en-us https://www.intensedebate.com/users/7985408 Comments by 26hrcharleston http://the-toast.net/2016/07/01/a-note-on-the-toast/#IDComment1025101308 Well now I'm crying. Which Toasties are working on the campaign? Fri, 1 Jul 2016 14:04:14 +0000 http://the-toast.net/2016/07/01/a-note-on-the-toast/#IDComment1025101308 http://the-toast.net/2016/07/01/the-final-link-roundup/#IDComment1025100964 Because I'm shy and a bit odd, the Toast is the only place I felt comfortable writing an occasional comment. Bless you, you wonderful (literal or figurative) queer librarians! Fri, 1 Jul 2016 13:59:21 +0000 http://the-toast.net/2016/07/01/the-final-link-roundup/#IDComment1025100964 http://the-toast.net/2016/06/02/link-roundup-583/#IDComment1022303928 As a doctor in residency, I have to say it sucks on both ends. After a long weekend, I can expect at least 3 hours of unpaid paper-pushing work (in addition to the constant stream of paperwork). I shudder to think of how much time I spend on hold every day as well; it once took a full 25 min to call in a new Rx and cancel the old one. I wish we weren't hamstrung by HIPAA restrictions that strongly discourage email communication of private health information (at least without expensive servers/software that are difficult for small clinic practitioners to have). I was playing phone tag with a patient the other day, and we were both frustrated we kept missing each other. In summary, the American healthcare system is the pits. Let's all move to Sweden. Thu, 2 Jun 2016 13:33:01 +0000 http://the-toast.net/2016/06/02/link-roundup-583/#IDComment1022303928 http://the-toast.net/2016/05/13/we-are-closing-the-toast-july-1st/#IDComment1021003231 Will I still somehow get Sansa pictures on a regular basis? Fri, 13 May 2016 13:15:43 +0000 http://the-toast.net/2016/05/13/we-are-closing-the-toast-july-1st/#IDComment1021003231 https://the-toast.net/2016/04/07/link-roundup-547/#IDComment1018628632 My uncle sounds exactly like Gable, and he (Clark) was notorious for having bad breath so... nah. But he was a charmer for sure! Thu, 7 Apr 2016 19:49:38 +0000 https://the-toast.net/2016/04/07/link-roundup-547/#IDComment1018628632 https://the-toast.net/2016/04/07/link-roundup-547/#IDComment1018628381 I have to say my G-Peck lady boner died with Cape Fear. He was so... impotent. Thu, 7 Apr 2016 19:46:18 +0000 https://the-toast.net/2016/04/07/link-roundup-547/#IDComment1018628381 https://the-toast.net/2016/04/07/link-roundup-547/#IDComment1018628257 Grace Kelly: The Secret Life of a Princess is the one I read. Thu, 7 Apr 2016 19:44:49 +0000 https://the-toast.net/2016/04/07/link-roundup-547/#IDComment1018628257 https://the-toast.net/2016/04/07/link-roundup-547/#IDComment1018605905 I've read that Grace Kelly bio! 1) Her dad was a dick. 2) Clark Gable spurning her is like the real life version of her infuriating relationship with Jimmy Stewart in Rear Window ("A got young thing is throwing herself at me? How loathesome! "). Thu, 7 Apr 2016 13:56:08 +0000 https://the-toast.net/2016/04/07/link-roundup-547/#IDComment1018605905 http://the-toast.net/2016/03/24/link-roundup-538/#IDComment1017409690 I'm sorry that happened to you. You're right - [the vast majority of] doctors do their best, and terrible things still happen unexpectedly. It's the nature of the field. I'm still wrapping my head around it as a relatively new doc. I have a tender heart that just wants everyone to feel better, but it doesn't always work out for a variety of reasons. The best we can do is be thoughtful and go with the available information. Thu, 24 Mar 2016 18:09:07 +0000 http://the-toast.net/2016/03/24/link-roundup-538/#IDComment1017409690 http://the-toast.net/2016/03/24/link-roundup-538/#IDComment1017404075 Absolutely. Look at C-section scars, hysterectomies - it's amazing. Thu, 24 Mar 2016 16:50:31 +0000 http://the-toast.net/2016/03/24/link-roundup-538/#IDComment1017404075 http://the-toast.net/2016/03/24/link-roundup-538/#IDComment1017403573 Proving something in medicine is often invasive and carries significant risks. The best we can do is evaluate the signs and symptoms, consider FHx/genetic risk, discuss the procedures/alternatives/risks of the options, and move forward in a way that balances patient preference with the lowest risk option for the individual. If every mass was considered cancer until "proven" otherwise, there would be lots of unnecessary biopsies. Moreover, biopsy carries the risk of spreading cancer via seeding. Do we favor surgical removal of all masses over biopsy because of that risk? Do we change to riskier methods when there is a rare adverse outcome? We can only do the best we have with the tools we have, and hope that better technology gets developed. The gyn onc walked through every study the FDA included in their warning. I can only remember the most egregiously poor quality studies included, but there were also studies that were looking at different scenarios and outcome measures than what they were commenting upon. It was not appropriate to include them. Thu, 24 Mar 2016 16:42:33 +0000 http://the-toast.net/2016/03/24/link-roundup-538/#IDComment1017403573 http://the-toast.net/2016/03/24/link-roundup-538/#IDComment1017393696 In conclusion, surgery is barbaric, and future doctors will look back on us and wonder how we ever did any of this to our patients. Thu, 24 Mar 2016 15:00:52 +0000 http://the-toast.net/2016/03/24/link-roundup-538/#IDComment1017393696 http://the-toast.net/2016/03/24/link-roundup-538/#IDComment1017393277 The morcellation story... I'm a PCP specializing in women's health, so naturally I read it and was shocked and outraged. Conveniently, a local oncology group have a talk a few weeks later, and a gyn onc addressed this subject. First, the "studies" the FDA used to justify discouraging the use of morcellation were astonishingly bad. Like, one of them involved a male (!!??) study subject and many poorly defined what was being studied. If you threw out the ones that were not directly about morcellation in women without suspected malignancy, the research showed morcellation saves lives. That's because the alternative surgery involves large incisions (with morcellation, you can do it transvaginal or with much smaller incisions). This doc totally changed my mind. The specific stories of bad outcomes are really sad, but bad outcomes are a risk of any surgery. Morcellation allows for a safer and less invasive surgery, and it is ultimately safer for women without any reason to suspect malignancy. Thu, 24 Mar 2016 14:54:35 +0000 http://the-toast.net/2016/03/24/link-roundup-538/#IDComment1017393277 https://the-toast.net/2016/03/18/link-roundup-534/#IDComment1016921027 I wish I could say that! Unfortunately, she's a very toxic person, so I think it's better if she thinks I'm a dull conversationalist. Fri, 18 Mar 2016 18:18:31 +0000 https://the-toast.net/2016/03/18/link-roundup-534/#IDComment1016921027 https://the-toast.net/2016/03/18/link-roundup-534/#IDComment1016902652 1) Steve and I have the same birthday. Happy birthday to us! 2) It seems like a lot of Prudie's job is confirming that people are petulant/terrible. I have a co-worker who refers to people who are homeless as "transients," and her voice is so full of venom that it sounds like a horrible slur (not that it's a good thing to say even sans venom). She somehow has not noticed I respond to her rants with a neutral face, total lack of minimal encouragers, and absolute silence. :/ Fri, 18 Mar 2016 13:53:02 +0000 https://the-toast.net/2016/03/18/link-roundup-534/#IDComment1016902652 http://the-toast.net/2016/03/15/how-do-you-handle-jet-lag/#IDComment1016661455 Tap into your divine inner sleep warrior. It is absolutely possible to sleep 8 hours during the day, eat a light dinner, and sleep 8 hours again. Alternatively, there's that fasting thing the CIA and Mormon Tabernacle Choir do, but it's too late for such measures. Tue, 15 Mar 2016 19:44:04 +0000 http://the-toast.net/2016/03/15/how-do-you-handle-jet-lag/#IDComment1016661455 http://the-toast.net/2016/01/29/cocktail-hour-open-thread-96/#IDComment1011626037 Thank you! Sun, 31 Jan 2016 00:45:19 +0000 http://the-toast.net/2016/01/29/cocktail-hour-open-thread-96/#IDComment1011626037 http://the-toast.net/2016/01/29/cocktail-hour-open-thread-96/#IDComment1011623980 Did Nicole ever share what breed her (achingly adorable) puppy is? My parent's dog died unexpectedly this week, and the [responsible Canadian] breeder they worked with before is now a dog physical therapist instead. They love big, long-haired dogs, and the daily Sansa pictures make my heart swell with joy. Sun, 31 Jan 2016 00:03:27 +0000 http://the-toast.net/2016/01/29/cocktail-hour-open-thread-96/#IDComment1011623980 http://the-toast.net/2016/01/26/great-lines-from-donal-logues-wikipedia-page/#IDComment1011223093 He has a recurring cameo on SVU now. I'll take the Logue I can get. Tue, 26 Jan 2016 21:03:51 +0000 http://the-toast.net/2016/01/26/great-lines-from-donal-logues-wikipedia-page/#IDComment1011223093 http://the-toast.net/2016/01/25/link-roundup-497/#IDComment1011098841 The polyphasic sleep thing makes me want to tear my hair out. Deep sleep is so important for cognitive function, and appropriate melatonin levels/circadian rhythms may play a role in overall survival. Also, I'm annoyed my ex tried it when we were dating. He decided to get edgy and weird with his sleep, and all I could do was roll my eyes with the force of my entire soul. Mon, 25 Jan 2016 14:18:15 +0000 http://the-toast.net/2016/01/25/link-roundup-497/#IDComment1011098841