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My Left Kidney

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Re: My Left Kidney

#201

Post by refurb »

manmal wrote: post #45

> Everyone knows we need a systemic solution, and everyone knows what that solution will eventually have to be: financial compensation for kidney donors. Another solution would be to tackle type 2 diabetes, since a big amount of kidney failures is caused by that. Apparently, 1/3 of Americans are at risk: https://www.health.com/cardiovascular-kidney-metabolic-syndr... Having worked for a few years in the diabetes spac…

The GLP-1 drugs should have a big impact for type II diabetes. Interestingly Fresenius, a massive dialysis provider, has taken a beating in terms of stock price with the GLP-1 data.

That said, diabetes is a long-term disease and it's going to take a decade or two to see a measurable difference.

Re: My Left Kidney

#202

Post by DoreenMichele »

ryanbrunner wrote: post #196
DoreenMichele wrote: post #180

Earlier quoted context omitted.

I was bluntly told "People like you don't get well. Symptom management is the name of the game." I replied "It may be true that I will always be infected with something but this particular infection has to go as it's killing me." My doctor physically took a step back as if I had slapped him. I'm quite confident it's due to lack of trying. If you have zero goal of actually getting me better, please don't blame my cond…

You're both sort of wrong. Solely symptom management should not be the recommended course of action for anything short of stage 5, and there is a ton you can do to slow or stop progression in the early stages, perhaps even avoiding the need for dialysis / tranplant altogether. But as much as you say kidney disease "has to go", it won't. Reduced kidney function from chronic kidney disease is permanent, and no matter h…

I don't have a diagnosis of kidney disease. I never claimed to.

Re: My Left Kidney

#203

Post by sgt101 »

abainbridge wrote: post #122
inglor_cz wrote: post #116

Earlier quoted context omitted.

"the risk of dying from the screening exam was 1/660" For someone as smart as Scott Alexander, this is an astonishing mistake. If CTs were such death machines, we would have seen a worldwide epidemics of CT-related cancers. There is no way you can cover up such a strong signal, given that people are screened all the time. Edit: thanks for unleashing such an interesting debate. I guess the problem is in my perception.…

The paper he links to [1] broadly agrees with his statement, eg "An estimated 1 in 270 women who underwent a coronary angiography CT at age 40 will develop cancer from that CT (1 in 600 men), compared with an estimated 1 in 8,100 women who had routine head CT at the same age (1 in 11, 080 men)". 1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4635397/

I felt less compelled by the paper after reading " 1,119 " as the sample size - how the fin f they think that they can get to estimates like 1:11,080 with a sample size of 1,119 I do not know.

Going the other way: on the internets I read that there are 5 million CT scans in the UK every year. If there was a 1:10k rate of cancer from these we would see 500 fatal cancers a year. If there was a 1:600 risk then we would see 8300 cancers a year. There are 400k cases of cancer per year in the UK as it is. So, at the top end about 2% of cancer could be hypothesized as from CT scans based on these numbers however they were extracted kicking and screaming from the case notes.

There is an interesting twist on this though - the mortality of people who get CT scans is probably much higher than the mortality of people who don't as there is probably a reason why they are getting the scan. One reason I have seen for people to get a CT scan is that they have metastasizing cancer. If you have metastasizing cancer you are probably going to get radiotherapy. Now, radiotherapy doses are quite difficult to understand as there is a big difference in the way it gets absorbed and handled, but as a layperson I look at the numbers and think that radiotherapy doses seem much bigger than CT scan doses. But I don't even know how I would go about comparing them and controlling for them in the stats.

I personally would have to sit and think for a long time about how to sort the causal factors out in the stats around this, I think I would not be doing that on a sample of 1k people.

Re: My Left Kidney

#204

Post by mort96 »

mort96 wrote: post #150
eru wrote: post #134

Earlier quoted context omitted.

Iran allows paying compensation to kidney donors. You can study how they are doing. Hint: they don't have much of a wait list. > I do not like the thought of desperate people selling their internal organs to survive one bit. See https://en.wikipedia.org/wiki/Repugnant_market Do you prefer desperate people have fewer options? Especially, do you prefer taking options from people that they prefer to take?

> Do you prefer desperate people have fewer options? Yes. For an individual poor person, one could argue that the individual would be better off if they were allowed to sell their internal organs. But this isn't just about individuals, this is about societies. A society which pushes poor people towards selling their organs to survive is worse than a society which doesn't do that, in my opinion.

The extreme example would be: I think an IRL version of something like the Squid Game should be illegal, even though that means "desperate people have fewer options".

Re: My Left Kidney

#205

Post by taylorius »

eru wrote: post #163
bowsamic wrote: post #148

Earlier quoted context omitted.

It does not take a genius to understand how bad it looks to buy a castle in the UK

The previous owners were using it as a single family home (according to Wikipedia). Make of that what you will. It's definitely a bigger 'waste' of resources than using it for conferences.

No-one cares about the waste of resources though. A castle is a symbol of power. It's the combination of lots of big, bold ideas, lots of public speaking, giving money out, THEN buying a castle. People begin to worry that these people want to rule them.

Re: My Left Kidney

#206

Post by astura »

hcks wrote: post #198

The whole benefits of kidney donation to a stranger comes down to an effective donation of $10,000 using the same logic. How is it effective when he could have probably raised 2 times that amount by working in place

He addressed this

>But it only costs about $5,000 - $10,000 to produce this many QALYs through bog-standard effective altruist interventions, like buying mosquito nets for malarial regions in Africa. In a Philosophy 101 Thought Experiment sense, if you’re going to miss a lot of work recovering from your surgery, you might as well skip the surgery, do the work, and donate the extra money to Against Malaria Foundation instead.

>Obviously this kind of thing is why everyone hates effective altruists...

>It starts with wanting, just once, do a good thing that will make people like you more instead of less. It would be morally fraught to do this with money, since any money you spent on improving your self-image would be denied to the people in malarial regions of Africa who need it the most. But it’s not like there’s anything else you can do with that spare kidney.

>Still, it’s not just about that. All of this calculating and funging takes a psychic toll. Your brain uses the same emotional heuristics as everyone else’s. No matter how contrarian you pretend to be, deep down it’s hard to make your emotions track what you know is right and not what the rest of the world is telling you

Re: My Left Kidney

#207

Post by stuartjohnson12 »

JacobDotVI wrote: post #200
ryanbrunner wrote: post #181

Earlier quoted context omitted.

One small advantage of kidney donation is that it comes with lifetime screening without some of the gatekeeping normally attached to that. I dunno exactly how it works in the US, but here in Canada you can't just really demand blood tests purely for screening reasons, there needs to be a reason for it. But if you're a donor, your transplant clinic will insist on periodic screening both to monitor for GFR dropping as…

Some screenings have gone direct to consumer in the US. Fairly easy to purchase online, make an appointment, then show up for a quick collection. https://www.ondemand.labcorp.com/ https://www.questhealth.com/sale Quest is even running a sale right now on some tests!

There are also at-home versions like this YC company https://siphoxhealth.com (full disclosure, I have a conflict of interest here)

Re: My Left Kidney

#208

Post by Waterluvian »

ryanbrunner wrote: post #199
caust1c wrote: post #53

Earlier quoted context omitted.

Just imagining a surgery gone sideways situation and they just decide to trade the one still in with the one they just took out. (Not even sure this is an option, orientation and all, just imaging)

Transplanted kidneys generally go lower in your belly than your "native" kidneys and they aren't swapped, the original kidneys are left in and they add another. Anyone who's had a transplant most likely has 3 or even 4 kidneys inside them.

This is probably the most concrete “I had no idea it worked that way” this year for me. So you can collect kidneys!

Re: My Left Kidney

#209

Post by pas »

mort96 wrote: post #117

This was an enjoyable read. The solution of giving people money to donate their kidneys is terrifying to me however. I do not like the thought of desperate people selling their internal organs to survive one bit. Of course, if inequality was dealt with and nobody was desperately poor, it would be a different question. If everyone had enough money to comfortably get by, and the extra $100,000 from a kidney donation wo…

What about lazy people? I'm not desperate at all, just regular depressed, desensitized, uncaring, unmotivated, due to all the shit going on constantly in this nice fancy interconnected world, blablabla.

Re: My Left Kidney

#210

Post by ryanbrunner »

DoreenMichele wrote: post #84
woodruffw wrote: post #64

I know a few people who have donated kidneys (both to friends and strangers), and I find it admirable (and supererogatory). At the same time, I think this post demonstrates a kind of selective unawareness that I’ve seen members of the EA community demonstrate. A significantly less charitable summary of Scott’s situation is “our prospective kidney donor is newly-married high-stress professional with a history of SSRI…

He was officially rejected due to mild childhood OCD. If you take that stated reason at face value, his rant about it is completely reasonable. If their "real reason" is more like your description, perhaps they should have found a way to try to say that.

I know at least for directed organ donation transplant teams will frequently lie - for instance, if a donor backs out, the clinic will default to telling the recipient it isn't a match rather than them backing out. I wonder if there's similar things going on here.
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