Central texas colon and rectal surgeons

We have been living in a rent house in TX for the last year and a half, and the property is owned by a major corp property management company. They are trying to evict us for not being able to pay rent on time, but the reason we are unable to pay is we had to buy 4 window ac units because they straight up refuse to fix the central a/c in the house. We have been dealing with issues the entire time we have lived here, but trying to survive the Texas heat without any kind of a/c was not something we could just roll over and take. In addition to this, we have had multiple electricians tell us that the wiring in this house is not up to code, the foundation is giving out, as it is basically just a double wide trailer placed on pier and beam 40+ years ago, and there is water sitting stagnant in the crawl space causing mold to grow in our walls and making the foundation issues worse. They keep dodging our questions about these issues to ask us why we haven't taken down the trampoline our kids got from their grandparents for Christmas (it does technically violate the lease, I checked, but my wife and I both work 60+ hours a week and I haven't had the time to take it down, nor the heart to take it away from the kids) any advice/help would be appreciated, we go to court next Tuesday.

Week 1

Time	FOX	FS1	BTN	CBS	CBSSN	NBC
Early Day	COL @ TCU	USU @ IOWA	FRESNO @ PUR		BGSU @ LIBERTY
Late Day	RICE @ TEXAS	BUF @ WISC	TOW @ UMD	OH ST @ IU	USF @ WKU	TEN ST @ ND
Early Night		UTSA @ HOU	TOL @ ILL	TTU @ WYO	WSU @ CSU	WVU @ PSU
Late Night		SHSU @ BYU			ID ST @ SDSU

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Time	ABC	ESPN	ESPNU	SECN	ACCN	P12N
Early Day	UVA vs TENN	ARK ST @ OKLA	LA TECH @ SMU	BALL @ UK	NIU @ BC
Late Day	BOISE @ WASH	UMASS @ AUB	CAL @ UNT	SE LA @ MISS ST	WOF @ PITT	POR ST @ ORE
Early Night	UNC vs SC	UNM @ TX AM	S. ALA @ TULANE	MTSU @ BAMA	ODU @ VT	NEV @ USC
Late Night		CC @ UCLA				N. AZ @ AZ

- This is just the Saturday schedule. It does not include the multitude of games scheduled on that Thursday, Friday, Sunday, or Monday.
- Some of the biggest games being broadcast outside of Saturday include: Nebraska @ Minnesota, Florida @ Utah, Kent State @ UCF, Louisville vs. Georgia Tech, Northwestern @ Rutgers, Oregon State @ San Jose State, LSU vs. Florida State, and Clemson @ Duke
- There are more streaming only games now than ever before. Every SEC team going forward has to have 1 game on ESPN+, and Peacock has the exclusive rights to 8 Big 10 home games plus 1 Notre Dame game a season.
- The first Saturday sees streaming exclusive games like: ECU @ Michigan, Mercer @ Ole Miss, UNI @ Iowa State, Colgate @ Syracuse, West Carolina @ Arkansas, UT Martin @ Georgia, Southeast Missouri @ Kansas State, Eastern Kentucky @ Cincinnati, Texas State @ Baylor, and Central Arkansas @ Oklahoma State.
- A big reason why so many of these games are going to streaming in Week 1 is that ESPN2 will only be broadcasting the US Open during this weekend.
- CBS is going to have an insane schedule this year. They are balancing the SEC's #1 games for the final season with 7 Big 10 games across the season, as well as the Mountain West's #1 games as well. This in-between year might create a big of confusion and less consistency in 2023 as to what games are where.
Week 2

Time	FOX	FS1	BTN	CBS	CBSSN	NBC
Early Day	NEB @ COL	TROY @ KSU	YT ST @ OH ST		DEL ST @ ARMY
Late Day	IOWA @ ISU		RICH @ MSU / UTEP @ NW	UNLV @ MICH	WAG @ NAVY
Early Night	ORE @ TTU	UCF @ BOISE	TEMP @ RUT / EMU @ MINN	UCLA @ SDSU	AFA @ SHSU	CHAR @ UMD
Late Night	STAN @ USC	OK ST @ AZ ST

​

Time	ABC	ESPN	ESPN2	ESPNU	SECN	ACCN	P12N
Early Day	ND @ NC ST	UTAH @ BAY	PUR @ VT	JMU @ UVA	BALL @ UGA	VAN @ WF
Late Day	TX AM @ MIA		MISS @ TUL		KNT ST @ ARK	C-SO @ CLEM
Early Night	WIC @ WSU	TEX @ BAMA		MCN @ FLA	AZ @ MS ST	APP @ UNC	TULSA @ UW
Late Night		AUB @ CAL				S-MISS @ FSU	UCD @ OR ST

- Streaming exclusive games this week include: Delaware @ Penn State, Holy Cross @ Boston College, SC State @ Georgia Tech, Eastern Kentucky @ Kentucky, SMU @ Oklahoma, Duquesne @ West Virginia, Lafayette @ Duke, Middle Tennessee @ Missouri, Grambling State @ LSU, Furman @ South Carolina, Nicholls State @ TCU, Southern Utah @ BYU, and Austin Peay @ Tennessee
- ESPN's late afternoon Saturday window is booked by the Women's US Open Final
- There are still a few games which do not have times set including: Illinois @ Kansas, Cincinnati @ Pittsburgh, Western Michigan @ Syracuse and Houston @ Rice. You would assume a few of those end up in the open ESPN2/ESPNU slots. There is also a slot reserved for a game on ESPN Friday Night that has yet to be filled.
Week 3

Time	FOX	FS1	BTN	CBS	CBSSN	NBC
Early Day	PSU @ ILL	N DAK @ BOISE	GA SOU @ WISC / LOU vs IND		LIBERTY @ BUFF
Late Day	WKU @ OH ST	SDSU @ OR ST	VT @ RUT / WMU @ IOWA	S CAR @ UGA	FIU @ UCONN
Early Night	TCU @ HOU	NIU @ NEB	BGSU @ MICH		VAN @ UNLV	SYR @ PUR
Late Night		FRESNO @ AZ ST			KAN @ NEV

​

Time	ABC	ESPN	ESPN2	ESPNU	SECN	ACCN	P12N
Early Day	FSU @ BC	LSU @ MS ST	ISU @ OH / WF @ ODU	ISU @ OH / WF @ ODU	KSU @ MIZZ		WEB ST @ UTAH
Late Day	BAMA @ USF	OU @ TULSA / MINN @ UNC	OU @ TULSA / MINN @ UNC	TUL @ S-MISS	ULM @ TX AM	NW @ DUKE	ID @ CAL / N. COL @ WSU / UNCC @ UCLA
Early Night	PITT @ WVU	TENN @ FLA	BYU @ ARK	AKR @ UK	GT @ MISS	FAU @ CLEM	HAW @ ORE / SAC @ STAN
Late Night		COL ST @ COL					UTEP @ AZ

- Streaming exclusive games this week include: Washington @ Michigan State, LIU @ Baylor, South Alabama @ Oklahoma State, Tarleton State @ Texas Tech, Samford @ Auburn, Miami (Ohio) @ Cincinnati, and Villanova @ UCF.
- The only game which has yet to have a time announced is VMI @ NC State, which likely could fill in the early window on ACC Network.
- Wyoming @ Texas is being broadcast on the Longhorn Network

Demographics
Gender: Female
Race/Ethnicity: Asian
Residence: International (Korean studying in England)
Income Bracket: 200k+
Type of School: British Private International
Intended Major(s): Computer Science
​
Academics
A-levels: Maths (Took in Year 12 and retaking. Just to let you know British education is 13 years), CS, Chemistry (+ EPQ). Predicted A*A* A* (+ A*)
AS levels (max A): CS A, Chem A
IGCSE(A*-U): Maths, Additional Maths, Chem, English as Second language, Bio, Physics - A*s except for the last two, which are As
GCSE(9-U): Business Studies, Psychology - 9s
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Standardized Testing
SAT: 1500 (Math 800 English 700)
Other (ex. IELTS, TOEFL, etc.):
IELTS overall 8.0 (Listening 9.0, Reading 8.0, Writing 7.0, Speaking 7.5) but I don't think this really affected me in any way since it should be expired by the time I am enrolling
Duolingo overall 145 (Literacy 155, Comprehension 150, Conversation 130, Production 140) - took this because my IELTS was invalid
​
Extracurriculars/Activities
(From here I will write the grades converted to the US system)
#1 Young Business Enterprise - student programme that students form a group and run their own company. Won regional runner-up. (Year 10)
#2 School Glee Club, but more like singing and dancing for school events such as Halloween and Christmas. (Year 11-12)
#3 Volunteered over Zoom to help Ukrainian students improve their English speaking. Had two students doing weekly. (Year 10-11)
#4 Regional volunteering centre that pairs up with a student with disability to become buddies. Went over to her house weekly and helped her and became her buddy. (Year 11)
#5 Internship(non-paid) at an online shopping mall (well-known in the Pan Asian area) over the summer for about a week. Technology department. (Year 11)
#6 Head of IT for a school club that produces blog posts, podcasts and Instagram posts for topics that we are interested in. (Year 11-12)
#7 Ritangle competition. Maths competition that students form a team and solve maths problems weekly during the competition period, and the team that solves the last challenge will be considered for an award. Was the leader for this, and we reached the last stage. (Year 11, but did same thing in Year 10 too)
#8 Charity activity/competition. Find ways to get funding and we donate the profit to the organisation. Was leader for this, and we won winner - entrepreneurship. (Year 11)
#9 School club run for charity for mental health. Creates podcasts and runs fundraising events. Edited podcasts and was an active member. (Year 11)
#10 School club that produces articles every month/two months on your own, in a topic that you are interested in. Articles go up on the club's dedicated website. (Year 10-12)
#11 MUN held nationally by a high school. (Year 10)
#12 MUN held nationally by the University of Oxford (Year 10)
#13 Global Space Design Challenge. Leader of a team consisting of about 25-30 students and created a design of a living craft to be used to settle people on Venus.
#14 UK Space Design Challenge. Created a video to explain our design of a spacecraft. (Year 10). I was invited by the school to participate in the regional heat. (Year 11)
#15 Mock Trial Club (back in my home country, Year 9)
#16 Debating Club (Year 11)
(these are written based on my UC application. It was very similar to Common App too)
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Awards/Honors
#1 British Maths Olympiad Round 1 Certificate of Participation - Can participate if you rank in Top 1000 nationally
#2 UKMT Senior Maths Challenge - Gold * 2 (Year 11 and 12. The one that I got during Year 11 qualified me for the olympiad I mentioned above, scoring 115/125), Silver * 1 (Year 10)
#3 National Cipher Challenge. Each week we solve a cipher and earn points. We were 3rd place nationally.
#4 School award - most merit points. One person per year group gets it but for that year, I had the most amongst the school. (Year 10)
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Letters of Recommendation
Counselor: Our head of education. I don't really have a lot of personal connections with her but I think she should have wrote it nicely and well. (7-8/10).But for my mid-year report, I think it was quite messed up due to hard exams + high in-school grade boundaries. She also converted A-level grades to GPA, which I don't even know how she did it and why she did it. Hence I think the GPA must have been lower than what I should be getting if they were put as A-level grades. I am assuming this and the mid-year report might have done something like acceptance -> waitlist or waitlist -> rejection. This happened to someone in our school.
Teacher 1: My maths teacher. He is a very professional, friendly, nice and just a fantastic teacher. One of the best teachers I've ever seen. I do well in his class and I had some sessions with him for my UK application before I started my maths lessons, so I assume I am pretty close to him and he is really nice to me as well. (10/10)
Teacher 2: My English teacher for my GCSE year and my EPQ teacher. She is a lovely person in general. I wouldn't say I am particularly close to her but she is really kind and she was happy to write a recommendation when I asked her. (8-9/10)
Other: CS professor back in my home country. I had personal sessions with him to get introduced to projects that are done in his university (and led by him), had a chance to evaluate these and wrote my own code based on this. He knows me quite well and he is a very nice person as well, and also very professional. (9-10/10)
​
Interviews
UPenn - alumni interview. It was more of a session to learn more about UPenn and the interviewer to learn more about me. The interviewer was really really nice and chill too. I just enjoyed the time speaking to him, he was just amazing.
Cornell - alumni. This is just to ask questions about Cornell. More of a Q&A than the UPenn one. Again, the interviewer was so nice and lovely, and she was just amazing. Both of my interviews had really good interviewers.
​
Essays
The quality of the words or fluency was good in my opinion, but thinking back I think some essays that I wrote might have been too general. I literally didn't know how to write them properly, and I didn't have a lot of feedback until mid-December. So my U Washington Seattle essay was actually so bad (idek why I submitted it), and my UC essay was worse than my Common App essays in general.
For the personal statement essay, I wrote about my challenges and how I overcame them. I think this was a good essay in my opinion. Compared to my other essays, I think was not generic at all.
Honestly, I don't really know how to comment about essays since we do it in a different way in the UK and their writing styles are completely different. Hence I cannot comment too much about if this is a good essay or a bad essay, but overall I think some might have been too generic.
I tried to look into every aspect of their college websites and write stuff, but I don't know how many students do this.
​
Decisions (indicate ED/EA/REA/SCEA/RD)
I will separate these into US and non-US, as my 1st choice is not a US university.
​
US
Acceptances:
UC San Diego (RA) - Math + CS (second choice major) -> committed but second choice; see below
------ below this I applied because I was getting rejected from a lot of universities so I applied to those around like March because my parents were worried about me not getting into any uni ---------
Arizona State University (RA) - CS + $14,500 per term scholarship
University of Arizona (RA) - CS + $22,000 per year scholarship
University of Texas Dallas (RA) - CS
University of Utah (RA) - CS
Iowa State University (RA) - CS + $12,000 per year Presidential Scholarship + $2,000 per year LAS Excellence Scholarship
Oregon State University (RA) - CS + $12,000 per year Europe and Central Asia Award Scholarship, Offered Honors College (if admitted free, which is $1,500 per year)
University of Washington - Bothell (RA) - CS
University of Michigan - Flint (RA) - CS + $14,000 per year True Blue Scholarship (First-year Merit Scholarship)
University of Michigan - Dearborn (RA) - CS + $12,500 per year scholarship
Waitlists:
Georgia Tech (RA) - CS -> Rejected
NYU (RA) - Tandon CS -> Rejected (they are saying their process is not over yet, but their incoming first-year class is full and it is unlikely to change)
U Michigan - Ann Arbor (RA) - CS -> Waiting (but at this point, I think I'm rejected)
Rejections:
Carnegie Mellon University (RA) - CS
UC Berkeley (RA) - CS
Cornell University (RA) - CS
University of Washington - Seattle (RA) - CS
UCLA (RA) - CS
UIUC (RA) - CS
UPenn (RA) - CS
USC (RA) - CS
UC Irvine (RA) - CS
University of Washington - Tacoma (RA) - CS
​
Non-US
Acceptances:
University College London, United Kingdom - CS(G400) -> firm choice and 1st choice (conditional offer A* A* A, A* required in maths)
The University of Edinburgh, United Kingdom - CS(G401) -> declined (conditional offer 3A*)
The University of Waterloo, Canada - Math Co-op
​
Rejections:
Korean Advanced Institute of Science and Technology (KAIST), South Korea- CS
King's College London, United Kingdom - CS
University of Warwick, United Kingdom - CS
University of St Andrews, United Kingdom - CS
​
​
Considering I didn't know too much about how to write a good essay + our school didn't even give that much support for US applications + I didn't do a lot of stuff for ECs because I didn't know I would apply to the US, maybe it is not a bad outcome and expected outcome anyway.
But yeah, depending on whether I meet my conditions for UCL, I would end up either in London or San Diego.
What I learnt: well, CS is really tough, especially in the US, and especially as an international.
Hope everything goes well for everyone who reads this, and fingers crossed & good luck to those who have A-level exams remaining just like me :)

Public opinion of TriMet's decisions have been pretty mixed, mostly because TriMet's decisions are so convoluted that they can be a real challenge to understand. In reality, Metro and Portlanders need to have a bigger civic conversation about the future of TriMet, looking at the big picture. We have 3 looming existential crises of TriMet to be concerned about that are bigger than revenue dips, crime, or homeless people.
Civic leaders and the public are focused on a quick "fix" for TriMet revenue drops - even though we've seen this coming for a long time, it's very predictable that TriMet's Board of Directors acts at the last minute. Also, very predictably, TriMet's Board opted for a fare increase because over the previous 20 years that's been a go-to answer to every problem (except for that one time they killed Fareless Square). The politically appointed boards of TriMet and Metro lack the unique specialized knowledge of the issues I'll bring up here. If TriMet knows about these larger issues, they're obviously burring it from public view. In the short term, increasing fares is like putting fresh paint on a house that's on fire; in this situation, that paint is HIGHLY flammable.
First - fare hikes as a tactic is a brain-dead move. Just the most utterly stupid and self-sabotaging response to a looming budget shortfall. I'm dwelling on this because it illustrates their terrible decision-making, which is functional proof they have no idea what they're doing. Some of the core reasons for this:

• Increasing fares reduces utilization. Higher cost means fewer people ride, which will decrease the ridership revenue. It will also marginally increase the number of people who won't pay (funny story, some of those who don't pay actually can't afford to). TriMet isn't a monopoly or inelastic service, and plenty of other choices exist that didn't exist 20 years ago: an actual bike share, scooters, electric bikes, UbeLyft, shared vehicles, and more bike paths. Before the pandemic, it was common that I would bus into downtown for work and then take a Lyft home because it wasn't all that expensive, like $8 more than a bus ride - TriMet's price increases make a system that wasn't very competitive simply less compelling.
  
• Across Portland we need to go through a process of austerity and downsizing government. I absolutely support Wheeler putting a pause on rate increases, but for God's sake, we have far too much largesse in every layer of government. If you need to learn what I'm talking about, read my old article on Parks & Rec. So many divisions/agencies have doubled their staff while reducing service levels. It's bonkers. Cutting throats needs to be an imperative. This is because the great majority of public sector employees in Oregon and Portland are incompetent, redundant, and only exist because Oregon and Portland have been reluctant to use automation. And I don't mean the cutting-edge AI stuff, I'm talking about people who still handle business processes as if they're paper forms. I could tell so many stories from my professional experience - but you'll have to take my word for it for now: culling this bureaucracy is the right move, and until there's a significant downsizing, the political class is taking none of the financial crisis or cost of living situation seriously.
  
• TriMet's operating budget/revenue is primarily Payroll Taxes, not passenger revenue. About 20-30% of TriMet's budget comes from people buying fares, whereas the bulk of money TriMet needs comes from payroll taxes that businesses pay directly. Because of this, transit activists (including myself) have been proponents of increasing the payroll taxes marginally to make TriMet free for riders. Of course, fareless transit comes with a wide variety of new and different problems (that's an article for another time). Still, when you understand that only a sliver of revenue comes from fares, increasing the fare simply results in a marginal increase in revenue. The much bigger problem is going to businesses investing outside of Metro, and changing workforces that 1) won't pay payroll taxes reliably, 2) don't need people to go into the office. Think about the longer-term game here: is TriMet's board going to increase fares as utilization drops and payroll taxes continually diminish? (See my point above about how their default answer is "yes" because it's the only politically expedient answer.)
  

Reading comments about the fare hikes, most of the public thinks TriMet is dealing with a safety or utilization issue. Both of these are 100% true: soft-on-crime progressives have wholly obliterated the working class perception of TriMet safety - there are so many different ways this has happened, but we should thank so many people in the media and political class: Ana del Rocio's crying wolf about racism in fare inspections (and the media entertaining it), or Mike Schmidt deinstitutionalizing of the justice system, or Legislature's inability to act on the massive mental health crisis and drug addiction crisis in Oregon. No matter the underlying cause, we have a system where deranged violent mentally ill tweakers can be disruptive on the train, but working-class people face a $250 fine if they can't afford a $2.50 ($2.80) ticket. TriMet is less safe, especially the light rail and bus lines. We could hypothetically talk about various policy and infrastructure changes, such as turnstiles and security guards - but pragmatically, this won't do shit when our society has adopted a philosophy of transforming the urban core into an open-air insane asylum and opened the doors to the prisons. This safety issue is well beyond TriMet's scope, and even if there was consensus among TriMet and Metro to solve this, the entire justice system and Legislature is still broken.

Fare Hikes and Utilization is the Red Herring - Let's talk about TriMet's future

In reality, multiple design choices made decades ago set us up for failure. But we also have to thank brain-dead progressive lunatics and corrupt politicos who have steered our transit decision-making into the ground.
There are three specific issues I'm going to talk about, with each becoming more consequential and disastrous for TriMet:

• Hub and Spoke Design and the need for a redesign of the entire system to fit new commuting/transit patterns
  
• Portland Light Rail's short cars are a capacity problem not worth the price tag to fix
  
• Autonomous vehicles are here, and it's just going to get worse for TriMet
  

The strategic design of TriMet's system is broken, and it's been broken before.

If you looked at a map of TriMet's bus and rail system, you'd see a design pattern often referred to as a "Radial Design" or sometimes a "Hub And Spoke" design. The Hub and Spoke strategy is building our transit system around centralized locations to connect to other routes. For Portland the idea is to go downtown (or sometimes a Park and Ride) where you can connect to your next destination. This is why the majority of bus routes and all the max routes go downtown, to our Transit Mall and Pioneer Square.
Downtown planning was a smart idea in the 1960s when it was coupled with Main Street economic theory and prototype urban development zones - all of this wrapped up in the 1972 Downtown Plan policy. During these decades, the primary economic idea of urban revitalization was that downtown cores could provide better business climates and shopping districts that amplify economic activity synergistically. In other words, packing all the office jobs and luxury shopping in one area is good for workers, business, and civic planning.
All very smart ideas in yester-year, so TriMet became focused on serving the downtown business community myopically. This myopia became so paramount that it was considered illegitimate (actually taboo, borderline illegal) if you used a Park & Ride facility to park and NOT ride downtown. Amanda Fritz once explained that we couldn't expand Barbur Transit Center because that would result in students parking at Barbur Transit Center and riding the bus to PCC Sylvania. This view implies that TriMet exists only to service downtown workers, not the students, not the impoverished mom needing to go to a grocery store.
How does TriMet's hub and spoke design represent its purpose?
Portland's unspoken rule of transit philosophy is that jobs pay for the system (remember, business payroll taxes pay for most of it), so TriMet should be focused on serving people utilizing it for their job - employers pay for it, and they get value out of it. But this is both unspoken (never said aloud) and largely unobserved. The whole idea of TriMet as a social service to serve low-income people, to help impoverished people - well, those ideas were just lukewarm political rhetoric that is tossed out as soon as some Undesirable with tattered clothing reeking of cigarettes gets aboard - then Portlanders jump right back "this is for workers only!" Sadly, there hasn't ever been a public consensus of why TriMet exists because I could equally argue that TriMet's purpose isn't serving the working class; it's actually vehicle emissions reductions - but here, too, reality contradicts that this is the purpose for why we operate TriMet. TriMet's real purpose seems to be "Spend money on lofty capital projects" and if we want to be cynical about it, we can elaborate "…because large capital projects enable grift, embezzlement, and inflating property values for developers."
We haven't always depended upon a hub and spoke design. A great article from Jarrett Walker written in 2010 on his Human Transit blog explains in "The Power and Pleasure of Grids"

Why aren't all frequent networks grids? The competing impulse is the radial network impulse, which says: "We have one downtown. Everyone is going there, so just run everything to there." Most networks start out radial, but some later transition to more of a grid form, often with compromises in which a grid pattern of routes is distorted around downtown so that many parallel routes converge there. You can see this pattern in many cities, Portland for example. Many of the lines extending north and east out of the city center form elements of a grid, but converge on the downtown. Many other major routes (numbered in the 70s in Portland's system) do not go downtown, but instead complete the grid pattern. This balance between grid and radial patterns was carefully constructed in 1982, replacing an old network in which almost all routes went downtown.

Over the years the grid pattern was neglected in favor of a downtown-focused investment strategy. To a real degree it made practical sense: that's where the jobs were. But again, this is the presumption that TriMet and Mass Transit ought to service workers first, and there's not much consensus on that. But while we can't decide on TriMet's purpose, we can absolutely agree on one important thing: Downtown is dead.
No 5-star hotel is going to fix it. (As of writing, I'm not even convinced that this mafia-connected bamboozle of public fraud will open.) No "tough-on-crime" DA to replace Mike Schmidt, like Nathan Vasquez, will fix downtown. It's not JUST a crime problem: most of the problems we deal with today mirror the problems facing Portland in the 1960s, especially our inability to invest in good infrastructure people actually want to use. That's on top of crime, vandalism, and an unhealthy business ecosystem.
IF we want to maintain TriMet (and that's a big IF, for reasons I'll explain below), then it will be focused on something other than downtown. We need to move back to a grid-design transit system, as this is a much easier way to use transit to get around the city, no matter your destination. If TriMet continues to exist and operate fleets in 20-30 years, this is the only way it exists - because it will just be too inconvenient to ride downtown as a side quest to your destination, especially as we look at 10, 20, 30, 40 years from now.
Of course, we can only transform some parts of the transit infrastructure this way, and there are no uplifting and moving train tracks here. So light rail doesn't have a future in the grid system - but even without the grid system, light rail is doomed.

The fatal flaws of light rail in Portland.

I want to preface this by saying I like light rail as a strategy, it's not a bad system or bad civic investment. I could write another 5,000-word essay on why Seattle did an excellent job with light rail and the specific decisions Portland made wildly incorrectly. In transit advocacy the wacktavists inappropriately categorized skeptics of Portland's light rail as some soft bigotry - as if you're racist if you don't like Portland's light rail - even though, ironically, most light rail systems tend to be built for the preference of white culture and white workers, precisely what happened here in Portland and most cities (but this is all a story for another time).
Portland's light rail system has a capacity problem and has dealt with this capacity problem quietly for the last 20+ years. When you see the capacity problem, you can quickly understand this light rail system won't work in the future. All the other smart cities in the world that designed light rail realized they needed big long trains to move many people. Portland decided to limit the train car length to the size of our city blocks to save construction costs - and this has always been a fatal flaw.
Portland's highest capacity train car is our Type 5, according to Wikipedia it has a seating capacity of 72 and an overall capacity of 186 per train car, meaning each train can accommodate up to 372, but even these numbers seem unreliable (*edit). Let's compare:

• Washington DC has 6-car trains capable of carrying 120 passengers per car, or 720 per train.
  
• Salt Lake City has a 4-car train capable of carrying 230 passengers per car, or 920 per train.
  
• Seattle's Link system has a 3 or 4-car train, each capable of carrying approximately 200 passengers per car, so 600 to 800 per train.
  

Portland's light rail lines have roughly the same people moving capacity as a single lane of a highway, maybe marginally more, maybe marginally less. These other cities have a light rail system that can move the same amount of people as an entire 3-lane highway.
You might suspect that Portland could simply run trains more frequently - but nah, that's impossible because the trains run through the central core of downtown Portland, and they're blocked by the real interfaces with road traffic and bottlenecks. TriMet/PBOT/Metro has offered rosy ideas that we could hypothetically run cars every 90 seconds, 2 minutes, 4 minutes, or 6 minutes (depending upon who you ask) - but these are garbage numbers invented out of thin air. For example, you could stand at Pioneer Courthouse Square at 4:50pm on a Wednesday in 2016 - there was a train opening doors to load passengers, and you could visibly see the next train at Pioneer Place Mall pulling into the station behind. Trains were running at approximately a 3 to 4 minute at peak - but on paper, TriMet will claim anything, as they don't give a shit about lying to the public. But the bigger problem is that trains were full. You might have to wait 90 minutes to find a train that offers a seat. And god forbid you had a bike.
I'm not making this very real capacity problem, Metro even acknowledges:

At the busiest hours of the day, 40 light rail trains must cross the river and traverse downtown – one train every 90 seconds. As the region grows and the demand for light rail increases, the region will need at least 64 MAX trains through downtown every hour, more than one train each minute. Our current system can't support that change.

Suppose you're silly enough to trust government propaganda. In that case, you can read the details of Metro study on this in 2019. If we assumed their numbers added up, it's just fucking impossible to run 62 trains per hour, because passenger loading and unloading can take a full minute (sometimes longer). So unless we want to apply substantial g-forces onto the passengers, the train isn't accelerating out of the stops fast enough. Not to mention how unreliable this whole system would be if a sole tweaker, bike rider, or person with a stroller held up the system for 2 minutes.
This is why the bottom line needs to be upfront about capacity - quoting Metro's study here:

Today MAX is limited to 2-car trains because of the length of downtown city blocks. A tunnel could allow for longer trains if the stations outside the downtown core are retrofitted. In the long-term, this could greatly increase MAX capacity.

Do you see that trick? Build a tunnel, yes - but the entire system has to be retrofitted. Literally every light rail station would need to be redesigned, the lines themselves recalculated for larger heavier trains - and extending platforms at Willow Creek might be simple enough, but how in the living fuck is Metro going to afford to expand the Zoo stop? Doubling the size of that platform would cost $500 million alone.
If the city weren't full of cheap dipshits, we would have elevated or buried our light rail lines in the 1980s or 90s, enabling longer train cars to run. Yes, we all knew back then that it was the best practice not to have light rail running on the street - it's less safe, less reliable, runs slower, and limits train car size. Oops.
Just to keep TriMet's own bullshit inflated utopian vision, it would mean spending another billion dollars just to unfuck downtown, bypass an aging bridge, and potentially allow a marginally higher volume of trains - which again is a band-aid on a mortal wound.
The real buried lede is that to add extra train cars means retrofitting all the stops in the system - that's tens of billions of dollars. You can argue costs, but Metro knows we need to do this. It means shutting down the system for a year or years while construction and retrofits happen. It's fucking outrageous. Is this system worth of people per line worth 20, 30, or 40 billion dollars? Fuck no, it ain't. Again, if we had a raging metropolis of industry and commerce downtown, we could reasonably entertain the idea for a moment - but we don't and never will again.
Some folks might argue that if we kill off the light rail system we'd lose out on all those lucrative Transit Oriented Developments. Originally the public was told that Transit Oriented Development strategy would cause a massive infusion of private investment because the light rail was so damn lucrative and desirable for Richard Florida's Creative Class. Turns out the Creative Class is now called today the Laptop Class, and they don't give a flying fuck about street cars, light rail, or walking scores - because most can't be bothered to put pants on during their "commute" from bed to desk. TOD was all a fantasy illusion from the beginning, as multiple studies about Portland commuters showed that college-educated white folks riding Max were equally comfortable riding their bike as a substitute for the same commute. All of these billions of dollars was to accommodate white fare-weather bikers. So here's my hot take on transit: pave over the rail lines and put in bike lanes, and boy, then you'd have a bike system to give folks like Maus a hardon. But of course, Bike Portland would complain because their focus isn't biking; they exist only to favor all poorly thought utopian transit ideas.
Another group of Max/TOD advocates would claim that TOD is better for disabled and impoverished people. And yeah, there's truth there, but see my entire argument above about the Hub & Spoke design of TriMet being the antithesis of transit as a social service. If you believe that TriMet should serve low-income people, you must advocate for a bus-centric grid design.
But even if you're a die-hard believer in light rail - there's another inevitable reality coming that is the nail in the coffin.

Autonomous vehicles will replace mass transit faster than the automobile replaced the horse.

I work in advanced technology, and the thing about tech is that the public and politicians deny that it's going to be there until the majority of the public finally experiences it. You could say this about personal computers, internet, cloud compute, electric cars, smartphones, distributed ledger (cryptocurrency), AI, and driverless vehicles.
Schrodinger's technology doesn't exist until it's measured in an Apple store or your mother asks you for tech support.
No one thought AI was really real until ChatGPT did their kid's homework, and today most people are coming to terms with the fact that ChatGPT 3.5 could do most people's jobs. And that's not even the most advanced AI, that's the freeware put out by Microsoft, they have paywalls to access the real deal.
In 2018 I rode in my colleague's Tesla in self-driving mode from downtown Portland to Top Golf in Hillsboro. We started our journey at the surface parking lot on the west side of the Morrison Bridge. He used his phone to tell the car to pull out of the parking spot and to pick us up. Then he gave the car the address, and it drove us the entire way without any human input necessary. The only time he provided feedback was to touch the turn signal to pass a slow car on the highway. People think self-driving isn't here - but it is - and it's gotten exponentially better and will continue to do so. People will complain and moan about idealized, utopian, pedantic "level 5" full self-driving, how none of it exists or could exist, as a Tesla passes them on the road and the driver is half asleep.
Of course, Portland and every major city have also thought deeply about self-driving technology, and a few places have implemented self-driving solutions - but so far, none of these are really at scale. Though it will be a short time before cost-conscious cities go all-in.
TriMet kicked around the idea of using an autonomous bus for a leg of the trip of the Southwest Corridor project, connecting a segment of the light rail route to the community college. It was bafflingly stupid and short-sighted to think they could use it in this niche application but that it wouldn't open the floodgates for a hundred different applications that eviscerate TriMet's labor model. The simplest example of autonomous operation would be to operate the light rail systems - because they don't make turns, all we need is an AI vision service to slam on the breaks if necessary - that technology has existed for 20+ years. We could retrofit the entire train system in about 3 to 6 months - replace every Max operator with a security guard, and maybe people would ride the Max again? But I digress.
Let's speculate about the far-future, some 5, 10, or 20 years from now: your transit options will expand significantly. The cost will decrease considerably for services using automated vehicles.
You'll look at your options as:

• Drive to work: fastest, takes $100+ worth of gas a month, but you also need $50+ for insurance and $500+ for the monthly car payment, plus those surprise maintenance and broken windows. Also, do you pay for parking? Pick a number for how much it costs to drive your personally owned and manually operated vehicle to work each month.
  
• Autonomous vehicle service: price TBA, but think of how much an Uber costs when you don't have to pay the driver, you don't have to pay for gas. An Uber that runs for $20 today would likely be $10 or less. So, to and from work 20 times a month, $200. $300? Ok, let's just say it's $400 a month. It's still all cheaper than owning a car and driving it to work. No parking fees, and it picks you up quickly enough that it's not a nuisance.
  
• Mass Transit: $150 per month, but ugghhh it's slow, it smells like piss, a guy jacked off in your hair, and you can't schedule a meeting for the first 30 minutes of your anticipated workday in case you miss a connection - and it breaks so often the government actively hides the reliability data from the public and media.
  

Just a few years into this future we'll see a brand new trend, one that already exists: a shared autonomous vehicle like a privately operated bus. For example, Uber Bus - it already exists as a commuter option in some cities, it's just not autonomous yet. The significant benefit of an autonomous bus is that these shared vehicles will utilize HOV lanes very commonly, and commuting in an autonomous vehicle will be as fast as driving to work in your manually operated car while also being less expensive.
Simultaneously automobile accidents in autonomous vehicles will be virtually non-existent, and insurance companies will start to increase prices on vehicles that lack AI/smart assisted safety driving features. Public leaders will see the value of creating lanes of traffic on highways dedicated explicitly to autonomous vehicles so that they can drive at much higher speeds than manually operated traffic. Oregon won't lead the way here, but wait until Texas or one of the Crazy States greenlights a speed limit differential, and self-driving vehicles have a speed limit of 90, 120, or 150 miles per hour. You might think "accidents would be terrible and deadly" but there will be fewer accidents in the autonomous lane than in manual lanes. At this point, it will be WAY faster to take an autonomous vehicle to your work.
Purchasing power of consumers will decrease while the cost of vehicles will increase (especially autonomous vehicles), making ownership of any vehicle less likely. Frankly, the great majority of people won't know how to drive and will never learn to - just like how young people today don't know how to use manual transmission. However, fleets of autonomous vehicles owned by companies like Tesla, Uber, and Lyft will benefit from scale and keep their autonomous bus fleets operating at low cost. This will lead to a trend where fewer and fewer people will own an automobile, and fewer people even bother learning how to drive or paying the enormous insurance cost.... while also depending upon automobiles more than we do today.
Eventually, in the distant future, manually driven vehicles will be prohibited in urban areas as some reckless relic from a bygone era.
Cities and public bodies don't have to be cut out of this system if they act responsibly. For example, cities could start a data brokering exchange where commuters provide their commuting data (i.e., pick-up point, destination, arrival time). The government uses either a privatized fleet or a publicly owned fleet of autonomous vehicles to move as many people as possible as often as possible. Sort of a publicly run car-pool list - or a hyper-responsive bus fleet that runs for the exact passengers going to exact locations. A big problem companies like Uber, Lyft, and Tesla will have is that they'll lack market saturation to optimize commuting routes - they'll be able to win unique rides, but the best way they can achieve the lowest cost service model is these super predictable and timely commuter riders. The more data points and riders, the more optimization they can achieve. These companies can look at the data for as many people as possible and bid for as many routes as possible - optimizing for convenience, time, energy usage, emissions, etc. The public will voluntarily participate if this is optimized to get the cheapest ride possible. If the government doesn't do this, the private sector will eventually.
As a parallel, no one today even considers how Metro runs garbage collection. No one cares. And if you didn't like Metro's trash service, if you needed a better service for unique needs, you go procure that on your own. Likewise, you wouldn't care about the quality of the commuting trip as long as it's up to some minimal standards of your class expectations, it's reliable, nearly as quick as driving your own vehicle, and it seems reasonably affordable.
If the public ran this data exchange, fees could subsidize lower-income riders. This is a theory on what a TriMet like system or mass transit system could look like in a primarily autonomous world where most people don't own their own or drive an automobile.
This system would be far from perfect, opening up all sorts of problems around mobility. However, it's hard to see how autonomous vehicles will not obliterate the value proposition of mass transit.

Another narrative on the same story.

As the working class moves to autonomous vehicles, transit agencies will collect fewer and fewer fares - prices and taxes will rise, creating a cycle of failure. As a result, some cities will make buses self-driving to cut costs. It could start with Tokyo, Shanghai, Oslo, et al. Again, it's unlikely that Portland or Oregon will be the first movers on this, but when cities start laying off hundreds of mass transit operators and cutting fares to practically nothing, there will be substantial public pressure to mimic locally. It will be inhumane, it will be illiberal, to make those impoverished bus-riding single mothers pay premiums. As most of the fleet becomes autonomous, responsive, and disconnected from labor costs, the next question arises: why do we still operate bus routes? Why big buses instead of smaller and nimble vehicles?
This alternative story/perspective leads to the same outcome: we figure out where people are going and when they need to get there - then dispatch the appropriate amount of vehicles to move that exact number of people as efficiently as possible.
But our local government getting its act together on all this is outside the world of possibility.
In a practical sense, we're going to see history repeat itself. Portland's mass transit history is about private and public entities over-extending themselves, getting too deep in debt on a flawed and outdated idea. As a result, the system collapses into consolidation or liquidation. Following this historical pattern, TriMet/Metro won't respond to changing conditions fast enough, and laughably stupid ideas like cranking up taxes or increasing ridership fares will continue to be the only option until the media finally acknowledges these groups are insolvent. I just hope we don't spend tens of billions of dollars propping up this zombie system before we can soberly realize that we made some mistakes and these vanity-laden projects 20 and 30 years ago need to die.
You see, the biggest flaw with TriMet isn't the design, it needs to be outpaced by technology, it's that the people making decisions at TriMet and Metro are going to make the politically expedient decisions, not the right decisions. They won't redesign, and they won't leverage technology for cost savings, so this charade will just get going along until the media simply declares they're insolvent.
Back to fares for a second - the media happily reprints TriMet's horseshit take about "The higher fares will bring in an estimated $4.9 million in annual revenue starting next year, the report says." Just sort of amazing to me there's no skepticism about this number - but most spectacular is no media considerations about alternative solutions. For example, I could tell TriMet how to save $9,548,091 next year - a useless program primarily utilized by white middle-class folks who own alternative methods of transport - and this would inconvenience way less transit-dependent people than raising fares. But, that's off the table - we're not even developing a decision matrix for when we kill the blackhole of money known as WES.

Background I (28f), met my stepdad (50ish male), in 2007. My parents were going through a nasty divorce that surprisingly ended with my dad taking custody of me and my 2 sisters who are in their 20s as well. Stepdad met mom and she fell oregnant with my half sister “R” who was born in 2007. They got married in 2007. Stepdad bought a house cash soon after. Immediately things changed. His behavior changed. Twin brothers “w” and “d” born in 2009. Stepdad’s Behavior gets worse. Financial abuse. He wouldn’t let mom work or go to any stores. If a man looked at mom he’d yell at her for hours after. He’d only put enough gas in the car to take us to school. If she deviated from the route home she’d be stranded. She wasn’t allowed access to the bank account. Almost every night he’d come home and tell us about the little side jabs he’d tell his surgeon and scrub tech buddies at work about mom. He’d make pig and cow noises at her during dinner. He’d call us like dogs with whistles sounds, actively ignore us when talking to him or asking questions. Stand over us to intimate us. He does and still does leave loaded guns ALL over the house. One time he refused to take mom to the ER because he wanted to sleep. He had me drive her as a teen to the ER and the doctors said she almost didn’t make it. Y’all get the picture. She wasn’t allowed a phone either. My uncle, her brother, sent her a phone from Texas and paid for it for her. Mom finally had enough and tried to start divorce proceedings. She hired a lawyer and got a good but very draining job. but said to the lawyer to give stepdad warning to pick up papers instead of being served. He never filed like he said he would and stepdad went and got the best lawyer who actively defends abusive men against the women at our local shelter. So stepdad filed first!!!The women’s shelter counseled mom to get out based on everything they were told. But when she told them who stepdad’s lawyer was they said there was no way she would win. By their advice and her lawyers, they said the kids were not allowed to choose where to live unless stepdad was “hanging them upside down in a dark room and beating them.” We live in a default custody state. Now one of my twin brothers (both 13) has been hospitalized for suicidal thoughts and DETAILED plans to kill himself and is on meds for that, anxiety, sleep, and wanting to hurt his abuser. he is out now. What can I do? I’ve gotten them into therapy after a year of my mom saying “the kids refuse therapy…stepdad says he’ll set up appointment…I can’t afford the copay.” Literally the day after suicidal brother’s first appointment he’s hospitalized. How can I help my siblings? One of my sisters pays for the 3 kids phones. I’m trying to help pay for therapy. But stepdad said in court order that mom is keeping them from him and made it to where they can’t leave the state and visit family in Texas. He never let us visit them as children either and would “fix moms car” when we wanted to go or if he did let us go’ he’d drive down 4 hours to see we were there and then go home. He bombards younger siblings with calls. If they don’t answer he drives to moms house and bangs on the door and says “answer your fathers calls.” His house is a literal pig stye. Guns and empty bottles of whiskey everywhere. Trash and dishes everywhere. His dog has destroyed my siblings room. They sleep in a camper outside because it’s so bad. Mom goes there almost everyday to have dinner with him and the kids. She’s trying to keep things from going further in court because siblings don’t want to live a week on and a week of with their dad. I’m falling apart from stress trying to help. What can I do?

I graduate this December in central Texas and am currently in an internship at a non profit (grief and loss focus). Love this place but they are not equipped to offer a full time job for an LPC-A after graduation. I would like to pursue the PSLF program when I graduate, but need to find a qualifying employer.
Anyone further along gone through that process? Seems like there should be plenty of 501(c)(3) options for this field. Did you have strategies for looking for qualifying employers who have full-time spots avail? Pros/cons of PSLF as an LPC? Would be even better if there was an LPC-S avail wherever I end up but I might be greedy for that.
Thanks in advance!

I had my reversal done in October. (The whole thing was traumatic)
Anyway, I went to dermatologist about this round rough spot on my colostomy scar. She told me to put aquafor on it and keep it covered. That only made it bleed every day. I returned today and she said "you need to see your surgeon, it's a fistula"
Does anyone have experience with this type of fistula?
Just for background: I had my colon perforated during colonoscopy. Developed abcess and peritonitis. I lost most of my rectum, entire sigmoid colon, most of descending colon. I also endured a blood infection after reversal surgery. The reversal was surgically difficult.

Basics: I am a 36yo Asian woman, 5'2", 150lbs. I vape. I have (mostly dormant) asthma, seasonal allergies, bipolar II, anxiety, and borderline personality disorder, though I suspect the last may be misdiagnosed autism (awaiting assessment). I deal with joint aches and hypermobility, and neck and back pain, which may be related to EDS-HT, though I lack family medical history necessary for diagnosis. I currently take Effexor XR (150mg), Lamictal (50mg), Klonopin (1.5mg), Metformin (500mg not for diabetes), Linzess (145mcg), Neurontin (900mg for the issue described below), Flexeril (5mg PRN), and Celebrex (100mg PRN).
I am dealing with the feeling of hypermobility/lack of support to the left side of my mouth and face. I have had brain, face, and neck MRI come back clean, and two doctors have told me the muscles in my face are functioning normally, with no signs of palsy. I have an upcoming appointment with a neurologist.
This is a strange issue from what I’ve gathered after multiple visits to different dentists, ENTs, periodontists, oral medicine specialists, and general physicians. I have been told a research centeuniversity is my best option, but I still worry they will not be able to help me, as I have already visited one university. I am constantly told there is nothing that can be done by an oral surgeon, as there is nothing visibly wrong with the tissue on my palate; I have also been told radiograph does have the capabilities of seeing the sort of detail I describe and can feel with my tongue, which is frustrating.
I cannot definitively say whether this is one or multiple issues, but the timing of the onset of symptoms and what feels like reciprocity between sensations in the face and mouth makes me think they all originated from the same injury. The areas affected also make it difficult to discern what sort of physician is ideal to see—I have been told ENT, oral surgeon, and plastic surgeon.
In 2017, I had a tiny but sharp protrusion on my anterior hard palate (near the left lateral incisor and cuspid) that continually bothered my tongue. In frustration, I pulled at it with tweezers. (Yes, I know this is stupid.) I have no recollection what the protrusion ended up looking like, but there was moderate pain and mild bleeding.
Shortly after—and potentially unrelated—I detected tissue poking out by the gumline near my maxillary left premolars. I used my tongue to pull at it constantly until I had a noticeable length of what felt like a smooth, flat ribbon of tissue that ran near the gumline toward the central incisors. At certain points, it felt like it was connected to thinner, more rigid pieces that lightly snapped as they were pulled out of place.
In late 2022, the tissue that formed a relatively cushy papilla felt like it unwound vertically towards the foramen, leaving a flat and narrow covering over the incisive canal. I have been informed the tissue covering the palate is a continuous sheet and cannot “unwind,” but I can only explain what it felt like. I also realize this likely means what feel like ribbons or fibers to me are likely either torn tissue or areas where the tissue has fused back together more thickly.
Shortly after, I noticed a heaviness and fullness to my left jaw and cheek, followed by pulling sensations in the left half of my face and intermittent asymmetry—mostly of the base of the nose, philtrum, and mouth, which all seemed to noticeably skew to the right.
I experienced occasional “episodes” of dystonia—tense neck, raised shoulders, chin toward shoulders—accompanied by sensations of light tingling that traveled forward over the head (a horizontal line of tingling that covered the face) and face or inward from the sides of the face (a vertical line). It made my eyelids flutter as it passed. I also experienced tension on the ears, a sensation of twisting in the throat with trouble swallowing, the feeling of indigestion, and was left with a temporary grinding sound when moving my neck. Sometimes with these episodes, I had the sensation of some layer below the skin of the face moving, as if being peeled, once with the sensation of membrane/tissue peeling upward in my left nostril. I also experienced the feeling of something taut slipping inward over the right sternocleidomastoid, followed by intense pressure at the suprasternal notch. I developed a vertical neck band on that side.
While I discounted this in the past as my imagination, I will add I experienced (more than once) the feeling of a line of pressure or tissue move from behind my left ear, over the edges, and down the ear into the face; I could pause the movement with my finger, and it was sensitive when passing the tragus. I experienced a similar sensation of a band pulling off my left nostril.
I was often left with the feeling my face was “twisted." Manipulating my face with my hands helped lessen the sensations in my face. The left and right sides of my mouth felt pulled in opposing vertical directions when smiling, e.g. right side up and out, left side down and out. When smiling, I am still able to run my finger from just above the upper left lip to below the lower left lip and my smile will turn more into a grimace on that side and hold position, while it remains a smile with similar motion on the right side.
I also experienced pain in the cuspids, coldness around the front six maxillary teeth, numbness in the lower half of the face and in the nose/to the sides of the nose, and increased twitching throughout my face.
Because I pick at my mouth with my tongue without thinking, I continued to pull on the annoyingly out-of-place tissue in my mouth. The aforementioned “ribbon” felt like it would pull across my palate, causing pain on the left side. Eventually, the layers of one of my left anterior rugae/ridges began to peel (I suspect the lateral end is where I tweezed), followed by the opposing ridge on the right. There are what feel like wiry pieces left around the little remaining tissue of the left ridge, which can feel painful. While anxious, I also pulled some of the tissue from central ridges further back on the palate, which was immediately followed by the feeling of a million pinpoint-like pressure points in the apples of my cheeks.
Here is a link with photos [LINK]. I felt pulling by my eye in the third face photo. The diagram of the palate is what the tissue in my mouth sometimes feels like—very uncomfortable.
Cont. in comment

I am at a crossroads in my life and I need to make a final decision on where I should raise my son. It’s hard to plan for the long term future when I don’t know where we will physically be. The issue is, I don’t really have a “home”.
Backstory: I was born in Virginia, and moved to California with my Mom at 13. The rest of my family remained on the east coast. I “came of age” in California and loved living there. I moved away due to being priced out (Bay Area 2014 was the last time I lived in CA).
I have moved nearly 40 times in my life, and I’m currently in Texas, which is the 8th state I have lived. My child was born here but I really don’t foresee staying here forever. I moved here on a whim in 2020, I have no friends or family close by, I’m not a fan of the weather and I’m worried it’s not the best place for my kid to grow up.
My family is scattered all over the east coast- VA, MD, FL… and my son’s father’s family is in Southern California. So Texas is a good central location between extended family.
Here are more details: I don’t think we could afford to live in California, but we have family and friends there. My kid’s dad doesn’t want us to go to the east coast because it’s so far away from his family.
I lived in Oregon for years, have strong friendships there, and loved it, but it’s so far from both families.
If we live away from a coast, I would prefer to live closer to a large city, if I’m on a coast, City proximity doesn’t matter.
I have thought about staying somewhere in the central US but with different weather and more left leaning policies(let’s not get into why). A city I have highly considered is Ft. Collins, CO.
My job is remote and very secure, I make over 70k, and I don’t plan to buy a home in the immediate future or maybe at all. So I make a decent income and I am looking to rent long term.
If you have any advice or recommendations of where I should bring my family, I appreciate the input.

1) Diff locks. I know what they are but what I'm really wondering is are they needed? The Defender and Discovery (I have a disco) don't need them. I have a center and rear diff and their software/computational power is so amazing that wheel won't slip 1/4inch before it's already been locked and power going elsewhere. I've been stuck one time and considering three tractors got stuck there as well I don't think I was ever getting out. Are the lockers even a thing now days if you're not rock crawling? I'll do trails, mostly beaches, sandy dunes, river crossings, but not boulder crawling. Is the central diff good enough? I'm in Texas so it's more about watemud.
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2) the high power addition. That's another 2k. The overhead panel is all screws so you can remove anything. Could you just add the switches later if you wanted? Outside of a winch what else is really considered high power? I'm starting to lean hard at doing the Fieldmaster now instead of building from scratch.

Hi everyone.
My family and I are currently in the middle of a terrifying health crisis involving my grandmother (74). My grandmother, “Nana”, is a 3 time cancer survivor (thyroid cancer and breast cancer twice), and is a remarkable strong and healthy person. In the last few months, she has been experiencing some gastrointestinal upset - heartburn, indigestion, bloating, etc., but nothing too bad. Two weeks ago, the pain got so bad that my grandfather had to take her to the ER. They ran a course of tests and at first determined that the problem was diverticulitis and prescribed a course of antibiotics. She took the antibiotics for a week and seemed to improve, before succumbing to a bout of vomiting and severe nausea last week. It became so bad that she couldn’t keep anything down and ended up back in the ER. This time, they said her colon looked fine, but she had gallstones. They decided to admit her to the hospital and she underwent surgery the next day to remove the gallbladder and to perform and upper endoscopy on her stomach to rule out any stomach issues. The stomach scope only revealed that her stomach wasn’t moving, but was otherwise healthy. No other issues in the liver, pancreas, duodenum, or any surrounding tissues were found during the procedure. Unfortunately, they found what they believe to be cancerous tumors on the gallbladder (three small, white, round lesions). The gallbladder was sent off for pathology and Nana was kept in the hospital under observation and was given Reglan to help her stomach to move and digest. She was placed on a liquid diet which she seemed to tolerate well. They released her after 4 days and immediately upon returning home, the nausea and inability to digest food returned and she began vomiting again after ingesting anything, even water. Nana and my grandfather returned to the hospital that night and were admitted immediately to give my Nana some much needed IV fluids, stop the vomiting, and determine what could still be wrong as we all waited for the pathology report on her gallbladder. Luckily, the doctors were able to stabilize her, re-administer the reglan, and she improved immediately. The following day, she was doing much better and felt great. Unfortunately, today, the first pathology report for her gallbladder revealed that the lesions are indeed cancerous. The doctors are still waiting for more specific results that should come in tomorrow. They also told my grandparents that gallbladder cancer is very rare and this type of cancer usually comes from somewhere else, usually either melanoma or breast cancer. The doctors are scaring us by saying that it could be stage 4 since it seems to be coming from somewhere else.
This leads me to my question - Nana stays on top of her health since she has had cancer before. She regularly sees her oncologist and is tested often, she has her skin checked by a dermatologist regularly for moles and irregularities (there are none), and she just had a mammogram three months ago which was perfectly normal. So far, the oncologist hasn’t actually spoken to my grandparents yet until they get the final pathology report, but the surgeon who performed the gallbladder procedure is the one telling my grandparents that this could be stage 4 cancer and so on. I’m just wondering if the surgeon could be wrong and is being a bit over dramatic with this or if we have cause to panic. Nana just doesn’t have any other signs of cancer: no jaundice, no weight loss, no other problems, and is tested regularly and often. We literally don’t know where the cancer could have come from.
My theory is that this is just gallbladder cancer that was caught early since there is no evidence that it spread to any surrounding organs.
What are your thoughts?
Obviously we are all in panic mode.

Hi everyone.
My family and I are currently in the middle of a terrifying health crisis involving my grandmother (74). My grandmother, “Nana”, is a 3 time cancer survivor (thyroid cancer and breast cancer twice), and is a remarkably strong, healthy, and active person. Her last bout with cancer was 15 years ago. In the last few months, she has been experiencing some gastrointestinal upset - heartburn, indigestion, bloating, etc., but nothing too bad. Two weeks ago, the pain got so bad that my grandfather had to take her to the ER. They ran a course of tests and at first determined that the problem was diverticulitis and prescribed a course of antibiotics. She took the antibiotics for a week and seemed to improve, before succumbing to a bout of vomiting and severe nausea last week. It became so bad that she couldn’t keep anything down and ended up back in the ER. This time, they said her colon looked fine, but she had gallstones. They decided to admit her to the hospital and she underwent surgery the next day to remove the gallbladder and to perform an upper endoscopy on her stomach to rule out any stomach issues. The stomach scope only revealed that her stomach wasn’t moving, but was otherwise healthy. No other issues in the liver, pancreas, duodenum, or any surrounding tissues were found during the procedure. Unfortunately, they found what they believe to be cancerous tumors on the gallbladder (three small, white, round lesions). The gallbladder was sent off for pathology and Nana was kept in the hospital under observation and was given Reglan to help her stomach to move and digest. She was placed on a liquid diet which she seemed to tolerate well. They released her after 4 days and immediately upon returning home, the nausea and inability to digest food returned and she began vomiting again after ingesting anything, even water. Nana and my grandfather returned to the hospital that night and were admitted immediately to give my Nana some much needed IV fluids, stop the vomiting, and determine what could still be wrong as we all waited for the pathology report on her gallbladder. Luckily, the doctors were able to stabilize her, re-administer the reglan, and she improved immediately. The following day, she was doing much better and felt great. Unfortunately, today, the first pathology report for her gallbladder revealed that the lesions are indeed cancerous. The doctors are still waiting for more specific results that should come in tomorrow. They also told my grandparents that gallbladder cancer is very rare and this type of cancer usually comes from somewhere else, usually either melanoma or breast cancer. The doctors are scaring us by saying that it could be stage 4 since it seems to be coming from somewhere else.
This leads me to my question - Nana stays on top of her health since she has had cancer before. She regularly sees her oncologist and is tested often, she has her skin checked by a dermatologist regularly for moles and irregularities (there are none), and she just had a mammogram three months ago which was perfectly normal. None of the CT scans, X rays, or any other imaging revealed anything either. So far, the oncologist hasn’t actually spoken to my grandparents yet until they get the final pathology report, but the surgeon who performed the gallbladder procedure is the one telling my grandparents that this could be stage 4 cancer and so on. I’m just wondering if the surgeon could be wrong and is being a bit over dramatic with this or if we have cause to panic. Nana just doesn’t have any other signs of cancer: no jaundice, no weight loss, no other problems, and is tested regularly and often. We literally don’t know where the cancer could have come from.
My theory is that this is just gallbladder cancer that was caught early since there is no evidence that it spread to any surrounding organs.
What are your thoughts?
Obviously we are all in panic mode.

Laparoscopic surgery, also known as minimally invasive surgery, has revolutionized the field of surgery by allowing surgeons to perform complex procedures through small incisions. One of the crucial steps in laparoscopic surgery is the creation of a pneumoperitoneum, which involves filling the abdominal cavity with carbon dioxide gas. This creates a workspace for the surgeon, enabling clear visualization and manipulation of the internal organs. However, establishing a safe pneumoperitoneum requires careful consideration and adherence to specific techniques to minimize complications and ensure patient safety.
https://preview.redd.it/854ew5222f3b1.jpg?width=1280&format=pjpg&auto=webp&s=23ed426829929f1799bb36ddf989b40abb115062
The first and foremost consideration in establishing a safe pneumoperitoneum is patient positioning. Proper positioning is crucial for both patient comfort and the surgeon's ability to access the surgical site. The patient is typically placed in a supine position on the operating table, with a slight Trendelenburg tilt to allow the abdominal organs to fall away from the diaphragm. Proper padding and securing of the patient's extremities are also essential to prevent nerve injuries and maintain stability during the procedure.
https://preview.redd.it/uchr90g32f3b1.jpg?width=777&format=pjpg&auto=webp&s=57525bf8f1059e14244ef1987bc2d826f8717e4c
Once the patient is adequately positioned, the surgeon selects the entry site for the initial trocar insertion. The most common entry point is the umbilicus, as it provides a central access point to the abdominal cavity. Prior to trocar insertion, local anesthesia is administered to minimize discomfort. Special care should be taken to avoid blood vessels, major organs, and previous surgical scars during trocar placement to prevent injuries.
https://preview.redd.it/t2oj74642f3b1.jpg?width=996&format=pjpg&auto=webp&s=6116781bbf2355b518952bd50e4ce3511ce72cfd
Next, the pneumoperitoneum is established by insufflating the abdominal cavity with carbon dioxide gas. This is typically achieved using a Veress needle or a direct trocar insertion technique. The Veress needle technique involves inserting a sharp, spring-loaded needle into the abdominal cavity, followed by the insufflation of gas. The direct trocar insertion technique involves inserting the trocar directly into the abdomen under direct visualization. Both methods have their advantages and potential complications, and the surgeon must choose the appropriate technique based on patient factors and the surgical procedure being performed.
https://preview.redd.it/guf3mbe52f3b1.jpg?width=777&format=pjpg&auto=webp&s=92ba6165d804d99d72bb93248dd87cd7eb693262
During gas insufflation, it is crucial to monitor the intra-abdominal pressure (IAP). Excessive pressure can lead to adverse effects such as cardiovascular and respiratory compromise, as well as organ injury. The recommended IAP for most laparoscopic procedures is around 12-15 mmHg. Monitoring devices, such as a pressure transducer connected to the insufflator, are used to continuously measure, and regulate the pressure. It is essential to ensure that the gas flow is regulated and adjusted to maintain the desired pressure within safe limits.
https://preview.redd.it/512gf1262f3b1.jpg?width=777&format=pjpg&auto=webp&s=2cf8abed600673ce9da2af64d5c90cb8ae267bea
Another important consideration is the choice of gas used for insufflation. Carbon dioxide is the preferred gas due to its non-flammability, rapid absorption, and minimal risk of embolism. Alternative gases, such as nitrous oxide or air, should be avoided as they can lead to serious complications.
https://preview.redd.it/sie6ur072f3b1.jpg?width=777&format=pjpg&auto=webp&s=c42c7e03f0b3ad0364ce2c494906a922c1752271
To minimize the risk of complications associated with pneumoperitoneum, it is essential to maintain a clear visual field throughout the procedure. This is achieved by continuous evacuation of smoke and condensation from the laparoscopic instruments. The use of appropriate suction and smoke evacuation systems is crucial to prevent obscuring the surgeon's view and to minimize the risk of thermal injury from electrocautery devices.
In conclusion, establishing a safe pneumoperitoneum is a critical step in laparoscopic surgery. Patient positioning, careful trocar insertion, monitoring of intra-abdominal pressure, and maintaining a clear visual field are essential elements of this process. Surgeons must adhere to established techniques and guidelines to minimize complications and ensure patient safety. By prioritizing patient well-being and employing best practices, laparoscopic surgeons can optimize outcomes and provide the benefits of minimally invasive surgery to their patients.
​
#LaparoscopicSurgery #PatientSafety #MinimallyInvasive #Pneumoperitoneum #SurgicalTechniques #HealthcareHeroes #laparoscopic #surgery #laparoscopy #doctor #surgeon #laparoscopicsurgeon #endoscopy #hospital #laparoscopia #surgical #medical #gynecology #surgicalinstruments #health #gynecologist #t #medicine #endometriosis #cirujano #generalsurgery #veterinary #urology #minimallyinvasivesurgery #vi #healthcare #forceps #laparoscopica #pregnancy

Some offseason drivel.
Simple ratio of number of instances of an FBS school's flair (including any alternate flairs) divided by the school's enrollment.
Note: This is a count of flair, not users. Example: If a user has [UCF] primary flair and [UCF alternate (the Citronaut)] secondary flair, that counts as 2 in the Flair column rather than 1. In other words, users who double up on their school's flair offerings count twice. There certainly are users who double up, but I feel like it does not affect the numbers much. This method makes sure to capture users who do not use their school's standard flair and instead use their school's alternate flair. (Note: Not every school has alternate flair. * Bearcat tears 😿 *)
Data sources:

• Enrollment (Some of these are out of date by a few years. This was the easiest source to pull from. I am not going to track down current official enrollment numbers for 133 separate institutions.)
• Flair count (Accessed 05/31/2023)

 

Rank	Program	Conf.	Flair	Enrollment	Ratio
1	Notre Dame	FBS Independents	7,745	13,139	58.9%
2	Michigan	Big Ten	17,127	50,278	34.1%
3	Oregon	Pac-12	6,789	22,257	30.5%
4	Alabama	SEC	11,674	38,316	30.5%
5	Ohio State	Big Ten	18,118	61,677	29.4%
6	Nebraska	Big Ten	6,963	24,431	28.5%
7	Navy	American	1,249	4,528	27.6%
8	Oklahoma	Big 12	7,349	28,042	26.2%
9	Georgia	SEC	10,467	40,118	26.1%
10	Army	FBS Independents	1,189	4,594	25.9%
11	Clemson	ACC	6,127	27,341	22.4%
12	Tennessee	SEC	6,856	31,701	21.6%
13	Auburn	SEC	6,349	31,526	20.1%
14	LSU	SEC	7,170	35,912	20.0%
15	Texas	Big 12	10,325	51,991	19.9%
16	Miami	ACC	3,307	19,096	17.3%
17	Florida	SEC	9,042	55,781	16.2%
18	TCU	Big 12	1,932	11,938	16.2%
19	Penn State	Big Ten	7,297	47,560	15.3%
20	Iowa	Big Ten	4,447	29,909	14.9%
21	Air Force	Mountain West	613	4,181	14.7%
22	Florida State	ACC	6,392	45,130	14.2%
23	Wisconsin	Big Ten	6,543	47,932	13.7%
24	Michigan State	Big Ten	6,394	49,659	12.9%
25	Arkansas	SEC	3,675	29,068	12.6%
26	South Carolina	SEC	4,455	35,471	12.6%
27	Virginia Tech	ACC	4,615	37,279	12.4%
28	Stanford	Pac-12	2,132	17,680	12.1%
29	Texas A&M	SEC	8,597	72,530	11.9%
30	West Virginia	Big 12	2,996	25,474	11.8%
31	Oklahoma State	Big 12	2,770	24,660	11.2%
32	Baylor	Big 12	2,238	20,626	10.9%
33	USC	Pac-12	4,995	49,318	10.1%
34	Georgia Tech	ACC	4,426	43,844	10.1%
35	Tulsa	American	384	3,832	10.0%
36	Kansas State	Big 12	1,940	20,229	9.6%
37	Iowa State	Big 12	2,895	30,708	9.4%
38	Ole Miss	SEC	1,957	21,203	9.2%
39	Kentucky	SEC	2,782	30,390	9.2%
40	Washington	Pac-12	4,721	52,439	9.0%
41	Vanderbilt	SEC	1,178	13,796	8.5%
42	Missouri	SEC	2,640	31,412	8.4%
43	Washington State	Pac-12	2,361	29,843	7.9%
44	Wake Forest	ACC	703	8,947	7.9%
45	Mississippi State	SEC	1,775	23,086	7.7%
46	Kansas	Big 12	2,035	26,780	7.6%
47	North Carolina	ACC	2,377	31,733	7.5%
48	Utah	Pac-12	2,535	34,464	7.4%
49	Pittsburgh	ACC	2,134	29,238	7.3%
50	Texas Tech	Big 12	2,927	40,542	7.2%
51	Northwestern	Big Ten	1,631	22,933	7.1%
52	Minnesota	Big Ten	3,474	52,376	6.6%
53	Boston College	ACC	991	15,046	6.6%
54	Louisville	ACC	1,441	22,140	6.5%
55	Appalachian State	Sun Belt	1,309	20,641	6.3%
56	Syracuse	ACC	1,364	21,772	6.3%
57	Virginia	ACC	1,616	26,026	6.2%
58	Colorado	Pac-12	2,280	37,956	6.0%
59	Boise State	Mountain West	1,545	25,830	6.0%
60	NC State	ACC	2,189	36,831	5.9%
61	Duke	ACC	1,047	17,620	5.9%
62	Cincinnati	Big 12	2,370	40,281	5.9%
63	SMU	American	728	12,385	5.9%
64	UCLA	Pac-12	2,737	47,516	5.8%
65	Oregon State	Pac-12	1,892	33,193	5.7%
66	Tulane	American	746	13,127	5.7%
67	California	Pac-12	2,563	45,435	5.6%
68	Purdue	Big Ten	2,688	49,639	5.4%
69	Maryland	Big Ten	2,149	41,272	5.2%
70	UCF	Big 12	3,619	70,406	5.1%
71	Wyoming	Mountain West	588	11,479	5.1%
72	BYU	Big 12	1,592	34,802	4.6%
73	Indiana	Big Ten	2,043	45,328	4.5%
74	Rice	American	373	8,285	4.5%
75	UAB	American	998	22,289	4.5%
76	Marshall	Sun Belt	484	11,125	4.4%
77	Illinois	Big Ten	2,450	56,607	4.3%
78	Western Michigan	MAC	741	19,038	3.9%
79	Houston	Big 12	1,828	47,031	3.9%
80	Coastal Carolina	Sun Belt	406	10,473	3.9%
81	Central Michigan	MAC	597	15,465	3.9%
82	Toledo	MAC	653	17,045	3.8%
83	Memphis	American	768	21,622	3.6%
84	Rutgers	Big Ten	1,790	50,804	3.5%
85	Arizona State	Pac-12	2,715	77,881	3.5%
86	Georgia Southern	Sun Belt	913	27,091	3.4%
87	Hawai'i	Mountain West	640	19,097	3.4%
88	Northern Illinois	MAC	534	16,234	3.3%
89	South Alabama	Sun Belt	452	13,992	3.2%
90	Louisiana Tech	Conference USA	355	11,037	3.2%
91	Arizona	Pac-12	1,551	49,471	3.1%
92	Ohio	MAC	753	24,429	3.1%
93	James Madison	Sun Belt	659	22,166	3.0%
94	Jacksonville State	Conference USA	269	9,238	2.9%
95	Troy	Sun Belt	416	14,901	2.8%
96	USF	American	1,232	44,322	2.8%
97	Louisiana	Sun Belt	426	16,225	2.6%
98	Miami (OH)	MAC	502	19,216	2.6%
99	Bowling Green	MAC	457	17,645	2.6%
100	Temple	American	897	35,626	2.5%
101	Connecticut	FBS Independents	800	32,146	2.5%
102	Southern Miss	Sun Belt	343	14,146	2.4%
103	San Diego State	Mountain West	778	35,732	2.2%
104	ECU	American	602	28,021	2.1%
105	Colorado State	Mountain West	702	32,777	2.1%
106	Eastern Michigan	MAC	328	15,370	2.1%
107	Fresno State	Mountain West	492	24,585	2.0%
108	UTSA	American	688	34,734	2.0%
109	Akron	MAC	274	14,516	1.9%
110	WKU	Conference USA	292	16,750	1.7%
111	Middle Tennessee	Conference USA	359	20,857	1.7%
112	North Texas	American	724	42,454	1.7%
113	Nevada	Mountain West	348	21,034	1.7%
114	Utah State	Mountain West	429	27,426	1.6%
115	Texas State	Sun Belt	576	37,864	1.5%
116	Old Dominion	Sun Belt	345	23,494	1.5%
117	Arkansas State	Sun Belt	188	12,863	1.5%
118	Ball State	MAC	270	19,337	1.4%
119	Buffalo	MAC	447	32,332	1.4%
120	ULM	Sun Belt	114	8,565	1.3%
121	Kent State	MAC	338	26,597	1.3%
122	FAU	American	374	30,155	1.2%
123	Charlotte	American	376	30,448	1.2%
124	UMass	FBS Independents	389	32,045	1.2%
125	Sam Houston	Conference USA	247	21,679	1.1%
126	New Mexico State	Conference USA	148	13,904	1.1%
127	New Mexico	Mountain West	228	21,738	1.0%
128	UNLV	Mountain West	313	30,679	1.0%
129	San José State	Mountain West	330	37,133	0.9%
130	Georgia State	Sun Belt	478	55,466	0.9%
131	UTEP	Conference USA	184	24,003	0.8%
132	FIU	Conference USA	217	56,732	0.4%
133	Liberty	Conference USA	225	95,148	0.2%

 
 
Here's conference summaries:
 

Rank	Conf.	Flair	Enrollment	Ratio
1	SEC	78,617	490,310	16.0%
2	Big Ten	83,114	630,405	13.2%
3	FBS Independents	10,123	81,924	12.4%
4	ACC	38,729	382,043	10.1%
5	Big 12	46,816	473,510	9.9%
6	Pac-12	37,271	497,453	7.5%
7	American	10,139	331,828	3.1%
8	MAC	5,894	237,224	2.5%
9	Sun Belt	7,109	289,012	2.5%
10	Mountain West	7,006	291,691	2.4%
11	Conference USA	2,296	269,348	0.9%

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Contact Info:
Yashoda Hospitals - Somajiguda, Raj Bhavan Rd, Matha Nagar, Somajiguda, Hyderabad, Telangana 500082
Gastro Care Clinics, Unit 201, Surya Arcade, behind Labonel Fine Baking, Cyberhills Colony, P Janardhan Reddy Nagar, Gachibowli, Hyderabad, Telangana 500032
Phone: +91 93901 50150 / 95810 00505
Mail Id: [email protected]

Looking to transfer my bedroom on a RECENTLY RENEWED lease to a responsible renter at the Palazzo on Wonderworld.
Rent is $1550 split between you and roommate.
No Deposit is required! Only a transfer fee and application fee. End of the day, my deposit is yours.
Hello, I am a texas state Alumni who is relocating to austin. Offering a renewed lease at one of San Marcos’ higher end apartment complexes. Down the block from the fire station and hospitals, easy access to and from highway. At least 4 or 5 police live in the complex as well, including an emergency on call officer for the tenants. Perfect for recent grads imo. My Roommate is great, keeps to himself, is amazing w pets, and is attentive to needs.
Amenities:

• In Unit WasheDryer
• Stainless steel appliances
• Dishwasher
• Bedroom advertised has bathtub
• Pet Friendly
• Balcony w Storage
• Central AC/Heat -Reserved Parking

For more information on community Amenities please use this link:
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If you’d like to come take a look DM me or comment and i’ll be sure to reach out. Also dont hesitate to reach out with any questions! Thank you for your time !

We're a level 1 trauma and a level 2 burn center. Coworker accepted a serious burn patient that woke up to their house on fire. Easily 50% burns, circumfrencial trunk burns. Soot in the nose, weak cough, BUT mentating, A/Ox4. The night Trauma doc refused to intubate, refused to get central access. Patient only had 0.5-1mg dilaudid for pain.
The day surgeon was even more useless for my other coworker. Outright ignored pages all day for urine output of none, to no more than 25ml an hour. Urine dropped to nothing at 0900, didn't order colloidal rescue until 1300. Still no access. Patient somehow still awake but muffled, and coarse lung sounds. Coworker literally charted q15 minute I&Os and assessments and filed no less than 6 notes about updating the attending because she knew what was coming.
1900 I take over. Night surgeon is back. I page and tell her to come to the bedside, stat. I want rationale for why we don't have a femoral line, or why we aren't concerned about 100ml of urine out over 14 hours when the patient is now 7L up, and why the only labs since admission have been one BMP, CBC, and a Type and Cross. Doctor starts going off about how central lines kill people(???) And wouldn't you know it my foot line infiltrates. She finally places it, bitching the whole time while in the room and the patient is awake. Lets me order a blood gas, repeat electrolytes "if I really want it",. ABG is trash. Lactic is 7. She places a cyanide order which is positive. Oopsie poopsies. Now we're doing the B-12 rescue kit and tubing urgently. And NOW the patient is really sick even though the whole trauma service was blowing the nurse off all fucking day.
But for the final slap in the face! When the doc is calling the level 1 burn center for report they outright LIE and say we under fluid resused the patient, and in the DISCHARGE note, hour by hour incorrectly recounts the fluid rates by about 50% and refuses to change it when I call her out on it. And I found out later the ER attending THREW HER OUT of the room for just being a total see you next tuesday to his staff too. Rumor mill is the surgeon is filing with compliance. My charge and I both filed adverse event reports. I made damn sure my charting was immaculate and my USO is updated because I'm absolutely sure this will be a malpractice suit.