I have a chronic illness, and so I received quite a few sterling gems in the months between onset and accurate diagnosis. I had one GP let's call him Dr Douche. I promise, it's the kindest way I could describe him. "The jacket means I know things." He came up with wilder and wilder theories as to why I was sick, and kept getting sicker. It should be said beforehand that few of these theories were embodied. He was sure it was something in my ladybrains that was preventing proper function of the rest of me. Dr Douche said so much weird, wild, and just-plain-unbelievable crap over the course of my diagnosis that someday I may create a novel that incorporates it all. But this here has to be the blue ribbon winner. I was describing a symptom to him: every time I got up in the morning, when I first stood, my heart would pound, my heart rate would accelerate, and I'd feel dizzy. After a few probing questions (only in the morning? no, but it's worst in the morning) "Maybe," he said sensitively, "you're afraid." "Of standing?" I asked, just to be sure. "You think I'm afraid of standing up." Maybe he meant there was some kind of existential fear, like, we're all afraid, it's a big old universe out there, and he wanted some comfort and reassurance. Nope. The man genuinely thought I had such a profound fear of verticality, that I was having a near-panic in response to being upright. POTS, folks. It was POTS. Literally THE most common sign/symptom/syndrome of autonomic dysfunction. The most common one. He could've confirmed right there in the office with a poor man's tilt table test, if he knew to Mayo Clinic had to confirm with expensive instruments because he'd never heard of a disease that affects 1/100 teenagers and between 13 million people in the United States! Would've done better with this Doctor. Who was named Dr Douche? Pick the correct answer from the following options: - The patient - The attending GP - Mayo Clinic staff - not enough information
The attending GP

And once again, high blood pressure is making headlines in the news: the American Heart Association and the American College of Cardiology (AHA/ACC) have just released new guidelines about hypertension. Since this development is likely to cause confusion and concern for many, I'm writing this post to help you understand the debate and what this might mean for you and your family. By the way, if you've read any of my other blood pressure articles on this site, let me reassure you: I am not changing my clinical practice or what I recommend to others, based on the new AHA/ACC guidelines. The core principles of better blood pressure management for older adults remain the same: * Take care in how you and your doctors measure blood pressure (more on that here), * Start by aiming to get blood pressure less than 150/90 mm Hg, as recommended by these expert guidelines issued in 2017 and in 2014, * And then learn more about what are the likely benefits versus risks of aiming for more intensive BP control. Perhaps the most important thing to understand is this: treatment of high blood pressure in older adults offers "diminishing returns" as we treat BP to get lower and lower. Scientific evidence indicates that the greatest health benefit, when it comes to reducing the risk of strokes and heart attacks, is in getting systolic blood pressure from high (i.e. 160-180) down to moderate (140-150). From there, the famous SPRINT study, published in 2015, did show a further reduction in cardiovascular risk, when participants were treated to a lower systolic BP, such as a target of 120. However, this was in a carefully selected group of participants, it required taking three blood pressure medications on average, and the reduction in risk was small. As I note in my article explaining SPRINT Senior, in participants aged 75 or older, pushing to that lower goal was associated with an estimated 1-in-27 chance of avoiding a cardiovascular event. (The benefit was even smaller in adults aged 50-75.) How long did it probably take the author to read the SPRINT study? Pick the correct answer from the following options: - a few hours - a few weeks - not enough information - a few days
a few hours

While I was in training, my class was 2 months out from graduation. We were in class, reviewing skills such as antenna theory, radios and map reading. Our instructor walks in and pulls a candidate, we'll leave nameless, aside. He walks him out of the classroom. I never really thought anything of it as instructors would often pull guys aside for reviews, specific instructions or taskings. I don't know how much time passed but the candidate walked back in. He gathered his things and left the room. Guys asked if everything was cool but he didn't say a word. The instructor came in and sat on the desk at the front of the room. We asked if everything was alright, and he told us that the day prior, the The candidate's wife had gone into labor however there were complications with the baby but the complications were unknown. He was reporting to the commander to let him know whether he wanted to stay in training or leave because the military does not consider a spouse's pregnancy to be an emergency even though the complication should be. If he were to leave he would have to drop from the TACP pipeline with a possibility of either starting it over from the beginning of quitting all together. The instructor shook his head and I could honestly see it was a difficult task for him to tell the candidate. It's rare to see an instructor be emotional but it was something that brought reality into the room for us. The candidate was given 24 hours to call the hospital, talk to his wife, learn more of the situation and make a decision. He ended up staying in the pipeline and graduated. His child was born with minor complications but is healthy to this day. It may not be an exact teacher to a student scenario, but it hits pretty damn close to those of us who went through military training. The author probably believes that: Pick the correct answer from the following options: - not enough information - The instructor did not care. - The instructor is nice human being. - The instructor is indifferent.
The instructor is nice human being.

The surgeon who had delivered my son by C-section an hour earlier stepping back from the table, and saying, "We're done, people. Good job, everyone!" That hour had been hell for everyone in the room, save only my little boy, sleeping peacefully in the warming crib, and his mother, who was just stirring from the general that had put her under about 55 minutes earlier. I had come within a few minutes, maybe seconds, of raising my boy as a single parent. Her OB/GYN had fought valliently to keep my family together, and won. Everyone who'd been awake knew exactly how close run a thing it had been. Mr. Murphy had been hanging around the whole time, and neither Doc nor mom was catching a whole lot of breaks that evening. But Doc only needed one, and he made full use thereof. One thing for all new dad's whose wives have had previous abdominal surgery. You never want to hear the muttered words, "Creative anatomy on the way out", when somebody has your wife's belly open. Those are about the worst words in the world, because they mean Doc's gotta put stuff to right in there, and he might not have what he'd like in order to get it done. But when he stands back, after the sponge count had to be done twice, and the tool count is right, and the belly is stapled closed, and everyone in the room is still breathing Just let it be known that the roving nurse has extra sponges for dad's nose. Oh yeah, and the neonatal nurses don't expect dad to change that first diaper. Maconium is nasty shit. Litterally. But I was happy to do it while talking to his groggy mom. After the end of the story, the wife is probably Pick the correct answer from the following options: - not enough information - hungry - groggy - exhausted
exhausted