Mick Schoech, MD

@KySportsRadio Have a drink at the Top of the Mark. Views at sunset are gorgeous

Nicer accommodations than the average KSR trip #CoverZero

@md_myer @BlaneyMD

@BlaneyMD Just to play devils advocate here. If I am doing a procedure myself of course no INR etc. But if the patient needs a pci prior to txp or a bone marrow bx etc and the proceduralist wants ffp then so be it

It is 2026. Can we please stop “correcting” the INR in patients with cirrhosis? Disheartening to sometimes see this advice still coming from community GI. Our societies have been working to change this with guidance in recent years—but we still have more work to do. 🚫FFP

@ebtapper @pgholam Sounds perfect for an e-consult

@pgholam Once, in my first year as an attending, I attempted to stop a visit for hcv ab by calling the patient and messaging the ob who referred them. I wanted to explain and spare the patient the copay and parking fee. The result? Everyone was more stressed out and confused. Never again

Dear #hepatology fellows, Nothing good can be achieved by wrinkling your nose at a consult for HCV Ab pos with aviremia or HAV Ig total pos or an elevated A1AT level… Answer the question and sign off. It’s the right thing to do. #livertwitter

@ByJayMorrison As a transplant physician, I can say there is no greater gift than this. Nicki’s generosity will change and save lives. My deepest condolences to her family, and my profound respect to her legacy.

We said our goodbyes to Nicki last night in the most appropriately meaningful way, with a hero’s Honor Walk. I need to advise that the video might be hard to watch, seeing her in that state. But we are sharing it in order to help bring awareness and positivity to the beautiful act of organ donation. True to her selfless spirit and soul until the very end, she will be giving people she never met the greatest of Christmas gifts.

@ebtapper What about @md_myer ?

Who else is excited about #tlm25?

Cirrhosis

@ebtapper @AshinaSingh2 I can’t reiterate how often the fluid restriction occurs for no reason other than lack of basic understanding

@AshinaSingh2 I was seeing a consult patient and they told me all they wanted was a grande latte and I said “hell yes you can have one” When the nurse said “but they are on a fluid restriction, I released a sound so high pitched that only dogs could understand

Ascites management

@ebtapper lol. I think we would be busy

@LiverDoc1 Let’s open a practice together “Common sense hepatology, LLC”

Another example Patient has SBP. So they should get albumin on day 1 and 3, at least 1g/kg Always? 1. What if on dialysis? Probably none is fine! 2. What if they have CHF? 3. What if the SBP was never confirmed and the patient is euvolemic and feeling great on day 3?

@ebtapper Finally a RCT on EUS PPG. Been a skeptic in general on EndoHepatology (“one-stop shop”) given lack of robust data. Txp surgeons love that they get a bx, pressure, stent at same time. I find that that’s just a way to minimize critical thinking. Not buying 60% for TJ pressures!

Trial of EUS vs TJ Biopsy AND portal pressure Huge win for EUS. The biopsy I buy. But 60% adequacy for portal pressure measures by TJ? I don’t know about that

@ebtapper Preach. No more One Drive files

People love links to, not the actual files and putting in usernames and passwords to access files. No more emails with attachments, we have hyperlinked keywords and two factor identification. Am I old?

Arch Manning of hepatology

@ebtapper Outside Hospital can’t PETH you

I have a good test. Tells you about alcohol intake over the last 3 weeks. Super sensitive. Super specific. Can reclassify the etiology of liver disease. These sorts of tests used to clean up. Total game changer. But remains underutilized. What gives?

Jon Stewart responded to CBS bowing down to Trump and canceling Colbert

@md_myer @ebtapper For those of us who still do our own liver biopsies

@ebtapper @LiverDoc1

Complications of liver biopsy are rare 1.4% And when they happen, the patient is in pain If the patient has severe pain after a biopsy, don’t just send home to walk it off doi.org/10.1111/liv.70…

@ebtapper Exactly.

There is a time and a place for everything. But usually things happen deliberately. In a sequence. To ensure patients benefit from each step

You don’t see the same slogan mentioned in every talk or review article on a subject There are very few catch phrases in gastroenterology Except for: “One stop shop” for EUS PPG Who came up with it? What does it really mean? And why do serious people repeat company marketing?

@md_myer @AtoosaRabiee @LTxJournal I do

@AtoosaRabiee @LTxJournal Do you still do your own biospies?!

Big news! 🎉🎊 Was a pleasure working on this with the @UCMCGIHEP team advancing DILI research! Shoutout to @md_myer for all the hard work. @AmJGastro @JasmohanBajaj @RobertFontanaMD @nagachalasani @jlouissaint89 @IBD_Afzali @AndrewMMoon @LiverDoc1 @UCincyIM

@DrBloodandGuts @ebtapper Ammonia: potential for harm with giving a non-encephalopathic lactuloae based on lab value

@ebtapper Greater sin: Ct or Ammonia level?

Mumbling and not quite vocal The exam performed but nothing focal Except of course for asterxis So …should we scan? let’s remix this I am definitely worried Their brain fully slurried But a CT head, ordered as if by reflex turns out, data shows, totally useless!