Ticker: Don't die of heart disease • Hacker News Board

Re: Ticker: Don't die of heart disease

#281

Post by lotsofpulp » Sat, Nov 08, 2025, 10:40 PM UTC

giardini wrote: post #259

lotsofpulp wrote: post #43

Earlier quoted context omitted.

Lentils/legumes are cheap. There is probably no better bang for the buck. Yogurt is also cheap.

Funny you should use the word "bang". My last experiment with lentils years ago began one evening with 3 excellent bowls of very tasty lentil soup and ended slowly with 2 days' worth of "bangs", quickly followed by ostracism by my house buddies. So bad!

lol, you probably just need time for your gut bacteria to adjust. My family makes lentils for at least one meal almost every day.

Re: Ticker: Don't die of heart disease

#282

Post by a1studmuffin » Sat, Nov 08, 2025, 10:40 PM UTC

btilly wrote: post #235

mac-mc wrote: post #82

Earlier quoted context omitted.

If you fix it without statins through better lifestyle and diet, that is the preferrable route. As to why medicine is like this, it's because it's conservative, usually about 17 years behind university research[0], and doctors are shackled to guidelines in most health systems or risk losing their licenses. It isn't a coincidence that the article author had his out-of-pocket concierge doctor tell him the more up-to-da…

I have an objection to the "better lifestyle and diet" approach. Sure, it is absolutely true that better lifestyle and diet has a huge effect. However it is absolutely certain that the vast majority of people who are told to improve their lifestyle and diet, won't. The result is doctors giving advice that they know won't be followed. And thereby transferring potential fault from the doctor to the patient, with no imp…

Your health is ultimately your own responsibility - it's your body. You have free will, and your appetite for risk is yours alone. You can choose to ignore expert advice and refuse to wear a seatbelt, skip your rehabilitation exercises, invest all-in on crypto, or smoke cigarettes. None of this responsibility should fall on the expert if they communicated the risks clearly.

Re: Ticker: Don't die of heart disease

#283

Post by aucisson_masque » Sat, Nov 08, 2025, 10:44 PM UTC

> I experienced this repeatedly. We were admitted to the hospital for over a week when my daughter contracted viral meningitis (the scariest experience of my life). Even while working with incredible infectious disease doctors, I still had to fight and constantly remind people what the next steps were during our admission. Nobody is watching over you - it’s your job to organize things and ensure they’re on track. I had to coordinate between the infectious disease departments and neurology departments and make sure the people doing the lumbar puncture on my 9-month-old daughter weren’t just residents practicing on my child but experts who had conducted the procedure countless times before. You must Advocate for yourself and the ones you love.

Don't know why his behavior wasn't noticed more in the comments but he's absolutely entitled.

Hospitals and everything have limited resources, by being the asshole who request things to go fast for him and only have the best of the best to practice on his daughter, he just deprived someone else daughter from good care.

This is selfishness, unless the nurses and doctors were napping, he shouldn't have that kind of behavior detrimental to everyone else. I couldn't read further what he got to say but, coming from this man, i don't see how it could be interesting or useful.

I don't have anything to prove it but the whole thing smell fishy, when he goes to these 'concierge doctors', of course they are going to find things that are not right and were 'missed' by his regular doctor. That's literally their business.

if you went there and you were told 'nop, everything is fine. Keep doing what you do', you would go back to your GP and forget about it. But if he frightens you with bloodwork that show 'not optimal' in big red, tells you how wrong your gp is and how you should listen to him, you're going to think this guy know so much more and deserve my money. It's business.

I trust the national health guidelines: eat healthy, do at least 30 min of activity per day and lift weights.

Everything else feel like nuisance, especially coming from folk like that.

Re: Ticker: Don't die of heart disease

#284

Post by kelseyfrog » Sat, Nov 08, 2025, 10:47 PM UTC

a1studmuffin wrote: post #282

btilly wrote: post #235

Earlier quoted context omitted.

I have an objection to the "better lifestyle and diet" approach. Sure, it is absolutely true that better lifestyle and diet has a huge effect. However it is absolutely certain that the vast majority of people who are told to improve their lifestyle and diet, won't. The result is doctors giving advice that they know won't be followed. And thereby transferring potential fault from the doctor to the patient, with no imp…

Your health is ultimately your own responsibility - it's your body. You have free will, and your appetite for risk is yours alone. You can choose to ignore expert advice and refuse to wear a seatbelt, skip your rehabilitation exercises, invest all-in on crypto, or smoke cigarettes. None of this responsibility should fall on the expert if they communicated the risks clearly.

What if you have an intrinsically lower ability to perform temporal discounting?

Re: Ticker: Don't die of heart disease

#285

Post by stefantalpalaru » Sat, Nov 08, 2025, 10:49 PM UTC

[dead]

Re: Ticker: Don't die of heart disease

#286

Post by mceachen » Sat, Nov 08, 2025, 10:52 PM UTC

aucisson_masque wrote: post #283

> I experienced this repeatedly. We were admitted to the hospital for over a week when my daughter contracted viral meningitis (the scariest experience of my life). Even while working with incredible infectious disease doctors, I still had to fight and constantly remind people what the next steps were during our admission. Nobody is watching over you - it’s your job to organize things and ensure they’re on track. I h…

You're conflating advocacy, which indeed he is entitled to, with how the hospital is allocating resources and if and how they apply competent resources.

Life or death procedures aren't a time for "you get what you get and don't have a fit."

Re: Ticker: Don't die of heart disease

#287

Post by pcl » Sat, Nov 08, 2025, 10:54 PM UTC

aucisson_masque wrote: post #283

> I experienced this repeatedly. We were admitted to the hospital for over a week when my daughter contracted viral meningitis (the scariest experience of my life). Even while working with incredible infectious disease doctors, I still had to fight and constantly remind people what the next steps were during our admission. Nobody is watching over you - it’s your job to organize things and ensure they’re on track. I h…

I think you really pretty fundamentally missed the point of what he's saying. Perhaps you've never had to confront the full brunt of the bureaucracy of a large-scale medical provider.

If you've got a serious condition, you really do need to have a patient advocate, whether that's yourself or a family member or someone you're paying to fulfill the role or some combination thereof. The medical systems I've encountered for non-trivial care (US HMO, US PPO, Belgium, Norway) just aren't designed for holistic patient care. Each department does their own thing, and it's just luck if there's someone watching over the whole process from the individual patient's standpoint.

Perhaps you took exception to the comment about looking for an expert instead of a newbie (a resident, in the text) working on the author's 9-month-old. One could argue that that's a different issue than the general need for a patient advocate. Fair enough. But if I were watching out for my 9-month-old, I'd definitely want to ask about the track record of each of the doctors in the room. I mean, sure, new trainees need to practice somehow and all, and there's a tragedy of the commons there. But I certainly wouldn't brush someone off as "absolutely entitled" just because he wants the best care he can get for his 9-month-old.

Re: Ticker: Don't die of heart disease

#288

Post by aucisson_masque » Sat, Nov 08, 2025, 10:58 PM UTC

mceachen wrote: post #286

aucisson_masque wrote: post #283

> I experienced this repeatedly. We were admitted to the hospital for over a week when my daughter contracted viral meningitis (the scariest experience of my life). Even while working with incredible infectious disease doctors, I still had to fight and constantly remind people what the next steps were during our admission. Nobody is watching over you - it’s your job to organize things and ensure they’re on track. I h…

You're conflating advocacy, which indeed he is entitled to, with how the hospital is allocating resources and if and how they apply competent resources. Life or death procedures aren't a time for "you get what you get and don't have a fit."

Hospitals are full of 'life and death' situation. If everyone were to behave like that, things would stop working or be severely slowed because you can't work correctly when you got that guy breathing on your neck constantly. You lose time answering to load of demands from people getting angrier and angrier because they feel that they don't get the care they need. That makes you angry. Other people are getting less attention, they get angrier.. Etc etc.

I believe you have the right to say it when things are not right, but there is a fine line between that and the behavior he described.

And he wrote that he went to an expensive hospital, this isn't some low tier hospital filled with under qualified, under staffed personals.

Re: Ticker: Don't die of heart disease

#289

Post by nradov » Sat, Nov 08, 2025, 11:01 PM UTC

mac-mc wrote: post #82

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…

If you fix it without statins through better lifestyle and diet, that is the preferrable route. As to why medicine is like this, it's because it's conservative, usually about 17 years behind university research[0], and doctors are shackled to guidelines in most health systems or risk losing their licenses. It isn't a coincidence that the article author had his out-of-pocket concierge doctor tell him the more up-to-da…

There is virtually zero chance that a doctor will lose their medical license for diverging from the from the usual clinical practice guidelines around statins. Check the state medical board disciplinary records.

But if they're employed by a health system and fail to follow company policy then yes, they could be fired.

Re: Ticker: Don't die of heart disease

#290

Post by zzzeek » Sat, Nov 08, 2025, 11:01 PM UTC

btilly wrote: post #235

mac-mc wrote: post #82

Earlier quoted context omitted.

If you fix it without statins through better lifestyle and diet, that is the preferrable route. As to why medicine is like this, it's because it's conservative, usually about 17 years behind university research[0], and doctors are shackled to guidelines in most health systems or risk losing their licenses. It isn't a coincidence that the article author had his out-of-pocket concierge doctor tell him the more up-to-da…

I have an objection to the "better lifestyle and diet" approach. Sure, it is absolutely true that better lifestyle and diet has a huge effect. However it is absolutely certain that the vast majority of people who are told to improve their lifestyle and diet, won't. The result is doctors giving advice that they know won't be followed. And thereby transferring potential fault from the doctor to the patient, with no imp…

> Sure, it is absolutely true that better lifestyle and diet has a huge effect.

not for me. My cholesterol was hovering in the high 200's, then finally hit 300 and I completely freaked out, radically changed my diet, and lost 22 pounds (from 180 to 158).

What did my high cholesterol do ? It did absolutely nothing. ticked down to like, 280.

So I'm on the statins. my total cholesterol went from high 200's to about 150 in a month and was impacting my liver function. so we reduced the statins to a very low dose (5mg three times a week, crazy low). My total cholesterol hovers around 200 now. My cardiologist tells me that the conventional wisdom of "diet and exercise" is almost entirely disproven to have any meaningful effect on lipids these days (though i havent researched deeply).