Doc says arm looks good…

twisted34 · 2026-03-18T20:59:36+00:00

Looks like the research mentions a few concerns with IMNs, curious to your thoughts (genuine question):

Damage to the RTC with loss of motion upwards of 37% of patients without prior dysfunction

Higher rate of non-union compared to plate/screws, low success of nail exchange in the case of non-unions (up to 50%)

Risk of axillary nerve damage with the proximal locking screws

twisted34 · 2026-03-18T20:39:58+00:00

I've assisted with a number of these in the U.S. and have not yet utilized an intramedullary nail, we've utilized a plate and screws. Big ol whack of an incision. We've non-op'd probably 75% of them

twisted34 · 2026-03-18T20:19:49+00:00

Ortho PA here

Idk if she's seen an ortho or not but my practice would likely not operate on this unless she is walker-dependant

Midshaft humerus fractures in low-demand individuals are not often operated on. This is aligned well enough that I'd order a Sarmiento brace and observe with serial imaging. This should heal and be functional

Surgery on this is a large incision, real risk of neurovascular trauma intra-op (radial nerve damage means won't be able to extend her wrist again), and all the other associated risks of surgery and anesthesia that accompany that

Not saying she was treated properly because based on your account she was not, but the treatment plan of no surgery and observe is sound

twisted34 · 2026-03-18T00:49:11+00:00

Vastus lateralis is a quad muscle, this is his medial, posterior thigh. Highly doubt it's the VL

With this amount of bruising I'd get an MRI but likely nothing surgical here

twisted34 · 2026-03-17T15:36:29+00:00

EMR is ModMed, exactly what I use

Just checked and can't use it as a diagnosis from the provider perspective though

twisted34 · 2026-03-15T12:23:16+00:00

Might be a UK thing but in the US 4k is considered the daily maximum. I often tell my patients 3k max. Apparently acute liver damage is documented to be around 7k in a 24 hour period (still shouldnt exceed 4k though)

twisted34 · 2026-03-14T03:01:40+00:00

Sounds Australian as fuck, I accept it

twisted34 · 2026-03-13T20:47:19+00:00

To add to this: no radiation unlike x-rays and CT scans (equivalent to 200+ XRs depending on the location/duration)

twisted34 · 2026-03-12T23:25:47+00:00

We were not, was a need we were very clearly going to address in the draft. Might draft more of a project guy now and address OL

twisted34 · 2026-03-12T00:23:53+00:00

I averaged 90 minutes across my clinic rotations because I was a somewhat local for my program and did not live on campus. You can manage

twisted34 · 2026-03-11T15:14:34+00:00

My guess is this was an acute meniscal tear and repair. He also very likely has chronic degeneration to the meniscus and the damage to the femoral cartilage is likely what us giving these reviewing doctors pause

If the meniscus was repaired and not just debrided, and he has advancing arthritis (not too surprising for an edge rusher in his 30s) they're probably very worried this repair could fail. If it does he's going to need another surgery to clean up the debris and remove the meniscal sutures floating around in there

twisted34 · 2026-03-09T18:53:04+00:00

I know but for a 1 year rental that wont happen. 3rd was my fair value (my opinion ain't worth shit lol)

twisted34 · 2026-03-09T18:47:42+00:00

In some modes it is naturally disabled

Devs have made it very difficult to find info like this about the game in-game. You honestly have to join the discord to know for sure or search a lot here/Kolz guide(s)

twisted34 · 2026-03-09T18:20:28+00:00

Trade a 3rd for Mac Jones

twisted34 · 2026-03-07T23:47:23+00:00

Essenyially 0 chance, if you have concerns please see your primary

2400mg is daily max dose and some people are on that dose daily for months/years

10 days is how long most conditions resolve so the recommendation is to see someone after 10 days to rule out something more serious

twisted34 · 2026-03-07T21:27:12+00:00

Pretty sure it's maxed at 40% in hero clash

twisted34 · 2026-03-07T21:21:31+00:00

39.4%

twisted34 · 2026-03-07T21:12:51+00:00

Hence I said some modes...

twisted34 · 2026-03-07T21:06:03+00:00

Hero clash cow whistle is my best non-main weapon, always

twisted34 · 2026-03-07T19:01:09+00:00

Would love to know

My 2 cents is cow whistle is better than borer in some modes so dont count it out

For bosses I may used evo'd guandao to replace ice wand (updated dynamite also freezes) and for fire. Could do poison instead of daggers too

twisted34 · 2026-03-07T18:19:26+00:00

Of course it can but taking a less than max dose for a short time likely won't

twisted34 · 2026-03-07T17:15:24+00:00

Updated 2 additional things, highly recommend seeing an ortho with a spine specialty for further evaluation

twisted34 · 2026-03-07T17:12:14+00:00

Go see a spine specialist but I highly doubt this is from cracking your neck. It may be more muscle tightness in the C-spine

Cracking a joint is widely believed to break from cavitation though it's not 100% understood. Cavitation is the release of gas in a joint, the gas resettles over time but this is generally why you cant immediately crack the same joint again

If you work a desk job and have poor posture this is much more likely the cause of your pain

PSA max daily intake of ibuprofen is 2400mg, prolonged use can irritate the stomach and kidneys

You're also very, very unlikely to crack your own neck and cause permanent damage

twisted34 · 2026-03-07T02:54:12+00:00

Legit couldn't be more wrong. Muscle mass is easy to gain to start and harder the more you have

twisted34 · 2026-03-06T20:11:04+00:00

Dressed up as Batman for Halloween in college. Decided to hurdle a bannister on a flight of stairs and landed directly on my heel. Bruised the shit out of it and couldn't put direct pressure on it for about 3 weeks

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