Bless your heart, chemistry made me despise our reality and how it works.

Oh you mean ENT? I refuse to acknowledge the existence of any other term for the specialty.

I’m a doctor and every time I write ophthalmologist I’m surprised at how many H’s there are and where they end up.

Depends on who you are, what your health is like, and why you’re there. 5 complex medical conditions needing management? I might be reviewing 50 pages of notes, labs, imaging, etc before I see you. Then I gotta figure out an overall plan, how to execute that plan, what to do if that plan fails, write my note, etc etc etc. known patient for a quick f/u on one or two issues? That still might include chart review, specialist notes, labs, etc etc etc. you have the sniffles and you’re fine and just need a note? 5 minutes. All depends.

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.

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.

A lot of DOs go to Osteopathic medical schools because getting into MD schools is crazy competitive. It’s just another path to becoming a doctor that’s an option if you don’t get into a US MD school. The medicine curriculum is basically the same between the two. Though I’ve worked with a bunch of DOs who believe in osteopathy and practice it.

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.

I’ve been using Autosync for years with good results first with Drive and Dropbox and now Pcloud. Supports a lot of different cloud services though not Proton which is why I haven’t started using that yet.

Autosync

Oh yeah, a lot of common causes need to be evaluated plus we need to assess if the person should be on blood thinners due to the risk for a clot in the heart that can travel to the brain. I’ve admitted quite a few patients for new onset Afib due to their underlying causes as we didn’t think they were good to go home. Admittedly most people would be fine and we can be too cautious due to legal liability and physician anxiety over bad outcomes but considering the possible consequences, it’s not a terrible thing to do that.

Afib, which commonly causes palpitations, should be seen in the ER if you can’t get in to your PCP that day. Could be caused by a lot of things and a work up is warranted including lab work, echo, etc if new.

If you in the US, you’re primary care doc’s office wil havel an after hours number to call if you’re not sure. Unfortunately you’ll likely be told to go to the ER if it’s heart related because we have to err on the side of caution since we can’t evaluate you very well over the phone. Urgent cares are hit or miss since they’re staffed mostly by mid levels who may or may not be well trained but they can handle sore throats/colds, simple cuts/infections/foreign objects, STD testing, etc. depending on their facilities. I’ve been to one without basic labs which is crazy. I’d suggest calling you doc’s office first to see if they have acute visit slots that day. A lot will.

Yeah, a good physical therapist will push you past your limits. From personal and professional experience, mental limitations will hold you back when you’re rehabbing. With my less uptight patients I’ll tell them physical therapists don’t give a shit about your pain and discomfort, they’re there to get you better. I love those fuckers, they do wonders.

Well shit, I grew one town over from there. Pretty sure that’s right by our cliff diving spot on the Croton Falls Reservoir. I never went in it most kids in highschool knew some “facts” about that mine.

Schwab app works for me on Graphene and that’s my main bank/stocks app. I’ve found I don’t really need all my credit card apps or my other bank app. I check once a day if that and just keep a bookmark. It hasn’t been bad at all.

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.

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.

Do you have a link for the paper that describes the process for converting blood into stem cells? Curious how they went about it because making red blood cells into stem cells would be hard since they have no nucleus and no DNA. I googled but couldn’t find anything about how they do it.