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Ticker: Don't die of heart disease

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Re: Ticker: Don't die of heart disease

#151

Post by Auracle »

puttycat wrote: post #117

I cannot judge the science in most of the article since I'm not a medical doctor. But since I have a PhD in computer science in a relevant subdomain, I can certainly judge the part where he recommends the following: > What should you do with your test results? Throw them into ChatGPT, of course! Do not count on anything coming out of ChatGPT for medical advice. Period.

ChatGPT is amazing for interpreting test results. Of course you should back it up with a doctor.

Back when 3.5 came out I gave it some information about me when I was a teenager on a condition that (multiple) doctors totally misdiagnosed. It immediately told me three tests I should have done, two of which would have diagnosed it right away. Instead, I had to deal with extreme fatigue for over a decade until I finally did research on my own and had those same tests done.

As far as test results go, right now we’re dealing with our dog having increased thirst. She’s been on prednisone for a year, and that’s not an uncommon side effect. We brought her in to the vet and they tested her and diagnosed in as stage one kidney disease, with no mention of the prednisone. I put those results and her details into ChatGPT and it told us it could absolutely be the prednisone, and told us we could use an inhaler for what we were using the prednisone for - chronic bronchitis. Our vet never offered than option. We’ll find out in a few months if she actually has kidney disease or not, but chances are it was just the prednisone.

As a bonus, the vet before this one diagnosed her bronchitis as heart failure. They didn’t run any tests, scans, etc. Just “sorry, your dog is going to die soon.” What a fun week that was.

ChatGPT is an amazing second opinion tool. Obviously you need to ask it neutral, well formed questions.

Re: Ticker: Don't die of heart disease

#152

Post by lateforwork »

Buttons840 wrote: post #58

I am not a statin skeptic--or rather, I don't want to be a statin skeptic. I've done the research and it makes sense to me, but I still feel some social and psychological pressures to reject statins. When I see that it is widely accepted that ApoB is better to measure than LDL-C, but the industry continues to measure LDL-C, but not ApoB, I wonder why. It makes me skeptical. When I see that the purpose of statins is t…

There are plenty of statin skeptics and for good reasons; see prior discussion here: https://news.ycombinator.com/item?id=45430939

Re: Ticker: Don't die of heart disease

#153

Post by kakacik »

Aurornis wrote: post #97

Going deep on biomarkers, blood tests, and debates about optimal levels is okay for some people who derive motivation from obsessing over topics, but I’m starting to notice a trend where people obsess about these things for a couple years before burning out and moving on to the next topic. The best thing you can do for yourself is to establish healthy diet and lifestyle habits that are sustainable. A lot of people wh…

Right on spot. Find a regime for body and mind that you can sustain without any significant mental effort, after some time lack of good behavior be it sports of healthy food makes one uneasy. Bonus points from getting happy from it / making it a passion, this helps a lot with coming back after some hiatus (ie injury, sickness, long travel etc.).

Personal story - I used to be super sporty, 4x gym training during work week - cardio & free weights, climbing over evenings after work, hiking/climbing/ski touring over weekends. Vacations were mostly more extreme variants of the same. Last year broke my both ankles with paragliding, one leg much worse, so took me some 8 months to be able to walk straight again, with some time in wheelchair, then crutches. All strength & stamina gone, flexibility 0, so had to rebuild from scratch and I mean deep bottom scratch from which you bounce very slowly, not some 1 month stop when things come back quicker. If all above weren't my proper passions I would have a hard time coming back to being again more active than most(sans that paragliding, took the lesson and have 2 small kids). That ankle won't ever be same but so far so good, ie managed some serious hike&via ferrata mix 2 days ago.

Re: Ticker: Don't die of heart disease

#154

Post by sixtyj »

Apes wrote: post #140
sixtyj wrote: post #112

Earlier quoted context omitted.

If there are two contradictory conclusions you should ask for the third one, independent on the previous ones.

The year is 1846, and a doctor has a radical new idea: doctors should wash their hands between performing autopsies and delivering babies! You're not sure of whether this is a good idea or not, so you ask various physicians, and the consensus is unanimous: the very suggestion is offensive, do you think doctors are unclean? A clear conclusion has been achieved.

You’re right. My comment doesn’t make sense.

Re: Ticker: Don't die of heart disease

#155

Post by Waterluvian »

I’m sensing a potentially significant misallocation of resources. My mental model is that there’s a hypothetical quantification of not just your time and money, but your anxiety, attention bandwidth, mental energy, etc.

I think, in some ways, the trick is being able to short circuit the entire journey represented by this website in favour of some form of, “I’m 40. I should be more mindful of heart disease. I should add a 30 min walk to my mornings.” And then move on with your life.

I think many cultures, but especially American healthcare culture, foment a growing background noise of constant anxieties and stressors. Life is sufficiently complex but there’s always a peddler eager to throw you a new ball to juggle (and pay for).

Re: Ticker: Don't die of heart disease

#156

Post by tonymet »

lotsofpulp wrote: post #27
tonymet wrote: post #6

Fabulous information, but lacking information isn’t the issue. The behavioral changes are obvious and well evangelized : lose weight, regular activity (walking), and if necessary, take meds. (Yes I know your marathon runner cousin who died suddenly of a heart attack, but these are still your best odds) Telling people what to do rarely fixes anything. People need dozens of impressions for those changes to sink in. Fri…

> The behavioral changes are obvious and well evangelized : lose weight, regular activity (walking), and if necessary, take meds. More specifically, it’s “change your diet and eat/drink less”, which is the hardest part. Diet’s impact eclipses regular activity, and it’s consequences build up and compound over decades.

i agree. Under-eating with baseline activity is better than overeating with excessive activity, excluding the extremes.

Re: Ticker: Don't die of heart disease

#158

Post by kqr »

kingofmen wrote: post #99

There's something I deeply don't understand about this. > I shared these results with a leading lipidologist who proclaimed: “Not sure if the lab or the primary care doc said an LDL-C of 116 mg/dL was fine but that concentration is the 50th percentile population cut point in the MESA study and should never ever be considered as normal. > It’s also important to note that, according to a lipidologist friend, an ApoB of…

I had assumed "the MESA study population" was a particularly unhealthy bunch in terms of this measurement, meaning the 50th percentile puts one in the worst half of an already bad off group.

Re: Ticker: Don't die of heart disease

#159

Post by evantbyrne »

camel_gopher wrote: post #147
evantbyrne wrote: post #52

Earlier quoted context omitted.

90 day supply of Atorvastatin costs $10. Running costs a pair of shoes.

You have to be able to get the prescription. HMOs (Kaiser specifically) will generally not provide any sort of preventative care in this area unless your numbers are very high. You can’t get access to a cardiologist unless you’ve already had an adverse event. If you can get time off work and have a PPO, you can get the preventative care.

$10 is the cash price. Your doctor diagnoses, not insurance, and you don't need a specialist to get diagnosed regardless of what your insurer wants. Even a nurse practitioner can prescribe you a statin.

Re: Ticker: Don't die of heart disease

#160

Post by portaouflop »

Flere-Imsaho wrote: post #139
Aurornis wrote: post #97

Going deep on biomarkers, blood tests, and debates about optimal levels is okay for some people who derive motivation from obsessing over topics, but I’m starting to notice a trend where people obsess about these things for a couple years before burning out and moving on to the next topic. The best thing you can do for yourself is to establish healthy diet and lifestyle habits that are sustainable. A lot of people wh…

I learnt a great trick about exercise: find a podcast or audio book that you really enjoy listening to. Here's the trick: you're only allowed to listen when you're exercising. Also with food and drink: place friction between the treat and yourself. The easiest example is to not have biscuits / alcohol in the house. Bonus tip: alcohol free beer is really good these days.

Alcohol free beer was a game changer for me. Also if I can’t avoid it alternating alcohol-containing and alcohol-free drinks.

For exercise your tip doesn’t help me at all. I hate audiobooks and podcasts so that would turn me off more from exercising. Also I want to concentrate on the exercise and not do it halfhearted.

What helped me was to realise how much better I feel after exercising - since then i kinda got addicted to it because I notice how much worse I feel after not doing it for a couple of days.

I agree on the friction. Just not having access to cigarettes is the best way for me to not smoke. I just don’t buy them and bumming one from someone else comes with a degree of personal shame for me that makes me avoid them (in almost all cases).

I naturally don’t like sweet stuff that much - however since I moved from EU to America (not US) it’s been really hard to avoid sugar. Y’all put that stuff into everything it’s crazy; I gotta watch out like a hawk and go to special stores. In Europe it was so much easier, there are always cheap sugar free whole foods available in every supermarket.

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