Boy, this reminds me of when boingboing decided to censor it's own readership by turning off comments. How's that for free exchange of ideas and community?
How about getting bent Cory? And while you're at it, would you and Xeni mind dialing up the self-promotion a little more?
If you like evidence, are "reality based," and actually believe in the scientific method, the answer is quackery.
There are no well designed scientific studies to support better outcomes with chiropractic over say regular back rubs. Period. For my money, I'd rather go someplace that also guarantees a happy ending as it's less disingenuous, and probably more legitimately therapeutic that way.
That said, there are plenty of case reports in the literature of broken necks resulting from over-enthusiastic chiropractors.
The whole article is totally off base from a medical perspective. I care for patients who have cancer and patients on ventilators on a daily basis, and the reality is that the measures we use, often quite futilely, to keep people's hearts beating amount to nothing other than prolonged torture. Being on a ventilator and conscious is not fun. That's why most people in respiratory failure require nearly around the clock sedation while intubated. Oh also, late-stage metastatic cancer -- not exactly pleasant. To write articles like this, with no real experience or frame of reference on the matter, particular spinning the subject for political ends, is disgusting, and I call bullshit.
And if you want to complain that they were trying to save a buck (which I'm quite sure the people that ultimately had to make this decision did not), then you have absolutely no idea how costly our healthcare system is, how much a day in an ICU costs, and how incredibly misappropriated our healthcare dollars already are. Being judicious about futile care isn't just about saving a buck. It's a moral imperative.
Well, the thing about surgical efficacy is really dependent on the patient. I could quote you numbers that may seem mediocre (perhaps 50% is right on average), but that's partly a matter of poor patient selection. There are DEFINITELY some patients who will benefit and they might be easy to spot. What I mean to say is if someone opens their mouth and has enormous tonsils, and you look in their nostrils and you see giant polyps... well, their statistics are better than someone who has no such anatomical obstructions, but instead has no neck and weighs 400 pounds. Because the underlying causes for the disease are so varied, their are definitely patient subsets that might benefit from surgery, while other would benefit from weight loss, or still others simply won't get much relief without positive pressure. I hope that made sense.
Another thing to consider since you're having all this surgery is that you may well not need the positive pressure after the procedure. If your obstruction is secondary to the anatomy around your pharynx, and the surgery relieves the obstruction, then I'm not sure you'll need CPAP at all. Have you considered waiting a few weeks postop, and then repeating the sleep study? Most insurers are unlikely to pay for multiple sleep studies, but if the alternative is paying for a pap they might go for it.
And as someone who's training in pulmonology in LA, I would recommend the humidifier. A sizable majority of people have problems with drying like nose bleeds and such. Some people swear by BiPap, but the truth is, most people just don't like using either. The compliance rates on CPAP, BiPap and the like aren't very good. So if you're lucky with the surgery, maybe you won't need either. Like I said, I'd consider a wait and see approach.
Also, yes. Tonsillectomy can be one of the most obnoxious procedures for a week or two following surgery. But if it does resolve your OSA, I guarantee you won't regret it.
Mary is bad because she is dishonest in hiding her prior exchange from John. Her degree of badness depends on the relative whiteness of her lie, as decided by the reader. Otherwise, all other decisions are made between consenting adults, and are neutral.
Yes, they can and they may. While policy probably varies from school to school, an aquaintance of mine had his admission to USC rescinded following a similar exhibit of his downright idiocy. I worked in admissions at Swarthmore, and in my time there, none of our admits ever did this so I can't even guess what we might've done, but I've heard of enough cases of other schools doing so. I suspect that if you can't turn things around, some tragic family excuse or other bullshit could still save you if it comes to it. My recommendation however would be not to play with fire (or your future).
If that's rosacea, I too need to go back to medical school. While I haven't seen a case of chloracne, I've certainly seen and treated countless cases of both rosacea and alcoholism. And this ain't them.
Also, this guy stinks of having an agenda. I just don't even care enough to fish around and find out what it is.
While every case is different, I can tell you that Grave's when caught and treated early, can be managed with minimal changes in quality of life. It more than likely will require life-long medication, but as previously noted, the medication is basically providing the homeostasis or balance that patient's with thyroid disease have lost. Of all the drugs out there, these are some of the most well-studied, and longest in use, with excellent side-effect profiles.
Those with longstanding, severe Grave's that is left untreated run the risk of heart failure (which is usually reversible), eye problems, and osteoporosis.
All-in-all, I'd say it's a bit of a drag, but yes, she'll probably be fine if she keeps up with it. My mom's got it, and she's been doing well for years.
As it has been, and apparently ever shall be, gods, superseded, become the devils in the system which supplants their reign, and stay on to make trouble for their successors, available as they are, to a few for whom magic has not despaired, and been superceded by religion.
-- William Gaddis, The Recognitions
If you want a song to cross that summer/winter divide, can I suggest "July, July!" by The Decemberists...?
I love that song.
Also, let me second "Summertime" by Jazzy Jeff and the Fresh Prince. It is perhaps the only good and decent thing that has kept me from personally putting Will Smith out of our misery.
Do they ever get ill? If kids aren't well-educated, who will be the next doctors? Do they ever need legal advice? (And one article describes setting up power of attorney) - who will be the next lawyers? Do they like having government pensions? If no one new is paying in, where will the money come from? I know these arguments are overused against childfree adults,
Not only are they overused, they make entirely no sense.
First, a thousand dollars a year in tax credit to be spent (or not) on your kids won't make the difference between a doctor and a gangbanger. I'll chip in for the public schools, but the tax break just makes no sense.
Second, people don't need economic incentives to have kids. There's already enough societal pressure, not to mention built-in arrogance, neediness, boredom and the like to foster a healthy enthusiasm for child birth. Look, people have kids because they want to have kids, not because they want to do us all a big favor.
Third, social security is already messed up and not going to last through the next 50 years whether we like it or not. And this has way more to do with the baby boom than the falling birth rate.
Don't get me wrong, kids are cool, and I'll probably have some someday, but I'm comfortable with the fact that I'll be having them for entirely selfish reasons. Otherwise I'd adopt.
Yeah the big spiderwebs are fine and all, but I'm a bit more concerned with the story lower down about people finding live black widows IN THEIR FOOD!
Enjoy those organic grapes while you can, my friend.
Psyko,
Well, then I guess we're going to have to agree to agree... Oh and I checked out your personal list and, well, just mentioning Neutral Milk Hotel at any point in any conversation, list, debate, or the like is enough to win me over...
Nice...
Psyko,
Never said youth = quality. What I implied was that the music performed by these musicians was dated. Dated in the context of a list compiled for this year.
You're not telling me anything I don't know. Yes, most of those guys reunited or put out records, and yes, I caught the Pixies and it was awesome. But it's hard to deny that it was awesome largely because it reminded me of my time as a college radio dj in ancient times.
The facts are the Pixies haven't really put out anything new. Smile is great but the music is so old most popheads and their parents had already compiled their own versions of the songs.
And the rest well, is ultimately a matter of taste, but I'd say most people don't think the Lips, GBV, Sonic Youth, Elliott Smith, or Byrne have been doing their best work lately. I guess I'll grant you Green Day put out a pretty good piece of work. Despite that, the rest still sound like the music I was listening to a long time ago, and if it comes to it, I'd rather put on Daydream Nation, XO, Bee Thousand, Transmission from the Satellite Heart, etc...
I mean c'mon... Whole genres hardly or not at all represented, and so much music's coming out these days.. And if you ask me, by your logic things are still shadey as the best comeback this year is actually Mission of Burma, who remain steadfastly brilliant and are not represented.
Boy, this reminds me of when boingboing decided to censor it's own readership by turning off comments. How's that for free exchange of ideas and community? How about getting bent Cory? And while you're at it, would you and Xeni mind dialing up the self-promotion a little more?
posted by drpynchon 18 years ago
In "Curious George: Chiropractic"
If you like evidence, are "reality based," and actually believe in the scientific method, the answer is quackery. There are no well designed scientific studies to support better outcomes with chiropractic over say regular back rubs. Period. For my money, I'd rather go someplace that also guarantees a happy ending as it's less disingenuous, and probably more legitimately therapeutic that way. That said, there are plenty of case reports in the literature of broken necks resulting from over-enthusiastic chiropractors.
posted by drpynchon 18 years ago
In "Meet Tirhas Habtegiris."
The whole article is totally off base from a medical perspective. I care for patients who have cancer and patients on ventilators on a daily basis, and the reality is that the measures we use, often quite futilely, to keep people's hearts beating amount to nothing other than prolonged torture. Being on a ventilator and conscious is not fun. That's why most people in respiratory failure require nearly around the clock sedation while intubated. Oh also, late-stage metastatic cancer -- not exactly pleasant. To write articles like this, with no real experience or frame of reference on the matter, particular spinning the subject for political ends, is disgusting, and I call bullshit. And if you want to complain that they were trying to save a buck (which I'm quite sure the people that ultimately had to make this decision did not), then you have absolutely no idea how costly our healthcare system is, how much a day in an ICU costs, and how incredibly misappropriated our healthcare dollars already are. Being judicious about futile care isn't just about saving a buck. It's a moral imperative.
posted by drpynchon 18 years ago
In "Curious George - Sleep Apnea Followup Questions"
Well, the thing about surgical efficacy is really dependent on the patient. I could quote you numbers that may seem mediocre (perhaps 50% is right on average), but that's partly a matter of poor patient selection. There are DEFINITELY some patients who will benefit and they might be easy to spot. What I mean to say is if someone opens their mouth and has enormous tonsils, and you look in their nostrils and you see giant polyps... well, their statistics are better than someone who has no such anatomical obstructions, but instead has no neck and weighs 400 pounds. Because the underlying causes for the disease are so varied, their are definitely patient subsets that might benefit from surgery, while other would benefit from weight loss, or still others simply won't get much relief without positive pressure. I hope that made sense.
posted by drpynchon 18 years ago
Another thing to consider since you're having all this surgery is that you may well not need the positive pressure after the procedure. If your obstruction is secondary to the anatomy around your pharynx, and the surgery relieves the obstruction, then I'm not sure you'll need CPAP at all. Have you considered waiting a few weeks postop, and then repeating the sleep study? Most insurers are unlikely to pay for multiple sleep studies, but if the alternative is paying for a pap they might go for it. And as someone who's training in pulmonology in LA, I would recommend the humidifier. A sizable majority of people have problems with drying like nose bleeds and such. Some people swear by BiPap, but the truth is, most people just don't like using either. The compliance rates on CPAP, BiPap and the like aren't very good. So if you're lucky with the surgery, maybe you won't need either. Like I said, I'd consider a wait and see approach. Also, yes. Tonsillectomy can be one of the most obnoxious procedures for a week or two following surgery. But if it does resolve your OSA, I guarantee you won't regret it.
posted by drpynchon 18 years ago
In "100 Favourite literary characters."
that said: Tyrone Slothrop Eustacia Vye Judge Fang Couldn't agree more (at least on the first). Also, yeah, Shakespeare? C'mon...
posted by drpynchon 19 years ago
In "A Quiz with no Right or Wrong Answer"
Mary is bad because she is dishonest in hiding her prior exchange from John. Her degree of badness depends on the relative whiteness of her lie, as decided by the reader. Otherwise, all other decisions are made between consenting adults, and are neutral.
posted by drpynchon 19 years ago
In ""
Yes, they can and they may. While policy probably varies from school to school, an aquaintance of mine had his admission to USC rescinded following a similar exhibit of his downright idiocy. I worked in admissions at Swarthmore, and in my time there, none of our admits ever did this so I can't even guess what we might've done, but I've heard of enough cases of other schools doing so. I suspect that if you can't turn things around, some tragic family excuse or other bullshit could still save you if it comes to it. My recommendation however would be not to play with fire (or your future).
posted by drpynchon 19 years ago
In "Victor Yushchenko was NOT poisoned"
If that's rosacea, I too need to go back to medical school. While I haven't seen a case of chloracne, I've certainly seen and treated countless cases of both rosacea and alcoholism. And this ain't them. Also, this guy stinks of having an agenda. I just don't even care enough to fish around and find out what it is.
posted by drpynchon 19 years ago
In "Curious George: Short story writers"
You have good taste, Medusa.
posted by drpynchon 19 years ago
In "Curious, George: Graves Disease"
While every case is different, I can tell you that Grave's when caught and treated early, can be managed with minimal changes in quality of life. It more than likely will require life-long medication, but as previously noted, the medication is basically providing the homeostasis or balance that patient's with thyroid disease have lost. Of all the drugs out there, these are some of the most well-studied, and longest in use, with excellent side-effect profiles. Those with longstanding, severe Grave's that is left untreated run the risk of heart failure (which is usually reversible), eye problems, and osteoporosis. All-in-all, I'd say it's a bit of a drag, but yes, she'll probably be fine if she keeps up with it. My mom's got it, and she's been doing well for years.
posted by drpynchon 19 years ago
In "Curious George - Searching for a College"
Swarthmore. All-around awesome. Loved it. Oh, but it'll kick your ass.
posted by drpynchon 19 years ago
In "Curious George: Weird Music"
In the Aeroplane Over the Sea. It is weird (to normal people). It is also gorgeous. And brilliant. And my favorite record of all time.
posted by drpynchon 19 years ago
In "Witnessing to Liberals."
As it has been, and apparently ever shall be, gods, superseded, become the devils in the system which supplants their reign, and stay on to make trouble for their successors, available as they are, to a few for whom magic has not despaired, and been superceded by religion. -- William Gaddis, The Recognitions
posted by drpynchon 19 years ago
In "Top 1000"
I hate this list. For obvious reasons.
posted by drpynchon 19 years ago
In "<b>Delerious George</b>...songs that make it summer "
If you want a song to cross that summer/winter divide, can I suggest "July, July!" by The Decemberists...? I love that song. Also, let me second "Summertime" by Jazzy Jeff and the Fresh Prince. It is perhaps the only good and decent thing that has kept me from personally putting Will Smith out of our misery.
posted by drpynchon 19 years ago
In "Ooops I Forgot to Have a Baby!"
Do they ever get ill? If kids aren't well-educated, who will be the next doctors? Do they ever need legal advice? (And one article describes setting up power of attorney) - who will be the next lawyers? Do they like having government pensions? If no one new is paying in, where will the money come from? I know these arguments are overused against childfree adults, Not only are they overused, they make entirely no sense. First, a thousand dollars a year in tax credit to be spent (or not) on your kids won't make the difference between a doctor and a gangbanger. I'll chip in for the public schools, but the tax break just makes no sense. Second, people don't need economic incentives to have kids. There's already enough societal pressure, not to mention built-in arrogance, neediness, boredom and the like to foster a healthy enthusiasm for child birth. Look, people have kids because they want to have kids, not because they want to do us all a big favor. Third, social security is already messed up and not going to last through the next 50 years whether we like it or not. And this has way more to do with the baby boom than the falling birth rate. Don't get me wrong, kids are cool, and I'll probably have some someday, but I'm comfortable with the fact that I'll be having them for entirely selfish reasons. Otherwise I'd adopt.
posted by drpynchon 19 years ago
In "What would it look like if millions of spiders spun webs in one place?"
Yeah the big spiderwebs are fine and all, but I'm a bit more concerned with the story lower down about people finding live black widows IN THEIR FOOD! Enjoy those organic grapes while you can, my friend.
posted by drpynchon 19 years ago
In "The top 40 Bands in America Today,"
Psyko, Well, then I guess we're going to have to agree to agree... Oh and I checked out your personal list and, well, just mentioning Neutral Milk Hotel at any point in any conversation, list, debate, or the like is enough to win me over... Nice...
posted by drpynchon 19 years ago
Psyko, Never said youth = quality. What I implied was that the music performed by these musicians was dated. Dated in the context of a list compiled for this year. You're not telling me anything I don't know. Yes, most of those guys reunited or put out records, and yes, I caught the Pixies and it was awesome. But it's hard to deny that it was awesome largely because it reminded me of my time as a college radio dj in ancient times. The facts are the Pixies haven't really put out anything new. Smile is great but the music is so old most popheads and their parents had already compiled their own versions of the songs. And the rest well, is ultimately a matter of taste, but I'd say most people don't think the Lips, GBV, Sonic Youth, Elliott Smith, or Byrne have been doing their best work lately. I guess I'll grant you Green Day put out a pretty good piece of work. Despite that, the rest still sound like the music I was listening to a long time ago, and if it comes to it, I'd rather put on Daydream Nation, XO, Bee Thousand, Transmission from the Satellite Heart, etc... I mean c'mon... Whole genres hardly or not at all represented, and so much music's coming out these days.. And if you ask me, by your logic things are still shadey as the best comeback this year is actually Mission of Burma, who remain steadfastly brilliant and are not represented.
posted by drpynchon 19 years ago
(limited to the most recent 20 comments)