u/srmcmahon

Just got an email encouraging constiuents to read a WSJ article criticizing Democrats regarding affordability and policies.

WSJ articles are pay-walled

Caregiver ideas for making hospital admissions less exhausting (for stable patients)

I recently posted about an ED visit and admission with my son (I'm his caregiver). We arrived at midnight on a Friday, so we rolled right into the weekend, when most attendings aren't around. The diagnostic steps were exactly what we expected. How long they took was not. A late night visit turned into a full weekend (with exhaustion for me from sleeping on a hospital recliner that doesn't actually recline and wearing the same clothes for more than 48 hours, and for the patient who does not sleep well on the air beds our hospita uses)

1. Explain the workflow. We knew he'd need an MRI to tell apart the two likely problems (one means steroid infusions, the other an outpatient referral). Last time, the ED attending ordered it. This time the ED attending had neuro see him first and place the order, which added hours. That would have been fine if we'd known, and I could have used that time for errands. We also didn't realize that because the MRI happened late Saturday afternoon, neuro wouldn't be back with her evaluation until Sunday. We saw the results right away and knew steroids were off the table, so all that was left was discharge planning.
2. Put a basic outline of the plan in MyChart. Research shows waits are less frustrating, and even feel shorter, when people know what to expect. Test results show up instantly, but clinical notes can take a day or two. I've seen them take four.
3. Think about the downside of "on stage/off stage" design. This hospital opened in 2016: all private rooms, with staff work areas closed off from patients and visitors. It's great for privacy, reduced noise, security, and letting staff work without interruption. It's a world away from the chaos of old ER reruns or the big central nurses' station. But you only see staff when they're in your room or at the workstation outside it. The combination of being in limbo (see 1 and 2) and isolated makes it harder. I have come across references to this, although most articles about this approach to hospital design only mention the benefits. Hospital units can sometimes appear to be deserted, like you're on the Enterprise and aliens have made the entire crew vanish.
4. Tell patients when attendings will round, especially on weekends. If it's 8 am and I know neuro is coming between noon and 3, that gives me a block of time to get the dog outside, feed the patient's cat, eat soomething that isn't from a vending machine, change clothes without worrying I'll miss the very short time out of 24 hours when the important information is provided. (More than once I've asked nurses if Dr. So and So is on the floor yet and nobody has seen them, I leave to get a cup of coffee, come back, and Dr. So and So has been there and left and the family member I'm there with can't clearly tell me what was said).

None of this will work everywhere, but for stable patients some of it seems doable. Curious what people on the clinical side think.

This is a 140 year old house. Most of the basement wall was replaced some years back but a small portion is the original brick. There is an outside entry to the basement, steps go down from ground level to the brick portion of the foundation (like how houses in rural areas were once built with a tornado entrance from the outside like in the Wizard of Oz) with another 10-15 feet of brick on one side of the entrance and a few feet on the other side. There's no direct access to the back yard from the house so the idea was a split entry to the basement and to the backyard and replacing the basement wall in that area. There is a city program with our bank which provides a slightly lower interest rate, so plans and estimate were submitted to the city and the bank. Then it turned out using a current exterior only appraisal of the house (could be done quicker than a full appraisal) the estimate was qutie a bit over what could be approved. All this probably took more time than going to the bank without city involvement because there are more layers of red tape.

We asked the contractor about possibly reducing the scope.

He got real irritated because he spent time coming up with the original plans and estimate at no charge and is also now saying he's booked up till spring. Not sure if that is exactly true or if just pissed. I can understand his frustration (although they also used architecture services at the big box store where they buy materials and there's no charge for that) and it could be reasonable to pay for a revised estimate, but is this the appropriate way to respond to a customer in this situation?

It;s ironic because we have a contracting business in a completely different field (network installations) and we do many quotes a year and some we get and some we don't. We're also a very small outfit, couple of guys who do the field work and a one and a half office people. We might bitch about certain customers and lost customers in the office but we never take it out on them.

I think the Mission ones I buy are around 6 inches. Doing a bit of searching and my suspicion is confirmed that corn tortillas have grown smaller over the years.

Long ago I lived in NM, and we used to make breakfast burritos that were simply scrambled eggs, cheese, and salsa rolled up in a corn tortilla cooked briefly on a grill to soften. To the best of my recollection, if you scrambled 4-5 eggs you could fill maybe 3 tortillas without a problem and a single filled tortilla was a decent breakfast. I'm sure those were 8 inch tortillas we used. Is there any such thing locally?

"This will be one of the Great Pieces of American Architecture, honoring the history and significance of Arlington Cemetery and befitting the most powerful Capital in the World," Burgum wrote Thursday in a post on X.

My niece's husband won 4 tickets from KFGO so they invited me to go along. On the way from Fargo to GF I pondered what demographic Weird Al plays to. Seems like. . . everybody. Also wondered how far people travelled.

We had seats close to the front but way way off to the side. What struck me most was the straight song they did ("The Letter" from the late 60s) and the insane group chorale/beatbox/you name it stuff they did near the end. Amazing talent and energy.

This, BTW was at the 13th Ave Walmart, mind you.

Went on a grocery run for my son who was busy dealing with a free log dump from a tree service. The routine is Sams then Walmart. He called to add organic bananas from Sams but I was already in Walmart, so he said organic if possible otherwise regular.

No organic in sight but there's a guy with a big handcard full of empty avocado boxes so I ask him. Wasn't sure how well he understood me, because I asked if they had organic bananas instead of just regular, I wasn't sure if he understood and he walked me to the regulcar bananas so I went to grab a bunch and he interrupted saying to wait, goes of trotting to the back of the store, a little later comes trotting back with a huge case of organic bananas on his shoulders.

His name is Oswaldo. I lost my receipt so not sure how to notify the store (and they never answer their phones, so that's a lot cause). Anyway, if you see Oswaldo in produce he's a good dude.

>Federal gov decides community groups can't pay for test strips and clean needles with federal grants
by u/goldstar971 in medicine

State money likely comes from fed grants so commission would have to appropriate.

I had to add Fargo to the title to show it is local interest

Awhile ago I saw some organizaiton asking for glass jars to use for flowers given to--not sure specifically--hospital/LTC patients or something.

I didn't like to toss glass jars I could use, so I have a big tote back I put them in, and do occasionally pull one for food storage and such (I keep the lids) but eventually it will get full. I found where city drop off locations are but curious how much those sites are used since no residential pickup.

Edit--Thanks for all the great input!

Does anyone know why A &E Liberian restaurant at Boradway and 6th closed in 2022? Apparent not covered by local news

I was the first kid in my grade to have glasses (grade 4). As an adult I have never thought new glasses were perfect. I'm 72 now and do not have an eye exam annually, mostly I wait until I can't read street and interstate signs. ("I'm fine when I know where I'm going.") By then my glasses are in rough shape because of things like falling asleep reading and laying on them, falling off when I'm sweaty and bending down doing outside work, ignoring eyeglass cases after the first 2 weeks.

Couple of years ago I told optometrist I was seeing double. He sent me to an ophthalmology surgeon (or are they all surgeons? NO idea) because it's caused by weakened muscle on the right side. Surgeon said I could go ahead with surgery or wait, and my nature is to wait. Now cataract on right side has gotten worse. So he says he can make my vision better but can't take me back to 2020.

I said what's in the title.

He laughed and said (surprised me) that this was the first time anyone had said that in his practice. We shared a few pandemic stories. He's a younger guy and told me how during lockdowns he panicked and made bad financial decisions, draining savings and being scared to take on a lot of debt.

Since younger people tend to go to chain places (do they get online eye exams now????) I'm sure his practice skews older. Plus they all have cataracts or weakened eye muscles or glaucoma or macular degeneration or floaters and detached retinas in addition to being near-sighted, and traditional medicare part b covers all that (no, you do not need to enroll in a Medicare Advantage corporate insurance scam).

I don't know how far this will go, but I brought before the commission the question whether the Downtown Community Partnership and Block 9 Partners, LLC have total authority to decide what expression is and is not allowed at Broadway Square. I won't go into the weeds here, but the gist is that even though the property itself is privately owned, the degree of public involvement (e.g. Park District co-management, participation of city and Park District on the square's governance committee--4 seats, DCP, Block 9, city, Parks), Park District ownership of social media accounts (all this is spelled out in the management agreement in which BLock 9 designates the Park District and DCP as co-managers of the square).

Basic principle is that with the city and Park District being directly involved with Broadway Square, 1st amendment trumps who pays the property taxes. There is SCOTUS precedent to support this.

I asked the commission to seek a legal opinion on this, because far as I can tell, nobody ever thought about this.0

UPDATE:

email from Gullickson (the new people are prompt in responding to emails) who says she thinks I will be getting a response (well, I want them to produce a formal opinion, but whatever) and said "My understanding is that it's about honoring a specific condition within the purchase agreement when the land was originally purchased from the most recent seller."

This is a problem. This is that kind of institutional thinking where people go along with whatever people in charge tell them, or even just a coworker. They say "it's policy" but they never looked it up to see if it even exists, and if the policy actually contradicts some applicable law they don't question it. IF my argument is sound, then the city can't simply sign a purchase agreement and discard their duty as a government entity.

The Songs of Peace, [Protest], and Hope was awesome. Would have liked to see more people there. Great performers.

She had testing recently, passed the written test but not the hands on test. Reason? They are not letting her train on tasks except pick up and drive thru, so she doesn't have a chance to learn the stuff. She has a retry in less than 2 weeks and she keeps asking to be rotated to other tasks. Scheduler just says they'll wait until the last minute because otherwise she'd forget the stuff. This is NOT how people learn to do this stuff.

She is very stressed and distressed. Her direct manager is someone totally new and no help at all.

Advice?

Always--well, 90% of the time. Sometimes just a stripe or part of a pattern but almost always there

Oh, Neela NO. Just NO. Not the dickwad.

Also, I get tired of Luka punching people. There's some toxic masculinity going on, I don't care how Croatian or brooding or traumatized he is. Guy needs anger management.

https://preview.redd.it/ghd69jmlwufh1.jpg?width=1207&format=pjpg&auto=webp&s=5c939b0fb93f0713541e275f27d686ea50ec460d

https://www.awesomefoundation.org/en/projects/606012-songs-of-peace-protest-and-hope

(one word apparently had to be removed from the event title)