Lurker > Soviet_Poland

My wife is my best friend. We have a lot of shared interests and frequently can go on adventures together. We have a similar thought processes and similar living habits so there is pretty much zero tension in terms of division of labor at home. Everything gets communicated, so we never argue. We both are fairly independent people so we're comfortable when we each need to do our thing (both in demanding careers), but we enjoy our time together.

Having those pooled resources, that emotional support, the reliable sex pretty much equates to such a fulfilling companionship. I'd do anything for my wife, which motivates me to be a better version of myself. It also keeps me accountable to my health and staying fit.

We've been together for 6 and a half years now. Marriage has been awesome. Granted, we'd stay together even if we weren't married. I think that's kind of key. When you don't need marriage with another person, then you know you've found the right person.

I respect if someone doesn't want that. I recognize it seems like a bad deal if you've never experienced the type of relationship I have. But judging from a lot of the comments in this thread, a lot of you have some unhealthy habits and some pathologic level of stubbornness to a particular routine. I understand why that might be incompatible to a relationship, but maybe some changes are in order. Not to become compatible with relationships, but rather that shit isn't healthy. An occasional 15 hour gaming binge I guess is okay. If it needs to be routine enough that it causes strain in a relationship, that is unhealthy in general. A mature relationship will offer some alone/me time. If a majority of your time needs to be me time, you need to learn to get along with people better.
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"He has two neurons held together by a spirochete."

You can also ascend a halberd +10 into a lifehunt scythe once you go through one of the DLC areas. It has the bleed effect, which works on some bosses too. But you pretty much have to use a bloodbite ring or the bloodshield to mitigate the self-bleed effect.
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"He has two neurons held together by a spirochete."

Spidey5 posted...

So whats the current number of posts about the topic and the current number about grammar?

They're one in the same. The person who is unequivocally wrong about the apostrophe is in denial about basic fact.

This is a good analogy to the current political climate.
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"He has two neurons held together by a spirochete."

a42ozslushie posted...

No, he's not right, and im beginning to get worried about you all....

Oh my sweet, summer child...
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"He has two neurons held together by a spirochete."

a42ozslushie posted...

Is English your second language? Not trying to be offensive, im genuinely curious

No he's right. Your intention was to use the possessive, which is "its"

it's is a contraction meaning "it is"
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"He has two neurons held together by a spirochete."

Uncle Choad posted...

You don't need to be rude

To be fair, being ignorant to what depression entails then interjecting with your shitty opinion is also "rude", so you shouldn't be surprised if that shit gets slung back to you.
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"He has two neurons held together by a spirochete."

High yield right here.
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"He has two neurons held together by a spirochete."

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"He has two neurons held together by a spirochete."

No_U_L7 posted...

Did you miss the part where I said a lot of different 1-2% things add up over time to make a big difference? There is no big secret to game...it's the accumulation of all these things. this is tip 115 of thousands

Alright. I'll now do the 115 steps to increase your attractiveness of me so you fuck me. How do you feel about that? You can't do anything about it. I'm executing the steps exactly right, so you have to be attracted to me now. You were on the fence, but fuck, the shoes were the final straw.

Now, that won't happen. Mostly because we're not gay, but the real answer is because that shit wouldn't make the difference anyway. Because attraction isn't some static thing that universally applies to everyone. And even considering the hypothetical that it did, then in that case it would be unethical to apply, because you're implying that you can make steps independent of the other person to take the control over whether or not they sleep with you out of their hands. Might as well slip them a roofie, because the intention is the same.

Now, I get it. People interested in fucking do things that they think are for the same purpose. A lot of their behavior is unconscious too. I get that. And it's acceptable behavior that isn't viewed as coercive. But that's because attraction goes beyond some simple recipe. And human sexuality goes beyond attraction too.
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"He has two neurons held together by a spirochete."

BlkPopeIseem posted...

Oh my mistake. Sounded like feminism calling a harmless gesture coercion, cheap, and manipulative just because someone wants to achieve some mutual agreement.

Nothing unethical about it. In no way is this tip abusing the intended target nor violating any sort of unwritten moral code.

Fair enough. I'll preface my statement as considering the hypothetical of if it made any meaningful difference in whether or not a woman would sleep with someone, then the application of it would be unethical.

But the reality is it makes no difference. So it's not unethical to ask someone to take their shoes off when they come over, but the manner in which TC presents the argument is kind of sleazy.
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"He has two neurons held together by a spirochete."

DanHarenChamp posted...

And the First Lady could be an alcoholic which means cirrhosis is possible lol, that's probably be way more common than pernicious anemia

Yeah, but #1 rule of test questions is not assuming more than the question states. These questions are designed that every answer is technically possible or reasonable, but that one answer is the "best" answer from a textbook point of view.
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"He has two neurons held together by a spirochete."

DanHarenChamp posted...

In real life he'd prolly get a cath anyways the afib might be paroxysmal when he drinks and cardiologists may be uncomfortable sending a guy out when he clearly has new onset heart failure and probably risk factors and needs an ischemic workup per heart failure guidelines, despite tachycardia induced CM being higher on the differential

This guy fucks.

No, but really, I should preface this with that board questions don't necessarily reflect clinical practice.
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"He has two neurons held together by a spirochete."

No_U_L7 posted...

Everything makes a small 1% difference, by adding up all of these 1%, over time it makes a huge difference. Attraction is difficult for a lot of people to understand and break down...but it is still a science that i just learned to understand. it was either go my life without understanding it at all, or learn...and i chose to learn. everyone runs game when talking to girls, most guys just dont know what they are doing or why what they are doing works. because i want to understand that, what is wrong with that? what is unethical about what i do other than understanding why it works? there is nothing i do different than a chad who does the same things subconsciously.

I don't say "you can take your shoes off", I say "can you please take your shoes off? I don't wear shoes inside my place". And that's also true, it's an asian thing.

Missed my point entirely.
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"He has two neurons held together by a spirochete."

BlkPopeIseem posted...

This guy serious? Asking someone to take their shoes off equates to coercion LMAO. Fucking feminism. It's shit like this that makes it look bad.

Lol, I tell people to take their shoes off at my house because I want clean carpet. Not in some ploy to get in a woman's pants. Intentions matter, bb. The act of asking someone to take their shoes off isn't coercion, so don't treat that as if it was my point. This has nothing to do with feminism.
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"He has two neurons held together by a spirochete."

megamanfreakXD posted...

Copyright (c) UWorld, Please do not save, print, cut, copy or paste anything while a test is active.

Hahahaha, this is why I can't copy paste these.
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"He has two neurons held together by a spirochete."

Answer is E) Rate or rhythm control

This patient has tachycardia-mediated cardiomyopathy. His fast and irregular heart rate and lack of P waves on EKG indicates he has atrial fibrillation with rapid ventricular response. Over a long enough time, this remodels the heart to dilate the top chamber of the heart as well as causes the valve problem. Functionally, this is pretty similar to congestive heart failure, and that's why the symptoms are the same, but medications to control the atrial fibrillation with rate or rhythm control will help to reverse the changes in the heart's shape and restore function. A third, unlisted option is ablation, which is killing the heart cells responsible for the irregular rhythm.
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"He has two neurons held together by a spirochete."

Kineth posted...

I'm gonna go with... F. Not exactly sure what B and D refer to and E seems like a trick answer.

The mitral regurgitation in this patient is due to the ventricular dilatation, so it's secondary (a result of) to the disease process. While fixing the valve surgically might help some of the symptoms, it doesn't address the root cause, and in this case, treating the root cause would fix the ventricular dysfunction.

B and D refer to the physics of the cardiovascular system. Think of it like a large, closed pump. The afterload is the resistance the pump must push against and the preload is how much is fed into the pump at a time. Too high afterload means the pump has to work harder to overcome the resistance. Too high preload means the pump is starting to get congested and can't pump it all out effectively. Since the heart is a muscle (the pump) and working harder means getting bigger, long term high afterload (say like in high blood pressure) causes the heart to enlarge to a point it's too big to relax efficiently, so it can't pump as well. So these play off each other and are what happens in congestive heart failure.

This patient has similar symptoms to congestive heart failure, but it is not the correct answer.
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"He has two neurons held together by a spirochete."

TC, you're getting backlash because the process of dissecting something as dynamic as human interaction comes off as....well....creepy. Instead of just interacting naturally, you're splitting up every interaction into a manufactured psychological consideration. Regardless of your intentions, it comes off as manipulative, or at the very least disingenuous.

And really, without a "control group" it's really nothing more than your own indulgence into the idea that human interaction is a chemistry experiment by which mixing the right ingredients in the right steps provides a predicted yield, when in reality, these tips really don't do anything meaningful.

You tell her she can take her shoes off. What if she doesn't? Are you now going to insist? She was either going to take her shoes off, or she wasn't. But in the end, if something so minute would have made the difference in her sleeping with you, to what end are your "pick up tips" bordering on outright coercion? If these tips really did make the difference, is it really ethical to apply them? Reverse the situation, how would you feel if someone were to control the environment such to attempt to "maximize" their chances with you. Comes off sleazy? Doesn't it? Nah, you won't admit to it. PUA's have this cult-like rationalization to it.

They're either worthless tips reflective of an obsessive personality, or they really do work, but then one really should consider the ethics of it. If I had the "formula" to sleep with you, whether you wanted to or not, how would you feel if it were applied?
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"He has two neurons held together by a spirochete."

A 53 year-old man is admitted to the hospital with a 4 week history of fatigue and decreased exercise tolerance. Climbing 2 flights of stairs causes significant dyspnea. He has had occasional palpitations for months but no chest pain. Past medical history is unremarkable and a routine check up 6 months ago was normal. He had 2 binge-drinking episodes last month, but usually only drinks in moderation. He does not routinely take medications. His blood pressure is 150/90, pulse is 130 and irregular. Lungs are clear. EKG does not show P waves. Echocardiogram shows ejection fraction of 35%, moderate mitral regurgitation, and left atrial and ventricular dilatation with global hypokinesis. Which of the following interventions will most likely restore left ventricular function?

A) Coronary revascularization
B) Decreasing afterload
C) Inotropic medications
D) Preload optimization
E) Rate or rhythm control
F) Valve surgery
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"He has two neurons held together by a spirochete."

Answer is E) Mycoplasma pneumoniae

Mycoplasma is a cause of atypical pneumonia and is colloquially called "walking pneumonia." It's highly infectious, but low virulence, so symptoms can be brushed off as indolent sometimes, or even completely asymptomatic. It's very common in younger populations who share close quarters (college students, military recruits). In additional to headache, malaise, and fever, you can have an unrelenting dry cough. Redness in the back of the throat, a macular rash, and low grade hemolytic anemia (which causes the fatigue) can also occur. X-ray is usually interstitial findings and an effusion is present in about a quarter of all cases.

Treatment is usually with Azithromycin ("Z-pak").
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"He has two neurons held together by a spirochete."

chrono625 posted...

A

Kineth posted...

Yeah, probably A then. iirc Epstein-Barr affects one gender more than the other, so the person carrying it wouldn't have appeared ill.

Very close, but no!

Epstein-Barr causes infectious mononucleosis, which share a lot of the same symptoms as our patient here: headache, malaise, fever. Also typical of EBV is an exudative pharyngitis (meaning white spots in the back of the throat) and cervical lymphadenopathy (swollen lymph nodes in the neck), as well as splenomegaly, none of which our patient has. The correct answer accounts for more of the respiratory symptoms.
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"He has two neurons held together by a spirochete."

Flockaveli posted...

Streptococcus pneumonia

No. Strep pneumo is the most common cause of pneumonia. Symptoms come on very rapidly. X ray findings would be limited to a particular lobe of the lung as opposed to all over. Sore throat and rashes are not very typical.

Kineth posted...

Hm. No sick contacts... I'll say F. Since that would suggest catching it from an animal, perhaps and not a person?

I like your thinking, but no. It's important to remember that it is no sick contacts from the patient's point of view. So you can rule out illnesses that are obvious when someone is sick (e.g., influenza), but they may have been exposed by someone who could carry a mild illness unsuspectingly.

Parvovirus can cause a flu-like illness with aches, fever, and malaise. A rash can be present too, but the pulmonary and x-ray findings would not be typical.
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"He has two neurons held together by a spirochete."

A 19 year-old man comes to the office due to a week of persistent dry cough that disturbs his sleep. He has also had a sore throat, headaches, and fatigue. Yesterday, he noticed a rash on his arms and legs. The patient has no known medical problems and takes no medications. He has not had any sick contacts. Temperature is 37.8 C (100F), blood pressure 115/78, pulse 86/min, respirations 16/min. Mild pharyngeal erythema is present. There is no cervical lymphadenopathy. Cardiopulmonary exam is normal. A faint macular rash is present on extremities. Chest x ray reveals increased interstitial markings and a small right sided pleural effusion. Which of the following organisms is the most likely culprit?

A) Epstein-Barr virus
B) Influenza
C) Legionella pneumophila
D) Moraxella catarrhalis
E) Mycoplasma pneumoniae
F) Parvovirus B19
G) Streptococcus pneumoniae
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"He has two neurons held together by a spirochete."

Answer is D) gastric cancer

This patient has classic signs and symptoms of vitamin B12 deficiency. Macrocytic anemia (low hemoglobin, high MCV), glossitis (shiny tongue), and peripheral neuropathy in her feet. The most common cause of vitamin B12 deficiency is pernicious anemia, an autoimmune disorder that creates antibodies against intrinsic factor (you need this to absorb vitamin B12).

The result is an atrophic gastritis, which increases the chances of developing gastric cancer.

I'll type up the next question soon.
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"He has two neurons held together by a spirochete."

thronedfire2 posted...

I'm gonna say...E

Nope, try again
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"He has two neurons held together by a spirochete."

chill02 posted...

lupus

It's never lupus

DeanAuryn posted...

If shes 54 then shes got disusting feet and Im not interested, so she can fuck off and see another doctor.

Hahahaha
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"He has two neurons held together by a spirochete."

A 54 year-old caucasian woman presents to your office with fatigue. She also reports dizziness and palpitations after moderate physical activity. Additionally, her feet feel "numb" and are less sensitive to cold than they used to be. She has no significant past medical history. Physical exam reveals pale conjunctivae and a shiny tongue. Ankle reflex is decreased bilaterally. Lab findings include:

Hemoglobin 7.6 mg/dL (normal: 12.0-16.0 in women)
MCV 110 fL (normal: 80-100)
MCHC 36 g/dL (normal 31-36)
WBC count 3,900/mm^3 (normal 4,500 to 11,000)
Platelet count 150,000/mm^3 (normal 150,000 to 400,000)

This patient should be monitored for which of the following long-term complications?

A) Acute myelogenous leukemia
B) Hodgkin's disease
C) Celiac sprue
D) Gastric cancer
E) Liver cirrhosis
F) T-cell lymphoma

(google any term you're unfamiliar with)
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"He has two neurons held together by a spirochete."

Is that why it's called a wash closet?
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"He has two neurons held together by a spirochete."

Airhammy posted...

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"He has two neurons held together by a spirochete."

You're not supposed to. It impacts the wax.

https://www.aafp.org/afp/2007/0515/p1523.html
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"He has two neurons held together by a spirochete."

Like, I bet they're really nice and all, but I just brewed a cup of coffee. That's not a conversation I want to have right now.
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"He has two neurons held together by a spirochete."

A_Good_Boy posted...

The cultists got real fucking triggered in this topic after they finished wiping their mouths off.

They become broken records at the slightest strain.
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"He has two neurons held together by a spirochete."

MrMimeTime posted...

Do you have trouble with critical thinking as someone who's (presumably) at least 13 years old?

I'll let the comments speak for themselves, lol.
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"He has two neurons held together by a spirochete."

MrMimeTime posted...

Godwin's Law and bad assumptions now. You must be fun at parties.

Did you have trouble fitting the shapes into the holes as a child?
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"He has two neurons held together by a spirochete."

No for real, NibeIungsnarf posted...

I don't think you know what reich means...

I edited it. I misspoke.
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"He has two neurons held together by a spirochete."

Muffinz0rz posted...

Soviet_Poland posted...

Muffinz0rz posted...

i know, and i acknowledge that.

but saying he is not your president is simply incorrect

In the context of TC's title it's metaphoric, not a literal statement. He isn't denying that Trump is president from a factual basis. He is making the judgement that Trump as a president is not acting in accordance with the values he attributes to what a president holds. Trump is not behaving presidentially. It is his opinion on the matter and does not refute his actual status as our president.

I wouldn't think twice of a Republican making the same comment about Obama because I'm not a moron who takes something like that literally.

Is TC the one that made that Facebook post? Or are you just straw manning? Not withstanding those posts mean the same thing. You'd literally have to be challeneged to pretend we literally don't have a president. It's a figure of speech. They're making a commentary that the actions of the current sitting president is as if we did not have a president. Not that we literally don't have a president.
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"He has two neurons held together by a spirochete."

MrMimeTime posted...

Doubling down on that Godwin's Law, huh? That's a bold strategy.

The mere mention of Hitler is not Godwin's Law. If I were to comment that the current political climate is reminiscent of 1940s Germany and comparing our current administration to the third reich, that would be Godwin's Law. I do not think that is the case. For whatever Trump is, it's not Nazi Germany.

I'm mirroring the structure of the statement to touch upon the idea of whether or not one's leader requires full support specifically because he is the leader and opening up the consideration that, no, that's not the case.

Then you pretend TC was literally denying Trump's position as our president rather than making a value judgement.
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"He has two neurons held together by a spirochete."

Muffinz0rz posted...

i know, and i acknowledge that.

but saying he is not your president is simply incorrect

In the context of TC's title it's metaphoric, not a literal statement. He isn't denying that Trump is president from a factual basis. He is making the judgement that Trump as a president is not acting in accordance with the values he attributes to what a president holds. Trump is not behaving presidentially. It is his opinion on the matter and does not refute his actual status as our president.

I wouldn't think twice of a Republican making the same comment about Obama because I'm not a moron who takes something like that literally.
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"He has two neurons held together by a spirochete."

MrMimeTime posted...

I can always tell the other person doesn't have much of a point when they need to resort to Godwin's Law.

I'm not comparing Trump to Hitler. I'm making a direct statement about your thought process.
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"He has two neurons held together by a spirochete."

Muffinz0rz posted...

What's dumb about it? If you're an American citizen, he is your president, like it or not.

Right, but there is no requirement that he be liked, or even supported. Taking the example to the ridiculous extreme, should we support fascism or genocide because they're our leader? (I know those words get tossed around a lot willy nilly by the left, so let's go back to the real meaning here).
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"He has two neurons held together by a spirochete."

MrMimeTime posted...

Assuming you live in the US, Trump is YOUR president whether you like it or not. Shut the fuck up and deal with it.

Assuming you live in 1940s Germany. Hitler is YOUR fuhrer whether you like it or not. Shut the fuck up and deal with it.

Dumb analogy for a dumb comment.
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"He has two neurons held together by a spirochete."

Technically episodes of Star Wars. Doesn't include every episode, but within this set specifically it's valid.
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"He has two neurons held together by a spirochete."

Pepys Monster posted...

I'm happy now.

Happy in which way?

Elated/infatuated? Unsustainable. The honeymoon phase eventually wears off. That's not necessarily a bad thing in a relationship, but read on further.

Content? Better, but if it's necessarily dependent on the relationship status, what about in the event of a breakup/death/cheating/etc?

When people say relationships can't make you happy, they don't mean it doesn't mean transiently in the moment. They mean that it's not a reliable source.

Find that happiness within. Be content with yourself without someone. Then if anything happens, it doesn't whirlwind you out of control in the event "something" happens. The plus side is that if you are happy and content with yourself without somebody, that when someone does come into your life, it is easier to develop healthier relationship habits as well. Sets you up for future success.

Everyone is elated and giddy in a new relationship. Some people get addicted to that feeling, and that's why they go from relationship to relationship. Because it's unsustainable and they chase that fleeting feeling.
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"He has two neurons held together by a spirochete."

No_U_L7 posted...

You misread, I meant no matter the profession/hobby, you can frame it in a passionate way.

Doctor kind of speaks for itself :x
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"He has two neurons held together by a spirochete."

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"He has two neurons held together by a spirochete."

"Pick up artist" tips are always just "how to be human 101" and "introduction to socializing."

You don't need to masquerade it as some tip to "increase attractiveness." Just don't answer open-ended questions with one word answers. In other words...how to carry a conversation? That applies to more things than just picking up women.
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"He has two neurons held together by a spirochete."

27. Married for 2.5 years. Together for 6.5.
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"He has two neurons held together by a spirochete."

clearaflagrantj posted...

That's cool I went straight into my career and now I'm making more than grad school graduates my age because I have actual work experience instead of wasting my time doing dumb bullshit research on studies nobody cares about for shit pay. I'm pretty happy where I am in life, so happy that I don't have to be a gatekeeper of science articles with annoying pseudointellectual garbage on a video game social board like it were the only thing I had going on in life. Like some miserable fucking failure of a human being looking for meaning.

Do you need a hug?
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"He has two neurons held together by a spirochete."