The Other Half(ascii.textfiles.com)
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The Other Half
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332 comments
>I felt silly, but really everyone that I dealt with was cool about it.
Twice in my life I've presented at the ER with severe chest pain that I thought was heart-related, twice it turned out to be nothing serious (musculo-skeletal pain in one case, very bad indigestion in another), and both times I felt like a fucking idiot for even just showing up, let alone after being told I just need to eat more fruit and shit more often.
But at no point did anyone in the hospital, from the cleaning staff to the nurses to the doctors to the x-ray technicians to the people at the front desk, ever make me feel unwelcome or that I had wasted their time.
When I apologised to a nurse for taking up space in a bed that should have been put to better use for someone who was actually ill, she sat down next to me for a moment and told me that she would rather I was wrong a thousand times and "wasted" a thousand beds in hospital, than right one time and dead at home because I was trying to avoid embarrassment.
Twice in my life I've presented at the ER with severe chest pain that I thought was heart-related, twice it turned out to be nothing serious (musculo-skeletal pain in one case, very bad indigestion in another), and both times I felt like a fucking idiot for even just showing up, let alone after being told I just need to eat more fruit and shit more often.
But at no point did anyone in the hospital, from the cleaning staff to the nurses to the doctors to the x-ray technicians to the people at the front desk, ever make me feel unwelcome or that I had wasted their time.
When I apologised to a nurse for taking up space in a bed that should have been put to better use for someone who was actually ill, she sat down next to me for a moment and told me that she would rather I was wrong a thousand times and "wasted" a thousand beds in hospital, than right one time and dead at home because I was trying to avoid embarrassment.
About 2 years ago I started feeling some chest pains at night. I was just over 40 at the time. I phoned the NHS helpline, who had a paramedic at my house within 1 minute (literally) and she hooked me up to a portable ekg. She found nothing wrong but thought it was a good idea to go to hospital. She stayed with me till the ambulance arrived about 45 minutes later. Ambulance staff was brilliant, and everyone at the hospital too. I checked out about 3 hours later after free everything (x rays, blood tests, egg, etc). I know the NHS has some problems, but they were outstanding in all respects that night, and not havin to even think about the financial side was pretty good too.
Regarding insurance, I wonder if you would have gone in if you were Keith, who at 35 is working sales at a department store. He might not even have been insured.
Want to disrupt the heart attack market?
Make a small home machine that can take an EKG and tell you if everything is fine, or if you should go get checked.
Adjust it to give some false positives, but no false negatives.
Make it cost around $50, and make sure it's fully reusable (i.e. you can borrow one from a friend for a quick check).
If machine learning is not up to the task, then send the EKG to a doctor, I believe they can read them in just seconds (correct me if I'm wrong), so it should not be expensive per-person.
To simplify it, have it connect via bluetooth to a phone, so you don't need to worry about WiFi, or a display. For reliability have it store the last 10 readings, even if not connected, so it should have a start button and indicator lights.
Make a small home machine that can take an EKG and tell you if everything is fine, or if you should go get checked.
Adjust it to give some false positives, but no false negatives.
Make it cost around $50, and make sure it's fully reusable (i.e. you can borrow one from a friend for a quick check).
If machine learning is not up to the task, then send the EKG to a doctor, I believe they can read them in just seconds (correct me if I'm wrong), so it should not be expensive per-person.
To simplify it, have it connect via bluetooth to a phone, so you don't need to worry about WiFi, or a display. For reliability have it store the last 10 readings, even if not connected, so it should have a start button and indicator lights.
An EKG machine cannot tell you whether you're fine or not. Not all heart attacks show up on EKGs, which is why the hospital will do a blood test for Troponin, too. A home Trop test would do what you want, but it can take several hours for the test to turn positive, and the hours between the onset of pain and the blood test showing that you're having a heart attack should really be spent attached to a cardiac monitor and in the presence of trained medical personnel, i.e. in hospital.
<quote> Want to disrupt the heart attack market?</quote>
Might be a good idea! Just don't stop there and be more ambitious. Kill the heart attack market as much as you can by making this technology widely available to those that need it at no cost. Find different ways to earn something from it...
If there is one thing that has been proven over and over again, it's that the market and health care don't go together in terms of efficiency. I'm not even touching the ethics angle here...
When I hear the n-th iteration of the basic income discussion and the "useless" class, health care strikes me as the area to make a real difference in, much more than "basic income". Because even the "useless" class will find ways to sustain itself, given adequate health.
Might be a good idea! Just don't stop there and be more ambitious. Kill the heart attack market as much as you can by making this technology widely available to those that need it at no cost. Find different ways to earn something from it...
If there is one thing that has been proven over and over again, it's that the market and health care don't go together in terms of efficiency. I'm not even touching the ethics angle here...
When I hear the n-th iteration of the basic income discussion and the "useless" class, health care strikes me as the area to make a real difference in, much more than "basic income". Because even the "useless" class will find ways to sustain itself, given adequate health.
Food as well. When I worked at a grocery store, it boggled my mind to watch food stamps families buy frozen meals. I wasn't on food stamps but I was paycheck to paycheck, what made me aware that it was cheaper and healthier to buy dry beans and raw veggies but them, unaware?
I don't think they're unaware. Frozen meals don't require preparation, when you're poor the mindset is very different, there were some really good articles on HN about that, I can't find them but for instance:
https://arstechnica.com/science/2016/12/junk-food-cravings-a...
https://arstechnica.com/science/2016/12/junk-food-cravings-a...
This is already a thing apparently (I never tried it so I cannot vouch for it's accuracy/reliability):
https://www.amazon.com/AliveCor-Kardia-Mobile-Android-device...
https://www.amazon.com/AliveCor-Kardia-Mobile-Android-device...
That only checks for atrial fibrillation, not heart attack.
> make sure it's fully reusable (i.e. you can borrow one from a friend for a quick check)
No, just put 24-hour machines in malls, then you don't need to delay going to market trying to get it under $50
No, just put 24-hour machines in malls, then you don't need to delay going to market trying to get it under $50
Good luck with the lawsuits when your machine gives the wrong answer.
The fuck is that country where working sales at 35 is wrong and an indication you might not have insurance despite having a job O_o
Seneca talks about this a lot. When I first started going to war in my early twenties, I began confronting my own mortality, and found myself slowly being funneled towards the great Stoics.
Humans have found different ways to deal with their own mortality - denial or religion or saying that's "natural". More people learn, their techniques have also changed, like (almost) no one thinks you/somebody died because it rained the day before and the rain gods spite you for doing XYZ.
My point being, drawing from the practices of people multiple centuries ago might not be the best thing
My point being, drawing from the practices of people multiple centuries ago might not be the best thing
> My point being, drawing from the practices of people multiple centuries ago might not be the best thing
Given how much of cognitive behavioral therapy borrows from stoicism in this case I think this assessment is premature. Stoicism like buddhism are great philosophies on how to deal with the world as it is. And to understand that most of the problems we think of are products of our own mind.
Stoicism doesn't do either denial or say its natural. It forces you to reevaluate how you think of the question. For that alone it is worth drawing from.
Given how much of cognitive behavioral therapy borrows from stoicism in this case I think this assessment is premature. Stoicism like buddhism are great philosophies on how to deal with the world as it is. And to understand that most of the problems we think of are products of our own mind.
Stoicism doesn't do either denial or say its natural. It forces you to reevaluate how you think of the question. For that alone it is worth drawing from.
It sounds like you haven't actually read Stoic philosophy. The central theme of the Stoics is that how you react to your situation and surroundings is entirely up to you. When someone spills coffee on you at Starbucks (or whatever), they aren't the ones making you mad. If you think Stoics are outdated, go read what Stockdale has to say about the philosophy and how it served him as a POW in Vietnam. I think once you've actually consumed (and grokked) what the Stoics said, you'll see that it's a philosophy that is timeless and as relevant as ever.
Your country amazes me. Where I live if you call the hotline for medical advice and describe anything that sounds like heartattack they are obliged to tell you to go to the hospital and wants to send an ambulance. I know because I was in one and felt supercity when it was a torn muscle
Yeah. The thought of not going to see a doctor or not calling an ambulance because it might cost me something is literally unfathomable.
Keith smoked. Smoking increases your risk of heart attack or myocardial infarction, amongst others. There's been a lot of public awareness campaigns on the dangers of smoking and in 2017, I can't believe he wasn't aware of them. Continuing smoking was a conscious decision.
This part fascinated me :
"" I waited 5 anxious minutes, and then was bought into a room with two doctors, one of whom turned out to be Dr. Sonny Palmer.
Sonny said Georg thought I needed some help, and I’d be checked within a day. I asked if he’d seen the letter with his name on it. He hadn’t. He went and got it.
He came back and said I was going to be operated on in an hour. "" You obviously don't want to be rude when talking with doctors, but you absolutely should be your own advocate. Any time you're dealing with medical choise ask questions, such as "did you notice X" or "did you see the information from other person Y" or "do I have other options here than the plan you outlines?" or "your advice sounds good, but what are complications / side effects in doing this?" In the United States it feels like our attitude is "I go to doctor to get fix for aliment. He prescribes X. Done", and it's never that simple.
"" I waited 5 anxious minutes, and then was bought into a room with two doctors, one of whom turned out to be Dr. Sonny Palmer.
Sonny said Georg thought I needed some help, and I’d be checked within a day. I asked if he’d seen the letter with his name on it. He hadn’t. He went and got it.
He came back and said I was going to be operated on in an hour. "" You obviously don't want to be rude when talking with doctors, but you absolutely should be your own advocate. Any time you're dealing with medical choise ask questions, such as "did you notice X" or "did you see the information from other person Y" or "do I have other options here than the plan you outlines?" or "your advice sounds good, but what are complications / side effects in doing this?" In the United States it feels like our attitude is "I go to doctor to get fix for aliment. He prescribes X. Done", and it's never that simple.
Couldn't agree with this more. I'm from MN, we tend to be pretty polite and understated, assume that doctors (and other authorities) know what they're talking about. Had a friend who progressed to a heart attack in a waiting room because he didn't want to make a fuss.
Make a fuss.
Make a fuss.
This was in Australia. A senior cardiologist has no motivation other than saving your life, and the symptoms were very clear.
Meanwhile a stent operation is relatively trivial - as was explained later in the piece.
If he'd asked for a second opinion it could very well have added enough time to make things a lot worse.
Interestingly this article on HN last week addressed the finding that while stents are often prescribed for chest pain symptoms it is doubtful they have a more favorable outcome than other treatments https://news.ycombinator.com/item?id=13713563#13716162
I think it was less about asking a second opinion than making sure the doctors opinion was drawn from all the available facts.
motivation doesn't imply correctness.
http://www.dailymail.co.uk/health/article-1373373/Study-show...
http://www.dailymail.co.uk/health/article-1373373/Study-show...
My aunt waited 4 hours even vomiting ... If you don't bleed out they assume you have nothing.
We need to adjust healthcare. Way more important than the digital world and social networks.
We need to adjust healthcare. Way more important than the digital world and social networks.
Sounds like standard triage, I've dated a nurse and the general order of priority was:
- unconscious/bleeding - bleeding - everything else
Its not that they assume you have nothing its that if you're conscious, whatever you have can wait.
- unconscious/bleeding - bleeding - everything else
Its not that they assume you have nothing its that if you're conscious, whatever you have can wait.
We all understand that there is priority. But it seems a corner case when you have a condition that will worsen a lot in hours even though you're not bleeding nor unconscious.
I've been in the hospital twice in the past year (once to visit my grandfather, once to have my appendix removed), and I was really bothered by the lack of communication. In my grandfather's case, the nurses were bewildered by the fact that his blood pressure varied so wildly between lying down and standing (which causes him to pass out). I finally had to ask them "Surely the doctor told you he has Shy-Drager syndrome, right?" They had no idea that this was normal for him, and will only get worse as he gets older. If it only took me 30 seconds to explain it to them, why couldn't his doctor have done the same.
When I had my appendix removed, I was on a couple of prescription medications, which I brought with me to the hospital to ensure I got the names correct when I informed the front desk clerk as I was admitted. Two days later my nurses had a hissy fit when they discovered that not only was I on prescription medications (this somehow hadn't been communicated), but that I was also administering them myself (apparently a no-no in the hospital).
Apparently no one talks to each other in hospitals.
When I had my appendix removed, I was on a couple of prescription medications, which I brought with me to the hospital to ensure I got the names correct when I informed the front desk clerk as I was admitted. Two days later my nurses had a hissy fit when they discovered that not only was I on prescription medications (this somehow hadn't been communicated), but that I was also administering them myself (apparently a no-no in the hospital).
Apparently no one talks to each other in hospitals.
Jason Scott, the heart attack guy, here.
During the weeks I was with my dad, at Duke Hospital, I got to see extremely excellent care - because he'd been a transplant patient, they took his medications incredibly seriously. Everything was charted and they were always on top of it. There were arguments about his exercise needs, but mostly between him and the nurses, who exhibited a wide range of bedside manner. I definitely think having an advocate with you at the hospital is critical.
At St. Vincent's, I really dealt with superior nurses. Only one was short with me, and that's mostly because she was asking me a question and my answers were too fru-fru for her; she wanted a number, and all I had was a guess. When I finally guesstimated a number, she went away; never saw her again. Meanwhile another walked me though a large post-heart attack education patiently to make sure I understood everything.
The hospital, I'm sad to say, makes a big difference.
During the weeks I was with my dad, at Duke Hospital, I got to see extremely excellent care - because he'd been a transplant patient, they took his medications incredibly seriously. Everything was charted and they were always on top of it. There were arguments about his exercise needs, but mostly between him and the nurses, who exhibited a wide range of bedside manner. I definitely think having an advocate with you at the hospital is critical.
At St. Vincent's, I really dealt with superior nurses. Only one was short with me, and that's mostly because she was asking me a question and my answers were too fru-fru for her; she wanted a number, and all I had was a guess. When I finally guesstimated a number, she went away; never saw her again. Meanwhile another walked me though a large post-heart attack education patiently to make sure I understood everything.
The hospital, I'm sad to say, makes a big difference.
Communications in hospital is so subpar it's alarming some times. Long wait for stupid data transfer. "Data races", contradictory informations and judgement.
I agree with your advice, but rare are the doctors that don't bounce what you say until it's really heavy.
I agree with your advice, but rare are the doctors that don't bounce what you say until it's really heavy.
Last August I go to bed one night and I feel extremely nauseous with a burden on my chest. After vomiting I feel relieved but the burden is still there. So I decide to visit the ER afraid that I might have a heart attack. They give me all the exams and it turns out it was a stomach problem, specifically GERD which turned out to be a bitch because it took 6 months to cure and a very strict diet.
While at the hospital the doctor informs me that quite a lot of people with stomach issues misinterpret them for heart attacks and vice versa, which is the really troubling thing because they think it's their stomach and they die since they neglect to see a doctor. So I ask him, how do you tell whether it's a stomach or a heart issue? You don't, he replies. If you feel anything funny related to your chest go to a hospital.
While at the hospital the doctor informs me that quite a lot of people with stomach issues misinterpret them for heart attacks and vice versa, which is the really troubling thing because they think it's their stomach and they die since they neglect to see a doctor. So I ask him, how do you tell whether it's a stomach or a heart issue? You don't, he replies. If you feel anything funny related to your chest go to a hospital.
the doctor informs me that quite a lot of people with stomach issues misinterpret them for heart attacks and vice versa
Yeah, my dad died (11 years ago) of a heart attack while he was thinking he had stomach issues.
Yeah, my dad died (11 years ago) of a heart attack while he was thinking he had stomach issues.
This story and the comments make me curious as to how many hard charging project leaders have, or would, work through a heart attack.
These words stuck out to me:
> I was fucking annoyed – I felt like I was just super tired and needed some energy, and energy drinks and caffeine weren’t doing the trick.
He then went on to keynote a conference and live for what seems like at least two more days without seeking medical attention.
I'm a mid 30's man, my family history includes heart disease, my father is stubborn as am I. If some day I felt tired, and constricted, my first thought would not be that maybe my heart is failing, but it probably shouldn't be my last thought.
We cannot achieve our goals or lead projects if we are dead. This close call woke me up to paying attention to my body, and maybe we all can benefit from it.
These words stuck out to me:
> I was fucking annoyed – I felt like I was just super tired and needed some energy, and energy drinks and caffeine weren’t doing the trick.
He then went on to keynote a conference and live for what seems like at least two more days without seeking medical attention.
I'm a mid 30's man, my family history includes heart disease, my father is stubborn as am I. If some day I felt tired, and constricted, my first thought would not be that maybe my heart is failing, but it probably shouldn't be my last thought.
We cannot achieve our goals or lead projects if we are dead. This close call woke me up to paying attention to my body, and maybe we all can benefit from it.
I'm not completely sold on the relationship of stress and heart disease. I spend some time working in politics, and almost all principals worked 18h-days with less than 5h of sleep during the week. Yet life expectancy is higher than average.
There are obviously ots of competing factors at work: they have plenty of opportunities to eat healthy, and the discipline that makes them get up at 5am also makes them go for a run at 5:30. Then again two of my bosses had to retire after run-ins with the crystal meth law they themselves passed...
Considering the limits of willpower, I'd rank it Smoking/Exercise/Food/Sleep/Stress.
There are obviously ots of competing factors at work: they have plenty of opportunities to eat healthy, and the discipline that makes them get up at 5am also makes them go for a run at 5:30. Then again two of my bosses had to retire after run-ins with the crystal meth law they themselves passed...
Considering the limits of willpower, I'd rank it Smoking/Exercise/Food/Sleep/Stress.
higher than average for people with similar wealth, education and medical history, or higher than average nationwide, including people in poverty with poor health care and nutrition?
> bosses had to retire after run-ins with the crystal meth law they themselves passed...
Wait, what?
Wait, what?
Sounds like his bosses were politicians who helped get stricter drug laws passed, then were caught using those drugs.
(Presumably to sustain the will power to work 18h days on 5h of sleep)
That is interesting. I wonder if there have been studies on occupation and heart disease. One contributing factor to the incidence of heart attacks in the tech field could be our propensity to sit still for many hours in a row to retain focus.
Maybe not for heart disease, but stress should be number one for health overall because it affects all the other things you mentioned: sleep, appetite, exercise, and smoking.
With the principals being able to work 18h days, I think their discipline plays a huge part, as you wrote, and maybe they're outliers who naturally cope with these demands better than the average person. I personally can't sustain 12h days for more than a month.
With the principals being able to work 18h days, I think their discipline plays a huge part, as you wrote, and maybe they're outliers who naturally cope with these demands better than the average person. I personally can't sustain 12h days for more than a month.
This is what is called a non-representative sample. To say the least...
Sheesh.
Sheesh.
They're called "elected representatives" for a reason :)... I had actually seen a study showing the advantage in life expectancy for high-powered executives/lawyers/politicians. Only the tendency to work long hours was from my sample.
Unless you smoke, heart attack or MI is highly unlikely before 40. I would review lifestyle choices though and make sure to have a complete medical checkup before 40
"I’d now had been experiencing a heart attack for about a week."
Holy cow. I didn't realize this was possible. This is a good lesson to all of us not to ignore weird, painful phenomena in our body.
Holy cow. I didn't realize this was possible. This is a good lesson to all of us not to ignore weird, painful phenomena in our body.
It's very possible. In EMS I meet folks that have been in having a heart attack for quite some time, it's not always dropping down like a rag doll you see on TV (though many times it is).
My dad did the same thing, one day he had some chest pain that he thought was related to something he ate. Drove a semi truck around for about 6 hours, decided to come home early. He came back to the shop, parked his truck and called my mom and said he had indigestion like he'd never experienced, and they went to the doctor. Turned out to be a full-on heart attack he'd been feeling the last 8 hours.
I guess that's a long way of saying listen to your body. Generally, it's trying to tell you something, and if feels just a little off, get checked out. Could definitely save your life.
My dad did the same thing, one day he had some chest pain that he thought was related to something he ate. Drove a semi truck around for about 6 hours, decided to come home early. He came back to the shop, parked his truck and called my mom and said he had indigestion like he'd never experienced, and they went to the doctor. Turned out to be a full-on heart attack he'd been feeling the last 8 hours.
I guess that's a long way of saying listen to your body. Generally, it's trying to tell you something, and if feels just a little off, get checked out. Could definitely save your life.
I'm assuming you mean people can be having an MI, or experiencing angina for quite some time, not actually in cardiac arrest
Yes, I edited it for clarity, because by definition cardiac arrest is the sudden stop of blood flow, where MI/AMI/Angina are more gradual. All are commonly called "heart attacks" but are quite different. Thanks for keeping me honest here.
A lot of people equate a heart attack with cardiac arrest, where the heart actually stops pumping blood and the patient suddenly collapses, but in reality, a heart attack refers to a complete blockage of blood flow to part of the heart, and is sometimes colloquially to refer to inadequate blood flow (the term is never really used clinically).
Also, heart attacks can present very differently in different people. A large number of people (especially women) have atypical presentations that may not include the classic sub-sternal chest pain, so the symptoms often get ignored or missed.
Also, heart attacks can present very differently in different people. A large number of people (especially women) have atypical presentations that may not include the classic sub-sternal chest pain, so the symptoms often get ignored or missed.
I had a heart attack two years ago. I spent a few weeks with some weird pain in my forearms (both of them) before realizing it was a heart attack. Never felt any pain in my chest.
How did you realize it was a heart attack? Did you go to the doctor and have them check it out?
At first I looked for information on the Internet about the pain in my arms an saw that, among many other things, it could be a heart problem.
A couple of weeks later I started feeling pain on the left side of my jaw (much like a toothache) at the same time I felt the pain in my forearms. Searching again on the Internet I saw that now it was quite probably a heart problem.
About 48 hours after that, the pain in my arms wasn't letting me concentrate on anything (it wasn't stronger, but it felt different, it made me feel that something was really wrong with my body), that's when I went to the emergency room at the hospital.
A couple of weeks later I started feeling pain on the left side of my jaw (much like a toothache) at the same time I felt the pain in my forearms. Searching again on the Internet I saw that now it was quite probably a heart problem.
About 48 hours after that, the pain in my arms wasn't letting me concentrate on anything (it wasn't stronger, but it felt different, it made me feel that something was really wrong with my body), that's when I went to the emergency room at the hospital.
It's also common for people to have a major heart attack without receiving medical attention at all, and only discover it much later when being analyzed by a doctor who notices the damage.
My Grandad drove himself to the hospital the second time he had a heart attack. He decided it was faster than waiting for an ambulance. His wife can't drive b/c she's legally blind now.
Reduced function is a lot more common than heart attacks. Coronary artery disease and such. A heart attack is when it gets bad enough that the heart is damaged.
Interesting story. Having a skilled doctor is essential to making it out of those situations unscathed. I was lucky enough to have one of those too.
I had an ischemic stroke at the age of 21 while studying abroad in Prague. Rushed to ER and emergency cutting edge surgery, intra-arterial thrombolysis, ensued. This is a 'test' procedure in many parts of the western world. They went through my groin to get to the blot clot in my brain. Woke up that evening in the ER with pretty much no clue what had happened.
While the quality of the care was pretty good, with the surgeon being spectacular, the language barrier made things a bit difficult for my two weeks stay there after! Not to mention I was hands down to everyone's junior in that section of the hospital I was moved to after the ER ha.
Anyway that's the short version of a story I should probably write down somewhere similar to yours. I'm 24 now and completely healthy =). For all the 'making the world a better place (at a macro level)' that us devs are doing it is a nice reminder that making the world a better place on an individual level is probably still the most impact any of us can have. I don't even know what my doctor's name was! But thank you to all you MDs.
I had an ischemic stroke at the age of 21 while studying abroad in Prague. Rushed to ER and emergency cutting edge surgery, intra-arterial thrombolysis, ensued. This is a 'test' procedure in many parts of the western world. They went through my groin to get to the blot clot in my brain. Woke up that evening in the ER with pretty much no clue what had happened.
While the quality of the care was pretty good, with the surgeon being spectacular, the language barrier made things a bit difficult for my two weeks stay there after! Not to mention I was hands down to everyone's junior in that section of the hospital I was moved to after the ER ha.
Anyway that's the short version of a story I should probably write down somewhere similar to yours. I'm 24 now and completely healthy =). For all the 'making the world a better place (at a macro level)' that us devs are doing it is a nice reminder that making the world a better place on an individual level is probably still the most impact any of us can have. I don't even know what my doctor's name was! But thank you to all you MDs.
>For all the 'making the world a better place (at a macro level)' that us devs are doing
Speak for yourself... I'm just automating peoples jobs and subsequently making them unemployed, lol.
Speak for yourself... I'm just automating peoples jobs and subsequently making them unemployed, lol.
In Ireland when you say "other half" you generally mean wife, husband, boyfriend, girlfriend or partner. And the No. 1 thing I thought reading this was that Rachel, whoever she is, must be a damn saint.
I sleep with my Fitbit Charge 2 on my wrist, and I found that the Resting Heart Rate value is extremely sensitive to what happens with my body. Drank a little alcohol? See a change on my Resting Heart Rate value for that night. Got too much stress, or maybe spent a day at home without exercise? Yes, I see it on the graph. So my question is whether such an event as the one that is described would be clearly visible to the fitness tracker, maybe even clear enough to alert the wearer.
I'm currently wearing a Zio Patch, which generally is used to track and monitor arrhythmia over a 2 week period. The last time I got the results back there was a section for something along the lines of "cardiac arrest" or something (which had a nice 0 next to it for me). Whether the patch itself has the computational power to both sense and interpret a cardiac event like that, or whether they can only do that after in the lab, I don't know, but I bet it could be modified to start squealing if it detects a heart attack. It's basically a 2 week EKG.
The only problem is my insurance pays 1000$ every time I wear it.
The only problem is my insurance pays 1000$ every time I wear it.
One reason I reduced my alcohol intake substantially is the effect that alcohol had on my resting heart rate. It would go up around 90bpm (or higher if I was dealing with a particularly bad hangover the next day). When I abstain it stays around 60.
Interesting. Did heart rate monitoring change any other behaviours?
Not that I can think of. Same schedule, diet, activity, sleep patterns, etc.
Much as I like to think about the potential usefulness of fitness trackers (I work for Fitbit, but speak only for myself), a much more useful approach is to pay attention to your body. If something's not normal a lot of insurance plans have nurse lines you can call to tell about your symptoms and find out if you should be seen.
The story includes a lot of things that sound like heart attack symptoms. http://www.mayoclinic.org/diseases-conditions/heart-attack/i...
The story includes a lot of things that sound like heart attack symptoms. http://www.mayoclinic.org/diseases-conditions/heart-attack/i...
I sat on a "weird pain" in my chest for a few days. Basically it was uncomfortable to sleep on my left side, and I felt a bit short of breath. Turns out I was suffering from a double pulmonary embolism, and that the only reason I wasn't doubled over in pain is because by an odd fluke of nature, the interior of the lungs do not have nerve endings (only the exterior) and had I waited any longer I could have died. At that point, a third of both of my lungs was basically gone already. And so, I ended up having to stay for an entire week in the hospital while they dripped anticoagulants into me. If my girlfriend hadn't strongly encouraged me to call my doctor... Who knows.
Guys/gals... If there's any unusual pain in your chest cavity at all, just drop whatever it is you're doing and get it checked out. It might not even seem that bad at the time... it didn't to me and it didn't to Jason Scott... just do it.
Guys/gals... If there's any unusual pain in your chest cavity at all, just drop whatever it is you're doing and get it checked out. It might not even seem that bad at the time... it didn't to me and it didn't to Jason Scott... just do it.
"What’s the biggest single factor that puts you at risk for ignoring your health? Being a man.
Sociologist Lisa Wade, interviewed in New York Magazine, says that 'some scholars argue that being male is the single strongest predictor of whether a person will take health risks.'
Men like risk it turns out. Most of them also hate putting lotion on their skin (too girly) and being afraid of things (not manly). They are also more likely to have outdoor jobs and do household tasks that involve being outside the house. Think lawn mowing and BBQ-ing. They also pay less attention to their skin and so don’t catch early warning signs.
Women, generally speaking, don’t mind lotions, do pay attention to changes in our skin, wear sunscreen to avoid premature aging and wrinkles, and often also wear make up year round that contains ingredients that protect skin from the sun."
"[...] part of the reason that married men, or men with female partners anyway, live longer. They’re nagged into healthy habits and visit the doctor more often."
https://fitisafeministissue.com/2014/08/16/men-and-skin-canc...
Sociologist Lisa Wade, interviewed in New York Magazine, says that 'some scholars argue that being male is the single strongest predictor of whether a person will take health risks.'
Men like risk it turns out. Most of them also hate putting lotion on their skin (too girly) and being afraid of things (not manly). They are also more likely to have outdoor jobs and do household tasks that involve being outside the house. Think lawn mowing and BBQ-ing. They also pay less attention to their skin and so don’t catch early warning signs.
Women, generally speaking, don’t mind lotions, do pay attention to changes in our skin, wear sunscreen to avoid premature aging and wrinkles, and often also wear make up year round that contains ingredients that protect skin from the sun."
"[...] part of the reason that married men, or men with female partners anyway, live longer. They’re nagged into healthy habits and visit the doctor more often."
https://fitisafeministissue.com/2014/08/16/men-and-skin-canc...
About a decade ago, I got a physical after having not set foot in a doctor's office in about 12 years. The doctor asked what made me come to get a physical after so long, and when I said nothing in particular, he pretended to write on his clipboard "Wife made me come here."
He said middle-aged guys with no obvious health problems pretty much only come to the doctor for one (or both) of two reasons: Their wife made them, or they want Viagra.
He said middle-aged guys with no obvious health problems pretty much only come to the doctor for one (or both) of two reasons: Their wife made them, or they want Viagra.
It's not just a macho thing.
I pretty severely injured an ankle back in September, at MMA, and for the first time in my life (at 38) it doesn't seem to be healing up very well. I keep finding new little movements that cause it to feel pretty wrong ("popping", "pulling", cold sensation, mild short-term pain, weakness).
One of these happened in front of my girlfriend, who ordered me to see a doctor, so I did. I filled out new copies of all the paperwork I filled out a year ago when I was grievously ill, sat around for a bit, got into the doctor's office, his assistant appeared and asked me a couple of questions, then the doctor appeared after a bit and asked me the same questions again. He palpated my ankle for a few seconds, told me to get a brace, and then left the room without another word.
Unless you're wealthy enough to afford a dedicated physician, there's just really no point in seeing a doctor for anything less than "I might be about to die".
...which sucks, because I'm a huge proponent of preventative medical care. It's just not available for most people.
I pretty severely injured an ankle back in September, at MMA, and for the first time in my life (at 38) it doesn't seem to be healing up very well. I keep finding new little movements that cause it to feel pretty wrong ("popping", "pulling", cold sensation, mild short-term pain, weakness).
One of these happened in front of my girlfriend, who ordered me to see a doctor, so I did. I filled out new copies of all the paperwork I filled out a year ago when I was grievously ill, sat around for a bit, got into the doctor's office, his assistant appeared and asked me a couple of questions, then the doctor appeared after a bit and asked me the same questions again. He palpated my ankle for a few seconds, told me to get a brace, and then left the room without another word.
Unless you're wealthy enough to afford a dedicated physician, there's just really no point in seeing a doctor for anything less than "I might be about to die".
...which sucks, because I'm a huge proponent of preventative medical care. It's just not available for most people.
> Unless you're wealthy enough to afford a dedicated physician
I think it depends on your doctor.
My GP is fantastic. He's always running late because the company he works for slots patients in 30 minute intervals, but he takes as long as is needed for his patients.
I'm not even close to wealthy ($50k/year) I can go to him for anything from the flu to broken bones to high cholesterol without thinking, "this is pointless".
I think it depends on your doctor.
My GP is fantastic. He's always running late because the company he works for slots patients in 30 minute intervals, but he takes as long as is needed for his patients.
I'm not even close to wealthy ($50k/year) I can go to him for anything from the flu to broken bones to high cholesterol without thinking, "this is pointless".
No idea which of us is more typical, but my doctor is awesome. Preventative care is deductible-waived, so there's really no good reason other than laziness for me not to get a regular annual physical.
But you don't know if that of pain is going to kill you or not
The whole "getting a physical" annually is purely an old school American thing anyway. I don't know anyone in my country who does this - although apparently nowadays US med associations recommended you go visit a doctor every 5 years or so if you're under 40.
Still, if I walked into a doctor and said "is anything wrong with me?" with no symptoms or obvious indication that this might be so, they would probably take blood pressure, do a breathing test, ask me if anything was actually wrong, and then wonder why I was wasting their time (or maybe ask if I was looking for a medical certificate cos I didn't feel like going to work, heh).
Still, if I walked into a doctor and said "is anything wrong with me?" with no symptoms or obvious indication that this might be so, they would probably take blood pressure, do a breathing test, ask me if anything was actually wrong, and then wonder why I was wasting their time (or maybe ask if I was looking for a medical certificate cos I didn't feel like going to work, heh).
Personally, I kind of wish my GP was there to help me optimize my health, rather than just to diagnose illness.
Like, all those dietary restrictions they give to people who've had heart attacks? Why not give them to me before I have a heart attack, so I won't ever get one? Make my life more of a hassle, so that I live longer!
I want to have someone in my life who plays the same role that a dental hygienist plays a dentist visit, but for my general physical health.
Like, all those dietary restrictions they give to people who've had heart attacks? Why not give them to me before I have a heart attack, so I won't ever get one? Make my life more of a hassle, so that I live longer!
I want to have someone in my life who plays the same role that a dental hygienist plays a dentist visit, but for my general physical health.
Okay.. so that kind of sounds like you need a dietician, which is someone you can ask your GP for a referral for, or in many cases just book an appointment with. Your GP doesn't send you to the dentist unless there's something so wrong with your teeth it's impacting the rest of your health; why would it be any different for your diet?
> I want to have someone in my life who plays the same role that a dental hygienist plays a dentist visit, but for my general physical health.
You better not expect doctors to be that. Most of them still believe cholesterol causes heart disease, for example, or that you need 50% carbs in your diet.
You better not expect doctors to be that. Most of them still believe cholesterol causes heart disease, for example, or that you need 50% carbs in your diet.
> He said middle-aged guys with no obvious health problems
Why would anyone see a doctor unless they had a health problem? (Or wanted health advice?)
Why would anyone see a doctor unless they had a health problem? (Or wanted health advice?)
> Why would anyone see a doctor unless they had a health problem? (Or wanted health advice?)
Because "sedentary middle-aged American eating a typical American diet" (possibly including "fat" as well) might as well be considered a preexisting condition all by itself, and a simple checkup may catch something that can be addressed before it becomes a hospital visit. Most notable as things to watch out for are high blood pressure, high/poorly balanced cholesterol and diabetes or early signs of it. Two of those you can do some checking for at home fairly inexpensively, but cholesterol not so much.
Despite having health insurance (Thanks Obama! while it lasts) I haven't actually had a checkup in probably 5+ years, but after this I'm going to see about getting in and at the least getting bloodwork, etc. which I've been thinking about anyway. Clearly Jason Scott can't be called all that sedentary given all the walking he did during his heart attack, which is why this is a bit of a wakeup call.
Edit:
I'll throw in a surgeon's commentary from when my wife had her gallbladder out: "Men are stupid."
Context: He was noting that most gallbladder problems are in women, that 90% of gallbladders are removed laparoscopically as outpatient procedures, and that of the other 10% where people end up hospitalized most are men because "Men are stupid." Men will try to tough it out and won't go see a doctor until they're in so much pain that they end up in the ER, and the ER isn't going to dink around with a laparoscope for investigation - if things are that bad, they may well slice you open so they can see what's going on and yank it right then and there leaving a nice scar, at least one overnight in the hospital, and some significant movement restrictions while you're healing.
Because "sedentary middle-aged American eating a typical American diet" (possibly including "fat" as well) might as well be considered a preexisting condition all by itself, and a simple checkup may catch something that can be addressed before it becomes a hospital visit. Most notable as things to watch out for are high blood pressure, high/poorly balanced cholesterol and diabetes or early signs of it. Two of those you can do some checking for at home fairly inexpensively, but cholesterol not so much.
Despite having health insurance (Thanks Obama! while it lasts) I haven't actually had a checkup in probably 5+ years, but after this I'm going to see about getting in and at the least getting bloodwork, etc. which I've been thinking about anyway. Clearly Jason Scott can't be called all that sedentary given all the walking he did during his heart attack, which is why this is a bit of a wakeup call.
Edit:
I'll throw in a surgeon's commentary from when my wife had her gallbladder out: "Men are stupid."
Context: He was noting that most gallbladder problems are in women, that 90% of gallbladders are removed laparoscopically as outpatient procedures, and that of the other 10% where people end up hospitalized most are men because "Men are stupid." Men will try to tough it out and won't go see a doctor until they're in so much pain that they end up in the ER, and the ER isn't going to dink around with a laparoscope for investigation - if things are that bad, they may well slice you open so they can see what's going on and yank it right then and there leaving a nice scar, at least one overnight in the hospital, and some significant movement restrictions while you're healing.
Interesting. I was one of those stupid men who was immobilized with pain from acute cholecystitis, I went to the ER, and they still did it laparoscopically.
I did spend two nights in the hospital (one before the surgery, one after), but I'm surprised that surgery would be considered outpatient under any circumstances. Do they really send people home immediately after putting them under and rooting around in their chest cavities?
I did spend two nights in the hospital (one before the surgery, one after), but I'm surprised that surgery would be considered outpatient under any circumstances. Do they really send people home immediately after putting them under and rooting around in their chest cavities?
The only reason my wife's involved an overnight stay was dehydration since she'd been unable to keep much of anything down for a couple days. That said, her surgery was scheduled after a pretty short series of doctor, ultrasound, surgeon, weekend, surgery.
Your last paragraph - about men not seeing a doctor when they are in pain - doesn't seem to fit the context of people seeing a doctor when they have no symptoms.
And how many of those women needed surgery?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3679744/
And how many of those women needed surgery?
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3679744/
Based on my reading of that, a very significant majority.
From a quick read before I dash out the door, it looks like at most ~21% had surgery based on indefinite or vague symptoms. I'd say that there's a good chance that many or most of those cases should have received at the least other treatment before surgery and that some physicians started resorting to surgery too soon once that surgery became easier, cheaper and safer.
That still leaves the other 79%.
From a quick read before I dash out the door, it looks like at most ~21% had surgery based on indefinite or vague symptoms. I'd say that there's a good chance that many or most of those cases should have received at the least other treatment before surgery and that some physicians started resorting to surgery too soon once that surgery became easier, cheaper and safer.
That still leaves the other 79%.
Annual physical exam (AKA annual wellness visit, annual preventive exam, periodic health exam, and routine checkup) - http://www.webmd.com/a-to-z-guides/annual-physical-examinati...
Last I knew though they weren't evidence based.
Last I knew though they weren't evidence based.
Regular preventive checkups are (or should be?) a thing.
Quite a few deadly things need to be caught before they become obvious problems. As a crude example, prostate cancer is one of diseases causing death for men; and has the "nice" property that if it's detected early in a screening then it's (usually) treatable with minor side effects, but by the time it causes symptoms serious enough to seek a fix for the symptoms, it generally has grown enough to be lethal.
Quite a few deadly things need to be caught before they become obvious problems. As a crude example, prostate cancer is one of diseases causing death for men; and has the "nice" property that if it's detected early in a screening then it's (usually) treatable with minor side effects, but by the time it causes symptoms serious enough to seek a fix for the symptoms, it generally has grown enough to be lethal.
Should they?
In 2012, the Cochrane Collaboration, an international group of medical researchers who systematically review the world’s biomedical research, analyzed 14 randomized controlled trials with over 182,000 people followed for a median of nine years that sought to evaluate the benefits of routine, general health checkups — that is, visits to the physician for general health and not prompted by any particular symptom or complaint.
The unequivocal conclusion: the appointments are unlikely to be beneficial.
From https://www.nytimes.com/2015/01/09/opinion/skip-your-annual-...
In 2012, the Cochrane Collaboration, an international group of medical researchers who systematically review the world’s biomedical research, analyzed 14 randomized controlled trials with over 182,000 people followed for a median of nine years that sought to evaluate the benefits of routine, general health checkups — that is, visits to the physician for general health and not prompted by any particular symptom or complaint.
The unequivocal conclusion: the appointments are unlikely to be beneficial.
From https://www.nytimes.com/2015/01/09/opinion/skip-your-annual-...
What you say about prostate cancer is wrong/misleading/outdated. The side effects of prostate cancer treatment can absolutely not be described as "minor." Routine screening of asymptomatic average risk men have caused more harm than good.
https://sciencebasedmedicine.org/a-skeptical-look-at-screeni...
>Prostate cancer is very common but isn’t always harmful. It is found in 80% of autopsies where the men died of something else. Many more men die with prostate cancer than because of it.
>The screening test for prostate cancer is a blood test for prostate-specific antigen (PSA). This is not a yes-or-no test. It must be interpreted in the context of the patient’s age and risk factors and the rate of rise, and any cut-off level is arbitrary and will miss some small percentage of cancers. If the PSA test is positive, the next step is biopsy. Typically, 12 needle biopsies are done, 6 on each side. They find cancer in 25% of patients. But if you go back and do more biopsies, you’ll find cancer in 25% more patients. Theoretically, if you could see every cell in the prostate, you might be able to find a cancer cell or two in almost everyone, most of which would never progress or kill the patient. So you have to decide how many biopsies are reasonable. If you find cancer on a biopsy, the next step is treatment, and treatments for prostate cancer are not benign.
>In a large European study, screening resulted in an absolute reduction in deaths from prostate cancer of 7 per 10,000 men screened. We can look at this in terms of number needed to screen (NNS) and number needed to treat (NNT). To prevent one death from prostate cancer, 1,068 men would have to be screened and 48 treated. But here’s the kicker: there was no reduction in all-cause mortality. The overall death rate was the same in the screened group as in the unscreened group.
>If a prostate cancer is localized and low grade, it is reasonable to observe the patient and not treat unless he develops signs of progression. A recent study compared surgery to watchful waiting and found no reduction in deaths. Within 30 days of surgery, 1/5 of the patients had complications including deaths. 2 years after surgery, these long term complications were present:
>The American Urological Association initially disagreed with the recommendation not to screen, but they have re-considered and issued these new recommendations:
https://www.uspreventiveservicestaskforce.org/Page/Document/...
>Although the precise, long-term effect of PSA screening on prostate cancer–specific mortality remains uncertain, existing studies adequately demonstrate that the reduction in prostate cancer mortality after 10 to 14 years is, at most, very small, even for men in what seems to be the optimal age range of 55 to 69 years. There is no apparent reduction in all-cause mortality. In contrast, the harms associated with the diagnosis and treatment of screen-detected cancer are common, occur early, often persist, and include a small but real risk for premature death. Many more men in a screened population will experience the harms of screening and treatment of screen-detected disease than will experience the benefit. The inevitability of overdiagnosis and overtreatment of prostate cancer as a result of screening means that many men will experience the adverse effects of diagnosis and treatment of a disease that would have remained asymptomatic throughout their lives. Assessing the balance of benefits and harms requires weighing a moderate to high probability of early and persistent harm from treatment against the very low probability of preventing a death from prostate cancer in the long term. The USPSTF concludes that there is moderate certainty that the benefits of PSA-based screening for prostate cancer do not outweigh the harms.
We are slowly learning to do much less asymptomatic screening, though charities and celebrities are fighting against it. Joe Torre still comes on my TV saying "get screened early and often." The generic advice about "always catching cancer early" being an unequivocal good thing is false. Over-diagnosis and over-treatment are huge problems. For another example, thyroid cancer screening in South Korea has resulted in a massive increase in thyroid cancer diagnosis and treatment but not any decrease in thyroid cancer mortality.
I can go on about this topic, but I won't. I suggest reading that blog I linked to, its fantastic.
https://sciencebasedmedicine.org/a-skeptical-look-at-screeni...
>Prostate cancer is very common but isn’t always harmful. It is found in 80% of autopsies where the men died of something else. Many more men die with prostate cancer than because of it.
>The screening test for prostate cancer is a blood test for prostate-specific antigen (PSA). This is not a yes-or-no test. It must be interpreted in the context of the patient’s age and risk factors and the rate of rise, and any cut-off level is arbitrary and will miss some small percentage of cancers. If the PSA test is positive, the next step is biopsy. Typically, 12 needle biopsies are done, 6 on each side. They find cancer in 25% of patients. But if you go back and do more biopsies, you’ll find cancer in 25% more patients. Theoretically, if you could see every cell in the prostate, you might be able to find a cancer cell or two in almost everyone, most of which would never progress or kill the patient. So you have to decide how many biopsies are reasonable. If you find cancer on a biopsy, the next step is treatment, and treatments for prostate cancer are not benign.
>In a large European study, screening resulted in an absolute reduction in deaths from prostate cancer of 7 per 10,000 men screened. We can look at this in terms of number needed to screen (NNS) and number needed to treat (NNT). To prevent one death from prostate cancer, 1,068 men would have to be screened and 48 treated. But here’s the kicker: there was no reduction in all-cause mortality. The overall death rate was the same in the screened group as in the unscreened group.
>If a prostate cancer is localized and low grade, it is reasonable to observe the patient and not treat unless he develops signs of progression. A recent study compared surgery to watchful waiting and found no reduction in deaths. Within 30 days of surgery, 1/5 of the patients had complications including deaths. 2 years after surgery, these long term complications were present:
17% were incontinent
81% had erectile dysfunction
12% had bowel dysfunction
>The American Urological Association initially disagreed with the recommendation not to screen, but they have re-considered and issued these new recommendations:
Don’t screen men under 40 or over 70
Don’t screen men with a life expectancy of less than 10-15 years
Don’t screen men age 40-50 who are at average risk
Consider screening men age 55-69 who are at average risk
Consider screening high risk men of any age
Before any screening, doctor should discuss risks and benefits with patient
https://www.uspreventiveservicestaskforce.org/Page/Document/...
>Although the precise, long-term effect of PSA screening on prostate cancer–specific mortality remains uncertain, existing studies adequately demonstrate that the reduction in prostate cancer mortality after 10 to 14 years is, at most, very small, even for men in what seems to be the optimal age range of 55 to 69 years. There is no apparent reduction in all-cause mortality. In contrast, the harms associated with the diagnosis and treatment of screen-detected cancer are common, occur early, often persist, and include a small but real risk for premature death. Many more men in a screened population will experience the harms of screening and treatment of screen-detected disease than will experience the benefit. The inevitability of overdiagnosis and overtreatment of prostate cancer as a result of screening means that many men will experience the adverse effects of diagnosis and treatment of a disease that would have remained asymptomatic throughout their lives. Assessing the balance of benefits and harms requires weighing a moderate to high probability of early and persistent harm from treatment against the very low probability of preventing a death from prostate cancer in the long term. The USPSTF concludes that there is moderate certainty that the benefits of PSA-based screening for prostate cancer do not outweigh the harms.
We are slowly learning to do much less asymptomatic screening, though charities and celebrities are fighting against it. Joe Torre still comes on my TV saying "get screened early and often." The generic advice about "always catching cancer early" being an unequivocal good thing is false. Over-diagnosis and over-treatment are huge problems. For another example, thyroid cancer screening in South Korea has resulted in a massive increase in thyroid cancer diagnosis and treatment but not any decrease in thyroid cancer mortality.
I can go on about this topic, but I won't. I suggest reading that blog I linked to, its fantastic.
[deleted]
[deleted]
A health problem that you are aware of. You're supposed to see a doctor periodically because they might catch health problems that haven't yet advanced to the point that you know they're happening.
It's not surprising that the US has such a problem of overdiagnosis and overtreatment.
http://www.bmj.com/content/349/bmj.g5432
http://www.bmj.com/content/349/bmj.g5432
Preventive maintenance.
If you are middle-aged (or older): to get a checkup
I can't deny the conclusion, and I agree that men are socialized to not show weakness ("macho"), but for me, I tend to avoid going to the doctor because, as a general rule, it rarely helps and it always costs money. (macho-ness may make more sensitive to that, hard to really know)
I was very sickly as a child. Every doctor's visit did nothing to change this (it wasn't even "Hmm, you have a trend", it was "oh, you have a cold/bonchitis/etc.) It wasn't until I was 30 that I learned I was allergic to pollen, molds, dustmites, cats, dogs, and rats - basically everything that won't kill you (no food allergies I've nailed down) - and that discovery was made when my symptoms suddenly got dramatically worse for months, and I pinned down the only three things that had changed in that time and went to an allergist myself.
Each winter for several years since then I would get bronchitis, and the coughing and shortness of breath would last for months. Every doctor told me to take some Delsym and wait 4-8 weeks. I eventually pieced together that this is my allergies (which, while treated, aren't gone) draining into lungs overnight and slowly being coughed up during the day. Some anti-inflammatory treatment that is now legal in Washington turns out to have stopped that for the last few winters.
I've had two rounds of kidney stones in the last 5 years (each involving at least two stones, because apparently the inflammation from a kidney stone tends to "shake more loose") - Doctors couldn't do much beyond painmeds and flowmax. (First time though, I had a $1000 CT scan (I think it was CT - I get CT and MRI mixed up) because the doc suggested it.)
I had pneumonia once - didn't realize it, it was just a bad cold/cough that got dramatically worse. Calling my doctor for an appt gave me something in 3 days. Day of, I wasn't sure I would be breathing by the time of the appt, so I was going to go to the ER. (which would have been ridiculously expensive). My wife took me to a local urgent care clinic (PatientFirst in VA) because she was worried about the wait time at the ER. They were awesome, saw me immediately as I walked in (they could hear me breathing), did in-house xray of my lungs and o2 sensor. Now that I'm in Seattle, the local clinics work differently - they REALLY want you to have a primary care physician. I recall a doctor there once saying that's because they want someone to coordinate your care, maintain a big picture view, and proactively look into potential issues. I told her I'd never had a PCP do any of those things)
I'm not knocking medical science - it's a near impossible job: "Debug this program to which you don't have the source code, can't control or even know all the environment and inputs, and if you crash it someone dies". It's amazing they can do what they can, and in certain circumstances they are responsible for saving and improving a lot of lives (see above having pneumonia).
But the reality is that if I went to the doctor every time some part of me hurt (and now that I'm 40, that's a lot of parts) based on my past experiences, I'd just spend a lot of time and money and be not much better off. So I'm all for being cautious on big things like chest pains. I'm all for knowing the warning signs of stroke, heart attack, and the like. But going to the doctor for every little thing? Seems a waste.
I was very sickly as a child. Every doctor's visit did nothing to change this (it wasn't even "Hmm, you have a trend", it was "oh, you have a cold/bonchitis/etc.) It wasn't until I was 30 that I learned I was allergic to pollen, molds, dustmites, cats, dogs, and rats - basically everything that won't kill you (no food allergies I've nailed down) - and that discovery was made when my symptoms suddenly got dramatically worse for months, and I pinned down the only three things that had changed in that time and went to an allergist myself.
Each winter for several years since then I would get bronchitis, and the coughing and shortness of breath would last for months. Every doctor told me to take some Delsym and wait 4-8 weeks. I eventually pieced together that this is my allergies (which, while treated, aren't gone) draining into lungs overnight and slowly being coughed up during the day. Some anti-inflammatory treatment that is now legal in Washington turns out to have stopped that for the last few winters.
I've had two rounds of kidney stones in the last 5 years (each involving at least two stones, because apparently the inflammation from a kidney stone tends to "shake more loose") - Doctors couldn't do much beyond painmeds and flowmax. (First time though, I had a $1000 CT scan (I think it was CT - I get CT and MRI mixed up) because the doc suggested it.)
I had pneumonia once - didn't realize it, it was just a bad cold/cough that got dramatically worse. Calling my doctor for an appt gave me something in 3 days. Day of, I wasn't sure I would be breathing by the time of the appt, so I was going to go to the ER. (which would have been ridiculously expensive). My wife took me to a local urgent care clinic (PatientFirst in VA) because she was worried about the wait time at the ER. They were awesome, saw me immediately as I walked in (they could hear me breathing), did in-house xray of my lungs and o2 sensor. Now that I'm in Seattle, the local clinics work differently - they REALLY want you to have a primary care physician. I recall a doctor there once saying that's because they want someone to coordinate your care, maintain a big picture view, and proactively look into potential issues. I told her I'd never had a PCP do any of those things)
I'm not knocking medical science - it's a near impossible job: "Debug this program to which you don't have the source code, can't control or even know all the environment and inputs, and if you crash it someone dies". It's amazing they can do what they can, and in certain circumstances they are responsible for saving and improving a lot of lives (see above having pneumonia).
But the reality is that if I went to the doctor every time some part of me hurt (and now that I'm 40, that's a lot of parts) based on my past experiences, I'd just spend a lot of time and money and be not much better off. So I'm all for being cautious on big things like chest pains. I'm all for knowing the warning signs of stroke, heart attack, and the like. But going to the doctor for every little thing? Seems a waste.
Sociologists and feminists like to chalk everything up to gender roles, as the author does here, and offer feminism as a solution, but this is dogmatic.
There's a difference between taking risks (if you take risks, and bad things happen as a result, that's often outside of your control; e.g. sharks when swimming in the ocean, there's always a risk) and self-neglect, which is within your control. Self-neglect is a consequence of low self-esteem, and has nothing to do with masculinity. This may be uncouth, but: think of the men who you think are least masculine, and ask yourself if they nurture themselves more, go more to the gym, and eat better. If anything, the opposite is true.
The real problem is self-neglect, whose root cause is low self-esteem.
I don't think women's average self-esteem is any higher or lower than men's, but theirs manifests itself in different ways, which explains why women would be more conscientious of their physical health, and push men to do the same. Still doesn't change the nature of the problem, or its real solution.
There's a difference between taking risks (if you take risks, and bad things happen as a result, that's often outside of your control; e.g. sharks when swimming in the ocean, there's always a risk) and self-neglect, which is within your control. Self-neglect is a consequence of low self-esteem, and has nothing to do with masculinity. This may be uncouth, but: think of the men who you think are least masculine, and ask yourself if they nurture themselves more, go more to the gym, and eat better. If anything, the opposite is true.
The real problem is self-neglect, whose root cause is low self-esteem.
I don't think women's average self-esteem is any higher or lower than men's, but theirs manifests itself in different ways, which explains why women would be more conscientious of their physical health, and push men to do the same. Still doesn't change the nature of the problem, or its real solution.
> The real problem is self-neglect, whose root cause is low self-esteem.
I'm not sure if I disagree with you, or if my perspective is this same perspective from a different angle, but: I would say that it's more that men tend to (expect to) derive their self-esteem from things they do, rather than things they are—so they invest much more time in doing things, and much less time in being things.
In order to "be" beautiful or to "be" athletic, it's usually a pre-requisite to be healthy—to take care of your body. In order to do things like building a successful business or finding cures for diseases, you don't have to be anything in particular, other than, perhaps, stubborn. So you tend to see things like your own physical health as distractions from "doing."
I'm not sure if I disagree with you, or if my perspective is this same perspective from a different angle, but: I would say that it's more that men tend to (expect to) derive their self-esteem from things they do, rather than things they are—so they invest much more time in doing things, and much less time in being things.
In order to "be" beautiful or to "be" athletic, it's usually a pre-requisite to be healthy—to take care of your body. In order to do things like building a successful business or finding cures for diseases, you don't have to be anything in particular, other than, perhaps, stubborn. So you tend to see things like your own physical health as distractions from "doing."
> I'm not sure if I disagree with you, or if my perspective is this same perspective from a different angle, but: I would say that it's more that men tend to (expect to) derive their self-esteem from things they do, rather than things they are—so they invest much more time in doing things, and much less time in being things.
I agree, but that seems tangential to the point. It's a gender difference that has been constant throughout history, and seems arbitrary to want to change. It also doesn't fix the main problem. Making men more feminine will not make them more self-nurturing.
To illustrate, putting on makeup isn't self-nurturing, anymore than getting a haircut. It's not something that depends on your self-esteem, everyone does it. Binge-dieting is self-neglectful (the opposite of nurturing), and so obviously doesn't come from a position of high self-esteem. Being more obsessed about your appearance doesn't make you more nurturing of yourself physically. Again, women don't nurture themselves more than men. You could chalk up wives' willingness to go to the doctor as higher fear of potential negative consequences, rather than self-nourishment.
The question is how do you get men to care more about their health, remember. And changing society or "gender roles" isn't the solution.
> In order to "be" beautiful or to "be" athletic, it's usually a pre-requisite to be healthy
The assumption here is that women nurture themselves because they want to look good, I don't believe that at all. You'll nurture yourself because you'll want to do it, instinctively, without needing any willpower. A necessary condition for that is high self-esteem.
Put another way: if you want to learn better eye contact, you have two ways. 1st: practice better eye contact. 2nd: increase your self-respect. The 1st won't work. The 2nd, will, because it addresses the actual cause. I'm arguing that the same is true for men's health.
I agree, but that seems tangential to the point. It's a gender difference that has been constant throughout history, and seems arbitrary to want to change. It also doesn't fix the main problem. Making men more feminine will not make them more self-nurturing.
To illustrate, putting on makeup isn't self-nurturing, anymore than getting a haircut. It's not something that depends on your self-esteem, everyone does it. Binge-dieting is self-neglectful (the opposite of nurturing), and so obviously doesn't come from a position of high self-esteem. Being more obsessed about your appearance doesn't make you more nurturing of yourself physically. Again, women don't nurture themselves more than men. You could chalk up wives' willingness to go to the doctor as higher fear of potential negative consequences, rather than self-nourishment.
The question is how do you get men to care more about their health, remember. And changing society or "gender roles" isn't the solution.
> In order to "be" beautiful or to "be" athletic, it's usually a pre-requisite to be healthy
The assumption here is that women nurture themselves because they want to look good, I don't believe that at all. You'll nurture yourself because you'll want to do it, instinctively, without needing any willpower. A necessary condition for that is high self-esteem.
Put another way: if you want to learn better eye contact, you have two ways. 1st: practice better eye contact. 2nd: increase your self-respect. The 1st won't work. The 2nd, will, because it addresses the actual cause. I'm arguing that the same is true for men's health.
> The assumption here is that women nurture themselves because they want to look good, I don't believe that at all. You'll nurture yourself because you'll want to do it, instinctively, without needing any willpower.
That wasn't what I was trying to communicate at all. My intended meaning was that women—by wanting to look good, or to seem happy, or to put on one of the numerous other faces people expect women to present to the world—are forced to pay attention to their own bodies. At which point they will notice if-and-when they're bodily unhealthy. (And in many of the other major roles women play, they're expected to be caregivers: people who pay attention to others, and are paid attention to in turn. Women in such roles have support networks who will notice if-and-when they are unhealthy.)
Men, meanwhile, usually are expected to strive toward goals that involve paying solely external attention—and often abstract attention, to things or systems or concepts more than to people. Their attention will almost never need to be on their own bodies to achieve their goals; and nor will anyone around them (in a professional capacity) pay attention to their state of being, as long as their work is getting done.
The stereotype is at its strongest in war narratives: "valor" is ignoring the bullet in your calf and the stab-wound in your left side and marching on to finish the battle. Because, relative to winning the battle, the state of your body is immaterial. All other stories of "heroism" tend to have some form of this—the mathematician who abuses drugs to find the answer, the entrepreneur who gives a thousand sleepless nights to their cause, etc.
Put women in those roles, and the immediate evaluation (in our culture) changes from "heroism" to "self-neglect." Which tells you a lot more about how our culture thinks of men, than how it thinks of women, since the evaluation for women is clearly factual.
That wasn't what I was trying to communicate at all. My intended meaning was that women—by wanting to look good, or to seem happy, or to put on one of the numerous other faces people expect women to present to the world—are forced to pay attention to their own bodies. At which point they will notice if-and-when they're bodily unhealthy. (And in many of the other major roles women play, they're expected to be caregivers: people who pay attention to others, and are paid attention to in turn. Women in such roles have support networks who will notice if-and-when they are unhealthy.)
Men, meanwhile, usually are expected to strive toward goals that involve paying solely external attention—and often abstract attention, to things or systems or concepts more than to people. Their attention will almost never need to be on their own bodies to achieve their goals; and nor will anyone around them (in a professional capacity) pay attention to their state of being, as long as their work is getting done.
The stereotype is at its strongest in war narratives: "valor" is ignoring the bullet in your calf and the stab-wound in your left side and marching on to finish the battle. Because, relative to winning the battle, the state of your body is immaterial. All other stories of "heroism" tend to have some form of this—the mathematician who abuses drugs to find the answer, the entrepreneur who gives a thousand sleepless nights to their cause, etc.
Put women in those roles, and the immediate evaluation (in our culture) changes from "heroism" to "self-neglect." Which tells you a lot more about how our culture thinks of men, than how it thinks of women, since the evaluation for women is clearly factual.
> That wasn't what I was trying to communicate at all. My intended meaning was that women—by wanting to look good, or to seem happy, or to put on one of the numerous other faces people expect women to present to the world—are forced to pay attention to their own bodies.
I misunderstood that, you're right.
About your wider point: you seem to put a lot of importance on societal roles ("expected to", "narratives"), and I don't think much of this (if at all) is caused by society rather than self-directed. You're arguing that women are more physically nurturing than men (which could well be true), I'm arguing that it's inconsequential as to how to make men more self-nurturing.
I misunderstood that, you're right.
About your wider point: you seem to put a lot of importance on societal roles ("expected to", "narratives"), and I don't think much of this (if at all) is caused by society rather than self-directed. You're arguing that women are more physically nurturing than men (which could well be true), I'm arguing that it's inconsequential as to how to make men more self-nurturing.
> About your wider point: you seem to put a lot of importance on societal roles ("expected to", "narratives"), and I don't think much of this (if at all) is caused by society rather than self-directed.
Why do you think so?
Why do you think so?
[deleted]
With the disclaimer that this is gender stereotyping (and my doubts have been increasing as to the utility of this way of thinking about people), this does seem like an insightful observation
Hmm, sex stereotyping is usually wrong, but I'm not sure what's wrong with gender stereotyping—as in, predicting that people will behave a certain way when (voluntarily, self-identifyingly) playing a defined gender role in a culture with clear gender-segregated role-scripts.
It's in the "Western man" role-script to "do" things—and to be expected to "do" things by others; it's in the "Western woman" role-script to "be" things—and to be expected to "be" things by others. As long as you "put on the mask", the people around you will generally push you toward playing your part. (This is what a large part of gender dysphoria is about: being pushed by society to play a part you don't identify with, because of what you present as.)
If you don't strongly identify with either of the roles of "Western man" or "Western woman", then the likelihood of you taking care of yourself isn't predictable. But if you do (and a lot of people do), it generally is.
It's in the "Western man" role-script to "do" things—and to be expected to "do" things by others; it's in the "Western woman" role-script to "be" things—and to be expected to "be" things by others. As long as you "put on the mask", the people around you will generally push you toward playing your part. (This is what a large part of gender dysphoria is about: being pushed by society to play a part you don't identify with, because of what you present as.)
If you don't strongly identify with either of the roles of "Western man" or "Western woman", then the likelihood of you taking care of yourself isn't predictable. But if you do (and a lot of people do), it generally is.
It has nothing to do with risk taking, quite the opposite. This is all pop culture.
Going to the doctor is a risk. You cannot and dont want to take that risk if you have to go to work. Most of the time if you dont have an issue that's stopping you from working, it's not an important issue worth risking work over.
To call men who dont want to go to the doctor basically "emotional pansies" is a very.. i dont know, maybe a very uninformed way to look at it.
It's not popular these days to claim that there are differences between men and women.
Is it? I know it's not popular to say things like "women can't do this" or "women aren't as good at this", but I've not actually heard someone say that men and women don't have differences. A great many of those differences are socialization, not biology, but even then there are physical differences.
For example, I know lots of people that want women to be able to be in combat roles in the military. I've not heard anyone suggest that any qualification standard that actually applies to fitness to do so be lowered. Given the biological range of the genders, this would mean that:
* there would be women who physically qualify * that number would be less than men that physically qualify
...and everyone seems okay with this.
Frankly, I've heard far more people get angry about some theoretical upset person than I've ever seen actual upset persons.
For example, I know lots of people that want women to be able to be in combat roles in the military. I've not heard anyone suggest that any qualification standard that actually applies to fitness to do so be lowered. Given the biological range of the genders, this would mean that:
* there would be women who physically qualify * that number would be less than men that physically qualify
...and everyone seems okay with this.
Frankly, I've heard far more people get angry about some theoretical upset person than I've ever seen actual upset persons.
It's funny though, because I've heard tons of women, many of them progressive, from 20s to 60s, who eagerly acknowledge differences between men and women.
I have to think hard to recall otherwise. Usually it would be in context of a specific argument. Maybe I just don't know any hard core feminists.
I have to think hard to recall otherwise. Usually it would be in context of a specific argument. Maybe I just don't know any hard core feminists.
Of course, acknowledging and appreciating differences differs greatly from enforcing differences.
I have traveled in some of the most socially liberal circles in the US, and I have to disagree with you about what's popular - or at least make it much more specific. It's not popular to claim that there are significant, biologically-determined, mental differences between men and women. Small differences, cultural differences, and corporeal differences are all accepted. This zeitgeist may still be incorrect, but it's not terrible as a heuristic.
Popularity and truth are correlated but sometimes orthogonal.
>Guys/gals... If there's any unusual pain in your chest cavity at all, just drop whatever it is you're doing and get it checked out. It might not even seem that bad at the time... it didn't to me and it didn't to Jason Scott... just do it.
Yeah, but where do you draw the line? I guess that will sound silly, but I'm always afraid that people think of me as a hypochondriac if I ran to the doctor for every little pain, most of them probably being some sprained muscle or indigestion.
Yeah, but where do you draw the line? I guess that will sound silly, but I'm always afraid that people think of me as a hypochondriac if I ran to the doctor for every little pain, most of them probably being some sprained muscle or indigestion.
https://www.ghc.org/healthAndWellness/?item=%2Fcommon%2Fheal...
TLDR: It's probably not a heart attack if you can pinpoint the pain, if the pain gets worse on a deep breath, the pain is related to movement of your shoulder or arm, or if it only lasts a few second.
You should call a doctor if the pain is mild but consistent and is untreatable by pain killers, and remains regardless of if you're resting or not.
You should call 911 or get to a hospital immediately if your chest pain is "crushing" or "squeezing," and especially if it is accompanied by ANY ONE of the following: sweating, shortness of breath, nausea/vomiting, pain that spreads from the chest to the neck, jaw, or one or both shoulders or arms, dizziness or lightheadedness, fast or irregular pulse, severe weakness, inability to walk.
So yea you don't go to the hospital for every pulled muscle, but do your best to memorize the above symptoms of escalating seriousness, and you should be ok.
TLDR: It's probably not a heart attack if you can pinpoint the pain, if the pain gets worse on a deep breath, the pain is related to movement of your shoulder or arm, or if it only lasts a few second.
You should call a doctor if the pain is mild but consistent and is untreatable by pain killers, and remains regardless of if you're resting or not.
You should call 911 or get to a hospital immediately if your chest pain is "crushing" or "squeezing," and especially if it is accompanied by ANY ONE of the following: sweating, shortness of breath, nausea/vomiting, pain that spreads from the chest to the neck, jaw, or one or both shoulders or arms, dizziness or lightheadedness, fast or irregular pulse, severe weakness, inability to walk.
So yea you don't go to the hospital for every pulled muscle, but do your best to memorize the above symptoms of escalating seriousness, and you should be ok.
Also remember that heart attacks in women can exhibit markedly different symptoms, e.g. without any chest pain or arm numbness, often misjudged until too late.
https://www.heart.org/HEARTORG/Conditions/HeartAttack/Warnin...
https://www.heart.org/HEARTORG/Conditions/HeartAttack/Warnin...
What do you do if you've had symptoms for weeks/months?
Until you've been diagnosed with a heart attack, the word "mild" does mean much. People over the age of 35-40 have many chronic mild pains
If you've had symptoms for a few hours that are untreatable by medication (like I said), then you call your doctor. Your doctor will tell you whether or not to come in. If it's chronic old-person pain, your doctor will find that out, and tell you next steps.
If you've had symptoms for weeks/months, well, I guess that's probably not a heart attack, good job? Still should have gone in within the first day.
If you've had symptoms for weeks/months, well, I guess that's probably not a heart attack, good job? Still should have gone in within the first day.
You're spot on with your previous post, but just wanted to add a note to anyone reading that if you've been having intermittent chest pain or discomfort for weeks/months, it still could be a heart problem (or reflux or a host of other things) that needs to be checked out. You could have a partial blockage of a coronary blood vessels (the blood vessels that provide blood/oxygen to the heart muscle itself) that provide insufficient blood flow, either when you're active, or randomly.
(this is not medical advice!)
(this is not medical advice!)
Don't "draw the line" anywhere with chest pains.
I say this as someone who has survived PE. In my case, I had pain that was a vague persistent discomfort combined with an evolving sense of panic. I hesitated for a day but then drove myself to the hospital just in time because it had progressed in the emergency room to searing pain where I "saw stars" upon each breath. Literally the most painful experience I ever had.
When you walk into an emergency room and indicate you have chest pains, they will immediately try to assess whether or not you're having a heart attack. After that there are checks to rule out PE and you may have a CAT scan w/contrast fluid.
There are other much less dangerous things that cause chest pain... stress-induced muscle pain is one. The problem is you can't be sure until its too late. Carry health insurance and don't try to second-guess chest pain.
I say this as someone who has survived PE. In my case, I had pain that was a vague persistent discomfort combined with an evolving sense of panic. I hesitated for a day but then drove myself to the hospital just in time because it had progressed in the emergency room to searing pain where I "saw stars" upon each breath. Literally the most painful experience I ever had.
When you walk into an emergency room and indicate you have chest pains, they will immediately try to assess whether or not you're having a heart attack. After that there are checks to rule out PE and you may have a CAT scan w/contrast fluid.
There are other much less dangerous things that cause chest pain... stress-induced muscle pain is one. The problem is you can't be sure until its too late. Carry health insurance and don't try to second-guess chest pain.
I've had PCS my entire life https://en.wikipedia.org/wiki/Precordial_catch_syndrome
Definitely not worth going to the ER for.
Definitely not worth going to the ER for.
OK, but you can say that because you happen to KNOW what it is, and that's fine.
People drop dead too frequently because they wait too long to get help when they have unexplained chest pains that [they think] couldn't possibly be a heart attack.
People drop dead too frequently because they wait too long to get help when they have unexplained chest pains that [they think] couldn't possibly be a heart attack.
Wow, thank you so much! I've had this my entire life, but never knew what it was, and never met anyone else who also got it. It's nice to be able to put a name to it.
Oh my goodness. I've had this my whole life too, and could never find out what it was! Wow, the relief I feel right now.
> Yeah, but where do you draw the line?
You can search the English NHS Choices website.
That gives calm mostly evidence based advice and lets you know when you should self care, or when you should see a doctor.
For example, here's "chest pain": http://www.nhs.uk/conditions/chest-pain/Pages/Introduction.a...
It says there are a variety of causes, but it says you must never ignore it, and gives some criteria for when you should dial 911.
In England we also have NHS 111, which is a free telephone advice line. It's not as good as it could be because fo obvious reasons they're risk averse.
You can search the English NHS Choices website.
That gives calm mostly evidence based advice and lets you know when you should self care, or when you should see a doctor.
For example, here's "chest pain": http://www.nhs.uk/conditions/chest-pain/Pages/Introduction.a...
It says there are a variety of causes, but it says you must never ignore it, and gives some criteria for when you should dial 911.
In England we also have NHS 111, which is a free telephone advice line. It's not as good as it could be because fo obvious reasons they're risk averse.
Yeah we have something like this in Ontario ("TeleHealth") and from my experience the calls usually end with "Go to the doctor / emergency room" because they're mostly unwilling to tell you "you're fine, it's in your head" unless it's completely obvious.
On the other hand, that kind of presentation can often COMPEL a doctor to prevent discharge, so lots of, uh, problem patients know they can eke out a few extra days if they mention those words to the right person.
Doctors and cardiologists are used to false alarms. In fact, according to mine, cardiologists provide more diagnoses of pleurisy than pulmunologists.
If it could be a heart attack, or similar life threatening thing, you go to emergency.
If it could be a heart attack, or similar life threatening thing, you go to emergency.
I've gotten the "pleurisy" diagnosis, twice even, and I don't believe it. Pleurisy seems to be the catch-all default diagnosis for when they can't find anything wrong and just want you to go away. There isn't actual evidence in favor of pleurisy, just the inability to find something else wrong.
In the first case, I'm pretty sure I had a panic attack. At least they served me bacon and eggs, probably hoping for a repeat customer with a real heart attack.
In the second case, I'm pretty sure I pinched a nerve in my back. I got shoulder pain associated with movement. I then got pain in the front -- but remember that a nerve pinched in one spot can cause pain to be felt elsewhere. Other back-related issues in the days afterward lead me to my conclusion.
I'm now way less inclined to go in to the emergency room. I don't want to spend 12 hours with an IV hurting my arm, no privacy, no sleep, and not being able to work on anything. One of the times the doctor even cleared me to go home, but the nurses didn't bother to remove the IV for hours afterward. Being in the emergency room isn't harmless; it is a place where diseases spread.
In the first case, I'm pretty sure I had a panic attack. At least they served me bacon and eggs, probably hoping for a repeat customer with a real heart attack.
In the second case, I'm pretty sure I pinched a nerve in my back. I got shoulder pain associated with movement. I then got pain in the front -- but remember that a nerve pinched in one spot can cause pain to be felt elsewhere. Other back-related issues in the days afterward lead me to my conclusion.
I'm now way less inclined to go in to the emergency room. I don't want to spend 12 hours with an IV hurting my arm, no privacy, no sleep, and not being able to work on anything. One of the times the doctor even cleared me to go home, but the nurses didn't bother to remove the IV for hours afterward. Being in the emergency room isn't harmless; it is a place where diseases spread.
> Pleurisy seems to be the catch-all default diagnosis for when they can't find anything wrong and just want you to go away. There isn't actual evidence in favor of pleurisy, just the inability to find something else wrong
It's a valid diagnosis: https://en.m.wikipedia.org/wiki/Diagnosis_of_exclusion
I once waited four hours to see a doctor because of a sharp pain in the left side of my chest when I breathed more than shallow. The doctor told me it was probably a muscle spasm and to take some Advil. I thought "what an asshole" as I left.
About 20 minutes later, someone told me a joke, I laughed, and was cured. Turns out the doctor was right.
If you had ECG, x-ray, CT scan, echo, and everything looks fine, then the treatment is the same regardless. If you think you had a panic attack or hurt your back, then communicate that to your doctor. It's important.
Edit: thought I'd mention: my wife is currently diagnosed with pleurisy. She went to the ER due to shortness of breath and chest pain a month ago. We've done all the tests possible. She's still in quite a bit of pain. Pleurisy usually takes months to resolve. If you were diagnosed and it disappeared within a day or a week, then you were likely misdiagnosed. However, it does not necessarily mean the prescribed treatment was erroneous.
It's a valid diagnosis: https://en.m.wikipedia.org/wiki/Diagnosis_of_exclusion
I once waited four hours to see a doctor because of a sharp pain in the left side of my chest when I breathed more than shallow. The doctor told me it was probably a muscle spasm and to take some Advil. I thought "what an asshole" as I left.
About 20 minutes later, someone told me a joke, I laughed, and was cured. Turns out the doctor was right.
If you had ECG, x-ray, CT scan, echo, and everything looks fine, then the treatment is the same regardless. If you think you had a panic attack or hurt your back, then communicate that to your doctor. It's important.
Edit: thought I'd mention: my wife is currently diagnosed with pleurisy. She went to the ER due to shortness of breath and chest pain a month ago. We've done all the tests possible. She's still in quite a bit of pain. Pleurisy usually takes months to resolve. If you were diagnosed and it disappeared within a day or a week, then you were likely misdiagnosed. However, it does not necessarily mean the prescribed treatment was erroneous.
hey man, there is a reason shortness of breath will get you rushed past the ER.
almost lost a buddy once to a brain tumor around 25. he was light headed with slight pain for a 3 days. checked himself in on day 4 for slight but persistent pain. rushed into surgery immediately. wouldn't have lasted another day.
don't take a chance. would rather be a hypochondriac than dead. a good doctor will respect that.
almost lost a buddy once to a brain tumor around 25. he was light headed with slight pain for a 3 days. checked himself in on day 4 for slight but persistent pain. rushed into surgery immediately. wouldn't have lasted another day.
don't take a chance. would rather be a hypochondriac than dead. a good doctor will respect that.
For my husband, it was a feeling of heartburn combined with an elevated heart rate in the middle of the night. Fortunately, my reaction was, "oh my god, get up, we're going to the hospital NOW!"
This was a bit over two weeks after a delayed Transatlantic flight with turbulence bad enough that we barely left our seats.
The main reason I freaked out and took him to the hospital immediately instead of just saying, "that's weird," was that a close friend had had a pulmonary embolism a few weeks after flying back to the US after tearing up her knee skiing (and having to wear a stiff brace on the plane).
This was a bit over two weeks after a delayed Transatlantic flight with turbulence bad enough that we barely left our seats.
The main reason I freaked out and took him to the hospital immediately instead of just saying, "that's weird," was that a close friend had had a pulmonary embolism a few weeks after flying back to the US after tearing up her knee skiing (and having to wear a stiff brace on the plane).
My wife sometimes reminds me "There's a reason married men live longer." When your wife tells you it's time to go to the hospital, it's usually time to go.
Yeah, there are some stereotypes I'm repeating, but they're accurate somewhat often.
Yeah, there are some stereotypes I'm repeating, but they're accurate somewhat often.
My wife saved my life by making me go to the doctor when I scoffed at it. Wear sunscreen folks.
I got my double pulmonary embolism after a flight from California to NY, as well. Odd thing is they never found the source of the clot (my legs showed nada).
I still make sure to get up and walk around frequently on flights now! (As well as the usual anticoagulant libation... Bloody Mary)
I still make sure to get up and walk around frequently on flights now! (As well as the usual anticoagulant libation... Bloody Mary)
[deleted]
>If there's any unusual pain in your chest cavity at all, just drop whatever it is you're doing and get it checked out.
My wife did this last year. Out of an abundance of caution they checked in her into the hospital for 8 hours and ran a battery of tests. A full work day and $30k in medical bills later they didn't find anything. By then she felt fine and went home. I'm not faulting the original advice, but medical intervention can be expensive and frustrating.
My wife did this last year. Out of an abundance of caution they checked in her into the hospital for 8 hours and ran a battery of tests. A full work day and $30k in medical bills later they didn't find anything. By then she felt fine and went home. I'm not faulting the original advice, but medical intervention can be expensive and frustrating.
I just don't understand how people take the USA seriously. One of the most important things, which I doubt is in dispute, is access to healthcare.
The USA tells us their model of capitalism is the best. They apply their system to healthcare. It utterly fails to deliver versus "socialist" solutions.
At what point are you guys going to join the dots on this contradiction?
The USA tells us their model of capitalism is the best. They apply their system to healthcare. It utterly fails to deliver versus "socialist" solutions.
At what point are you guys going to join the dots on this contradiction?
> One of the most important things, which I doubt is in dispute, is access to healthcare.
One dispute seems to be over the meaning of the word "access". Some people, like my Libertarian friend, feel that "access" is satisfied if you have the freedom to choose your provider (or none at all) -- but god help you if you don't have any money, because no one should be taxed to pay for others' health care. For many, taxation is viewed as state-enforced theft. (I'm not sure how to argue against that viewpoint.)
Others (like Senator Sanders) believe that "access" means "you can get it" -- and include the ability to afford it in that metric. This is why some people in our country argue that we Should Be making sure that people _get_ their medical costs subsidized by taxes. While it's a tax on all of us, the costs end up being lower, and you don't end up people forgoing routine preventative care because they feel they can't afford it, simply because the chance of them having something catastrophically bad is low.
Many that oppose this point to anecdotes of people who needed Serious Help and could not get to it in time, or flew to the US to get it, rather than in their home country.
The last time I participated in a discussion about this, the best system seemed to be Australian. I'm likely oversimplifying, but basically everyone paid into a national system that covered basic things and normal socialized care, and you also had the freedom to have additional insurance that would cover the things that the national system might not be inclined to give you for various reasons. I liked this idea because it meant that poor people and children all had basic care, and anyone who cared about their freedom to choose their doctors / treatments could do so (at a price). The net price still sounded like it was less than what I pay for my family here in the US for medical care.
One dispute seems to be over the meaning of the word "access". Some people, like my Libertarian friend, feel that "access" is satisfied if you have the freedom to choose your provider (or none at all) -- but god help you if you don't have any money, because no one should be taxed to pay for others' health care. For many, taxation is viewed as state-enforced theft. (I'm not sure how to argue against that viewpoint.)
Others (like Senator Sanders) believe that "access" means "you can get it" -- and include the ability to afford it in that metric. This is why some people in our country argue that we Should Be making sure that people _get_ their medical costs subsidized by taxes. While it's a tax on all of us, the costs end up being lower, and you don't end up people forgoing routine preventative care because they feel they can't afford it, simply because the chance of them having something catastrophically bad is low.
Many that oppose this point to anecdotes of people who needed Serious Help and could not get to it in time, or flew to the US to get it, rather than in their home country.
The last time I participated in a discussion about this, the best system seemed to be Australian. I'm likely oversimplifying, but basically everyone paid into a national system that covered basic things and normal socialized care, and you also had the freedom to have additional insurance that would cover the things that the national system might not be inclined to give you for various reasons. I liked this idea because it meant that poor people and children all had basic care, and anyone who cared about their freedom to choose their doctors / treatments could do so (at a price). The net price still sounded like it was less than what I pay for my family here in the US for medical care.
First up: I'm using the non-muddled version of access. Libetarians might say you can access it but they would also want full death tax, free access to land and a money system based on fair issuance of debt, meaning that people had a fighting chance of affording said care.
The US is a crazy cult for "capitalism" and "free" markets. The problem I have is the absolutism about it. Markets can solve everything. This is the USA position. They force other countries to change to it via the IMF, not content with messing up their own country.
Yet even on a very simple system to model, sports, they have a socialist model. You finish bottom you get the first draft pick. Because when reasoning about a small group of teams it's patently obvious that if you give all the TV rights to the top team, all the draft picks to the top team, you end up with a total mess.
The US is a crazy cult for "capitalism" and "free" markets. The problem I have is the absolutism about it. Markets can solve everything. This is the USA position. They force other countries to change to it via the IMF, not content with messing up their own country.
Yet even on a very simple system to model, sports, they have a socialist model. You finish bottom you get the first draft pick. Because when reasoning about a small group of teams it's patently obvious that if you give all the TV rights to the top team, all the draft picks to the top team, you end up with a total mess.
You can tell them that taxation isn't theft because taxation is legal and democratically decided, and theft is not legal.
They will probably argue back, "in both cases you're taking something by force," but there are lots of pairs of things that share some traits but not others.
Sharing a trait does not make the two things the same thing (i.e. prison vs kidnapping, again, one is legal and one is not).
They will probably argue back, "in both cases you're taking something by force," but there are lots of pairs of things that share some traits but not others.
Sharing a trait does not make the two things the same thing (i.e. prison vs kidnapping, again, one is legal and one is not).
> the best system seemed to be Australian
> An important element of the French insurance system is solidarity: the more ill a person becomes, the less they pay.
It is a false assumption to say that because socialized healthcare works in some countries, the entire scheme of capitalism is therefore inferior. There are a number of unique aspects of Human health and insurance that make it very difficult to manage using conventional capitalistic means. (Namely that a human cannot be totalled whereas an object can) However, that is not an indictment on capitalism but is instead a consequence of the fact that Human life has no price. Capitalism has no means of appraising the value of priceless things.
>It is a false assumption to say that because socialized healthcare works in some countries, the entire scheme of capitalism is therefore inferior
GP didn't say this, though. They said applying the model of American capitalism to healthcare fails to deliver (a reasonable standard of care, I assume). Your assessment seems to largely agree.
GP didn't say this, though. They said applying the model of American capitalism to healthcare fails to deliver (a reasonable standard of care, I assume). Your assessment seems to largely agree.
"The USA tells us their model of capitalism is the best. They apply their system to healthcare. It utterly fails to deliver versus "socialist" solutions.
At what point are you guys going to join the dots on this contradiction?"
Perhaps we interpreted these paragraphs differently because I read it as saying "when are we going to connect the dots and see that capitalism is not the best because it utterly fails in healthcare and thus by extension elsewhere too"
Perhaps we interpreted these paragraphs differently because I read it as saying "when are we going to connect the dots and see that capitalism is not the best because it utterly fails in healthcare and thus by extension elsewhere too"
We can start by asking if capitalism is inferior at providing health care, at least. People sometimes assume that capitalism means free markets. In practice it can also mean oligopolies, monopolies, rigged systems, and scams. That may describe the US health system, propped up with government regulations and subsidies.
For my part, I don't see a need to try out a more capitalist health care system when there are lots of people showing a good working socialized model in lots of other countries.
I'd say, go with what works.
I'd say, go with what works.
Usa says: no we are zealots, forget your evidence!
"In practice it can also mean oligopolies, monopolies, rigged systems, and scams" - Pure capitalism has none of those things. What you are referring to is cronyism which increases proportionally to the size of the market. Regulation should in theory be used to keep markets of sufficient size in check but it's a double edged sword. Often times regulation creates even more cronyism since only the approved players can access a communal resource or service.
Pure capitalism, the real world system dominant in the industrialized West in the 19th Century for which critics coined the term "capitalism", has all of those things.
The unrealistic fantasy later capitalists developed as a propaganda to sell capitalism doesn't have those features, but then it also has nothing to do with anything that is, has, or ever could be, realized in the real world.
The unrealistic fantasy later capitalists developed as a propaganda to sell capitalism doesn't have those features, but then it also has nothing to do with anything that is, has, or ever could be, realized in the real world.
The only unrealistic expectation is thinking people will be happy working unequally hard for equal pay. Capitalism funnels that motivation to set oneself apart into a system where many can benefit from the creations of a relative few. Politics came about long before the first political system. It stems from the evolutionary compulsion to compete and reproduce. There will always be in-crowds and out-crowds of any group of sufficient size. This is where cronyism comes from. Not the political systems themselves. Humans play favorites, not free markets
There are upsides.
We all die. The more healthcare technology we invent, the more we can spend. If you are willing to spend unlimited money to save a life, then you will... except that every system finds a way to stop you.
Traditional all-out capitalism stops you when you can't pay. (people also don't WANT to pay with their own money, so costs go down) Some government systems will say "no" to some people, but that isn't too popular. Most common is to say "yes" to everybody, but underfunding means you go on a waiting list and might not make it to the other end of the waiting list. These approaches can be mixed: some procedures for pay, some favored people being able to jump ahead on the waiting list, etc.
Underfunding is a given, because full funding for all the care that people want is impossible. The amount of care desired exceeds the GDP.
We all die. The more healthcare technology we invent, the more we can spend. If you are willing to spend unlimited money to save a life, then you will... except that every system finds a way to stop you.
Traditional all-out capitalism stops you when you can't pay. (people also don't WANT to pay with their own money, so costs go down) Some government systems will say "no" to some people, but that isn't too popular. Most common is to say "yes" to everybody, but underfunding means you go on a waiting list and might not make it to the other end of the waiting list. These approaches can be mixed: some procedures for pay, some favored people being able to jump ahead on the waiting list, etc.
Underfunding is a given, because full funding for all the care that people want is impossible. The amount of care desired exceeds the GDP.
I'm currently on anticoagulants for my second run-in with pulmonary embolisms, and they were fairly different experiences both times. The first one started out as what felt like a sore shoulder, which "migrated" down to my chest over a few hours, and then felt like I had a cactus in my lungs. The second instance felt more like pressure than pain, but was similar enough to the tail end of my previous encounter that I was able to recognize it.
In the first case, a clot dislodged and traveled through my heart about an hour after I arrived at the hospital. I had debated waiting until morning as I wasn't sure an ER visit was necessary, but if I had waited any longer I likely would not have survived.
In the first case, a clot dislodged and traveled through my heart about an hour after I arrived at the hospital. I had debated waiting until morning as I wasn't sure an ER visit was necessary, but if I had waited any longer I likely would not have survived.
Just curious: how did you have shoulder/chest pain before the clot embolized to your lungs? Or did you go with a swollen leg and the rest happened after you arrived?
Also, the vast majority of people with PE survive. Depending on the size of the bastard, you can get heart dysfunction and pulmonary hypertension (which can be very severe) down the road.
Basically, unless your blood pressure tanked, your chance of dying from it was probably close to zero.
Not to say it's not a scary thing or that you shouldn't go to the hospital immediately, but we over-diagnose and over-treat PE's all the time. The latter is because we over-estimate their severity.
Also, the vast majority of people with PE survive. Depending on the size of the bastard, you can get heart dysfunction and pulmonary hypertension (which can be very severe) down the road.
Basically, unless your blood pressure tanked, your chance of dying from it was probably close to zero.
Not to say it's not a scary thing or that you shouldn't go to the hospital immediately, but we over-diagnose and over-treat PE's all the time. The latter is because we over-estimate their severity.
The clot started out in my legs, likely formed as a result of a transatlantic trip a few weeks prior. Parts of the clot had previously dislodged and traveled to my lungs, leading to multiple embolisms. When the much larger clot dislodged and traveled through my heart it dropped my heart rate to about 20bpm, which is fairly close to zero.
I've had chest pain, shortness of breath, and odd pain in my left arm on and off for most of my life. I've complained about it and have had tests at various stages. Nothing. I'm a little scared, because I don't know what to call unusual any more.
Especially guys: https://www.cdc.gov/nchs/pressroom/01news/newstudy.htm
> Guys/gals... If there's any unusual pain in your chest cavity at all, just drop whatever it is you're doing and get it checked out.
Also, if you have any unusual shortness of breath. Pulmonary embolisms are no joke, and depending on how much of the lung has been affected, every minute can count.
Also, if you have any unusual shortness of breath. Pulmonary embolisms are no joke, and depending on how much of the lung has been affected, every minute can count.
Or even if you're not experiencing any pain -- if you haven't been to the doctor in a long time... go to the doctor. Get a routine checkup! It can save your life.
I almost learned this the hard way a few years ago. I was in my late 30s, and handled going to the doctor the way I always had since reaching adulthood -- which is to say, I didn't bother with it unless I was feeling out of sorts. Routine doctor visits seemed like a waste of time. Why sit an hour in an office to have somebody tell me I was doing OK, which I already knew?
Then my glasses broke, so I went to my local optician's to get a new pair. They did a routine eye exam to make sure my prescription hadn't changed, and in the process noticed something odd about the little blood vessels in my eyes. That led them to take my blood pressure, which turned out to be high. Like, really high. The kind of high where the person giving you the test looks you in the eye afterwards and asks you, entirely seriously, how you are still alive.
I was a stroke victim waiting to happen. (See http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/W...) And I had no idea. And would have continued to have no idea, right up to the moment when my circulatory system strangled my brain to death, if my glasses hadn't broken.
I went to the doctor, they gave me some pills to handle the immediate crisis, we changed my exercise routine and diet a little to bring my blood pressure down for the long term, and now I'm fine. But I don't skip out on routine doctor visits anymore! And neither should you.
I almost learned this the hard way a few years ago. I was in my late 30s, and handled going to the doctor the way I always had since reaching adulthood -- which is to say, I didn't bother with it unless I was feeling out of sorts. Routine doctor visits seemed like a waste of time. Why sit an hour in an office to have somebody tell me I was doing OK, which I already knew?
Then my glasses broke, so I went to my local optician's to get a new pair. They did a routine eye exam to make sure my prescription hadn't changed, and in the process noticed something odd about the little blood vessels in my eyes. That led them to take my blood pressure, which turned out to be high. Like, really high. The kind of high where the person giving you the test looks you in the eye afterwards and asks you, entirely seriously, how you are still alive.
I was a stroke victim waiting to happen. (See http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/W...) And I had no idea. And would have continued to have no idea, right up to the moment when my circulatory system strangled my brain to death, if my glasses hadn't broken.
I went to the doctor, they gave me some pills to handle the immediate crisis, we changed my exercise routine and diet a little to bring my blood pressure down for the long term, and now I'm fine. But I don't skip out on routine doctor visits anymore! And neither should you.
> Get a routine checkup! It can save your life.
There is no evidence that routine checkups lead to better outcomes.
http://www.health.harvard.edu/blog/a-checkup-for-the-checkup...
"But what are the true benefits of this practice? Careful reviews of several large studies have shown that these annual visits don’t make any difference in health outcomes. In other words, being seen by your doctor once a year won’t necessarily keep you from getting sick, or even help you live longer."
There is no evidence that routine checkups lead to better outcomes.
http://www.health.harvard.edu/blog/a-checkup-for-the-checkup...
"But what are the true benefits of this practice? Careful reviews of several large studies have shown that these annual visits don’t make any difference in health outcomes. In other words, being seen by your doctor once a year won’t necessarily keep you from getting sick, or even help you live longer."
That seems unbelievable. Do the doctors _never_ find a heart attack, or get a patient treated for high blood preassure or skin cancer?
Of course not, it's just rare to find problems without symptoms. And going for a check up is not without risks. Sometimes doctors produce false positives. Sometimes you catch a bug in the doctor's office that you would not otherwise have gotten. Going to the doctor can be stressful. All of these things are small effects, and they all generally cancel each other out so that the net effect of going for a routine physical is a no-op.
What is a long time? I came to the US in 2012 and haven't been to a doctor since. Not going to lie, the $ sign is a deterrent.
But I am moving back to Europe this year so I will go to a doctor there and get all checked up etc.
But I am moving back to Europe this year so I will go to a doctor there and get all checked up etc.
The idea of a 'routine checkup' is an American thing as far as I can tell. I've lived in the UK and New Zealand and adults only go to the doctor when there's something wrong, or if you have known chronic conditions. You certainly don't have regular blood tests.
How do they catch things like kidney disease early? I have stage four kidney disease and there are barely any symptoms. Stage five means dialysis. For me it is too late to properly fix it but if caught early with regular blood tests there are ways to slow it down. My feeling is regular blood tests are a necessity for many health issues.
I had a kidney disease while in puberty, specifically nephritis. Since then, I take a blood test every six months. It's a great habit because it can catch a lot of problems, for example diabetes, cholesterol levels, etc. Urinary tests are also very good because they can detect stones in your kidneys.
Isn't that rather expensive?
You can get a checkup every two years when you're 40+ (paid for by your health insurance). Also skin cancer screening.
Yes, that is how I remember it as well.
Most decent insurance plans will fully cover the cost of a routine checkup, or at least only charge you a minimal co-payment. (They don't want to pay for a hospital visit for you any more than you want to have one.)
I'm no doctor, so I'm the wrong person to ask about how often you should see one. But if it's been five years, it's probably time.
I'm no doctor, so I'm the wrong person to ask about how often you should see one. But if it's been five years, it's probably time.
"Wellness visits" under Obamacare are supposed to be covered in full, with no co-pay, but exactly what counts as a wellness visit (and not an office visit) is (probably intentionally) confusing.
https://www.usnews.com/news/articles/2015/12/10/confusion-su...
https://www.usnews.com/news/articles/2015/12/10/confusion-su...
In Canada annual checkups by your GP are free. If needed, blood tests, x-rays, CT, MRI, whatever, free.
'If needed' is slippery slope. I had multiple visits to NHS with chest pain and got nothing but a blood check. I still don't know whats wrong with me, but its not looking good.
Part of what they're looking for is likely the chemical signs of a heart attack - if heart muscle is dying off, it's generally detectable in the blood. I suspect part of what they were looking for is BNP: "When your heart is damaged, your body secretes high levels of BNP into your bloodstream to try to ease the strain on your heart." (http://www.mayoclinic.org/diseases-conditions/heart-disease/...)
Sometimes a high BP is just a reaction to someone measuring your BP. One side effect of a high BP is that you hear the thumping sound of your blood pulsing.
I personally have my heart rate and blood pressure explode whenever anyone tries to measure them. So I was referred to a cardiologist who did some basic checks like an echo, found nothing wrong and wired me up to a device that measures BP continuously for 24h. My BP was perfectly normal.
I personally have my heart rate and blood pressure explode whenever anyone tries to measure them. So I was referred to a cardiologist who did some basic checks like an echo, found nothing wrong and wired me up to a device that measures BP continuously for 24h. My BP was perfectly normal.
The first thing that tipped them off was looking at the blood vessels in my eyes, not measuring my BP. This is an absolutely routine part of an eye exam, so I wasn't stressed out or anything like that while they were doing it.
High blood pressure will not always be accompanied by easily detectable symptoms like audible thumping. There's a reason why it's called "the silent killer." (See: https://www.cdc.gov/bloodpressure/index.htm).
High blood pressure will not always be accompanied by easily detectable symptoms like audible thumping. There's a reason why it's called "the silent killer." (See: https://www.cdc.gov/bloodpressure/index.htm).
An interesting thing I heard from my dentist and my optometrist is that dentists and optometrists often diagnose (or successfully refer for) a fairly wide variety of conditions that manifest as symptoms visible in the gums and eyes. A lot of stuff that can go wrong in the body can apparently mess up your gums or eyes in a way that an expert can notice.
Also, people who have excellent vision can still benefit from optometrist exams because they can catch early stages of eye problems, and even other kinds of medical problems.
Also, people who have excellent vision can still benefit from optometrist exams because they can catch early stages of eye problems, and even other kinds of medical problems.
I've been seeing the same doctor for nearly two decades. She does the same routine every time she takes my blood pressure: "So, (puts on cuff), do you have any trips planned? Anything fun coming up? (pump pump pump)".
I laugh inside at how consistent she is, so I guess it still works on me.
I laugh inside at how consistent she is, so I guess it still works on me.
I'm similar, every time I get my BP taken, I have to ask them to take it one more time, because the sounds and feeling of the machine make me very anxious. The results are usually worrying the first time, and then perfectly normal on the second take.
In this case the solution is to measure your BP yourself at home.
You should definitely keep an eye on your blood pressure every once in a while because there no symptoms of high blood pressure until it's way too late (kidney damage for example). Even if you are too lazy to go to the doctor, at least in the US you can find blood pressure monitors frequently installed in the pharmacy area of your nearest Safeway, Walmart, etc. If it's been more than a few months and I run into one of these things I sit down and take my blood pressure just to see how it is. If it's a bit high on first read I will repeat the test two more times. This usually gives my body a chance to relax to make sure that I get an accurate reading.
If your blood pressure spikes a lot when you are stressed that's good to know too. For example I've found that when I drink coffee my blood pressure reacts to stress a lot stronger than when I don't drink coffee.
If your blood pressure spikes a lot when you are stressed that's good to know too. For example I've found that when I drink coffee my blood pressure reacts to stress a lot stronger than when I don't drink coffee.
I probably haven't been to a doctor for years and years. Like most Americans I have pretty shitty health insurance, and it's mostly about avoiding unnecessary expenses. I don't have any burning desire to pay a doctor, a blood test lab, and all the other various administrative leeches, just for them to all tell me everything's good. If something happens and I get seriously ill, I accept that I'll be paying through the nose for it, but that's the case whether or not I waste time/money on "checkups".
Every insurance plan in the US will cover an annual checkup with $0 out of pocket expense to you.
Nope. The longer you wait, the worse are your chances and the more expensive it will be.
Thats a pretty bold conclusion. What evidence do you have to assert this? I'm not being a jerk, its just everything I've read in the past indicated that routine checkups do not lead to better health outcomes. If new contradicting evidence is available I'd love to know.
Chest pain can also be related to muscle spasms in the ribs or other areas, or even heart burn, said my doc for my own symptoms.
It's impossible to tell. Thus it would be wise to get checked up just in case.
It's impossible to tell. Thus it would be wise to get checked up just in case.
The only problem is a checkup on my fantastic insurance costs 25$, 50$ if I go to the urgent care. There was a time in my life when that would mean I'm eating beans and rice for 2 weeks to make up for that. It's a damn shame but going in "just in case" isn't really an option for everybody, especially if you're on the types of insurance lower-income people have (or, none whatsoever).
That's the sad shit the US is in. I am sorry :(
On the other hand, here at the great socialist Nordics, if I go to the public health care and say I want a check-up, they'll laugh me out. I won't even meet a doctor.
And I guess they are right. They say our public health care system is excellent.
And I guess they are right. They say our public health care system is excellent.
Doing a check up on an apparently healthy person would be wasting time and money looking for something to be wrong. That seems right to me..
What if you went in saying you had chest pain? And what do you do for annual checkups?
If I say I have chest pain, a nurse will assess me and decide if I need to see a doctor. Overall, real, acute emergencies are taken care of quite well.
I don't do annual checkups. They say such checkups are not needed. My employer paid for one at a private doctor when I turned 50. I've heard that if we were more like Canada, that would be illegal.
I don't do annual checkups. They say such checkups are not needed. My employer paid for one at a private doctor when I turned 50. I've heard that if we were more like Canada, that would be illegal.
I've checked with my doctor and she told me to keep a pain diary. No real science was given me in three visits I had before giving up. It has progressed so I cannot sleep on my left side anymore.
Hooray NHS free "healthcare"...
Hooray NHS free "healthcare"...
I wonder if a finger blood oxygen meter ($20 on Amazon [1]) is a good tool to diagnose that you might be having a heart attack. It's easy to carry one with you. I am not a doctor, and Googling for it isn't turning up much useful, but it'd seem logical that during a heart attack your blood oxygen would be abnormally low? Perhaps someone in the know can comment?
[1] https://www.amazon.com/Santamedical-Generation-SM-165-Finger...
[1] https://www.amazon.com/Santamedical-Generation-SM-165-Finger...
A pulse oximiter measures the oxygen content of arterial blood in the peripheries. A heart attack is caused by a localised blockage of the arteries to the heart, causing reduced oxygen and nutrient delivery to an area of heart muscle. A heart attack alone would not affect peripheral oxygen content unless it was severe enough for a complication such as heart failure to develop, but by that stage it's much too late.
Indeed the vast majority of patients with an acute heart attack would have completely normal pulse oximetry findings, the only way to properly diagnose a heart attack is with an electrocardiogram (EKG) and/or blood tests to look for markers of heart muscle damage
Indeed the vast majority of patients with an acute heart attack would have completely normal pulse oximetry findings, the only way to properly diagnose a heart attack is with an electrocardiogram (EKG) and/or blood tests to look for markers of heart muscle damage
While a low reading on one of those meters (coupled with symptoms) is likely a good sign that something's wrong, I think it's quite possible for the pulse oximeter to read normal even if you're having a heart attack. There's a saying in medicine that "time is muscle" because the longer you wait to "fix" an obstruction in a coronary artery, the more likely that region of heart tissue is to die. However, tissue death is not (usually) sudden, so even if you're experiencing a significant heart attack, the heart may be pumping sufficiently and the lungs functioning normally to give you a normal oxygen reading
(this is not medical advice)
(this is not medical advice)
I wouldn't count on it. During a heart attack, it's the blood flow to the heart muscle that's blocked, but the lungs are still working and oxygenating the blood. So these oxygen meters will show a normal value, since your finger is still receiving the normal amount of oxygen in the blood.
For a pulmonary embolism, on the other hand, I'd expect them to be useful. And always keep in mind that they can't detect carbon monoxide poisoning, even though the blood oxygen is low in that case.
For a pulmonary embolism, on the other hand, I'd expect them to be useful. And always keep in mind that they can't detect carbon monoxide poisoning, even though the blood oxygen is low in that case.
This is why it is important that you monitor your stress level and eventually just say "stop." Yes you may miss due dates, plans, and even make some people angry, but at least you don't die. I realize this is not always possible, but the "can do (everything)" attitude is not always the right one.
Also, having a surgery while being awake? Not sure how to think about that. I mean just imagining that makes me feel weird.
Also, having a surgery while being awake? Not sure how to think about that. I mean just imagining that makes me feel weird.
For a stent, they only use conscious sedation, that's enough. It's not like they open up your chest; they go in through your wrist or your goin.
In the article he said he could see his heart on a monitor. Was he maybe referring to the camera they use when they are in your body?
There is imaging but not from a camera in the body (blood is not exactly transparent).
It's a form of x-ray video with a tracer in the blood, so they can observe both the guide and the blood irrigation.
The doctor will use live x-ray pictures to carefully guide the catheter up into your heart and arteries. Dye will be injected into your body to highlight blood flow through the arteries. This helps the doctor see any blockages in the blood vessels that lead to your heart.
A guide wire is moved into and across the blockage. A balloon catheter is pushed over the guide wire and into the blockage. The balloon on the end is blown up (inflated). This opens the blocked vessel and restores proper blood flow to the heart.
Source: https://medlineplus.gov/ency/article/007473.htm
It's a form of x-ray video with a tracer in the blood, so they can observe both the guide and the blood irrigation.
The doctor will use live x-ray pictures to carefully guide the catheter up into your heart and arteries. Dye will be injected into your body to highlight blood flow through the arteries. This helps the doctor see any blockages in the blood vessels that lead to your heart.
A guide wire is moved into and across the blockage. A balloon catheter is pushed over the guide wire and into the blockage. The balloon on the end is blown up (inflated). This opens the blocked vessel and restores proper blood flow to the heart.
Source: https://medlineplus.gov/ency/article/007473.htm
Verified - this is what I saw and what was used on me.
My dad this operation in 2013 (and in 2007 before that), and I was allowed to watch it with his cardiologist (who was not the surgeon). They keep you awake, just insert something through the wrist. All the while you can just watch the insides on a TV. My dad reported that the only "weird" feeling he had was some sort of bubbling in his throat. He complained real time, and the doc said it's fine.
Off Topic: The stent cost INR 150000 (they give you the box), but the hospital procures it for way cheaper. My dad's entire stay cost slightly less than that.
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Three years ago Jason was speaking at the vintage computer festival in Atlanta. He gave a talk about emscipten and all the cool things they do with it. I talked with him for a bit. Super cool and knowledgeable guy. I wish him well.
I attended one of Jason's talks on taking control of your own data. Super inspiring. I went up to ask him a question after (and I never do that!) and went away satisfied.
* Regardless, I personally would have been fine on the accomplishment/legacy scale, if not on the first-person/relationships/plans scale.*
Jason, I think it's an understatement to say that you've done incredible things on the accomplishments/legacy/contributing-to-society front. Thanks for your incredible work.
I hope the next however-many-years allow you to do all you wish to on the person/relationships/plans front. Godspeed!
Jason, I think it's an understatement to say that you've done incredible things on the accomplishments/legacy/contributing-to-society front. Thanks for your incredible work.
I hope the next however-many-years allow you to do all you wish to on the person/relationships/plans front. Godspeed!
A (35ish y/o) family friend died 2 months ago from a heart attack, suspected high cholesterol. He was seemingly healthy, active and not overweight.
Anyone else have experience with cholesterol in early 30's?
Anyone else have experience with cholesterol in early 30's?
Last time I had my cholesterol checked about 6-7 years ago, it appeared normal, though my HDL was low. I'm 31 now and have been having a weird heart feeling. Not a pain though, but like beating issues. Depending on what I eat and which supplements I take, my heart starts beating weird and my blood pressure goes up.
The weird beating seems like my heart is either beating normally or weakly and then there's a "hiccup" every minute or so. When I lay down with my ear against the pillow when this happens, I can hear my blood flow, which seems weird, like my blood containing tubes/pump is wider than the amount of liquid in the chambers; like an echo-y water flow sound.
Part of me thinks this is the L-arginine I take (to get "swoll" as they say) combined with the amount of caffeine I take in? Another part of me thinks this is a valve issue from bacterial endocarditis, since I still have my wisdom teeth, though I brush 3+x/day, but I've had 2 splinter hemorrhages without trauma on my fingernails recently, though I like any signs of Osler nodes.
I'm 6'1", 184-ish, muscular build, so maybe it's all in my head and the above paragraphs are the result of hypochondria exacerbated by a lack of health insurance or the money to even pay for a routine doctor's visit. I mean, I eat all healthy homemade food; currently cooking black beans + garbonzo beans to make a hummus of sorts.
Hoping my anxiety stays tempered long enough for me to get back on my feet while finishing my current project.
EDIT: I forgot to mention a frequent shortness of breath, though like in Jason Scott's case, this doesn't seem to prevent me from physical activity, but it bothers me that I can't take deep breathes all the time.
The weird beating seems like my heart is either beating normally or weakly and then there's a "hiccup" every minute or so. When I lay down with my ear against the pillow when this happens, I can hear my blood flow, which seems weird, like my blood containing tubes/pump is wider than the amount of liquid in the chambers; like an echo-y water flow sound.
Part of me thinks this is the L-arginine I take (to get "swoll" as they say) combined with the amount of caffeine I take in? Another part of me thinks this is a valve issue from bacterial endocarditis, since I still have my wisdom teeth, though I brush 3+x/day, but I've had 2 splinter hemorrhages without trauma on my fingernails recently, though I like any signs of Osler nodes.
I'm 6'1", 184-ish, muscular build, so maybe it's all in my head and the above paragraphs are the result of hypochondria exacerbated by a lack of health insurance or the money to even pay for a routine doctor's visit. I mean, I eat all healthy homemade food; currently cooking black beans + garbonzo beans to make a hummus of sorts.
Hoping my anxiety stays tempered long enough for me to get back on my feet while finishing my current project.
EDIT: I forgot to mention a frequent shortness of breath, though like in Jason Scott's case, this doesn't seem to prevent me from physical activity, but it bothers me that I can't take deep breathes all the time.
I used to get these skipped heart beats all the time (I even went to the emergency room thinking I had a heart attack over it several years ago), along with tightness in the chest.
I also went to a cardiologist about it, and he pretty much just said "your EKG is normal and you're fat, work out 7 days a week, have a low fat diet, and lose weight".
It stopped being anywhere near as frequent, along with a drop in resting heart rate, lower blood pressure, less back pain (probably due to less inflammation) once I went on a low carb diet (notice the low fat diet the cardiologist suggested didn't help much) last year. I also lost 45 lbs in four months, mostly just the diet. I certainly didn't work out 7 days a week.
I have periodically cheated since, and each time I get a reminder I shouldn't because I get skipped heart beats, tightness in the chest, and an elevated heart rate and blood pressure.
I'm not sure the mechanism behind this (anyone? local doctors have been completely unhelpful), and I almost wish there was another cause, because every once in awhile I really, really want to have those carbs, but I feel a lot better overall when I don't.
Something to consider.
I also went to a cardiologist about it, and he pretty much just said "your EKG is normal and you're fat, work out 7 days a week, have a low fat diet, and lose weight".
It stopped being anywhere near as frequent, along with a drop in resting heart rate, lower blood pressure, less back pain (probably due to less inflammation) once I went on a low carb diet (notice the low fat diet the cardiologist suggested didn't help much) last year. I also lost 45 lbs in four months, mostly just the diet. I certainly didn't work out 7 days a week.
I have periodically cheated since, and each time I get a reminder I shouldn't because I get skipped heart beats, tightness in the chest, and an elevated heart rate and blood pressure.
I'm not sure the mechanism behind this (anyone? local doctors have been completely unhelpful), and I almost wish there was another cause, because every once in awhile I really, really want to have those carbs, but I feel a lot better overall when I don't.
Something to consider.
I am not a doctor. Here are some thoughts (addressed to both you and the GP):
I have a hietal hernia[0] that causes reflux and dyspepsia (trouble swallowing) and mimics these heart symptoms: shortness of breath, arrhythmia, chest pain, and tachycardia. A ketogenic diet helps, as does an OTC PPI[1] (e.g. Prilosec, Nexium). You might consider getting scoped to see if you have one as well (or just take a PPI for two weeks and see if it helps).
I've had arrhythmia since I was a teenager. Some of it is sinus (i.e. pressure on my vascular system caused by breathing) and some of it is not[2]. I've found that taking a daily multivitamin helps considerably, as does a diet rich in magnesium and potassium (occasionally supplemented), so I must have some deficiencies. I can't take too much pseudoephedrine (and try to avoid it completely after a particularly scary episode). Regular exercise helps as well. If I start to freak out about a particularly bad spell of arrhythmia and/or palpitations, I tell myself to eat an apple or a banana and go for a walk.
Alcohol and caffeine wreak havoc on all of the above, so I can't drink like I did in my 20s, and I try to limit myself to one pot of coffee per day. ;-)
> "your EKG is normal and you're fat"
If I had a nickel for every time I've heard that...
If you have bacterial endocarditis[3], that could explain why a low-carb diet is helpful: lower blood sugar -> less fuel for bacteria -> reduced heart valve inflammation. Maybe.
I have something else going on right now that I don't understand: waking up at night with back pain under my right shoulder blade, anxiety, and arrhythmia. I went to the hospital after the third incident and the EKG, blood work, chest X-ray, CT scan, etc. didn't reveal anything. I suspect it's stress-related and either an ulcer or bacterial endocarditis, so I need to get those looked at by specialists. I also had a clot in my leg last year for which I needed six months of blood thinners, so I wonder if that's related...
Getting old sucks.
0. https://en.wikipedia.org/wiki/Hiatus_hernia
1. https://en.wikipedia.org/wiki/Proton-pump_inhibitor
2. https://en.wikipedia.org/wiki/Premature_ventricular_contract...
3. https://en.wikipedia.org/wiki/Infective_endocarditis
I have a hietal hernia[0] that causes reflux and dyspepsia (trouble swallowing) and mimics these heart symptoms: shortness of breath, arrhythmia, chest pain, and tachycardia. A ketogenic diet helps, as does an OTC PPI[1] (e.g. Prilosec, Nexium). You might consider getting scoped to see if you have one as well (or just take a PPI for two weeks and see if it helps).
I've had arrhythmia since I was a teenager. Some of it is sinus (i.e. pressure on my vascular system caused by breathing) and some of it is not[2]. I've found that taking a daily multivitamin helps considerably, as does a diet rich in magnesium and potassium (occasionally supplemented), so I must have some deficiencies. I can't take too much pseudoephedrine (and try to avoid it completely after a particularly scary episode). Regular exercise helps as well. If I start to freak out about a particularly bad spell of arrhythmia and/or palpitations, I tell myself to eat an apple or a banana and go for a walk.
Alcohol and caffeine wreak havoc on all of the above, so I can't drink like I did in my 20s, and I try to limit myself to one pot of coffee per day. ;-)
> "your EKG is normal and you're fat"
If I had a nickel for every time I've heard that...
If you have bacterial endocarditis[3], that could explain why a low-carb diet is helpful: lower blood sugar -> less fuel for bacteria -> reduced heart valve inflammation. Maybe.
I have something else going on right now that I don't understand: waking up at night with back pain under my right shoulder blade, anxiety, and arrhythmia. I went to the hospital after the third incident and the EKG, blood work, chest X-ray, CT scan, etc. didn't reveal anything. I suspect it's stress-related and either an ulcer or bacterial endocarditis, so I need to get those looked at by specialists. I also had a clot in my leg last year for which I needed six months of blood thinners, so I wonder if that's related...
Getting old sucks.
0. https://en.wikipedia.org/wiki/Hiatus_hernia
1. https://en.wikipedia.org/wiki/Proton-pump_inhibitor
2. https://en.wikipedia.org/wiki/Premature_ventricular_contract...
3. https://en.wikipedia.org/wiki/Infective_endocarditis
Thanks for that, I'll look into it. I wouldn't be surprised if I had something similar to that hernia. I thought I had pancreatitis for awhile, but that looks like it fits better.
I also just got an MRI and an ultrasound for a hard lump on my leg to make sure it wasn't a clot (they thought it was cellulitis but antibiotics didn't make it go away, now they think it was cellulitis and the remnants just might just stick around for awhile).
Honestly I'm just tired of getting all this checked out all the time. I max out my rather high deductible pretty quick these past couple of years, mostly to get tests taken that (so far) have been negative, so I don't really know what's actually wrong (although apparently the doctors don't ever think it's too serious, but I'm worried they make some assumptions because of my weight and something more serious might be hiding).
I agree, getting old sucks. And I'm still considered too 'young' for half the things they're testing on me, from what they keep telling me.
I also just got an MRI and an ultrasound for a hard lump on my leg to make sure it wasn't a clot (they thought it was cellulitis but antibiotics didn't make it go away, now they think it was cellulitis and the remnants just might just stick around for awhile).
Honestly I'm just tired of getting all this checked out all the time. I max out my rather high deductible pretty quick these past couple of years, mostly to get tests taken that (so far) have been negative, so I don't really know what's actually wrong (although apparently the doctors don't ever think it's too serious, but I'm worried they make some assumptions because of my weight and something more serious might be hiding).
I agree, getting old sucks. And I'm still considered too 'young' for half the things they're testing on me, from what they keep telling me.
It's likely https://en.wikipedia.org/wiki/Premature_ventricular_contract..., a lot of people have them but some people feel them more than others and unfortunately once you start noticing them it becomes really annoying (needless to say the more caffeine you take/the more anxious you are, the more you will feel them). Still you should do a heart check with a cardiologist to be sure there is no underlying condition (unlikely) which can help living with it by being less anxious.
Edit: replaced french word
Edit: replaced french word
Consider asking your doctor for a coronary artery calcification (CAC) scan. It only takes a few minutes and in the US typically costs only $100. For some reason it doesn't seem to be very well known, but high scores seem to be a reliable indication of heart disease.
Some more info:
https://www.youtube.com/watch?v=RFRCzuAdl6A [11:54]
https://www.nhlbi.nih.gov/health/health-topics/topics/cscan
Some more info:
https://www.youtube.com/watch?v=RFRCzuAdl6A [11:54]
https://www.nhlbi.nih.gov/health/health-topics/topics/cscan
It's probably worth going to a doctor to get an EKG and get checked out. If your heart beat is irregular (either the time between beats seems random, or you have pauses or early beats), it could be a sign of an electrical disturbance in your heart.
(this is not medical advice - go see a doctor!)
(this is not medical advice - go see a doctor!)
Completely understand, and I agree with you. I just wish it was an easy decision to make.
(I am not a doctor).
Skipped beats are often normal (see PVCs, PACs).
A highly irregular rhythm, e.g. where your heart goes beat..beat..beatbeatbeat.beat...beat..beatbeat may be a sign you have Atrial Fibrillation, and you should definitely jump on that if you do.
Skipped beats are often normal (see PVCs, PACs).
A highly irregular rhythm, e.g. where your heart goes beat..beat..beatbeatbeat.beat...beat..beatbeat may be a sign you have Atrial Fibrillation, and you should definitely jump on that if you do.
Are you really seeking medical advice on HN? See a doctor for goodness sake.
Similar thing happened with my grandfather. He was a great athlete, was the varsity quarterback for a division 1 school, and was on the varsity basketball and baseball teams. He had his first heart attack at 27. He was lucky, though. Managed to live another 50 years with serious heart disease.
I don't know specifically about cholesterol but I make a point (as a 40+yo) to get an annual physical and associated tests.
I think based on Obamacare, this is actually copay free for most/all insurance plans. Cholesterol screening is included [1].
I strongly recommend everyone to take advantage of the free preventative care (until Trump/GOP kills it)
[1] http://obamacarefacts.com/questions/exactly-covered-preventa...
I think based on Obamacare, this is actually copay free for most/all insurance plans. Cholesterol screening is included [1].
I strongly recommend everyone to take advantage of the free preventative care (until Trump/GOP kills it)
[1] http://obamacarefacts.com/questions/exactly-covered-preventa...
Yeah. It was due to a bunch of factors.
* Sitting a lot (Standing desk didn't help, regular breaks and walks did.)
* Diet (Carbohydrate heavy)
* Alcohol consumption
* Lack of intense exercise.
Of all of those, diet and alcohol consumption were the most important. No one really understands how these metabolic processes actually work, it seems.
* Sitting a lot (Standing desk didn't help, regular breaks and walks did.)
* Diet (Carbohydrate heavy)
* Alcohol consumption
* Lack of intense exercise.
Of all of those, diet and alcohol consumption were the most important. No one really understands how these metabolic processes actually work, it seems.
Diagnosed in mid-30s. Genetic component likely. Taking statins daily since then, now late 40s.
Wow, this is timely, I'm going to stay with my Dad while he goes in for heart surgery on Monday. It's kind of terrifying since he's had no heart problems his entire life until very recently, and unless he was taking his pulse for another issue wouldn't have even known it as he's had no other symptoms or any sort of discomfort.
I also used to work with an older guy who had known heart problems and a defibrillator. He worked on a piece of equipment that required him to lean over a big moving dangerous piece of mechanical moving death trap. One day we noticed him leaning in in a weird way, jolting and then getting back into the correct position as if nothing had happened, it happened three times during a week. We talked to him and he just insisted he was tired. But the shift boss took him off the equipment and told him to go see his doctor. They checked his defibrillator and it had gone off something like a half-dozen times in that week. His heart had stopped and he would have died a couple different ways if he hadn't had that thing in his chest. He never even knew anything was happening except feeling lethargic. But he wasn't passing out, he was dying.
Jason Scott on the other hand had lots of discomfort, but didn't realize it was his heart at all. The signs of heart trouble are so many and this just reminds me of how unclear they can be. We're a lot better off with a Jason Scott than without, so I'm delighted to hear that they caught the trouble and sorted it out with what sounds to be a miracle of modern science.
I also used to work with an older guy who had known heart problems and a defibrillator. He worked on a piece of equipment that required him to lean over a big moving dangerous piece of mechanical moving death trap. One day we noticed him leaning in in a weird way, jolting and then getting back into the correct position as if nothing had happened, it happened three times during a week. We talked to him and he just insisted he was tired. But the shift boss took him off the equipment and told him to go see his doctor. They checked his defibrillator and it had gone off something like a half-dozen times in that week. His heart had stopped and he would have died a couple different ways if he hadn't had that thing in his chest. He never even knew anything was happening except feeling lethargic. But he wasn't passing out, he was dying.
Jason Scott on the other hand had lots of discomfort, but didn't realize it was his heart at all. The signs of heart trouble are so many and this just reminds me of how unclear they can be. We're a lot better off with a Jason Scott than without, so I'm delighted to hear that they caught the trouble and sorted it out with what sounds to be a miracle of modern science.
I wonder all the time why we don't have more widely available, "consumer grade" tech like handheld ECGs, etc., to help better detect stuff like this. (There are products like this, but not in U.S. markets to my understanding - at least not without a prescription)
If you're unfortunate enough to suffer from something like anxiety attacks and also have heart trouble in your family's medical history it is very difficult (and expensive) to ascertain if you're having a panic attack or an actual cardiac episode.
If you're unfortunate enough to suffer from something like anxiety attacks and also have heart trouble in your family's medical history it is very difficult (and expensive) to ascertain if you're having a panic attack or an actual cardiac episode.
To properly rule out a heart attack you would need
a) A twelve-lead EKG - which requires twelve wires to be connected to specific locations on your body
and
b) Blood tests
Therefore for a consumer-grade device to properly rule out a heart attack it would need to be a large EKG machine with multiple connectors as well as a blood test analysis machine. And that's not even considering that proper analysis of an EKG trace requires a trained medical professional, as the automated traces are notoriously unreliable
a) A twelve-lead EKG - which requires twelve wires to be connected to specific locations on your body
and
b) Blood tests
Therefore for a consumer-grade device to properly rule out a heart attack it would need to be a large EKG machine with multiple connectors as well as a blood test analysis machine. And that's not even considering that proper analysis of an EKG trace requires a trained medical professional, as the automated traces are notoriously unreliable
Is that very different from a Holter monitor? Those are cumbersome, but seem like they could be a feasibly portable technology at some point. Also, those two tests are necessary for getting a relatively immediate result. Might a) alone provide valuable insights over a longer period of time? I could see your EKG over the course of 48 hours having the potential to provide a comparably accurate test result. Layman, obviously.
A Holter is essentially an EKG that's left on for a longer period of time. If a patient is coming in with chest pain and your want to evaluate for a heart attack, you really just need a single EKG (and ideally, an older EKG to compare to) to look for the characteristic EKG changes, and blood work to look for signs of damage to the heart muscle. It's really an instantaneous yes/no decision since if the answer is yes, you're likely going to the cath lab or the operating room within minutes (we're often judged on our "door to balloon time", meaning the time from the patient entering the ER to the time the stent is deployed in the heart)
There are other heart conditions that manifest intermittently for which a Holter can help diagnosis. There are a few companies out there working on innovative approaches to make the Holter less cumbersome -- I think iRhythm's ZIO patch was the first on the market and there's several more now. There also some interesting evidence that more subtle signs in the EKG or even unrecognizable-to-humans features of the electrical signal can help proactively predict heart attacks before they happen, but I think that's not yet validated or ready for clinical use. If those type of metrics/analyses prove useful, you could make a case for using Holter-type monitoring to identify a heart attack before it happens
There are other heart conditions that manifest intermittently for which a Holter can help diagnosis. There are a few companies out there working on innovative approaches to make the Holter less cumbersome -- I think iRhythm's ZIO patch was the first on the market and there's several more now. There also some interesting evidence that more subtle signs in the EKG or even unrecognizable-to-humans features of the electrical signal can help proactively predict heart attacks before they happen, but I think that's not yet validated or ready for clinical use. If those type of metrics/analyses prove useful, you could make a case for using Holter-type monitoring to identify a heart attack before it happens
Thanks for the response. Interesting stuff. Time will come when people look back and have trouble believing we lived without this stuff (like lacking antibiotics, knowledge of hygiene, etc.).
Once I learned I had Atrial Fibrillation (AF) I wrote an app that pulls my heart rate data from a normal consumer Polar chestband, then pushes it to a server where I can see it on Grafana.
It was incredibly useful, and helped me learn what the different feelings in my heart mean. I know exactly when I am in AF and when I am not.
There seems to be a huge gap for this kind of consumer grade offering, probably because the medical fraternity is extremely conservative about any technology, even though the alternative is ... nothing.
It was incredibly useful, and helped me learn what the different feelings in my heart mean. I know exactly when I am in AF and when I am not.
There seems to be a huge gap for this kind of consumer grade offering, probably because the medical fraternity is extremely conservative about any technology, even though the alternative is ... nothing.
We are currently beta testing a device that can take your EKG and provide some level of analysis on your phone. If you are interested, we have currently have a private beta and have a few more openings! Of course we have much more planning in our production version. Please feel free to take a look: www.grektek.com. As the other reader mentions, cardiologists are the ultimate judges and even that can be difficult, but we have found helpful information can often be gleaned using our device and App.
There are products like AliveCor's Kardia on the market. The issue is that it's difficult even for a physician to interpret EKGs, and automated interpretation has proven quite challenging. There's been a lot of progress in detecting certain rhythms like atrial fibrillation (which is what AliveCor's product is able to auto-detect), but other rhythm detection remains difficult.
Edit: Data science types wanting to tackle this problem, check out https://physionet.org/challenge/2017/
Edit: Data science types wanting to tackle this problem, check out https://physionet.org/challenge/2017/
There are plenty of those available in the US. Check out https://www.alivecor.com/en/ for an example.
That wouldn't be able to detect a heart attack, its to look for atrial fibrillation (AF), which is a long-term abnormality of heart rhythm associated with increased stroke risk
Awesome, thank you for the link. I don't know why I've not seen or found that yet!
All of the symptoms can also be caused by panic disorder. Advice like "IF YOU FEEL ANY DISCOMFORT AT ALL GO TO THE EMERGENCY ROOM ASAP" is bad advice for people with anxiety disorders.
Go to a doctor and get checked out to rule out any heart issues. If it's panic disorder, there are safe drugs that are great at making these symptoms go away.
Go to a doctor and get checked out to rule out any heart issues. If it's panic disorder, there are safe drugs that are great at making these symptoms go away.
My dad dropped dead from an arrhythmia whilst at work. People nearby performed CPR on him immediately, the ambulance was there within 7 minutes and he was rushed to the Alfred hospital in Melbourne.
He was literally dead for 20 minutes, but they managed to revive him and a few weeks later, with a newly installed pacemaker, better than new.
He had a very, very, very high probability of dying, or requiring specialised care due to brain damage from brain hypoxia. Those that knew CPR, and did it properly for those excruciating 7 minutes gave him his life back.
The moral of the story is, if something feels awry, go and see a doctor (he wasn't taking it seriously), and learn CPR, you might just save someone's life.
Oh, and our hospitals and doctors/nurses are top notch. He was in intensive care for a few days and the final bill was a few hundred dollars. Hooray for universal healthcare!
He was literally dead for 20 minutes, but they managed to revive him and a few weeks later, with a newly installed pacemaker, better than new.
He had a very, very, very high probability of dying, or requiring specialised care due to brain damage from brain hypoxia. Those that knew CPR, and did it properly for those excruciating 7 minutes gave him his life back.
The moral of the story is, if something feels awry, go and see a doctor (he wasn't taking it seriously), and learn CPR, you might just save someone's life.
Oh, and our hospitals and doctors/nurses are top notch. He was in intensive care for a few days and the final bill was a few hundred dollars. Hooray for universal healthcare!
I'm glad that your dad is OK. Was he experiencing symptoms prior to him falling unconscious at work?
He was having occasional shortness of breath at night. He wasn't particularly good at reporting symptoms, and our GP was a bit of a dingdong (he should have been rushed to a cardiac unit in retrospect after a recent round of testing, rather than be sent home).
That's quite the story. I'm glad he made it-the loss of him would have been keenly felt.
I had a spontaneous pneumothorax in my late teens. I was lying in bed and felt a sudden extreme pain in my chest. It was worsened with every breath. I had been drinking and decided to try and sleep it off. Over the next couple of weeks the pain got slightly better but persisted, and I noticed a shortness of breath. Eventually I went to the doctor and was sent straight to hospital where I discovered my left lung was 50% collapsed.
I've had several more subsequently and went straight to hospital each time. Thankfully I haven't had a recurrence in years now, but I learned the same lesson the author of this post did - you shouldn't ignore chest pain.
I've had several more subsequently and went straight to hospital each time. Thankfully I haven't had a recurrence in years now, but I learned the same lesson the author of this post did - you shouldn't ignore chest pain.
Hi, I'm Jason Scott. I had a heart attack and I'm the one who wrote the essay this is linking to.
Since the entry was written last week, I went back to the Emergency Room twice. The first was because I was just feeling "a little weird", and they did a round of tests and verified that no, I'm healing fine, that's just how I feel now (I feel less weird every day). The second time was a few days later when I experienced a notable shortness of breath. This time, the cardiologist said it was likely a side effect of one of my drugs (it's known to do this) and we swapped the medication. Now I'm feeling pretty great.
I mention this because one of the themes of messages in here are "I don't want to be a bother/I don't know if this warrants a trip to the ER" and those two thoughts should NOT be calculated into your deciding to go. Believe me, they'd MUCH rather work on "guy feels funny" than "guy got shot by other guy in argument over the Playstation" or "Guy drank so much he crapped himself and fell onto a sprinkler and is bleeding profusely".
The doctors thought I should not fly for two weeks after the procedure, so we booked an AirBNB for the extra time. My hosts of the two events I spoke at (ACMI and MuseumNext) have essentially paid for this entire extra AirBNB time, which is generous and wonderful and I give a shout-out to them. Additionally, the hospital gave me a letter indicating I couldn't fly, and MuseumNext was able to move my international flight with no real added cost; that's also worth a shout-out. Melbourne is a very nice place to be resting.
The main annoying part is I was (mostly) doing the right things, health wise - I had dropped 30 pounds, and was walking like crazy - I'd upped my step goals on the fitbit after I kept smashing them. On a trip to Japan last year for three weeks, I'd walked over 160 miles. I'd done this because I'd seen so many contemporaries drop dead or get really sick in their 40s and 50s - computer life is not a healthy life. The silent and unaddressed problem, on my side, was cholesterol - it was choking my arteries. Drugs will help that, but I've now radically shifted my diet to approach it naturally as well. I'm raring to go on long walks again, so I will definitely continue that. But please bear in mind - I might still die! Nothing is guaranteed!
I also see a lot of differing opinions on "see doctors" versus "not see doctors". I can't imagine how having a regular doctor checkup is in any way bad. It might not affect what you DIE OF, but it can't hurt quality of life - when I had bad kidney stones for years, it was certainly my doctor who gave me the drug that fixed that. And other small notes have made my life better as well.
Money/cost issues are worth a whole other post.
Finally: I see that 25% of the thread is an argument over linking to the title versus describing the essay's contents. I see people are VERY INTENTLY CONCERNED over the two sides in this discussion. As always, HN knows where to aim the energy.
Since the entry was written last week, I went back to the Emergency Room twice. The first was because I was just feeling "a little weird", and they did a round of tests and verified that no, I'm healing fine, that's just how I feel now (I feel less weird every day). The second time was a few days later when I experienced a notable shortness of breath. This time, the cardiologist said it was likely a side effect of one of my drugs (it's known to do this) and we swapped the medication. Now I'm feeling pretty great.
I mention this because one of the themes of messages in here are "I don't want to be a bother/I don't know if this warrants a trip to the ER" and those two thoughts should NOT be calculated into your deciding to go. Believe me, they'd MUCH rather work on "guy feels funny" than "guy got shot by other guy in argument over the Playstation" or "Guy drank so much he crapped himself and fell onto a sprinkler and is bleeding profusely".
The doctors thought I should not fly for two weeks after the procedure, so we booked an AirBNB for the extra time. My hosts of the two events I spoke at (ACMI and MuseumNext) have essentially paid for this entire extra AirBNB time, which is generous and wonderful and I give a shout-out to them. Additionally, the hospital gave me a letter indicating I couldn't fly, and MuseumNext was able to move my international flight with no real added cost; that's also worth a shout-out. Melbourne is a very nice place to be resting.
The main annoying part is I was (mostly) doing the right things, health wise - I had dropped 30 pounds, and was walking like crazy - I'd upped my step goals on the fitbit after I kept smashing them. On a trip to Japan last year for three weeks, I'd walked over 160 miles. I'd done this because I'd seen so many contemporaries drop dead or get really sick in their 40s and 50s - computer life is not a healthy life. The silent and unaddressed problem, on my side, was cholesterol - it was choking my arteries. Drugs will help that, but I've now radically shifted my diet to approach it naturally as well. I'm raring to go on long walks again, so I will definitely continue that. But please bear in mind - I might still die! Nothing is guaranteed!
I also see a lot of differing opinions on "see doctors" versus "not see doctors". I can't imagine how having a regular doctor checkup is in any way bad. It might not affect what you DIE OF, but it can't hurt quality of life - when I had bad kidney stones for years, it was certainly my doctor who gave me the drug that fixed that. And other small notes have made my life better as well.
Money/cost issues are worth a whole other post.
Finally: I see that 25% of the thread is an argument over linking to the title versus describing the essay's contents. I see people are VERY INTENTLY CONCERNED over the two sides in this discussion. As always, HN knows where to aim the energy.
I don't have anything to add other than to say thank you for sharing this with us, and I wish you a speedy and full recovery.
I appreciate you taking the time to share your story!
A tablet of aspirin taken (even chewed if it's too bad) by the first symptoms of the chest pain can save your life.
Why? Because: (small amount works, chewed is better)
http://www.health.harvard.edu/heart-health/aspirin-for-heart...
As an aside, I know this simply from experience with taking drugs recreationally. Chewed or otherwise ground up pills hit you faster, and I've found dissolving a ground up pill in hot water is the winner, as far as time to kick in.
Pharmaceutical pills have all sorts of additives intended to delay the release of the active chemical, recreational pills have an obviously less rigorously tested version of the same.
My mother, a (retired) cardiovascular pharmacologist, taught me that the quality/effectiveness of those additives is often what differentiates brand name drugs from generics (sometimes significantly, admittedly she's been retired for quite a while now, so that information might be out of date, but she actually did some professional research on the subject back in the day).
I'll never forget the time when I, at about the age of 11, was sent in to the store to buy a big bottle of Aleve that my mom was going to "smuggle" across the border to Canada for her sister (Naproxen was prescription only at the time in Canada, but available OTC in the US - amusingly, Tylenol w/codeine was the inverse). I bought a generic naproxen sodium instead (thinking I was so clever for saving about half the money I'd been given), and I got chewed out and sent back into the store to replace it. That was what she got for teaching me to actually read the active ingredients of drugs on the label ;)
Pharmaceutical pills have all sorts of additives intended to delay the release of the active chemical, recreational pills have an obviously less rigorously tested version of the same.
My mother, a (retired) cardiovascular pharmacologist, taught me that the quality/effectiveness of those additives is often what differentiates brand name drugs from generics (sometimes significantly, admittedly she's been retired for quite a while now, so that information might be out of date, but she actually did some professional research on the subject back in the day).
I'll never forget the time when I, at about the age of 11, was sent in to the store to buy a big bottle of Aleve that my mom was going to "smuggle" across the border to Canada for her sister (Naproxen was prescription only at the time in Canada, but available OTC in the US - amusingly, Tylenol w/codeine was the inverse). I bought a generic naproxen sodium instead (thinking I was so clever for saving about half the money I'd been given), and I got chewed out and sent back into the store to replace it. That was what she got for teaching me to actually read the active ingredients of drugs on the label ;)
Something that I learned in a recent first-aid class: the symptoms for a heart attack often differ between women and men and that women more often experience burning sensations that can be confused with heartburn or indigestion. This can contribute to more women not seeking medical care because the symptoms can be more nuanced.
Better safe than sorry, especially where the heart is concerned.
Better safe than sorry, especially where the heart is concerned.
I love Jason Scott. Just a real upstanding guy. Hoping for a speedy recovery!
How is it THAT IN 2017 someone is still designing business critical systems with single points of failure?!
Seriously though I wish him a full recovery and we all need to remind ourselves that all too often we lose track of what's really, life stoppingly, important.
Seriously though I wish him a full recovery and we all need to remind ourselves that all too often we lose track of what's really, life stoppingly, important.
Fair's fair: the system flagged up an error condition, and faced with a quarter of the critical system failed degraded performance but kept going until it could be patched.
[deleted]
Backward compatibility :)
I wish him a fast and full recovery, too.
I wish him a fast and full recovery, too.
No budget.
Two Christmases ago I had a 100% blockage of the LAD for about 45 minutes - the time it took to get me from my house to the cardiac unit. It's called the Widow Maker for a reason. I was extremely lucky in that the pain was acute enough we called 911 immediately, and both the firehouse and hospital were very close by. I was 41 and in excellent health. No drinking, smoking, drugs, etc.
If you're feeling chest pain, please don't mess around. Get checked immediately. Better to feel silly than miss a heart attack and die!
If you're feeling chest pain, please don't mess around. Get checked immediately. Better to feel silly than miss a heart attack and die!
My highest appreciation for Dr. Sonny Palmer. He went above and beyond his duties and I truly believe he is not the exception, but the norm.
Man that's young.. What are the best ways of actually reversing blocked arteries/artherosclerosis? Excercise? Statins?
As the article started out describing spending an exorbitant amount of money to achieve a bunch of non-essential goals (not counting being with his father, of course) I was expecting "the other half" to refer to a friend or acquaintance without "means" dying in an alley due to lack of funds for medical treatment.
I'll get it better next time.
[deleted]
Who is this about? I read a well-written and beautiful story, I just have no idea what the context is.
Jason Scott is a computer archiver, in that he works to preserve the history of all things computing. He works for the Internet Archive.
He's been featured around here a few times: https://hn.algolia.com/?query=textfiles.com&sort=byPopularit...
One of the more memorable posts was the one where they worked frantically to preserve a warehouse full of old manuals: https://news.ycombinator.com/item?id=10076974
https://en.wikipedia.org/wiki/Jason_Scott
(and even his cat has a wikipedia page: https://en.wikipedia.org/wiki/Sockington)
He's been featured around here a few times: https://hn.algolia.com/?query=textfiles.com&sort=byPopularit...
One of the more memorable posts was the one where they worked frantically to preserve a warehouse full of old manuals: https://news.ycombinator.com/item?id=10076974
https://en.wikipedia.org/wiki/Jason_Scott
(and even his cat has a wikipedia page: https://en.wikipedia.org/wiki/Sockington)
That's what I said!
I saw Jason perform at Internet Archive's anniversary party this year and was really captivated by his stage presence, showmanship, and ability to wrangle and move a show forward.
Glad he's doing OK. Good vibes, Jason!
Glad he's doing OK. Good vibes, Jason!
Quick readability fix: open DevTools and paste:
document.body.style.fontSize = '14pt';
document.body.style.fontFamily = 'Georgia,Cambria,Times,Times New Roman,serif'Or click your browser's “reader” button.
I'm guessing this should be applicable in bookmarklet too?
Really glad he got in there and got it taken care of before it got really bad.
I cringed when I read he was chugging energy drinks to stay awake, given the context of the post.
I cringed when I read he was chugging energy drinks to stay awake, given the context of the post.
Sending healing thoughts your way, Jason!
Good ending now.
I wonder after reading, is Wikipedia the new "Who's who in America?"
>[His] Wikipedia page.
I wonder after reading, is Wikipedia the new "Who's who in America?"
>[His] Wikipedia page.
I love that textiles.com exists
Jason described HN once as "the ass-end of the tech elite" and I still use that quote to this day. Wonderful dude.
Once again, the policy on headline titles for articles on HackerNews is a bit bizarre. The original title explained that the man almost died. This current title is "The Other Half" and does not explain anything at all.
As a practical matter, the policy seems to amount to "We use the title of the original article, unless it is strongly stated, in which case we regard it as clickbait and change it to something dull." That is not a good policy, since we should all hope for and promote strong writing, and the fact that a strong headline could be confused for clickbait is not a good reason to change it. Nor should the default be "use the article's original title" since a better default would be "Highlight what part of this article would be interesting to the Hacker News audience."
As a practical matter, the policy seems to amount to "We use the title of the original article, unless it is strongly stated, in which case we regard it as clickbait and change it to something dull." That is not a good policy, since we should all hope for and promote strong writing, and the fact that a strong headline could be confused for clickbait is not a good reason to change it. Nor should the default be "use the article's original title" since a better default would be "Highlight what part of this article would be interesting to the Hacker News audience."
The policy avoids encouraging/endorsing clickbait. Aside from that, headlines are not purely functional. Preserving the author's creative choices seems valuable to me in cases such as this. If I haven't got time to skim the start, I probably shouldn't be on HN right now.
That doesn't work. The submitter of an HN story doesn't own the story; stories are community property. Submitting doesn't entitle you to choose for the whole site what is or isn't interesting about a story. If you want to do that, you write a comment, like everybody else.
This is one of the oldest meta-arguments on the site. Once or twice a month, perhaps, we get a story that isn't particularly well served by the guidelines, and people have to click one more time than they might have, or read a few more sentences than they might have. But pretty much every day, and probably more frequently than that, we see problems stemming from the guideline being broken.
Almost everybody reading these comments knows what this story is about now. It's a shame a pointless meta-complaint is bolted to the top of the thread, instead of something actually about the post itself.
This is one of the oldest meta-arguments on the site. Once or twice a month, perhaps, we get a story that isn't particularly well served by the guidelines, and people have to click one more time than they might have, or read a few more sentences than they might have. But pretty much every day, and probably more frequently than that, we see problems stemming from the guideline being broken.
Almost everybody reading these comments knows what this story is about now. It's a shame a pointless meta-complaint is bolted to the top of the thread, instead of something actually about the post itself.
The rules already allow using a different title if the original is misleading or clickbait. Adding "or totally uninformative of the nature of the content" to that wouldn't be so bad.
No, that would be bad. A criterion that's both subjective and elevates pedantry over writing - "this thing is totally not about bananafish!"
tptacek, I never suggested that the person submitting the article should have monopoly control of the title. My comment is aimed at dang. I suggest the default question to be answered in the title should be "What part of this article is interesting to the Hacker News crowd?" It's fine if dang re-writes all the titles, but why re-write the title to make it something dull or confusing? We've all seen cases where the original title of a blog post was deemed too strong, and was thus re-written to make it something dull -- the kind of title that a college professor of writing would give a bad grade and suggest "You need a bolder title." We should generally want strong writing, because strong writing is good writing.
> My comment is aimed at dang.
Then please email him and the mods directly at [email protected]
ADD: in order to keep a high signal to noise ratio. Comments on stories should be reserved for discussing the contents of the story, not meta issues with the forum. For meta issues either email the mods directly or start a meta thread with a Ask HN: post.
From the site guidelines[1]:
If the original title begins with a number or number + gratuitous adjective, we'd appreciate it if you'd crop it. E.g. translate "10 Ways To Do X" to "How To Do X," and "14 Amazing Ys" to "Ys." Exception: when the number is meaningful, e.g. "The 5 Platonic Solids."
Otherwise please use the original title, unless it is misleading or linkbait.
Please don't post on HN to ask or tell us something (e.g. to ask us questions about Y Combinator, or to ask or complain about moderation). If you want to say something to us, please send it to [email protected].
[1] https://news.ycombinator.com/newsguidelines.html
Then please email him and the mods directly at [email protected]
ADD: in order to keep a high signal to noise ratio. Comments on stories should be reserved for discussing the contents of the story, not meta issues with the forum. For meta issues either email the mods directly or start a meta thread with a Ask HN: post.
From the site guidelines[1]:
If the original title begins with a number or number + gratuitous adjective, we'd appreciate it if you'd crop it. E.g. translate "10 Ways To Do X" to "How To Do X," and "14 Amazing Ys" to "Ys." Exception: when the number is meaningful, e.g. "The 5 Platonic Solids."
Otherwise please use the original title, unless it is misleading or linkbait.
Please don't post on HN to ask or tell us something (e.g. to ask us questions about Y Combinator, or to ask or complain about moderation). If you want to say something to us, please send it to [email protected].
[1] https://news.ycombinator.com/newsguidelines.html
Ah, sorry. That's a more reasonable request. I shouldn't have responded so petulantly.
I still think it's not going to work out. There aren't many moderators, and fixing the titles on this site is a huge amount of work. For instance, it's also probably not reasonable to expect the mods to read every story on the site, or even just the stories with broken titles.
A thing you can do to help is, when an article has a title that doesn't follow the guidelines, suggest a better title. The mods often use those suggestions as the replacement title.
I still think it's not going to work out. There aren't many moderators, and fixing the titles on this site is a huge amount of work. For instance, it's also probably not reasonable to expect the mods to read every story on the site, or even just the stories with broken titles.
A thing you can do to help is, when an article has a title that doesn't follow the guidelines, suggest a better title. The mods often use those suggestions as the replacement title.
And rather than rely on the moderators having to sift through comments and hope they see a suggested better title, email them directly with the HN submission link/id and your suggested better title.
"stories are community property."
If stories are community property, then the community and not the editors should decide whether the story submission with the title it was submitted with was valuable or not by upvoting it (or not).
"Submitting doesn't entitle you to choose for the whole site what is or isn't interesting about a story."
I don't see why they couldn't. But using the same argument, the editors shouldn't get to choose for the whole site what the title should be either.
I've run across so many, many great stories with super generic, boring titles that will never be even glanced at by most readers. Those stories deserve better, and editing the title to make it reflect what the story is actually about is helpful.
HN editors should restrict their roles to keeping the conversations civil, and let the community take care of the rest.
If stories are community property, then the community and not the editors should decide whether the story submission with the title it was submitted with was valuable or not by upvoting it (or not).
"Submitting doesn't entitle you to choose for the whole site what is or isn't interesting about a story."
I don't see why they couldn't. But using the same argument, the editors shouldn't get to choose for the whole site what the title should be either.
I've run across so many, many great stories with super generic, boring titles that will never be even glanced at by most readers. Those stories deserve better, and editing the title to make it reflect what the story is actually about is helpful.
HN editors should restrict their roles to keeping the conversations civil, and let the community take care of the rest.
> I've run across so many, many great stories with super generic, boring titles that will never be even glanced at by most readers. Those stories deserve better
Indeed they do, and there are other strategies for achieving that than gutting HN's approach to titles which is critical to how the site functions.
If you have links to stories that fit that description and haven't had attention on HN yet, I'd love to see them.
Indeed they do, and there are other strategies for achieving that than gutting HN's approach to titles which is critical to how the site functions.
If you have links to stories that fit that description and haven't had attention on HN yet, I'd love to see them.
Are you suggesting users start emailing you directly when they find such stories? Is that really practical or scalable?
Also, doesn't having to run stories past a gatekeeper go against the community rating system that HN is based on?
I don't see administrator interference in story titles as particularly critical to the site, but community voting on stories is.
Is there maybe some way to experiment with leaving story titles unchanged from how they were submitted? What would happen if HN tried that for a week?
Also, doesn't having to run stories past a gatekeeper go against the community rating system that HN is based on?
I don't see administrator interference in story titles as particularly critical to the site, but community voting on stories is.
Is there maybe some way to experiment with leaving story titles unchanged from how they were submitted? What would happen if HN tried that for a week?
Movie titles according to Hacker News:
Man finds wife's head in box. Therapist of boy who sees ghosts is a ghost. Man who killed hero's father is actually his father.
I get that you want more information, but sometimes getting the information makes reading something less pleasurable. The author here doesn't disclose the detail you're talking about until a third of the way through. Disclosing it in the title fundamentally changes it, and not in a good way.
Man finds wife's head in box. Therapist of boy who sees ghosts is a ghost. Man who killed hero's father is actually his father.
I get that you want more information, but sometimes getting the information makes reading something less pleasurable. The author here doesn't disclose the detail you're talking about until a third of the way through. Disclosing it in the title fundamentally changes it, and not in a good way.
Those are the best kinds of headlines for most informational writing. Look at a newspaper from the early 1900s. You can skim just the headlines in a minute and have a pretty good idea what's gone on.
EDIT: see: https://upload.wikimedia.org/wikipedia/commons/b/b8/New_York...
Basically an unbeatable news consumption interface. Notice even the smaller headlines down the page, which are either independent lower-importance articles or minor articles related to the major ones above. You can read ~15-20 words on each the give you the basics of what happened, very quickly because it's called out in larger type and because the authors were competent and weren't trying to drive clicks, but to deliver value.
EDIT: see: https://upload.wikimedia.org/wikipedia/commons/b/b8/New_York...
Basically an unbeatable news consumption interface. Notice even the smaller headlines down the page, which are either independent lower-importance articles or minor articles related to the major ones above. You can read ~15-20 words on each the give you the basics of what happened, very quickly because it's called out in larger type and because the authors were competent and weren't trying to drive clicks, but to deliver value.
That's great, but it's totally irrelevant to the style of writing linked here.
I disagree. Glancing down the headlines on the front page right now, I'd say ~half would be better if they were written in that style.
By 'here', I specifically meant this article.
If you don't want to read that style of writing, then I would suggest not clicking links with this style of title.
If you don't want to read that style of writing, then I would suggest not clicking links with this style of title.
Understood, and I concede that this veered off-topic, hence the talking past one another.
And hey, I love "Frank Sinatra Has a Cold" as much as the next person.
And hey, I love "Frank Sinatra Has a Cold" as much as the next person.
You happen to get lots of information about books and movies from sources other than just the title. Trailers, synopses on the back/inside sleeve, location in the bookstore, genre, all are meant to give people an idea of what they are getting into, rather than pure mystery.
Nobody is asking for the hyperbolic titles you gave, they simply would like to know what they are getting into before clicking on some random link.
Nobody is asking for the hyperbolic titles you gave, they simply would like to know what they are getting into before clicking on some random link.
Movies are meant to entertain, and creative titles are part of that.
News is meant to inform, and non-creative titles are part of that.
Look at any decent newspaper and the headlines will look like your satirical movie titles. HN is much closer to newspapers than movies.
News is meant to inform, and non-creative titles are part of that.
Look at any decent newspaper and the headlines will look like your satirical movie titles. HN is much closer to newspapers than movies.
I disagree. If you were to link a public domain movie (say a documentary) from Youtube, it would suffice to use the title of the movie, with maybe a [Documentery] and (date) stamp.
The largely fluff (imo) articles from nautil.us and the like are generally left with the original article title intact. The essay is left to the reader.
As for news and technical articles, these are expected to make a clear and concise argument or statement of facts, and the title linking the articles is expected to be accurate and informative. This seems like a pretty fair standard.
The forum as a whole is content and audience sensitive, fairly inclusive when it comes to topics, and in my opinion generally gets it right when it comes to adjusting post titles.
The largely fluff (imo) articles from nautil.us and the like are generally left with the original article title intact. The essay is left to the reader.
As for news and technical articles, these are expected to make a clear and concise argument or statement of facts, and the title linking the articles is expected to be accurate and informative. This seems like a pretty fair standard.
The forum as a whole is content and audience sensitive, fairly inclusive when it comes to topics, and in my opinion generally gets it right when it comes to adjusting post titles.
Bad analogy. All movies have spoiler-free synopses, e.g. "Two detectives, a rookie and a veteran, hunt a serial killer who uses the seven deadly sins as his modus operandi." And that's exactly what you read before deciding which movie to watch. That's more or less what we're asking for here, in title form.
It's not 'bizarre', it's unfortunate at best. The piece has a title that isn't very descriptive, and HN policy biases towards transparent link-sharing with no editorialising. No policy is perfect, and it has some casualties, this being one of them. But it has to be weighed against the (IMO) very strong general case benefits of avoiding editorialising.
The policy is a good policy 90% of the time. But there are edge cases where the author writes a terrible headline and then we're also stuck with a terrible headline.
This one is not a "terrible headline". The author is emphasizing what matters to him about a profound, life-altering experience. We're supposed to overwrite that because internet readers (all of us) are addicted to instant gratification? Nope, that's not how HN works. We want reflective responses, not reflexive ones, those take a bit longer and that's good. If the difference between 1 second and 10 seconds is critical to you (I don't mean you personally, of course, but any reader), HN may not be the website you're looking for. Making a little effort, poking around a little, figuring things out: those are some of the qualities we want to engage here.
I could go on about this for hours. Of all the things that make HN different and matter most, this is the one I'm surest of. However, after yesterday I think a better use of resources would be to go back to working on making HN faster. There the difference between 1 and 10 seconds really does matter.
I could go on about this for hours. Of all the things that make HN different and matter most, this is the one I'm surest of. However, after yesterday I think a better use of resources would be to go back to working on making HN faster. There the difference between 1 and 10 seconds really does matter.
That's not the case. Truly terrible titles - ones that are outright misleading or clickbait get rewritten. "I can't instantly tell what this thing is about from the title" is not really a forum-damaging problem.
I disagree. The idea that headlines serve only informative purposes is rather bizarr. Ever since people wrote words on things, they were an entire literary genre for themselves.
Nowadays, people decry anything that isn't a completely literal summary of the article as "clickbait", ignoring decades of history and hundreds of masterpieces.
in this case, the actual "event" is not mentioned in the first few paragraphs. This is clearly a literary choice made by the author, and changing the headline would defeat his intentions and be somewhat lacking respect.
Here are some historic examples, and The Atlantic's humorous efforts at de-phantasizing them (from https://www.theatlantic.com/technology/archive/2016/08/famou...):
– "Frank Sinatra has a Cold"
(Frank Sinatra Is a Complicated Person (and Unfortunately Our Reporter Did Not Get to Speak to Him))
– "Ford to City: Drop Dead"
(Ford to New York City: Drop Dead (but He Only Means That Figuratively, As He Intends to Veto Any Bail-Out for New York City’s Municipal Budget))
– "Death of an Innocent"
(A Young Man Hiked Into the Alaska Wilderness and Died Under Somewhat Mysterious Circumstances, and Also His Ordeal Raises Larger Questions About American Culture)
– "Pearls Before Breakfast"
(Most Commuters Didn’t Even Notice When a Violin-Playing Prodigy Masqueraded as a Street Performer)
– "Headless Body in Topless Bar"
Nowadays, people decry anything that isn't a completely literal summary of the article as "clickbait", ignoring decades of history and hundreds of masterpieces.
in this case, the actual "event" is not mentioned in the first few paragraphs. This is clearly a literary choice made by the author, and changing the headline would defeat his intentions and be somewhat lacking respect.
Here are some historic examples, and The Atlantic's humorous efforts at de-phantasizing them (from https://www.theatlantic.com/technology/archive/2016/08/famou...):
– "Frank Sinatra has a Cold"
(Frank Sinatra Is a Complicated Person (and Unfortunately Our Reporter Did Not Get to Speak to Him))
– "Ford to City: Drop Dead"
(Ford to New York City: Drop Dead (but He Only Means That Figuratively, As He Intends to Veto Any Bail-Out for New York City’s Municipal Budget))
– "Death of an Innocent"
(A Young Man Hiked Into the Alaska Wilderness and Died Under Somewhat Mysterious Circumstances, and Also His Ordeal Raises Larger Questions About American Culture)
– "Pearls Before Breakfast"
(Most Commuters Didn’t Even Notice When a Violin-Playing Prodigy Masqueraded as a Street Performer)
– "Headless Body in Topless Bar"
> since we should all hope for and promote strong writing, and the fact that a strong headline could be confused for clickbait is not a good reason to change it.
i don't know what you mean by "strong writing" here.
i don't know what you mean by "strong writing" here.
+1
Much of language derives its meaning from its context. In the context of this blog a title of "The Other Half" can have a very different meaning than a title of "The Other Half" on Hacker News. Lifting the title verbatim to a new context can change its meaning. Even though the intention may be good to be faithful to the original, purely by being in a new context, the title has been effectively changed. In fact, using different words for the title in the HN context can well be more faithful to the meaning than the using the same words.
Much of language derives its meaning from its context. In the context of this blog a title of "The Other Half" can have a very different meaning than a title of "The Other Half" on Hacker News. Lifting the title verbatim to a new context can change its meaning. Even though the intention may be good to be faithful to the original, purely by being in a new context, the title has been effectively changed. In fact, using different words for the title in the HN context can well be more faithful to the meaning than the using the same words.
+1. I didn't know where this article was headed for the first half. Partway through I scrolled and saw "On Thursday I had a heart attack" and with that context I could understand the point of the article.
Why the title change? "archive.org guy nearly died" was much more direct/informative. I wouldn't take a second glace at this thread under "the other half" assuming it to be marriage advice.
Because it's the author's own title. That's significant, especially for so intimate and personal a piece.
It's true that one can trade that off for immediate factual placeability, but on HN we prefer to make the opposite tradeoff. That's one of many reasons why the guidelines say "Please use the original title, unless it is misleading or linkbait." (https://news.ycombinator.com/newsguidelines.html)
It's true that one can trade that off for immediate factual placeability, but on HN we prefer to make the opposite tradeoff. That's one of many reasons why the guidelines say "Please use the original title, unless it is misleading or linkbait." (https://news.ycombinator.com/newsguidelines.html)
I recently saw a suggestion that there should be two titles: one that's the author's own title and a second that's the HN submission title (which could be identical if the HN submitter prefers so). Any opinion on the suggestion?
In my opinion, too complicated, and people would use it to editorialize.
After returning from a Disney World trip, he told me how he spent most of it on the hotel room floor because he 'threw his back out' and had general chest pain. Nothing excruciating, just annoying enough that he wasn't up for hours of walking. His friends told him to go the doctor, but he blew it off and said he was feeling better.
The next day he died in the store, behind the register, before we opened, from a heart attack. He was 36.
Last year I went to an urgent care because of chest and back pain. They sent me on to the ER after an EKG showed an abnormal rhythm. Turns out I hit the rowing machine too hard the day before and had a massive case of indigestion from Mexican food at lunch.
I felt silly, but really everyone that I dealt with was cool about it. I'm lucky enough to have insurance that covered it all, and I'm happy that it wasn't a heart attack.
I don't know if there's a moral to this story, just that... shit, you never know when your day is coming, and I still have a lot to do before it happens.