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Joined 3 years ago
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Cake day: July 2nd, 2023

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  • McKenzie method for low back pain is a starting point. It’s stretching, maybe strengthening I can’t remember. Hip flexors, hamstrings, calves are usually tight and can cause back pain. The front and back of the legs have to be balanced or they’ll pull your pelvis out of neutral. Modern day sitting doesn’t do us any good, tightening all the posterior compartment muscles in the legs.

    Core strengthening is important for good posture. Being aware of your overall posture is also really important too. Yoga is fantastic for stretching, posture, and strengthening.

    Caveat: sometimes it’s structural and this stuff may only help somewhat but chronic pain is treated with multiple modalities. If this stuff doesn’t improve it significantly along with NSAIDs, follow up with your primary care doc.

    How I know: I’m a physician who screwed up his back and had to figure all this out and now I teach my patients how to treat their back pain. I also use physical therapy liberally because it’s fucking awesome.


  • Man, that’s old shit. I’m wearing a pink rugby, Carhartt doublee knee work pants, Zhanko duck print socks, and Quoody mules. I also wore an outfit I dubbed “70s French cocaine dealer” Motherfucking plague doctors left in the dust.

    On a serious note, most people in white coats aren’t doctors anymore, they’re midlevels. Or female physicians since they’re mistaken for nurses a lot though less common.


  • Oh they’re definitely not judged the same. There’s a reason DOs interested in the more sought after specialties rarely try for MD programs. When you have a bunch of alpha nerds who base their self worth on test scores and other stuff like that, you get arbitrary stratification. And I’ve seen good doctors fail STEP tests and shit doctors who graduated from Harvard. There’s always those situations when some happen to be good at the stuff a system deems worthwhile but suck at being a person and vice versa.



  • So I’m a physician and I support most things people do to import their health but I do try to make sure they’re fully informed. In terms of fasting, this cohort study found an adverse association between fasting and cardiovascular death. There are limitations to the study (self-reported diet, etc.) but it followed 20,000 people for 8yrs which is pretty good. Definitely need more study in this area, especially considering the complexity of human metabolism. Here’s the highlights from the study but the full text is available at that link:

    • People who followed a pattern of eating all of their food across less than 8 hours per day had a 91% higher risk of death due to cardiovascular disease.
    • The increased risk of cardiovascular death was also seen in people living with heart disease or cancer.
    • Among people with existing cardiovascular disease, an eating duration of no less than 8 but less than 10 hours per day was also associated with a 66% higher risk of death from heart disease or stroke.
    • Time-restricted eating did not reduce the overall risk of death from any cause. An eating duration of more than 16 hours per day was associated with a lower risk of cancer mortality among people with cancer.

  • Not videos that I know of but maybe? I Iove both of these though:

    Not Another D&D Podcast. Hour long or so a week with interspersed non-play episodes. Hilarious improv people, great characters, lots of jokes, some good emoti stuff. Bunch of prior campaigns to listen already.

    Pink Faux Hawk. Newish podcast playing Shadowrun. Funny, over-the-top action movie play style. One player has health issues so they’re oe on uploads lately but I still love it.





  • Just bought a couple of their 4oz coffees, thanks for the suggestion. The Gera Honey dark roast I have high hopes for since I hate light roasts but I don’t really understand what the fuck they’re taking about on their product pages. All I understood was dark roast so I’ll giveit a shot.

    And on the total opposite side from the neo-African coffee roaster you suggested, Harrio has the hipsteriest hipster pictured on the Switch product page. Instantly made me hate the product with absolutely no basis for that opinion. Interesting dichotomy of suggestions, 9/10 would look at again.



  • Oof this is definitely wrong. A blood thinner is one of the most important things whether a patient is taking or not. It’s the nurses job to let the doctor know whether the patient is compliant not only for medical reasons but for documentation. That’s outside the argument about profit in healthcare in US, that’s basic medicine. What if that patient falls and hits their head? Do we need to know if they’re on s blood thinner? What if they’re hemoglobin starts dropping? What if they need a procedure? What tif their platelets start dropping? Etc, etc, etc.

    Don’t be a dick and not do your job, that makes your coworkers miserable and puts people in danger especially in medicine. I agree with burlit being and issue and chronic understaffing but be an adult and quit or move positions if you don’t like it.


  • What about the 19yo I saw today, with a BMI of 62, who’s so far stuck in the cycle of self loathing, inactivity, depression, and pleasure seeking behavior that he can’t see a way out let alone start creating himself a new reality? What if I have a drug that I’m pretty confident can help him lose 200lbs? Is it ethical for me to not prescribe it because “he should be able to do it on his own?” How many people do you know who have done that? Out of the hundreds or horribly obese patients I’ve seems, I have tow that have done it with diet and exercise. We have not evolved for a world where 20,000 calories costs $20 and is available 24/7.

    I agree we need to be cautious with these drugs since long-term adverse effects aren’t known but the long-term effects of obesity are well documented. I have backed off on pitching these drugs since I learned the companies making them have infiltrated the obesity research community in the US (because of course they did). They’re still an amazing tool in the fight against an obesity epidemic which has many, many different contributing factors li ok e trauma, depression, mental health issues, upbringing, genetics, etc, etc. it’s not as easy as “just don’t eat so much.”


  • It’s not that CPR doesn’t work, it’s that outcomes after resuscitation usually aren’t great. The study doesn’t disclose ages or neurological outcomes post-rescuscitation so that limits my interpretation but quick rescue and quick CPR is key in those acute, single reason emergencies. That isn’t to say in an emergency situation you shouldn’t try especially since you don’t know that person’s wishes. There are good outcomes but usually for underlying healthy people who had one thing go wrong. Think the athlete who’s heart stops on the field for some reason.

    I’ve admitted at least a thousand people into a hospital through the ER and I tell everyone that it’s not like on TV. If you’re older, sick, multiple chronic diseases, don’t take care of yourself, etc. the chances of any kind of quality of life after CPR is limited. Death is terrifying and I understand them wanting to try but it’s just not realistic a lot of the time. We need better deaths in the US and more in-depth end-of-life conversations with our patients. That should be starting in the PCP’s office. Trying to discuss that with a patient in the ER who’s already scared isn’t ideal. I’ve seen patients with do not resuscitate/do not intubate orders on file change their mind when they’re suffocating and panicking then once they’re more stable immediately change their mind back.


  • Thanks, that looks legit, especially considering they got a Nobel for the process. Red blood cells wouldn’t work though, no genetic material to tell the cell what to do. Skin cells sure but deeper layers before they ditch their nucleus. The bottom layer of your epidermis is already made of stem cells that continuously produce new keratinocytes (skin cells). That’d make sense as a starting point for what they did. I’ve been in medicine for seven years and there have been all kinds of crazy claims made but researchers so I’m always skeptical.




  • I’m a casual D&D fan since my only exposure is from Not Another D&D Podcast but I think it adds to the overall story telling experience. Super charges the lows and highs if it’s a 1 or 20 especially on an important role. Does it break the game? Eh, not that I can tell and I’ve listened to hundreds of hours of the podcast. Though this is my opinion and not based on D&D rules, history, etc.

    I also highly recommend Not Another D&D Podcast if you like silly shit mixed with crass humor, some good emotional content, and players fucking with their DM.



  • Couple of things it could be:

    1. You locked your knees without realizing it, shut down the blood return from your legs, then had a drop in blood pressure due to decreased blood return to your heart causing you to pass out.
    2. You took a big hit, expanded your chest, held it, decreased blood flow through your thoracic cavity due to the increased intrathoracic pressure then a blood pressure drop as above.
    3. Your vasovagaled yourself somehow (bearing down on a held hit maybe or just due to weed effects) which is increased parasympathetic nervous system tone that drops blood pressure
    4. Some weird shit 🤷🏼‍♂️, the body can be odd and changes as we age so maybe you just can’t smoke weed now cause of the earlier mentioned weird shit

    I agree with your doc (I’m a family med physician), don’t smoke if all of a sudden you’re passing out.