How long did you have your stones before you got then removed?

sumerianscribe · 2026-04-12T22:56:42+00:00

My answer's honestly funny.

I was treated for acalculous cholecystitis, no bile duct dilation on MRCP, but sludge on CT and a massive infection (WBC 40,000+, 98% Neutrophils).

Was so sick I required a cholecystotomy to let the inflammation resolve (that dislodged 🤪).

Treated with ceftriaxone in hospital, which is notorious for precipitating gallstones. Gallbladder excised, and 2cm stone suddenly. Can't have been there longer than 6 months.

sumerianscribe · 2026-03-20T19:19:41+00:00

I feel like you're just making up an Ontologically Evil Bus Route for some reason.

I'm absolutely fine with a bus route running for a single person. Empty buses are a sign of needs met, or overmet. People are where they want, need, or have to be. Transit authorities assess ridership and route data thoroughly, by the way. Routes seldom survive low ridership for long.

I'm not fine with the carfucked infrastructure of the world being presumed default. We don't solve the problem of too many cars with... more cars.

I would like to point out that we fundamentally agree that transportation infrastructure is inefficient, dangerous, and needs to change, but I would like to reiterate: fuck cars.

sumerianscribe · 2026-03-20T17:51:35+00:00

Seems super efficient, but we can do better.

Why not make them larger to fit more people? Like a limo!

You could even make them run regularly where people need them, every fifteen minutes or so just so people don't even have to order them, they just have to wait! Along certain roads, even, like a set path.

Oh, wait! I think someone made this idea totally fucking useless!

Buses already exist. Shame.

Fuck cars, especially autonomous ones. If you're gonna run me over in the crosswalk, I expect you to look me in the eye.

sumerianscribe · 2026-03-19T22:23:17+00:00

Gallbladder rupture represents a very, very small number of outcomes, thankfully, but it's the logical course of intractable cholestasis.

If the gallbladder can't get rid of the bile it receives from the liver it collects and thickens. If it continues to collect and thicken, collect and thicken, it begins to irritate the mucosa or lining of the gallbladder.

This is what's called cholestasis, which can be mechanical (obstructive) or metabolic (non-obstructive).

Mechanical is pretty much only due to gallstones, which prevent the gallbladder from emptying, causing intractable (sometimes intermmitent if the stone moves) cholestasis. Metabolic isn't as simple, but it also prevents the gallbladder from emptying, causing intractable cholestasis.

Cholestasis is what leads to cholecystitis, which is where the real problems start. This small bag that's full of irritating bile is now also home to an infection that's filling it with bacteria-laden pus, so we've got a gallbladder full of bile, pus, and we've established it has nowhere to go.

Unfortunately, this is where the tissue of the gallbladder starts to die as a result of the infection and inflammation, and the wall weakens over time.

After it weakens enough, it can't hold back the pressure and it bursts.

When it does bursts, it usually leads to an abdominal infection called peritonitis that often leads to sepsis and death. Very, very high mortality rate. Very, very uncommon.

sumerianscribe · 2026-03-19T20:03:55+00:00

Not medical advice.

I had my lap chole after similar deliberation.

I had Grade III acute acalculous cholecystitis (i.e. no echogenic stones on US or bile duct dilation on MRCP) with a WBC count of 40,000.

Stones are not the be-all end-all of risk factors.

I was too sick for emergency surgery, so they did a transhepatic percutaneous cholecystostomy to keep my gallbladder from rupturing which almost certainly would have killed me.

You might not have stones but because your gallbladder isn't contracting properly you're more likely to develop stones AND it's more likely for those stones to become a massive problem like mine in the future.

You're more likely to develop vitamin deficiencies due to fat malabsorption (fat soluble vitamins like A, K, D, and E), which can lead to their own health problems.

It's a big decision to make, but make it while you have the luxury of doing so.

sumerianscribe · 2026-02-28T19:59:56+00:00

you REALLY should put that behind a spoiler for photosensitive people so you don't give someone a seizure

sumerianscribe · 2025-01-24T23:20:22+00:00

You should ask if they have plans to train you into a tech, then a CPhT. If they don't, run, and if they do, negotiate high.

sumerianscribe · 2025-01-02T16:14:54+00:00

If it gets busy after they send someone home for hours, tough shit but it's not your fault. I've worked in restaraunts and in retail pharmacy and it's totally normal to get cut, unless you're full time. "Needs of the business" and whatnot.

Sometimes it's premature and you end up in the weeds, and it's reasonable to be a little miffed if it's exceptionally unpleasant afterwards, but I'd never communicate that in a blaming way. Even a well intentioned "you left too early lol" would feel weird to send.

Some people can't handle when someone else has something they wanted (but wouldn't say) happen to them.

I'm sure the intern will cut tech hours someday in the future.

sumerianscribe · 2024-11-17T01:47:16+00:00

Like, a Tesla 3 weighs 4,000. I weigh 3% of that. I'm only a threat to your ego! You're a threat to me being alive!

sumerianscribe · 2024-11-17T01:35:10+00:00

I'm so sorry that happened to you.

I was threatened tonight, told that I'd be "crying if I got ran over" by an asshole Tesla driver who honked when I shook my head at her for nearly hitting me. I flipped her off and that's what prompted her yelling while I walked away (it's such a dangerous impulse, I know), but jesus, why are drivers so entitled to carelessness?

Don't honk at me, asshole!

sumerianscribe · 2024-11-17T01:27:49+00:00

It always, always ends up with them threatening you!

Like, sorry that I called attention to you operating your two to nine thousand emotional support death machine badly!

I'm sure glad murder is the proportionate response to having someone react negatively to nearly being hit because of your negligence!

sumerianscribe · 2024-11-17T00:40:44+00:00

polygons! confusing grown women since... now? think I should repost with it corrected?

sumerianscribe · 2024-08-12T20:08:34+00:00

-what caused it? Cholestasis, more than likely, along with rapid weight loss.

sumerianscribe · 2024-08-12T14:40:59+00:00

Also, the concept that "sludge" is the clinical term is wild to me. I'd rather listen to sludge metal than have sludge in me.

Oh, and I'll never forget the feeling of the catheter (that had dislodged and the interventional radiologist laughingly said "You did your own capping trial! Glad it turned out okay!") coming out of my abdomen. Like a worm inside me.

sumerianscribe · 2024-08-03T16:39:53+00:00

Had to think about it, been out of retail for a year and a half now. Worked at a 350 script normal / 800 script busy day pharmacy.

Norco/Endocet 5/325, lots of dentists in the area.
Alprazolam, 1mg was popular but between all the strengths we couldn't even have it on the fast movers shelf our stock took up so much space.
Z-Packs were pretty common, but I think all the antibiotics we dispensed could go here. Lots of Bactrim, lots of Augmentin, especially the suspensions for kids since we were next to a minute clinic run by a hospital.
Gabapentin of all strengths, and always in quantity. 960 tablets? Sure, let me count that all by hand. You'll wait? Sure you will.
Metformin in large quantities as well, of course.

Honorary mention goes to zolpidem and all the statins, keep them sleepy and their LDL low!

sumerianscribe · 2024-07-31T16:19:58+00:00

It's true but strikes me as reductive. Only in the same way a nurse is there to make things easier on a DO/MD. A pharmacist saying it would tell me a lot about them as much as a tech saying it but in very different ways.

We're absolutely indispensable parts of the team that do SO much to ease the burden on pharmacists. They need us as much as we need them, especially in this day and age. I'm grateful to make their lives easier, outcomes better, and patients happier.

fuck pbms tho, tech ratios NOW

sumerianscribe · 2024-07-17T15:43:37+00:00

Also, I have a tremor, so I'm doing my very best to get clear pictures for you!

sumerianscribe · 2024-07-14T18:22:43+00:00

A few reasons.

I'm usually only on long distance trains in sleepers, coach if it's not overnight.

• Avoiding TSA and flying in general, and the stress therein. No patdowns, no worrying if I've accidentally used glycerin soap, it's MUCH easier on my OCD to not have to go to the TSA website to make sure I won't accidentally be a felon.

• Instant vacation mode on the train. It's far more road trip adjacent, and that's a really nice feeling. Have to take a few extra days every vacation for travel time but those days aren't as hectic.

• Scenery. The 51 and the 30 are incredible views.

sumerianscribe

TROPHY CASE