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wathe

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Posts posted by wathe

  1. 1 hour ago, Quill said:

     

    It’s honestly more of a feeling about rebelling against the aim of expectation, that in order to look “put together”, this *has* to mean makeup. 52-year-old men do not invest time and money every morning into making their skin tone more even, eyes stand out better, lashes longer… nobody says they have to do stuff to their faces in order to be polished and professional. 
     

    I think I just no longer feel that need to look good for other people looking *at* me. ***
     

     

    100%.

    I am a professional who does not wear make-up.  I don't wear it because don't like it.  I also think it's important to normalize natural faces (un-made-up?  I'm having trouble finding the the right word) for women in professional environments as an equity issue.  I have the same feelings about fillers and elective cosmetic surgery -- it may make individual women feel great, but the normalization of the practice is bad for women collectively.

     

    Edited to make clear I mean elective cosmetic surgery -- the kind women get to look younger; not  reconstructive surgery

    • Like 10
  2. 10 minutes ago, wintermom said:

    I drive mostly in eastern Ontario and Quebec. Loads of snow accumulation that can also be too quick for the plows to manage, as well as frequent freezing rain. 

     

    Ontario's a huge province, so you might be surprised at the difference in road maintenance budgets across the province. Orgs with big bucks, such as the National Capital Commision, clean roads in the winter to a level that I appreciate driving but don't even want to think about the cost (which I'm contributing to as a taxpayer). 🤪

    Yes, Ottawa has famously excellently plowed roads.  And Quebec, infamously, does not...

    Big difference between urban and rural too.  I often have to navigate drifts on my rural road.  That would never happen in the city.

    Smart car would be fine in Ottawa, I think.

    • Like 1
  3. 1 hour ago, Katy said:

    My apologies, I didn’t realize she was in Canada.  Canadian roads are remarkably better than those in the US. Wisconsin may be close, they handle snow and ice very well, but build roads to be redone frequently rather than last a long time. 

    No worries!  It's a majority American board; it was a reasonable assumption

    If our roads are good, then I would hate to see what bad roads look like!

    • Like 1
  4. It's fine slush, and in snow with some accumulation (a few inches), and on ice.   I would not try to take it through a drift.  Not good for deep snow, because of lower clearance.

    It's rear-wheel drive.  But it's also rear-engine, so the weight is where you need it.

    Like all cars, good snow tires matter.

    • Like 3
  5. 13 hours ago, Katy said:

    I would not compare Ontario's well maintained winter roads to the conditions in most of the Northern states.

    I don't think I am?  I'm pretty sure that @wintermom is in Canada (and lives in the same province that I do), so I don't think that Northern states roads are relevant?  I've lived in her city and done quite a lot of winter driving there, and DH grew up there, his family are still there - I am very familiar with the likely road conditions.   (Maybe she's moved?)

    Maybe your comment wasn't directed at my post?

     

    • Like 1
  6. 2 hours ago, Mrs Tiggywinkle Again said:

     I think most HCW were probably picking up Covid socially and not at work.

    100%.  In almost all cases, HCW in my department got it from their kids, or could be traced to an out-of-work social function.   And the one large at-work outbreak was linked to an unmasked break-room pot-luck (that broke the rules).

    N95s absolutely work.   I haven't had it yet.  My workplace exposure is extremely high.

    • Like 11
  7. My mom and dad have one.  It's fine on the road in winter with snow tires.   It can handle 99.9% of winter conditions in southern Ontario.  

    DH and I test drove on on a winter snow course at the Toronto auto show years ago when they first came out.  It was surprisingly good in snow.

    I would not drive it in deep snow.  But I wouldn't do that with my subaru wagon either.  

    • Like 1
  8. I can attest to the increase in opiate poisonings --- this one is up significantly in both the US and Canada.

    Not an ED shift goes by where I'm not narcaning at least one pt (now it's a medical slang transitive verb.....) or receiving a pt who has been narcaned by EMS.  Often multiple per shift.  This is new in the past 10 years or so, much worse over the past 5.  A very dramatic increase.

    I didn't narcan anyone even once during my entire residency or first few years of practice. 

    ETA: and I don't even see the ones that go straight to the coroner.  Those have increased dramatically too.

    • Sad 5
  9. 1 hour ago, Bambam said:

    These are my dd's favorite too. We have 3 in different colors. If you put the colored ones in the dishwasher, the paint/stain/whatever is coming off the body of one. 

     

    Mine is missing about half its paint.  Eventually it will be bare steel LOL.   It has dents too, and lid is scratched, from having dropped it eleventy-billion times.  And it still functions perfectly - keeps my drink hot, never leaks, feels good in the hand.   It has a certain well-used, well-loved beauty of its own.

    • Like 3
  10. For camping and outdoors:  Standard 1L nalgene water bottle, and GSR infinity much for hot drinks

    For life in town, Contigo autoseal.  100% spill-proof and leak-proof, reasonably well insulated, and comfortable in the hand.  The canteen at work will fill it for me, to avoid take-out cups.  Fast food and coffee shops do this too.

    And a proper screw-top thermos vacuum bottle for when I want tea to stay properly hot for many hours.  Decant into contigo to drink it.

    • Like 1
  11. 2 hours ago, Quill said:

    It might be a dumb question but: what do you make in them? I did not have these as I developed my cooking style and so this is not what I thinking of when I plan a meal. I make most meals in either a soup pot or a skillet. 

    These are our go-to microwave cookware: veg, soup, leftovers.  I have some left-over pot-roast sitting in one in the fridge right now.

    I have 8 of them in various sizes, all inherited.

     

    • Like 2
  12. 3 hours ago, skimomma said:

    I have no idea, lol!  I do know they drive a huge truck and just about fill it up so the trip might be worth it just to avoid dealing with that much package materials.  Not to mention one has to drive 4 hours (one way) to do a lot of "normal people things" like car recall work, orthodontist appointments, furniture shopping, etc., so I am guessing their Costco habit started as a side-trip.  I have noticed and been confused about finding Costco vodka for sale in other stores.  Not in my own state but in a neighboring state.  No idea how that works......

    I think re-selliing Costco in other stores is a thing.  I saw Kirkland seaweed packets for sale individually at the Northern Store in Clyde River, Nunavut.  Approximately 3000km from the nearest Costco.

    My beef with Costco is excessive packaging.  Multiples of products shrink-wrapped together.  Frozen products in bag containing other bags, containing other bags or product individually placed on plastic trays.  I just need a bag of frozen dumplings.  I don't need each dumpling to be specially protected in layers of plastic packaging.

    • Like 3
  13. 7 hours ago, Corraleno said:

    I believe this is the original study that the articles are referencing: https://www.medrxiv.org/content/10.1101/2022.10.31.22281756v2

    Two factors worth noting, which do not seem to be mentioned in any of the the news articles I've seen: (1) this study only involved people who received 2 or 3 shots of the original vaccines, NOT omicron-specific boosters, and (2) they only saw this effect after BA4/5 took over, not when BA1/2 predominated. The US opted for an updated booster based on BA4/5, and this study did not look at any scenario involving people's susceptibility to reinfection with the BA4/5 variant after receiving a BA4/5 booster.

    ETA: Also, none of the reinfections resulted in  severe disease or death, regardless of the number of shots.

    Thank you Corraleno.  I've given it a cursory read.

    I wouldn't be too worried @TexasProud.  This isn't a very strong study.

    We haven't seen this effect anywhere else in the world (that I'm aware of)

    It's a retrospective medical-records data-mining study.

    Endpoint was re-infection only.  A more important outcome would have been infection severity: hospitalization/death.

    There are lots of reasons why their 3-dose  cohort might have more documented infections that 2-dose cohort, that have nothing to do with immune imprinting:  3-dose might have tested more often ("Differences in testing rate during follow-up may introduce differential ascertainment of infection across the cohorts if routine testing varied by cohort. There was evidence for differences in the testing rate across the cohorts. These differences could result in different rates of undocumented infection before and during follow-up", which authors attempted to address with math, italics mine), cohorts might have had different exposure risk, different co-mobidity profiles (authors counted number of comorbidities, but not which ones - and which ones matters),  different occupations (maybe 3-dose cohort were more likely to be in high risk occupations  - we can't know), the list is endless.

    The study population was very unlike the US (or Canadian population).  The vast majority of study subjects were under age 50, and healthy.  Results not necessarily  generalizable to our population.

    Also, interestingly, they compared 3-dose cohort with unvaccinated.  Those results were buried in the supplementary materials.  There was no difference.  That does not match real world experience.  When results make no sense, it causes me to question the whole study.

    At the very least, these results need to be replicated before they can be trusted.

    • Like 2
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  14. 1 hour ago, Malory said:

    Maybe they meant immune imprinting? I'd never heard it called "negative imprinting" though. This article talks about immune imprinting:

    “If you got infected with Omicron at any time, a third vaccine dose actually doubles your risk of reinfection compared to 2 doses only,” Dr. Daniele Focosi, who specializes in hematology and works at Pisa University Hospital in Italy, wrote on Twitter in response to the findings. “Amazing immune imprinting at work.” The study points to immune imprinting as the reason why “three-dose vaccination was associated with reduced protection compared to that of two-dose vaccination.”

    But what exactly is immune imprinting?

    Read more at: https://www.miamiherald.com/news/coronavirus/article268224827.html#storylink=cpy

    Do you have a link to the actual study?  This sounds off to me.

    I cannot access the Miami Herald article.

     

  15. 5 hours ago, Mom_to3 said:

    Hmm, any idea why? I wonder what the reason for the difference in protocol is. It can't be that Canadians are more reliable in reporting onset than Americans?! May be a good reason to get a device like an Apple Watch or do a daily Kardia to be able to prove timing of onset?

    Medical culture shaped by liability is the most likely reason, I think.  Cardioversion in the ED has risk: increased sedation risk (pt not NPO, limited pre-proceedure workup) and stroke risk (duration of a fib based on history alone, pt not anticoagulated, limited pre-preoceedure workup) and the risks added by the rushed, chaotic environment --staff are frequently distracted and interrupted. Definitely riskier than elective cardioversion.  Not cardioverting in the ED is much less medico-legally risky for the doc (for stable patients) and for the hospital too.  Cardioversion is also resource intensive; this is a disincentive in packed, under-resourced EDs.  There may also be direct or indirect financial reasons (cost to hospital, emergency vs elective billing, opportunity cost to MD who could be seeing other patients etc) that are different in the US health-insurance/hospital funding environment vs Canadian environment; this last one is just a guess.

    ETA: I don't think the difference has anything to do with what's actually best for the patient, sadly.

  16. It's a matter of balancing thromboembolic risk with bleeding risk. Anticoagulation is not benign.  If MD judges that bleeding risk on thinners > ischemic stroke risk without thinners, then MD will advise against anticoagulation.  

    ED MD probably used  CHA2DS2-VASc tool to evaluate risk.  If the score is low, then it's likely that bleeding risk outweighs clotting risk, and therefore unlikely that  thinners would be started from the ED.    Starting a patient who doesn't meet criteria on thinners from the ED isn't really defensible, and  ED MD's have all seen catastrophic bleeding events in patients on thinners.  Intracranial hemorrhage is no picnic, nor is GI bleed;  

    I wonder if you might benefit from further discussion with your PCP, in order to more fully understand the risk/benefit trade-off in your DH's particular case.

  17. 39 minutes ago, Kassia said:

    bringing up this old thread because I have a question.  At my screening mammogram earlier this week "focal asymmetry" was seen so I have to go back for diagnostic mammogram and maybe u/s.   This is the second time it happened and the last one was in 2019 and was nothing.  At the end of the report, it says "Other significant interval changes since prior."  I'm wondering if the radiologist meant to say NO other changes and forgot to type in the no?  I checked my last report and it did say "No other significant..."  

    My appointment is on 4/3 so a little bit of a wait.  

     

    Almost certainly a dictation error. Most medical systems have moved away from live dictatypists and replaced them with speech-recognition software for generating reports.  This is the sort of error commonly seen with speech-recognition software. A dictatypist would usually recognize weird wording/errors and check with the reporting radiologist before releasing the report.  The software, on the other hand, will happily spit out completely ridiculous reports.  Dropping words at the beginning of a sentence is common.   But it's cheaper !!!!!  ...sigh.   (As an aside, it's an extra big problem for Canadians, because all the software is American, and It writes extra dumb things for Canadian drug names and place names.  I say Replavite, it writes reptile bite, or rectal right.  I say Ontario, it writes anterior.  I say Yukon, it writes University of Connecticut. I say Maxeran, it writes wax her hand or backs her van.  It can't spell any of the hospital's 400+ doctor's names)

    Contact the medical records department and tell them you wonder if there is an error in. the report.  They should have the reporting rad review it, and amend it if there is an error.  Happens all.the.time.

    • Like 2
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  18. 1 hour ago, ScoutTN said:

    I have a (possibly stu)pid) question. How does anyone actually know how many people where have it? Almost no one gets a lab test. Almost no one reports to any medical or gov’t authority if they test positive on a rapid test. No telling if the rapid tests are even correct. The only people there can be actual data for are those who seek medical help, those with severe cases, complications from pre-existing conditions, and long covid. 

    1) Wastewater surveillance

    2) Hospitalizations.  Covid related admissions are obvious indicators of community spread, but here we also still covid test every admission, no matter what the reason for the admission - including labour and delivery, elective joint replacement surgery etc.  Hospital data in these patients reflect community trends.

    3) Nursing homes and other congregate living are still testing liberally.  Rates in institutions also reflect community trends.

    • Like 6
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  19. I totally understand the reasons for such a policy.  Teens may be near-adults, but the point is that they are not adults.  They are legally children. Who are in the care of the school staff while on an overnight trip away from home -- staff, who, (here at least), are loco parentis. 

    Teens get up to all kinds of shenanigans.  Stealing meds, abusing meds, overdosing on meds, sharing-meds-with-good-intentions-scenarios-that-go-sideways.  The school is legally liable for all of it.  And also genuinely cares for children and wants to reduce the risk dead or injured kids.

    It's annoying but necessary.

    The weird part of the policy to me is that a doctor is dispensing meds.  Medication administration would usually be a nursing task. But,  I've never heard of bringing a doctor along on a school trip (and even less likely, an out of state field trip, where a doc from home would likely not even be licensed to practice -- licensing is by state, right?), never mind for the purpose of dispensing meds.  But, I'm not American, so take that for what it's worth, I guess.  Maybe USA school trip culture is different than here.

    ETA - I realize that OP did not specify whether or not the trip is out of state.  I am assuming based on balance of probabilities.

    ETA again - sounds like nightmare gig for the doc.  I would not want that job!

    • Like 3
  20. On 3/10/2023 at 2:51 PM, Corraleno said:

    People from other countries must read these threads with their mouths hanging open.

    The idea that access to healthcare should be controlled by private insurance companies, who can not only charge outrageous fees but also maximize profits by denying necessary treatment, is so dystopian it beggars belief. 

    The US healthcare system is just insane.

    Yes.  It is insane.

    The out-of-pocket cost to the patient for removing and imbedded IUD here is $0.  Well, if you park, you would have to pay for parking....

    Major surgery:  $0

    Emergency department visits: $0

    Family doctor visits $0

    Specialist MD visits $0

    Hospitalizations: $0

    Hospitals charge for room upgrades, parking, phone service, internet access and other extra amenities, but the cost of care and basic hospital stay is $0 out-of-pocket.  No forms.  No insurance claims.  You pay your taxes and register for a free health card, which require periodic (free) renewal every 5 years or so.  The card is your ticket to $0 out-of-pocket hospital care.

    Canadians love to complain about their healthcare, but it's actually pretty great.

     

    • Like 1
  21. Coach might send out a notice to all families, indicating that a child on the team has a court order of protection and please do not share photos or video that contain images of any child other than your own.  There is no reason for the other families to know which kid, or protection from whom.

    • Like 30
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  22. 12 minutes ago, HomeAgain said:

    I'd be calling all my medical friends to help me convert dosage if it came down to it.

    Fortunately, the math is not complicated. Weight-based dosing for acetamonophen and ibuprofen of page 2 of this chidren's hospital handout.  Once you've calculated the child's dose in mg, then just have to figure out what fraction of an adult tablet will give the right number of mg

    ETA: Ooops, forgot link.  Fixed it

    • Like 3
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  23. 2 hours ago, KSera said:

    Embark is the one who always comes out the most accurate, which is backed up by this. The people submitting don't seem to understand the "Village Dog" classification, which is one of the things that makes Embark more accurate than the others. You can't have a result made up of modern domesticated dog breeds with a dog from a region where those aren't the dog breeds that have gone into their village dog population. Ridiculous the two cheap companies that couldn't even tell they had human DNA 🙄.

    Oh for sure.  The Embark results make sense.

    But, the 2 companies that matched the human DNA to dog breeds was super funny.  And the company that matched the pure-breed great dane to 100% chihuahua, because the submitted form stated the dog was suspected to be chihuahua (it's a trap!)...... Oh my goodness.

    • Like 2
  24. Totally frivolous post.

     This news article on DNA dog testing had me laughing out loud.  Obviously, some of these companies are more reliable that others (and one of them seems straight out scammy!).  CBC Marketplace is a national consumer watchdog news series.

    ETA: They sent DNA for 2 mixed-breed dogs of unknown ancestry, one known pure-breed, and human DNA from the show's host, to 4 different testing companies.  With wildy varied results.

    • Like 2
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