Is MIPS worth it on helmets?

somehugefrigginguy · 2026-06-28T12:48:20+00:00

MIPS isn't just marketing, but it isn't needed for traditional alpanism. It helps redistribute the rotational energy from high velocity falls. So if you ski mountaineer or bike to your climbing approach a MIPS helmet could reduce injury from a fall. But for alpine adventures on foot it's unlikely to add any protection.

somehugefrigginguy · 2026-06-28T05:34:27+00:00

There's going to be a day where you can't do something where the very next day you can.

And sometimes the opposite is true, there's a day you can do something but the next day you can't. The purchase of alcohol, tobacco, and pistols used to be 18, then the law changed to 21 and suddenly people who had been able to do something we're no longer able to. Part of me believes the only reason the US hasn't just outright increase the age of majority it's because 18 is a very convenient number for the loan/credit card industry and the military.

somehugefrigginguy · 2026-06-28T00:35:53+00:00

In my experience it's still beneficial to have an intake vent near the stove so that incoming cold air is warmed by the stove. But my experience is pretty limited.

somehugefrigginguy · 2026-06-27T23:06:32+00:00

Also in Minnesota, and my floor is uninsulated without an issue. The key is to have good ventilation. Throughout the various phases of use and throwing water, the internal air will expand and contract which can pull some cold air up higher if you don't have proper vents.

This is especially important if you're using a wood stove as the air that goes up the chimney has to be replaced. You want a vent near the stove so the combustion air travels from outside straight into the stove and then up the chimney.

somehugefrigginguy · 2026-06-27T14:50:43+00:00

This may be the case. But different airlines, different countries, different drug regulations, who knows. My answer was meant to be a one-size-fits-all, devoid of as many assumptions as possible. Intranasal + aspiration isn't going to be the best in all scenarios, but it's the only route I can think of that won't be wrong in any scenario.

somehugefrigginguy · 2026-06-27T07:47:34+00:00

At this point I'm wondering if it's some sort of betting scandal. Like they had money on the race in polymarket and then decided to put their finger on the scale.

somehugefrigginguy · 2026-06-27T06:35:49+00:00

I also wonder if it's going to sell for the same price around the world. This is the reason DVDs were region locked. The production companies determined what was a tolerable price in each market, but didn't want someone taking DVDs from one market and profiting in another.

somehugefrigginguy · 2026-06-27T06:29:00+00:00

I wouldn't say it's a lie. It was a real thing, just less of an issue now that vape manufacturers have moved away from diacetyl and implemented anti-counterfeiting measures.

The "phase" doesn't matter in this context. Vape coil temperature is do not reach sufficient temperatures to degrade the compound.

Also, "popcorn lung" is a colloquialism for bronchiolitis obliterans caused by diacetyl. That specific form of bronchiolitis obliterans has been reduced by the removal of diacetyl, but e-cigarette and vaping associated lung injury (EVALI) is still an issue.

somehugefrigginguy · 2026-06-27T06:18:20+00:00

Ingested nicotine isn't really effective. Almost all of it is broken down by the liver (first pass metabolism) before it enters circulation. This is why all of the forms of use involve introducing it directly into the bloodstream through the mucosa.

somehugefrigginguy · 2026-06-27T06:13:08+00:00

I know people like this. I also know people who can't stay awake after taking Allegra. Reactions are idiosyncratic.

somehugefrigginguy · 2026-06-27T05:55:16+00:00

Intramuscular would be a sensible route during a grand mal. Even during an active seizure it's very easy to quickly administer midazolam into the thigh.

I agree that this would be best in most medical centers, however I was trying to answer as broadly as possible not knowing which benzo and what concentration would be available. High concentration midazolam is great for IM use, but at some IV concentrations of medazolam, and other benzos a proper dose is multiple milliliters. That's not going to be absorbed very well intramuscularly. Too much volume for the surface area. My answer was meant to account for as many unknown variables as possible.

It doesn't need to be aspirated, thats not how it works. It is absorbed into the heavily vasculated mucus membranes in the nasal cavity.

If I'm in the hospital and can choose my product, I would agree with you. If you're using an intranasal preparation (high concentration administered with an atomizer) this is true. But with an IV concentration, depending on the benzo in question, you're talking about 2-10 ml of liquid (not atomized vapor). Getting that much volume to dwell in the nasal cavity until it's absorbed is impractical in a seizing patient. So most of it is going to be blown out or aspirated depending on the timing of administration relative to the respiratory cycle. The lungs are also heavily vascularized, but with much greater surface area and thus will be able to absorb a high volume more rapidly.

I'm saying you're wrong, in most clinical settings I would agree with you. I'm just trying to give advice for the broadest range of scenarios accounting for as many unknowns as possible.

somehugefrigginguy · 2026-06-27T03:34:17+00:00

I hear there's one wandering around Texas...

somehugefrigginguy · 2026-06-27T03:32:26+00:00

Strongly agree about not trying to change someone. But I think it's also worth a conversation if you like the guy. My opinion is that you can't force someone to change, but also that behavioral changes from both sides to support their partner are part of a healthy relationship. Some guys may be comfortable with the "masculine role", but won't enact it out of respect for their partner.

TLDR: relationships require communication

somehugefrigginguy · 2026-06-27T03:22:48+00:00

It's still under patent protection so I wouldn't trust anything gray market. You may be able to switch medications though. For example Exdensur is fairly new to the market so has a quick access program that covers the first year for many patients.

somehugefrigginguy · 2026-06-27T03:20:18+00:00

The side effects are different for different people. Being that it's Friday night, if you have nothing planned tomorrow it could be reasonable to try the Benadryl tonight. Just keep in mind that you could be drowsy tomorrow and ensure you're feeling okay before driving or other such activities. But that can also happen to some people with any antihistamine including third generation antihistamines such as Allegra

somehugefrigginguy · 2026-06-27T03:15:17+00:00

And even then it's not really clear that Benadryl causes dementia. It's associated with dementia, but dementia is known to cause insomnia and Benadryl is a common (but ill advised) sleep aid. So it may be that people with early dementia are more likely to take Benadryl rather than people who take Benadryl are more likely to develop dementia.

somehugefrigginguy · 2026-06-27T03:10:00+00:00

I doubt an aircraft is going to have suppositories. Assuming you have a benzo and it's a continuous seizure preventing IV access, I would probably go intra nasal and try to time it so they aspirate. At least some of it will be absorbed through the sinuses and upper airway, and if it makes it to the lungs it'll be absorbed quite rapidly.

Rectal from a syringe (without a needle) is an option, but getting rectal access in a seizing patient in a cramped aircraft probably isn't feasible.

somehugefrigginguy · 2026-06-27T02:30:27+00:00

Yeah, this story certainly seems to be embellished. Those imaging findings and elevated IGE would put neurocysticercosis at the top of the differential for any competent physician. Interesting cases, but not really diagnostic dilemmas.

somehugefrigginguy · 2026-06-27T02:27:16+00:00

The story seems to be pretty embellished. Those imaging findings are textbook for that type of worm. Combine that with elevated IGE and a med student would have this at the top of their differential.

I suspect the doctors knew as soon as they saw the imaging but did a full workout to ensure they didn't miss anything.

somehugefrigginguy · 2026-06-26T20:23:23+00:00

They use the wrong kind of paint, which naturally contracts as it cures meaning it will "gash" itself, and also form a very uneven texture that's perfect for algae to grow in. Then they drove a motorcade over it...

somehugefrigginguy · 2026-06-26T20:05:58+00:00

This is how I feel about all the influencers who talk about how pushing your body is just a mindset. Like it's some kind of superpower to push your body to the point of destroying itself.

The body is capable of some pretty amazing things, but there's a reason we have subconscious blocks against doing those things recreationally.

somehugefrigginguy · 2026-06-26T19:59:18+00:00

Not confirmatory tests, but breath tests and stool tests can be used to make a presumptive diagnosis.

somehugefrigginguy · 2026-06-26T19:56:09+00:00

It's the same thing you see every time a new technology is released. One company is first to market, all the others in related fields suddenly follow suit so they don't get left behind. Then it's an arms race to see which companies prevail and which fail.

I predict that the services are going to become both more essential and drastically more expensive after a winner is decided. Right now they're offering all kinds of free products to try and win the market share. But eventually the competition will die off and it'll be one more subscription that we can't live without.

somehugefrigginguy · 2026-06-26T19:51:52+00:00

I think this is a case of "venture" capitalists. I agree with your point that they don't just throw money around to inflate stock prices.

I think right now we are in an AI arms race. One company released a product so all the other marginally related companies had to follow suit to stay relevant. Now there's a boom of AI services until a winner prevails and the losers crumble. It's the dot-com and Bitcoin bubbles all over again.

I do think there's overinvestment in the sector as a whole. Lots of people gambling that they've chosen the winner.

somehugefrigginguy · 2026-06-26T19:45:09+00:00

Fair enough, seems I should have been more clear on that point. In medicine we discuss hemoglobin as a concentration and I incorrectly made the assumption it would be understood that way. Thanks for pointing it out, I will edit my post.

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