Dave Johnson

@ChengaziMD @drochohan @SDhandMD @traumaticum @AustinBourgeois @keithppereira @farkomd @brianchiong @karananandpara @linemonkeymd @t_intheleadcoat @pparikhxr Keep posting

I guess this got enough traction Cryptogenic cirrhosis with chronic PV occlusions and splenectomy - no good route for PVR/TIPS so percutaneous #mesocaval shunt created by #chogazi @drochohan Percutaneous trans abdominal esophageal varix embolization was something new. Technique evolves and a lot to learn with every case.

@NaineshParikhMD @MoffittNews @MoffittRadOnc @KOSJ12 @gdgrass @VaseemKhatri @ctRO_journal What’s the time interval between PAE and RT?

HOT OFF THE PRESS! Neoadjuvant PAE prior to prostate radiation therapy: A single institution experience on the durability of clinical urinary improvement after radiation - ctro.science/article/S2405-… @MoffittNews @MoffittRadOnc @KOSJ12 @gdgrass @VaseemKhatri @ctRO_journal

@dr_cellini @northwoods1980 If you use ICE you can get procedure time pretty consistently down to 1 hour or so for TIPS pubmed.ncbi.nlm.nih.gov/27052948/

@northwoods1980 And can take an entire morning to do and the performing doc gets minimal reimbursement per time spent in the case and also high radiation exposure. Haven’t done one since fellowship? And never will

This accurate?

@thats_bone @rkh_md Peripheral IVs?

@rkh_md Written consent for all needle procedures.

When you do a joint injection/aspiration, do you have the patient complete a written consent form, or do you get verbal consent and document it in the chart?

@ToddZywicki @sgremminger

I'm at the pediatrician office for a well child visit with my daughter. Appointment was 9:20. Vitals taken and paperwork filled out, but still waiting to see a doctor. Reason #30584 of why healthcare in the US sucks. Why can every other sector keep appts, but physicians can't?

@dr_cellini I didn’t realize you could just pay to become FSIR

Rather than spending $950/yr for 8yrs to become FSIR, you could invest $950/yr and have $11,480 after 8 years, instead of spending $7600. (w/ annual 6% rate of return). But to each their own…

@SPuro88 MIPS measure #405 qpp.cms.gov/docs/QPP_quali…

Why don’t radiologists put “this requires no follow up” when Bosniak 1 or 2 simple renal cysts are noted on CT or MRI? Would really cut down on patient anxiety when they look at their MyChart results and make emergent office visits/decrease silly referrals.

@JoeTMarion @SIRspecialists Non-IR radiologists should easily be able to do those tasks

#RuralIR. Rural ND patient (pop 750), hepatic abscess. Traveled 330 miles for drain placement. 2 weeks later drain occluded and patient septic. Traveled 175 miles to a different hospital for exchange. Will travel 95 miles to a third hospital for drain removal. @SIRspecialists

"A weak person magnifies their problems. A strong person minimizes them."

My favorite Charlie Munger story: In 1953, Munger was 29 years old. Recently divorced. Lost the house. Huge social stigma of divorce back then. His 8-year-old son, Teddy, was diagnosed with cancer. The leukemia was incurable. No medical insurance - Munger paid for all his medical care. Charlie would visit Teddy in the hospital every day -- and then walk the streets crying. Teddy died at the age of 9. Charlie was broke, divorced and just lost his child. 99.9% of people would've turned to alcohol, drugs, or suicide. (And you'd understand why) Munger never did. Fast forward to 52 years old, a failed surgery left him blind in one eye with the potential of going fully blind one day. Charlie was an obsessive learner who read every book he could get his hands on. When confronted with the possibility of going blind and no longer being able to read he said: "It's time for me to learn braille!" The only thing that might be more impressive than his intellect was his actions. RIP. --------- Munger on Self-Pity: "Generally speaking, envy, resentment, revenge, and self-pity are disastrous modes of thought. Self-pity gets pretty close to paranoia… Every time you find your drifting into self-pity, I don’t care what the cause, your child could be dying from cancer, self-pity is not going to improve the situation. It’s a ridiculous way to behave. Life will have terrible blows, horrible blows, unfair blows, it doesn’t matter. Some people recover and others don’t. There I think the attitude of Epictetus is the best. He thought that every mischance in life was an opportunity to behave well. Every mischance in life was an opportunity to learn something and that your duty was not to be immersed in self-pity, but to utilize the terrible blow in a constructive fashion. That is a very good idea."

It’s been a long road and not done…but it’s a great start! @riadsalemIR @SIRspecialists @SIRRFS @AriIsaacsonMD @UsaProstate @pryce227 @AlexPavidapha @NoLimitIR @UrologyUS @UrologyPractice

@northadapt Yeah looks nasty but they said that all the pt’s hands returned to normal appearance by the time they sent home.

@DaveJohnsonMD Um. Not sure. Don't like the look of that hand.

🤯 Hand embo for interphalangeal joint OA pain may become a viable treatment option. It’s such a prevalent problem for pts, and this is so simple of an intervention. IR always pushing the boundaries of what is possible! jvir.org/article/S1051-…

@IRadPatwary That’s understandable. The issue is that we don’t have a crystal ball. If the guy has the potential to live to 110yo or something then maybe you could make a difference. It’s really a quite low risk intervention if you can do w/o anesthesia and if anatomy is favorable

@IRadPatwary What does the patient want?

@esambolmd @AmputationSuck @RosenthalHealth The 100 wRVU code, obviously!

@AmputationSuck In standard @RosenthalHealth fashion she grossly exaggerates reality. Or finds a tiny percentage of docs who bill inappropriately and passes that off as the norm. What CPT code has an RVU that pays $3000/hr?

This is an intellectually dishonest tweet

@tropicalupdate Us in July 😂

@DaveJohnsonMD Yes... usually end of May for sure early June. I think overall numbers leading up to now are lower making it seem worse.

Number one question my locals are asking Google: Is it ever going to rain again? Florida rains here through Friday. Coastal areas staying dry while random inland stuff gets some chances. Booo. spaghettimodels.com