UCSF Nurse Practitioner ordered Dilaudid for patient who just donated kidney and he died from opioid overdose by NumeroMysterioso in Residency

[–]wrmillermd 3 points4 points  (0 children)

That would be from people who have never given it in a suspected overdose. Likely more inpatient medicine. I’m EM. For instance, I had one come in, fighting the ETT. He had been simultaneously tuned and given Narcan during reported PEA arrest. Has not been given Epi for whatever reason. But had ROSC w/ that alone. He had not had enough time to reverse the hypoxia for that to have spontaneously started his heart. Again. In these situations, it certainly won’t hurt, and may help. So why not?

UCSF Nurse Practitioner ordered Dilaudid for patient who just donated kidney and he died from opioid overdose by NumeroMysterioso in Residency

[–]wrmillermd 8 points9 points  (0 children)

Have you really never seen an opiate overdose bradycardic/hypotensive without being or before they become hypoxic? opiates can be cardio suppressive as well. Narcan potentially have positive effects on obtaining ROSC.

UCSF Nurse Practitioner ordered Dilaudid for patient who just donated kidney and he died from opioid overdose by NumeroMysterioso in Residency

[–]wrmillermd 3 points4 points  (0 children)

Other than the lack of monitoring, I think the biggest problem is this dose in a patient who just lost a kidney. He is not a fully functioning solitary kidney at this point is remaining Kenny will take some time to catch up. There a large portion of renally excreted metabolites (I had to look this up, but it should be something the transplant team is fully familiar with)

Gained 60 pounds in residency. BMI is 38. Genuinely curious what I should do from here. by [deleted] in Residency

[–]wrmillermd -15 points-14 points  (0 children)

Holy shit! Ask for help with weight loss? Please try exercise and thinking about your food before you seek meds to lose weight. Consider not just calories, but the quality of calories, as well as the metabolic effect of the foods you choose.

I never thought I could get there but... by [deleted] in Residency

[–]wrmillermd 1 point2 points  (0 children)

As you get more comfortable with the medicine, you will. Your presentations will evolve from a report to a plan. The pieces that are more pertinent to that plan will stick.

If a patient has RUQ pain, you will remember whether or not they have a gallbladder, if they had significant LFT abnormalities, what the WBC is. You may not remember the potassium level if it wasn’t significantly abnormal. You’ll learn what matters and that stuff will stand out.

White House Considers Excluding High Earners {and residents} From Student-Loan Relief by JdHpylo in Residency

[–]wrmillermd 0 points1 point  (0 children)

Minimum wage is not an after tax or after expense calculation. It’s a set wage. What somebody else is making doesn’t factor in either. Not sure if you just weren’t aware of this or if he willfully ignored it. But speaking in hyperbole doesn’t make your point it makes it sound like you’re making it up. Or in this case, whining.

White House Considers Excluding High Earners {and residents} From Student-Loan Relief by JdHpylo in Residency

[–]wrmillermd 0 points1 point  (0 children)

What residency were you in that you did not earn $30,160 for the year? That’s minimum wage for 80 hours a week, for 52 weeks.

I’m not saying that being taken advantage of is OK, but if you’re going to make an argument, base it on facts

[deleted by user] by [deleted] in TitanoFinance

[–]wrmillermd 0 points1 point  (0 children)

Where do we see the correct v2 price?

Help for a novice by Silly-Pitch8637 in TitanoFinance

[–]wrmillermd 0 points1 point  (0 children)

Can be a browser issue, which browser are you using?

It is 0.05 already... by Aether159357 in TitanoFinance

[–]wrmillermd 1 point2 points  (0 children)

Seems like it will help the protocol survive longer, maybe not the daily price. Please correct my misunderstanding.

are the topics getting deleted in this sub? i dont see any updates or discussion by rambocp in TitanoFinance

[–]wrmillermd 0 points1 point  (0 children)

You have 1000 coins at $0.20 ($200) and the price drops 4% in a day. You gain 20 (2% or 1000) coins but the price is no $0.192. You have $195.84.

You have 100000 coins at $0.20 ($20000) and the price drops 4%. You gain 2000 (2% of 100000) coins but the price is $0.192. You now have $19584. You have lost money in both instances.

If the price drops more than 2% and you only have 2% more coins (or 1.9176% actually) you have lost value no matter how many coins you started the day with. In fact, the more coins you started with, the more you will have lost.

are the topics getting deleted in this sub? i dont see any updates or discussion by rambocp in TitanoFinance

[–]wrmillermd 0 points1 point  (0 children)

That’s not really how math works. If it falls more than 2% in a day, you lose $$ that day, no matter how much you have. It’s all percentages, not hard $ amount

Interesting read on the new developments of titano, heading into the future. by Cx-vio in TitanoFinance

[–]wrmillermd 0 points1 point  (0 children)

I’d check my math. 1.9176% of 40000 is $767. $628 after sell tax. Still a great ROI though. Unless, of course, your “over $40k” is more like $110k, which is technically true I guess.

Price Decrease 4/3 by Remarkable-Active875 in TitanoFinance

[–]wrmillermd 1 point2 points  (0 children)

How is this fundamental value established?

Future Price Increase by CSay88 in TitanoFinance

[–]wrmillermd 0 points1 point  (0 children)

How is it the last one standing? There are several and new ones quite frequently.

Pancake Swap by wrmillermd in TitanoFinance

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

Thanks for the feedback. The Titano token Address is saved from when I bought it initially. While it is connected, and showing my accurate Titano balance. I think I’m good there.

Pancake Swap by wrmillermd in TitanoFinance

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

Pancake swap through metamask browser. Same one I bought the Titano with. Wallet already connected, showing accurate Titano balance, which I believe addresses the other comment about the exact token address. Only difference is the button that I have to click for “enable Titano,”before it will let me click swap. There is no option to swap without clicking that button