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NEAG, not really. Generally, strep is far more often a respiratory born infection. You are more likely to get inadvertent mouth-to-ass exposure since undies (tighty whiteys, boxers or the combo boxer-briefs) are all laden to some degree with crap - literally. That is often E Coli. That is one reason women urinary tract infections.....


I admire your effort to poke fun and provoke. I've never before witnessed this unswerving dedication to provocation before on the interwebz!

Well played all, well played.

Alternate diagnosis for f-d:

Jules, do you often have chicks react like the hot ass blonde in the "Certain Dri" commercial when they find out you are a Dr.?
link

Some definitely do. Sadly, not all of them or enough of them.

I remember being out in LA and this one chick said to my friend, "resident.....that means you are still in training." (code for you don't make any money at this point).

Jules don't take it badly, LA bitches are gold diggers.

Jules, I'm curious as to your professional opinion on this article talking about 40% of medicare screenings are unnecessary and costing taxpayers around $2 billion a year. Is this BS or legit?

How many Xanax, and what strength, do I need before the Phils game tonight? (I will be drinking too)

honestly, i took half a xany for game 3 and it worked well (wasn't drinking). game 4 i was strangely mellow and didn't need anything.

It is partly legit. I am confident that the figure provided is a gross exaggeration of expense. The mammography screening is the most widely and routinely performed screening exam outside of the Pap smear. So, if they "wasted" 31 million on the most widely performed screening exam, it becomes impossible to comprehend 1.9 billion in waste.

The problems:

(1) As stated regarding breast cancer screening, "no evidence" that it is helpful to screen above 75 doesn't mean that it ISN'T helpful. It just hasn't been documented. AND, the incidence of breast cancer increases with age. So, it would make sense to screen.

(2) Having said that, you have to put things in perspective. A healthy 80 year old is probably a better candidate for screening than an unhealthy 67 year old. In medicine, it is NOT for the physician to be the arbitrator of who should or should not have tests performed. That becomes discrimination against age. There are MANY people who live well into their 80s or 90s and who are highly functional.

(3) Then you have to remember with the litigious bent of society in some markets, I'd screen rather than explain it to 12 of my "peers".

So, it is incumbent on the patient, family and their PCP to help decide what makes sense for that patient. A demented 82 year old in a nursing home that is visited once a year on Christmas is probably not the right person to screen for certain cancers. The active 85 year old who has no serious health risk could live 5 more years. It becomes hard to draw a hard line because one size doesn't fit all.

now the recommendation is that men shouldn't get PSA testing.

Cool, thanks Jules!

Jules, what's the turnaround time typically for a strained hamstring?

Doc, my dad had a heart attack and he's going in for a cathorization. What's the risk in this?

jules - flu shots: yay or nay?

Great question, Flesh. I just had my son in for an annual doctor visit and he asked about the flu shot.

I passed because I've never had a flu shot, my wife has never had one, and we hadn't discussed it.

I'm not a paranoid guy, but I'm a bit of a minimalist in terms of health care. Like, I don't think a flu shot will make the kid retarded, but I don't really know if its necessary.

I've been re-thinking it ever since and considered taking him back in because I don't want to regret it. I'm just on the fence.

Doc, my dad had a heart attack and he's going in for a cathorization. What's the risk in this?

Bass, sorry to hear about this. How's he doing?

yeah, i had a flu shot for the first time last year. didn't get the flu, but then again, i don't think i've had the flue in about 15 years. i'm pretty confident i'm past the window for developing autism, so i'll probably just go ahead and get it.

Get the flu shots.


Bass, I can sort of answer your question, my dad had a heart attack 30 years ago and has had numerous catherizations, all of which over 20 years ago, I am sure it's gotta be even safer now, but he never had any issues.

Flesh, adult onset autism is rising rapidly. Have you heard of the Tea Party?

Get the flu shots.

I might have had the flu once in my life and I feel like getting the flu shot will jinx it, scientifically.

I like to think my kid's infected with at least 4,000 strains of something at any given time because of daycare so I've already been exposed to most of the crap I could get a shot for anyway.

Lyte,
Totally get where you're coming from. When my guys went to DC, I think I was pretty much sick for something like 9 months straight. The plus side is that after going through that, you're going to have some seriously kickass antibodies in your system. When EagleDude and I worked together (this was after my afore-mentioned daycare "break-in period), he called me "unbreakable". He was like "Dude, you neve get sick, I mean I've worked with you for two years, and you are absolutely NEVER SICK. This works with the kids too, neither one of my kids had a sick day (for actual illness) for their first five years of school.

Bass, sorry, I never saw your post till now. I assume he's already had it done. The risks are small (<1%) in good hands. They are often related to excessive bleeding at the puncture site.

Rare complications include pseudo-aneurysm (injury to the common femoral artery which is the site of puncture), dissection of a coronary artery (extremely rare but would require emergent surgery.....extremely rare is < 1/20000). I've the last situation once in 13 years.

As for the flu shot, it will make you a little ill feeling because it generates an immune response. If you are healthcare worker you are obligated to have one. If you are not in that biz, then, it is probably better to consider it if you are exposed to lots of children.

Having said that, I also wonder how necessary it is. The real value-added (business speak) is that if you get the flu, you aren't sick as long.

As stated, there are thousands of strains and the vaccine only protects fully against those felt to be most common and likely. Therefore, you are still able of contracting the flu from different strains, however, your course of illness is often far milder.

Oh, the reason we are required to have them is that we are exposed to sick patients all the time and, we, in turn, become the source of illness for many patients who are already in some way compromised.

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