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The Fight

dcurt.is

61–70 of 140 posts

Re: The Fight

#61
post #36

Earlier quoted context omitted.

I had a good friend over for dinner recently, and learned that he had recently suffered a heart attack. Not a really bad one, but there aren't exactly 'good' ones either. Pretty scary, as he's still in his 30ies, like me, in good health, no smoking, not much drinking, some exercise, eats ok, and so on.

still in his 30ies, like me, in good health, no smoking, not much drinking, some exercise, eats ok, and so on. This is the problem. In the absence of proper diagnostics, people look at popularly touted risk factors like age, alcohol/smoking/drugs, exercise, diet, etc. But these are highly generalised factors that don't take into account: genetic/congenital/epigenetic conditions, stress/emotional issues, environmental…

Not to be a downer, but I suspect that we are decades away from meaningful diagnostics that would get you anywhere close to being able to declare someone in "perfect health". In fact, I will say that we are 20 years away, and we always will be.[1] For someone who believes that "perfect health" is of little meaning in an adaptive evolutionary framework, this isn't a big issue, but it could be disquieting to some.

Let's say you sequence everyone's genome and can do it for $0 per person. Even if you could, having a genome sequence gets you only so far. We don't know what many genes do; even less so do we know what changes in their structure or in their regulatory elements may do. We have useful, powerful ideas coming from evolutionary biology, but these won't be enough to let one feel confident about health claims.

And this says nothing about infectious, environmental, and behavioral components to risk.

[1] = I know that the fusion "20 years away and always will be" actually refers to the fact that if insufficiently funded it will always be 20 years away. But most people don't know that part of the reference, so I will ignore it at will.

Re: The Fight

#62
post #19
post #9

Earlier quoted context omitted.

Nobody wants to live in a world where people find a dying person laying on the floor and let him die because they're afraid of legal issues. The law protects you from such nonsense. Even if it didn't, in my opinion, no person worth a damn would allow that consideration to color their response.

A few months ago there was an incident in China where a young girl was run over by a truck while crossing a street. Nobody stepped in to help, precisely because they were afraid of the legal consequences. The entire thing was recorded on video, and it got a lot of exposure. It was horrific, the kind of thing one wishes you had never seen or heard about. On the other hand, and thankfully this was a much minor event, m…

[deleted]

Re: The Fight

#63

It's a great post, but to me there's another message that Dustin - understandably - hasn't focused on: "perfect health" is often (usually?) an illusion. Given what I've learned about health in recent years, I can't accept that this guy really was in perfect health; if he was, he wouldn't have suffered a major cardiac arrest while simply jogging on a treadmill. I think it's mostly a failure of modern medicine and mode…

Most commonly, this is going to be attributed to a ventricular arrhythmia, likely due to hypertrophic cardiomyopathy. This has nothing to do with cholesterol, lifestyle, diabetes, etc.

I wasn't referring to cholesterol, lifestyle, diabetes, etc - or at least not only those things.

I'm talking about any condition at all that diminishes one's health condition from being "perfect" - regardless of whether the cause is genetic or something else. Some of these can currently be understood and diagnosed (but usually aren't), whilst others may become understood, diagnosable and curable in the future.

To me, hypertrophic cardiomyopathy would disqualify someone from being described as having "perfect health".

BTW, this is interesting: http://med.stanford.edu/ism/2010/june/hypertrophy.html - and it includes a mention of epigenetics, which I think is highly relevant to what we're talking about.

Re: The Fight

#65
post #58

Earlier quoted context omitted.

We have that. In germany the Berufsgenossenschaft mandates that every company with more than 2 and up to 20 employees has at least 1 person trained in first aid on site. Companies larger than that need 5% - 10% of the personal trained, depending on what work is done. http://de.wikipedia.org/wiki/Unfallverh%C3%BCtungsvorschrift...

Right, and that is probably a negligible cost as you can get first aid training for free in a lot of places. The point is the op is advocating that businesses be required to buy expensive equipment that they themselves probably wouldn't be willing to spend the money on.

I need to pay that persons training, the wage for the lost day of work once a year. The training cost itself is negligible, but a day not billed to a customer costs me ~ 800 USD. I can nearly pay an AED for that.

However, given that a colleague nearly died from a stroke (he completely recovered) and another colleague permanently failed to show up for work after a bike crash, I think that having more people solidly trained in emergency procedures can't be a bad thing. And a one-time investment for medical equipment mandated for companies from a certain size on might be a good thing to consider.

Re: The Fight

#66

It's a great post, but to me there's another message that Dustin - understandably - hasn't focused on: "perfect health" is often (usually?) an illusion. Given what I've learned about health in recent years, I can't accept that this guy really was in perfect health; if he was, he wouldn't have suffered a major cardiac arrest while simply jogging on a treadmill. I think it's mostly a failure of modern medicine and mode…

> I can't accept that this guy really was in perfect health; I guess that depends on why you mean by 'perfect health.' He may very well have been in perfect health by every outward appearance. There are a large number of surprisingly minor things that can make you dead in an instant. A brief primer on electrocardiology... Each heart beat is divided into several phases. An electrical impulse in generated in the two sm…

I guess that depends on why you mean by 'perfect health.'

I know :)

He may very well have been in perfect health by every outward appearance.

Exactly what I'm saying.

There are a large number of surprisingly minor things that can make you dead in an instant.

Yes, but my contention is that the likelihood of these things happening is influenced by the degree to which your health is "perfect".

some random cell in the heart decides it's pissed off and wants to contract early

Again, from my point of view, the likelihood of this happening, or the potential harm that can come of it, is influenced by the level of perfection in one's health.

Your comment is very informative btw, so thank you.

I know we're talking about areas of health that are not yet very well understood, which is why there is scope for discussion, and why there are no irrefutable facts that can close the debate.

But this is exactly what I'm taling about; I'm hoping for a time when medical science has progressed to a point where these issues are very well understood, and seemingly random cardiac arrests like this can be preempted and prevented. I believe it's possible.

Re: The Fight

#67
post #58

Earlier quoted context omitted.

We have that. In germany the Berufsgenossenschaft mandates that every company with more than 2 and up to 20 employees has at least 1 person trained in first aid on site. Companies larger than that need 5% - 10% of the personal trained, depending on what work is done. http://de.wikipedia.org/wiki/Unfallverh%C3%BCtungsvorschrift...

Right, and that is probably a negligible cost as you can get first aid training for free in a lot of places. The point is the op is advocating that businesses be required to buy expensive equipment that they themselves probably wouldn't be willing to spend the money on.

Actually if you read the OPs statement twice, you'll realize that he just voices his surprise that no AED was on site and does not advocate anything.

Re: The Fight

#68

Earlier quoted context omitted.

still in his 30ies, like me, in good health, no smoking, not much drinking, some exercise, eats ok, and so on. This is the problem. In the absence of proper diagnostics, people look at popularly touted risk factors like age, alcohol/smoking/drugs, exercise, diet, etc. But these are highly generalised factors that don't take into account: genetic/congenital/epigenetic conditions, stress/emotional issues, environmental…

Not to be a downer, but I suspect that we are decades away from meaningful diagnostics that would get you anywhere close to being able to declare someone in "perfect health". In fact, I will say that we are 20 years away, and we always will be.[1] For someone who believes that "perfect health" is of little meaning in an adaptive evolutionary framework, this isn't a big issue, but it could be disquieting to some. Let'…

I'll have to disagree with you on that. Genetics is the wrong approach to dealing with all this and was a wild goose chase. Regenerative medicine is the correct approach, the body has all the mechanisms already to regrow itself, after all, it did grow in the first. Regrowing the body and keeping it from being a cancerous growth is the actual challenge. Noninvasive surgery like radiosurgery, focused ultrasound, and photoacoustic surgery is the correct approach along with floating growth factors. This is not really biological engineering but electromechanical engineering and well within grasp. A proper effort would get this done within a year.

Re: The Fight

#69

Earlier quoted context omitted.

Counterpoint and proviso: know what the hell you are doing . It's easily possible to do more harm than good if you don't know better. For example, whenever a motorcyclist gets into a crash, people get the bright idea that they need to get the helmet off. No, the helmet is bracing their neck, which may very well be badly injured, so sometimes if you just pull it off, now the guy's a quadriplegic, and since you were ju…

I agree with that, but in the specific case of AEDs it's hard to get something badly wrong to the extent that you actively harm: the main failure case is not doing something properly that could've been done. So you should definitely yield to someone who has better training, if available. But if there isn't such a person available, the AEDs thesmelves are completely automated and intended to be used by non-experts (ex…

Yeah, AED's are a massive help.

Re: The Fight

#70

Earlier quoted context omitted.

still in his 30ies, like me, in good health, no smoking, not much drinking, some exercise, eats ok, and so on. This is the problem. In the absence of proper diagnostics, people look at popularly touted risk factors like age, alcohol/smoking/drugs, exercise, diet, etc. But these are highly generalised factors that don't take into account: genetic/congenital/epigenetic conditions, stress/emotional issues, environmental…

Not to be a downer, but I suspect that we are decades away from meaningful diagnostics that would get you anywhere close to being able to declare someone in "perfect health". In fact, I will say that we are 20 years away, and we always will be.[1] For someone who believes that "perfect health" is of little meaning in an adaptive evolutionary framework, this isn't a big issue, but it could be disquieting to some. Let'…

Optimal is perhaps a more useful term.

I'm more optimistic than you about how soon we might see major advances.

The emerging field of epigenetics seems very promising.

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