Those were likely manufactured in 1934

I love Peeps.

None for me this year.

At my old job we had an office in Reston VA, ERJ on United was the only direct option. I like that plane.

You can make them at home...

My dad has long been a Peeps fiend, but this year he complained to me about some of the newfangled varieties. He says that he binned a bunch of 'em and had to go back to the store for his classic yellow Peeps. :lol:

Hey datlas and MoAlpha

Updates on my fungal dog:

1. I got a multitude of texts about the fact that the dog's head was swelling while out on my ride last Friday. Annoying because I cannot diagnose the severity of any problem like that, nor can I help, from astride my bicycle in the rain. "Do you want us to schedule a CT?" WTF no. I want someone to decide if the problem is severe enough to been seen through the ER and if it is, I want a doctor to examine the dog before we schedule any tests. And if its not severe enough to be seen through the ER, then put it on my schedule for Monday (today) and I will decide what tests might be indicated after examining the dog and listening to the medical history. PS I also got 4 texts about where to put my dog food order which had just arrived at the clinic. Uh, its frozen dog food. So... in the freezer maybe?

2. The fungal titers and galactomannan titer all are negative. So... we either have a false negative, or more likely, an opportunistic fungal infection

3. I saw said dog today and she is doing much better. Her facial (not "head") swelling is almost completely resolved. I assume that was due to fungal die-off from the 2.5 days of voriconazole she had received at that point. Her non-weight-bearing right thoracic limb lameness is now a weight-bearing lameness. But...

4. Her original subtle hind limb ataxia is back now that she's off cyclosporin and pred. I am decreasing her gabapentin just in case. Its pretty mild so maybe I am overreacting. But... I'm not sure what's going to happen to our original problem in the absence of the immunosuppressants.

5. I want to MRI her brain/head and do an excisional biopsy of the lymph node/granuloma and submit the mass for histopath and fungal culture and sensitivity. I called up to the vet school at UC Davis and they all over it, would love the samples if I can get em. Of course if we can even get something to grow in culture it may take so long as to be clinically not terribly relevant.

6. Owner is thinking about my suggestions. Wants to give it a week since she's doing better. I am actually totally ok with this, it will make my post-cyclopsorin CSF results less likely to be equivocal. The longer I can have her off pred and cyclosporin before I collect spinal fluid, the less likely I am to get a false negative result.

So right now I am happy. I feel like I have a better shot at clearing up an opportunistic fungal infection vs a pathologic fungal infection like Aspergillus.

However the big picture is way more concerning. If she relapses with her original immune mediated disease any time soon, I am going to be screwed. Maybe I could do some kind of weenie half-assed immunosuppression and get away with that without the fungal thing raging out of control. But I'd be really lucky if I could.

#reallifedogstory

PS hey the censor let me say half-assed

Probably. I don’t eat anything with marshmallow in it so I’m safe.

Wut?

Best candy = See's Scotchmallow = marshmallow, caramel, dark chocolate

https://cimg5.ibsrv.net/gimg/bikefor...0aeefea8fe.jpg

No s'mores? No Phish Food? Sad!

Why not?

After seeing your 50 feet of climbing rides on Strava, I am curious how you'd do in the foothills. :foo:

I noticed that's past tense. Did you eat the whole pan? NTTATWWT

me too.

This. Now craving Phish food.

Survived a busy Monday of telemedicine. Some older patients just can’t do it, and in those cases we use a plain phone call as plan B.

On account of stores being Hot Zones nowadays.

I went ahead and signed up for my club’s Monday evening group ride. I think 50-50 they drop me.

:bday:

I wish you all would stop showing chocolate deserts. I trying to become less dependent and getting back to merely being a casual user.

Mrs. Pirkaus made the worlds' best carrot cake, yummm. Seriously that's the name of the recipe, and it lives up to the name.
I ate a large piece, but not the whole thing. ;)

My teeth ache just thinking about them.

Hate caramel! Gets all stuck to your teeth. My teeth ache just thinking about them.

Just go to a meeting tonight, you'll be alright.

Do you even see live patients anymore?