Jacob Fleming, MD @JacobFlemingMD Twitter profile

Last Seen Profiles

@benapampa

@Meiyxtxin

@stw_pdg

@ystk_199S

@dungi_1004

@ENPRCnews

@itsshaqii

@ubh_I8

@penyukastw21

@ksagaykwt4

@gscumming

@Buhhdeee

@AiraStasia19733

@CristinaUm61027

@littlesammyxoxo

@LindiniJ

@martharotter

@Taif1599980

@DuddridgeClaire

@mzulfiqor

@dogsdoor1020

@d53917010

@nenedehiroshima

@hodl_shop

@undisrwk

@krige09

@Taif1599980

@RobinAndraca

@marcosmsx1

@Father_Ted_

@Taif1599980

@col_96

@EvanEverhard

@bokeplokalmalam

@ShaunDedri75741

Jacob Fleming, MD

@JacobFlemingMD

3 years

So my wife is almost 37 weeks pregnant and our son will be here any day now. I'm mostly excited but I am a little anxious. What's a good APGAR score for us to aim for for him to be competitive for the 2048 derm match?

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Jacob Fleming, MD

@JacobFlemingMD

4 years

@memenendez1 Blue veins/red arteries = biggest scam in the history of medical education

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Jacob Fleming, MD

@JacobFlemingMD

3 years

"AI will replace radiologists within 5 years!" PACS: *loads a 5 year old hand radiograph as comparison study for a leg CT* I'll be happy if we can get useable PACS software within 5 years.

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Jacob Fleming, MD

@JacobFlemingMD

3 years

Radiology is pretty easy tbh. All you need to know is every possible imaging manifestation of every disease and anatomic variant in every organ. And then how to stick catheters and/or needles in 'em #IRad #IRadRes #RadRes

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Jacob Fleming, MD

@JacobFlemingMD

4 years

I've never understood the practice of a consultant telling the primary team what imaging/tests to order instead of just ordering them. Almost always the primary team has less knowledge of the specialized orders. Often the wrong thing gets ordered.

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Jacob Fleming, MD

@JacobFlemingMD

3 years

Not a subtweet, I just think there is no reason to say this #RadRes @DrLongissimus @DShadowgazer

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Jacob Fleming, MD

@JacobFlemingMD

2 years

Clinic note: "Patient has done well status post radical resection of XYZ mass. He is asymptomatic with no pain but notes a new area of swelling 2.3 cm lateral to the proximal aspect of the incision site. We will obtain MRI to evaluate for recurrent disease." MRI request: pain

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Jacob Fleming, MD

@JacobFlemingMD

2 years

The surgery team when I report the retro-aortic left renal vein and fat-containing inguinal hernias #SavedTheDay #RadRes

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Jacob Fleming, MD

@JacobFlemingMD

2 years

Radiologist: *invents axial, coronal, and sagittal planes* God: *invents rotator cuff* I don't think so, bub

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Jacob Fleming, MD

@JacobFlemingMD

3 years

Welcome to the dark side, colleagues #RadRes

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Jacob Fleming, MD

@JacobFlemingMD

3 years

@kellengoff

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Jacob Fleming, MD

@JacobFlemingMD

3 years

I called intestinal ischemia on two patients on a recent call shift. 👎 right both times 😢 👍 both recovering from surgery A year ago I didn't have the confidence to come down hard. This time I had no doubt. Some teaching points below, which I may have learned the hard way:

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Jacob Fleming, MD

@JacobFlemingMD

2 years

I passed the Diagnostic Radiogy Core Exam! Thanks to all who made it possible, especially my wife @severelylindsay for dealing with the grueling study schedule! Good start to #RadRes senior year 👍🏻

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Jacob Fleming, MD

@JacobFlemingMD

3 years

A few days ago, I decided I will no longer pursue VIR. I'm focusing on MSK IR/spine 100%. Too many thoughts for a tweet; check out my blog and let me know your thoughts! @dougbeall @neuroradiology @AaronFrittsMD @ReedOmary @MolanoBayona @DoctorCliffyy

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Jacob Fleming, MD

@JacobFlemingMD

4 years

I aspire to be as smart as a pediatric radiologist one day. How do they do it? They’re all, “This is a fairly typical case of juvenile neuroangiopericytoblastoma, the partial T2 lengthening is characteristic, and of course the 13.5 month old age of the patient is classic.”

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Jacob Fleming, MD

@JacobFlemingMD

3 years

Adult radiologists when a pediatric elbow radiograph pops up on the list

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Jacob Fleming, MD

@JacobFlemingMD

3 years

I'm excited to share that I'll be joining @dougbeall for MSK IR and pain management fellowship at the Spine Fracture Institute in '23-'24. This amazing opportunity is a dream come true and I can't wait. Thank you Dr. Beall for giving me a shot! #MSKIR #OrthoIR

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Jacob Fleming, MD

@JacobFlemingMD

8 months

Stressful day. Hugs make it better.

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Jacob Fleming, MD

@JacobFlemingMD

8 months

I'm excited to share that I'm starting my attending career this fall with Vascular and Interventional Specialists of North Texas (aka RANT @radntx_vis @RADNTX ) and I will return to @methodistdallas ! #MskIR #SpineIR #IRad #WingingIt #DoItLive #Humbled more detail in link

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Jacob Fleming, MD

@JacobFlemingMD

1 year

Oklahoma move-in phase 1 complete. Got quad monitors up in this piece. Still not the final form!

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Jacob Fleming, MD

@JacobFlemingMD

4 months

More than 3 years ago, I committed to fellowship under Dr. Beall. Yesterday my fellowship ended, concluding 10 years of medical training. I'm thankful for incomparable interventional spine training and excited for the next chapter of my career!

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Jacob Fleming, MD

@JacobFlemingMD

5 years

In 2004, at the age of 13, I first thought I might want to be a radiologist. Today, for the first time, I dictated reports as a radiology resident. It was awesome. I hope my fellow #RadRes and #IRadRes also had a great first day! #WorthTheWait

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Jacob Fleming, MD

@JacobFlemingMD

11 months

Got my radiology school certificate in the mail. Oh yeah! I look forward to hanging this next to my other framed pieces of paper. #NoTakeBacks @UTSW_RadRes

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Jacob Fleming, MD

@JacobFlemingMD

11 months

Two major kypho pearls I've learned in fellowship that have changed my approach completely Quick 🧵(1/3) #SpineIR #MskIR #Spine #Ortho

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Jacob Fleming, MD

@JacobFlemingMD

3 years

On September 13, 2021, Elliot Jack Fleming arrived and changed our lives forever. ❤️ @severelylindsay

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Jacob Fleming, MD

@JacobFlemingMD

4 years

Highly underrated experience in IR: talking to your non-IR doctor friends about stuff you're doing in the angio suite and they respond, "Wow, I had no idea that was possible." 👍 #IRIsMagic #WithoutAScalpel #OkSometimesWithAScalpel @SIRRFS @SIR_ECS

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Jacob Fleming, MD

@JacobFlemingMD

1 year

Graduated from residency the other day. 5 years since med school, 10 since undergrad, 18 since first thinking being a radiologist sounded pretty cool. So much gratitude for everyone who helped. Next up: 1 yr #MskIR fellowship in Edmond, OK with @dougbeall and @neuroradiology .

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Jacob Fleming, MD

@JacobFlemingMD

1 year

Not sure why it took me so long to think of putting a tegaderm over a sticker, but I now have #CorgiLead #PostFactoryMods #CorgiRad #RadCorgi

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Jacob Fleming, MD

@JacobFlemingMD

3 years

@DrLongissimus Man’s signature is an osteosarcoma periosteal sunburst, dang. Respect

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Jacob Fleming, MD

@JacobFlemingMD

2 years

Me: Not sure whether this is a tear... or just volume averaging 🧐 Attending MSK Radiologist: Ah yes, a classic type IV ALPS PASTA PSPSPS injury

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Jacob Fleming, MD

@JacobFlemingMD

2 years

If I had a nickel for every time an IR told me "IRs can't do XYZ because surgeons won't send referrals," I would have enough capital to open my own OBL. Bad advice is often free, unsolicited, and comes from people who think their limited experiences reflect reality. ¯\_(ツ)_/¯

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Jacob Fleming, MD

@JacobFlemingMD

3 years

America: I did an internship, radiology residency, and an IR fellowship. Now I'm an interventional radiologist Europe: I undertook internships in urology, dermatology, and obstetrics before I was registrar in neurosurgery and then ??? and now I'm an interventional radiologist

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Jacob Fleming, MD

@JacobFlemingMD

3 years

True Life: our infant son is overtired 24/7 and refuses to nap He cute doe @severelylindsay

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Jacob Fleming, MD

@JacobFlemingMD

2 years

I'm going to be fired from my job and specialty for saying this, but I'm tired of reading fluff language ("noted", "there is", "again seen", etc.) in radiology reports. As a radiologist it pains me to read. I can only imagine how other clinicians feel, but I doubt favorably.

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Jacob Fleming, MD

@JacobFlemingMD

2 years

I deeply enjoy learning radiology. There are so many good educational resources, it's like having multiple fine dining options. Then you have board studying, which is like drinking unflavored protein shakes for five meals a day for weeks at a time. #CorePosting #2Weeks

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Jacob Fleming, MD

@JacobFlemingMD

3 years

@JMichaelBarraza Dude, your baby’s left arm is huge.

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Jacob Fleming, MD

@JacobFlemingMD

3 years

Excited for our new (under construction) interventional CT suite @UTSW_Radiology ! Angio and CT capabilities for a lot of possibilities. Who is already using one and what are you using it for? @SIRRFS @SIRspecialists

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Jacob Fleming, MD

@JacobFlemingMD

1 year

Weekend light reading. Kid has good taste.

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Jacob Fleming, MD

@JacobFlemingMD

2 years

@EMPAthy_atrophy The difficult part of this is that direct patient care opportunities can be difficult to come by for premeds who don't already have family/family friends in medicine. Even shadowing or basic volunteer experiences were not easy to get into.

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Jacob Fleming, MD

@JacobFlemingMD

2 years

Last overnight in the bag. Many feelings about this chapter coming to a close—relief, pride, sadness (surprisingly)... Too many to name. But mostly, gratitude. I got to be part of something very special. Wouldn't trade it for the world. Peace out, Parkland. ✌🏼

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Jacob Fleming, MD

@JacobFlemingMD

2 years

If the IUD isn't "intrauterine", is it... an "EUD"? Or just... a "D"?

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Jacob Fleming, MD

@JacobFlemingMD

5 years

@DGlaucomflecken I'm down, I've got the 411, and you are not going out and getting jiggy with some boy, I don't care how dope his ride is. My momma didn't raise no foo'!

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Jacob Fleming, MD

@JacobFlemingMD

4 years

@DevanSinha Nice arrow sign!

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Jacob Fleming, MD

@JacobFlemingMD

9 months

@AshleyGWinter One of the top benefits of being a healthcare workers is getting the monthly commission check for pain pill dispensing and COVID death certificate fabrication 🙄

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Jacob Fleming, MD

@JacobFlemingMD

1 year

Turned in my badge and gun (pager). Residency is officially done. What an experience. So thankful for excellent clinical training and incredible colleagues. See you, space cowboys/cowfolks👋🏼 #RadRes #Done

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Jacob Fleming, MD

@JacobFlemingMD

2 years

It's a-me, Medicare fraud!

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Jacob Fleming, MD

@JacobFlemingMD

3 years

Placing ports in patients with large breast tissue can be difficult. In general best to minimize length to venotomy. This placement shows how long extravascular length + mobile tissue can cause loop + potential for kinking. Worst case would be retraction of intravascular portion

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Jacob Fleming, MD

@JacobFlemingMD

2 years

#AngioVibes #VIRDropOut #DollarStoreIRResident #RadRes #CorePosting

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Jacob Fleming, MD

@JacobFlemingMD

3 years

@mahad_minhas 7. Decent human respect

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Jacob Fleming, MD

@JacobFlemingMD

3 years

@janeni_nayagan Don't try to fix the system (you will most likely become angry and jaded). Do what you can to improve the experience for junior residents. Make friends with other specialties as much as possible. Otherwise just focus on showing up and doing a good job one day at a time.

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Jacob Fleming, MD

@JacobFlemingMD

2 years

Idk why I feel compelled to take the extra 2 seconds to say "Roman numeral" and "lower case" but it just feels right #RadRes #Couinaud @ericwpepin @danbrownIO @LetDdiceFlyHigh @leyendecker_rad @SocietyAbdRad

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Jacob Fleming, MD

@JacobFlemingMD

4 years

Today seems an appropriate day to announce that our (partly) Irish clan is growing!

Lindsay Seidel

@severelylindsay

4 years

Happy St. Patrick’s Day! 💚 Our little lucky charm is due in September 🍀 Ajax the leprecorg is very excited 🐶

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Jacob Fleming, MD

@JacobFlemingMD

2 years

Calories don't count on night float. I don't make the rules.

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Jacob Fleming, MD

@JacobFlemingMD

3 years

Good morning to everyone except the people who make scrub tops with front pockets too small to hold a phone

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Jacob Fleming, MD

@JacobFlemingMD

3 years

I mean, c’mon! 💕

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Jacob Fleming, MD

@JacobFlemingMD

1 year

#MskIR #VIR #NeuroIR #TheTrifecta @UTSW_Radiology Graduation

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Jacob Fleming, MD

@JacobFlemingMD

2 years

My son is unreasonably handsome. #notbiased

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Jacob Fleming, MD

@JacobFlemingMD

2 years

I can't believe Elliot is already 1! What an amazing experience it's been watching his personality unfold. I can't wait to see how he surprises us and makes us laugh this year ❤️

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Jacob Fleming, MD

@JacobFlemingMD

1 year

Getting into the last two months of residency is making me way more sad than I expected... way more than high school, undergrad, or med school. Feels like I'm leaving a whole saga of my life in these hospitals—not just what was, but what could've been. #SeniorYear

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Jacob Fleming, MD

@JacobFlemingMD

3 years

In residency you have to claim small victories in the war on call even though you know you're never really done. "Yeah, this is my last night on call. At this hospital. I mean, until next academic year. As long as you don't count weekends. Or evenings. Or this coming Tuesday."

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Jacob Fleming, MD

@JacobFlemingMD

3 years

I try to tweet mostly positive or "funny" things, but with new interns starting I thought I should share something not funny but real. For the last week I have felt completely obliterated by residency. I have had regrets about going into healthcare every day. 1/

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Jacob Fleming, MD

@JacobFlemingMD

2 years

First block of #RadRes night float: I’m gonna be as efficient and helpful as possible, exercise and take care of myself, and be a positive presence at the hospital Last block of night float:

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Jacob Fleming, MD

@JacobFlemingMD

2 years

Runners be like "yeah I love the runner's high I can't get enough" My friend your menisci have had enough

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Jacob Fleming, MD

@JacobFlemingMD

1 year

Nice diagram depicting the retrodural space of Okada, an underappreciated structure in spinal anatomy . Thanks to @Miriam_Peckham and @dougbeall , I was able to recognize when I inadvertently opacified it in two different patients in one day. 👍🏼 😁

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Jacob Fleming, MD

@JacobFlemingMD

2 years

After multiple disappointments, Elliot finally got the PS5 he's been asking for!

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Jacob Fleming, MD

@JacobFlemingMD

3 years

RadPrimer questions have 2 modes "Patient was involved in a trauma. What is the etiology of the abnormality? A. Neoplasm B. Infection C. Congenital D. Trauma" or "6 month old has MRI. What is the diagnosis? A. Periastrocytoma B. Hemangioperiastrocytoma C. Periastroblastoma"

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Jacob Fleming, MD

@JacobFlemingMD

6 months

Sclerotic fractures on CT are often described as "remote" or "chronic" because it's something that can be said pretty confidently. Unfortunately this descriptor sometimes ignores other salient features, such as a hypotrophic nonunion cleft with pain >6 months after injury.

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Jacob Fleming, MD

@JacobFlemingMD

5 months

T3-T4 bone tumor ablation and kyphoplasty for metastatic NSCLC, helping to keep this elderly pt mobile, out of the hospital, & away from further deconditioning & pneumonia. Outpatient operation, 4 small pokeholes. Tumor dead, pain resolved. Love my job. #IRad #MskIR #SpineIR

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Jacob Fleming, MD

@JacobFlemingMD

2 years

Weekend baby call is harder than weekend radiology or surgery call #ISaidWhatISaid

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Jacob Fleming, MD

@JacobFlemingMD

4 years

@DShadowgazer point tendernesssssss*

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Jacob Fleming, MD

@JacobFlemingMD

3 years

@samsfeelinggood @AmputationSuck Nice thread. Good pointers. Thanks for not making step 1: “Call IR.” Lol

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Jacob Fleming, MD

@JacobFlemingMD

4 years

Last day of R1 year of #RadRes ! The year has flown by. Monday will be my first night on call at Parkland. I can’t wait.

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Jacob Fleming, MD

@JacobFlemingMD

1 year

1st week of fellowship was awesome! Already learning a ton, including a lesser known benefit of private practice: office dog. It's about time Ajax started earning his keep around here, and those CDs were apparently due for a good sorting/snoofing. #CheapOfficeLabor #MskIR

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Jacob Fleming, MD

@JacobFlemingMD

2 years

Excited to share some interesting cases, techniques, and learning points at @The_ASSR this week! Check out our virtual abstracts and let us know what you think. #MskIR #SpineIR #BVNA #sacroplasty #cementoplasty #SIfusion #facetscrews

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Jacob Fleming, MD

@JacobFlemingMD

7 years

I'm thrilled to match to Interventional Radiology residency at @UTSW_Radiology , following surgery internship at @methodistdallas ! @severelylindsay and I are going back to Texas! #IRadRes #RadRes #Match2018 @SIRRFS @SIRspecialists

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Jacob Fleming, MD

@JacobFlemingMD

3 years

Just to clarify my previous post (which I guess is my first "viral" tweet?): I do not actually want my son to match into derm nor do I have an expectation that he will. That was a joke. Obviously I want him to match to #IRad and will be supportive as long as he does that.

Jacob Fleming, MD

@JacobFlemingMD

3 years

So my wife is almost 37 weeks pregnant and our son will be here any day now. I'm mostly excited but I am a little anxious. What's a good APGAR score for us to aim for for him to be competitive for the 2048 derm match?

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Jacob Fleming, MD

@JacobFlemingMD

2 years

Please stop doing this or I will have my techs throw you in radiology jail (the barium supply closet) #MSKRad #RadRes

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Jacob Fleming, MD

@JacobFlemingMD

1 year

Great first day of @CIO_Oncology including catching up with @AlanAlperMD to talk the latest in cryoablation/neurolysis & more, with exceptional stock photo posing! #TotallyCandid Coming soon to @_backtableMSK See y'all tomorrow for more! #IRad #MskIR #SpineIR #CIO2023

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Jacob Fleming, MD

@JacobFlemingMD

2 years

@GoodishIntent Otherwise how will the sound waves see

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Jacob Fleming, MD

@JacobFlemingMD

3 years

If you see: -bowel lumen dilation (ischemic injury to myenteric plexus-->focal ileus) -paper thin bowel (ischemic sloughing) -mesenteric fluid (might be succus) think ischemia 1st. FWIW, that combination has a 100% predictive value for me. (n=3)

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Jacob Fleming, MD

@JacobFlemingMD

2 years

"Most problems can be solved with brute force." One of many pearls from @dougbeall at a great @SpinalSimpLLC course in Dallas. Nice prelude to @The_ASSR workshop next week! #MskIR #SpineIR

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Jacob Fleming, MD

@JacobFlemingMD

3 years

ED CT Brain ED CT Abdomen/Pelvis Name a more iconic duo. I’ll wait.

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Jacob Fleming, MD

@JacobFlemingMD

3 years

Check out our article on IR subspecialty training in IR Quarterly and let us know your thoughts! Thanks to @dougbeall and @kmadass for contributing to this piece, which was a blast to write. @SIRSpecialists @SIRRFS @SIR_ECS

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Jacob Fleming, MD

@JacobFlemingMD

3 years

@IEMcElroy People like this use their "back in my day" BS as an excuse to have 0 emotional intelligence and torment med students and residents instead of working to make the training process better than it is. The rigor of training is hard enough. We don't need to torture each other too

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Jacob Fleming, MD

@JacobFlemingMD

2 years

Incredible @SIO_Central #MSK oncology course today surpassed even my high expectations. Thank you @SeanTutton @JackASSR23 @JenEberly and all involved. Great to meet and catch up with great ppl and learn paradigm-shifting techniques for cancer care in a multidisciplinary format.

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Jacob Fleming, MD

@JacobFlemingMD

2 years

I'm speaking today at ⁦the ASSR annual meeting. Please check out my talk on our multicenter sacroplasty registry if you're attending the event! @The_ASSR #ASSR #ASSR23 #SpineRadiology #MskIR #SpineIR - via #Whova event app

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Jacob Fleming, MD

@JacobFlemingMD

3 years

We've been working on something new for y'all. 😎 Soon... 🤫 #MSKIR #OrthoIR @_backtable @dougbeall @AaronFrittsMD @JMichaelBarraza @AlanAlperMD @SeanTutton @bkeyMD @satyamvmd @DoctorCliffyy

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Jacob Fleming, MD

@JacobFlemingMD

1 year

Trigeminal (gasserian) ganglion block: crucial diagnostic and therapeutic procedure for trigeminal neuralgia. Good view of foramen ovale and understanding of the anatomy in the needle trajectory (just soft tissue) make it safe. Expert @neuroradiology hands make it smooth.

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Jacob Fleming, MD

@JacobFlemingMD

1 year

Did training on our new PACS (Sectra) yesterday. Blown away! A PACS that actually facilitates clinical workflow instead of limiting it...😮 Feels like I just met my new crush after being in a dysfunctional relationship for four years 😍 @ericwpepin @ajaykohlimd @AliTejaniMD

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Jacob Fleming, MD

@JacobFlemingMD

3 years

Yes, he is the future (of chonky cheeks) ❤️ @UTSW_RadRes @UTSW_Radiology @UTSWNews 📸: @severelylindsay

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Jacob Fleming, MD

@JacobFlemingMD

2 years

It is done. #LifestreamAndChill #RadRes #CorePosting

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Jacob Fleming, MD

@JacobFlemingMD

1 year

Never want to forget these moments

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Jacob Fleming, MD

@JacobFlemingMD

4 months

To commemorate the last day of fellowship, Dr. Nguyen and I had to do it to 'em. (Obviously, I had to wear all my conference and course lanyards from the year as bling.) Thank you for being such a fantastic mentor! #NeuroIR #SpineIR #HardImages #Swag #DoItToEm #YouKnowIHadTo

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Jacob Fleming, MD

@JacobFlemingMD

2 years

Four years ago, my colleague Shaun Nordeck and I were about to start surgery internship at @methodistdallas . Yesterday, we had a beer to celebrate being done with radiology boards! Residency: Long days, short years. #RadRes #IRadRes @SIRRFS @UTSW_RadRes @UTSW_VIR @Mike_TruittMD

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Jacob Fleming, MD

@JacobFlemingMD

3 years

@SohailCmd @AmericanMedic10 @ACPinternists @EricTopol @IR_Ethics @SIRspecialists @JAMA_current @TheLancet @NEJM "A physician who treats himself has a fool for a patient"

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Jacob Fleming, MD

@JacobFlemingMD

4 years

SpineJack/kypho lab with fellow @UTSW_RadRes @prakationary , courtesy of @stryker_spine and the great Dr. Linnan Tang. Excited to bring the next generation of vertebral augmentation to our future patients. @UTSW_VIR @SIRRFS @dougbeall @AlanAlperMD @DavidGimarc @SeanTutton

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Jacob Fleming, MD

@JacobFlemingMD

2 years

Had a great experience at #ASSR23 . Thank you Dr. Beall & Nguyen and @UTSW_RadRes for the opportunity to attend. This meeting has the densest concentration of amazing people anywhere. See y'all next year for more #SpineIR in #Vegas ! (forgot to take many pictures, whoops)

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Jacob Fleming, MD

@JacobFlemingMD

2 years

At the risk of making a controversial statement, I think many prospective students realized that the integrated IR residency was widely overhyped. Relatively few benefits to most integrated programs & students like the flexibility of DR+ESIR

Daniel Pope

@DannyPope_

2 years

The new Match data shows that DR and IR are now equivalent in competitiveness. Nearly identical board scores, match rates, AOA membership, and extracurriculars. Wonder what caused such a big shift in a short time.