medgremlin
@medgremlin@midwest.social
- Comment on doctors 2 days ago:
For a lot of doctors, the incentive to not do risky procedures is the fact that you have to live with the guilt of your patient’s death, even if you did everything perfectly. Or, you do everything perfectly, but they still have a poor outcome because they weren’t healthy enough to go through the procedure and the recovery, and you get sued for millions of dollars because you didn’t spend 4 hours going through the informed consent with the patient to ensure that every single possible complication was adequately discussed.
I’ve worked in emergency medicine and I’ve had patients die in my care that we had absolutely no way of saving. The screams of their families still haunt me and I will carry those cries of anguish and loss to my grave. I would not perform a procedure that was not 1000000% necessary if the risks are too high because I have enough blood on my hands already, and I haven’t even finished medical school.
- Comment on doctors 2 days ago:
Sometimes. It depends why the first surgeon would be unable to do the procedure. If the problem is that the patient might not wake up from anesthesia because of problems with heart disease, lung problems, or other metabolic issues, then it doesn’t really matter what the surgeon has to say about actually doing the procedure because the anesthesiologist is the one saying “no”. If it’s an issue of too much adipose, sometimes it would mean that the surgery would take longer than it’s safe for the patient to be under anesthesia.
Another possibility is that the first surgeon operates at a facility that doesn’t have access to more advanced technologies or other medical specialists in the event that something goes wrong. And there are some surgeons that are just more willing to accept the risk of a bad outcome, and I would argue that that’s rarely in the patient’s best interest. There are alternative options that the surgeon should discuss with the patient as part of the informed consent process, and sometimes, the alternatives to surgery are just safer than the risk of the surgery itself, even if they aren’t as effective or are a long term treatment (ongoing) as opposed to a definitive treatment (cure). If the patient has a high risk of serious complications, up to and including death, then attempting the curative procedure might be more risk than it’s worth compared to a long term medication that mitigates the disease.
You’ll see this with pregnant patients too. For elective procedures that have safer alternatives or temporizing measures (a holdover treatment until surgery is safe), those are generally preferred to putting a pregnant patient under anesthesia because of all the cardiovascular, immunologic, and other physiologic changes that happen during pregnancy alongside potential risks to the fetus.
- Comment on doctors 2 days ago:
There’s a reason you have to get a pre-op physical exam for any non-emergent surgery. Figuring out if you’ll wake up from the anesthesia at all is part of the calculus that determines whether the benefits of the procedure outweigh the risks.
- Comment on How do children address a non-binary parent? 3 days ago:
I’m in my 30’s and my Dad still refers to me as “kiddo” sometimes.
- Comment on doctors 3 days ago:
Another option for diabetes are the SGLT-2 inhibitors like Jardiance. They work by making you pee out all the excess sugar. You won’t have the diarrhea issues, but you will be peeing a lot. (It’s basically a special diuretic, so it’s also really good for blood pressure.) Bonus: they’ve also gained approval for slowing the progression of diabetic nephropathy (kidney disease), so if that’s something you have any trouble with, it can help get it covered.
- Comment on doctors 3 days ago:
One of the biggest problems with the GLP-1’s (Ozempic, etc) is the fact that people lose weight by just not eating as much, and the things they do eat aren’t likely to be very nutritious. Protein malnutrition and muscle wasting are very common sources of weight loss on Ozempic. That’s why it’s standard of care to get your patient to a licensed dietician before starting them on one of those drugs if at all possible.
- Comment on doctors 3 days ago:
The BMI number that is calculated just from weight and height is really just a number that tells us we need to go look at some other numbers. The other numbers are things like body fat percentage, cholesterol levels, blood pressure, blood sugar, etc. It is entirely possible for someone to have a “normal” BMI and still be very fat and unhealthy, and those people are pretty easy to identify visually, just as someone with a “high” BMI who is a powerlifter or something is very easy to visually identify.
- Comment on doctors 3 days ago:
I’m a medical student and I have some direct experience with this. Sometimes, the difference between the surgeon who will do the procedure versus the surgeon that won’t do the procedure is the availability of specialized facilities and equipment that they have access to. An elective surgery (i.e. not an emergency surgery) can go from routine to very high risk depending on the amount of adipose tissue the patient has.
And it’s not just a matter of the fat tissue overlying the surgical site. Morbidly obese patients are much more likely to have things like sleep apnea which can make anesthesia more risky and might require more specialized equipment than a particular surgeon/hospital/anesthesiologist might have access to. The “morbid” part of “morbid obesity” also refers to the fact that people above a certain threshold of weight are much more likely to have other health conditions like heart disease that make anesthesia more risky.
- Comment on Pictures of Animals Getting CT Scans Against their Will: A Thread 1 week ago:
They’re probably having a better time than the ones that aren’t intubated. The intubation is to make sure they’re still breathing while they’re anesthetized. The ones without tubes are just awake and angry/scared.
- Comment on Pictures of Animals Getting CT Scans Against their Will: A Thread 1 week ago:
The crossovers between veterinary medicine and pediatric medicine are a lot more significant than most people like to think about. The Venn diagram isn’t a perfect circle…but it’s close.
- Comment on TRUCKIN' 1 week ago:
As an ED tech, I had to clean up C diff and chemo diarrhea off patients, beds, floors, and commodes multiple times. ED boarding meant that patients that should have been admitted to hospital rooms that had a bathroom attached were stuck in the ED for hours or even days.
- Comment on TRUCKIN' 1 week ago:
I worked as an assistant in a plastic surgery office for a while as well, and I had to clean lipoaspirate out of the suction tube/syringe and the erlenmyer flask it was emptied into. That was still preferable to the time it got splattered on my scrubs because the surgeon emptied it into a kidney basin the first time. (The flask was my idea to prevent getting splattered again.)
- Comment on TRUCKIN' 1 week ago:
As a former ER tech that had to hold up a belly that size for 30 minutes for a doctor to put in femoral central lines…I feel your pain. (literally)
- Comment on Anon is worried about men 1 month ago:
As a woman who has been trying for literal decades to exist in traditionally male nerdy spaces, there are a LOT of asshole gatekeeper guys that keep the women away. I’ve gotten everything from inquisitions into my “nerd cred” to outright rape threats from guys in nerdy and gaming communities.
- Comment on "You should probably just throw it away" 1 month ago:
Yeah, my old desktop computer is getting turned into my first dedicated Linux machine and my current desktop isn’t getting updated to 11 until October 13th.
- Comment on life changed due to shrimp 2 months ago:
A girl from a religious family in a rural community that was home-schooled until starting at a strict Catholic school in 6th grade and has not looked at porn…yeah, she had no idea what sex is or that what her 3-years-older-than-her boyfriend wanted was actually sex.
- Comment on life changed due to shrimp 2 months ago:
It’s hard to have that conversation with a 17 year old who just gave birth to their second child. There’s children out here having children because we have fuckall for sex ed in this country and human instincts and desires aren’t going to go away. I have met pregnant teenagers that knew that sex before marriage was bad and would send them to hell, and that sex is where babies come from…but didn’t know that “sex” is when “he puts his thing into me where I pee from down there” because no one ever explained to her what sex actually is.
- Comment on life changed due to shrimp 2 months ago:
Kids are a really big commitment in a different way because of the psychological and cognitive needs of the child, and it would be a lot better for the kiddos if the parents have their spoons together before the kid arrives. It can be very chaotic and damaging for the child if the parent is getting their stuff together during the developmental periods. This especially goes for pregnancy because mental illness and substance use during pregnancy can seriously affect fetal development in some cases and it can even lead to miscarriage or stillbirth if things aren’t sorted out fast enough.
So, maybe having kids might be more viable for fathers, but it’s still not a great idea because disengaged fathers can be damaging to both the baby and the mother.
- Comment on *cough cough* GOLLUM *cough cough* 4 months ago:
I have interpreted it less as “the hobbits are less powerful”, and more as “what would a powerful hobbit even want?”.
If a hobbit had all the power in Middle Earth, they would have an amazingly cozy hobbit hole with the best food and their parties and garden would be the envy of every hobbit and probably some elves and men. Hobbits don’t really have much interest in conquest, and their definition of dominance includes being well-liked or admired by those they dominate.
- Comment on *cough cough* GOLLUM *cough cough* 4 months ago:
That is an insult to Babish.
- Comment on Anon sees happy people 4 months ago:
The thing you can change is your outlook and interpretation regarding the immutable parts of yourself. Your attitude about something is almost always much more important than the thing itself when it comes to relationships.
- Comment on Anon sees happy people 4 months ago:
I think it’s important to consider who is on the other side of that conversation. If a woman rejects a guy, she does not owe him an explanation. She does not owe him “constructive criticism” and actionable things to work on because that is a monumental amount of emotional labor that is wholly unreasonable to demand of someone. This isn’t even getting into the issue that many women feel unsafe about rejecting certain types of guys because there’s a very reasonable fear that her “no” will just be ignored and she will become the target of assault or stalking.
Yes, someone needs to have serious, in-depth conversations with these young men, but the quiet part no one is saying is that that nebulous “someone” is implied to be the women that reject them. It is frankly disgusting to expect that emotional labor from someone who is explicitly trying to extract themselves from that relationship/interaction.
- Comment on Anon sees happy people 4 months ago:
It’s really unhealthy to categorize people by something as superficial as height though. I’m about 1 inch taller than my husband. The only consequence of that is the fact that it looks kinda silly if I wear really high heels. He’s not self-conscious about it, I’m not self-conscious about it, and if either of us placed value on the woman in a heteronormative relationship needing to be shorter, I wouldn’t have ended up with the love of my life.
Writing someone off because of one stat/measurement is absolutely insane and I think a lot of people would be happier if they quit or heavily limited their social media use to limit the torrent of self-criticism from comparison that come from social media.
- Comment on Well, I guess that settles it 4 months ago:
My great grandfather was an Italian immigrant. My father is looking into getting an Italian passport. Maybe being a soon-to-be physician will improve my chances of getting one too. (Maybe I’ll switch from learning French to learning Italian too)
- Comment on FedEx has absolutely no clue what 'economy' means. 5 months ago:
Also check out www.pirateship.com
- Comment on Funko, BrandShield speak out about itch.io takedown 5 months ago:
Unfortunately, the swing to the right and the rise of shit like “Blue Lives Matter” has changed this in some places. When I was in the western part of Virginia for school, there was a local car dealership called “Pinkerton” and I saw their dealership license plate frames and emblem on a LOT of cars in the area. Many of those cars also had the Gadsden vanity plates and a bunch of blue lives matter, trump, etc. stickers on them.
- Comment on Clever, clever 6 months ago:
Generational AI like ChatGPT is absolutely useless for anything besides maybe making summaries. Humans use language as a default method of communication, and if you are trying to produce academic work, the onus is on you to learn how to use language effectively. These heaps of algorithms and marketing exclusively hallucinate and plagiarize, both of which are absolutely unacceptable in academia (and should be unacceptable in society at large, in my opinion.)
- Comment on Clever, clever 6 months ago:
Tell me you haven’t reviewed classmates’ papers without telling me you haven’t reviewed classmates’ papers.
Some of the papers I’ve read from my classmates make me wonder how they got out of high school, let alone into university or (!!) medical school. There are a lot of people who cannot write decently to save their lives that are still somehow in academia.
- Comment on [deleted] 6 months ago:
I thought the point was to be better than Hamas? Of course they mistreat detainees, but that doesn’t mean Israel gets a blank check to do the same. Also, many of the Palestinians currently being held by Israel without charges in indefinite detention are innocent civilians, including many from the West Bank. Israel has been illegally detaining and mistreating thousands upon thousands of Palestinians without any kind of due process or concern for human rights for decades. Pointing a finger at Hamas and saying “Look! They’re doing it too!! October 7th!!1!!” is not a valid argument for how Israel has been treating captive Palestinians for years.
- Comment on [deleted] 6 months ago:
The way that Hamas treats Palestinians is partially the responsibility of Netanyahu and the Likud given that they provided Hamas with material support to take power in the first place. Also, the fact that Israelis stormed an IDF base in protest of the punishment of IDF thugs that anally raped innocent Palestinians to death with rifles tells me a lot about what Israel thinks of all Palestinians, not just the ones that are actually part of Hamas.