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Old 02-02-11 | 03:40 PM
  #13776  
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Originally Posted by rjones28
At least Lauren's customer's lack of math skill worked out in her favor.
They can't english either.
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Old 02-02-11 | 03:41 PM
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https://rutgers.scout.com/a.z?s=183&p=8&c=1&nid=3773429

VV, This guy was RU's biggest pickup. I want you to look at his GPA etc. He chose RU over the other schools that gave him offers (Auburn, Vols, etc.) because of the superiour academics.
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Old 02-02-11 | 03:42 PM
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I was very happy with Schiano's job this year. Filled a lot of holes with fast, quality guys
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Old 02-02-11 | 03:53 PM
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Old 02-02-11 | 04:15 PM
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Originally Posted by BillyD
How so, I mean besides the fact it's not high on the favorites list of either patient or doc?
I will try to sum it up as simply as possible:

A digital exam, not controversial, should be done yearly for men over 50 or younger for those at high risk

However, by the time a prostate tumor is noted on a digital (finger up the butt), it is often advanced....so nowadays the controversy surrounds the PSA (prostate specific antigen) test....it's a BLOOD test.

There are really two problems with detection with a PSA:

First, the MAJORITY of men who have an elevated PSA do NOT have prostate cancer. But like a "shadow" on a mammogram, a PSA slightly above 4.0 raises the specter of cancer and must be investigated - next step is a prostate biopsy. Not pleasant. And it turns out that about 75% of men with a PSA a bit above 4 do NOT have a cancer, but you have to get the biopsy to find out.

That's annoying but the real controversy is that even men WITH prostate cancer, a large number of them have a cancer that is indolent (very slow growing), that would not become serious or life threatening for 20-30 years. So a lot of guys in their 60's are diagnosed with prostate cancer are getting treated (most often with surgery) to treat a cancer that might not be life threatening until they are 90ish. However, once you have a diagnosis of cancer most men want to be treated/cured.

Now there are SOME prostate cancers that are serious and aggressive and really should be treated. But not all of them.

Anyway I still order PSA's on all my patients who have a life expectancy of say 10 or more years (generally up to age 80) because it's "standard of care" and it's the best test we have.

But I am hoping we eventually find a better test that will (A) find folks with cancer and leave the ones without cancer alone (better specificity) and (B) detect only cancers that are aggressive or potentially so.

Last edited by datlas; 02-02-11 at 04:19 PM.
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Old 02-02-11 | 04:18 PM
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Originally Posted by datlas
I will try to sum it up as simply as possible:

A digital exam, not controversial, should be done yearly for men over 50 or younger for those at high risk

However, by the time a prostate tumor is noted on a digital (finger up the butt), it is often advanced....so nowadays the controversy surrounds the PSA (prostate specific antigen) test....it's a BLOOD test.

There are really two problems with detection with a PSA:

First, the MAJORITY of men who have an elevated PSA do NOT have prostate cancer. But like a "shadow" on a mammogram, a PSA slightly above 4.0 raises the specter of cancer and must be investigated - next step is a prostate biopsy. Not pleasant. And it turns out that about 75% of men with a PSA a bit above 4 do NOT have a cancer, but you have to get the biopsy to find out.

That's annoying but the real controversy is that even men WITH prostate cancer, a large number of them have a cancer that is indolent, that would not become serious or life threatening for 20-30 years. So a lot of guys in their 60's are diagnosed with prostate cancer are getting treated (most often with surgery) to treat a cancer that might not be life threatening until they are 90ish. However, once you have a diagnosis of cancer most men want to be treated/cured.

Now there are SOME prostate cancers that are serious and aggressive and really should be treated. But not all of them.

Anyway I still order PSA's on all my patients who have a life expectancy of say 10 or more years (generally up to age 80) because it's "standard of care" and it's the best test we have.

But I am hoping we eventually find a better test that will (A) find folks with cancer and leave the ones without cancer alone (better specificity) and (B) detect only cancers that are aggressive or potentially so.
This is seriously terrifying to me in so many ways and i'm only 25!
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Old 02-02-11 | 04:20 PM
  #13782  
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Originally Posted by darb85
This is seriously terrifying to me in so many ways and i'm only 25!
Cancer? Or the digital exam?
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Old 02-02-11 | 04:21 PM
  #13783  
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Originally Posted by Velo Vol
Cancer? Or the digital exam?
Probably both.
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Old 02-02-11 | 04:25 PM
  #13784  
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Originally Posted by RUOkie
https://rutgers.scout.com/a.z?s=183&p=8&c=1&nid=3773429

VV, This guy was RU's biggest pickup. I want you to look at his GPA etc. He chose RU over the other schools that gave him offers (Auburn, Vols, etc.) because of the superiour academics.
Rutgers had the best class in the Big East?

One good thing about real "student athletes" is they're probably less likely to get into trouble.

I saw a tweet about UT's class having a 3.0 GPA or something to that effect. Yet deep down, I doubt many fans really care.
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Old 02-02-11 | 04:26 PM
  #13785  
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if that colonoscopy post had been made in this thread, i dread to think how differently that would have gone.
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Old 02-02-11 | 04:26 PM
  #13786  
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datlas, my internist checked my PSA last month, he told me that my level rose by 0.3 over the past 3 years. I asked him why he was checking it at all, since I am in my 40's. He was not able to answer me, and won't be checking again.
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Old 02-02-11 | 04:29 PM
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Originally Posted by Velo Vol
Cancer? Or the digital exam?
more the cancer, but not looking forward to the exam
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Old 02-02-11 | 04:29 PM
  #13788  
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Originally Posted by Velo Vol
Rutgers had the best class in the Big East?

One good thing about real "student athletes" is they're probably less likely to get into trouble.

I saw a tweet about UT's class having a 3.0 GPA or something to that effect. Yet deep down, I doubt many fans really care.
most fans don't care, but I do. I am proud of my degree, and want to remain proud. The dumbing down of good academic schools in exchange for athletic prowess pisses me off. I would rather be a fan of a school with good academics and a mediocre team than the converse
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Old 02-02-11 | 04:32 PM
  #13789  
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Originally Posted by RUOkie
datlas, my internist checked my PSA last month, he told me that my level rose by 0.3 over the past 3 years. I asked him why he was checking it at all, since I am in my 40's. He was not able to answer me, and won't be checking again.
That is reasonable. I am lucky I am "only" 45 so I would not even start checking mine until age 50.

But whether to continue to check is very controversial, there are potential risks and benefits on both sides. In my community it is standard of care so I order it unless the patient doesn't want it (and I document this fact).
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Old 02-02-11 | 04:33 PM
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Originally Posted by darb85
more the cancer, but not looking forward to the exam
When it get closer, I have a few suggestions:

1. Find a doctor with long skinny fingers (which is what I have, btw)
2. It's not really a big deal, it takes approx 10 seconds and compared to what the women have to go through, it's really quick, easy, and painless.
3. Don't pinch if you can help it.
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Old 02-02-11 | 04:38 PM
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A few months ago the blood center was offering free PSA screening. (I don't believe you even had to donate). I thought about going, but didn't.

I'm not sure how helpful of a public health exercise that kind of thing is, given that it's apparently not targeted toward any particular group.
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Old 02-02-11 | 05:01 PM
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Originally Posted by datlas
1. Find a doctor with long skinny fingers
My doc hired a female PA a couple years ago who is 5'2", with small hands. I didn't know the exam could be that painless.
Originally Posted by datlas
3. Don't pinch if you can help it.
MUCH easier to do if #1 above is true.
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Old 02-02-11 | 05:03 PM
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Originally Posted by datlas
When it get closer, I have a few suggestions:

1. Find a doctor with long skinny fingers (which is what I have, btw)
2. It's not really a big deal, it takes approx 10 seconds and compared to what the women have to go through, it's really quick, easy, and painless.
3. Don't pinch if you can help it.
but what does this have to do with road cycling?
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Old 02-02-11 | 05:11 PM
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Finger up the butt. HTFU all of you.
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Old 02-02-11 | 05:12 PM
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Originally Posted by Velo Gator
Finger up the butt. HTFU all of you.
haha. i didn't have the nerve to post that. you is shameless.
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Old 02-02-11 | 05:14 PM
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Harden TFU? really VG?
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Old 02-02-11 | 05:16 PM
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Originally Posted by RUOkie
Harden TFU? really VG?
I know, I know.
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Old 02-02-11 | 05:19 PM
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Originally Posted by RUOkie
I would rather be a fan of a school with good academics and a mediocre team than the converse
That's why I was happy to see Stanford do so well this year. My parent's alma mater, I grew up going to games and remember so many years of getting beat up by UCLA, USC, Washington and God forbid, Cal. I'd be curious whether they relaxed their standards for atheletes but I'd like to think not.

There were many "big games" against Cal, where the Stanford students would cheer to the Cal fans "That's alright, that's okay, you're gonna work for us someday!"
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Old 02-02-11 | 05:21 PM
  #13799  
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Originally Posted by Velo Gator
Finger up the butt. HTFU all of you.
Agreed. Compared to what you women go through (presumably) with pelvics and PAPs etc, it's not a big deal.
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Old 02-02-11 | 05:22 PM
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Originally Posted by dstrong
That's why I was happy to see Stanford do so well this year. My parent's alma mater, I grew up going to games and remember so many years of getting beat up by UCLA, USC, Washington and God forbid, Cal. I'd be curious whether they relaxed their standards for atheletes but I'd like to think not.

There were many "big games" against Cal, where the Stanford students would cheer to the Cal fans "That's alright, that's okay, you're gonna work for us someday!"
I was rooting for Stanford too. But Cal is not what I would call a slacker school either.
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