151–160 of 277 posts
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It sounds like the bluetooth functionality is only there for telemetry.
An interesting thought would be to have a nano-lead down the arterials to the wrist, where an external telemetry relay-watch could read the signals, and have the BLE device top dermal. (apple watch) eliminating RF/BLE bullshit from talking to the pacemaker.
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> allowing for doctors to check in on their patients and replace either the batteries or the pacemakers themselves I cynically read this as "we needed to get more money out of these patients"
There’s not a single cardiac surgeon in the world who thinks he’s gonna get rich with once-every-10-years follow up appointments. We produce enough new patients to keep them all sufficiently busy.
I agree that a surgeon at a general hospital probably wouldn’t care (little financial incentive).
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You really should not. 60 beats per minute means that in ten years the leads of a pacemaker will be bent *315 million* times. That's an order of magnitude higher than we typically test fatigue resistance, and even if we were that confident about being able to produce flawless materials, there are millions of different enzymes and acids and temperature fluctuations in the body. Any one of those could impact the fatigu…
It sounds like you have quite a bit of knowledge on the subject. I had to get a pacemaker a couple years ago, and am an embedded engineer. I hope to live another 50 years at least, so this is an interesting subject for me. Maybe my cardiologist is just trying to make me feel good, but he says my leads will likely last 30-50 years. Intuitively that seems unlikely, but we'll see. It's got to be one of the most engineer…
One of my favorite learnings in school was about the "Endurance limit".
Some materials, like aluminum, will eventually fail under cyclic loading even at tiny, tiny loads. This was a big problem when they built the first passenger jets. Other materials, like steel, have a threshold at which they can be cycled indefinitely without issue.
For something like a pacemaker, I like to imagine they dialed the materials and forces to be within such a threshold so you can keep on ticking!
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I know that low-empathy privileged commenters are to be expected on HN, but I nonetheless find it impressive that such a short comment can illuminate so many biases in one go.
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The kids weren't scavengers. There are so many things we could have if we actually could somehow have faith that the required (for safety, pollution mitigation, etc.) full lifecycle was actually honored. Instead, everything is dominated by lazy jerks. The other day, I noticed my neighbor's house painter digging a hole. I said hello and asked what was up, and he said "Yes, I need to dispose of the water and paint from…
What's the recommended method of disposing of paint waste water in the Bay Area? I'd assume soil sequestration (we're not talking lead paint here, presumably) is preferable to storm drain dilution?
Paint is explicitly mentioned. SF even has free home pickup for it via Recology.
Just got me thinking: What would it take for us to get to a point where there are small, safe nuclear powered "batteries", that can supply enough electricity for a building.
RTGs have been around since the 50's and 60's: https://en.wikipedia.org/wiki/Radioisotope_thermoelectric_ge... For example Russia used them to power lighthouses in super remote parts of their coast. Space probes, mars rovers, etc. use them too.
https://www.emergencylights.net/collections/self-luminous?gc...
They aren’t generating electricity though.
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> EDIT: oh, and heart disease is the #1 cause of death in the US, while heart surgery is one of the most difficult specialties to get in to. They are absolutely never short on patients, lol. This is still relevant to his concern, but from the other end. They might be making the labor artificially scarce to increase pay.
> This is still relevant to his concern, but from the other end. They might be making the labor artificially scarce to increase pay. This is very much true. I find that a lot of people in tech seem to put healthcare on a pedestal and believe that the professionalisation and gatekeeping of the industry create a better outcome than other engineering fields. This is very much untrue, the healthcare field is in need of m…
I heard consistently that residency slots are extremely competitive and a lot of qualified candidates get passed over. The more I learn about the process the more insane it seems.
From the student perspective you go from paying to work one day and spending most your time working cases with zero relevance to your actual specialty, to raking in several hundred thousand a year.
It also seems like hospital systems seem to spend more than half their capacity either dealing with patients that don’t need to be there but there’s literally no place to send them, or patients that are too far gone and untreatable but there’s literally no place to send them.
Healthcare is like a Gordian knot of terrible policies cemented into place by trillions of dollars of government spending.
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There’s not a single cardiac surgeon in the world who thinks he’s gonna get rich with once-every-10-years follow up appointments. We produce enough new patients to keep them all sufficiently busy.
A private surgery business that specialised in pacemakers would surely care, because those 10yr repeat customers would be part of the valuation (valued like SaaS with long duration and high churn?). That would matter to a surgeon with an ownership stake on retirement. I agree that a surgeon at a general hospital probably wouldn’t care (little financial incentive).
The vast majority of pacemakers are placed by cardiologists with an additional two years of training in electrophysiology (not by cardiothoracic surgeons, who prefer to do complicated open heart surgeries and generally find things like pacemakers boring).
Contrary to the conspiratorial thinking all over this thread, medical society guidelines have scaled back the indications for putting in pacemakers time and time again, so the market has shrunk. Electrophysiologists have to make up for the lost pacemaker volume by doing newer procedures (ablations) that reimburse less per hour of work. Even then, the volume at a lot of shops isn't enough to merit full time work. A lot of graduating electrophysiologists have to take mixed electrophysiology/general cardiology jobs where less than 50% of the work is electrophysiology.
All that is to say, no, pacemakers are not a money making scheme. While there is decent money to be made, it's a shrinking market and those who got obscenely rich putting in pacemakers in the 80s and 90s have mostly already retired.
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An interesting thought would be to have a nano-lead down the arterials to the wrist, where an external telemetry relay-watch could read the signals, and have the BLE device top dermal. (apple watch) eliminating RF/BLE bullshit from talking to the pacemaker.
Being pragmatic, that sounds way worse than just having a little ceramic 2.4ghz antenna and some extra silicon potted into the device!
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Oops - I didnt realize you were same poster from other comment
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What's the recommended method of disposing of paint waste water in the Bay Area? I'd assume soil sequestration (we're not talking lead paint here, presumably) is preferable to storm drain dilution?
https://sfenvironment.org/article/household-hazardous-waste-... Paint is explicitly mentioned. SF even has free home pickup for it via Recology. https://sfenvironment.org/safe-disposal
I was curious, because I know SF has a high enough population:water ratio that stricter treatment is required, but on the other hand modern non-oil paints are relatively chemically safe (at worst, probably the off-gasing parts).