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

Luck based medicine: my resentful story of becoming a medical miracle

lesswrong.com

Post reply on HN
Print view View original

11–20 of 36 posts

Re: Luck based medicine: my resentful story of becoming a medical miracle

#11

Post by analog31 »

cjbgkagh wrote: post #6

Should have gone to a psychoneuroimmunologist… shame it’s such an overlooked and rare specialty; anti-histamines are often quite powerful anticholinergics, especially when combined, and will substantially perturbe autonomic function. Autonomic dysfunction is often a cause for digestive issues, plus a raft of other things. People with these problems typically also have inflammation issues so the doctor may have come t…

Ironically, finding just the right type of specialist is its own kind of luck.

Re: Luck based medicine: my resentful story of becoming a medical miracle

#12

Post by mannykannot »

arpyzo wrote: post #5

My experience with western medicine has been very black and white. Either you're completely broken and it's so obvious what's wrong with you that you barely need a doctor, or you're partially broken in which case doctors know very little and rely on experience, murky clues, and their gut. This made sense once I realized doctors know much less about the human body then they pretend to. Not only is our understanding of…

> In contrast to the author, I find joy in this.

As the author had a serious and mysterious chronic condition, I can understand her take on this.

Re: Luck based medicine: my resentful story of becoming a medical miracle

#13

Post by PragmaticPulp »

So the author was “prescribed” a cocktail of 5 supplements, found they could eat more protein afterward, and then assumed that Boswelia was the solution? Did I miss something, or did they just assume 1 of the 5 supplements was the solution?

This entire post is a good example of how post-facto reasoning can take over in the space of anecdotal medical changes. The author doesn’t even seem to realize that Boswelia is a notable anti-microbial, which is a nontrivial factor when considering gut issues and potential microbiome changes. Several supplements are potent antimicrobials against the microbiome, some on par with prescription antibiotics. I wouldn’t be surprised if the combination of 5 supplements the doctor prescribed simply nuked their microbiome from orbit and it happened to come back in a somewhat healthier combination. There is precedent for this in controlled studies, but results are very mixed.

The SlimeTimeMoldTime blog they (rightly) criticize is another example of post-facto reasoning taking over at the intersection between “rationality blogging” and medicine: We’ve known for a long time that monotonous diets like potato diets result in weight loss. It’s not magic, it’s just that potatoes are boring and bland and you’re going to eat less food if much of your diet is potatoes. Yet the rationalist community has been doing mental backflips to try to come up with a more complicated explanation for why this might be the case.

Re: Luck based medicine: my resentful story of becoming a medical miracle

#15

Post by cobertos »

That affiliate link in the article made this much harder to trust. Wonder if ChatGPT could generate articles like this, just to put some product at the center of story.

That being said, 33% of doctors I've dealt with follow a simple heuristic[1], which makes paying for those visits so much more annoying. But it is worth it when I find a specialist that legitimately ends up helping.

[1]: https://astralcodexten.substack.com/p/heuristics-that-almost...

Re: Luck based medicine: my resentful story of becoming a medical miracle

#16

Post by cjbgkagh »

analog31 wrote: post #11
cjbgkagh wrote: post #6

Should have gone to a psychoneuroimmunologist… shame it’s such an overlooked and rare specialty; anti-histamines are often quite powerful anticholinergics, especially when combined, and will substantially perturbe autonomic function. Autonomic dysfunction is often a cause for digestive issues, plus a raft of other things. People with these problems typically also have inflammation issues so the doctor may have come t…

Ironically, finding just the right type of specialist is its own kind of luck.

Double ironically; people told 'it's in your head' if they go to a psychiatrist that'll probably be the closest they'll get to a psychoneuroimmunology (PNI) specialist. Though I figure the chance of finding a good doctor to be akin to finding a winning lottery ticket on the ground.

Re: Luck based medicine: my resentful story of becoming a medical miracle

#17

Post by simonh »

PragmaticPulp wrote: post #13

So the author was “prescribed” a cocktail of 5 supplements, found they could eat more protein afterward, and then assumed that Boswelia was the solution? Did I miss something, or did they just assume 1 of the 5 supplements was the solution? This entire post is a good example of how post-facto reasoning can take over in the space of anecdotal medical changes. The author doesn’t even seem to realize that Boswelia is a…

> So the author was “prescribed” a cocktail of 5 supplements, found they could eat more protein afterward, and then assumed that Boswelia was the solution? Did I miss something, or did they just assume 1 of the 5 supplements was the solution?

The author isn’t explicit, but it seems like the pills were prescribed over a period of time, possible separately, possibly overlapping. The author describes using a spreadsheet up correlate which pills coincided with what dietary changes and identifying it that way. So it wasn’t an assumption, but it wasn’t definite either until it was properly tested.

> The author doesn’t even seem to realize that Boswelia is a notable anti-microbial

The author explains that they researched Boswelia and it’s mechanisms of action, so while they don’t explain everything they know about it in the article, assuming they don’t know basic facts about it seems unreasonable.

Re: Luck based medicine: my resentful story of becoming a medical miracle

#18

Post by spiffytech »

PragmaticPulp wrote: post #13

So the author was “prescribed” a cocktail of 5 supplements, found they could eat more protein afterward, and then assumed that Boswelia was the solution? Did I miss something, or did they just assume 1 of the 5 supplements was the solution? This entire post is a good example of how post-facto reasoning can take over in the space of anecdotal medical changes. The author doesn’t even seem to realize that Boswelia is a…

The author sounds like they methodically tested their supplement intake until they identified the one that produced the change.

The fact that the symptoms returned after they stopped taking the supplements indicates the solution wasn't a one-time microbiome adjustment.

> Back in May the timing of the miracle suggested that one of Dr. Spray-n-pray’s pills was responsible. This was more or less confirmed when I weaned off the various pills and the subtle grossness around food started to return. I could also feel growing sugar cravings. So it was important to figure out what the miracle pill was and get back on it immediately.

> I made a spreadsheet tracking the changes as best I could – when my diet changed (using grocery order data), when I’d started and stopped which pills.

Re: Luck based medicine: my resentful story of becoming a medical miracle

#19

Post by specialist »

arpyzo wrote: post #5

My experience with western medicine has been very black and white. Either you're completely broken and it's so obvious what's wrong with you that you barely need a doctor, or you're partially broken in which case doctors know very little and rely on experience, murky clues, and their gut. This made sense once I realized doctors know much less about the human body then they pretend to. Not only is our understanding of…

I think of Western doctoring (diagnosis) as running an expert system. Like a game of twenty questions. If your specific conditions aren't found in your doctor's knowledge base, too bad. Maybe try another doctor, who has different experiences, different training.

I've been lucky in that two of my doctors treated my rare conditions as mysteries, puzzles to be solved. Not much like House MD, which requires an explicit explanation. But more like "Hmmm. That didn't work. Let's try this other thing I've been reading about." Instead of summarily dismissing my experience because there was not "hit" in their knowledge base.

FWIW, in the USA, at least, the combo of fee-for-service and compensation model discourages sleuthing. (But does encourage more testing, ironically.) IMHO.

Re: Luck based medicine: my resentful story of becoming a medical miracle

#20

Post by alexvoda »

objetovoador wrote: post #10
arpyzo wrote: post #5

My experience with western medicine has been very black and white. Either you're completely broken and it's so obvious what's wrong with you that you barely need a doctor, or you're partially broken in which case doctors know very little and rely on experience, murky clues, and their gut. This made sense once I realized doctors know much less about the human body then they pretend to. Not only is our understanding of…

> Either you're completely broken and it's so obvious what's wrong with you that you barely need a doctor, or you're partially broken in which case doctors know very little and rely on experience, murky clues, and their gut. > This made sense once I realized doctors know much less about the human body then they pretend to. I find myself agreeing with this so strongly. Couldn't have put it better myself. Further - I'v…

> And there's such a strong force to silence criticism of the system

This is partly because public discourse is incapable of nuance and because often those criticizing are in fact much much worse than the system being criticized.

In the early years of the internet, we naively believed the interconnectedness of the internet would solve such things. Good will, honesty, and, proper information hygiene do not scale.

Post reply on HN