Recent content by DubVille

I'd rather make half my current salary than do 100% work comp if I had a decent mix of patients and potential to feel like I help people on occasion. 90% of the time it feels pointless with WC. Goodluck, but sounds like a recipe for massive burnout to me, ymmv.

"Least worst "straight medicare, BCBS federal, and actually around my parts medicaid indian health service (pay isn't good but they don't deny much). Worst: humana, carefirst (a version of medicaid in my state, deny everything), and california work comp.

My pointer is next to a tiny appearing epidural space. Too small for me to be comfortable targeting. So I would drop a level to C7-T1.

None of the imaging centers include Axial T1. I don't trust myself to see small epidural space on axial T2, I can't always tell it apart from csf.

I wouldn't go at C6-7 in this instance. C7-T1 is the highest I would go.

Look at the MRI. Often no epidural space.

Occasionally I feel it but it's based on imaging and contrast really.

I wish I could say I had some measurement guidelines I use but I don't. I need to see more than a paper thin white line on T1 sequence for sure, but otherwise it's kind of just "eyeballing it."

I tend to aim at inferior lamina (usually a tad of cephelad tilt to see the interlaminar space) just a bit lateral to not hit spinous process/ligaments. Touch down on superior lamina (about in line with c-arm to have close to hubogram) and slide up along lamina. Once my needle is just above...

Look for an epidural space on T1 MRI. I use contrast spread technique and not LOR. I've always hated the feeling of breaching ligament with a larger tuohy. I use 25 g spinal for all IL ESIs. I think I saw Lobel post about it and tried. Never going back. Very, very rarely I may go C6-7 if...

Do they have several comorbidities? (I know that is a stupid question about a 90 y/o) but my n of 2 has been 3 relatively healthy 90ish patients with awful OA. Had them see a good surgeon in town who takes train wrecks and revision work. They all did awesome and were told no by a few ortho in...

Ahh the irony. From college of rheumatology. Every rheum in town refuses to do anything but diagnose fibro and send to "pain management."

I do alot of emg/ncs for ortho group (nearly 400 a year total from all referrals) and at prior job did nearly that many mostly for upper extremity ortho group. Think it can be helpful for peripheral entrapment vs radic at times. Not a very good study for radics. Very, very rarely helpful...

They pay well in the office and tend to get better. I'd still say I wait out 90% of fractures I see

I've always been slightly biased towards endurance over strength. So to me the 2k is best blend. But the 1k is killer. Sprinting on a rower imo is on a different level than almost any other form of exercise. Just uses everything you've got.