I don’t care if you’re the moderator here. And if you are I’m blocking this shit because it’s a cesspool. The fact that you’re a Hassan Piler fan is pretty telling. Pretty boy communist almost certainly a shill for China and Russia living in a multimillion dollar home in LA? It’s sad he’s got a following. Communists are just as bad as fascists and your behavior is exactly the kind that allows for purges. If you’ll ignore kids being hurt and even enjoy it, you’ll let anything happen.

And should we revel in that fact, that kids are being traumatized due to unstable parents? And look at this thread, this whole conversation is disrespectful.

Yeah I don’t really care about respectful when people target kids. And that is what you’re doing by ignoring the damage this will do to this couple’s kids. If that’s ok to put here in a public forum then what I said is also permissible.

And “watch it”? Really? You think that’s gonna shut down my argument? You haven’t responded to your behavior and me calling it out. My guess is that’s because you can’t justify your stance and now you’re trying to end the conversation.

I don’t believe that’s what I said. What I said was your response to whether his kids deserve this points you out to be an idiot and/or a sociopath. You may just be talking tough online but the fact that you have no empathy for innocent kids means you are just as toxic as whoever this fucking guy is.

I’m not commenting on whatever this dude has done, I’m commenting on your response to someone asking if the guy’s kids deserve this. I just read the first sentence of your response and the utter disregard for children is abhorrent. I don’t expect a normal human being response after reading that so I responded to the person who started this chain. I’m happy to argue this though, it’s a slow day at work and I love a good internet rage fest once in awhile.

You’re not going to get a rational answer here. This is frothing at the mouth internet vigilante shit.

It's really not the doctors charging crazy amounts, it's the hospitals. MBA types got into medicine and squeeze it like any other industry. GI does a scope? Doc gets $200 for doing the procedure, facility gets $5k for a facility fee.

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.

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.

An opthalmologist is an eye doctor. They go to medical school and do a residency for extra training. Optometrists have doctorates in optometry meaning they do four more years of school after their bachelor's. They can call themselves doctor because in the US that's the convention for doctorate's (in Europe ony medical doctors use the term). There's avast difference in intensity, depth, bredth, etc. of training between the two. It's easy to miss the difference if you're not familiar with the system.

Amazon drivers (the ones in budget or Amazon cans, not flex in personal cars) do okish. I just quit working for a third party company Amazon uses to shield them from liability and unions because it's miserable work but the pay was $22.50 which isn't too bad. The workload is crazy, it's all rush rush rush, and they don't care about you at all though so fuck them and Amazon. The drivers would appreciate the tip, they're generally hardworking and decent people.

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.

I can't speak for every hospital since I've only worked at a few but this is rare. Some places might still be doing it, dumping people who can't be placed or don't have insurance, but EMTLA was put in place to combat that stuff and the lawsuit and probably fines would make this a bad move. We've kept people where I work for months because we can't place them or psych won't take them. At minimum they're going to a nursing home.

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.

Fucking not 9lbs that's for sure. Around 1/2lb usually.

Reuters 10:09 ET 02/26/2024

UPDATE 1-Intuitive Machines stock plummets after moon lander tips over

Fantastic headline this morning

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.

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."

Listening to Making Money, read it a few years ago. Pretty good though I'm not a huge fan of the voice actor doing the reading. it's tolerable though. Pratchett is what got me into sci-fi and fantasy, he'll always be one of my favorites and always holds up when I go back to something of his.