Edmunds Members - Cars and Conversations (Archived)

bwia

ab348 said:

abacomike said:

Well, I am scheduled to have the spinal injection on Thursday of this week. They are putting me under anesthesia IV for the procedure to make sure I do not move. The doctor is injecting the steroids into the foramen at L3/L4 where the stenosis is the most acute. The procedure is supposed to take 45 minutes. He uses a fluoroscope to ensure the injection is placed correctly. Sure hope it helps me.

On Friday I am scheduled for an angiogram which, near as I can tell, will be the 6th of my career. I hate them and with good reason. On #2 back in the early '90s I bled into my leg from the incision in my femoral artery and nearly died - BP 20/0, not breathing, no vision, essentially a near-death experience that they barely brought me back from. Ever since I have been terrified of the procedure. For a while now they have done them both the traditional way via the groin and also via the wrist, which is less limiting afterwards, but I have never been lucky enough to get a doctor that does it that way. I'm hoping I do on Friday. The problem with the groin procedure is that you have to lay flat on your back and not move for 4 hours afterward. If you need to urinate it is very touch and go, and if you have back muscle spasms it can be agonizingly painful. None of those apply if they do it via the wrist.

@ab348, good luck with your angiogram procedure on Friday. Try to forget the bad memories of procedure #2, and given so much time has elapsed you are unlikely to have the same negative experience or doctor again. Still, remain calm as I wish you the best possible outcome. By the way, is an angiogram the same procedure as an angioplasty? If so, please take comfort in wife's experience. She had angioplasty with stent some seven years ago and she is doing fine ever since. Prayers.

ab348

bwia said:

@ab348, good luck with your angiogram procedure on Friday. Try to forget the bad memories of procedure #2, and given so much time has elapsed you are unlikely to have the same negative experience or doctor again. Still, remain calm as I wish you the best possible outcome. By the way, is an angiogram the same procedure as an angioplasty? If so, please take comfort in wife's experience. She had angioplasty with stent some seven years ago and she is doing fine ever since. Prayers.

Angiogram is a dye test where they assess the state of your coronary arteries. The dye lets them see any narrowing or blockages. The last one I had in 2017 showed all was well in that department. Angioplasty is a similar procedure but instead of just looking for blockages/narrowing, they try to fix them using a balloon catheter to expand the artery and usually insert a stent to keep it in its widened state. In my case they are doing the dye test as a standard operating procedure in advance of an expected mitral valve replacement procedure which still needs to be scheduled.

ab348

bwia said:

In a couple of weeks I will be doing a bone marrow biopsy. They've tried twice before without success claiming the hip bone was so dense and hard that the needle was ineffectual. Interventional Radiology (IR) is another option they are considering as well. Unlike traditional surgery, patients undergoing interventional radiology procedures generally do not receive general anesthesia. Yikes!

That reminds me of something else in my rogue's gallery of harrowing medical procedures I have endured. I'm thinking this was 4 years ago, though it is all a bit of a blur. A MRI in advance of heart valve replacement revealed some unusual growths on both of my kidneys. I was having no symptoms, nothing had ever been seen previously, and urology was stumped, so they decided to do a needle biopsy. They did some local freezing of the site where the needle would go in but nothing more. Imagine my surprise when I felt it hit paydirt inside me! It hurt like the dickens, I let out a yell, and the doc seemed surprised that I felt anything. He shot me up with something to knock me out at that point. To this day they remain somewhat stumped by what these things are but they don't seem to be changing much and until they do they are just going to keep monitoring.

dino001

Carvana has been messing up all over the place. One out of their three NC locations got their sales license suspended for I think six months (or more) as a voluntary penalty for essentially falsifying registration/title paperwork on at least one proven case (they didn't run their paperwork within required time, so they issued an in-state buyer out-of-state tags to cover the error, but got caught), in turn the State won't dig any further for other such cases in the past, another location is on "probation" whatever that means in practicality. Seems like big growth sometimes comes at price of losing control.

dino001

stickguy said:

the old wrong car delivered trick. I had an Acura dealer do that with our first RDX. was enough of a hassle just dealing with an actual dealer (unfortunately 2 hours away). If it was one of these online places I imaging it would have been like this poor woman's story.

This was not a "trick", rather a huge blunder. The "trick" is when they call you back to bring the car back (yo-yo tactics) and switch something in the paperwork (typically raise the price of the car they gave you). Carvana was oblivious until the lady called them.

BTW, I also had a wrong VIN on my contract long time ago (1999). The sales woman called me back in next day or two, but it was an honest mistake. I think they discovered it when they checked their inventory against the papers at the end sales event (it was one of those off-site Fairground events). They didn't try to get any more money, or upsell anything, just sign new paperwork and I was back on the road.

explorerx4

I got my loan payoff paperwork for the MKZ today.
Don't see it for sale yet.

stickguy

No, mine was not some sneaky trick. Just a massive screw up that put them in a panic. But caused me hassle.

oldfarmer50

bwia said:

abacomike said:

Well, I am scheduled to have the spinal injection on Thursday of this week. They are putting me under anesthesia IV for the procedure to make sure I do not move. The doctor is injecting the steroids into the foramen at L3/L4 where the stenosis is the most acute. The procedure is supposed to take 45 minutes. He uses a fluoroscope to ensure the injection is placed correctly. Sure hope it helps me.

Good luck with your procedure tomorrow and I hope they are able find a vein easily for the jab.

In a couple of weeks I will be doing a bone marrow biopsy. They've tried twice before without success claiming the hip bone was so dense and hard that the needle was ineffectual. Interventional Radiology (IR) is another option they are considering as well. Unlike traditional surgery, patients undergoing interventional radiology procedures generally do not receive general anesthesia. Yikes!

You and Superman have the same problem.

explorerx4

@driver100,
I know you like to watch court shows. You might like these 'Caught in Providence' episodes.
It's about 8 minutes.
https://www.youtube.com/watch?v=VJ7pCB4g3sU

This one is pretty funny. You have to wait until the end.
https://www.youtube.com/watch?v=OzNKND8ObyI

jmonroe1

explorerx4 said:

@driver100,
I know you like to watch court shows. You might like these 'Caught in Providence' episodes.
It's about 8 minutes.
https://www.youtube.com/watch?v=VJ7pCB4g3sU

Our poster buddy @andres3 needs an understanding judge like that.

jmonroe

abacomike

@oldfarmer50 said:
You and Superman have the same problem.

I am more concerned about their search for a vein than I am with the propofol they will be injecting into that vein. I am what they call in the medical profession a “hard stick” meaning I would not have a fear of Dracula going after my jugular because he’d never find it.

Propofol sedates you - puts you into a sleep as opposed to heavy anesthesia. They used propofol during my colonoscopy and I don’t remember anything about that contraption they stuffed up my derrière. Doctor said he puts me out so I don’t move during the procedure to avoid hitting a nerve.

So I am looking forward to getting some relief from this awful pain!

mjfloyd1

Surely they have an IV access team with an ultrasound to get your IV started. I’m assuming that you mean that even your external jugular vein is difficult to access. The internal jugular vein should be relatively easy to access with an ultrasound but that seems a bit extreme for your procedure.

Propofol causes amnesia. It is not a complete anesthetic in that it does not provide analgesia or muscle relaxation. You must add an analgesic and muscle relaxant to propofol to provide complete anesthesia. Sometimes you have no choice - the patient has a history or family history of malignant hyperthermia and you must avoid triggering agents, so you use a propofol drip (higher dose than needed for sedation) combined with a narcotic or non narcotic analgesic and a non-triggering muscle relaxant.

driver100

@explorerx4" @driver100,
I know you like to watch court shows. You might like these 'Caught in Providence' episodes.
It's about 8 minutes.

Thanks Explorer...I will watch those...looks interesting, I might like these more than Hot Bench!
I'll check them out tomorrow!

bwia

@mjfloyd1 said:
Surely they have an IV access team with an ultrasound to get your IV started. I’m assuming that you mean that even your external jugular vein is difficult to access. The internal jugular vein should be relatively easy to access with an ultrasound but that seems a bit extreme for your procedure.

Propofol causes amnesia. It is not a complete anesthetic in that it does not provide analgesia or muscle relaxation. You must add an analgesic and muscle relaxant to propofol to provide complete anesthesia. Sometimes you have no choice - the patient has a history or family history of malignant hyperthermia and you must avoid triggering agents, so you use a propofol drip (higher dose than needed for sedation) combined with a narcotic or non narcotic analgesic and a non-triggering muscle relaxant.

Thank you doctor. This is an eye opening and well written contribution that increased my knowledge base. Bravo.

cdnpinhead

Occasionally we get people on here who actually know what they're talking about. It's a good thing, even though sometimes it takes awhile to figure out who they are.

fintail

Best of luck to everyone with their upcoming...repairs. Think positive, and you'll be back on the road in no time.

ab348 said:

bwia said:

In a couple of weeks I will be doing a bone marrow biopsy. They've tried twice before without success claiming the hip bone was so dense and hard that the needle was ineffectual. Interventional Radiology (IR) is another option they are considering as well. Unlike traditional surgery, patients undergoing interventional radiology procedures generally do not receive general anesthesia. Yikes!

That reminds me of something else in my rogue's gallery of harrowing medical procedures I have endured. I'm thinking this was 4 years ago, though it is all a bit of a blur. A MRI in advance of heart valve replacement revealed some unusual growths on both of my kidneys. I was having no symptoms, nothing had ever been seen previously, and urology was stumped, so they decided to do a needle biopsy. They did some local freezing of the site where the needle would go in but nothing more. Imagine my surprise when I felt it hit paydirt inside me! It hurt like the dickens, I let out a yell, and the doc seemed surprised that I felt anything. He shot me up with something to knock me out at that point. To this day they remain somewhat stumped by what these things are but they don't seem to be changing much and until they do they are just going to keep monitoring.

tjc78

Well said @fintail. +1 from me. Hang in there guys!

driver100

bwia said:

@mjfloyd1 said:

Surely they have an IV access team with an ultrasound to get your IV started. I’m assuming that you mean that even your external jugular vein is difficult to access. The internal jugular vein should be relatively easy to access with an ultrasound but that seems a bit extreme for your procedure.

Propofol causes amnesia. It is not a complete anesthetic in that it does not provide analgesia or muscle relaxation. You must add an analgesic and muscle relaxant to propofol to provide complete anesthesia. Sometimes you have no choice - the patient has a history or family history of malignant hyperthermia and you must avoid triggering agents, so you use a propofol drip (higher dose than needed for sedation) combined with a narcotic or non narcotic analgesic and a non-triggering muscle relaxant.

Thank you doctor. This is an eye opening and well written contribution that increased my knowledge base. Bravo.

+1 Amazing!

bwia

All this time I thought money laundering was the domain of international crooks and shady characters, but apparently not. Look, see how easy it is, just wash and dry.

abacomike

@driver100 said:
+1 Amazing!

We have a few doctors who are poster buddies here - one of them tries his best to be more “incognito” rather than espouse his knowledge and skills of medicine and several, like me, who are, in fact, “doctors”, but alas, it’s just a PhD, not an MD.

abacomike

I will be leaving for the outpatient surgical center in about 2 hours. I think I am scheduled for 1:30 PM so they want me there at 12:30 PM. I am getting a bit nervous about the procedure but I am sure that is a normal reaction. My best friend is driving me there and back. It’s about a 10 minute drive to the center so at least it’s close.

abacomike

Just got my condo insurance renewal - an increase of 48% over the current year ($655 to $975). That’s a huge increase mainly due to the condo collapse a couple of months ago in Miami. But my building is 4 stories high and all concrete and I live 8 miles west of the coastline. Granted, my building is 30 years old, but we just had an inspection and there were no engineering concerns.

I mailed a copy of the inspection to my broker, but the underwriters declined to adjust their rating. It’s all done by zip codes and Southeast Florida had a huge rate increase. Ugh! 😤

ab348

mjfloyd1 said:

Propofol causes amnesia. It is not a complete anesthetic in that it does not provide analgesia or muscle relaxation. You must add an analgesic and muscle relaxant to propofol to provide complete anesthesia. Sometimes you have no choice - the patient has a history or family history of malignant hyperthermia and you must avoid triggering agents, so you use a propofol drip (higher dose than needed for sedation) combined with a narcotic or non narcotic analgesic and a non-triggering muscle relaxant.

Now you've reminded me of another procedure I've had - or actually two, both of them transesophageal echocardiograms. The first I had while I was in hospital after my bypass/valve replacement surgery in '09, while the second was as an outpatient a few years ago. On the first one, they had me gargle with an anesthetic mouthwash and did the thing while I remained conscious. Not fun but I got through it. With the second as an outpatient they knocked me out. I remember I woke up back in the ward and felt totally normal, not groggy at all. I asked the nurse what they had given me to put me out and she told me it was fentanyl. I assume they gave me naloxone or something similar to cancel its effect when they woke me up. Remarkable.

tjc78

@abacomike said:
Just got my condo insurance renewal - an increase of 48% over the current year ($655 to $975). That’s a huge increase mainly due to the condo collapse a couple of months ago in Miami. But my building is 4 stories high and all concrete and I live 8 miles west of the coastline. Granted, my building is 30 years old, but we just had an inspection and there were no engineering concerns.

I mailed a copy of the inspection to my broker, but the underwriters declined to adjust their rating. It’s all done by zip codes and Southeast Florida had a huge rate increase. Ugh! 😤

I was surprised that our condo insurance for the property we are buying in Wildwood NJ was $640 for the year. I thought that was high considering it’s only the interior and possessions. Liability and flood is handled by the HOA

That’s nearly as much as I pay for my primary residence.

sda

I suspect everyone will experience homeowner's rate increases as the insurance companies spread the love.

dino001

Funny thing, Miami at least has 40-year certification process, inadequate but at least something. Most other Florida cities/counties do not have anything. I work in bridge design, DOTs have annual or biannual bridge inspections, depending on structure types and all cost calculations/estimates are always done in min. 15 year, up to 75 year time horizon, depending on the circumstances. I think 25 years is a good cycle, when you can catch serious problems in their nascant stage and address them. After first 25 years, next intervals should probably be somewhere around 15.

I suspect there will be a big change in a way common structural building areas will be treated, from HOA reserve dues, to inspections/certifications, to insurance. It will make living in high rise building much more expensive, but I think it should. It shouldn't be that you spend last dollar to buy a unit and then have no money to put into its maintenance. Currently unit owners have zero incentive to look ahead more than 3-5 years (some for "biological" reasons, others for reasons of coming life change, like new job or others), so reserves are often pitifully inadequate and people fight tooth and nail about $20 per month increases to in their condo HOA fees, cause in their mind they won't likely see any benefit from sufficient reserves. With that attitude building a multimillion dollar reserve over time is next to impossible. It creates of course that sudden cliff in building conditions, when instead of on-going structural maintenance, they spend money on new reception area or pool planters and structural deterioration progresses until it can't be addressed without spending tens of millions, translating in tens of thousands per unit. If not government, insurance industry may be the first to force these changes by structuring their premiums to incentivize proper maintenance. Another motivator may be a condo value cliff created by the market, i.e. if the condo is too old and has poor structural ratings it will become money loser for the owners. The downside is it may start turning into a slum, which has been happening with other types of developments.

It will take some time, though, at least a few years to fully digest this terrible event, just like it did for Hyatt Regency in Kansas City in 1981, or Sunshine Skyway vessel collision, or FIU bridge collapse (we're already seeing significant changes in practice for this one, just in three years, more to come).

stickguy

I assume on the condos they are factoring in possible renting.

driver100

abacomike said:

@driver100 said:

+1 Amazing!

We have a few doctors who are poster buddies here - one of them tries his best to be more “incognito” rather than espouse his knowledge and skills of medicine and several, like me, who are, in fact, “doctors”, but alas, it’s just a PhD, not an MD.

But he explained it so well, even I understood what it means. And, yes, we do have at least one other doctor here who also has very sound advice, and is a real resource.....we are fortunate.

driver100

abacomike said:

I will be leaving for the outpatient surgical center in about 2 hours. I think I am scheduled for 1:30 PM so they want me there at 12:30 PM. I am getting a bit nervous about the procedure but I am sure that is a normal reaction. My best friend is driving me there and back. It’s about a 10 minute drive to the center so at least it’s close.

Wishing you the best possible results

driver100

@explorerx4 Thanks for the show with the judge. They were fun shows to watch...I wish I had about 6 more hours in each day - I'd watch it more.
I can't make up my mind whether the judge is just a nice softy, or if he is out of it a bit...he's not very coherent at times. He sure doesn't mind wandering off the topic. The young lady blew right through a red light that had been red for some time, and he was soft on her because she was new to the area. What he said originally was perfect, a red light is a red light wherever you are...in any country, whether you know the area or not. But, good light entertainment.

driver100

cdnpinhead said:

Occasionally we get people on here who actually know what they're talking about. It's a good thing, even though sometimes it takes awhile to figure out who they are.

Don't be too hard on yourself.

jmonroe1

@driver100 said:
But he explained it so well, even I understood what it means. And, yes, we do have at least one other doctor here who also has very sound advice, and is a real resource.....we are fortunate.

That doctor must be a lot like me in that he explains things well. At least you have said that before and we all know you’re never wrong.

As for another doctor in here, I don’t know who that is but the more the merrier.

jmonroe

driver100

@jmonroe1 Yes, you have given excellent explanations of how and why things work. You were off a bit about hand nailing shingles though.

Another reason it is better to have hand nailed shingles is because they can't let some goof who doesn't know what he is doing nail your roof;

explorerx4

A little tribute to Charlie Watts the quiet backbone of the Rolling Stones.
https://www.youtube.com/watch?v=CL614PU-EQE

benjaminh

My guess that Costco would put Michelin tires on sale next month has panned out according to their latest flier. They're even picturing the specific tire I'm considering.

sda

benjaminh said:

My guess that Costco would put Michelin tires on sale next month has panned out according to their latest flier. They're even picturing the specific tire I'm considering.

They have received positive reviews by CR and Tire Rack. I will be interested with your experience. The Passat may benefit at replacement time. I am not impressed with the OE Bridgestones.

qbrozen

So we left Hilton Head today and are now in Myrtle Beach. This looks more promising.

jmonroe1

@driver100 said:
@jmonroe1 Yes, you have given excellent explanations of how and why things work. You were off a bit about hand nailing shingles though.

Another reason it is better to have hand nailed shingles is because they can't let some goof who doesn't know what he is doing nail your roof;

As much as tool makers have tried you can’t make everything sailor proof and believe me they’ve tried.

People without basic skills should not do jobs that require even the least bit of skill. That’s why folks call “The Guy”, right?

jmonroe

jmonroe1

@benjaminh said:
My guess that Costco would put Michelin tires on sale next month has panned out according to their latest flier. They're even picturing the specific tire I'm considering.

Once again I’m convinced we have lurkers in here.

jmonroe

explorerx4

I wonder what those Michelin tires look like on a 2018 Acura TLX?
This is a test.

jmonroe1

@qbrozen said:
So we left Hilton Head today and are now in Myrtle Beach. This looks more promising.

I like Myrtle Beach better than Hilton Head. We just came back from a week at Myrtle Beach 2 weeks ago this weekend.

If you have a chance go look at Sea Watch Resort Plantation. It’s a Whyndam timeshare place but there are always units for sale. Lots of pools and other amenities.

No, I don’t own timeshare but we rent from individuals who own condo units there who rent either themselves or through real estate places.

Worth a look anyway.

jmonroe

oldfarmer50

explorerx4 said:

I wonder what those Michelin tires look like on a 2018 Acura TLX?
This is a test.

I’m a big fan of Michelins. Today I wasn’t paying attention and I took a turn at about twice the speed I thought would be prudent. The car just carved the corner without even a squeak. Great tires.

driver100

explorerx4 said:

A little tribute to Charlie Watts the quiet backbone of the Rolling Stones.

One of the all time greats!

driver100

benjaminh said:

My guess that Costco would put Michelin tires on sale next month has panned out according to their latest flier. They're even picturing the specific tire I'm considering.

Go for it......otherwise your tires will go when you are out of town and there isn't a sale.......or it will be a huge inconvenience.
I got Michelins for the C250 about 5000 miles ago....and I am glad I did! You can't do much better!

mjfloyd1

@benjaminh said:
My guess that Costco would put Michelin tires on sale next month has panned out according to their latest flier. They're even picturing the specific tire I'm considering.

I was going to joke that the voices in my head told me that there would be a Labor Day tire sale, but there is always a Labor Day tire sale.

I just slept in a Holiday Inn last night and only play a doctor on TV.

snakeweasel

oldfarmer50 said:

bwia said:

abacomike said:

Well, I am scheduled to have the spinal injection on Thursday of this week. They are putting me under anesthesia IV for the procedure to make sure I do not move. The doctor is injecting the steroids into the foramen at L3/L4 where the stenosis is the most acute. The procedure is supposed to take 45 minutes. He uses a fluoroscope to ensure the injection is placed correctly. Sure hope it helps me.

Good luck with your procedure tomorrow and I hope they are able find a vein easily for the jab.

In a couple of weeks I will be doing a bone marrow biopsy. They've tried twice before without success claiming the hip bone was so dense and hard that the needle was ineffectual. Interventional Radiology (IR) is another option they are considering as well. Unlike traditional surgery, patients undergoing interventional radiology procedures generally do not receive general anesthesia. Yikes!

You and Superman have the same problem.

What? He also has friends that won't recognize him if he puts on a pair of glasses?

oldfarmer50

Are you sure your EV won’t catch fire? Who made the batteries?

https://youtu.be/K-ttMnctVyU

benjaminh

I'm probably overthinking my tires, but I need something to do to avoid real work!

Anyway, I checked with my Acura dealer and they can't get close to the Costco price on the CrossClimate2. Dealer regular price is $203 per tire. When I asked if they could get close to the Costco price, they said the lowest they could go would be $168 per tire. But Costco's price is $152.50 per tire. The dealer said you should consider that we include 2 years of rotations, balance, and road hazard repair. But Costco includes life-of-the-tire rotations and balances, road hazard repair for 5 years, plus pro-rated replacement tire if it can't be repaired for 5 years.

I also called the Michelin tire concierge, and he said what I expected, that the CrossClimate2 would perform significantly better in wet conditions and snow when compared with their Defender T + H. When I asked about mpg, he said that Michelin's tests rate both the CrossClimate and the Defender the same for mpg—8 out of 10. My guess is that real world there is a cost in mpg for the three peak mountain snowflake rating.

Calling my local Costco tire guy to set up an appointment, he somewhat encouraged the Defender T + H, in part because they already have it in stock for my size, but also because he said that's the Michelin tire that most at Costco get for a sedan. He said the CrossClimate2 would need to be special ordered and paid for in advance, and then delivered to their location. The sale starts Monday, and so if I order that day the tires might be available by Tuesday. Total with Tax, installation, and tire disposal looks to be about $750 at Costco, compared to the Discount Tire price of $898 for the same tire installed.

https://tires.costco.com/CostcoAdvantage

"Purchasing your tires from Costco Wholesale, whether it be online or from one of our local warehouse locations, provides you with several key advantages. Our published retail pricing includes all of the shipping and handling costs associated with your tires. The Installation Package also includes Lifetime Maintenance Services that extend throughout the life of the tires you purchase (some limits may apply). These Lifetime services include inflation pressure checks, tire balancing, tire rotations, as well as flat repairs. Upon the service of your tires we also install new rubber valve stems (Note: TPMS valve stems and accessories will be an additional charge). Additionally, we inflate your tires with nitrogen, not compressed air. Nitrogen retains tire pressure better over time than compressed air, which can positively impact the life of your tires, as well as the fuel economy of your vehicle. Finally, for your protection, all of our tires are backed with the Costco Road Hazard Warranty."

stickguy

If you don’t get the CCs that you are fixated on sounds like you’ll have a serious case of FOMO. so spring the $750 (cheap these days for a set of high quality tires OTD) and enjoy them!

imidazol97

I recall buying a Michelin tire for my 1980 Cutlass Supreme Brougham as replacements. They were rated much higher for ice and packed snow traction because of the tread compound which contained certain oils keeping the tread more compliant at colder temps. They did have better grip. The tread also was slightly coarser than the highway treads I had before. The Cutlass was less stabile driving when there was a crosswind. I believe the tire was called X-One. I see there is currentlly an X-one in their lineup.

I think IF the store has a 30-, 60-day replacement with another tire, or if Michelin will back them if you don't like the stability of the tread design, you likely need to get the Cross Country to try them. I understand the feeling wanting to try them because they seem to do what you need based on advertising.


Did the Concierge have any other comparisons with other Michelin tires other than the Defender H/T? It sounded like the concierge was just reading from the public data for fuel mileage comparisons.