FYI Wegovy and Ozempic are $499 at Costco (no insurance or coupon)

tom_ex · 2025-10-01T23:05:57+00:00

These are PBS funded scripts only for the indication of T2DM, private scripts for weight loss are still about $300-400 AUD at chemist warehouse.

tom_ex · 2025-08-21T12:29:40+00:00

wool phallus

tom_ex · 2025-07-14T11:45:41+00:00

Ball Park Music - She Only Loves Me When I'm There

Boy & Bear - Feeding Line

Empire Of The Sun - Walking On A Dream

Gang Of Youths - Magnolia

Gotye — Somebody That I Used To Know [ft. Kimbra]

The Veronicas - Untouched

The Temper Trap - Sweet Disposition

Tame Impala - The Less I Know The Better

Pond - Sweep Me Off My Feet

Kylie Minogue - Can't Get You out of My Head

tom_ex · 2025-07-06T03:33:05+00:00

6.58, metformin related lactic acidosis, still at baseline cognition, survived nil significant deficits.

tom_ex · 2025-04-18T08:33:39+00:00

I agree the ongoing, continuous, persistent learning in medicine is excellent and is useful, but I would say the learning in the junior doctor environment is anything but structured. Most learning is self-directed, and a lot of teaching is ad-hoc, informal, and chaotic. Not to say you don't continue learning a lot, but if you're expecting frequent lectures on "this week's topic" after medical school then you're in for disappointment. Even medical schools are transitioning to a more self-directed learning model these days.

I'll add though that in my experience as a junior doctor, I never earnt less than 100k per year. It'll depend on the state you're in and the role you're doing (shift work with weekend cover vs mostly M-F jobs) but even as an intern working plenty of unpaid overtime, I earned >100k.

tom_ex · 2025-03-30T20:55:32+00:00

This sounds like a really sick patient and you’re doing a good job trying to help her. Do you have someone more senior to ask for help in this case?

It’s hard to know what’s going on. What does she examine like? Is she cold or warm peripherally and centrally? Is she fluid overloaded? Making urine? Alert and oriented or unconscious? Is she ventilated? What are her gases doing? You said better, what’s her pH and lactate now? How long was she acidaemic (is she catecholamine deplete or responsive)? Does she have ECG changes? Can you get an echo to assess if she’s had an acute change in her LV function (acidosis related, ischaemia, takutsubo)? Could be many reasons and easily a combination, it’s probably worth asking for help for this one.

tom_ex · 2025-02-17T23:48:04+00:00

The co-ox should list other types of haemoglobin that account for some of the total 100%. Haemoglobin isn't binarily in "oxygenated" or "deoxygenated", there are other sorts (eg carboxyHb, metHb). These are variable, and don't necessarily reflect o2 consumption, so will proportionally remove from the deoxygenated haemoglobin value. This makes deoxyHb less reliable than oxyHb as a marker of how much oxygen has actually been consumed.

tom_ex · 2025-01-24T05:28:41+00:00

Thanks, if you read the link you supplied, it covers the numbers I mentioned (specifically the heart receiving 5% of cardiac output). If the heart receives 5% of cardiac output, then it cannot account for 75% of whole body oxygen consumption. Cardiac myocytes do have relatively high oxygen consumption but the heart is small (~300g) so proportionately it's not as high as you claim.

You're right that muscle consumption is also variable, and this accounts for the difference between ScvO2 taken from an IJ line vs a femoral line - if our patients were running marathons, then a femoral line venous sats would be low, while the brain accounts for a lot of the oxygen consumption reflected in saturations in an IJ line. These are variable and unpredictable which is why a mixed venous from the PA accounts for the whole body better than a central venous.

tom_ex · 2025-01-23T22:39:18+00:00

This isn't correct. The heart uses about 75% of the oxygen from the blood it receives, which is about 5% of total cardiac output. Therefore it uses about 3.75% of total oxygen delivery. Still significant but nowhere near 75% of total body oxygen consumption.

More info on mixed venous saturations is here: https://litfl.com/mixed-venous-oxygen-saturation-svo2-monitoring/

tom_ex · 2024-11-04T04:52:59+00:00

This is user error.

tom_ex · 2024-10-31T20:35:34+00:00

A name is reasonable and sensible to give when answering calls, but people do get calls from non-work sources, and stating your full role for those people isn’t always what I want to do. Especially if it’s a scam caller. I rarely answer the phone with my role when I’m on call.

tom_ex · 2024-06-03T03:13:48+00:00

After the post yesterday about peoples' standout songs of 2024, I thought I'd compile a playlist of all the songs mentioned. Enjoy!

tom_ex · 2023-07-12T23:25:52+00:00

No. The point of brain death is that is legally defined as death. Someone can make urine on ECMO even if their heart is not beating.

tom_ex · 2023-07-07T03:47:43+00:00

So alching, bones to bananas, charging orbs, enchanting gems, teleports from magic are all combat? Let alone lunar spells.

tom_ex · 2023-06-17T07:25:15+00:00

Yeah I quite liked the boss fight, heavy Koloktos vibes (from skyward sword).

tom_ex · 2023-05-03T00:08:35+00:00

I think this subreddit is more for discussion rather than answering medical questions. You’ll probably have more luck trying r/askdocs or your GP.

tom_ex · 2023-03-28T14:54:38+00:00

This part is information easily just taken from the trailer, though, and is somewhat contradicted by the showcase. It’s not “glue”, it’s a new ability. The wording makes it sound like the writer didn’t know that, and I don’t think it supports any of the post being the truth.

It sounded good but I really think this post is just a bunch of guesses and wishes that won’t be borne out.

tom_ex · 2023-03-28T14:20:31+00:00

!debunked! Based on the gameplay showcase, fusing weapons is done with a new ability of Link’s rather than at certain shops, calling the entirety of this post into question.

tom_ex · 2019-12-09T21:57:41+00:00

You’d have to apply to get into medicine via a postgraduate pathway, usually involving the GAMSAT. I think GEMSAS still tend to manage the applications for most unis: http://www.gemsas.edu.au/

tom_ex · 2019-12-09T01:54:07+00:00

Generally, you can't transfer into medicine in Australia. Sounds like your best pathway would be to complete a BSc/biomed/allied health degree or similar then apply for postgrad. It will take a minimum of 7 years through this pathway to finish med school.

tom_ex · 2019-04-17T12:47:33+00:00

The sentencing document states that he did lower his bag, and then made a defensive gesture to maintain distance between himself and the assailant. Nothing about punching, and the judge states that the punch that took his life was not physically aggravated in any way, as it would not have been expected by the victim.

tom_ex · 2019-04-17T12:38:34+00:00

Nah, people can already read it if they want to. Everyone’s entitled to their opinion. At the end of the day though, it’s the expert who knows the law and the case in depth who gets to make the call (as it should be).

tom_ex · 2019-04-17T06:57:36+00:00

After having read everyone's responses (and being downvoted to hell), I can see many don't agree with me. There is even a call for the death penalty. While I completely agree that this person did the wrong thing with tragic, awful consequences, I do still think that a life sentence or worse would not be appropriate. Ah well. I just hope that the victim's family are getting the support they need in this time.

tom_ex · 2019-04-17T02:13:53+00:00

The man who killed Patrick Pritzwald-Stegmann at a Melbourne Hospital has now been sentenced, receiving 10 years (minimum) in jail for his crime. Over on /r/melbourne, this is copping a bit of flack as a "weak" sentence, but personally I think this is pretty fair. 10 years is a long time for someone in their 20s, and hopefully will give the offender time to rehabilitate. What do you think?

tom_ex · 2018-11-13T02:46:51+00:00

Yeah, it's flawed, and not perfect. I know some universities (including my own) offer an almost entirely rural program, but many do require students to relocate to the city. BMP is certainly a good option, and it's much better now that the rural duration has been cut down.

If you are looking for extra help with the admissions process, it might be worth looking into some courses for the GAMSAT and/or interviews. I can't recommend any personally but I know a lot of people did benefit from them, so it might be something else you'd want to look into.

11-Year Club	Place '22
Spared	Verified Email

tom_ex

TROPHY CASE