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Comment: Re:How do I get one? (Score 1) 59

A friend, who is a sleep apnoea specialist, said the most effective treatment was to lose 5-10kg of weight. That takes some weight of the lower jaw, so it doesn't hang so low when sleeping -> less loud noises/shitty partners/shorter lifespan.

I used to snore. I lost 5kg in weight, drank a bit less alcohol, and my snoring disappeared, except when really tired.

I was part of the biggest demographic of snorers. Yes, there are those that need better masks, but really, most are too fat or drink too much.

Yes, I applaud a better mask, it is needed. But really, most need a simpler fix, They are too fat.

Yes, you fix the fatty snorer with a gizmo, but there is the increased risk of diabetes, heart attacks, osteoarthritis, etc etc etc, which are not addressed. Focus on what is the real problem, not fixing a small part of the problem.

Comment: Re:Regulation of currency - 2 issues (Score 4, Insightful) 240

by meander (#46386729) Attached to: MtGox Sets Up Call Center For Worried Bitcoiners

1) bitcoin value goes up and down, so does everything else. Live with it or dont use it.

2) Storing your bitcoins on a server owned by someone else is like giving your cash to someone you dont know. Maybe it will still be there, maybe it wont. If you are on Linux, or Windows or OSX, use a client like electrum (electrum.org). You can store the bitcoin wallet on your own computer, without relying on some not so trusted intermediary. You do do backups dont you?

Yesterday I transferred most of my bitcoin stash (~$500 Aussie) into my own wallet on my own computer, and backed it up elsewhere.

The bitcoin is now safe, the value of it may change up and down. Bit like owning shares, isn't it?

Comment: Re:Child porn, think of the children, blah blah bl (Score 1) 195

by meander (#46089553) Attached to: FBI Has Tor Mail's Entire Email Database

Before this became an issue, it was, or appeared to be, much less of a problem. Most parents had explicit photographs of their children. And I just don't see that as a problem.

At my sons' 21st birthdays, among the many photos shown, were several of them in the bath, or in the backyard under a sprinkler, with genitalia showing. They were 1 or 2 at the time. These were shown simply to amuse the crowd. My sons were certainly not upset, I doubt anyone in the crowd was upset. I would bet serious money that no one present felt these photos were pornographic in any way.

Two bricks to the testicles of paedophiles would not upset me. Innocent photos of my kids being labelled as pornographic does.

Comment: Re:supplementing the diet of well-nourished adults (Score 1) 554

Ok, you eat junk food, and add vitamins, in the hope you now have a 'balanced' diet.

You are assuming that vitamin supplements contain all the goodies you need, on top of junk food.

The catch is, we really don't know about all the good stuff in veggies, beans/pulses, fruits. Assorted veggies lower your risk of cancer, most help you poo well, which also decreases your cancer risk. What are these substances? We don't know yet. Are they in multi vitamin preparations? That's easy to answer. No, because we don't know what they are yet.

We have a million years of eating an omnivore diet, our gut is designed around it

What is more important? Convenience, or your long term health? Make your own choice.

Comment: Re:They are scared (Score 1) 670

by meander (#45629325) Attached to: Diet Drugs Work: Why Won't Doctors Prescribe Them?

That is a terrible situation, but the physics is still the same: energy in versus energy out. Any surplus is stored. It is still finding an exercise she can do a little more, and finding away of getting a few less calories. The tabs do help, but really only for several months.

"If I take the tabs and lose some weight, then I will be motivated to stay trimmer". That sometimes works, and I confess to being surprised when it does. But sadly not that often.

Sickness really screws with the ability to do exercise. Keep trying every sort of exercise till she finds one that she can do long enough to burn some calories off. I wish you well.

Comment: Re:Perhaps physicians are just sick of the BS (Score 1) 670

by meander (#45626481) Attached to: Diet Drugs Work: Why Won't Doctors Prescribe Them?

Never been sued, and unlikely to happen. I tell them these drugs will work, for awhile only. I describe the side effects. If they get them, well stop taking them for christ's sake!. A couple days later the drugs are out of their system.

I understand that reality and my patients do as well. Its folk who cant lose weight, and find psychopathic lawyers who will blame someone else, for a big fee, that screw with the system. That gets into the news, but it is really very rare. I don't have any colleagues who have been sued over this, in 30 years.

Comment: Re:Simple.... (Score 1) 670

by meander (#45626391) Attached to: Diet Drugs Work: Why Won't Doctors Prescribe Them?

In my primary physician cohort, now 30 years out, about a third are very active in keeping up to date, a third meet statuary requirements by doing assorted online courses, and I worry about the other third, who get by doing mickey mouse courses that get them over the line.

Pick who you see. Most, even the out of date, are fine for most conditions, but some are better for when the going gets tough.

Comment: Re:They are scared (Score 5, Interesting) 670

by meander (#45626343) Attached to: Diet Drugs Work: Why Won't Doctors Prescribe Them?

Nah, as a doctor (in Australia, but i suspect most places are the same), we prescribe them only when a patient goes on & on, "but honestly, I dont eat much...", especially when the waiting room queue is getting longer.

We know they work, for a few months, before becoming less and less effective.

I'm guilty, I prescribe them to turn off a patients demands and get them out of my room, knowing they will see that the response is poor after the first few months.

Eat less, do more. That is reality, everything else is bullshit, or very temporary.

After 3 or 4 months, when the drugs stop working, some are ready to face reality. Those I can work with.

Comment: pills work, but only short term (Score 5, Interesting) 670

by meander (#45626241) Attached to: Diet Drugs Work: Why Won't Doctors Prescribe Them?

As a primary care physician, I gave in years ago. I now prescribe assorted appetite suppressants whenever some one asks me, it saves me lots of arguments, and a lot of time.

However, I get them back monthly for weigh ins. The drugs work great for a couple months, losing 4~8kg a month, then tapering off to nothing. Folk then realise that this is not a wonder cure.

The only stuff that works long term is eating less +/- exercising more, or surgery to shrink your stomach (actually the latter works pretty well, better than pills long term, in my experience. little change out of $10K, but probably worth it)

Pills are short term appetite suppressants. The following year, you are back to your previous weight, but your wallet is much lighter. Look to advice that you already know about for long term losses.

Comment: Re:Kind of agree... (Score 1) 566

by meander (#36062456) Attached to: Doctors Are Creating Too Many Patients

Yep, I get tons of folk coming in asking for miracles. "How do I stop getting older?" sums up a lot of them. They want an (unavailable) miracle, but they use up my time. Should I not charge them?

My car mechanic, has worked on several of my kids cars. Sometimes he says, "this car is stuffed". I pay him for his time to work that out.

As a GP, folk pay for my time. I mostly can help in some way, but not always. If someone comes with a crazy stupid request, like can you regrow my lost leg, should I forfeit any payment when I spend half an hour saying why I cant do it? Basically, if you use my time, why shouldnâ(TM)t you pay for it.

Comment: predicting those at risk doesnt help much (Score 2) 341

by meander (#35665492) Attached to: California Healthcare Provider Wants Illness-Predicting Algorithm

The commonest disabilities in the western world are heart disease, stroke, diabetes, and multiple arthritis from being too heavy for your poor bones to handle.

I'm a GP doctor; as folk walk in the door, it is usually obvious who is going to be at risk for future problems. They are fat, overflowing my poor abused seats, they groan as they stand up, they are obviously unfit. As a added bonus, I can often smell the cigarettes on their breath.

Does knowing who is at risk help? Sadly, all too often it doesnt.

Lazy fat slobs will on average die considerably younger of way too many diseases, and I have not even mentioned chronic crappy disabilities like back pain, hip pain, knee pain. I pride myself that I turn a few of these folks to the bright side of eating a bit better, exercising a tad more, and thus living longer and actually enjoying those healthy extra years.

You don't need an algorithm to work out who is at risk of future disease, it is bloody obvious (can I have my $3M now?). The problem is getting these fat, unfit folk to realise there is more to exercise than driving to buy their next greasy pizza.

Oh! they deliver now as well...

Comment: end of life medicine is expensive (Score 5, Interesting) 651

by meander (#31388488) Attached to: Lessons of a $618,616 Death

In Australia, the last time I looked, around 90% of the lifetime medical expenses is spent on the last year of life. This has been true for decades.

You think you are doing good stuff, but all too many suffer and die. As a GP, my role is to keep folk alive. If I was a complete rationalist, I would work out some way of stopping useless treatments, but unfortunately that is usually only obvious in retrospect.

I counsel folk on the pros & cons of cancer treatments.

Sometimes it is obvious you are flogging a dead horse, and really they should pull out and enjoy their last days in comparative health, without the misery of chemotherapy et al, with the horrible side effects, and before you recover, the cancer catches up to you & you die in continued misery. I kept one of my mates out of lung cancer chemotherapy (in this case there really was no chance), and he enjoyed his last few good months without being stuffed by chemo. His family still thank me years later.

Then there are the less obvious cases, where the therapy may help, but usually just adds to life's burden of misery, worst just before they die.

Then there are the successes. They are wonderful, but not that common.

Sure, some guys making chemo drugs make a lot of dollars, but what drives most medicos is that we care, and we are not very good at pulling back when things are hopeless, because sometimes we succeed.

Comment: Why would anyone want to use lousy software? (Score 2, Interesting) 294

by meander (#28464543) Attached to: IT and Health Care

However, the biggest stop to systems like this is the medical staff. Doctors seem to think they're above having to enter medical details - as it's mere clerical work (I've heard: "I didn't spend years at med. school, just to be a secretary") and they, personally, don't gain anything from a system such as this. Until somoeone gieves the profession as a whole a kick up the rear, this kind of prima-donna attitude will prevail.

I speak as a general practitioner of many decades, and I've been playing with computers since the early 70's. The main reason medical records software is not accepted is that it sucks.

My 24" screen holds far less information than a bunch of scribbled A4 pages. Time is what I lack, and scrolling through pages & sections on a screen is just not very efficient.

Yes, there are some great aspects in most of the software I have used over the last decade, but as far as being a place to store info that I want to easily access & collate later, all too often it is too bloody slow & awkward.

Except for one feature of electronic records, I would go back to pencil & paper.

The only really successful feature was the first; writing scripts & recording the fact that a script was written. In the 'old' days, you would write a script, then the phone would ring, on hanging up, you forgot to record what you had just prescribed, leading to problems down the track. Software to prescribe & automatically store a record of that transaction has been fantastically useful for both myself & the patient.

I have sat here for some 10 minutes, and the only other feature I like is that my notes are more legible to me down the track. As a computer nerd, I want to love these systems, but so far they are not very good.

Comment: Re:A rant (Score 1) 565

by meander (#27858207) Attached to: Debian Switching From Glibc To Eglibc

> A...Goddamn people, I swear we are getting as blase about fixing bugs as a Microsoft shop. There is no such thing as a good bug, a less important bug, etc.... ?

Try Debian Linux. There are 3 main flavours.

1) unstable - pretty much the latest software, has bugs, can crash.

2) testing - lasted in 'unstable' for awhile & survived. is pretty good for most desktops, rare crashes, but fairly up to date.

3) stable - tried and tested. stable, but usually an older version. use it when your system MUST work.

You can pick your own trade off between stability & the latest software. Personally, most of my system is 'testing', with a few favored applications from 'unstable' for the latest features. If they crash, you can always go back to the less feature full, but more stable option.

You know, the difference between this company and the Titanic is that the Titanic had paying customers.

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