#Medicine and Critical Care

[balajihospital]

Balaji Hospital | Contact Us for Expert Healthcare Services

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[creature-wizard]

That's a nice anecdote about the miraculous efficacy of your alternative healing method you've got. Too bad actual statistical data doesn't suggest these results can be reliably repeated on a large scale.

[populationpensive]

Abdominal Pain PSA

I've had a run of people admitted to the ICU after have 1-2 weeks of abdominal pain who were struggling to eat or drink that ended up having conditions leading to necrotic bowel. Dead bowel makes people incredibly sick. Like, death's door sick. Anecdotally, I'd say maybe 60% of our patients make it through such an ordeal. Every time I talk with their families, their loved ones say that they looked bad and they tried to get the patient to go get some help. Often, these people wait too long.

So.

PSA: if you're having abdominal pain and can't keep anything down for more than 48 hours (especially in the context of N/V WITHOUT bowel movements), you NEED to go to the ER. Not urgent care. Not your PCP. The ER. Please get checked out. Do not let things sit. If you have known GI disease like diverticulosis, a hernia, etc, even more of a reason to get checked out.

[obstinatecondolement]

In other news, I watched a great video earlier today which I found very validating about how therapy is not the universal cure-all it is presented as and often individualises and pathologises a person's issues in an ultimately victim blaming way when what's "wrong" with them is better understood as the impact of broader systemic and environmental factors.

[doctorspork]

You're the dumpster fire extinguisher. Good luck.

my boss, when I said work was a dumpster fire today

[harryskanes]

IM OFFICIALLY A DOCTOR IN INTERNAL MEDICINE STARTING RESIDENCY IN OCTOBER !!!

[skyloftian-nutcase]

Me: *having a perfectly good and normal time hanging out with my family*

Brain: Hey what would you do if your mom dropped dead in your kitchen right now.

Me: What—why are you—?

Brain:

Me:

Me: UGH fine I’d make sure she’s flat in her back, check for responsiveness, check a carotid and signs of breathing—*proceeds to run through entire scenario in my head*

Brain: K

Me: WHAT WAS THE POINT OF THAT

[johnny-depplyloveyou]

I know there are many bad takes about Gale on this site, but the worst takes I’ve seen on another social media site in another language are much more abhorrent than anything here tbh, the recent one I’ve seen even gets some popularity among his “fans”... They were basically saying it’s Mystra who made him the humble man he is now, without her influence on him he would be as egotistical as in his god ending, and more than a hundred of reblogs are all thanking Mystra for “training her lapdog so well” for them🤢

Did we even play the same game? Isn’t his god ending a direct result of Mystra making him think he will never be enough as he is, and he can only find his self-worth through gaining more power? Didn’t Tara say he’s not himself anymore and she would no longer be his companion in his god ending, she knew him long before Mystra made him her chosen, he was powerful enough before his relationship with Mystra, if he’s anything like god!Gale at the time wouldn’t Tara just leave him? I’d imagine he would have been more confident and had a more stable self-image if Mystra had never contacted him, therefore he didn’t even need the Gale of Waterdeep persona. He would always have been Gale Dekarios in that timeline. And people glorifying Mystra’s grooming and abuse towards him and unironically calling him “her lapdog” is just... I have no words. But what do you expect from an online space that’s infested with terfs and radfems? They just won’t recognize or acknowledge any abuse from women towards men...

[pocketgalaxies]

are u going to watch candela obscura chapter 2?

glad you asked! probably not right now - school has been very very tiring recently and i'm getting a lot of joy out of nier:automata in my small amounts of free time. i've been on my surgery rotation after finishing an internal medicine rotation so things are really dicey in the Staying Alive department. fulfilling! but also killing me

i def want to watch it eventually but chapter 2 is prob something that just gets added to the end of my catch-up list (along with c2 and all the one shots). it feels like unfortunate timing bc marisha is in this chapter but the heart wants what it wants and right now my heart wants sleep and biddy games ¯\_(ツ)_/¯

[doctorweebmd]

okay i really AM working on the path to paradise. if all goes according to plan i'll have chapter 15 this weekend AHHHHHH

[balajihospital]

Balaji Hospital | Medicine & Critical Care for Acute Conditions

Balaji Hospital provides healthcare services in internal medicine & critical care using diagnostic tools & evidence based treatments for patient safety & comfort

[readerzone]

Brain Death New Protocol 2023

Pediatric and Adult Brain Death/Death by Neurologic Criteria Consensus Guideline | Neurology

Pediatric and Adult Brain Death/Death by Neurologic Criteria Consensus Guideline

Report of the AAN Guidelines Subcommittee, AAP, CNS, and SCCM

[populationpensive]

Trauma Season

Well with nice weather comes all the traumas. It has begun.

It's fine - entering my 6th summer as a PA, I have a good barometer for the crazy shit that comes our way. At this point, it is fair to say that I've seen just about every weird fucking thing you can see.

I'll be picking up more HBOT than ICU over the next several months. Usually, I do 18 shifts in 6 weeks and 7 of those are HBOT. I'll be shooting for 9-12 for the time being.

Truth is, I am a little burnt out. And, if I am honest with myself, I have not really organized or processed some of the things I have seen and dealt with. Compartmentalize, yes. 110% great at that. But it's like my foggy ass brain is full of boxes that I need to unpack. I feel like a sponge that has soaked up too much.

We do an AWFUL fucking job at this in my specialty. Like, a horrible job. It didn't occur to me that this was a problem until recently when I had a difficult family. The patient came in brain dead and no matter how I tried or the approach I used, this family didn't believe their loved on was gone. I found myself rather angry and ultimately took a day off of work because I didn't want to interact with them or be around the situation. I had completely lost sight of the pain and grief these people were going through and was just...completely pissed at their ignorance. And while it is ok for me to feel frustration with the ignorance (truly, it took almost 2 weeks for them to get it), the intensity of that anger was...not normal.

I've been doing some version of critical care for 5 years. I love my job. I love the clinical complexity. I love the stories. But it has cost me mentally and emotionally.

I am so tired. All the time. I can't sleep enough if I tried.

I am bloated. Puffy. I feel alien in my own skin.

I am foggy. Exhausted. Apathetic. Blank. It's just...not ideal.

Honestly, if my work would let me be 0.8 FTE or something that would be great. At least temporarily. They won't do that (we are short staffed all the fucking time) but less time there would probably be good. Hence why my option to do less ICU is to do more HBOT.

My department would LOVE a straight HBOT person. Like, they are hankering for that. But lord that would be SO boring. I could not go from the continual excitement of ICU to...that.

I'll see how the next few months go. I have a lot of figure out moving forward but ultimately I have worked so hard to get where I am that I am unclear how ready I am to give up the privileges or autonomy I have earned for a different specialty. Only time will tell, I suppose.

[doctorfoxtor]

I thought I saw a post with a link to an RCT showing a benefit (either to mortality or to duration of illness) to early initiation of vasopressin in septic shock patients. I thought I saved it. But for the love of God I can't find it now that I actually want to read. I didn't like it, I didn't draft it, I didn't reblog it. It's not in my Twitter bookmarks or reddit saved posts either. I can't even find it on Google, Google Scholar or PubMed. Did I just hallucinate this paper? Can someone help me out if they know this RCT exists?

[dramatic-dolphin]

not the person in the notes of that last post going "some syndromes render your life literally unlivable" and then listing two conditions that people are literally living full adult lives with...... ok go tell them their life is unlivable. i don't think they'd agree.

[strayskinny]

today was actually so awful i hate everything,,,,,,