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The Uselessness of Phenylephrine

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Re: The Uselessness of Phenylephrine

#491

Post by nradov »

Raineer wrote: post #349
travisathougies wrote: post #159

Earlier quoted context omitted.

You seem to be under the impression that there is some 'advanced technology' out there that will magically solve your problems that the US fails to have. In my experience, many people have a quasi-religious belief in the capability of modern medicine to perform what would otherwise be called a miracle. This belief is typically held without any evidence whatsoever. In reality, there are a plethora of conditions, some…

"This is why things like 'evidence based' medicine is so dangerous -- we don't have evidence for the vast majority of impactful conditions, simply ignoring patients with these conditions is not a workable solution." Citation needed.

What kind of citation are your looking for? It's just obvious to anyone who works in the medical field. There are only evidence based treatment guidelines for a minority of conditions, and those often don't account for individual variations between real patients. So physicians often have to resort to trial and error in order to find an effective treatment.

Re: The Uselessness of Phenylephrine

#492

Post by grog454 »

LorenPechtel wrote: post #434
grog454 wrote: post #384

Earlier quoted context omitted.

I think you are right that there is a natural and understandable psychological resistance to a data-based evaluation system. I understand that the doctor may realize something about the patient that will lower his/her chances of success. I'm arguing that a sufficiently comprehensive system would take in to account whatever that doctor realized (and perhaps much more) and compensate for it when determining expected ou…

This assumes a level of knowledge that simply doesn't exist. A simple illustration: I have medical issues with no meaningful diagnosis, despite seeing many doctors. If the medical community can't figure out what's wrong, how can they have an understanding of all the relevant factors in determining risk?

> I have medical issues with no meaningful diagnosis, despite seeing many doctors.

This isn't directly related to your point, but why is this even the norm? Why are you going from human to human seeking answers to some arcane mystery like you're on a Skyrim quest.

Imagine a system where you wouldn't need to see any doctors. You would type in all of your symptoms as accurately as you can with as much detail as you can, perhaps with a timeline, and as output you'd get the most likely causes (a diagnosis). Maybe that system would even have your medical history (and that of other people and related diagnoses) to better predictions.

It seems to me that a system like this would be significantly better than going to a couple of humans that are arbitrarily local to you and asking them to figure it out. It is slowly improving all the time just in the form of Google and WebMD. Even before 2010 I accurately diagnosed myself with Bell's palsy with the internet and the doctor begrudgingly asked how I had made that diagnosis. Confirmation from the human doctor was nice but redundant.

Re: The Uselessness of Phenylephrine

#493

Post by nradov »

sterlind wrote: post #377
ipaddr wrote: post #318

Earlier quoted context omitted.

This is the reason why the US system is better than Canada. In Canada you can't shop around and need referrals for specialists.

I think you can shop around in Canada, if you have private insurance. the universal healthcare system is just a baseline, to keep people from dying on the street after medical bankruptcy. many jobs offer supplementary health insurance as a benefit. the US just uses ERs as an infinitely shittier but equally costly version.

Wealthy Canadians tend to just come to the US in order to skip the waiting lines.

Re: The Uselessness of Phenylephrine

#494

Post by throwaway684936 »

astrange wrote: post #288
joecool1029 wrote: post #150

Phenylephrine does have one use that the author missed: It's used in ophthalmology to dilate the pupils before eye exams. On the topic of other use case medications, I used to take Sudafed (the real pseudoephedrine kind) during allergy season for a few weeks each year and noticed my productivity skyrocketed during that time, when I normally had issues context switching. Eventually I narrowed it down to taking Sudafed…

Bit disappointing that everyone starts commenting about amphetamines on a post about Sudafed working the same way as Strattera, which isn't a stimulant. Though him telling people Strattera has no side effects hopefully didn't surprise anyone when they went on it, it feels (literally) like being kicked in the stomach and can make you quite nauseous.

>Sudafed working the same way as Strattera

Well I have (currently) unmedicated ADHD and pseudoephedrine never did a thing for me besides clear my sinuses, so it's good to know beforehand that trying Strattera will be useless. My problem must be more dopamine and less so norepinepherine.

Re: The Uselessness of Phenylephrine

#495

Post by grog454 »

sxg wrote: post #405
grog454 wrote: post #371

Earlier quoted context omitted.

Are you aware of any attempts to use machine learning in medical analysis and outcome prediction? I feel like this is one of the few applications where it could shine. I have no formal training in data science, but everything I've read so far seems to indicate that noisy and unreliable data is not an insurmountable problem. All of this talk about how "hard" the statistical analysis is, is strange to me. Maybe "advanc…

Before you can even do the statistical analysis you suggest, you need large amounts of high quality data—which we don't have. One place where the US (and the world?) gets data privacy right is in healthcare, but unfortunately that also means it's nearly impossible to create the data sets we need to do the statistical analysis you want. Institutions face severe penalties for wrongfully sharing patient data, so most op…

> If the model is trained on data from Colorado, it will underdiagnose Lyme disease in patients from New England (high false negative rate). The only way I know to overcome this problem is to create even larger data sets, but this just isn't possible with data privacy laws.

My understanding is that high dimensionality in the domain is exactly where ML excels (so add location as an input), and that is exactly what a medical diagnosis involves. Perhaps the legislation will get there one day.

Re: The Uselessness of Phenylephrine

#497

Post by hedora »

ipaddr wrote: post #416
ionicgiraffe wrote: post #397

Earlier quoted context omitted.

I would even say that any person of any country with enough financial resources could afford and get the best treatment in whatever country of the world would happen to be offered.

That involves flying to the US in many cases

And flying out of the US in most cases.

Re: The Uselessness of Phenylephrine

#498

Post by skyechurch »

fluoridation wrote: post #418
slowmovintarget wrote: post #312

Earlier quoted context omitted.

After going nearly a year without taking painkillers of any kind (not an aspirin, ibuprofen, or acetaminophen dose), I took some Tylenol for a bad headache, and it worked far better than it had ever worked for me before. Granted, I've had to learn to put up with a lot more constant low-level pain in my day-to-day life. But I think that's a reasonable trade off for choosing between cooking my kidneys (aspirin, ibuprof…

>After going nearly a year without taking painkillers I find this pretty shocking. Is this how people normally take painkillers, would you say? Speaking for myself, I normally go for years without taking anything.

People with chronic pain do what they have to do to get through the day.

Re: The Uselessness of Phenylephrine

#499

Post by thehappypm »

JohnTHaller wrote: post #308
thehappypm wrote: post #294

I need a tl;dr: what medicine should I take if I’m congested??

pseudoephedrine. The ingredient in Sudafed, Nyquil, etc that actually works. You'll usually need to go to the pharmacy counter to get it and show ID. They track how much each person gets because some folks were using it to make meth a while back. The replacement in the OTC Sudafed, etc out one the shelves, phenylephrine, doesn't work.

Thank you!

Re: The Uselessness of Phenylephrine

#500

Post by hedora »

ipaddr wrote: post #415
sterlind wrote: post #377

Earlier quoted context omitted.

I think you can shop around in Canada, if you have private insurance. the universal healthcare system is just a baseline, to keep people from dying on the street after medical bankruptcy. many jobs offer supplementary health insurance as a benefit. the US just uses ERs as an infinitely shittier but equally costly version.

You can't book an appointment directly with a specialist. You can't even shop around for a family doctor. You have to sell them accepting you as a patient. With that power inbalance you better follow what they suggest and avoid questioning too much or you won't have a doctor.

I've had the same experience with non-HMO coverage in the US.

With HMO's, you're guaranteed someone will be assigned to you. With traditional insurance, there's a big labor shortage, and there are often <= 1 doctors accepting patients in some towns.

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