Hyponatremia

[jetproppilot]

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Why arent you offering partnerships to dem guys military out of curiosity? because he wouldnt do a case with a sodium of 124.. Thats good medicine wanting to know the reason for a sodium of 124 before doing the case. THats a pretty involved workup as you know already. WHy risk it if it is an elective case. Patient may have a malignancy that you are not aware of.. THat would be important information. Just offer dem guys partnership military.. and dont hold the delay of the case against the poor guy.. man.. talk about a divisive group.. Tell me wehre you are so i dont apply there..

Oh, and a little advice, Dude. Go find a corner, rock back and forth in the corner for a few hours. Then throw darts at the Buzz Lightyear doll you sleep with, instead of throwing darts at everyone on this site.

 

[Justin4563]

Oh, and a little advice, Dude. Go find a corner, rock back and forth in the corner for a few hours. Then throw darts at the Buzz Lightyear doll you sleep with, instead of throwing darts at everyone on this site.

hey jet
i dont throw darts at everyone on this site just when its deserved it.. I give credit when credit is due.. Im easygoing guy. But dont crap on your colleague for not doing a case for a sodium of 124 cmon. partner or no partner. its his call. everyone is an individual with different thought processes. and dont invoke im board certified in anesthesia and whatever else initials. thats what i hate. A medical student can tell you w/o even having anesthesia training its not a good i dea to do case wiht a sodium of 124. Of course, it can be done. and you did it. you took the risk. but not everyone else is willing to. i can drive with my feet.. IS it a good idea.. NO. first do no harm.. I dont care if the surgeon wont invite you to the july 4th shin dig. dont go.. have your own shin dig at the house. plus it wont be that fun anyway. He will appreciate that you are looking out for his patient. Just dont be an ass hole about it to the surgeon.

and jet im 6'2 235.. i work out every day. I play tennis 3 times a week.. I serve at about 120.... I wrestled in hs.. so bring it on baby.. you wanna a peice of me

 

[Justin4563]

and did i forget to mention.. Im board certified.. which means IM always right.. Dont **** with me..

 

[jetproppilot]

hey jet
i dont throw darts at everyone on this site just when its deserved it.. I give credit when credit is due.. Im easygoing guy. But dont crap on your colleague for not doing a case for a sodium of 124 cmon. partner or no partner. its his call. everyone is an individual with different thought processes. and dont invoke im board certified in anesthesia and whatever else initials. thats what i hate. A medical student can tell you w/o even having anesthesia training its not a good i dea to do case wiht a sodium of 124. Of course, it can be done. and you did it. you took the risk. but not everyone else is willing to. i can drive with my feet.. IS it a good idea.. NO. first do no harm.. I dont care if the surgeon wont invite you to the july 4th shin dig. dont go.. have your own shin dig at the house. plus it wont be that fun anyway. He will appreciate that you are looking out for his patient. Just dont be an ass hole about it to the surgeon.

and jet im 6'2 235.. i work out every day. I play tennis 3 times a week.. I serve at about 120.... I wrestled in hs.. so bring it on baby.. you wanna a peice of me

I'm ready to sink you like a four foot putt.

 

[Justin4563]

lets go

 

[Justin4563]

well go at it New York style.. I mean new jersey style

 

[jetproppilot]

well go at it New York style.. I mean new jersey style

What does that mean? When we meet I'm supposed to say;

HOW YA DOOOIN?

and then you say

WHAT THE ***K YOU LOOKIN AT? 😱

 

[Justin4563]

I'm ready to sink you like a four foot putt.

well what does this mean? is this a gay reference? do you wanna come out jet on sdn?

 

[jetproppilot]

well what does this mean? is this a gay reference? do you wanna come out jet on sdn?

Gimme a break, Slim. You've never seen the Budweiser commercial with the dorky guy saying to his buddy "I'm gonna sink you like a four foot putt".

Dude you know what? I'm sick of your posts, I'm sick of your incessant negativism on this board, and mostly I'm sick of how you charade your comments with references to your "nice guy" mannerisms and how good of a dude you are.
OK Slim, according to you, Military is practicing below the standard of care and UT is wrong about everything he posts politically, anesthesia sucks, doctors suck, CRNAs have it all figured out, life is unfair because hospitals give groups exclusive contracts, Military wanting to go ahead with a case where there is no literature ANYWHERE supporting that he shouldnt is wrong according to you, blah blah blah.
Ever consider charm school?

 

[Justin4563]

Gimme a break, Slim. You've never seen the Budweiser commercial with the dorky guy saying to his buddy "I'm gonna sink you like a four foot putt".

Dude you know what? I'm sick of your posts, I'm sick of your incessant negativism on this board, and mostly I'm sick of how you charade your comments with references to your "nice guy" mannerisms and how good of a dude you are.
OK Slim, according to you, Military is practicing below the standard of care and UT is wrong about everything he posts politically, anesthesia sucks, doctors suck, CRNAs have it all figured out, life is unfair because hospitals give groups exclusive contracts, Military wanting to go ahead with a case where there is no literature ANYWHERE supporting that he shouldnt is wrong according to you, blah blah blah.
Ever consider charm school?

Ok turbo,
I did not say military was wrong. I dont give a **** if he does a case with a sodium of 100. its his call. I said he was wrong for taking a dump on the non boarded non partner because the guy was practicing good medicine by wanting to get to the bottom of the hyponatremia before he proceeded with an elective case. . And I was further miffed when he said we are not offering partnership. Hey of course the guy is going to think you are a dick if after he said no you do the case.. Yeah there will be a divide if that kind of crap goes on.

Hey Im entitled to my opinions just like you are jet.. was i wrong on any of my assertions NO.. so shut up and come up to the sitay and lets throw down..

 

[Justin4563]

military and ut strike me as one of those attendings i had when i was in residency who would give me **** for using one strip of tape to tape both eyes.. they would give me a lecture on the proper way to tape the eyes. then if I took 16 mins for my morning break I would get lectured..

 

[Justin4563]

hey whats the matter jet.. went to bed.. cmon say something i dare ya

 

[jetproppilot]

Ok turbo,
I did not say military was wrong. I dont give a **** if he does a case with a sodium of 100. its his call. I said he was wrong for taking a dump on the non boarded non partner because the guy was practicing good medicine by wanting to get to the bottom of the hyponatremia before he proceeded with an elective case. . And I was further miffed when he said we are not offering partnership. Hey of course the guy is going to think you are a dick if after he said no you do the case.. Yeah there will be a divide if that kind of crap goes on.

Hey Im entitled to my opinions just like you are jet.. was i wrong on any of my assertions NO.. so shut up and come up to the sitay and lets throw down..

Hmmm...Turbo..I kinda like that.

From what I've read, Military IS offering partnership. His partners strike me as lazy obstructionalists. Theres a difference between using common sense and looking for any excuse to cancel a case.
As far as your opinion of Military and UT, I'm in stark disagreement with you. If I had more partners like them I'd be taking over my SITAY right now.

And if you review your posts and don't see an anger/disgruntled/individual-instead-of-team viewpoint, you're not being honest with yourself.
Theres a reason you are by yourself in practice.

 

[militarymd]

You know what?? I use one piece of tape on both eyes, and it drives everyone at work nuts right now

As for the guy not getting partnership....well, there is more to it than just a low sodium....I don't think I need to get into that.

I would not criticize someone for cancelling any case for any reason.....as long as there is a reason that you can EXPLAIN beyond "I am not comfortable"....and a history of repeatedly doing the same type of thing.

What can possbily happen with a sodium of 124???? Absolutely nothing!!!! It is not normal, but I would not have even checked a CHEM 7 if the surgeon hadn't ordered it unnecessarily.....there is a difference between modifiable and non modifiable risks....and in this particular case, with essentially a no risk surgery, I deem a sodium of 124 an essentially non-modifiable risk.


Boy, I lose power for a couple hours, and I miss a page worth of threads!!

 

[militarymd]

military and ut strike me as one of those attendings i had when i was in residency who would give me **** for using one strip of tape to tape both eyes.. they would give me a lecture on the proper way to tape the eyes. then if I took 16 mins for my morning break I would get lectured..

I was teacher of the year, and runner up many years in a roll when I did academics....I guess my residents must be *****s.

Dude, why are you so bitter? Is there something else going on that you aren't telling us? Is there a body part that is a little too small or what?

 

[Justin4563]

If he consistently says im not comfortable.. find out why.. Is he really not comfortable.. Help him.. teach him... have meetings every monday or something to talk about issues.. when i first got out i wanted a platelet count and pt ptt on every patient for a turp i was going to put a spinal in. until an older guy (non board certifie) said what the **** are you doing if this 75 year old has no hiistory of a bleeding diathesis or he is not on any aspirin etc.. throw the spinal in.. *****.. and dont bother me again...

 

[UTSouthwestern]

military and ut strike me as one of those attendings i had when i was in residency who would give me **** for using one strip of tape to tape both eyes.. they would give me a lecture on the proper way to tape the eyes. then if I took 16 mins for my morning break I would get lectured..

Isn't that transference or some **** like that?

In my best Vader like voice: I am not your teacher, JD.

I am, however, one who respects your gumption and fervor. Just don't agree with them, but I'm sure there are many people who don't agree with mine.

 

[militarymd]

If he consistently says im not comfortable.. find out why.. Is he really not comfortable.. Help him.. teach him... have meetings every monday or something to talk about issues.. when i first got out i wanted a platelet count and pt ptt on every patient for a turp i was going to put a spinal in. until an older guy (non board certifie) said what the **** are you doing if this 75 year old has no hiistory of a bleeding diathesis or he is not on any aspirin etc.. throw the spinal in.. *****.. and dont bother me again...

The guy has been in practice many more years than me.

 

[militarymd]

If he consistently says im not comfortable.. find out why.. Is he really not comfortable.. Help him.. teach him... have meetings every monday or something to talk about issues.. when i first got out i wanted a platelet count and pt ptt on every patient for a turp i was going to put a spinal in. until an older guy (non board certifie) said what the **** are you doing if this 75 year old has no hiistory of a bleeding diathesis or he is not on any aspirin etc.. throw the spinal in.. *****.. and dont bother me again...

If you were ordering coagulation studies on patients w/o clinical history of bleeding, then you should probably go back to residency, and study some more.

See, the board process allows some people through too with poor judgement.

 

[bigdan]

See, the board process allows some people through too with poor judgement.

😎 ...them's fightin' words!

*ding ding* Round 2!

 

[Justin4563]

If you were ordering coagulation studies on patients w/o clinical history of bleeding, then you should probably go back to residency, and study some more.

See, the board process allows some people through too with poor judgement.

Oh you are so pompous.. Do you know there is an ivy league institution that orders coags on all parturients.. I assume those docs study a little

 

[Justin4563]

If you were ordering coagulation studies on patients w/o clinical history of bleeding, then you should probably go back to residency, and study some more.

See, the board process allows some people through too with poor judgement.

Oh you are so pompous.. Do you know there is an ivy league institution that orders coags on all parturients.. I assume those docs study a little.. and my point was not to illustrate how smart i really was not.. my point was that other clinicians actually helped me see things in a different ways instead of saying how much of a young dingus i am.. and i will never make partner.. They actually changed the way i practice.. so instead of bashing.. talk to the guy.. find common ground.. you may make a friend..

 

[militarymd]

I don't need friends. I need good associates.

What's up man? You read a few things on the internet, and you automatically take sides with the person who does not meet standards....Boards.

 

[WhataBreeze]

You know what?? I use one piece of tape on both eyes, and it drives everyone at work nuts right now

As for the guy not getting partnership....well, there is more to it than just a low sodium....I don't think I need to get into that.

I would not criticize someone for cancelling any case for any reason.....as long as there is a reason that you can EXPLAIN beyond "I am not comfortable"....and a history of repeatedly doing the same type of thing.

What can possbily happen with a sodium of 124???? Absolutely nothing!!!! It is not normal, but I would not have even checked a CHEM 7 if the surgeon hadn't ordered it unnecessarily.....there is a difference between modifiable and non modifiable risks....and in this particular case, with essentially a no risk surgery, I deem a sodium of 124 an essentially non-modifiable risk.


Boy, I lose power for a couple hours, and I miss a page worth of threads!!

Happy New Year to you all in our, "World of Medicine and Healthcare."

On February 6th, 2007 I will become a 5 Year Survivor with "CPM." (CENTRAL PONTINE MYELINOLYSIS or also called Osmotic Demyelinating Syndrome) I'm not here to bring posts and threads out of moth balls, dust, wood work or also between the cracks to bring up a very sad part of my life because of "An essentially non-modifiable risk," called hyponatremia.

I can only assume you have not reached the point when your educators have hopefully subjected you to the AWARENESS that possibly been lost after Dr. R.D. Adams, along with his associates made available in 1959 and was strongly advised again in the 1970's (Hyponatremia And Hyperatremia) called Central Pontine Myelinolysis.

For those of you who, like myself started my reseach career on GOOGLE, please note that in 2003 there were 1500 links available including all the generic "Cookie Cutter" links with an institution name planted on it. Today there is over 73,000 links which is still nothing in comparison the actual facts in regard to CPM.

Why am I making an effort to bring this Thread back up? Those few of us who survive don't even have the faculties to do what I'm trying to succeed at. I hope to tell you more to make the "CPM Awareness Foundation," an important world factor during your tenure as a "Professional Healthcare Specialist," in the World of the Healing Arts. G-d Bless....


Franky and Breeze


NOTE: Sometimes MISPELLED words such as "IA T ROGENIC" will draw extra attention. I did not do it on purpose. Unfortunately, I don't know how to correct it just as those responsible for Central Pontine Myelinolysis. However, the cure is in your hands. Please be "Pro-Active as many all over the world are counting on YOU daily."

 

[EtherMD]

You know what?? I use one piece of tape on both eyes, and it drives everyone at work nuts right now

As for the guy not getting partnership....well, there is more to it than just a low sodium....I don't think I need to get into that.

I would not criticize someone for cancelling any case for any reason.....as long as there is a reason that you can EXPLAIN beyond "I am not comfortable"....and a history of repeatedly doing the same type of thing.

What can possbily happen with a sodium of 124???? Absolutely nothing!!!! It is not normal, but I would not have even checked a CHEM 7 if the surgeon hadn't ordered it unnecessarily.....there is a difference between modifiable and non modifiable risks....and in this particular case, with essentially a no risk surgery, I deem a sodium of 124 an essentially non-modifiable risk.


Boy, I lose power for a couple hours, and I miss a page worth of threads!!

Fine you would do the case. I do 6-8 of these a week with similar age and history. The surgeon who does these cases is great and we work well together. But, he is very reasonable fellow and has a million dollar a year practice. He would have no problem waiting one to two days in order to get a consult and possibly correct the Na a bit. Why? THe same reason many of us still utilize cricoid pressure (worthless) and do other things stated in our textbooks. In my area the malpractice climate can be rough so being a little conservative does not hurt particularly, when the surgeon is a reasonable guy and has a busy practice.

By the way, this guy can do the case in about 15 minutes under "Mac" and he does two levels in about 30 minutes. Still ,the case was your "call" and I am glad it worked out for you.