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

Google almost convinced me to spend $400 on useless laser treatments

blog.tjcx.me

Post reply on HN
Print view View original

291–300 of 438 posts

Re: Google almost convinced me to spend $400 on useless laser treatments

#291

Post by bryanlarsen »

FollowingTheDao wrote: post #234
bryanlarsen wrote: post #226

Earlier quoted context omitted.

Lupus is really hard to diagnose. There's a reason that ends up being the diagnosis on pretty much every episode of House M.D. Doctors generally see 6 patients an hour, and have 5-7 minutes of paperwork per patient. The remaining 3 minutes gives enough time to diagnose the obvious, but not much else.

It is not hard to diagnose once you eventually get to a person that can diagnose it. You said it yourself. It is not about difficultly, but time spent with the patient. But I literally showed my doctor the cutaneous lupus in my ear and she said "Oh, some people just get gunk in their ears" and would not send me to a rheumatologist. The slow diagnosis is because the specialists are so reluctant to see people. Right no…

Lupus is a broad category of auto-immune diseases. Some are easier to diagnose than others. It sounds like yours was one of the easier ones. Easier, but not easy! Many Lupus diagnoses rely on differential diagnosis. AKA eliminate every other possible diagnosis and if they all are negative it must be lupus.

Re: Google almost convinced me to spend $400 on useless laser treatments

#292

Post by ALittleLight »

jnovek wrote: post #40

“ Medicine has become a three-way negotiation between you, your doctor, and The Algorithm.” This characterization makes it sound like a good thing. In reality, the doctor’s responsibility is being pushed to the patient because they are overbooked in the name of economic efficiency. As a patient with complex, non-specific medical condition, I can tell you how miserable this is. I can’t count on doctors _at all_ to mov…

A few years ago I noticed my stool was unusually dark (sorry for too much information). I did some googling and discovered this was an indication of blood in stool. I went to the pharmacy to buy a fecal occult blood test - a strip of paper that you add to the toilet bowl and it changes color if it detects blood in the water. When I got a positive result I retrieved my strip with tweezers and put it in a ziploc bag and went to go see a doctor.

The doctor decided this was an ulcer and said the ulcer could be bacterial, viral, or idiopathic (meaning without a cause). His solution was to prescribe an anti-bacterial and a steroid and to take both. I asked if there would be any complications or drawbacks to taking both, and he said there would not. I asked if I should take one first and then the other so I could narrow down whether the ulcer was bacterial or viral. The doctor thought this was a good idea and said I could do it if I wanted. I asked if I should take the medications in any specific order and he said it did not matter.

I went home and read up on the two medications he had prescribed. Sure enough, the steroid would make a bacterial infection worse. Following the doctor's advice, without my own research, could have made things worse. Without doing my own diagnosing and testing I would have had a much longer time to treatment too. (Wound up going away with the anti-biotics)

Re: Google almost convinced me to spend $400 on useless laser treatments

#293

Post by AlbertCory »

albrewer wrote: post #287
Auracle wrote: post #246

Earlier quoted context omitted.

If you go to the Mayo Clinic in Minnesota you'll see people from all over the world for a reason. It feels like the UN, where everyone has some sort of debilitating disease. They have a system where you get evaluated by a general practitioner (or someone more relevant), and then they schedule you to see however many specialists you might need to see - all within a day or two. It's not perfect, and I've found it's sti…

I recently had to make an emergency visit to a hospital in a major city, with a really weird presentation. Within 45 minutes of arrival they had figured out what was immediately wrong and had me hooked up to an IV drip of stuff to fix it. An hour later, a specialist for my issue came and talked to me about the problem and had an idea for a root cause. I was held overnight for observation and had several more tests ru…

"IV drip" - that rang a bell. 25 years ago I was admitted to a hospital with severe abdominal pain. They had a surgeon who was preparing me, mentally, for a temporary colostomy. Fortunately, that IV drip fixed me up within half an hour.

Those antibiotics, man. They work.

Re: Google almost convinced me to spend $400 on useless laser treatments

#294

Post by mmcdermott »

FollowingTheDao wrote: post #234
bryanlarsen wrote: post #226

Earlier quoted context omitted.

Lupus is really hard to diagnose. There's a reason that ends up being the diagnosis on pretty much every episode of House M.D. Doctors generally see 6 patients an hour, and have 5-7 minutes of paperwork per patient. The remaining 3 minutes gives enough time to diagnose the obvious, but not much else.

It is not hard to diagnose once you eventually get to a person that can diagnose it. You said it yourself. It is not about difficultly, but time spent with the patient. But I literally showed my doctor the cutaneous lupus in my ear and she said "Oh, some people just get gunk in their ears" and would not send me to a rheumatologist. The slow diagnosis is because the specialists are so reluctant to see people. Right no…

> The slow diagnosis is because the specialists are so reluctant to see people. Right now I am on a six month wait to see a rheumatologist. Why? Capitalism.

This remark seems somewhat lacking in rigor. I know bagging on capitalism is a common reflex, particularly in medicine, but something more is almost certainly going on.

The default thought process for a retailer is to move units. A lawyer wants to rack up billable hours. A subscription service wants more subscriptions.

So why would a specialist look for fewer cases? There is almost certainly a perverse incentive involved, because a competitive market would usually prompt a service provider to accept business and grow with demand.

Re: Google almost convinced me to spend $400 on useless laser treatments

#295

Post by whatshisface »

ALittleLight wrote: post #292
jnovek wrote: post #40

“ Medicine has become a three-way negotiation between you, your doctor, and The Algorithm.” This characterization makes it sound like a good thing. In reality, the doctor’s responsibility is being pushed to the patient because they are overbooked in the name of economic efficiency. As a patient with complex, non-specific medical condition, I can tell you how miserable this is. I can’t count on doctors _at all_ to mov…

A few years ago I noticed my stool was unusually dark (sorry for too much information). I did some googling and discovered this was an indication of blood in stool. I went to the pharmacy to buy a fecal occult blood test - a strip of paper that you add to the toilet bowl and it changes color if it detects blood in the water. When I got a positive result I retrieved my strip with tweezers and put it in a ziploc bag an…

If you were on both at once would the antibiotics have stopped the steroids from making it worse?

Re: Google almost convinced me to spend $400 on useless laser treatments

#296

Post by AlbertCory »

bcoughlan wrote: post #277
salsadip wrote: post #119

Earlier quoted context omitted.

I‘m really not trying to sound snarky, but - is this the supposedly high quality treatment that U.S. citizens get that is so much more expensive as opposed to the „socialized“ insurance we get in Europe that is cheaper for everybody and supposedly therefore not as good/cutting edge?

So tired of these "European" comments feigning cluelessness to try to feel above others. There is huge variety in healthcare quality across EU countries (waiting lists are years long in my country) and no one can speak of Europe as a monolith and make much sense. People in my (EU) country who have serious illnesses often seek to go to the US for treatment because they have facilities and doctors that specialise in th…

I'm reminded of that Simpsons episode (can't find it on YouTube easily) where they temporarily have to take in boarders: backpackers and so forth.

Then the financial problem is fixed, and Homer carries one of them, all the while spouting about the European health system, to the garbage can. He says "Time to take out the Eurotrash."

Re: Google almost convinced me to spend $400 on useless laser treatments

#297

Post by throw10920 »

JamesBarney wrote: post #290
FollowingTheDao wrote: post #234

Earlier quoted context omitted.

It is not hard to diagnose once you eventually get to a person that can diagnose it. You said it yourself. It is not about difficultly, but time spent with the patient. But I literally showed my doctor the cutaneous lupus in my ear and she said "Oh, some people just get gunk in their ears" and would not send me to a rheumatologist. The slow diagnosis is because the specialists are so reluctant to see people. Right no…

There are too many patients and not enough doctors. This isn't caused by capitalism, capitalism doesn't limit the # of doctors. Becoming socialist doesn't magically allow doctors to see patients for twice as long. If we had socialism more people could afford doctors(a good thing!) but it would make this specific problem worse, because there would be more patients. This is caused by the AMA lobbying to limit the suppl…

> This is caused by the AMA lobbying to limit the supply of doctors in order to drive up salaries.

This. This is the problem - not the vague spectre of "capitalism" being waved around.

Re: Google almost convinced me to spend $400 on useless laser treatments

#298

Post by ALittleLight »

whatshisface wrote: post #295
ALittleLight wrote: post #292

Earlier quoted context omitted.

A few years ago I noticed my stool was unusually dark (sorry for too much information). I did some googling and discovered this was an indication of blood in stool. I went to the pharmacy to buy a fecal occult blood test - a strip of paper that you add to the toilet bowl and it changes color if it detects blood in the water. When I got a positive result I retrieved my strip with tweezers and put it in a ziploc bag an…

If you were on both at once would the antibiotics have stopped the steroids from making it worse?

I don't know that. My research didn't turn up anything about taking both at once. I think, either way, it would have been safer to try anti-biotics first then the steroids. It's not like I was suffering from the ulcer, I had time to experiment, so why not go with the simplest and safest treatment route?

Re: Google almost convinced me to spend $400 on useless laser treatments

#299

Post by kobalsky »

matsemann wrote: post #12

Why are dentists so scammy? In Norway I've seen documentaries about them sending the same people to multiple dentists, and some of them receive wildly different advice. Some of that can be ascribed to some being in the school of pro-active, so they want to fix your teeth at the first glance of issues. But in the end, most of the things being quoted were unnecessary. They all seemed very intent on removing wisdom teet…

my dad is a dentist (oral surgeon by usa definition) and he took out all my wisdom teeth (that didn't bother me at all) one time I visited him at his practice.

from my single data point I can conclude that:

1) dentists will remove wisdom teeth that don't bother you even for no financial gain. 2) never visit your parents practice unless you have a excuse to bail out immediately if they try to get you on the chair.

Re: Google almost convinced me to spend $400 on useless laser treatments

#300

Post by cptskippy »

I feel at this point that dentistry is closer to chiropractics and homeopathy than actual science.

Many years ago I wasn't in the best financial position and went to the dentist. He identified a number cavities needing filled and quoted a hefty sum, and I put off the procedures because I couldn't afford them. I diligently saved for 6 months to pay for them and when I went in for my next checkup, I asked about them. What cavities? No your mouth looks fine.

I've had similar situations with my children, getting quotes for thousands of dollars worth of work. Getting second opinions and using different insurance changes those quotes and scope of work dramatically.

At this point in my life, I don't trust dentists at all. I'm sure they're not all crooks but how do tell?

Post reply on HN