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Comment Re:Too Many Women Die from "All in your head." (Score 1) 47

Too many women die by the "all in your head" diagnosis.

My friend's ex-girlfriend went to the hospital for chest pain, was diagnosed with anxiety. She died less than a week later.

There's too many generalities and not enough specifics for this to be useful, in any way. To preface what I'm about to say: yes, medicine, like most professions, historically has had sexism problems. Although with the older generation of doctors retiring and/or dying, and more women studying medicine than men at many schools, that is changing.

For every woman that dies by the "all in your head" diagnosis, there's a substantial number of women that are harmed through expensive and unnecessary testing and even surgery or procedures because everyone involved is sure there's an actual physical problem related to a symptom that isn't going away and everyone involved is willing to dive down the rabbit hole to figure out what it is. Case in point: one of my hospital's most frequent patients is a nice woman who came in originally due to unexplained long standing abdominal pain and nausea and vomiting. Even though all the relevant testing was coming back negative, eventually after enough visits, a consulting surgeon felt her symptoms resembled dysfunctional gallbladder pain enough for her to have it surgically removed. Fast forward, the patient is still coming in for the same symptoms, but develops a small bowel obstruction from scar tissue from her previous surgery. Fast forward again after multiple bowel resections for multiple obstructions, and she has developed short gut syndrome on top of her previous symptoms with chronic diarrhea and malabsorption of basic nutrients. She's doing better now on daily IV nutrition. I'll let you imagine what her quality of life is with a permanent IV that has to be changed every so often for serious line infections, and being tethered every day to a bag of nutrients to drip in. And she is by no means a unicorn in the medical world.

And now, back to your friend's ex-girlfriend. What tests were run? What were the results? What description of pain was she having? What did she die of? Have you contemplated the possibility that the hospital ran appropriate tests for a chest pain evaluation, everything came back negative, your friend's ex-girlfriend was dealing with concurrent anxiety disorder, and died with something unrelated a week later?

Comment Re:Something wrong with this story (Score 1) 47

Since you're asking a similar question to someone else I replied to, I'll cut and paste my answer from below.

The doctor didn't think her story, as it was told to them at the time, was a TIA. What happened to cause the misdiagnosis? Most likely, a "failure of doctor-patient communication. With a completely normal physical/neurological exam, all it takes is for a slightly confusing or badly told patient story (which NEVER happens, of course, with a patient freaked out about a possible medical problem) or a doctor that's not hearing or associating the right phrases to lead them down the TIA/stroke diagnosis pathway to be sent home." Sometimes it's a fine balance to walk between putting words in a patient's mouth that they can enthusiastically nod their heads to versus listening to them stumble around trying to find a way to describe what happened.

"Why didn't the doctor ask for an MRI the first time around? Well, she went to the ER. Now, admittedly, I haven't worked in the Canadian system or outside of 2 confluent states here in the US, but standard of practice where I have worked is that ER doctors do not have access to MRI scans. They take way too long for the fast turnaround of ER care. MRIs can take 30 minutes to multiples of hours. CT scans take a few minutes. MRIs are either handled by outpatient scheduling or by admitting the patient for an inpatient stay in the hospital. On top of that, any stroke suspicion automatically gets a CT of the head without contrast to rule out intracranial bleeding, which is by far the most serious and emergent diagnosis from that class of symptoms. Tangentially, a CT of the head likely would not have picked up a small ischemic stroke like her later MRI."

Comment Re:Why no MRI the first time? (Score 4, Insightful) 47

I'd like to know why the doctors didn't ask for an MRI the first time around. Why did the patient need to wait and get "proof" there was a real problem? Intact why don't we get an full body MRI and maybe even a CT scan maybe every 20 years to find possible problems before they happen?

Well, IAAD. I don't have access to the notes/file, but I can give a pretty reasonable guess to your answers.

Why didn't the doctor ask for an MRI the first time around? Well, she went to the ER. Now, admittedly, I haven't worked in the Canadian system or outside of 2 confluent states here in the US, but standard of practice where I have worked is that ER doctors do not have access to MRI scans. They take way too long for the fast turnaround of ER care. MRIs can take 30 minutes to multiples of hours. CT scans take a few minutes. MRIs are either handled by outpatient scheduling or by admitting the patient for an inpatient stay in the hospital. On top of that, any stroke suspicion automatically gets a CT of the head without contrast to rule out intracranial bleeding, which is by far the most serious and emergent diagnosis from that class of symptoms. Tangentially, a CT of the head likely would not have picked up a small ischemic stroke like her later MRI.

Why did the patient need to wait and get proof? Well, with the story written down and no workplace rush, hindsight says she probably deserved an inpatient workup for a TIA the first time around. The #1 cause of misdiagnosis is failure of doctor-patient communication. With a completely normal physical/neurological exam, all it takes is for a slightly confusing or badly told patient story (which NEVER happens, of course, with a patient freaked out about a possible medical problem) or a doctor that's not hearing or associating the right phrases to lead them down the TIA/stroke diagnosis pathway to be sent home.

Now let's turn this around, based on her initial episode on presentation to the ER. You're the patient that just had a five minute spell of weirdness that includes, "had trouble speaking words". In a few minutes, those symptoms were gone like it never happened. A CT scan will likely be negative for anything (but it will dose you with about 20 chest X-rays' worth of radiation to your brain). By definition, a TIA won't show anything on MRI (a small-scale infarct on MRI is a stroke, period). There is no medical "fix", as TIAs are self-limiting and resolve themselves - there is only secondary prevention. If this is a TIA, your best treatment includes going on aspirin daily (ulcer risk), antiplatelet medication like Plavix daily (bleeding risk), and a statin daily (multiple adverse effects well-documented. You can avoid taking if LDL is already low). On the basis of five minutes of symptoms that haven't returned, would you feel like taking this medication for the rest of your life? Does dosing every single person that comes in with a similar story with a combination of multiple medications sound like a good outcome?

Third, why doesn't everyone get a full body MRI and maybe even a CT scan every 20 years? Well, you can. You'll need a credit/debit card or an appropriately-sized stack of cash, but radiology suites will be glad to scan you. I'd hate to put words in their mouths, but I would venture to say that would be their preferred business model. Especially if they could get away with not having to deal with third-party payers.

Oh! You want someone else to pay for your scan. First, you need a good reason to order the scan to get someone else to pay for it. So let's think about it. Multiply thousands of dollars of unnecessary scans times 300 million people+ here in the US, rotating every 20 years. Then factor in all the incidental findings which will be inconclusive and need either further scans or maybe invasive surgical procedures to investigate. Factor in complications and harms from procedures and radiation dosing (a single CT of the chest is equivalent to about 70 chest X-rays, which is not insignificant in terms of lifetime cancer risk), and the fact there will be a lot of false positives, especially when you're screening 300 million people. Then, after all that, you've caught a very small percentage of actual problems by doing mass screenings. A significant fraction of those you will have no better outcomes than if you waited for symptoms to develop (see: prostate cancer). So now you get to weigh spending billions of dollars every year to get the benefit described

Comment Re:Overreacting (Score 1) 384

Why don't you read it with s/LGBT/polygamists/ or s/LGBT/pedophiles/

Probably because pedophelia doesn't involve acts between consenting adults able to give appropriate, informed consent. Given that you couldn't resist that analogy, it gives a pretty good idea of where you're coming from on this issue--and it's not a good place.

And yet you say nothing about consenting polygamy, or the fact that age-based consent is strictly based on an arbitrary line of 18, when in many other cultures the age of consent is less. Given the fact that you can't be ideologically consistent, I have to conclude that you just have a pet issue to grind with homosexuality, and you are not really interested in extending your arguments to their logical conclusions.

You see, you are super quick to jump to the "excluding gay marriages is just like excluding black people marriages in the game!" and yet, where is your outrage for the polygamists? I don't see it or hear it. Or the fact that you don't even have a decent argument why the age of consent is different in some communities than others, but morally it's OK to throw some people but not others in jail for the same act based on location?

And if everyone's faux outrage...

Personally, I'm just going to stand up for "disappointment", rather than "outrage". (I would go with "outrage" when talking about how, for instance, it's still legal in most U.S. states to fire someone from their job for no reason other than their being gay--but that's just my opinion.) That said, I will firmly declare a "Fuck you and the horse you rode in on" for presuming that because you're not outraged, or you think it's a dumb thing to be upset about, that anyone else expressing serious anger has to be faking it.

We'll just have to agree to disagree then. If you don't think there's faux outrage over this stupid Nintendo game being drummed up by the media looking for eyeballs and clicks, and from some members of the LGBT community and its proponents looking for another axe to grind, you sir, are fucking stupid, and that's just a statement of fact. But, indeed, I don't doubt that there are some people out there who aren't faking it, expressing serious anger about this retarded Sims wannabe produced by Nintendo. But that may be more fucking stupid by orders of magnitude more than someone faking it, self-interestedly looking for an angle to play on this issue. That's just my opinion, though.

Comment Re:Overreacting (Score 1) 384

Now read that with s/LGBT/Black/

Now read that with s/LGBT/animals/.

Which is totally sound reasoning, if you would like to make the assertion that "LGBT people", "black people", and "animals" are all proper subsets of the group "people". Or, alternatively, that "LGBT people", "black people", and "animals" are all not subsets of the group "people". Which one of those arguments did you want to plant your flag on?

I'm not the OP, but I'll bite. Why don't you read it with s/LGBT/polygamists/ or s/LGBT/pedophiles/? Regardless of the manufactured controversy over a stupid kids Nintendo game, there will always be someone's morality and outrage somewhere being stepped on "because they weren't included". And if everyone's faux outrage over homosexuals doesn't extend to consenting polygamists, what kind of fucking hypocrites are they really being?

I mean, Good Noodly Flying Monster, can 3 or more people not enter into a consenting relationship? Why doesn't my Nintendo 3DS let me explore my money's worth of marrying my own bisexual harem??? It's blatant discrimination, I tell you!! (/sarcasm)

Comment Re:I must live in a different country... (Score 1) 1374

I hear my fellow Americans talk about needing guns in every room of the house to ward off the nightly assaults of Orc maurders but what country do these people actually live in? How many times has anyone ever personally had to fire a gun for self defense?

Trolling won't help, especially with something as flagrantly invented to distort reality.

Reality is that people know that the 2nd amendment is not, and was not, primarily intended to protect yourself from a bad guy. The primary purpose of the 2nd amendment is for the populace to defend themselves against tyranny.

Really? Please, in this age of the NSA surveillance state and free speech zones, let me know when my fellow gun owners are or are planning on defending themselves against tyranny. All I see is tacit complicity with the actual tyranny and a bunch of idiots in Nevada defending a tax avoider on Fox News.

Comment Re:Gun nuts (Score 2) 1374

There are commonly used legal/medical avenues to declare a person unfit to make life-changing decisions for themselves, to declare guardianship by others, and to likewise screen out those that are a danger to themselves and others.

How else do you think there's a legal basis for taking away grandma's car keys when her driving is a danger to everyone else on the road?

As a gun owner, I would welcome having to take a screening along with my weapons safety and firearm training classes. Especially if it meant some of the loons out there would be weeded out from gun ownership.

Comment Interest (Score 2) 405

Making an easy mode golf will surely bring people back to the expensive courses, like Reynolds Plantation resort! In fact, they should invent a throwing golf - Americans like throwing things - they could even use some sort of flattened plastic disc, to make it more aerodynamic. If only golf would be more innovative like that, people would flock to play golf!

Sarcasm aside, my friends and I never cared about how "hard" golf was. In fact, most of the charm of actually going out and playing was laughing about how bad we all were. We don't go back very often because most of us can think of 30 or 40 other things that we'd rather be doing for those 6 hour consecutive stretches on a weekend.

Comment Re:Why fear designer babies? (Score 1) 155

The assumption here is that there is no set of genes that are guaranteed to be purely negative for humankind. That's just false. There's just no reason we'd want to let somebody grow up with cystic fibrosis, for instance.

Yes, except being heterozygous for the cystic fibrosis mutation actually turns out to give resistance to cholera, in the same way that being heterozygous for sickle cell gives resistance to malaria.

The sickle-cell anemia vs. malaria case is actually unusual, and a population high in sickle-cell anemic individuals is not actually a desirable outcome.

The former is false, the latter is true. The only reason something as disadvantageous as sickle cell has existed to be passed down through the generations is, and I cannot stress this enough, malaria is such a horrible disease (and thus a good natural selector) that such a disadvantage can be outweighed by its survival advantage in heterozygous form. There is NOTHING unusual about that situation; if it was unusual 200 years ago, sickle cell as a trait would have quietly died out.

Also, if we can prevent genetic engineering, then surely we can prevent choosing the gender of children. If you can't prevent choosing the children's gender, then how do you think we can prevent other genetic engineering?

You can't. Once the Pandora's Box is open to the rich, enough money can not only get the genetic meddling done, but keep the appropriate parties quiet. But just like you don't get rid of murder by outlawing it, it doesn't mean society should give a green light to weeding out diversity from the human genome based on what popular culture believes is attractive and beneficial today.

Comment Re:Paranoia (Score 1) 155

They lead to more spying, which is what GP said but was omitted in your quote.

I omitted it because it it is true. I question the part about "more death and destruction". I am allowed to question part of a statement without questioning every singe part.

And sooner or later they'll be armed, let's not kid our selves.

Spying does not inevitably lead to armed drones, lets not be paranoid. If armed drones are ever proposed then we can deal with the proposal. That is not happening now so lets just deal with surveillance drones.

My original statement still holds "Not all government drones are bad".

Wait, what??? "If armed drones are ever proposed then we can deal with the proposal." Is this along the same vein as, when the US government gave the CIA and NSA armed drones with Hellfire missiles, there was a very public and conscientious debate about their use, when to use them, when not to use them, and who will provide oversight and transparency to the process of killing by armed drone?

I agree 100% with the grandparent poster. We'll know when the drones are armed after the trigger is already pulled.

Comment Re:Personal Drones (Score 1) 155

It amazes me how people don't understand that owning weaponry is a right that NO OTHER CITIZEN is supposed to be able to infringe. Every single adult citizen is supposed to be able to own a weapon, regardless of training or qualification. The only true qualification is to be alive. You, me, your waiter, your drycleaner, EVERYONE.

Um, no. Just like the freedom of speech is not 100% absolute, there are reasonable limits to owning weaponry. Felons, especially with violent crime histories, and people with mental illnesses rendering judgement suspect have NO BUSINESS owning firearms or gaining access to them. The regular citizenry, with a few exceptions, doesn't need to own heavy weaponry (what some people arbitrarily separate into "ordnance").

The truth is, every right, including every constitutional right, has its logical limits. What they are is up for healthy debate. But until the fringe of the gun rights crowd can mature enough to realize that yes, healthy limits do exist, they will be part of the problem, not part of the solution.

Comment Re:wouldn't matter if it weren't canned (Score 1) 396

This is a nicely sanitized story with a pro-Russian jingoistic slant, and is nearly identical to the propaganda coming out of the Putin mouthpieces. Completely missing are the brutal suppression tactics by Yanukovych and his cronies on the protesters in Ukraine, the looting of Ukraine's economy and corruption that occurred under his leadership and his puppet status to Moscow.

This is like a setpiece on Syria and Bashar al-Assad that neglects the fact that al-Assad imprisoned, tortured and killed tens of thousands of his own subjects in his quest to retain power, even before foreign extremists started supporting both sides. Oh yeah, little details like that.

Comment Re:Old proverb (Score 1) 396

BS? Diane Feinstein said "Snowden should be killed", as did at least a dozen other politicians and heads of 3 letter agencies. His trial would have been any different than any other whistle blower trial? Meaning they would be fair and impartial in both verdict and penalties. Was media blocked from broadcasting slander or printing libel statements against him so he had a chance of getting a fair trial? (Claiming a person is guilty and treasonous when the person has never been in court is slander and/or libel, go check a law book).

Those allegations are all based on verifiable facts. Facts are not BS, unless you are delusional. You on the other hand, are handing out an opinion without any factual basis. Your circular logic about him running would be laughable if it was not so pathetic and popular as propaganda.

Citation, please. Extraordinary claims... I just ran a google search on Dianne Feinstein calling for Edward Snowden to be killed, and turned up zero hits. Now I also found a ton of articles saying Feinstein and other career politicians butthurt in the scandal were calling him a criminal. But please, feel free to support your assertions.

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