My co-workers call me the "prince of pee" yesterday I lived up to my nickname diuresing 15 L off a patient 😆 #medsky #nursesky

I hope residency programs in family medicine, pediatrics, PA programs, and FNP programs in Florida really bulk up the lectures for diptheria, pertussis, polio, mumps, rubella, measels, and all the other vaccine-preventable illnesses so we can at least quarantine and treat the new outbreaks to come.

Just a PSA, going off your antihypertensives in favor of a more "natural" approach is a poor way to deal with HTN, but a great way to meet a heart failure specialist. #medsky #nursesky

Spring in Seattle is gorgeous! #pnw #Seattle #spaceneedle #mtranier

Just saying

This little monster is 3 today, love her so much! #dogsky #pomsky #pomeraniansky

This furry gremlin is happy I'm home from work #dogsky #pomeraniansky

Reading this amazing book about nursing history & current nurse leaders. All of my #nursesky friends should grab a copy. #booksky

For #hfweek2025 let's continue our discussion of WHF with a bit about vericiguat, a soluble guanylate cyclase stimulator. For patients who are experiencing WHF this medication has a class II indication in the current guidelines for the management of heart failure with a specific indication for WHF.

The #hfweek2025 topic today is risk for mortality associated with worsening heart failure. As demonstrated here in this graphic, patients with WHF are at a 40-60% risk of death, far higher than ASCVD risk and much higher than in many other disease processes.

Let's talk GDMT today for #hfweek2025. Foundational therapy is ARNI, SGLT2i, BB, & MRA at OPTIMAL doses. GDMT saves lives: ‼️ Relative risk reduction 73% ‼️ Absolute risk reduction 26% ‼️ NNT = 3.9 ‼️ Extending median survival 7-11 years

As #hfweek2025 continues, some trends in epidemiology. Currently there are ~7 million adults with HF in the US, and projected to grow to 8.5 million by 2030. Mortality is rising again after years of decline.

Today kicks off #hfweek2025 with @hfsa.bsky.social Hopefully my @accintouch.bsky.social colleagues join in spreading the word to increase visibility We as a healthcare system have so much work to do for heart failure patients, but the best thing we can all do is commit to starting GDMT early!

Despite the chaos of the world, spending an evening with a great book and this furry gremlin in my lap is the best

Practicing what she preaches, if more were like her this country would be a much better place

www.linkedin.com/posts/americ... We lost a giant in the field for sure!

Seattle/King County public health has zero chill

More HF rounding thoughts: you can't chart that you "optimized GDMT" if a Pt is only on an ACEi/BB. Remember GDMT is quad therapy ARNI/SGLT2i/BB/MRA at optimal doses. Every touchpoint with a HF patient is a chance to optimize therapy. #medsky #cardiologysky

Rounding thoughts from the HF service today: 1) If no neurogenic bladder/retention and the patient is ambulatory, TAKE THE FOLEY OUT 2) With no hyponatremia, a 1500 mL fluid restriction is draconian and just makes the patient miserable 3) TED hose are your friends for LE edema

You have the potential to be invincible. All you have to do is never enter a contest where victory isn't up to you. -Epictetus, Handbook 19a

Did a crazy thing and got married today

Well thanks to a gift from my soon to be in-laws I squeaked in 1 last NPD to end 2024. Added 1 more Pilot Custom 74 in a lovely grenadine with a fine nib. Also trying the Apica CD notebooks.

Do you ask what is the proper limit to wealth? It is, first, to have what is necessary, and, second to have what is enough -Seneca

It's a NPD again (probably last one of 2024) the Sailor Plus X pro gear slim "jellyfish" with a fine nib, Ancora put together this lovely ink and notebook to complement the ocean and jellyfish theme.

I was just informed that I've been appointed to the Heart Failure & Transplant Section Leadership Council for ACC! Term will be effective April 1st, excited and humbled for the opportunity!

A question for my academic colleagues. Do you offer your lectures on Zoom/Teams/whichever platform during class times? Giving students the option to join online or inperson.

Adding to my pen addiction. I love the Pilot Custom 74, write with it every day. Goal is to get all the colors, but the clear, blue, and forest green arrived today!

My team and I have diuresed 78 pounds and counting off a patient in 2 weeks, definitely in my top 10 hospital weight loss

Me and all my cardiology peeps getting the lasix, torsemide, and bumex ready to go

Doing some data collection prior to getting all the food going, I have an excellent colleague assisting (mostly supervising) me #pomeranian #dogs #dogsofbluesky

I 100% do not care about the citizenship status of an individual in the hospital bed or clinic exam room. They are there for treatment and they are safe with me.

Got this shipped to me from Ancora in Tokyo, from their limited release birthday line. I'm a March baby, so a gorgeous aquamarine with tulip accents on the nib and cap. A Sailor pen with a 14k gold fine nib. Paired it with the Sailor birthmonth blend ink.

American College of Cardiology has made it to bluesky!

Treatment inertia in HFrEF is a real phenomenon that leads to increased morbidity and mortality. This article onlinelibrary.wiley.com/share/YQEURF... is a great read on how to approach treatment inertia in practice.

For those that like to write or gain knowledge, are you a fan of commonplace books vs compendium, and any examples to share?

In these stressful times my aquarium and growing fish population greatly help relax me

Just completed a peer review for a journal, I'm reviewer #1 thankful not to be reviewer #2 lmao