Shows the Silver Award... and that's it.

  1. You may find some of the youtube grand round videos on this helpful.

  2. I’ve had a small cyst in a side branch duct in the tail of my pancreas for four years now. When it was first discovered I made an appointment to see a surgical oncologist to formulate a plan of surveillance and frequency. IPMN’s in non-communicating branch ducts are generally benign. The protocol for cysts that are in non-communicating branch ducts that are under 3 cm is to watch them. If they grow to 3 cm, then there is a risk of blocking a duct leading to symptoms of pancreatitis. A surgeon will make a determination at that point on intervention. In the meantime, it is nothing to have worry about. As mod/ddessert suggests, contact PanCan.org to obtain names of medical centers with a pancreas program in your region as well as names of surgical oncologists who specialize in IPMN’s. My personal opinion is a surgical oncologist in a pancreas center of a large medical center will have more knowledge and experience in managing IPMN’s than a GI specialist.

  3. I have one that's growing and now communicating with the main duct although it's just 1.5cm. I get a yearly MRI bc I have tumors everywhere but so far no cancer. This is the first growth to make a move so to speak. Is this when I should be getting established with specialists and getting second opinions or should I wait for the 6 month mrcp the gi ordered? There's no info on when it's small but growing...not even in the decision tree charts they have for these.

  4. Have a close friend who was diagnosed with this. Lucky for her, her family was pretty wealthy. After years and years of doctors she was finally diagnosed with a mitochondrial disease. I realize this condition has a lot of causes but it's an interesting possibility for some people.

  5. Makes you wonder if genetic testing might be useful to find those with cfs who actually have a known mitochondria disease.

  6. a medical fatigue is different from a fatigue after a long day at work. it is muscles that can't or won't or don't want to move, a brain that doesn't process like it should, a complete lack of stamina for every day activities.

  7. Yes. You don't have a choice.

  8. Michigan has the latitude for wine. Amazing cherries. Amazing beaches...it's like a freshwater California up north.

  9. It is exactly what I thought it will be like: After 7 months of not being able to provide it's standing army on the battle field and losing a ton of its heavy equipment, who would have thought that russia will not be able to train and equipt 300.000 or more men?

  10. Not even spears. Just random sticks and some stones.

  11. What grows well for you? Lean into that.

  12. I mean, there is still candy on the shelves but it's pretty thin and hard to find certain things in some places.

  13. Low on chocolate bars. Empty spots in shelves. I had to go digging to find one snack size bag.

  14. I called this one. Lots of people think it will only affect poorer countries, but conveniently forget a huge chunk of Americans were living paycheck to paycheck even before the uptick in food prices. There maybe food on the shelves but less people will be able to afford it.

  15. And our crop yields are down too. But people are stubbornly clinging to American exceptionalism as if our droughts are magically different.

  16. I think you misunderstand the point. The US is a LARGE scale food exporter, it would take a truly prolonged national catastrophe to get to a point of actual famine here. Even with regional droughts and other problems, on a national scale there is still buffer, yields are no where near the point of domestically being insufficient. Food can definitely get more expensive, because right now we have some of the cheapest costs for food in the world. The inputs cost more so that is almost inevitable. Even more likely is a poorer selection with decreasing quality.

  17. You know other countries export food too right? And their crop shortages are somehow going to starve the world yet our shortages are totally fine?

  18. Build a lot of things. Do a lot of diy. There's a book I found that fits this. I'll go dig up the title. Brb.

  19. This one. Survival Hacks: Over 200 Ways to Use Everyday Items for Wilderness Survival

  20. Newsweek has an article on the rumors so they are serious enough for some fringe media reporting. Definitely something to keep an eye on.

  21. You can try counting calories and exercise but ime at some point the dose has to go up.

  22. Yes. I do need to exercise more but it's not easy with the fatigue. Counting calories is not my thing but I should try. Thanks!

  23. I got suuuuuper strict on calories and exercise and still couldn't break my stall. I went 8 months busting my ass and I just really needed a higher dose.

  24. Cleaning. Mulching. Collecting seeds. Laying weed barrier. Prepping a new bed to let the hay mulch compost breakdown over the winter.

  25. Hot dogs in a slow cooker and a lot of fun toppings?

  26. Robot hoover (I got a very basic model), still gotta tidy before but then it just does it’s thing. An automatic mop, I basically never mopped before this now it’s fun, aircraft powerglide cordless mop, I love it. Now I have more spoons left for kitchen tasks

  27. I have a roomba actually! It’s great for the floors most of the time, stairs are the only thing that I still need to vacuum manually. It’s mainly chores that require standing still that I can’t tolerate well

  28. Roombas are great but finicky sometimes. Mine apparently didn't charge before it's next run and died two feet from the dock.

  29. Imo yes. I was just at the Dr discussing this for one of my teens this week and this looks like their pronation.

  30. As someone who has had to eat a very restricted diet... eventually you'll feel the lack of the micronutrients and protein. There's a point at which you need real food.

  31. He might use tactical nukes in Ukraine but I don't think he would use nukes against NATO. Even if he was terminally ill, he has family and friends he cares about and nuking a NATO country means everyone he cares about and millions of his countrymen and women would die as well. Like someone else mentioned, not much we can do about it if it does go down. No need to get too worried.

  32. I'm not convinced he's capable of caring about anyone. If he nukes or if he doesn't it's bc it feeds his delusions of power. That's it.

  33. Part of the math I've been doing is realizing the scale of increase means people won't be able to economize their way out of it.

  34. Here in Europe prices went up for electricity by 100-300%. The governments put a cap on price per kWh, then compensated from the public coffers the energy companies the difference.

  35. My area will be at 100% increase this winter. It's not just Europe. A lot of the US reporting is ignoring the increases that hit last year. These are year on year increases of 50% in many places.

  36. Yes. I have actually starved due to medical issues and often found myself unable to eat as planned.

  37. I was thinking there's no way this conflict doesn't end with nukes. The 100k troops already sent have failed, how do 300k conscripts change the balance of power against a trained, well equipped army with a perpetual source of funding and advanced military tech, not forgetting they're now spiritually driven to defend their homeland? Even if Russia through some fluke took Ukraine there's no way they could hold it. The best they could hope for us to annex Donbas or for Putin to get some Napoleon style off ramp. If neither of these things happen, I can see nukes being used to drag the rest of the world down with Putin/Russia. The most galling, outrageous thing is that it would be so utterly fucking stupid and pointless.

  38. If we get lucky something happens to remove Putin. I could see a special force of Ukrainians infiltrating Russia to remove him.

  39. This makes me so sad. My one exchange student is from Siberia and I don't want them to be nuked bc Putin is a megalomaniac dumbass.

  40. I believe that most of these surgeries and interventional methods are placebo. Everyone in my FB chronic pain groups has these done and has to get them repeated every 3 to 5 years. Hundreds of people over the years and they all say they feel worse, their meds don't help either but they keep listening to these doctors and take them. There's a reason they call it ' Practicing Medicine'.

  41. I do know people who've had good outcomes with fusions. I've had spine surgery as well although not a fusion with a good outcome.

  42. Hrm. The odd thing is ime Advil is contraindicated for spine fusion surgery for up to a year.

  43. Druiddawn? It's rpg where you get stuff for writing. Very supportive environment and loads of fun.

  44. Ime peds are quick to prescribe for respiratory issues because children's airways are much smaller and become critical much faster so peds don't play. Respiratory issues in children can become life-threatening very quickly. My kiddos got them too for bronchiolitis when they were little. Don't need them now.

  45. Yes, im russian. Officially you still can leave the country unless you have the call-in (i dont know the english word for it) from recruitment centre. But i’ve heard that males 18-65 y.o. can’t buy tickets yet. Plus, tickets prices just skyrocketed (yesterday you could buy plane ticket to Armenia for $150, today it is something like $2k)

  46. Dress as a woman. Use a female relative's passport. Turn yourself in to the Ukrainian embassy once you're out of the country.

  47. TL:DR Expect your heating bill to go up if I’m interpreting right

  48. It's going to be worse than that. Our gas bill already doubled last year and we're being told it will double again this year.

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