Patrick Hickey, MD

You can't. Which means at the end of the day the humans are responsible whether they're actually in control of targeting or the machine is. The real problem is, as I've described here & elsewhere before & I've been explaining since 2008, everyone is trying to do alchemy. 3/

My guy just laughed

Alexander Thomas Augusta - Wikipedia

And you may find this of interest too: Dr Alexander Thomas Augusta, civil war surgeon, one of the first faculty at Howard, and namesake of the Army Hospital at Fort Belvoir, Virginia en.wikipedia.org/wiki/Alexand...

I’ve really appreciated your posts, thanks for doing it

Came here for this comment

And, as an ID doc, I’ll caveat* my shin splints and CECS are on a spectrum statement to say that IF they aren’t- then functionally they are getting conflated by the average clinician.

* I don’t need a fight with OrthoSky and SportsMedSky

IMO it’s one of those things that got diagnosed only for the worst but is really jus the tip of the iceberg

Botox- Like I said, it’s wizardry!
bsky.app/profile/pwhi...

Chronic exertional compartment syndrome: current management strategies Chronic exertional compartment syndrome (CECS) is an underdiagnosed condition that causes lower and upper extremity pain in certain at-risk populations. Lower-extremity CECS is most often observed in running athletes and marching military members. ...

And a review paper. Would love to see the evidence basis grow and hopefully more people gain access to a minimally invasive treatment that could have a big impact on quality of life and activity level

pmc.ncbi.nlm.nih.gov/articles/PMC...

Botulinum Toxin as a Novel Treatment for Chronic Exertional Compartment Syndrome in the U.S. Military Abstract. Chronic exertional compartment syndrome (CECS) is a debilitating condition that is not uncommon in athletes and military service members. The onl

Here was one of the papers that helped inform the decision making from a patient perspective- they saw this as relatively low risk but high return if successful.

academic.oup.com/milmed/artic...

This is an emerging therapy, but one that I think is promising and I hope studies gain traction to better define the utility and optimal dosing. Shout out to the sports medicine community for this - y’all are wizards

But this time- provocative exertion followed by immediate physical exam & point of care ultrasound ➡️ diagnostic/therapeutic injection of lidocaine to verify location of compartment & muscle site. Returned a couple days later for Botox.

People suffer & restrict activity because diagnosing CECS traditionally meant intramuscular manometry and treatment was either restricted activity or fasciotomy so everyone just 🤷‍♂️ excerpt for the worse outliers (this is my opinion)

A certain athlete I know has suffered and fought through “shin splints” for years but was just diagnosed with Chronic exertional compartment syndrome. now I’m radicalized into believing they are the same thing (??? a spectrum). Botox earlier this week & just had their first pain free game in years.

But a code share to fly on South African Airlines or Kenya Airways or whatever is fine. Make it make sense

A text exchange: I did some TDYs to South Asia that were infuriating because we couldn’t book on certain wonderful big name mid eastern airlines and instead had an extra 8-12 hours of travel time… at a higher price

Texting with my travel partner earlier today about the “fly American” rule in DTSs

This is true. It’s my fault for not paying attention to the airports on each leg when the system served it up as an option

You may have heard those of us on MilSky complain about the DTS travel system that books our flights. That’s how….

Chicken stew…. The fish must have been in business class or a special meal.
Shout out to the French who will give you two mini bottles of wine with your meal and then ask if you want some champagne as well 😵

I think there’s a fish option for the in flight meal (Air France) and I might pick it.

@kwh1.bsky.social

The word for the day is: foreshadowing

4+ hour layover for the win I guess

2nd leg of the flight underway- 6 hours of transatlantic posting or should I sleep…

American sports has a perverse chicken & egg approach to where it will put resources. I think the eyeballs will help more than not.

It’s a dilemma- As a past rec league girls lacrosse coach, whose kids eventually made the “jump” to club (for profit model) & with 1 still playing in college. I’d love to see us fund rec sports in general & girls sports in particular, but TBH I’m okay with this calling attention to their excellence.

Easy peasy

Yep- silver line

Game of thrones: Lord Walder Frey sits at the head table at what would become known as the red wedding

Same energy

US-Iran talks end after 'significant progress', mediator says The indirect negotiations in Geneva are seen as a last-ditch effort, but the chances of a nuclear agreement are unclear.

Thinking to myself that a decapitation strike less than 48 hrs after this is going to do wonders for any future attempts at US diplomacy anywhere
www.bbc.com/news/article...