Echo Boards 2021 and random thoughts

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periopdoc

Cardiac Anesthesiologist
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A day before my 49th birthday, I took the last exam of my career, RePTE. It was interesting walking into the same building that I have taken all my exams in, except USMLE step 3. Lots of memories there, and it got me thinking about SDN, and the time I spent here, back when I was prepping for previous tests.

I have to say that I was pleasantly surprised with the exam. Lots of practical questions that I would sit back and think about. Very little theoretical, useless bull****. I've never before had an exam where I used every minute of the allotted time. I went through and answered everything, then went back to just ponder the interesting case examples they had. How would I approach this case? What other possibilities could there be. It was quite enjoyable, even though it probably was unnecessary.

I'll probably retire from cardiac anesthesia before the results are back, and I'll probably cut back to 20 weeks or less per year, starting next year. I have enough. The markets have been good to me. Absent an unforeseen crash, I'll be able to retire next year. Looking back, I no longer understand the common sentiment of working hard until the kids are out of the house, then cutting back. I would much rather work half time while they are living with us, and go back to full time, if needed, after they have moved on with their lives. Thankfully I have had a career, and a lifestyle, that gave me plenty of time to spend with them.

If I had any advice for new grads, it is to live the lifestyle you want to afford. Job share. Enjoy the time you have. We make enough in this specialty that you don't have to get caught up in the rat race. It is unfortunate that so many do.

I've always done things a little differently, I suppose. Maybe not quite to Zippy's level, but still differently.

See y'all on the lake, or on the slopes

-pod

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Handsome man. Good for you. You’ve been gone a while.
Who’s the one that’s eating good in the back?
That's my best friend, Fat Boy. I'm Slim. Those are the names we go by on the boat and skiing. LOL

He was totally healthy until 3 years ago last Sunday. He went into V-Tach on my boat while we were surfing. When I felt his pulse, it was too fast to count. We had to call the helicopter in to rescue his ass, and somehow kept him conscious for the 30 min it took for them to get there. For obvious reasons, I can't post his EKG, but it looked pretty much like the image below. Vtach at 250ish. We converted him with a couple of shocks, and now he walks around with an AICD. He's put on a bit of weight since then, but we figure he earned the right to enjoy whatever life he has left.



gr1.jpg
 
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A day before my 49th birthday, I took the last exam of my career, RePTE. It was interesting walking into the same building that I have taken all my exams in, except USMLE step 3. Lots of memories there, and it got me thinking about SDN, and the time I spent here, back when I was prepping for previous tests.

I have to say that I was pleasantly surprised with the exam. Lots of practical questions that I would sit back and think about. Very little theoretical, useless bull****. I've never before had an exam where I used every minute of the allotted time. I went through and answered everything, then went back to just ponder the interesting case examples they had. How would I approach this case? What other possibilities could there be. It was quite enjoyable, even though it probably was unnecessary.

I'll probably retire from cardiac anesthesia before the results are back, and I'll probably cut back to 20 weeks or less per year, starting next year. I have enough. The markets have been good to me. Absent an unforeseen crash, I'll be able to retire next year. Looking back, I no longer understand the common sentiment of working hard until the kids are out of the house, then cutting back. I would much rather work half time while they are living with us, and go back to full time, if needed, after they have moved on with their lives. Thankfully I have had a career, and a lifestyle, that gave me plenty of time to spend with them.

If I had any advice for new grads, it is to live the lifestyle you want to afford. Job share. Enjoy the time you have. We make enough in this specialty that you don't have to get caught up in the rat race. It is unfortunate that so many do.

I've always done things a little differently, I suppose. Maybe not quite to Zippy's level, but still differently.

See y'all on the lake, or on the slopes

-pod

Anybody have a link to Zippy's last post? That's a nice fun read.

@periopdoc Congrats dude. Happy for you and glad you made it happen.

This time next year I should be 1/2 time or less and it can't come soon enough. About to start a 6 week hiatus from work for the first time in my career to get a taste of what is to come.
 
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Last day of residency was ,without a doubt, one of the best days of my life... I was on call, 3AM get a call from burn unit to emergently intubate a big guy that had been 50% burned upper torso with smoke inhalation. Half a stick of STP and 100 o' sux-- all edema. I told myself I wasn't goin' out like this. Just rammed a 7.5 where I thought it should be and it slid in. BS bilateral and PCXR was solid. O2 sats golden and RT lady all happy. No procedure note, no charge sheet. Beeper left at OR board when no one was lookin'. Slid out hospital at 0645 with no goodby's, thank you's or gonna miss you's. Got to the apt. and loaded up U-Haul with 100% VA disability, 100% SS disability uncle( Vietnam, agent orange, PTSD--you know the bogus gig). Letter and keys in an envelope dropped in the apt. night box. No change or forwarding of address with post office, no cares about apt. or electric deposits. ZIPPY DONE EVAPORATED! Roll on out at 1700 with floorboard boom box playin' "Comfortably Numb", and a bottle of chilled Wild Turkey in the ice chest. Uncle drivin' and on outskirts of town we light up a big fat doober. I told him not to shut off the old biitch until we were home. Ole Hunter Thompson didn't have a thing on us that night... Regards, ---Zip
 
Good for you man.
I went 1/2 time this year and it's great (but makes you want to go even lower : )
Currently on a 5 week vacation for the first time in 20y.
 
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precordial thump or nah
Valsalva, carotid massage, 6 pack of ice cold beer to the right side of the neck, bottle of ice cold Bulliet to the left. Some godawful, prepackaged, frozen concoction to the forehead. Ice cube on the dingus.

Nothing was stopping it except electricity. He has an infiltrative cardiomyopathy, and a one-way ticket to transplantsville.

I saved that mother****er's life because I knew what to say to get them to launch the chopper.
 
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Valsalva, carotid massage, 6 pack of ice cold beer to the right side of the neck, bottle of ice cold Bulliet to the left. Some godawful, prepackaged, frozen concoction to the forehead. Ice cube on the dingus.

Nothing was stopping it except electricity. He has an infiltrative cardiomyopathy, and a one-way ticket to transplantsville.

I saved that mother****er's life because I knew what to say to get them to launch the chopper.
Unlucky for him that it was a ventricular arrhythmia since vagal maneuvers aren't really gonna help. Other than a precordial thump, you're just plain stuck until electricity and/or drugs arrive.
 
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Yep. We didn't know the underlying rhythm, so did what we could. A precordial thump would have been reasonable, but it would not have worked in this instance. If you saw his cardiac MRI, you would see why.

I've considered putting a defib on my boat, but I would be really annoyed with only an AED, and the manual models are super expensive.
 
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Yep. We didn't know the underlying rhythm, so did what we could. A precordial thump would have been reasonable, but it would not have worked in this instance. If you saw his cardiac MRI, you would see why.

I've considered putting a defib on my boat, but I would be really annoyed with only an AED, and the manual models are super expensive.
There's worse ways to go out than chilling on a boat.
 
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If I had any advice for new grads, it is to live the lifestyle you want to afford. Job share. Enjoy the time you have. We make enough in this specialty that you don't have to get caught up in the rat race. It is unfortunate that so many do.


Its hard for a leopard to change its spots


type-a-personality.jpeg
 
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Although relative to other specialities anesthesia as a whole is closer to the Type B side, we are, relative to the general population, still pretty solidly type A.
I'd say this is accurate. Though, I probably fall heavier than most on the type B side. To the point that most who know me outside of work say things like "i can't believe you're a doctor."

I just kick on the seriousness a bit at work I guess.
 
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I took the rePTE as my final career written exam and asked to be removed from cardiac call in October when the current rotation ends. I plan to go part time next year.
 
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What did you say?
This is Doctor Anderson, my phone number is 406-***-****. I'm a cardiac anesthesiologist at KRMC (the hospital where the chopper lives), and I need medics and ALERT to the McGregor Lake Lodge boat dock, for a 36-yo-man who is likely having a heart attack. His heart rate is too fast to count, at least 180 bpm, he is having chest pain, his blood pressure is thready, and he is slipping in and out of consciousness.
 
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I took the rePTE as my final career written exam and asked to be removed from cardiac call in October when the current rotation ends. I plan to go part time next year.

I’m due to rePTE in 2023 but I’m planning to stop taking cardiac call by the end of this year. Still staying full time but it’ll probably seem like part time with no more q4 cardiac call:)
 
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