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eragone

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Former software engineer (finance and healthcare). Now an emergency medicine physician.

ellie.ragone at gmail

[ my public key: https://keybase.io/eragone; my proof: https://keybase.io/eragone/sigs/aaAqatzvyqZP8lGFDstUHogmSK1Ed1RpYb3Sl9CNW2c ]

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There’s actually another company called SleepMe (or maybe that’s the product…?) that makes a mattress cover that’s water cooled (or warmed)

As a night shifter it’s completely life changing in allowing me to sleep comfortably during the day. 100% worth the price to me

I think any reasonable interpretation of the comment you’re replying to is not “sleep is always good” but rather “sleep is good, on the whole”, which is absolutely true.

Both studies you linked indicate correlation not causation

Personally I use it more as a reminder than an official reference. So, for example, reminders of less common diagnoses or less common presentations of common diagnoses that I’ve learned and know but may not remember the details of but will come back to me with some prodding. If I actually need to dive deep, I usually use UpToDate

Not sure where you went to med school, but couldn't be different for me for med school and residency. Very little of being a doctor has to do with money. If I wanted money, I would have stayed in software and not gone another half a million in debt.

Strokes can present in truly any number of ways. The Cincinnati Stroke Scale, often seen in public health campaigns as "FAST", provides three simple, quick assessments that can reliably delineate a majority of strokes. It is the standard for basic EMTs as well. More advanced providers should perform a more comprehensive exam, testing all the cranial nerves (actually usually just II through XII). A more formalized, advanced stroke scale is the NIH stroke scale: http://stroke.nih.gov/documents/NIH_Stroke_Scale.pdf

While there are often some kind of neurologic deficit associated with a stroke, the goal standard is, of course, a CT or CTA that should be administered immediately upon arrival in the ED of a suspected stroke (depending on the presentation of symptoms an exam by a neurologist may occur first).

The symptoms described in this story would absolutely make me think this person was having a stroke if she had verbalized them to someone with my training.

It's also worthwhile to point out that the person having a stroke may not realize they are having a stroke. People may have the obvious symptoms - slurred speech and hemiparesis - and refuse to acknowledge that these problems exist, because, in their mind, they don't.

If you think someone is having a stroke, record the time you first noticed symptoms and call 911 immediately.

I came here to say something similar - you do not "get over" clinical depression caused by a biochemical imbalance in your brain. It does not get fixed without making biochemical changes to your brain.

The advice the author gives is very sound advice (exercise, for example, does indeed induce biochemical changes in your brain), but without first becoming convinced of the advantages of getting treated, and taking the time to understand how those treatments effect you and how you need to actively participate in them, the rest of his suggestions are near impossible to follow through on.

The stigma around psychological and psychiatric care do not help the situation; however, the numerous stories on these issues here on HN I do hope shed some light on those that are still suffering without help to know that there always is a chance to get better, and it can be as easy as calling your doctor or telling your friend you need help. Or even talking to one of us here who have been suffering from depression and suicidal ideations for many years - I certainly would be more than happy to talk with anyone who is struggling with these issues.