RedRocket1647545505

I'm not sure who is trying harder to give the game away, Miami or Florida. Jesus.

Cheby has zero room to talk. The front rotor design on my 2007 Colorado is the most ridiculous design I have ever seen in my life.

LOL https://ftw.usatoday.com/2019/08/tate-martell-swing-and-miss-tweet-miami-qb-reaction-starter

Please destroke this thing and throw in the lightest moving parts you can find. I want to hear it scream at 9k rpm.

Was that taken when they were on the East side?

Roll right on past integrity.

What do you expect from a 'Bama fan?

I've met some patients with some high-quality tats over the years. More often than not, the memorable ones seem to come out of C-block at Madison Correctional Institution (4.4/5.0 stars on Google) in London, Ohio. They're pretty backed up though. You pretty much have to kill someone to get an appointment.

Gladiator with 6sp manual.

Keep in mind the story is a bit skewed. It's hard to tell what exactly happened (though I'm sure the charts say). Some of the people got 1000+mcg of fentanyl, but it doesn't specify over how much time. Was this a drip? A push? It makes a difference. If he ordered large dose IV pushes, then he's stupid and so are the nurses (I know a couple of them). If they were on a vent and getting several boluses for whatever reason, then that's a different story. Either way, some folks are going to go down hard. Court of public opinion and all. Also, don't come crying to the healthcare community when your family member is in pain because our hands are tied from legislation that will probably sprout from these events. I'm curious to see how this plays out. The nurses would be better off at this point claiming they falsified their documentation and were actually pocketing it. Probably too late for that though. Or, just don't be an idiot in general.

Breathing tube has a balloon (cuff) on it as well, which he would have pulled through his vocal cords. I'm betting he's pretty raspy right about now.

FYI, there's a balloon that is inflated inside your bladder to hold it in place. Its about 1" in diameter....

The trach will help with the anxiety of constantly being gagged by the ET Tube. It's easy for us to say, "Calm Down", but imagine having something tripping your gag reflex while you're breathing through a straw and trying to ignore it... The trach, however, can also induce some of its own anxiety, though not nearly as bad. When they initially put it in, there will be some irritation to his airway. Expect blood and drainage/secretions from around it; this is normal. The irritation will cause him to cough constantly until his airway gets used to the foreign body that's in it. Try not to get bothered by the sound. You'll know what I mean. He will be able to breathe easier, though. The trach is typically a little bigger in diameter and about 1/4 the length of the ETT. Bigger hole + shorter length = less resistance to flow (Ohm's law, if you care). And no problem on the info. Let me know if you guys have any questions about anything. I'll help in any way that I can.

Typical progression from ICU to discharge is incrementally decreasing levels of care; there are typically 3 levels in a hospital. Once he's trach'd, he will most likely go to a step-down/intermediate unit, especially if he is still vent-dependent. This takes into account that he's off of everything else that might hold him in an ICU, such as IV meds to control his blood pressure, vital signs in general, oxygen requirements, certain sedating/pain meds, and how likely he is to regress back towards needing intensive care. Once in a step-down unit, they will continue to work towards liberating him from the vent. They will start stripping away ventilator support and start making him do more of the work, with the goal that he will eventually do most of the breathing on his own. That's the great thing about trachs. A lot of families get scared by them but they really are a great safety net to have during the rehab process. If you want to see how he breathes on his own, you just disconnect him from the vent. If he fails, you just pop him back on the vent. With the tube in his mouth, if you want to see how he breathes on his own, you have to take the whole tube out. If he fails, then they have to try to emergently put it back in, which doesn't always go as planned. Physical/Occupational therapy will get more intense. I assume they will place a PEG tube in his stomach (so he can get some nutrition) while he's getting a trach, so at some point Speech therapy will step in to evaluate his ability to safely swallow in hopes that he can start eating some actual food again instead of that yellow bag of shit we feed patients. They will continue to tweak his oral meds to help with any issues he's having. Once he's off the vent, they will place him on a trach-mask or a T-piece to deliver some supplemental humidified oxygen to him. Once his oxygen requirements are low enough (and if he's not on any IV meds that require an Intermediate level of care), they will transfer him to 'The Floor'/MedSurg, which is typically the lowest acuity unit in a hospital. Once on The Floor, he will hopefully be up and moving around more, gaining more independence and plans will most likely be made via a Social Worker/Case Manager for placement in a rehab facility (Probably Dodd Hall...). The best thing for him at this point, mentally, is to get out of the ICU. People get delirious as fuck with long stays in ICUs (is actually called ICU delirium). They get this 1000yd stare to them and it can be a PITA to manage, really throwing a wrench in their progress. The best way to fix it is to get him out of the hospital and back to a normal life. Hopefully that paints somewhat of a picture of what you are probably going to encounter on his road to recovery. It's a marathon, not a sprint. Try to hang in there and don't forget to take care of yourselves as well during this time. He's really going to lean on you guys when he gets home, at least for awhile. Sitting in an ICU waiting room all day staring at the walls really doesn't do anyone any good. He's in the best hands right now. Have faith in the system.

FYI, a Gear S3 won't survive being within close proximity of a 1.5T MRI scanner if you happen to forget to take it off before entering the scanner room. Ask me how I know.

Have they tried Precedex/Dexmedetomidine?

What are his oxygen requirements at now? What sedation is he on?

That's correct. It typically happens in diabetics though. I can't remember the exact pathophysiology of why it happens though.

Uncontrolled diabetic? We recently had a girl in Critical Care at Grant who had pancreatitis due to high triglyceride levels. She was sick as shit.

Any word on the cause of his pancreatitis yet?

Gallstones? People can often get worse before they start getting better so try to hang in there. Wish him the best.

I kind of did the same for my house a few years back. I bought it as a foreclosure and didn't pay as much attention to the lay of the land as I probably should have. Once I got moved it, I noticed the sump pump running a lot which prompted me to start investigating. There wasn't really any standing water in the yard, but there wasn't much grade for it to run away from the house either. Long story, short, whoever (Digger McCray...) set the original grade, didn't build the damn thing high enough. So, I spent $10k to have the front yard sloped away from the house as much as possible. It wasn't much, because the house was nearly on the same plane as the drainage ditch near the road. It helped quite a bit, but could be better (I'd love to have a natural drain). However, it's as good as its going to get. I can't raise the house up, so it is what it is. It really depends on what's around you. If you have a farm field anywhere near you, you're probably screwed. I see it all the time out here in the country. People buy a new plot of land some farmer has sold off, plop their new houses right along the edge of it, and their houses sit basically underwater for most of the year due to the watershed coming off the fields. You might be able to do something with your land, but you can't really do shit about adjacent land that's draining onto yours (if that's the case). So either, look into grade work (not cheap), drainage tile if you have the rise/fall to do it, or possibly like Mensan said, dig a sump in your yard for it to drain into, but you'll probably have to pump it out to divert around your house.

Stats guys drive me fucking nuts.

https://www.10tv.com/article/proposal-honor-ohio-popular-presidential-vote-withdrawn-2019-apr Thots?