u/earthsunsky

Several months ago there was a thread on this from a kid having a bad experience and y’all made some commentary about how a department that doesn’t invest in its people isn’t worth working for, and damn did that cut deep.

It cut deep because I was reading it the kid who posted it was sitting across the kitchen table from me on OT on my shift. It wasn’t a shock we’d created a culture where they weren’t comfortable reaching out for help internally. I’d had a couple of shitty probationary experiences in my career myself.

I took them aside at shift change and told them I’d read what they wrote, and asked them if this job and organization was for them. They said yes. I asked them to sign up for every OT on my shift that they could between then and the end of probation and we got them across the finish line. Kid then got moved to my shift and is thriving. We had a long chat the other night as we’re about to hire again about giving the next kids a better experience than they got and changing the culture from the bottom up.

I’m not sure what the point of this is besides recognizing how serendipitous it’s was to see the post. I’m proud of the kid for gutting it out, and no matter how salty you get, train your damn probies.

Didn’t know if the belonged in emergency medicine or hear so I’ll toss it out there.

I recently had a patient who got chewed on by a Garter snake. 100% confirmed, not a crotalus, we don’t have any confirmed locally.

About 6 hours later he developed some bruising and tingling in the arm that got bit.

I know they are mildly venomous but difficult to actually get bitten effectively by.

He was moved to a big city hospital with anti venom, statewide we have Prairie and Norther Pacific Rattlers so I assume they carry what’s effective for them. Last I heard they had administered an initial dose and were considering a follow up due to no effect in the swollen arm. My questions is if there’s any known or proven efficacy of that type of antivenom for a Garter bite? I couldn’t find any literature supporting it either way. It’s an interesting case and was not on my bingo card yesterday.

So I was never on MTX, went straight to Humira after long term high dose prednisone due to trying to have kids. That is (successfully) behind us and Humira still works, just not as well as it used to. Is it worth adding MTX to the biologic? I wasn’t super sad to skip it due to all the side effects you read about but I’m curious if the juice is worth the squeeze. The morning stiffness is back and the humira seems to totally wear off around day 10.

Awaiting to hear back from my MD, but curious if anyone has gone this route.

Against my better judgement I purchased a pair of Orvis Pros last year. The seam in the foot has completely come apart on both sides where the V separates. Orvis warranty wants me to send them to a 3rd party repair center for $60 and 8 weeks turn around time for some aqua seal 🙄 I can do that myself but the seam will likely keep ripping away up the line.

I wore Simms classics for years back in the day and they were bomb proof. Went to G3s that were garbage and swore off Simms. Patagonia next and enjoyed just getting a replacement whenever I had an issue. Went to Redington Sonic Pros for years and never had issues, most durable wader ever. I think I have a back up pair in a box someplace. They’re obviously muerto from the wader business. With a size 8 foot my options are limited, even Patagonia smalls have a 9-11 foot and I hate the bootie being bunched up. Grundens is an option but I’ve heard mixed things. skwala and Sitka only go down to a 9-11? Any brand I’m overlooking that won’t fall apart after a season or less?