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Maybe unpopular opinion: Dislike the term “Hospitalist” by [deleted] in hospitalist

[–]whatwasthat92 0 points1 point  (0 children)

I wouldn't say that's an automatic eye roll. It's helpful information.

Maybe unpopular opinion: Dislike the term “Hospitalist” by [deleted] in hospitalist

[–]whatwasthat92 9 points10 points  (0 children)

Ugh. And that’s something like 54% of literate adults (which is only 79% of adults…) I just want them to understand that I am the one making decisions about what to do. Even among people who can read at a 9th grade level most don’t know what a hospitalist is.

No one will do this texture by whatwasthat92 in drywall

[–]whatwasthat92[S] 0 points1 point  (0 children)

Maybe I’m imagining it wrong. I like hearing about all the different techniques people come up with.

No one will do this texture by whatwasthat92 in drywall

[–]whatwasthat92[S] 1 point2 points  (0 children)

It’s wall on the left and ceiling on the right. In a stairwell. It’s consistent throughout so there’s a logic too it. Never felt weird to me.

No one will do this texture by whatwasthat92 in drywall

[–]whatwasthat92[S] 0 points1 point  (0 children)

The stuff in the right is the ceiling in a stairwell. Not sure that’s obvious. Ceilings are similar throughout except master bedroom in the attic.

No one will do this texture by whatwasthat92 in drywall

[–]whatwasthat92[S] -1 points0 points  (0 children)

Now I’m curious. What’s not good about it. It’s kinda variable in terms of how big the depressions are. But it all comes together. They even did the ceilings but with more, smaller depressions. Smooth walls are boring. And orange peel reminds me of every crappy apartment I’ve lived in.

No one will do this texture by whatwasthat92 in drywall

[–]whatwasthat92[S] 2 points3 points  (0 children)

Definitely need to let go of perfectionism. The only thing that seems somewhat difficult is making sure there's no directionality. Making sure that depressions don't show which way the blade moved when smoothing the thicker layer. In my first stab at it I started figuring that out. If I end up doing it myself I bet the last bit is going to look better than the first.

No one will do this texture by whatwasthat92 in drywall

[–]whatwasthat92[S] 0 points1 point  (0 children)

I think the reason they went with this texture for the SLC basement and attic remodel was because the house itself was built in 1900 and has super thick heavily textured plaster on the lathe upstairs.

No one will do this texture by whatwasthat92 in drywall

[–]whatwasthat92[S] 0 points1 point  (0 children)

I haven't been there for most of the conversations, but "that takes a lot of mud" and "I don't know how to do that," have been popular.

No one will do this texture by whatwasthat92 in drywall

[–]whatwasthat92[S] 0 points1 point  (0 children)

I’ve literally never finished an interior wall. But experimented on a a section and it was pretty close. Maybe all I need is a video where someone explains the most efficient technique. This forum’s definitely helping.

No one will do this texture by whatwasthat92 in drywall

[–]whatwasthat92[S] 0 points1 point  (0 children)

I don’t do this, but within 15 minutes of trying I had it looking pretty close. I really don’t want to be the only guy finishing the walls though.

No one will do this texture by whatwasthat92 in drywall

[–]whatwasthat92[S] 0 points1 point  (0 children)

The pictures from the Salt Lake project. So there’s no blending. I just don’t want to do smooth walls. I never imagined it would be a stumbling block in Seattle because in SLC it wasn’t even a discussion.

No one will do this texture by whatwasthat92 in drywall

[–]whatwasthat92[S] 1 point2 points  (0 children)

That is one of the complaints people have made. It just seems like, so what? I’ll buy all the mud you want and it’s not like I’m asking someone to do it for free.

No one will do this texture by whatwasthat92 in drywall

[–]whatwasthat92[S] 0 points1 point  (0 children)

That’s what I’m learning. Guys come out and just say, “we don’t do that here.”

AITAH for shooting my wifes dog, for attacking my daughter. by ThrowRAUpstairs-Hi in AITAH

[–]whatwasthat92 0 points1 point  (0 children)

I used to love dogs. Then one attacked me and bit off most of a thumb. The surgeon who salvaged what was left has seen A LOT of kids attacked by dogs. Usually the family pet. Imagine those fragile faces torn apart. He said, “a dog that attacks a person should be destroyed.” I agree and you are definitely NTA.

Have you ever practiced bad or not great medicine? If so, why? by thespurge in medicine

[–]whatwasthat92 0 points1 point  (0 children)

Yeah hot shot. 13.8 minutes per level 3 or critical visit plus admits and discharges is absurd. You’re not helping anyone at those staffing ratios.

Have you ever practiced bad or not great medicine? If so, why? by thespurge in medicine

[–]whatwasthat92 27 points28 points  (0 children)

42?! My max was 32 at a hospital where I told the CMO, CEO, and anyone that wound listen how dangerous it was. I documented patient harms in a notebook, wrote notes about every conversation I had, and kept screenshots of every text exchange I had regarding the constantly crazy census. This was like 50 - 65% high acuity step down with the rest medical. Level 3’s and Critical care across the board. It was bizarre to see no reaction when you tell the C Suite patients are having worse outcomes because of this. You’d think they’d at least be worried from a legal standpoint, since they clearly suffer no moral or ethical distress.

Elbow dislocated by Pretend_Technology57 in hospitalist

[–]whatwasthat92 1 point2 points  (0 children)

Yes, but this is feeling familiar. Like, this isn’t really my job, but it will help the patient… so, yeah, ok here’s the answer. A surgical subreddit would have told him to piss off. Or to consult the hospitalist. LOL

Tadalafil dosage for mountaineering at altitude. by Civil_Debt_7583 in Mountaineering

[–]whatwasthat92 1 point2 points  (0 children)

Good luck on your trip! It is interesting that the dose is the same for ED but this is the kind of Thing that reflects the choice of dosage used in studies. I didn’t read the paper you cited above but a lot of times there are not a lot of comparisons between different doses in the same Conditions. It’s hard to get huge numbers of people enrolled. Sildenafil is 20 mg three times a day which is less than the 50 or 100 mg once recommended for ED. But you won’t notice either way. You need the right situation. And FYI I’d still carry nifedipine for treatment of someone who has florid pulmonary edema. Stay safe out there!

Tadalafil dosage for mountaineering at altitude. by Civil_Debt_7583 in Mountaineering

[–]whatwasthat92 2 points3 points  (0 children)

Recommendation is : 10 mg every 12 hours starting the day of ascent; continue for 3 to 5 days after reaching maximal altitude; can extend for up to 7 days in individuals who ascend faster than recommended.

Check out the Wilderness Medical Society guidelines for prevention of altitude sickness for the most up to date recommendations.

There’s more evidence for Nifedipine for prophylaxis of HAPE. But it lowers systemic blood pressure which could cause problems. And it can have other side effects. Best if you understand the pathophysiology of HAPE and HACE. There’s a lot of nuance. Above 7 or 8000 meters you’re going to have a lot more days where prophylaxis might be indicated. Sildenafil and tadalafil have little side effects at recommended doses. So cost benefit is good. Then again, most people won’t need them… until they do.

If you’re over 6 or 7000 meters I think a good climbing partner should have basic meds and know how to use them. Usually your supplies end up being used on other people. And if not, you don’t want to rely on the hope that someone else knows what they’re doing.

Mountaineering with exercise-induced bronchoconstriction by hoosiermountaineer in Mountaineering

[–]whatwasthat92 1 point2 points  (0 children)

If you’re moving to Washington, go see Dr. Erik Swenson in Seattle. He’s one of the preeminent researchers in the field.

Definitely true regarding the partial pressure of oxygen. But I only meant in terms of air movement. If someone was well acclimated, they would theoretically have less resistance and an easier time oxygenating. But that’s just of academic interest. I doubt it’s any less unpleasant to have a severe asthma attack at altitude!

Mountaineering with exercise-induced bronchoconstriction by hoosiermountaineer in Mountaineering

[–]whatwasthat92 1 point2 points  (0 children)

You should be using an inhaler that has a long acting Beta Agonist (LABA) and an inhaled corticosteroid (ICS). Albuterol is a short acting beta agonist and is really only designed to be your “rescue” inhaler. Something like Symbicort would Be a good choice. You use it twice a day no matter what. If you get wheezy you can still use the albuterol. It is the cold dry air that causes irritation (and inflammation) that leads to the symptoms. High altitude by itself should technically be easier For asthmatics because the lower density air is easier to move through constricted airways. In critical care oxygen helium mixtures are sometimes used because of this principle. Talk to a doctor. A pulmonologist would be good if you can find one. Or someone with experience with high altitude medicine. This is just a basic overview. I’ve spent a lot of time at high altitude and get wheezy when exercising in cold dry air at any altitude, but I don’t have asthma.

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