OT: Hurricanes Lounge XLVI: Really, It's All About Beer and Bojangles

[Nikishin al Gaib]

As if the US Government would allow these things to fly anywhere CLOSE to important government buildings unless they knew exactly what they were and why they were there.

I saw this one pop up on socials over the weekend and just had to log off



Its the f***ing Goodyear Blimp.

 

[Blueline Bomber]

I saw this one pop up on socials over the weekend and just had to log off



Its the f***ing Goodyear Blimp.

I give it 5 years before we go straight past aliens and start claiming it's witchcraft again. I have a few neighbors that could use a good burning.

 

[Nikishin al Gaib]

But again, tell me why we should feel sympathy that someone finally snapped on an exec of this shit company

 

[tarheelhockey]

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www.npr.org

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www.reddit.com

But again, tell me why we should feel sympathy that someone finally snapped on an exec of this shit company

These are coming too fast for me to gather the level of outrage that they each individually deserve.

 

[MrazeksVengeance]

But again, tell me why we should feel sympathy that someone finally snapped on an exec of this shit company

If small enough… DVT can be treated in an outpatient manner.

PE? At least three days to set up medication and check vitals. Ideally discover the origin - arythmia, onclogical disease, some hereditary coagulopathy.

…

Also I cannot emphasize enough how wrong that sentence about hypotension/lab tests and other stuff is.

You see… Imagine I have a patient during my internship at ER. Relatively young (32-40) male. Clear as hell pneumonia. Given demography and epidemiological situation at the time I assume it’s origin is Mycoplasma pneumoniae. High fever, elevated liver enzymes, slight corresponding coagulopathy, CRP and leukocytes elevated to all hell, nasty X-ray especially for a relatively healthy male of this age. Like… I can risk it and give him one i.v. fluoroquinolone (our local Mycoplasma is resistant to macrolides) and send him home with pills, but it’s still preferable not to risk a long-term health of a productive member of society just because he was healthy thus far and his vitals haven’t gotten to shit, because they STILL MIGHT.

PATIENT’S VITALS WERE OKAY BECAUSE I MADE SURE THEY WERE.

 

[Nikishin al Gaib]

 

[bleedgreen]

But again, tell me why we should feel sympathy that someone finally snapped on an exec of this shit company

It’s crazy but pulmonary embolisms are generally considered stable once blood thinners are on board, as messed up as it might sound. If a PE is a saddle embolism it essentially kills you immediately but if they’re in your lung fields your body can compensate. My ex wife had multiple at the same time, she spent three or four days in the hospital while they stabilized, got the thinners on board and to control the pain associated but then they kicked her out with Oxy pills instead of the IV dilaudid she had been on while there. So basically I was taking care of a drug addict who still couldn’t breathe very well. Like MV said that’s ridiculous what they said about blood pressure. They’re saying you only need to be in the hospital from this if your pressure is crap, which means you’re actually dying from it.

That was 12 years ago. Today we’ve progressed to “if it hasn’t killed you yet then you’re probably good, pick up your blood thinners from the pharmacy and follow up with us next month”.

 

[MrazeksVengeance]

It’s crazy but pulmonary embolisms are generally considered stable once blood thinners are on board, as messed up as it might sound. If a PE is a saddle embolism it essentially kills you immediately but if they’re in your lung fields your body can compensate. My ex wife had multiple at the same time, she spent three or four days in the hospital while they stabilized, got the thinners on board and to control the pain associated but then they kicked her out with Oxy pills instead of the IV dilaudid she had been on while there. So basically I was taking care of a drug addict who still couldn’t breathe very well. Like MV said that’s ridiculous what they said about blood pressure. They’re saying you only need to be in the hospital from this if your pressure is crap, which means you’re actually dying from it.

That was 12 years ago. Today we’ve progressed to “if it hasn’t killed you yet then you’re probably good, pick up your blood thinners from the pharmacy and follow up with us next month”.

Some notes

1) Considered stable once there is a therapeutic level in the blood. Perorall anticoagulation is slower than heparine. And even LMWH should ideally have a level of anti-Xa taken.

2) It is kind of ironic, but I’d guess bunch of people with habitual hypotension (as in their relative “hypotension” is normotension”) got covered because they were 4’11 and 90 pounds and they are 90/60 torr… all the time.

3) You should probably be treated
a) for arrythmia if one was discovered
b) or have a basic onco screening - mammaries/prostate, gastroscopy, occult bleeding/colonoscopy, chest x-ray, abdominal somography

Because it should be known why you got PE (or DVT) in the first place.

I have seen enough PEs that ended up as undiagnosed (til that point) metastatic cancers.

4) God fu^king dammit USA. Ever heard of NSAID? Metamizole? Weak opiates?

 

[bleedgreen]

Some notes

1) Considered stable once there is a therapeutic level in the blood. Perorall anticoagulation is slower than heparine. And even LMWH should ideally have a level of anti-Xa taken.

2) It is kind of ironic, but I’d guess bunch of people with habitual hypotension (as in their relative “hypotension” is normotension”) got covered because they were 4’11 and 90 pounds and they are 90/60 torr… all the time.

3) You should probably be treated
a) for arrythmia if one was discovered
b) or have a basic onco screening - mammaries/prostate, gastroscopy, occult bleeding/colonoscopy, chest x-ray, abdominal somography

Because it should be known why you got PE (or DVT) in the first place.

I have seen enough PEs that ended up as undiagnosed (til that point) metastatic cancers.

4) God fu^king dammit USA. Ever heard of NSAID? Metamizole? Weak opiates?

Yes, she was admitted to get to the therapeutic levels (Heparin in her case). I remember helping her at home with Lovonox shots in her belly once she was home. For cause it was blamed on birth control as she was given Yaz by her PCP, which was an interesting choice since it was already part of a huge court case due to clotting….

Then while she was there they also found a PFO. She had two huge clots in her bases and more micro clots in her lung fields than you could count.

Crazy with the opiates, huh? Wonder how we ended up with our issues with it? Took her two days to be hooked on the IV good stuff and switched her to the pills in one day and sent her home craving pain meds. The nurse saw it coming and tried to warn me. They sent her home because her coverage ran out for the hospital we were at.

What I love the most about that tweet is that it’s an AI generated auto response looking paragraph that probably wasn’t even proof read before being sent out to auto deny claims.

 

[MrazeksVengeance]

Yes, she was admitted to get to the therapeutic levels (Heparin in her case). I remember helping her at home with Lovonox shots in her belly once she was home. For cause it was blamed on birth control as she was given Yaz by her PCP, which was an interesting choice since it was already part of a huge court case due to clotting….

Then while she was there they also found a PFO. She had two huge clots in her bases and more micro clots in her lung fields than you could count.

Crazy with the opiates, huh? Wonder how we ended up with our issues with it? Took her two days to be hooked on the IV good stuff and switched her to the pills in one day and sent her home craving pain meds. The nurse saw it coming and tried to warn me. They sent her home because her coverage ran out for the hospital we were at.

What I love the most about that tweet is that it’s an AI generated auto response looking paragraph that probably wasn’t even proof read before being sent out to auto deny claims.

Addendum to non-medical folks. He’s talking about Low Molecular Weight Heparine which is applied via subcutaneous injection. Reliable, low amount of systemic side effects (bleeding complications are rare compared to other forms of anticoagulation), metabolizes quickly, which is handy before surgeries or other invasive procedures. Annoying application though and often causes hematoma.
…
God fu^king dammit. Just tell her to switch to condoms. Hormonal contraception related PE should be contraindicating any HC.
…
I deal with lung tumors fairly often. As some of you may know, these sometimes spread to bones. Which hurts. A lot.
It’s not unusual to combine 2-3 analgetics and 1-2 coanalgetics (antidepressants, gabapentin - great for neuropathic pain).

Doesn’t mean it’s a good idea to immediately switch to the hard stuff
- because weaker analgetics can get it done
- if the pain gets worse… there is lot less room for changes

For fu^k’s sake. I.v. opiate is reserved for ICU/terminal patients. Mind you where I am from we are the clinic which is lenient with opiates. Largely because opiates help with shortness of breath and pain, two chief concerns of our terminally ill.

I had tramadol (with ketprofen) once in my adult life. (Last 30th December I stepped on my toe.) I was opiate-naive. Was absolutely smashed after one usage. Also hiccups for days.
…
Yeah that was not written by a human. Or someone with human emotions

 

[Boom Boom Apathy]

Caesars Virginia opens Tuesday in Danville

There are festivities planned for the opening with a parade on Tuesday morning. Doors open at 12 p.m. and a fireworks and drone show are planned for 8 p.m.

www.wral.com

How much you want to bet (pun intended), that it will be flooded with people that complain about grocery prices being too high?

 

[Derailed75]

Caesars Virginia opens Tuesday in Danville

There are festivities planned for the opening with a parade on Tuesday morning. Doors open at 12 p.m. and a fireworks and drone show are planned for 8 p.m.

www.wral.com

How much you want to bet (pun intended), that it will be flooded with people that complain about grocery prices being too high?

Haven't got near the place yet. I am looking forward to eating at Ramsey's restaurant once it's open and calms down a bit. Folks around here flood new eateries for the first 2 months and you can't get in.

 

[Boom Boom Apathy]

Haven't got near the place yet. I am looking forward to eating at Ramsey's restaurant once it's open and calms down a bit. Folks around here flood new eateries for the first 2 months and you can't get in.

I just looked it up. At the listed prices, I won't have to worry about not getting in, because I'd never go.

I get it though, it's a famous guy with a restaurant in a Casino and people will pay it. Prices aren't all that different than the Angus Barn, but I don't frequent that place either.

Ramsay's Kitchen Main Menu - Caesars Virginia Danville

Gain a glimpse into Chef Gordon Ramsay’s culinary restaurant experiences across the globe at Caesars Virginia Danville.

www.caesars.com

 

[Boom Boom Apathy]

Crazy with the opiates, huh? Wonder how we ended up with our issues with it? Took her two days to be hooked on the IV good stuff and switched her to the pills in one day and sent her home craving pain meds. The nurse saw it coming and tried to warn me.

And the Sackler family walks away with $10B+ leaving a trail of destruction and a long list of OD deaths in their wake.

 

[Blueline Bomber]

What I love the most about that tweet is that it’s an AI generated auto response looking paragraph that probably wasn’t even proof read before being sent out to auto deny claims.

That's the main crux of it. I understand why they use AI to deny claims, because I imagine they receive a bunch of claims and it's more efficient to have AI handle it. And while some patients are going to appeal and thus force a manual review (which would likely override the auto-denial of the AI as soon as a human actually looks at it), not every patient will. Thus, it's still more efficient.

It's also a horrible practice that completely f***s over the patient, but that's low on the list of these companies concerns.

 

[Nikishin al Gaib]

That's the main crux of it. I understand why they use AI to deny claims, because I imagine they receive a bunch of claims and it's more efficient to have AI handle it. And while some patients are going to appeal and thus force a manual review (which would likely override the auto-denial of the AI as soon as a human actually looks at it), not every patient will. Thus, it's still more efficient.

It's also a horrible practice that completely f***s over the patient, but that's low on the list of these companies concerns.

And its also bullshit because it completely f***s over the patient financially because they're still technically on the hook for payment on these denied claims even while you're going through the appeal process. And if that drags out, you could end up owing more money than the actual bill because of interest.

 

[WreckingCrew]

And its also bullshit because it completely f***s over the patient financially because they're still technically on the hook for payment on these denied claims even while you're going through the appeal process. And if that drags out, you could end up owing more money than the actual bill because of interest.

I don't think most of them charge interest? Of course it'll chip away at your credit score. It's still bullshit either way. Insurance has gotten way too much power

 

[Nikishin al Gaib]

Oh FFS

 

[Derailed75]

I just looked it up. At the listed prices, I won't have to worry about not getting in, because I'd never go.

I get it though, it's a famous guy with a restaurant in a Casino and people will pay it. Prices aren't all that different than the Angus Barn, but I don't frequent that place either.

Ramsay's Kitchen Main Menu - Caesars Virginia Danville

Gain a glimpse into Chef Gordon Ramsay’s culinary restaurant experiences across the globe at Caesars Virginia Danville.

www.caesars.com

I ate a Micheal Simon's place while visiting in Cleveland. It was unbelievably good. Not saying i will at Ramseys often but I'll go.once at least.

 

[Boom Boom Apathy]

I ate a Micheal Simon's place while visiting in Cleveland. It was unbelievably good. Not saying i will at Ramseys often but I'll go.once at least.

yeah, I get that.

I just don't like spending that much on a fancy restaurant when a) my wife and I love to cook and b) there are tons of great restaurants at reasonable prices to hit up the few times we do decide to go out to eat.

I do understand the experience part of it though. I've been to the Angus Barn 1 time in over 20 years of living here and it was only because somebody gave me a $100 gift card for helping them out one time. I still think we shelled out another $60 or so on top of that after dinner, drinks, and tip for just my wife and I. It was a cool experience though as the place was decorated for the holidays.

 

[hblueridgegal]

One of my pleasures in life is travel coupled with the dining out experience in restaurants of all price levels in the locale that I am visiting. It's one of the things I miss most about working and hanging with my co-workers in their home cities abroad. We'd go to the best spots and local gems for a 2-3 hour dinner.

Now, I will say, while the food is often enjoyable, most of the time when I go out with my son, daughter-in-law and her parents in NYC and NE locales, I often find the prices to be crazy expensive.

 

[MinJaBen]

That was 12 years ago. Today we’ve progressed to “if it hasn’t killed you yet then you’re probably good, pick up your blood thinners from the pharmacy and follow up with us next month”.

Can confirm the desire to discharge. My wife had to have emergency surgery back on October 2nd for an intestinal blockage. A cecal volvulus. They removed the cecum and did a repair. They were trying to get her out of the hospital with a wound vac and oral dilaudid two days later, when they repair perforated and flooded her abdomen with contents of her digestive track. Back to the OR for a second emergency surgery that resulted in an ileostomy. She then spend the next month in the hospital bouncing in and out of the SICU on ventilators and lost about 20% of her weight. She was finally discharged the night before Halloween, but in a condition so weak and in need of care that I had to take the whole month of November off from work to be part of her at home health team.

 

[bleedgreen]

Can confirm the desire to discharge. My wife had to have emergency surgery back on October 2nd for an intestinal blockage. A cecal volvulus. They removed the cecum and did a repair. They were trying to get her out of the hospital with a wound vac and oral dilaudid two days later, when they repair perforated and flooded her abdomen with contents of her digestive track. Back to the OR for a second emergency surgery that resulted in an ileostomy. She then spend the next month in the hospital bouncing in and out of the SICU on ventilators and lost about 20% of her weight. She was finally discharged the night before Halloween, but in a condition so weak and in need of care that I had to take the whole month of November off from work to be part of her at home health team.

Awful. I’m sorry you went through that. I hear and see too many stories like this. I transport people to the hospital frequently with stories of being released too soon and now have to go back from home because they’re sick again or the family just can’t care for them enough. Always bring them right back to the hospital that discharged them if I can. I can tell you the ER docs are never happy to see someone that recently got released from a few floors above them being brought right back and sick as hell.

 

[Boom Boom Apathy]

One of my pleasures in life is travel coupled with the dining out experience in restaurants of all price levels in the locale that I am visiting. It's one of the things I miss most about working and hanging with my co-workers in their home cities abroad. We'd go to the best spots and local gems for a 2-3 hour dinner.

Now, I will say, while the food is often enjoyable, most of the time when I go out with my son, daughter-in-law and her parents in NYC and NE locales, I often find the prices to be crazy expensive.

I never had a problem eating at fine restaurants all over the world when traveling for business. It was indeed a pleasure. I agree with you that one thing I do miss about retiring was I used to get to travel to some incredible places and have made friends with co-workers or customers in those places. I still stay in touch with many of them, but it's not the same.

I prefer to seek out good places that aren't over the top expensive when it's on my own dime. It's not hard to do. Granted, places like NYC is a different animal.

 

[MrazeksVengeance]

Can confirm the desire to discharge. My wife had to have emergency surgery back on October 2nd for an intestinal blockage. A cecal volvulus. They removed the cecum and did a repair. They were trying to get her out of the hospital with a wound vac and oral dilaudid two days later, when they repair perforated and flooded her abdomen with contents of her digestive track. Back to the OR for a second emergency surgery that resulted in an ileostomy. She then spend the next month in the hospital bouncing in and out of the SICU on ventilators and lost about 20% of her weight. She was finally discharged the night before Halloween, but in a condition so weak and in need of care that I had to take the whole month of November off from work to be part of her at home health team.

This… ENRAGES ME.