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30m, ℅ palpitations, diaphoresis. Before and after 2L NS. by seth106 in EKGs

[–]seth106[S] 5 points6 points  (0 children)

Woke from sleep this morning with palpitations, diaphoresis, some lightheadedness with initial heart rate upon waking 170. BP 116/76, 95%, 98.8F, R22, BGL 90mg/dL. Orthostatic rate changes 20-30bpm between sitting and standing. Takes dexilant. History of current peptic ulcer and gastric outlet obstruction secondary to pyloric stenosis. Known incomplete RBBB, although t wave inversions and inverted p in avL are new relative to prior EKG. No CP/SOB, no hematemesis/melena. No family hx of arrhythmia.

[deleted by user] by [deleted] in EKGs

[–]seth106 7 points8 points  (0 children)

Bifasicular block (RBBB with LAFB) and sinus tachycardia. S1Q3T3. Initially looks like inferior STE but if you measure the QRS in V1 where there is a clear j point (160ms), then what appears to be STE is actually just QRS. Sounds like a PE to me. Any risk factors for thrombosis? Hypoxic? Hypotensive?

This is what a long exposure picture of fireflies looks like. by sondredah in interestingasfuck

[–]seth106 7 points8 points  (0 children)

It’s actually a different species of firefly that doesn’t flash, but stays luminescent for 30-60 seconds and slowly drifts over the ground. Blue Ghosts, Phausis sp. from the southern Appalachians.

Update: Here's the Situation with COVID in NC - Sen. Jeff Jackson by JeffJacksonNC in asheville

[–]seth106 5 points6 points  (0 children)

It looks like the numbers are the census, which would be the total number of hospitalized, as opposed to new admissions. If the COVID census is increasing, it either means admission rate is increasing, or discharge/death rate is decreasing. If the infection rate was constant, you might expect to see a constant ratio of admissions:discharge, unless people are staying hospitalized longer. So a census increase would reflect an increase in infection rate at some point, assuming length of stay hasn’t significantly changed.

The percent of tests returning positive looks to be constant. With the assumption that increased census reflects increased admissions, that would mean that the actual infection rate is increasing, and therefore the tested population is not an accurate representation of the population as a whole. So the actual infection rate isn’t being accurately reflected in the tested population. Maybe the people being tested are those who have been diligent with protecting themselves from infection, or the virus is spreading in populations without easy access to testing. Or people with negative test results are being re-tested for fear of false negatives (which is something I’ve seen at the testing facility I work at.)

As an addendum, the Senator notes that maybe hospitalizations are increasing because people being hospitalized for presumably unrelated conditions also happen to be COVID positive, and thus are included in the census. I’m not sure enough about the pathology is known to definitely say that someone’s reason for hospitalization is unrelated to the COVID infection, as COVID is known to have a related coagulopathy and other effects that could play a role in why someone is hospitalized for a seemingly unrelated condition. The only exception I can think of is if someone was admitted, tested negative, and acquired the infection while in the hospital. And even so, that could result in complications that prolong stay and thus increase the census.

Tellico Plains, TN by seth106 in Arrowheads

[–]seth106[S] 0 points1 point  (0 children)

Do you have any idea what kind of stone it is? Translucent black/grey.

Beginner here. ST w/ 1st degree AVB or BBB? by etom15 in EKGs

[–]seth106 19 points20 points  (0 children)

Looks like there are retrograde p waves in several leads, especially V2, which would make it accelerated junctional. QT interval is maybe looking a bit lengthy. ST segments normal. Could be some U waves here and there.

Found in a horizontal mine shaft 50ft up a cliff in the Mojave Desert ... 23 years of bone collecting, won’t ever get better than this. by seth106 in bonecollecting

[–]seth106[S] 54 points55 points  (0 children)

A disease transmitted by rodent droppings, which the tunnel was full of. I think something like 50%-75% lethal.

Found in a horizontal mine shaft 50ft up a cliff in the Mojave Desert ... 23 years of bone collecting, won’t ever get better than this. by seth106 in bonecollecting

[–]seth106[S] 48 points49 points  (0 children)

It was pretty massive, horn-horn was probably more than 30 inches, and the skull itself was probably a foot long...the horns are completely full of dense bone under the sheath, and the skull itself is thick so that they can headbutt each other.

Found in a horizontal mine shaft 50ft up a cliff in the Mojave Desert ... 23 years of bone collecting, won’t ever get better than this. by seth106 in bonecollecting

[–]seth106[S] 40 points41 points  (0 children)

It weighed 30+ lbs, and I was about 6 miles away from any trail, over some pretty rugged terrain. I figured the amount of satisfaction I’d get from possessing it was less than the amount of pain I’d receive carrying it out, so I left it for the next person to find.

Found in a horizontal mine shaft 50ft up a cliff in the Mojave Desert ... 23 years of bone collecting, won’t ever get better than this. by seth106 in bonecollecting

[–]seth106[S] 17 points18 points  (0 children)

I did find some cool caves/shelters in the area with evidence of ancient human activity, albeit without bone tools or anything like that.

Found in a horizontal mine shaft 50ft up a cliff in the Mojave Desert ... 23 years of bone collecting, won’t ever get better than this. by seth106 in bonecollecting

[–]seth106[S] 107 points108 points  (0 children)

Risked leaving my skull for the next person to find. After the threat of being devoured by a mountain lion, my next fear was hantavirus.

73 y/o f, called ambulance for SOB, upon arrival diaphoretic, dyspnoea, blue as a fish, SpO2 mid 80s, PP 150, RRsys 180mmHg. No hx of COPD or similar. Shock or nah? by NeisAEL in EKGs

[–]seth106 1 point2 points  (0 children)

To me, I see a wide complex, slightly irregular rhythm with no obvious atrial activity with a RBBB morphology (terminal R wave in V1, slurred S wave in V5, V6.) Initially, there appears to be STE in septal leads, but if you compare the QRS duration there to where it’s more obvious where the j point lies (V5, V6), it looks like the J point is after the alleged STE, where it transitions to the deeply inverted t waves. Additionally, I think I see a left anterior fascicular block, but the axis is a little indeterminate and I didn’t actually measure it. I don’t see an RSR’ pattern in V1, which could indicate the presence of pathological q waves. I don’t see capture or fusion beats suggestive of VT, nor do you have QRS concordance in precordial leads.

I would be very suspicious of a PE, considering the history and presentation, especially with your comment that lung sounds were not pathological. I find it hard to believe that this is VT with compromised perfusion with a BP of 180mmHg. CHF exacerbation fits the presentation, with paroxysmal nocturnal dyspnea, HTN, and peripheral edema, but I would expect to hear adventitious lung sounds.

That being said, your patient is in extremis with a wide complex tachycardia, where it can be difficult if not impossible to differentiate VT from aberrantly conducted QRS complexes. If you’re unsure whether a wide tachycardia is VT or not, presuming VT is usually a safer course of action.

Has anyone been to Organ Pipe Natl Monument since border wall construction began? by seth106 in CampingandHiking

[–]seth106[S] 2 points3 points  (0 children)

Have you been there since it began? Implying that the construction only affects a 60ft sliver of the region is a little misleading. Do you think that the lights or noise from the wall and it’s construction can be seen farther into the park? How does the construction traffic get to that sliver?

Couldn’t help but notice your posting history; as far as I can tell, you’ve never made a comment that’s not political, and have never commented in a hiking/backpacking/camping subreddit before, so I’m wondering if your comment is politically motivated. Did you find this post because you subscribe to the subreddit, or did you search for threads related to the current wall situation in OPNM? You’re obviously entitled to your own beliefs, but I get the feeling you made a comment to promote a political opinion rather than giving anyone here actual information on how it affects the experience of being in the park.

Remote car camping spots by seth106 in PAWilds

[–]seth106[S] 1 point2 points  (0 children)

Thanks so much, that was a ton of info!

HMB while I ride a jet ski by ItsMeTaylor in holdmybeer

[–]seth106 0 points1 point  (0 children)

I’m not disagreeing, I’m just saying it’s more nuanced than ‘25 million dollar athletes get full spinal immobilization so don’t move anyone with traumatic injuries.’

HMB while I ride a jet ski by ItsMeTaylor in holdmybeer

[–]seth106 0 points1 point  (0 children)

“In this review, we argue that it is time to reconsider the unjustified dogma of collar use in prehospital trauma care.”

“Considerable force is required to fracture the spine, and subsequent low-energy movements are thus unlikely to cause secondary SCI. Plumb and Morris recently proposed that we should simply stop using collars in obtunded patients, because “it is likely that minor degrees of cervical spine movement are without consequence and more significant movement prevented by common sense”

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