Disappointing

So close this week. I actually thought they might win. Tough to do so, however, with two interceptions in the end zone.

In related news, my Colts franchise on Madden NFL 11 just won it's fourth Super Bowl. Maybe it's time for a change in management for the real team?

Uncharted 3: Drake's Deception

System: PS3
Release Year: 2011
IGN Score: 10


The Uncharted series on the PS3 is one of my favorite gaming series. The third installment of the series was released just a few weeks ago. This time adventurer Nathan Drake sets off to the Rub' al Khali desert in Arabia in search of Iram of the Pillars, a lost city in the desert of incredible wealth. Along the way Drake learns that Solomon imprisoned the evil Jinn (genies) within the city. Drake picks up clues throughout the game which helps him identify the location of the lost city and of course is in a race with a terrorist group who always seem to be one step ahead of him.

Uncharted 3 is easily one of the best games I've ever played. It does everything well. The visuals are flawless. Especially impressive are the scenes where Drake's been drugged and his vision is impaired. The voice acting is probably the best in the business. The conversations seem real, the characters are charming and funny and you really get attached to them. Speaking of the characters, favorties Sully, Chloe, and Elena return in this episode as well.

The game play is where Uncharted 3 is spectacular. It's a third person shooter which mixes in some over the top gun fights, puzzle solving, lots of jumping and platforming, and a bit of stealth action. There is more hand-to-hand combat in this game than in previous games. This game is not a one trick show. Each chapter involves different game play elements than the previous chapter and the game handles each element well. Combine this with great visuals and amazing story telling and you have one of the great games of the year. This game really has it all.

There are a few aspects of the game that I didn't like. My biggest complaint is that the game is pretty short. It took me about 10 hours to complete. I could really go for another 4-6 hours of game play. Overall I didn't like the story in this game as well as I did the story in Uncharted 2, but this really is a minor complaint as the story really is quite good. The third thing I didn't like is some of the gun fighting scenes are a bit ridiculous. All of the Uncharted games have this trait, and to be honest, I know nothing about modern warfare armor, but I counted it took me 41 shots at close range with a pistol to kill a heavily armored guy. That seems a bit much. The one thing that makes up for this is the fact that you can now toss back grenades that have been thrown at you to kill the enemy, which is awesome!

Uncharted 3 is an amazing game that does everything well and is nearly flawless. When I play a game like this it excites me for the future of gaming because I see how good games can really be. This game plays like a big budget action/adventure movie in terms of delivering excitement and a great story. My only real complaint is that it is a bit short but most of the Uncharted games clock in at around 10 hours. Overall that is a minor complaint. Up next for me is The Legend of Zelda: Skyward Sword, a game that got a 10 also from IGN. This game is not short, clocking in at around 50 hours. This might be the biggest fall season in video game history. What are the chances of two games from some of my favorite series being released within weeks of each other and both getting 10s? Despite an overall slow 2011 for games, we are definately ending the year with a bang.

No Antibiotics?

There hasn't been a whole lot going on over the past few weeks except work which is why there has been a lack of updates on the site. After several months of paperwork I finally started my moonlighting gig which is both exciting and a little stressful. I now work Tuesday and Thursday evenings at a medical clinic seeing overflow patients with acute problems who couldn't be fit in during the day. It is the first time I've done my job without a supervising physician directly overseeing what I'm doing or without there being someone else around I can ask for some advice. Like I said, it can be a little stressful but overall I think it is going pretty well and I'm enjoying the extra experience (and money).

By far the most frequent ailment I've seen while moonlighting is the dreaded sinus infection. We all know the symptoms: sinus congestion, runny nose, ear pressure, sore throat, and in general just not feeling well. I wanted to quickly go through my treatment regimen for a sinus infection, as backed by evidence-based medicine.

• The overwhelming percentage of sinus infections are caused by virus infections (>90%). This has been shown in studies using CT imaging and sinus cultures. Unfortunately, this isn't practical in an every day clinical setting so practice guidelines state to assume the infection is viral unless it lingers more than 7-10 days. Since viral infections don't respond to antibiotics, that means no antibiotics unless you've had symptoms for over a week.
• Intranasal steroids have the best evidence supporting them to relieve sinus pressure and head congestion
• If there is a cough from post-nasal drip, I'll use a codeine-containing antitussive, especially if they've failed over the counter cough medicine.
• I suggest Tylenol for throat pain and plenty of fluids.

In summary, intranasal steroids (Flonase) and cough medicine is generally what I prescribe. I don't give antibiotics unless symptoms have been going on for 7 days at a minimum. Most people are used to getting antibiotics initially but usually when I explain to them why they won't help for a viral infection most people are understanding.