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Have you ever laughed when a doctor told you a diagnosis?Not at the diagnosis itself but getting here has been kind of amusing.A few years back, a doctor looking at a chest x-ray noticed that I had a healed crushed vertebra. I knew that I had hurt my back a year earlier but didn’t realize it was a crushed vertebra. When I told her that I got it lifting a shop-vac into my pickup truck, she was suspicious. As a (then) early 50’s male, I shouldn’t have bones getting crushed for something that innocuous. She ran some tests that showed that I had abnormally low bone density but everything else was fine. She suggested that I see a specialist.After a (long story) while I get to see an hematologist/oncologist. They start doing some measurements of protein in my blood. The value keeps rising. Bone marrow and biopsy tests from my hip shows unusual cells. The doctor says I have Waldenstrom’s macroglobulinemia. But … they keep testing and the protein value roughly stabilizes. It’s too high but not high enough for a definitive Waldenstrom’s diagnosis. I have Monoclonal Globulinemia of Unspecified Significance, MGUS. Treatment is to watch and wait to see if it develops into something more serious.This summer, I crush another vertebra lifting up a computer. MRI scan shows a tumor in the crushed vertebra and the vertebra next to it as well as some other damage. Diagnosis? Multiple myeloma.I get signed up for a clinical study for multiple myeloma. Doctors need to get another bone marrow and biopsy from my hip to baseline my condition before starting treatment. Diagnosis? Not multiple myeloma. It’s Waldenstrom’s.The hematologist wants to have a back specialist take a look. When I see the very experienced back specialist he says that he’s never seen Waldenstrom’s lead to crushed vertebra. Diagnosis? It’s probably multiple myeloma.But, importantly, he says we can’t keep guessing. We need to get a bone marrow and biopsy test from the vertebra to be certain. Result? It’s Waldenstrom’s. Everybody is now in agreement.I know way more about my immune system than I ever expected to know.
If someone borrowed your body for a week, what quirks would you tell them about so they are prepared?Hello! And welcome to Richard’s Body. I certainly hope that you enjoy your time with us. If there are any questions not covered by this handy brochure, please call customer service at 1–800-GUD-LUCK. Thank you for the patronage.Here are some things to know when navigating the use of Richard’s Body:Richard’s Body struggles to sleep, it frequently stays up too late. Not out of choice but out of that’s just the way things are. Sleep can be a touchy subject.Because of this, Richard’s Body tends to feel a little off in the morning. Have no fear Valued Customer, because after 15 minutes or so Richard’s Body is up and running. Even though this body is not a morning body, so slight crabbiness is expected.Speaking of running, Richard’s Body likes to run in the morning. Usually between 3 and 5 miles. If running isn’t your thing, perhaps try one of our other exciting products like Richard’s Unmoving Neighbor, that brings the new experiences of laziness and irritability.When you shower following your run, you will notice Richard’s Body is in good shape. So yeah, you have that going for you.Richard’s Body has one tattoo, it is meaningful to him. Please do not expand on said tattoo when you’re utilizing our service. Such actions will result in a withholding of deposit and possible surcharges.After getting out of the shower, you will notice a steel stand. On that stand will a DE safety razor, a brush, a stainless steel bowl, and Proraso shaving cream. That’s because the face portion of Richard’s Body likes a good classic wet-shave in the morning. You will also see several small towels in the drawer to the left, where you can wet and heat them. We have left a new blade in the DE razor for your convenience. However, if you don’t know how to wet-shave, DON’T. You will cut up Richard’s Body’s face, which we result in withholding of deposit. There is an emergency electric shaver in the right drawer, use that.There are numerous clothing items from which to chose. If you look at the convenient schedule in your Welcome Packet, you will see what Richard’s Body has on its schedule. Dress accordingly. Richard’s Body is equally comfortable in suits as he is in linen shirts and jeans, use your judgment. If you’re unsure, an automated style guide is available when contacting customer service.You will notice two racks of shoes in the closet. Richard’s Body will hate all of them, it generally prefers to go barefoot. So just choose whichever matches the clothes for the day. Note: that if campus schedule dictates you can go barefoot for the day using Richard’s Body. Depending on your personal level of comfort.In the garage, you will notice two vehicles. One car and one motorcycle. Because we’re unsure of how the whole consciousness swap/muscle memory thing works, we are limiting the use of the motorcycle (unless you have filled out form 11E-1z, proving a high degree of knowledge in the operation of powerful superbikes). We are sorry for the limitation, but you will find the car reasonably thrilling.During the workday, Richard’s Body will tend to get tired eyes, it’s all the monitor time when working on specific projects. You will find Refresh eye-drops in Richard’s Backpack. Use them at will. Richard’s Body’s last eye exam says that he has perfect vision, although Richard is sometimes skeptical. Or there needs to be better monitors provided. We look forward to hearing your feedback on this issue!Richard’s Body is sometimes prone to tension headaches. A quick walk around campus is usually enough to fix this.Richard’s Body is used to martial arts practice multiple times per week. Class times and training blocks are outlined in the provided schedule.DO NOT SPAR when using Richard’s Body. You don’t know how to fight, the people you train with do, again the whole consciousness/muscle memory question. Richard knows but is not currently in the Body. As such, doing so will result in possible damage to Richard’s Body.Unfortunately, Richard’s Body has suffered a prior knee injury. It starts to ache after specific activities. High-knee-stress activities like burpees are not recommended.Richard’s Body likes walks on the beach, you have several nearby. Please refer to the custom Points of Interest in the car’s GPS.Richard’s Body also eats healthy, there is an information card regarding possible meals (with recipes) in your Welcome Packet.On a personal note: if this week should occur when Richard’s Body’s Girlfriend is visiting, she has been apprised of the situation. She knows what to do to please herself and Richard’s Body, advanced sexual knowledge isn’t required (although appreciated. We, however, understand lack of knowledge, the consciousness/muscle memory situation again). We here at Out-Of-Body Experiences advises you to just enjoy the ride.Alright Valued Customer, we think you’re prepared to enjoy your week in Richard’s Body. We hope that your experience is a pleasant one. Following your visit, we hope that you’ll take the time to fill out a quick survey about your stay with Us.Thank you again,Out-Of-Body Experiences
At what moment in your life did you witness true evil?(Graphic/sickening content) To this day, I hate the person who did this. I never got a good look at this person and have never seen them or their care ever since.I was doing my normal 30 minute run of the day and I would usually finish my run at a dead end street, where I would give myself a 5 minute break. Once signNowing my stop, I would always go right under a tree to block the burning sun and rest. I was a bit hidden by the tree, so no one would be able to spot me unless they truly tried.I was in the middle of having my drink, when I noticed a navy blue Ford Explorer with tinted windows make a stop right next to the empty road, almost right beside me. I continued drinking my water, but stopped when the driver slid their window fully down. I couldn't see the driver well, because the driver seat was facing the opposite way from me. So I was only able to see the silhouette of the driver through the tinted windows.I was able to hear a commotion going on in the car, but after the driver put down their window, all I heard then were two children, a boy and a girl, repeatedly crying out, “Please don’t do it mom! Please don’t do it!” I was a bit interested in what they were talking about, so I hid a bit more, so that I wouldn't be seen snooping. The mother, who was the driver, kept telling them to shut up and in her exact words said “Shut up! Shut up, you crybabies! I have enough trouble caring for you two! I'll be damned if I have to care for these stupid things!”Through the tinted window, I was able to see her pick up what seemed to be an open cardboard box that was small enough to fit through the window, but big enough to put a variety of small objects in. The children kept screaming, “NO! NO!”. As a speeding car was coming down the road, she threw the box right in its path without giving it a chance to react. At that moment, I heard tiny meows coming from in the box as it flew through the air towards the ground. I froze in horror as the box hit the front tire of the speeding car and the box went right under. All heard as the box went under the tire was a disturbing wet crackling noise that still haunts me to this day.By the time the car fully ran over the box, the mother with her children were long gone, speeding the opposite direction of the other car. I couldn’t believe what I just saw. I just stood still and watched as the man came out of his car to see what he ran over. I was hoping that it was anything other than what I thought it was. To my horror, the man pulled out the now almost fully flat box and it was oozing out this bright reddish liquid, which I believe was blood. The man took one look in the box and immediately threw up on his car. The man dropped the flat box, went in his car, and drove away.I was so stunned that I stared at the box for a good ten seconds. I couldn't believe I witnessed this. I knew what was in the box, but I refused to believe it. My sick curiosity wanted to see what was truly inside that box. I didn’t want to believe that there were kittens in there. I finally came out of my daze and went across the street towards the box. The closer I got, the faster my heart began to beat. Standing right over it, I saw the small opening the man left as he peeked inside. Looking inside the box was the biggest mistake of my life. What I saw was the most traumatizing image that still sticks to me to this day. I won’t describe it because just thinking about the image makes me sick.After seeing what was inside, it was for a fact that inside the box was a group of disfigured, flat baby kittens that weren't even given a chance to live another day. How could she? I said to myself. How could anyone be so disgusting? I knew there was nothing I could do, so instead of leaving the box on the ground exposed, I put it in a nearby garbage can. The box left a red stained road with a bit of the box left on it and all I did right after was walk straight home, leaving behind my bottle of water at the tree where this all started.I wanted to share this story because I had it as a secret from my family at home and I don't plan on ever telling them. Just writing this story was a huge struggle for me. As you can see on my profile picture, I own an orange male cat that I have taken care of since birth. I could not stand it if anything horrible were to happen to him.Thank you for reading my experience.Those poor poor children.
Have you ever had to deal with a ridiculous policy at a doctor's office?Two days before my wedding and honeymoon (our flight was a few hours after the wedding), I showed up at least 10 minutes early, let’s say 12 minutes and got into an unusually long line at the check-in window. No problem, I have plenty of patience; The nerves in my hip and leg don’t, but I was close enough to lean on a chair after about 5 minutes.While I’m waiting, I observe that the patients checking out are now checking out at the check-in windows for some reason, are being given priority, thus making the check-in process even slower. Not only that, but I can hear clearly, despite HIPAA, all of the patients’ information as both windows were calling other offices to make appointments for specialty services.Half an hour later, they gave the man standing in front of me, who had to be pushing 90 years old, grief for how late he was at 13 minutes, and how he better call next time. I got told I was 19 minutes late where 15 minutes was the deadline, I had to pay a $50 missed appointment fee (which is double my co-pay), and they had another appointment in 10 days, when I would be on my honeymoon. She was usually very nice, but today she was a disciple of Lucifer himself. I explained that I had been there for over a half hour, and even started my wait in line DIRECTLY UNDER A SURVEILLANCE CAMERA that they should check, that the only reason I didn’t make it to the window was because they were not only doing check-outs, but prioritizing them, when I was, in fact, at least 10 minutes early. There was no way I was flying back from my honeymoon just for a doctor’s appointment that I didn’t miss, and that my medication would not last me through my vacation.Finally, she told me why all this was happening (the letting go of the other employees) and told me to wait. The nurse then came out around 20 minutes later with prescriptions that would last me one week, but gave me an altered appointment for the day after I get back clearly showing that the girl at the window told her what my return date was. When I told her the medications would cut me short by 6 days, she then tells me I can take it or get nothing. I mean, nerve damage and pain that can get so severe I could lose my ability to walk isn’t all that important, nor the withdrawals from the drugs they’ve had me on for so long…When I got home from my honeymoon we were obviously exhausted and one of the things we didn’t do was read the giant pile of mail on the table; All our bills were on auto-pay anyway. The next day I went to my doctor’s appointment 45 minutes early just to be told they can’t find my appointment in the system. Then they tell me they can’t find ME in the system. The doctor asked me if I got his letter, to which I had not yet gone through the bushels of mail at home, and reprinted the letter before slamming the door. He then went to the window, as if he needed protection, and told me I was to leave immediately or the police would be called. I wasn’t even given enough time to read the two-page letter where the doctor stated that I was unacceptably late, rude, disruptive to the other doctors and patients, and a drug seeker, and they would not be prescribing medication for me anymore.
What are some unusual pediatric medical diagnoses and how are they treated?My 8 year old son’s doctor kept stammering his words as he tried to explain to us why our son was so sick. He had called us into his office (which I had always heard was NOT a good sign) to tell us it looked like our son had cancer all in his abdomen.I already had an idea of what the doctor was about to say. I had opened the large packet of (supposedly confidential) newly developed X-rays and held them up to the light in the elevator when my son and I were going back up to the doctor's office, and I didn't care, I did it right in front of all those elevator strangers.They saw it too…a huge white glowing mass covering the left half of my son's abdomen. I muttered to my son without realizing it, “It looks like we've got trouble, little guy.” No one else in the elevator said a word.The nurse kept my son company while the doctor spoke with his dad and me in his office. I began to softly cry, more so at the moment from the sheer frustration of trying so long and hard to get a diagnosis. I had known something was wrong with my son's health for years, as he always complained of severe pain right under his left ribs, yet I couldn't get anyone to take us seriously. I had taken him to several doctors for help, and he had even been hospitalized trying to find this pain.This new doctor, originally from India and just out of a US medical school, found the problem in just under an hour.The rest of the day was filled with an extended array of tests, with my son being such a good boy, even though he felt awful. At one point he looked at me so sweetly and asked why “tears kept falling from my eyes”.“I've got a bad headache, honey. Mommy is okay,” I lied. I was worried to death.I can't even begin to tell you the amount of people that began to show up to observe my son's subsequent tests as word spread in the hospital there was a possible Wilms Tumor diagnosis. This is a cancer, diagnosed in young children, of the kidney(s). All sorts of technologists and doctors in various fields were packed into each observation room as my son went through Ultrasounds, CT-Scans and MRI’s. I never complained about all the observers because in the confusion, they let me stay in there with the medical staff. I don't think they realized I was the mother watching each test being administered. I even asked a plethora of questions during each test, and they'd answer and explain.After a long, arduous, draining day, it was 5 p.m. and it was pretty clear from test results my son's left kidney was filled with tumors. There were so many that his left kidney had stretched from under his lung to deep into his pelvis.Emergency surgery was needed. His blood had become septic because uric acid was leaking from the kidney where the tumors were. My son was becoming sicker by the hour and a strange rash started covering his body the night before. I could hear my son's doctor, being new to the hospital, making urgent phone calls to various connections within the hospital to find out the exact protocol to set up surgery to save my son's life.Just then, the head radiologist was hurrying down the hall with his briefcase trying to make it home for a prior engagement, and he was actually trying to avoid the crowd of medical staff that had gathered around my son's case.Someone from the MRI team said, “You've got to see this!” and took his arm to come see. He reluctantly came into the room where the technologists were recording images and stared intently at the screens. He asked them to show him the previous 10 images, and the next 10, then the previous 10 again, back and forth, back and forth.He took me into the room where my son was lying in the MRI machine and started drawing me pictures of what was really wrong with my son, and it wasn't cancer. It was a diagnosis, that if it had been caught early, would not have put his life in such danger. I'm telling you about this diagnosis in case you have, or know of, a child who keeps having severe pain on either side in the front of his abdomen under the ribs (small children's kidneys present themselves towards the front of their small body until they grow more) or pain in the back near their kidneys when older children, teens, or young adults.It turns out my son was born with a birth defect, one we had no way of knowing. His left ureter, the tube leading from his kidney to his bladder, was tied in a knot! This is called an UPJO or Ureterpelvic Junction Obstruction and occurs in 1 per 1,000–2,000 newborns. The ureter can be tied in a knot, or it can be so narrowed or crimped that urine can not drain from the kidneys. In my son's case, this knot kept his urine from draining, which caused his kidney to eventually become filled with uric acid crystals, which then formed hundred of various sized stones.Here is an image which shows a normal urinary system on the left, and a similar drawing of my son's condition on the right, except there's no knot in this drawing, but a crimp at the top of the ureter.images upj in children:“Defects in the urinary tract may block the flow of urine and create pools of urine. In stagnant urine, stone-forming substances tend to settle together into stones. Up to one-third of children who have stones have an anatomic abnormality in their urinary tract.”Kidney Stones in Children | NIDDKHere are some images that are very close resemblances of my son's condition. These imaging views are views from the top. Notice the differences between kidney size. The healthy kidney is on the left.images upj in children:In the following image, it shows the various infiltrations in the kidney cavities with stones and concentrated uric acid crystals. You can see three stone filled dark cavernous regions in the kidney on the right as compared to the healthy kidney on the left.images upj in children:In this image, you can see presented a photo of a kidney damaged from the failing ureter:My sweet little boy had been suffering, since age 3, from kidney stone pains, pains which most adults can't bear to tolerate even a tiny speck of a stone, and I had been trying to get his doctor to take us seriously for years. When I finally changed doctors, after over many many visits to other doctors within my insurance’s “approved” doctors, the problem was found, but now he was going to lose his kidney. It was so damaged from scar tissue and infection, taking out the diseased kidney was the only way to save his life.I'm writing this to hopefully save someone from going to the horrible experience we did. My son almost died that day. The doctor who refused to believe his pain moved to a new practice in another city. I found him, though it wasn't easy, and told him what his continued doubt had done. I even reminded him how he accused my son and me of needing psychological help.He apologized over and over and said he had never heard of that diagnosis, though it's not that uncommon. Many times it's seen in ultrasounds of the baby in the expectant mother. It was the way he spoke to me that solidified my decision to not file for malpractice, though I had two doctors who said I had a solid case.However, I think I made a wrong decision not doing so. Having only one kidney affects life in more ways than you'd think. It's a pre-existing condition, which sometimes affects insurance (depending on who's in political office) and though one can survive with just one kidney, many medical considerations need to be adhered to.Here are some other symptoms, besides the pain, which children with this presentation exhibit. Many times there are no symptoms. It took a while for my son to show his symptoms and it wasn't until it had progressed quite a bit.Extreme pain on either side under the ribs in small children, or the back where kidneys are located in older children.Vomiting, a lot. This could be from the pain or the enlarged kidney pressing against the stomach.Low weight gain, also called “failure to thrive”. My son had just looked “sick” as a one and two year old, and my dad kept telling me he didn't look well. I took him to the doctor many many times but nothing was found.Urinary tract infection. A doctor did do that, but since just one kidney was working, the urine from that kidney looked fine. The urine from the diseased kidney wasn't being released.Finally the symptom that made me call work and say I wouldn't be back until I found out what was wrong with my son, and also what made me tell the new doctor at his primary care clinic that I wasn't leaving until they found out what was wrong with him, was a protruding side where his kidney was. Then he developed a rash all over his body.UPJ Obstruction - Symptoms, Diagnosis, Treatment of UPJ Obstruction - NY Times Health InformationI can't tell you how guilty I feel even all these years later that he suffered so much, but I took him to three different emergency rooms and a total of 35–40 doctor visits. He just got married last weekend to a beautiful woman, but when I think how close it came to never happening, my heart breaks for him all over again.I wrote this hopefully to help another parent or guardian in case their child is experiencing these same symptoms.Thank you for reading.
What is the procedure to fill out the DU admission form? How many colleges and courses can I fill in?It's as simple as filling any school admission form but you need to be quite careful while filling for courses ,don't mind you are from which stream in class 12 choose all the courses you feel like choosing,there is no limitations in choosing course and yes you must fill all the courses related to your stream ,additionally there is no choice for filling of college names in the application form .
What could disrupt McKinsey, Bain, or BCG? When will it happen and how?Management consulting is clearly being disrupted already. But I from what I have observed, the MBBs are actually responding quite well to it. If there are to be losers, they are more likely to be smaller firms that don’t evolve fast enough and the Big 4.The old way of doing consulting - impressing clients with basic logical thinking, neat slides, excel models and benchmarks - is dying very fast. When I started into consulting, 4 years ago, you could deliver an engagement by sticking to the tried and true approach of “Where to play?, How to win?, What to do next?”.Now, most clients have much more complex problems. From my talks with my own clients, here are some of the big questions that are keeping senior executives of large businesses awake at night:“What to bet on next, and how to scale? There are a lot of technologies, disruptions… going on in our industry. We know it’s useless to build a “grand strategy” like in the old days, and that nobody really knows what will come next, so how can we make sure we’re exposed to the key bets and can change our core business very fast once we see a bet getting traction?”“How to build our capabilities with less traditional MBAs and more software engineers, data science talents… - which we know we can’t afford in our current salary grid. Obviously we can’t change our workforce overnight, so how can we ensure their re-skilling?”“How to innovate and develop new products? We know our traditional process is not working anymore. We need to start from the customer, iterate fast, be ready to pivot… but we are beholden to the old, bureaucratic model: How can we change, and fast?”“How to reap some actionable benefits from our data science teams? Of course, we are well aware that the future lies in the power of data. We have invested a lot in building our data infrastructure, retraining our old CRM teams to keep their skillset current, invested millions in services and software from Data Science companies… but we don’t have a lot to show for it yet, because no matter how valuable the insights, it’s not easy to implement them throughout the business”What is not keeping them up at night, is “How can I build a beautiful slidedeck for my strategic plan review next quarter”, “What should be my Grand Strategy for the next 3 to 5 years”, “How should I sell more of product B, which is already slowly dying”… i.e. the traditional consulting questions.As you can see, not all large companies are complacent are waiting to be disrupted and die slowly. Most of them are acutely aware of the need to transform and move fast, but initiating change at that scale is a challenge.Now, for all of those questions, the MBBs have formulated offers quite quickly:Now, I would say that since last year 1/3 to 1/2 of all engagements are around building a Digital Factory, a Corporate Venture unit, developing a re-skilling plan… (at least, that’s the case in France, where I’m working)MBBs have also developed their own structures to complement their traditional consulting offer: For instance the Gamma Lab for Data Science at BCG, BCG Ventures which are staffed with more designers than consultants…So even if consulting is being thoroughly transformed, MBBs are moving fast as well, and have well responded to those needs.I think this disruption of consulting will also benefit emerging / innovative new entrants, who propose this hybrid approachNow, as for the potential losers:Smaller firms / boutiques who don’t evolve : The obvious one. Most boutiques, founded in the heydays of the consulting of the 1980s / 1990s, managed so far to keep a similar talent pool to MBBs. But having less leverage, they might be more conservative and reluctant to invest outside their traditional business model. Some will use their small size at their advantage to move as fast as MBBs, if not faster, and thrive. But others will wake up later and have a hard time competing. I would also include tier-2 firms who haven’t started to transform yet: for instance, compare Roland Berger, who has embraced change, vs. A.T. Kearney who has not yet developed a robust digital offer.Big 4: Now this one is probably more controversial, but hear me out.To build those new offers, it requires to be able to attract top talents outside the traditional MBA pool. Big 4 already are struggling to source from the same “general business” talent pool: How hard do you think it will be for them to acquire top designer / developers / data scientists? MBBs already can’t target the really top talents, but just like investment banks, they have enough of a cachet, prestige and are used to highly paying their employees to source a “strong enough” talent pool. But Big4? No disrespect for those firms - which are very good in what they do - but that’s going to be a hard sellClients don’t care about paying MBBs twice as much, so the cost advantage of the Big 4 is limited. There’s a lot of doom & gloom among senior executives. Nobody is stupid, all of them have seen how the world is changing before their eyes and how entire chunks of the economy have been simply remodeled in a few years. Even Big Firms who have been genuinely successful at innovating and moving fast (for their scale) are still very wary. If MBBs firm provide actionable solutions to help them stay relevant, they really don’t care if it’s a $10M or $20M project at that level.Unlike traditional boutiques, who are at risk of being wiped out, Big 4 will have something to fall back on: They are strong in Operations, and will probably continue to do well in this area. But their foray into the kind of strategic work I described will be challenging.A couple of observations based on the other answers I have seen:About freelance consultants platforms : Whilst there is definitely a market for it, I don’t believe it will disrupt the MBBs. This is further evidence that we are moving towards a two-tiered consulting market: For price-sensitive engagements - which usually where smaller firms and Big4 had an advantage - body-shopping through freelance platforms will become an alternative, which will further drive costs down. But for critical engagements, clients are not really price-sensitive, and they will be more than ready to pay for MBBs.About the risk that MBBs can’t attract top talents anymore. I think that’s a bit exaggerated: MBBs still offer interesting projects, a high level of prestige and very competitive packages. That now the really best and brightest don’t go to MBBs anymore but join tech companies or found their startups instead might be true. But it’s actually not necessary for MBBs to get the absolute best level of talent. Maintaining a strong enough talent pool is enough for MBBs.About the risk that former consultants in the corporate world render MBBs useless: It’s true that clients are much more mature now than in the heydays of consulting in the 1980s. It would be a threat if MBBs did exactly the same thing as 10 or 20 years ago, which in-house strategy departments know how to do. But if MBBs are as little as 6 months-to-1 year ahead of their clients - and they are on those topics - they’ll maintain their advantage.
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