CrackaAssCracka

joined 2 years ago
[–] CrackaAssCracka 7 points 1 year ago

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."

[–] CrackaAssCracka 12 points 1 year ago

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.

[–] CrackaAssCracka 1 points 1 year ago

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.

[–] CrackaAssCracka 3 points 1 year ago (2 children)

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.

[–] CrackaAssCracka 2 points 1 year ago

That makes sense. I don't think there's been a moment like that in the podcast, the DM keeps expectations in check.

[–] CrackaAssCracka 2 points 1 year ago* (last edited 1 year ago) (2 children)

I'm a casual D&D fan since my only exposure is from Not Another D&D Podcast but I think it adds to the overall story telling experience. Super charges the lows and highs if it's a 1 or 20 especially on an important role. Does it break the game? Eh, not that I can tell and I've listened to hundreds of hours of the podcast. Though this is my opinion and not based on D&D rules, history, etc.

I also highly recommend Not Another D&D Podcast if you like silly shit mixed with crass humor, some good emotional content, and players fucking with their DM.

[–] CrackaAssCracka 3 points 1 year ago

Gave Fallout 76 a shot again after trying it early in it's release and quitting due the travesty it was (also because I was disappointed in Starfield). It's good now, very similar feel to 4 though with some differences. It's a Fallout game so not perfect but the feeling of endless possibilities you get when stepping out of the vault for the first time is classic Fallout.

[–] CrackaAssCracka 5 points 1 year ago* (last edited 1 year ago) (1 children)

Couple of things it could be:

  1. You locked your knees without realizing it, shut down the blood return from your legs, then had a drop in blood pressure due to decreased blood return to your heart causing you to pass out.
  2. You took a big hit, expanded your chest, held it, decreased blood flow through your thoracic cavity due to the increased intrathoracic pressure then a blood pressure drop as above.
  3. Your vasovagaled yourself somehow (bearing down on a held hit maybe or just due to weed effects) which is increased parasympathetic nervous system tone that drops blood pressure
  4. Some weird shit 🤷🏼‍♂️, the body can be odd and changes as we age so maybe you just can't smoke weed now cause of the earlier mentioned weird shit

I agree with your doc (I'm a family med physician), don't smoke if all of a sudden you're passing out.

[–] CrackaAssCracka 9 points 1 year ago

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

[–] CrackaAssCracka 2 points 1 year ago (1 children)

But then you don't get that cheese that dribbled out and sat on the pan and got crunchy and savory and delicious. Like caramelized cheese.

[–] CrackaAssCracka 2 points 1 year ago

Thank you. I was struggling to find the connection to the 12th Postmaster General and inventor of the postage stamp Cave Johnson. Fuck that's a good name.

[–] CrackaAssCracka 4 points 1 year ago

Good hoodie section for quality stuff made in Canada or the US (I didn't check them all). Didn't know about Camber but I'll probably hey something from them. The work pants are dope too. Just bought some from Epaulet and American Trench and digging them.

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