Zach Goulet

EM PGY-4 | Virginia Tech Grad

[Zach Goulet @GouletZach]

@olsonplanner @JeffSteinerDO These are some of the concerns I had as well. Even outside of the whole life policy it felt weird having such a large chunk going to low risk areas.
We may be talking more in the future.
Thanks for your time today and knowledge shared to others in the past

[Zach Goulet @GouletZach]

@olsonplanner @JeffSteinerDO In total it would be
47000 + 14000 + 60000 = 121,000 as I'm married and my wife would still work and we will fully fund her accounts as well

So 25000/121000 = 0.206 or 20.6%

[Zach Goulet @GouletZach]

@olsonplanner @JeffSteinerDO Yes the whole life policy is the low risk portion of my investments

[Zach Goulet @GouletZach]

@olsonplanner @JeffSteinerDO I think I will have roughly 5k/month to go towards the high risk stock and low risk portfolio outside of the contributions to 403b and backdoor roths

[Zach Goulet @GouletZach]

@olsonplanner @JeffSteinerDO He is recommending 25k/year into the whole life policy with a 3m death benefit. We didn't get into details on premium vs cash value. I've asked for the actual policy information so I can review it and he is quoting a 4.6% return on the whole life policy

[Zach Goulet @GouletZach]

@olsonplanner @JeffSteinerDO Whole life is being recommended as a substitute for low risk investment portfolio (bonds etc.)

The remainder of my retirement plan would be a 403b through employee, backdoor Roth, then a high risk (stock investment portfolio), then a low risk portfolio that he highly recommends.

[Zach Goulet @GouletZach]

@medmalreviewer Reminds me a bit of Brugada Syndrome. Were they febrile?

[Zach Goulet @GouletZach]

@Gabby_Brauner27 Thanks!

[Zach Goulet @GouletZach]

@acweyand Certaintly has it's role as an acute phase reactant but I'm fairly sure this comes back within a reasonable time for me to consider prescribing iron from the ED in select cases. Will do some more reading! Thanks!

[Zach Goulet @GouletZach]

@IR_Doctor That's weird as I have done 3 this week...

[Zach Goulet @GouletZach]

@KelseyMedicine Facts. My wife and I hated planning it. So many things other people said we had to have that we didn't want/couldn't afford/didn't need. The day of was fantastic but the rest 🤮

[Zach Goulet @GouletZach]

@IsaacLamb01 Lactate 37.8. endocarditis patient
TBilli 32.4
Na 98
ETOH 564
Ammonia was ~440
Ck: 220k
I also have a small list
Recently had a diurised patient of 20L negative, was like 50ish lbs just during ICU stay

[Zach Goulet @GouletZach]

@ChrisCarrollMD Seems very wrong.

[Zach Goulet @GouletZach]

@TraumaSoapBoxes I think context is probably most important. Vaso and NE started in the ED coming to the ICU absolutely not stable. Day 3-5 in the ICU weaning NE throughout shift with vaso on, kind of stable.

[Zach Goulet @GouletZach]

@ABsteward My only fun fact is that even though it is a first gen cephalosporin it has 0 cross reactivity to penicillin allergic patients and is safe in penicillin allergies. (Feel free to correct me if I am wrong but pretty confident in that)

[Zach Goulet @GouletZach]

@reverendofdoubt @blondemedSJW How do HST rule out unstable angina?

[Zach Goulet @GouletZach]

@swoonganz I read this directly after restarting home psych meds for an overnight admission that were all held. I do this at least 2-3 times a week I feel. And it's common knowledge that these meds should not be abruptly stopped yet I still see it constantly