How much does it cost to be an audiophile?

[Audiophile Neuroscience]

11 minutes ago, esldude said:

Doctors can use Google too!  No need to handicap ones font of knowledge. 

Indeed.

 

I once had a rather OCD guy that had obviously spent a lot of time on google and seemed to want to share it all with me in some detail. I said, you are paying me a lot of money, do you want to hear what you are paying for or would prefer to tell me what Google said. The price is the same !

[Ralf11]

1 hour ago, AudioDoctor said:

 

The patients aren't the problem, its their parents... ?

 

 

 

the child patients aren't the problem because they are all perfect

 

until the Heisenbergian 'touch' of an OBGYB or pediatrician 

[fas42]

3 hours ago, Ralf11 said:

sounds like Frank has never used a properly tuned golf club

 

I used to hack my way around a golf course, winter sports at my high school - my skin hates cold weather, and the tips of my fingers managed to inflict deep wounds on themselves, splitting badly from the stress of the golf swing ... constant greasing is the way to 'tune' my skin.

[AudioDoctor]

1 hour ago, Ralf11 said:

 

 

the child patients aren't the problem because they are all perfect

 

until the Heisenbergian 'touch' of an OBGYB or pediatrician 

 

If you never take the kid to see the Doctor, he will never be sick, right?

[Ralf11]

it would still be the Doctor's fault, no matter what

[Audiophile Neuroscience]

3 hours ago, Ralf11 said:

it would still be the Doctor's fault, no matter what

 

It is Never the doctors fault.

 

A cardiologist told the story of how he gave a patient a clean bill of health only to have said patient leave the consultation room (opening on to the waiting room) and promptly drop dead of a heart attack. When asked what he did about this obviously embarrassing misdiagnosis he replied, " I did what any sensible doctor would do. I quickly turned the patient around to make it look like he was on the way IN to my room!

[elcorso]

7 hours ago, Audiophile Neuroscience said:

 

It is Never the doctors fault.

 

A cardiologist told the story of how he gave a patient a clean bill of health only to have said patient leave the consultation room (opening on to the waiting room) and promptly drop dead of a heart attack. When asked what he did about this obviously embarrassing misdiagnosis he replied, " I did what any sensible doctor would do. I quickly turned the patient around to make it look like he was on the way IN to my room!

 

Wise doctor ! ?

 

By the way, some of my friends have fallen dead for a heart attack coming from an exam where the cardiologist. It was definitely not the cardiologist's fault.  A simple electrocardiogram does not reveal the whole truth and sometimes it does not say anything, but an electrocardiography under stress and modern ultrasound equipment, among others. The angiogram being the most accurate but the most invasive.

 

This does not come from Google search, but from my 18 years of personal experience.

 

Please, never lie to your doctor or cardiologist about your personal habits and less about symptoms, even if you think you are very young.

 

Oh, and never learn to smoke cigarettes. Once the habit is acquired it is VERY difficult to leave it !

 

Carpe diem,

 

Roch

[gmgraves]

15 hours ago, Audiophile Neuroscience said:

 

It is Never the doctors fault.

 

A cardiologist told the story of how he gave a patient a clean bill of health only to have said patient leave the consultation room (opening on to the waiting room) and promptly drop dead of a heart attack. When asked what he did about this obviously embarrassing misdiagnosis he replied, " I did what any sensible doctor would do. I quickly turned the patient around to make it look like he was on the way IN to my room!

An old joke but humorous, nonetheless!

[gmgraves]

7 hours ago, elcorso said:

Oh, and never learn to smoke cigarettes. Once the habit is acquired it is VERY difficult to leave it !

 

Also, they used to say that if you stop smoking, your body will repair the damage in a few years. Now we know that's not true. The damage done by smoking is is irreparable. I had a friend who smoked when he was younger but gave it up in his 30's. When he died at 69, the autopsy revealed that his lungs were so full of tar and nicotine that the strain that put on his heart was too great and it failed. Anecdotal, yes, but it seems to back up the findings that the body doesn't purge itself of the effects of smoking. 

[mansr]

2 minutes ago, gmgraves said:

Also, they used to say that if you stop smoking, your body will repair the damage in a few years. Now we know that's not true. The damage done by smoking is is irreparable. I had a friend who smoked when he was younger but gave it up in his 30's. When he died at 69, the autopsy revealed that his lungs were so full of tar and nicotine that the strain that put on his heart was too great and it failed. Anecdotal, yes, but it seems to back up the findings that the body doesn't purge itself of the effects of smoking. 

Some damage might still be repaired, and giving up smoking will certainly end continued damage. Obviously, never taking up the habit in the first place is the best option.

[Audiophile Neuroscience]

7 hours ago, elcorso said:

 

Wise doctor ! ?

 

By the way, some of my friends have fallen dead for a heart attack coming from an exam where the cardiologist. It was definitely not the cardiologist's fault.  A simple electrocardiogram does not reveal the whole truth and sometimes it does not say anything, but an electrocardiography under stress and modern ultrasound equipment, among others. The angiogram being the most accurate but the most invasive.

 

This does not come from Google search, but from my 18 years of personal experience.

 

Please, never lie to your doctor or cardiologist about your personal habits and less about symptoms, even if you think you are very young.

 

Oh, and never learn to smoke cigarettes. Once the habit is acquired it is VERY difficult to leave it !

 

Carpe diem,

 

Roch

 

Hi Roch

 

Carpe Diem, wise advice.

 

Yes, sadly for quite a few the first sign of heart disease is sudden death.

 

You are correct about the sensitivity and validity of tests to reveal heart disease (sound familiar !?). The Gold standard AFAIK still remains the traditional angiogram but yes it is the most invasive. IMO/IME the tests that have changed the game in the last couple of decades are 1) better understanding, refinement and stratification of risk attending lipid blood tests [Total cholesterol and triglycerides with fractions of HDL/LDL....... +/- Apolipoprotein A [Apo (A)] and Lipoprotein B (Apo B) +/- Lipoprotein (a) [Lp (a)] etc  2) Stress ECG with Ultrasound (stress Echo)  3) Cardiac Coronary Calcium CT / CT angiogram ( a relatively quick CT scan where they may also inject you with a contrast material using a standard injection technique (takes 2 secs) but not where they stick and feed a probe up a blood vessel like a normal angiogram)

 

The latter (CT scan) probably the more controversial but makes great sense to me, is evidence based, and a non invasive structural and functional test where you get a "Calcium score" (indicative of calcified (old) plaque build up) as well as a very good angiogram picture of flow and blockages in the coronary vessels. It is particularly useful in sorting out people where the risk category is other wise fuzzy and where it may be uncertain whether statins may be indicated.

 

As always seek advice from your own dr.

[Audiophile Neuroscience]

13 minutes ago, mansr said:

17 minutes ago, gmgraves said:

Also, they used to say that if you stop smoking, your body will repair the damage in a few years. Now we know that's not true. The damage done by smoking is is irreparable. I had a friend who smoked when he was younger but gave it up in his 30's. When he died at 69, the autopsy revealed that his lungs were so full of tar and nicotine that the strain that put on his heart was too great and it failed. Anecdotal, yes, but it seems to back up the findings that the body doesn't purge itself of the effects of smoking. 

Read more  

Some damage might still be repaired, and giving up smoking will certainly end continued damage. Obviously, never taking up the habit in the first place is the best option.

 

Correct. I can't quote the figures off the top of my head but risk profiles start returning to non smoker status after a certain time, for certain diseases, even if never reaching the base line.

[elcorso]

21 minutes ago, gmgraves said:

Also, they used to say that if you stop smoking, your body will repair the damage in a few years. Now we know that's not true. The damage done by smoking is is irreparable. I had a friend who smoked when he was younger but gave it up in his 30's. When he died at 69, the autopsy revealed that his lungs were so full of tar and nicotine that the strain that put on his heart was too great and it failed. Anecdotal, yes, but it seems to back up the findings that the body doesn't purge itself of the effects of smoking. 

 

That's precisely why I have not stopped smoking?

 

Now, seriously, when quitting smoking there is not so much vasoconstriction, which helps the circulatory function a lot and favors the functioning of the heart.

 

Your friend's lungs should have come out pretty clean after 10 years of quitting. That indicates the studies I've read. I do not know if these studies are reliable. On the other hand, each organism reacts differently to the different oxidizing substances ...

 

Roch
 

[elcorso]

38 minutes ago, Audiophile Neuroscience said:

 

Hi Roch

 

Carpe Diem, wise advice.

 

Yes, sadly for quite a few the first sign of heart disease is sudden death.

 

You are correct about the sensitivity and validity of tests to reveal heart disease (sound familiar !?). The Gold standard AFAIK still remains the traditional angiogram but yes it is the most invasive. IMO/IME the tests that have changed the game in the last couple of decades are 1) better understanding, refinement and stratification of risk attending lipid blood tests [Total cholesterol and triglycerides with fractions of HDL/LDL....... +/- Apolipoprotein A [Apo (A)] and Lipoprotein B (Apo B) +/- Lipoprotein (a) [Lp (a)] etc  2) Stress ECG with Ultrasound (stress Echo)  3) Cardiac Coronary Calcium CT / CT angiogram ( a relatively quick CT scan where they may also inject you with a contrast material using a standard injection technique (takes 2 secs) but not where they stick and feed a probe up a blood vessel like a normal angiogram)

 

The latter (CT scan) probably the more controversial but makes great sense to me, is evidence based, and a non invasive structural and functional test where you get a "Calcium score" (indicative of calcified (old) plaque build up) as well as a very good angiogram picture of flow and blockages in the coronary vessels. It is particularly useful in sorting out people where the risk category is other wise fuzzy and where it may be uncertain whether statins may be indicated.

 

As always seek advice from your own dr.

 

Thanks a lot, David,

 

You can be sure that I am in doctor's hands. When in my country my heart problems are not resolved to my satisfaction I go to Miami, FL.  For that I have a good health insurance policy. I have even a joke with my friends, I can recognize a hospital in Miami just by looking at the ceiling.

 

I do all the tests you mentioned and I have never had high blood lipids. The times I have been prescribed statins has gone very bad with them, a lot of muscle pain. What I do have is a very bad genetic inheritance of heart problems.

 

Two years ago, thanks to a young medical nephew, I was diagnosed with sleep apnea. I had it for many years and I did not know it. Now I use the CPAP machine every day and there has been a lot of improvement, although the apnea had already caused me a lot of damage. At least, since the use of CPAP, I have not had any new crises.

 

Best,

 

Roch

[gmgraves]

53 minutes ago, elcorso said:

 

That's precisely why I have not stopped smoking?

 

Now, seriously, when quitting smoking there is not so much vasoconstriction, which helps the circulatory function a lot and favors the functioning of the heart.

 

Your friend's lungs should have come out pretty clean after 10 years of quitting. That indicates the studies I've read. I do not know if these studies are reliable. On the other hand, each organism reacts differently to the different oxidizing substances ...

 

Roch
 

The Tobacco industry is one of the largest industries on earth. They will pay anyone any amount to debunk the notions that A) cigarettes are addicting (while at the same time gene manipulating tobacco to make it even more addictive!) and B) that there are long term health consequences associated with smoking.

[elcorso]

1 minute ago, gmgraves said:

The Tobacco industry is one of the largest industries on earth. They will pay anyone any amount to debunk the notions that A) cigarettes are addicting (while at the same time gene manipulating tobacco to make it even more addictive!) and B) that there are long term health consequences associated with smoking.

 

Completely agree !!!

 

Roch

[Audiophile Neuroscience]

26 minutes ago, elcorso said:

 

Thanks a lot, David,

 

You can be sure that I am in doctor's hands. When in my country my heart problems are not resolved to my satisfaction I go to Miami, FL.  For that I have a good health insurance policy. I have even a joke with my friends, I can recognize a hospital in Miami just by looking at the ceiling.

 

I do all the tests you mentioned and I have never had high blood lipids. The times I have been prescribed statins has gone very bad with them, a lot of muscle pain. What I do have is a very bad genetic inheritance of heart problems.

 

Two years ago, thanks to a young medical nephew, I was diagnosed with sleep apnea. I had it for many years and I did not know it. Now I use the CPAP machine every day and there has been a lot of improvement, although the apnea had already caused me a lot of damage. At least, since the use of CPAP, I have not had any new crises.

 

Best,

 

Roch

 

Just some thoughts that may not be relevant for you (since you are already receiving good care)  but possibly be of interest to others.

 

Muscle aches (myalgia) are not the same as muscle breakdown (rhabdomyolysis). Myalgia is common and sometimes manged by taking a statin less frequently or a less toxic statin like pravachol.

 

Ezetimide, sometimes given with a statin, can reduce chol absorption in the gut.

 

Risk levels appear to drop directly related to LDL chol levels and an absolute lower level target (2.8 mmol/l) was/is advocated by some. This is a bit controversial if one compares the American and European guidelines in recent years (IIRC they diverged a bit since 2013).

 

Anyway worth thinking about

 

 

[Bill Brown]

Unfortunately it seems, at least in my experience, that those who develop myalgias on statins are those who need them the most!  Thankfully it isn’t terribly common.  And as you suggest, it is infrequently associated with rhabdomyolisis. 

 

Worth trying others as you said- I wouldn’t describe them as less toxic, though, simply as less potent. More of a class effect than toxicity. 

 

Finally, I can’t resist noting, based on the current literature, that the role for coronary angiography is largely limited to the setting of an acute coronary syndrome- MI or unstable angina. 

[Bill Brown]

Oh, and regardless of associated other factors/illnesses, smoking cessation has to be numbers 1,2, and three on the list of priorities. Simply can’t overstate that, though I wish I could, as even I tire of hearing myself say it. It is simply profoundly true, unfortunately. 

[Bill Brown]

I’ll say one more thing then shut up. 

 

While nicotine certainly is a vasoconstrictor, the real problem is the smoke- endothelial (lining of the vessels) damage/inflammation leading to atherosclerosis, unstable plaques that rupture (MI), etc. Much more common than lung cancer.  I encourage folks to be in no hurry to get off nicotine replacement (gum, patches, vape, etc.) if that enables them to stay off cigarettes. 

[Audiophile Neuroscience]

29 minutes ago, Bill Brown said:

While nicotine certainly is a vasoconstrictor, the real problem is the smoke- endothelial (lining of the vessels) damage/inflammation leading to atherosclerosis, unstable plaques that rupture (MI), etc. 

 

Absolutely agree.

 

It also applies for cva/stroke and no surprise that the conditions are linked.

[Jud]

My wife stopped 40 years of smoking after two weeks of Chantix. It only works in about one third of the people who take it, but that's twice the rate of any other method.  Worth a try.

[elcorso]

27 minutes ago, Jud said:

My wife stopped 40 years of smoking after two weeks of Chantix. It only works in about one third of the people who take it, but that's twice the rate of any other method.  Worth a try.

 

I tried everything Jud, Champix (this side of the planet) and even a shrink...

 

Best,

 

Roch

[elcorso]

1 hour ago, Bill Brown said:

Oh, and regardless of associated other factors/illnesses, smoking cessation has to be numbers 1,2, and three on the list of priorities. Simply can’t overstate that, though I wish I could, as even I tire of hearing myself say it. It is simply profoundly true, unfortunately. 

 

I would put stress as number one. At least that part I got over ...!

 

The irony of all this is that when I try to quit smoking anxiety stresses me and my heart goes crazy.

 

Roch

[elcorso]

1 hour ago, Bill Brown said:

Unfortunately it seems, at least in my experience, that those who develop myalgias on statins are those who need them the most!  

 

That is not the opinion of my cardiologists.

 

1 hour ago, Bill Brown said:

Thankfully it isn’t terribly common.  And as you suggest, it is infrequently associated with rhabdomyolisis. 

 

It's more common than medical industry want to recognize. 

It is the main cause why people stop statins (accepted by my cardiologists).

That's why they screen test for CK (CPK) after the treatment.  I find it ironic that it is the same test to determine if you are going to be or had a heart attack.

 

Best,

 

Roch