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Comments

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Diet Drugs Work: Why Won't Doctors Prescribe Them?

jds91md they don't work (670 comments)

Hi folks, I am a primary care doctor. I have tons (literally) of obese patients with all the attendant consequences like diabetes, arthritis, sleep apnea, high blood pressure, poor circulation, and more. I do not prescribe weight loss drugs, never have, doubt I ever will. Reasons are simple and obvious. 1) they don't work. They produce an insignificant amount of weight loss and do it only over the shortterm. 2) they have bad side effects. Along with the lack of benefit, they sure do harm people. Xenical causes such massive diarrhea as to cause fecal incontinence. Pooping your pants uncontrollably... do I need to explain any further why no one takes this med? 3) they have a LONG history of causing severe and unanticipated health damage. Heart valves with fenfluramine, addiction with amphetamines, etc. 4) they do nothing to change people's underlying weak efforts at diet, exercise, and fitness, which produce real health. When patients stop the drugs, they lose the (minimal) benefit, and they go back to being what they were before. --JSt

about 8 months ago
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Why Organic Chemistry Is So Difficult For Pre-Med Students

jds91md organic chem pretty much a waste (279 comments)

Hi folks, Nice to imagine that something about "orgo" is fruitful to the process of making doctors, but I disagree. Organic chemistry has NOTHING to do with day to day doctoring for probably 99.9% of us. I don't have to draw a molecule of penicillin or know anything about how it interacts with other molecules in order to use it for strep throat or syphilis. We need in this day and age doctors who know science, probability, the human psyche, communication, and teamwork. But they don't need to know organic chemistry. And there are other fruitful ways to weed out those who can't hack it in med school. I know because I am a physician and I teach medical students and resident physicians in New York. --JSt

about 9 months ago
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I typically visit a doctor (for medical reasons) ...

jds91md Re:I only go... (415 comments)

"I haven't had a flu shot, or any other vaccination, in over 10 years. I have managed just fine." Yes. I love the "no vaccines and I've been fine" argument. I counter with, "so if you don't wear your seat belt for 10 years driving and are lucky enough not to crash, that means it's fine to keep on not wearing your seat belt, right?" Right. --JSt

about 9 months ago
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Ask Slashdot: Suitable Phone For a 4-Year Old?

jds91md supportive suggestions (682 comments)

Hi. Sorry that you are away from your son more than you prefer. Everyone here assumes it's divorce, but for all we know you work on a nuclear sub or a marine biology platform away from home for months at a time. Either way, you deserve our sympathies for having to be separated, and you deserve our support for wanting to stay close to your boy. For me it was divorce around when our son turned 3. We had (and still have) shared custody with him living with each of us on certain days. But for practical reasons, he's with his mom more, so the issue of how to stay connected was most important for me. In my experience, a child that young has a tough time staying focused and connected to a voice on a phone. A voice alone is somewhat of an abstraction. As you surely know already, kids are really concrete. My son at that age found it difficult to stay focused and pay attention on the phone. If he held the phone himself, he was as fascinated by the buttons and the neat sounds they made when pressed as he was to talk to me (or to talk to my ex when he was with me). And if an iPhone with shiny screen buttons, even more distracting. If my ex held the phone near him on speaker phone, usually as he took his evening bath, he'd stray in and out of paying attention. It's just hard at that age. I gave my ex my old MacBook so that we could do Skype and/or Facetime (when latter came along). That helped a good amount. Voice plus video is a lot better. Matters not whether it's an iPod Touch or iPad or laptop. Clear audio plus video equals better likelihood of paying attention and staying connected. My son is 8 now. We still do the same arrangement, wherever he is, he calls the other parent and tries to do video chat every night. Neither of us has gotten him his own phone, and I think it will stay that way at least another couple years. He uses my ex'es iPhone or laptop to call me or he uses my iPhone or laptop to call her. I think it's better that we parents maintain control of devices and not let him have a phone for his own, at least so far. He'd be overjoyed to have a smartphone, no doubt about it, but we know that less phones and screens and more friends and outdoors and diverse activities is better. I hope you find a way to make a good connection. Good luck, -- Josh

about 10 months ago
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Apple: Developer Site Targeted In Security Attack, Still Down

jds91md Re:They know what - not who (112 comments)

My developer info as an iOS developer includes my Apple ID and my password. The same ID and password for my iTunes account which is connected to my credit card. If my name and email was compromised, I'm not terribly worried. If my password was compromised, then my credit card was compromised, and that's a problem. --JSt

1 year,6 days
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Ask Slashdot: Exploiting 'Engineering And ...' On a Resume?

jds91md Re:saving money (207 comments)

Awesome set of skills and experiences. But must note that it weakens the presentation of them to misspell HIPAA

about a year ago
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I'd most rather, of the following, search with:

jds91md strange question, strange choices (277 comments)

"I'd most rather, of the following, search with..." 1) of the following is unnecessary 2) how about "I prefer"? And since I only use Google to search, I have no opportunity to answer this poll. -- Lemming

about a year ago
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My credits by name in (released) software:

jds91md quantity quality... (190 comments)

it's easy when you're the sole developer of simple little medical apps for iPhone You folks do all the real programming, development, and I.T. work. It's fun just to read about it here and enjoy your world vicariously. Best, --JSt

about a year ago
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In terms of general neatness, I am ...

jds91md I'm actually some of each (181 comments)

I have a mix of neatness and sloppiness which I hadn't really reflected upon until this question. For instance, I keep meticulous notes and do meticulous written work in the workplace. But my desk at work is sloppy with papers that I have failed to get around to filing or disposing. Why the conflict and contrast? I'm not sure. --JSt

about a year ago
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Windows 8 Killing PC Sales

jds91md Re:Its not all bad. (1010 comments)

Win8 may not be all that bad. But I only use it at work. And I'm not going to muck around with software add-ons and then screw something up and then call the I.T. help desk here at work begging for them to fix what I screwed up on their computer. I'm willing to try stuff out on the computer I own and maintain at home, my Mac laptop. But I'm not going to screw around with someone else's computer which I need to work for workplace productivity. --JSt

about a year ago
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Windows 8 Killing PC Sales

jds91md Re:Companies shouldn't' like where this is going (1010 comments)

Go back to the beginning of what made the IBM PC great. It was spreadsheets, databases, word processing, and boring financial programs. These were, and still are very much critical to businesses. These needs are not going away!

Correct. There will still be millions of users at work needing these applications. And Win7 runs them just fine. My medical organization still runs mostly XP (transitioning to Win7). If it ain't broke, no one will fix it for the sake of change itself. Change sucks. Only undertake it when necessary. What is essential or necessary for business on Win8? If you have no answer just like me, then I guess we know why Win8 is floundering. --JSt

about a year ago
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Windows 8 Killing PC Sales

jds91md no surprise here (1010 comments)

My workplace (medical) is all Windows, transitioning from XP to Win7. All of our key applications will not run on Win8. I am replacing an old Motion Computing tablet. It is not easy to shop for a Win7 computer, but that's what I did. Alternatives were buy a Win8 machine and hope it's downgradable or buy a native Win7 machine, and I went with the latter. Home users have had a growing choice of platforms since iOS and Android arrived. But I figured workplace use would remain solidly Windows. Suspect it still will. But maybe companies will wait for Win9 --JSt

about a year ago
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Open Source Radeon Gallium3D OpenCL Stack Adds Bitcoin Mining

jds91md yawn (140 comments)

Bitcoin? Really? I thought news is information that someone cares about. 10 years from now people will chuckle or roll their eyes at the thought of Bitcoin. In 20 years, people will go "huh?" --JSt

about a year ago
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Most Doctors Don't Think Patients Need Full Access To Med Records

jds91md Re:Patients (659 comments)

1) not required to report unexplained loss of consciousness like seizure or fainting to Dept Motor Vehicles in NY State. In fact, if I did so, I would be in violation of patient privacy 2) yes, a physician is a mandated reporter of child abuse, so are nurses, teachers, and several other professionals. You have a problem with that? --JSt

about a year ago
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Most Doctors Don't Think Patients Need Full Access To Med Records

jds91md Re:Conspiracy! (659 comments)

I'm sorry about your friend. But you don't see the flip side of this. If every tiny white dot lead to a massive investigation, we'd kill more patients. It goes like this. Every tiny questionable finding white dot would lead to big investigation with endoscopy (garden hose scope down your throat) with biopsies to get the truth about the terrifying "white dot". Every now and then the procedure and the anesthesia would lead to a patient breathing in mouth saliva or gastric juices and catching a wicked pneumonia, a few might die. Every now and then the biopsy would perforate the stomach and a few might die. Every now and then the biopsy would nick a blood vessel in the stomach causing massive bleeding, leading to emergency surgery, blood transfusions and blood bourne infections and transfusion reactions, surgical wound infections, and a few would die. Or the white dot would be further evaluated not by scope but by CT scan, and every 1100 CT scans cause 1 additional case of cancer from the high dose of radiation, and so a few people would die. Get it? It takes experience and judgment to notice a tiny abnormality and decide whether it warrants further investigation. Mostly we get it right. Sometimes we get it wrong. But don't imagine that every white dot overlooked goes on to be bad just because it happened to someone you know, and that every white dot investigated improves the health of those lucky enough to not to be overlooked. Again, same reason why you folks should not look at your records: you won't know what you're looking at and you won't be able to make useful sense of them to improve your health. --JSt

about a year ago
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Most Doctors Don't Think Patients Need Full Access To Med Records

jds91md Re:Doctors are still better than patients at rare (659 comments)

Not quite true. Doctors are supposed to look for highest probability diagnoses and most dangerous diagnoses first. Common because that's probably the correct diagnosis, and dangerous ones because those cannot afford to be missed, even if they are less likely. --JSt

about a year ago
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Most Doctors Don't Think Patients Need Full Access To Med Records

jds91md Re:Conspiracy! (659 comments)

this is so silly. If you complain to me that you have explosive diarrhea, I write down "patient had explosive diarrhea". My medical notes are just that -- notes to help me remember and understand what I heard, what I examined, and the plans I made. You people are a bit prudish if you think that explosive diarrhea is titilating to a physician. It is not. We deal with complaints of vaginal discharge, anal bleeding, coughs with nasty phlegm, rashes with putrid oozes, everything which can be vomited, and all manner of intimate stories from our patients over their sexual indiscretions, their substance abuse, their crushing sadness from social estrangement or divorce or death of a loved one, and everything else which causes suffering in the human condition.

about a year ago
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Most Doctors Don't Think Patients Need Full Access To Med Records

jds91md Re:Patients (659 comments)

Doctors are deputized agents of the State? You need to go see your doctor for some psych meds to make those delusions stop haunting you...

about a year ago
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Most Doctors Don't Think Patients Need Full Access To Med Records

jds91md Re:Conspiracy! (659 comments)

Stuff you don't understand that only doctors understand like a zillion test results that to you might look concerning but to a doctor look fine

about a year ago
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Quadrocopters Throwing and Catching an Inverted Pendulum

jds91md remember this... (103 comments)

As amazing as this is (and it IS friggin' amazing), remember that the human brain does this throw, catch, reposition, recalculate, and respond stuff effortlessly. Just play catch with a ball and your 5 year old child. Animals with pea-sized brains do it great, too! -- Josh

about a year and a half ago

Submissions

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Story of the development of the iPhone leading up to the '07 debut

jds91md jds91md writes  |  about 10 months ago

jds91md (2439128) writes "Today's NY Times delivers a great story, tense with suspense, reviewing the development of the iPhone by Apple in the leadup to Jobs taking the stage with shockingly buggy prototypes and pulling off the show that is now history. Enjoy!"
Link to Original Source
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a lot of brains were "burned and melted" in order to achieve these images

jds91md jds91md writes  |  about a year ago

jds91md (2439128) writes "And the images are amazing. A technique to see the structural detail of actual brains with resolution down to the cellular and axonal/dendritic level has been developed. We will learn amazing things from this, I suspect. Check videos and pictures here from NY Times online:
http://www.nytimes.com/2013/04/11/science/brains-as-clear-as-jell-o-for-scientists-to-explore.html?hp"

Link to Original Source
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Ask Slashdot: Win7 tablet for doctor?

jds91md jds91md writes  |  about a year and a half ago

jds91md (2439128) writes "Hi folks,
    I am a physician doing hospital and office work. I have to use a Windows PC at work. I basically need to use just a few applications: Dragon Medical, MS Word, a browser, and an electronic medical record system called NextGen. NextGen currently only runs on Windows 7 (or lower). I have an old Motion Computing tablet which is getting quite old and heavy (6 lbs with expansion 2nd battery, I weighed it on office baby scale!). Batteries no longer hold charge and hard to get replacements. So I want a new tablet. Which one? Must get Windows 7. Would like 12" screen and 1366x768 resolution or better. Would like slate with optional docking keyboard. Must have battery life of appx. 8 hours, preferably more. Needs a USB port (or microphone-in port). So far I haven't found anything that meets all criteria (Acer Iconia came close, too small). I'm a Mac person for the rest of my computing needs where there are but a few models and choices, whereas the PC world has dozens of makes and models, so I can't be sure I'm aware of the great model out there waiting for me. Any suggestions? --JSt"
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Baseball pitched near the speed of light

jds91md jds91md writes  |  about 2 years ago

jds91md writes "You know what will happen if we don't get steroids, growth hormone, and other PED's (performance enhancing drugs) out of sports? Soon pitchers will throw baseballs at 90% of the speed of light, and that's what this whimsical yet careful discussion discusses. It doesn't end well for the batter. Fun read for the physics-o-philes among us. Great last line in italics at bottom, too."
Link to Original Source
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Security measures which make you less secure

jds91md jds91md writes  |  more than 2 years ago

jds91md writes "Marvelous free audio & video of economist Tim Harford's presentation at the London School of Economics on one of the chapters in his recent book, "Adapt: How Success Always Starts With Failure". In it he details history and interesting cases of trying to produce more safety and security in devices and systems which turn out to do the opposite. His examples span from oil rig disasters to financial instruments, and of course have much bearing on IT security. Includes marvelous quotes like, "it's like we gave airbags to Wall Street, so they decided to drive drunk", and mentions of tribbles. Excellent speaker, I hope you all enjoy."
Link to Original Source

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