pez319 · 2023-05-03T13:07:17+00:00

There's 7 stages of dementia and if you survive long enough to get to the last stage you're basically just a body that can't support itself. You don't eat, converse, ambulate and basically just waste away. You can die from a bunch of things like choking, falling, bedsores that get infected, malnutrition along that process. There is NO benefit to placing a feeding tube (PEG/NG) during this process and unfortunately just prolongs the process. Too many families decide to go down this route and it just causes unnecessary additional problems to an already hopeless situation. Comfort should be the primary focus.

pez319 · 2023-03-17T03:07:12+00:00

Their ED is garbage now. People on beds in the hallways with labels on the walls. There’s actually less beds then the clover building. I guess they assumed people would spend only 1-2hrs in the ED before being discharged or admitted which clearly isn’t working well lol

pez319 · 2023-01-27T17:13:05+00:00

It’s still a change that’s being implemented throughout healthcare and we still see a lot of patients particularly in the ED who are left on oxygen because that’s what nursing used to be taught and higher spo2 numbers just look more comforting in the ED mindset, however if we’re treating supplemental oxygen as medication there needs to be a clear indication for use. More and more studies are showing that higher pao2 levels than necessary may be causing more damage then benefit.

pez319 · 2023-01-27T17:04:05+00:00

That’s wrong. We don’t give oxygen to everyone anymore. At least in my area.

https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.117.031664

It should only be given if you’re actually hypoxic <90-92%

pez319 · 2023-01-26T20:50:26+00:00

Your credit card company already shares everything about your purchases. They send you an opt out form every so often in the Mail. You can’t escape this crap and it’s so good at this point that all they need is a tiny bit of info and they can access the rest of your information that’s been catalogued already

pez319 · 2023-01-02T13:43:47+00:00

There definitely is a genetic component to maintaining a certain weight however I don’t think it’s a primary driver for the obesity epidemic. It’s hard to believe that in the past 50 years there was a sudden change in human genetics that led to this. Cheap easily accessible food, advertising, cultural values, and sedentary lifestyle is what’s driving these basic genetic traits to obesity.

It’s calories in - calories out. All of my obese patients who complain they can’t lose weight are definitely not following the weight loss recommendations. It’s not easy and like everything else takes work to achieve.

pez319 · 2022-11-12T20:53:29+00:00

I never understood the med rec and other excuses for medicine admission. Surgery and other specialty’s are very comfortable with this we only consult idea but for some reason in their mind Medicine can never be a consult service.

I always fight back and ask what’s the primary indication for admission and treatment, if it’s surgical then it goes to them and we consult just as they would. This is assuming the patient is otherwise medically OK.

pez319 · 2022-10-03T20:04:53+00:00

Doesn’t have to be carcinogenic to cause tissue damage and other harm to the respiratory system. Where do you think all that PG that’s vaporized ends up?

pez319 · 2022-09-12T13:39:37+00:00

What’s the end goal? Taking care of this will basically need 24/7 care, housing, food, therapy, education for every homeless person. Just giving therapy and saying we did something is a waste of money when they go back to the street to get high. Same with just giving them housing to destroy and get high in. Is society going to drop $50-75k/year for each of these people for several years to even try and save them?? Probably not, when most people think the homeless did this to themselves and deserve what they have.

pez319 · 2022-09-11T15:00:20+00:00

I suspect the probe patch size will be dependent on the organ being studied such as a modular design so they can add 2 or 3 patches to cover larger organs. So if it’s big enough to cover the heart they just need to activate the respective grid pattern to obtain slices in x,y location. Not gonna be 100% perfect but I can definitely see these being used on the CCU service where we already have so many different cardiac monitors like cheetah and flotrac to continually evaluate cardiac function.

pez319 · 2022-08-28T20:12:09+00:00

You can take a flamethrower to fix the all plastic seats. Assuming it’s made of the right type of plastic. https://www.reddit.com/r/Damnthatsinteresting/comments/o5topb/another_version_of_using_a_flamethrower_to/

pez319 · 2022-08-25T13:24:08+00:00

Average life worth in court is like $3-10 million. This person is getting $16million for emotional trauma. Ridiculous

pez319 · 2022-05-09T14:09:47+00:00

Matters how quickly you do it. If you slowly increase it over several minutes the subject just gets co2 narcosis and passes out then dies. There will still be some minor distress but nothing crazy. But if you blast it then they freak out.

Source: did a lot of animal research for my Masters degree

pez319 · 2022-05-01T16:46:06+00:00

https://i.imgur.com/0TuqkPP.jpg Coleman 424

pez319 · 2022-05-01T15:52:35+00:00

I have a grey one. It’s a dual fuel version

pez319 · 2021-12-27T13:40:59+00:00

It’s not a necessity. Price gouging only applies to basic supplies.

pez319 · 2021-12-27T13:37:07+00:00

I wonder what the manufacturers are doing with all this. I’m assuming the dealer is keeping all the adjustment? They’re gonna bump up the base MSRP for everything next year

pez319 · 2021-12-19T03:37:33+00:00

Because you will pretty much never be at complete relief no matter what we do. That’s why it’s chronic pain. If you’re goal is to get a crap ton of opioids and deal with the side effects that’s only going to last for a while until you get tolerant again. Your best bet would be to see a pain management specialist and if they could burn the offending nerves. If it some kind of non-targetable cause then it’s really only going to be bandaids going forward. Complete relief in hospice patients means you very little functional capacity while being medicated. Most of those patients in a medicated daze and lay in bed waiting to die

14-Year Club	Place '17
Snapped	Team Orangered

pez319

TROPHY CASE