nooneofconsequence posted:

As far as I can tell the stricter lockdowns are yielding success so people are pretty okay with that. Like New Zealand is happy af.

Sphyre posted:

There's one active case of coronavirus in NZ.

FizFashizzle posted:

im going to make a big thread about this town here in the next couple days. my rotation is over and im on to an even MORE remote part of tennessee. Basically if you need a gallbladder removed in the next few weeks in northern central tennessee im probably going to do it.

here's a sneak peak.

go half a mile out of down town and this is what you'll see. this is not an abandoned house. the guy inside doesn't come out except to buy cigarettes from the gas station across the street. presumably he gets groceries.

he can't keep the place up anymore so nature is just kinda taking it back over. Where I am in tennessee is basically just short of being a rainforest. things grow fast here.

some day a meth head will go in to steal the copper wiring and find the body.



This is across the street from the clinic I work, just down the hill from the regional hospital that closed last year. Every morning the workers wave sandwich boards trying to get people to come in. I can't imagine it's a hard sell. the people around here are desperate.

That truck is probably worth more than the building.

It shouldn't surprise you that the nicest building in town is the funeral home. It's on the other side of the downtown.

Xaris posted:

I've never been to applachia before until a year or so ago when I did some work on a TVA project outside of Kingston/Johnson City and hoo boy i don't think i've ever seen so many fat people and diabetes billboards and help diabetes signs in every retail and restaurant before. it was kinda eye-openining from being relatively sheltered west coast only mostly been west of the 100th meridian (and new jersey).

johnson city was actually really nice tho, i wouldnt have minded living there. lots of actually good food, but the bbq sucked rear end despite the hype.

Comfy Fleece Sweater posted:

it could turn into 55 thousand if you play your cards right

I’ve been thinking about moving to NZ since the LOTR movies came out but for sure not gonna happen this year

Xaris posted:

I've never been to applachia before until a year or so ago when I did some work on a TVA project outside of Kingston/Johnson City and hoo boy i don't think i've ever seen so many fat people and diabetes billboards and help diabetes signs in every retail and restaurant before. it was kinda eye-openining from being relatively sheltered west coast only mostly been west of the 100th meridian (and new jersey).

johnson city was actually really nice tho, i wouldnt have minded living there. lots of actually good food, but the bbq sucked rear end despite the hype.

Xaris posted:

I've never been to applachia before until a year or so ago when I did some work on a TVA project outside of Kingston/Johnson City and hoo boy i don't think i've ever seen so many fat people and diabetes billboards and help diabetes signs in every retail and restaurant before. it was kinda eye-openining from being relatively sheltered west coast only mostly been west of the 100th meridian (and new jersey).

johnson city was actually really nice tho, i wouldnt have minded living there. lots of actually good food, but the bbq sucked rear end despite the hype.

SKULL.GIF posted:

The waitresses were griping because there was barely anything to do with the patio being closed (rain) and the low amount of tables.

JesustheDarkLord posted:

Who the gently caress is hyping Johnson City bbq? Go to Memphis

FizFashizzle posted:

quote:

I've never seen a diabetes amputation at the pelvis. But you'll definitely have conversations about if they need to have a foot or BTK (below the knee) amputation and it all depends on blood flow. Like i've had patients who's lower legs are bright red, hairless, and painful to the touch. They're just not getting bloodflow and there's no reason to keep the leg.

The real arguments are if you cut above or below the knee. Below has the possibility of them learning to walk with a prosthetic. Above? No dice.

cash crab posted:

i called a friend in vancouver a few hours ago and he's sitting on the beach with his sister and a few friends. he said the bars are open and people are hugging and their province is getting like four new cases a day. mine's at more than 400 a day.

i hate this

Notorious R.I.M. posted:

aaaaaAAAAAAAAAAAAAAAAAA

cash crab posted:

i called a friend in vancouver a few hours ago and he's sitting on the beach with his sister and a few friends. he said the bars are open and people are hugging and their province is getting like four new cases a day. mine's at more than 400 a day.

i hate this

SKULL.GIF posted:

can we hurry up and get to the point where poo poo gets bad enough I no longer have to pay rent

SKULL.GIF posted:

can we hurry up and get to the point where poo poo gets bad enough I no longer have to pay rent

Taintrunner posted:

some free real estate just opened up in minnesota

a bit of a fixer upper though. stinks of pig on the inside too

Chris James 2 posted:

the fact this is more likely than student loan payments getting stopped

i'm in hell and i can't escape

FacebookEmpathyMom posted:

They got stopped through September.

FacebookEmpathyMom posted:

They got stopped through September.

Xaris posted:

i guess so, i didnt get a chance to travel outside the tricities(?) area.

wanted to go to smokie mountains to see the fireflies but apparently they're all dead lol

SKULL.GIF posted:

Federally held ones, anyway

fosborb posted:

* federal

good luck if you have private student loans

fosborb posted:

favorite time in Appalachia was one summer back in the mid 90s, finding a dusty go-kart track behind a locally owned gas station with every kart self-welded out of scrap, various CCs of lawn mower engines, and absolutely zero governors, helmets or really any concern for safety at all tbh

fosborb posted:

favorite time in Appalachia was one summer back in the mid 90s, finding a dusty go-kart track behind a locally owned gas station with every kart self-welded out of scrap, various CCs of lawn mower engines, and absolutely zero governors, helmets or really any concern for safety at all tbh

Victory Position posted:

for some reason, this sounds like the stuff of one magical summer

FizFashizzle posted:

Patient today was being seen for drug refills and a "spider bite."

Spider bite in primary and emergency medicine usually means infected injection site. "Yeah, I got a spider bite there, no idea what happened." This is the reason that antibiotics are worth more than meth right now. So many people are using needles to shoot meth they're getting horrific cellulitis. Clindamycin is worth more than any drug right now.

She hasn't been seen in 3 months when she first presented with the spider bite. She has citalopram on her med list so I'm preparing myself for her to ask me for pills. She's also due for a urine drug screen. This is going to be a nightmare.

I walk in and she's a 60 yo WF in pink scrubs. "You're wearing scrubs too," I mention. "Yeah, I work for a living." She works home health as a CNA.. She's 60 but looks 80. Sounds like she's been smoking 2 packs a day since she was born.

We go through her pills, nothing crazy. Get the refills lined up. Ask her about the spider bite. "Well, I just dressed it, but if you must."

She starts unwrapping the coban from her ankle as she talks about how much she needs us to write her some more "healing cream." She starts talking about the infectious disease doctor she's seeing and how she tried to get home health to come see her because she doesn't want to go to wound care with this covid19 business but they said she can't get home health because she can't drive etc etc

she mentions a brown recluse

The coban is off and there 4x4 on her ankle. I slowly pull it off. There's a yellow thick cream she's applied to the wound. "That's the silvadyne they gave me. costs 75 bucks a bottle."

As I pull the 4x4 away, a chunk of the cream comes with it. About 1 inch by a half inch. This was the part of the cream that was in the wound. It has solidified. It's about a quarter of an inch deep.

I'm looking at her bone. This spider bite has eaten all the way down to her tibia. The flesh around is black. Necrotic.

She doesn't need wound care. She's needs a surgeon. She's needs a total debridement and skin graft.

"It hurts like hell," she says. I take off her shoe. Her toes are swollen, cold, and blue. I can barely feel a pulse. Smoking wrecks your immune response and your blood flow. Wounds don't heal. This brown recluse wound is so bad it's killing her venous return. So throw a vascular consult on it all.

"I ain't going to crossville with all this covid19"

I tell her she's going to lose her foot. Not like in the future or a few months from now but like soon. She just shrugs and tells me whatever. She refuses to quit smoking. We set her up for another consult after telling her home health will not come see her. Maybe she goes.

On the way out she asks for some free samples of breo ellipta. it's an inhaler for COPD.

The drug reps give us a bunch to pass out as samples, but we just give them out to people that can't afford their meds.

Inceltown posted:

Wondering what Murpts thoughts on the riots are?

https://twitter.com/realDonaldTrump/status/1266231100780744704

On the plus side, between this and the roni, there probably won't be a USA left for two term Trrrp

Inceltown posted:

Guess how you get 400 a day though? Hint it's all the hanging out together and touching each other.