Hemodynamics

Random Thoughts (10/3/18) by Muhammad Amir Ayub

1) I just attended a course on advanced hemodynamic monitoring sponsored by Edwards Lifesciences. It was pretty valuable especially when the ClearSight technology was demonstrated. Seeing accurate beat to beat BP monitoring via a tiny cuff on a finger, with (assumed correct) cardiac output measurements is nothing short of amazing (so are the prices for the technology). This totally changes the game in terms of negating the need for arterial lines, especially if you want that more careful management of awake but not so healthy patients undergoing surgery (they’re not so good for monitoring critically ill patients). But there’s something I wish that the organizers could have done better: when having interactive Q&A sessions, please go through the stuff with the clinical expert beforehand; quite a number of the questions were based on outright wrong assumptions or not relevant to even day-to-day practice (nobody cares if the heart has a high extraction ratio at rest or not; in clinical practice you want to preserve the coronary perfusion pressure regardless). There was a few instances where the clinical expert did not appear amused.

Beat to beat BP, SVRI, CI (and others) with just this

Beat to beat BP, SVRI, CI (and others) with just this

2) I was thinking of writing down ideas on how to move forward with my studying methodology, but I think I'll wait until the FCAI written results come out first. But I have a few ideas and things to focus on.

3) Competition-grade powerlifting belts are wide and thick, to the point whenever I do deadlifts/squats one problem I encounter is that there's some difficulty getting to the bottom position as the belt literally eats into my stomach fat. No worries now, as my stomach clearly won after just 3 months (during 2nd rep of 6 of 180 kg deadlifts):

The stitching actually remained intact!

The stitching actually remained intact!

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The belt, costing I think RM 200 in comparison to the cheap RM 70 typical gym belt, completely tore apart in its leather, leaving no room for repairs. Looks like an excuse to upgrade to an IPF-grade belt. If I compete in future in IPF-sactioned events, I get the advantage of avoiding steroid-laden competitors (winners are tested) but no room for weight manipulation (weigh-ins are done immediately pre-competition).

More importantly, I didn't lose focus and lose my back posture when my stomach popped the belt .

4) I really want to work on editing the videos of my win in the Tony Roma's Rib Eating Contest last November, but there's no time then. Now that exams are over I can hopefully edit and publish it (the way I did during the MPA Meet that same month).