Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Experts warn yearly checkups carry risks and do not reduce mortality

english.elpais.com

Post reply on HN
Print view View original

151–160 of 269 posts

Re: Experts warn yearly checkups carry risks and do not reduce mortality

#151

Post by hayst4ck »

Half the posts in this thread bring back the old SlashDot adage: The plural of anecdote is not data.

I am not sure what the point this article is trying to make is. I do not feel more informed for having read it.

It seems a populist appeal to the idea that the medical institution has no idea what it is doing. Is it good, is it bad? It doesn't matter. The end result is damaged institutional trust.

How many people would read this article and go "yeah doctors have no idea what they are doing," then go to their alternative medicine to spend $100 on a dubious "medicine"? How many people here are actually equipped to have a meaningful understanding of the information presented? Why did the author not present the institutional position or data supporting yearly checkups and why it's misleading?

As long as billionaires are able to influence people to fight about anything other than wealth disparity, they win. We are not experts, we should leave decision making to people who know what they don't know rather than to people who don't know what they don't know (us).

Re: Experts warn yearly checkups carry risks and do not reduce mortality

#152

Post by hnbad »

ghostpepper wrote: post #9

There's a similar phenomenon when you look at fetal heart monitoring for otherwise healthy pregnant women going into labour. The two options are continuous monitoring, where the monitor is left in place for the entire hospital stay, and periodic monitoring, where a nurse installs it, takes a reading, and removes it about once an hour. Common sense would dictate that negative outcomes are reduced with continuous monit…

It's an open secret that the readouts from the monitoring during labor don't really mean anything by themselves. They are mostly used to make sure something is going on and that the baby is doing okay. Theoretically you can calibrate the monitoring to have continuously comparable results but in practice there's no point. It's less about the values or the patterns and more about a general trend. But in terms of measuring the actual process, dilation trumps every other metric.

Also contractions stopping when you go to the hospital is a well-known thing literally caused by the change of scenery. This is why some midwives recommend taking the stairs: not because the elevator might get stuck but because the pelvic motion of going up stairs while very pregnant can (re-)induce the contractions. Also while being stuck in one place because of continuous monitoring can mess with labor (which is why midwives recommend pacing, squatting, etc rather than lying down), the periodic checks can also be counterproductive because they can "pause" the process.

It's good that we have modern pre-, post- and natal care available nowadays but a lot of the medicalization of the birthing process actually makes it more difficult to give birth and doctors (and lawyers tbh) tend to err on quantifiable metrics even when everything is fine and the measuring is counterproductive.

(this was written as a reply to hospitalhusband's reply which has since been deleted)

Re: Experts warn yearly checkups carry risks and do not reduce mortality

#153

Post by cmos »

bombcar wrote: post #43
ghostpepper wrote: post #9

There's a similar phenomenon when you look at fetal heart monitoring for otherwise healthy pregnant women going into labour. The two options are continuous monitoring, where the monitor is left in place for the entire hospital stay, and periodic monitoring, where a nurse installs it, takes a reading, and removes it about once an hour. Common sense would dictate that negative outcomes are reduced with continuous monit…

Also from my experience the "left in place" part is technically very challenging, because a woman in labor tends to move around quite a bit , whereas the nurse holding something against the patient for a moment is much more workable.

..and the woman can hear the heartbeat, and when it gets different it can have a closed loop affect that causes unnecessary stress.

Re: Experts warn yearly checkups carry risks and do not reduce mortality

#154

Post by _skel »

Fire-Dragon-DoL wrote: post #141

How to discover cancer early without screening though? I understand that's a rare occurrence, but you still wished for that early screening if you are the one with it

Everyone I know who had cancer (and that is a large and increasingly growing list...) found out about it because they went in to the doctor for a non-routine appointment because they felt pain, or felt a lump, or had a weird reaction to a vaccine, or whatever else. Even early stage cancer can produce symptoms, and luckily most of those people survived.

Re: Experts warn yearly checkups carry risks and do not reduce mortality

#155

Post by elevatedastalt »

prirun wrote: post #92

Personal example: my primary care physician scheduled me for a physical, including picking the date, without even asking. It just showed up on my online chart. Okay, I hadn't had a physical for a while, so I just went with it. While stopped at an intersection on the way to his office, a woman plowed into me and 2 other cars because she wasn't paying attention, and was likely on her phone. That wreck generated $45K of…

Oh, wow, I had the exact same experience (about elevated AST, ALT, not the car accident). It's got nothing to do with protein shakes, it happens when you start working out after a long break.

I went for my regular checkups and my AST ALT levels were through the roof (3-4 times the max value). The doctor ordered a few more tests, an ultrasound etc.

I was very shocked, because my levels were perfectly normal a year before that, and I had not had any major lifestyle change. I went on an extensive search and finally concluded something similar—when you start working out after a long break, the breakdown in your skeletal muscles causes ALT ALT to be released into the blood, and it remains there for 1-2 weeks. In this process I also learned that the AST / ALT ratio is diagnostic. Depending on the ratio, it could be cirrhosis, or acute hepatitis, or fatty liver etc. My ratios were consistent with the working out after a long gap scenario, further increasing my confidence.

Note that this does not happen once you work out regularly, it only happens when you start working out after a long gap.

I told this to the doctor and linked him to the papers. He didn't outright say No but his response made it look like he didn't take my suggestion seriously. I guess he was bothered that I was playing "Youtube doctor", but well.

I said I would like to confirm my theory by not working out for 2 weeks and then re-doing the tests. He also added a few more liver function tests to get more data. Everything turned out perfectly normal.

Re: Experts warn yearly checkups carry risks and do not reduce mortality

#156

Post by user3939382 »

hayst4ck wrote: post #151

Half the posts in this thread bring back the old SlashDot adage: The plural of anecdote is not data. I am not sure what the point this article is trying to make is. I do not feel more informed for having read it. It seems a populist appeal to the idea that the medical institution has no idea what it is doing. Is it good, is it bad? It doesn't matter. The end result is damaged institutional trust. How many people woul…

We can’t have faith in any of our society’s major institutions because they’re all corrupt https://youtu.be/z6IO2DZjOkY

Re: Experts warn yearly checkups carry risks and do not reduce mortality

#157

Post by elevatedastalt »

ChancyChance wrote: post #113
prirun wrote: post #92

Personal example: my primary care physician scheduled me for a physical, including picking the date, without even asking. It just showed up on my online chart. Okay, I hadn't had a physical for a while, so I just went with it. While stopped at an intersection on the way to his office, a woman plowed into me and 2 other cars because she wasn't paying attention, and was likely on her phone. That wreck generated $45K of…

Did you go back to working out and protein shakes? Because if you did, you still don't know why you are reacting that way which could be masking a problem elsewhere, and are exposing yourself to risk. There is a reason why metabolic values have "normal" ranges. Heck, if this were a JIRA ticket, I'd want a code review!

Yes, my experience was very similar, and I did A/B test it. More details here—https://news.ycombinator.com/item?id=35432067

Summary:

* Test after starting to work out after a long gap—elevated AST ALT, consistent with the research papers.

* Test after pausing working out for 2 weeks—normal levels.

* Test after working out consistently for a few months so it's no longer after a gap—normal levels.

Re: Experts warn yearly checkups carry risks and do not reduce mortality

#158

Post by jrootabega »

wyldberry wrote: post #53
sklargh wrote: post #18

I have a personal example of this. My father died largely because of his annual physical. He hated doctors, became nervous around them and thus expressed hypertension in-office. He did not have material hypertension but did defer to his physician. Over the long term, despite my best efforts, this killed him. His blood pressure medication regime was poorly managed and severely impacted his quality of life. He eventual…

I was listening to Peter Attia on some podcast and he says to essentially throw out any BP reading that didn't occur after sitting down for five minutes. In his practice they have patients measure many times a day for multiple weeks just to get a baseline point to work from. More and more i find that, at least in America, if you're talking to a GP you're just talking to a human interface of insurance approved treatme…

I did this for the doctor, and my pressure readings were much better at home, which should be no surprise. They asked me to bring in the machine to check it against their own measurements. It takes three readings a minute apart, and then does its calculations to produce the numbers. After the first cycle, the assistant wanted nothing to do with it, and started fiddling with the machine in annoyance to get it to do whatever she wanted. There was not even a discussion about it. There must have been many other sides of beef in the office that she had to hurry to poke and prod as fast as possible. And what do you know, I think that visit produced the highest blood pressure they had seen in me yet. I think that was the same visit I had to point out that their fridge with blood samples in it wasn't closed fully. The doctor made it a point to stop and ask me if something was bothering me that visit because my frustration at how bad US general practice had become was obvious.

Re: Experts warn yearly checkups carry risks and do not reduce mortality

#159

Post by [deleted] »

hayst4ck wrote: post #151

Half the posts in this thread bring back the old SlashDot adage: The plural of anecdote is not data. I am not sure what the point this article is trying to make is. I do not feel more informed for having read it. It seems a populist appeal to the idea that the medical institution has no idea what it is doing. Is it good, is it bad? It doesn't matter. The end result is damaged institutional trust. How many people woul…

[deleted]

Re: Experts warn yearly checkups carry risks and do not reduce mortality

#160

Post by [deleted] »

user3939382 wrote: post #156
hayst4ck wrote: post #151

Half the posts in this thread bring back the old SlashDot adage: The plural of anecdote is not data. I am not sure what the point this article is trying to make is. I do not feel more informed for having read it. It seems a populist appeal to the idea that the medical institution has no idea what it is doing. Is it good, is it bad? It doesn't matter. The end result is damaged institutional trust. How many people woul…

We can’t have faith in any of our society’s major institutions because they’re all corrupt https://youtu.be/z6IO2DZjOkY

[deleted]
Post reply on HN