As an IM person - neurology residency seems like a special kind of hell and while neurologists are the most like us of all the non IM fields, the patient often is still better off in your hands. Stupid admissions count towards your cap just like the interesting ones do.
I was married to a physician who forbid me from listing my self as an organ donor on my license and said they won’t try as hard to revive me if I was in a crash because of my blood type being so in demand. I didn’t believe them at all but now I kind of do..
Probably depends on where you are. I’m an ICU doc practicing in the US and here the medical team is not made aware of the patient’s donor status until they’re either brain dead or unlikely to recover (at which point the OPO approaches the family), so everyone is treated the same as a result.
Prognosis given based type and severity of aphasia the individual has and by the location and extent of injury to the brain. He did not live in an area that could provide speech therapy. I don't think there is any such definition of global aphasia, but that is why I believe short but stern feedback is necessary. Cause you don't really know what the patient understands and whatnot.
Neurologist here - the speech therapist’s definition of global aphasia is correct in the neurological sense, as is their experience in rehabbing patients with aphasia. You’re overstepping the bounds of your knowledge if you’re prognosticating in the acute period after a stroke without understanding what global aphasia means.
When I was on the epilepsy monitoring unit, we allowed a patient to bring in alcohol to induce seizures. The hospital made us jump through all sorts of hoops, and in Epic we put it in as “Other.”
We were able to order vodka for our EMU patients in residency. Not alcohol, not EtOH… order was literally in Epic under “vodka” and came in those tiny plastic bottles you see at the liquor store.
Why tf do some people have 3+ cars. Seems like a waste of money to me just having cars sit around doing nothing. If they’re all being used daily that makes sense, but some of these cars are only being used like 1-2x month
You can, but how will this save your life? Aren't you just putting urea and salt back into your body along with water content? Is there a net hydration?
I imagine that drinking the dilute urine you made while hydrated & peeing out more concentrated urine later when you’re less hydrated would result in some sort of net win, but I have no idea if there’s any data out there to support this.
Comon man, partying in a luxurious apartment while literally the world is going down and you are one of the most important people in the world to stop this? Fucking insane if you ask me.
As an ICU doc who worked through the asscrack of COVID I gotta say, people need to take a breather once a while or they will break. The Normandy needed maintenance and nobody was chained to their consoles.
This is a highly experimental treatment with no guarantee of success. Subjecting economically underprivileged (and desperate) patients to known risks and unknown benefit is ethically inexcusable.
Nope. I need help understanding why some fields admit mistakes and others don’t. Can you help explain? If I make a mistake in the ICU, I admit my mistake for two reasons: 1) to take responsibility in order to emphasize that humans are behind the medicine, not some cosmic force that reveals complications that I say I “saw” and 2) maintain medical trust with open, honest, and timely commutation, all of which are essential in the ICU. I apologize for ruffling feathers as a guest in this sub. I didn’t realize communication was so different here. Next time an anesthesiologist is involved in consultation on one of patients and I make a mistake that affects their expert management, I’ll be more mindful of my communication by saying that I saw a complication instead of “I apologize, that was my mistake, and here is what I will do make it better and prevent it in the future.” Thanks :)
The point is that dural puncture during epidural placement is not a mistake. It’s a complication that is known to happen in some instances. The distinction is important, and it’s something that you should make clear to patients.
I think it’s ignorant at best and glib at worst to refer to the amyloid hypothesis as “dead” and for other commenters to be calling anti-amyloid therapies “dead” when they’ve been FDA-approved and thousands of people are about to receive them.
I’m bracing myself for the slew of problems lecanemab could bring once our hospital system starts infusing in the next year or so. The NEJM case report of that one woman who massively bled and died with tPA was not pretty. And what about procedural anticoagulation? You still get heparin boluses during thrombectomies and caths and whatnot, and there’s very little safety data there. We’ll have a registry and all that but I wonder if patients truly understand what they’ll be signing up for.
Stop being racist lmao
As an IM person - neurology residency seems like a special kind of hell and while neurologists are the most like us of all the non IM fields, the patient often is still better off in your hands. Stupid admissions count towards your cap just like the interesting ones do.
What is this “cap” you speak of? - former Neuro resident
I was married to a physician who forbid me from listing my self as an organ donor on my license and said they won’t try as hard to revive me if I was in a crash because of my blood type being so in demand. I didn’t believe them at all but now I kind of do..
Probably depends on where you are. I’m an ICU doc practicing in the US and here the medical team is not made aware of the patient’s donor status until they’re either brain dead or unlikely to recover (at which point the OPO approaches the family), so everyone is treated the same as a result.
How can the ER not know? It is on your ID?
It’s on your ID, but your ID is the last thing we’re looking at when we’re slamming blood and pressors into you in the trauma bay.
If you read the actual lawsuit, this person’s issues are far beyond what can be reasonably attributed to obesity.
Prognosis given based type and severity of aphasia the individual has and by the location and extent of injury to the brain. He did not live in an area that could provide speech therapy. I don't think there is any such definition of global aphasia, but that is why I believe short but stern feedback is necessary. Cause you don't really know what the patient understands and whatnot.
Neurologist here - the speech therapist’s definition of global aphasia is correct in the neurological sense, as is their experience in rehabbing patients with aphasia. You’re overstepping the bounds of your knowledge if you’re prognosticating in the acute period after a stroke without understanding what global aphasia means.
Differentiating the leukodystrophies is my nightmare fuel
Am a board certified neurologist. Still have to look them up.
Telestroke is getting pretty huge.
I think a better question is, can you leave it in its case when going through TSA?
You can with pre check (did it yesterday)
When I was on the epilepsy monitoring unit, we allowed a patient to bring in alcohol to induce seizures. The hospital made us jump through all sorts of hoops, and in Epic we put it in as “Other.”
We were able to order vodka for our EMU patients in residency. Not alcohol, not EtOH… order was literally in Epic under “vodka” and came in those tiny plastic bottles you see at the liquor store.
🥹🥹
Jfc your username has me in shambles
Why tf do some people have 3+ cars. Seems like a waste of money to me just having cars sit around doing nothing. If they’re all being used daily that makes sense, but some of these cars are only being used like 1-2x month
It’s just like having any other money burning hobby. Life is hard enough without people judging you on where you decide to blow your cash.
How are you able to tell the VCA if fake? What is the give away? The shape? Color? Asking for a friend lol.
It’s the shape
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Omg this is painful
You can, but how will this save your life? Aren't you just putting urea and salt back into your body along with water content? Is there a net hydration?
I imagine that drinking the dilute urine you made while hydrated & peeing out more concentrated urine later when you’re less hydrated would result in some sort of net win, but I have no idea if there’s any data out there to support this.
Eyebrows
Interesting how globally shaky fund of knowledge becomes "they didn't listen that one time they were tutored" when context is added
Funny how from a single given example you made a giant leap to assuming that it was the only instance of its kind
Comon man, partying in a luxurious apartment while literally the world is going down and you are one of the most important people in the world to stop this? Fucking insane if you ask me.
As an ICU doc who worked through the asscrack of COVID I gotta say, people need to take a breather once a while or they will break. The Normandy needed maintenance and nobody was chained to their consoles.
I understand this in normal scenarios. But this is the most important person in the whole universe and it's about all life in the universe.
Being important doesn’t stop you from being human.
Isn't wealth wonderful!!
This is a highly experimental treatment with no guarantee of success. Subjecting economically underprivileged (and desperate) patients to known risks and unknown benefit is ethically inexcusable.
This is a dumb question, but how would a cancer vaccine help with currently existing cancer? Would it simply halt growth?
The idea is using the vaccine to train your immune system to fight the cancer. The practicalities are… complex.
In my field, it is the incorrect way to talk about it.
So your field is not anesthesiology then.
Nope. I need help understanding why some fields admit mistakes and others don’t. Can you help explain? If I make a mistake in the ICU, I admit my mistake for two reasons: 1) to take responsibility in order to emphasize that humans are behind the medicine, not some cosmic force that reveals complications that I say I “saw” and 2) maintain medical trust with open, honest, and timely commutation, all of which are essential in the ICU. I apologize for ruffling feathers as a guest in this sub. I didn’t realize communication was so different here. Next time an anesthesiologist is involved in consultation on one of patients and I make a mistake that affects their expert management, I’ll be more mindful of my communication by saying that I saw a complication instead of “I apologize, that was my mistake, and here is what I will do make it better and prevent it in the future.” Thanks :)
The point is that dural puncture during epidural placement is not a mistake. It’s a complication that is known to happen in some instances. The distinction is important, and it’s something that you should make clear to patients.
Crit care seems spot on lmao
That's, what, 4d6+26 feral hogs?
This person did the math
What the actual fuck
I'm going dual-wield proctoscopes. Good weight, stainless steel, and the flange would make a pretty good handguard.
I applaud your taste
Bet you don't appreciate the taste of the proctoscope though
That is the joke
-Subclavian central line placed successfully on first attempt
Triple digit versed gtt for NORSE bomb - inspired by your username
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DOACs are no longer as much a hard contraindication for IV thrombolytics as you think. See
I think it’s ignorant at best and glib at worst to refer to the amyloid hypothesis as “dead” and for other commenters to be calling anti-amyloid therapies “dead” when they’ve been FDA-approved and thousands of people are about to receive them.
I’m bracing myself for the slew of problems lecanemab could bring once our hospital system starts infusing in the next year or so. The NEJM case report of that one woman who massively bled and died with tPA was not pretty. And what about procedural anticoagulation? You still get heparin boluses during thrombectomies and caths and whatnot, and there’s very little safety data there. We’ll have a registry and all that but I wonder if patients truly understand what they’ll be signing up for.
A pro-tip that has been known by everyone since day 1, since it's a very obvious dialogue option. But thanks I guess.
What is it like, going through life without a basic understanding of sarcasm?