I tried feeding a lot of this into various Als (Kagi gives you access to a few with a nice interface) and I found that they mostly were stupid in ways that made me think.
Perfect summary of why AI is useful for rubber ducking. Doing this with a co-worker you always get some questions that are a few layers too shallow for what you need (because they haven't been thinking about it more than a few minutes), but it always makes you think and really helps.
I’ve been wearing a heart rate monitor for a while, and after analysing the data, I noticed something interesting: my heart rate spikes in only two situations, when I’m driving, and when I’m talking to my wife.
Oura often interprets gym sessions as stress, and some people on social media argue that it's correct, that you can be stressed at the gym instead of simply listening to their bodies.
Last week, I met an experienced top swimmer who doesn't use any devices, he just listens to his own heartbeat.
My friend went to see the doctor. A very attractive nurse took his blood pressure, which turned out to be off the charts. She goes out, comes back 5 minutes later and repeats, same results. Goes out and 10 minutes later and old bearded doctor comes in and repeats the tests.
Doctor ends up telling him that he was hoping it was just the attractive nurse, but no. He'd be starting medication today.
I had a doc appointment a couple of weeks ago. My wife was driving and we were running late, so I was getting stressed about missing the appointment on top of being stressed about going to see the doctor. There was a lot of traffic so I decided to get out at a red light and run to my appointment while my wife parked the car. I only barely made it and the first thing they did was take my pressure. They took it twice, because at the first they were like, this can't be right. When I explained, they asked if I had a blood pressure monitor at home so I could take my own pressure at a more quiet moment.
The guidelines for taking blood pressure state you should be sitting quietly for 5 minutes beforehand, something that almost never happens at the doctor's.
My wife developed an autoimmune condition a few years ago that causes her to need to see a specialist every few months. For some reason, the hospital we've been going to uses these automated blood pressure readers that literally need to get wheeled around because they're four feet tall with a digital display, and during one of the early visits she had because of one of these conditions, the device bugged out or something and it kept squeezing her arm without releasing the pressure, and the person taking the reading didn't know how to disengage it manually and ran out of the room to go and find someone to help them without taking the time to rip off the velcro band on my wife's arm or anything. Ever since then, I literally get stressed every time my wife's blood pressure gets taken from one of those devices even though I'm not even the one who's getting measured!
I have an intense phobia of dentists; if I were wearing a constant monitor, I bet you could tell when I was at the dentist just by watching the blood pressure and heart rate spikes. (You'd have to find some way of differentiating them from me being in a car accident, or being attacked by a werewolf.)
I wonder if it would show up on the heart rate (or heart rate variability) tracking from an Apple Watch or similar. My Garmin picks up stressful events all the time.
I have a mild fear of needles. Whenever my wife does acupuncture on me, I am quite uneasy in the beginning, looking away but still I end up covered in a bit of sweat till she finishes putting needles on all the points (and sometimes they are properly weird places I wouldn't imagine sticking tiny needle into... doesn't help). Don't monitor the heart rate/pressure but it must jump up significantly
White coast hypertension isn't just about a clinical setting, it's more generally about the worry about the results of having your BP measured. [EDIT] OK, well maybe there's another type of hypertension which is related to anxiety about a high result regardless of the measurement setting.
I have to take daily BP measurements during titration for ADHD medication. (Using an _A&D UA-611 Plus_ machine at home.)
I can put the cuff on my arm and sit at my desk for 20 minutes to be nicely rested and calm, and then take 5 different measurements with a few minutes between each one. They'll vary quite wildly (anything from, say, 115/75 to 135/90) despite not moving between measurements or having any reason to be more or less agitated. I generally just ignore the low/high outliers and average the others. There's no pattern either, sometimes the outliers are first, sometimes last.
Also it's not just the monitor I have at home, the same is true of a probably more trustworthy machine in a clinical setting. I mentioned this to my doctor when I last visited and we saw the same thing with multiple measurements using a more sophisticated machine at the clinic.
I check my BP a lot for reasons, too, and this matches my experience as well. A few tips to reduce the variance (but it'll never go away):
* the position of both of your arms, and the angle your elbows are bent at matters. make sure the edge of your desk isn't pushing into your forearm.
* same goes for both of your legs. make sure you're sitting with legs uncrossed, relaxed angles, make sure the edge of your chair isn't pushing into the back of your thighs excessively.
* control your posture. slouching seems to have an effect too, but I'm unclear on the mechanism.
Anecdotally, the nurses at the doctor's offices I go to rarely (~never) bother to control for any of this other than telling me not to cross my legs. So while I fully believe white coat hypertension is a thing, I also think there's a lot of poor control of variables here. If you look up the AMA/AHA guidelines for blood pressure, the ranges they offer are predicated on some very prescriptive protocols for measurement.. which I virtually never see adhered to.
Is this a digital reader? My readings were always high both at the doctors and at home. Bought an old school analog cuff and stethoscope, now it’s like 120/70 almost every time.
It was apparently the lack of control and the whizzing motor. Having direct fine control over the pump is downright relaxing in comparison.
> I can put the cuff on my arm and sit at my desk for 20 minutes to be nicely rested and calm, and then take 5 different measurements with a few minutes between each one. ...
Doesn't it take more than a few minutes for one's circulation to return to normal after a BP measurement?
Eh, not really. We measure blood pressure every five minutes (or less) for patients under anesthesia. They're pretty reliable. Of course, they're unconscious, so they can't really anticipate the discomfort of the cuff going up on their arm and react to that, and frankly given that they are being carved open the pain of a cuff is pretty minimal by comparison.
Yep. My heart-rate is normally pretty low (45bpm or so, 55 if I'm walking around), and my BP is on the high end of normal, but white-coat syndrome reliably brings it up to a fluttery 110bpm and 155/125 pressure. I was just in a wreck last week, so I got to see the before-and-after measurements from a few medical providers, and it's shocking how the act of talking to a new person in an unfamiliar environment spikes my BP even when I "know" that it's fine, and also how quickly it falls back down to normal.
I got it when an eye clinic wanted to do my blood pressure (which is kind of weird in itself), which they did shortly after the glaucoma test which never works for me because I have an overdeveloped blink reflex and it turned up high.
It really amazes me how people whose job it is to take blood pressure don’t recognize the stress situations that people are in might result in abnormal readings.
> It really amazes me how people whose job it is to take blood pressure don’t recognize the stress situations that people are in might result in abnormal readings.
I've had a doctor measure my heart rate right after remarking on my "elevated HR during intake" (I walked there and I was running late), after telling me some slightly distressing news on what was already a very stressful day, knowing about my white coat anxiety, and right around the time of peak effects of stimulant medication which they also know about. Wouldn't you believe it, my heart rate was high (110)!
Then I got a front seat to watch their confirmation bias kick in, and have them make some really faulty assumptions based on this bad information. They were quite sure that I had developed a certain medical condition but the lab tests quickly proved them completely wrong.
I tend to always have a higher heart rate whenever I'm at a doctor's office compared to when I've tested resting at home (in the 100-110 range compared to 90-95), and my experience is that anything in the triple digits will tend to get some concern from whoever is taking the measurements. It's gotten to the point that I need to preemptively tell them before they take the measurements that yes, it's going to be high, but I've seen a cardiologist about it, and they didn't consider it to be an issue given that it's consistently lower when tested in other circumstances. Without that disclaimer before hand, whoever takes the measurement often will grow concerned even a rate of something like 105 and feel the need to test again and ask a lot of probing questions. At this point I have to imagine that the level of scrutiny has only made my heart rate go up even more during those tests, making the disclaimer even more necessary to avoid my visits getting derailed.
I had an astoundingly high blood pressure reading last year when I tore my bicep the day after the election and dragged myself to the ER. The staff freaked. I was like, "I had a normal reading two weeks ago in my doctor's office and I'm really in an awful lot of pain and worry right now". But it still earned me the "oh shit hypertension you must do extra pre-surgical clearance".
It was kind of interesting watching my blood pressure tick down back to normal over the course of about 4 days though.
I guess the lesson is don't rip your bicep off, it will transiently elevate your BP. ;)
If they’re doing surgery it doesn’t matter why you have hypertension, or how temporary it is. The high blood pressure causes complications for the surgery itself.
That makes intuitive sense, if blood is under higher pressure they're going to need to work harder to prevent you from losing too much blood I would imagine.
Basically, yeah, that’s one of the concerns. Drug dosages and other things are affected too, but the most simple concern is “if we accidentally hit something and you start bleeding, above a certain blood pressure it won’t stop.”
Edit: Well, it will stop bleeding… once you lose enough blood.
Beyond any clinical reason that your eye clinic might want to know your blood pressure (your vascular system is pretty important to your vision) - they may have been incentivized by the CMS to track blood pressure via the MIPS program which ties provider payments to specific documentation and screening measures.
AKA - the government might pay your eye clinic more if they screen you for high blood pressure. (Among other things).
If you've got one of these machines at home it seems you really want to run it a couple of times. Often I find the first reading I get is quite alarming but then if I sit for a bit longer and run it another 1-2 times I get a very normal reading.
A big reason people's first measurement is often high is the positioning while putting the cuff on, adjusting to the pose, and then settling in place, a process which can spike pressure. Ideally you prepare yourself (cuff on, in place with your arms at rest, etc) and sit there and relax for five minutes before you take the first measurement, making it legitimately reflective of the at-rest state.
This often isn't possible, but it's a reason doctor visits usually drop you in a room by yourself with a machine that will take multiple measurements with a lengthy delay between. Though that's where the white coat thing comes into play and people are stressed about a doctor coming in, etc.
I probably have this, I've had several specialists take my blood pressure during consultations and express concern. I was prescribed a 24 hour ABMS (ambulatory blood pressure monitoring system, ie. wearable monitor) test, and came back with normal (if slightly high) readings.
This prompted me to do some research, and it turns out there's very strict guidelines for how to 'accurately' measure blood pressure, almost none of which were followed by most specialists. There's a laundry list of things that can each increase your blood pressure by 10-15mmHg (eg. drinking water, sitting cross legged, recent physical exercise, not sitting with the right posture, not sitting for at least 15 minutes).
Given this lackadaisical approach to measurement, I seriously question the diagnostic validity of blood pressure tests 'in the wild'.
Taking a BP in person during a medical consultation, while stressed out because I know I have a very limited amount of time to do a verbal data dump of a large amount of information in a good way never fails to give me extreme values.
It also never helps to explain that this has happened many times before and that I have a reasonably high quality BP measurement device at home (most recently the exact same Braun model) that gives me decent measurements when I'm at rest/relaxed. They just look at me like I'm an idiot. How could a civilian conceivably perform such a complex measurement?
Then I get the predictably insanely high measurement and they look satisfied. Gotcha!
> I tried feeding a lot of this into various Als (Kagi gives you access to a few with a nice interface) and I found that they mostly were stupid in ways that made me think
"stupid in ways that made me think" is (IMO) a really good summary of how AI is useful, as well as its pitfalls.
This would imply most LLMs on the market are decent rubber ducks. Search engines unrelated. Kagi isn't changing too much (I think) besides adding additional context from search results to your requests for XYZ LLM.
So I did something similar (well less cool), but as old Software devs start finding our bodies don’t work as well after a while we will see more and more of this sort of “taking control”
FWIW the latest version of the app does export the previous day's averages to Apple Health (only when you open the app, mind, which can make it look like there's missing data.) I use BPExtract to read the PDF and export every reading to Apple Health but I'll definitely be giving your stuff a go as well (because automation >> manual every time.)
I did wonder but I keep downloading to the app to “see how I am doing”
Throughout the day so I would not be easily able to sniff it - and I assumed that as a highly engineered professional “medical device” it would of course be encrypted with unbreakable … oh it’s probably base64
I am not even that old, but already seeing need to take some things into my own hands. I find going to a GP is more or less just a semaphore for specialists, and those specialists have wait times measured in months to years. I would be insane to just do nothing for that timeframe.
Although I think you need to be quite critical to have such a mindset, and assume you are wrong rather than right.
Would be fun to see the traffic dumps, I would love to try to figure out the protocol offline with them.
Just spent half a day reverse engineering a Windows virtual printer driver (for work) and had to force myself to stop spending the rest of the day doing it.
Las organizaciones obreras de los países petroleros mayores del mundo abusan de un derecho tecnológico q ayudara a avanzar en la extracción sin problemas e daños de los obreros o trabajadores en los cuales tienen una baja de 32 %de muertes en el trabajo
Bottles is essentially a frontend for Wine, it lets you put every single app to its own WINEPREFIX, so that each one can have their own settings, C: drive, etc.
If you've heard of Lutris, Bottles is essentially the same thing, but aimed at general software instead of only focusing on games
Well, things have to be named something. At least "Bottles" are related to "Wine" in a way that makes sense for a name for isolated Wine environments. It is also unique enough that Google will give you the answer quickly.
These have been around since I last used WINE in anger on macOS. Basically think of it as a container for running an app in WINE with all the settings predefined for best compatibility. The homepage doesn’t really highlight this but you can look through the docs for more information.
"Easily run Windows software on Linux with Bottles!"
That's all you need to know. If Linux wants to be more mainstream it needs to drop the "Bottles is a wrapper around WINE". What's a wrapper? What's WINE? It doesn't matter. All the user need to know that you can easily run Windows software on Linux with Bottles
The reason Bottles/WINE doesn't work with USB devices like that is likely because WINE isn't supposed to support kernel level device access. It's for running programs and just fakes enough for that to work.
I am only just learning this space but I believe you can set udev rules to get some USB devices working that might otherwise be failing. Worth a tinker.
I had my blood pressure tested several times over the course of the month and each time it was high, weirdly high, like 160/100. If I drove in, weirdly high. If I cycled in, weirdly high. If I got another reading after sitting quietly in the waiting room reading my book for half an hour, weirdly high.
They wanted me to start on all sorts of medications immediately.
The second-last time, they got a reading of 220/130, and were going to get an ambulance to take me into hospital immediately.
Er, hang on a minute, folks.
That's beyond "hypertension crisis" and well into "incompatible with life" levels. That's the kind of pressure I see in hydraulic servo feedback channels, not living things.
They grudgingly agreed that someone with high blood pressure probably ought not to be making as much sense as I was, although what would I know about it, they're the professionals, etc etc.
The next time I noticed the automatic blood pressure cuff had a fresh new calibration sticker on it.
130/90. Not bad, for a reading taken at the doctor's surgery.
I wonder how many people are on medication they just plain don't need because of a plainly faulty sphyg though?
> That's beyond "hypertension crisis" and well into "incompatible with life" levels. That's the kind of pressure I see in hydraulic servo feedback channels, not living things.
Blood pressures at this level can be observed from time to time. It’s not an instant death level.
Getting multiple readings is a good idea, but I would caution against picking the reading you like the most as the one which you believe to be correct.
You should also know that there are some conditions where high blood pressure can be transient. Some of these are very serious (tumors which secrete hormones which spike blood pressure). Having occasional scary high readings mixed in with occasional normal readings is actually typical with some of these conditions.
If I had any measurements show up that high I would invest in a cheap at home blood pressure device. They can be as cheap as $20. Then I’d collect a lot of measurements over several days.
Agree with all of the rest of your points, but a legitimate 220/130 is something that a typical doctor's office does observe* on occasion, so that (by itself) wouldn't have made them think their instrument was faulty. Some of those people would even be outwardly asymptomatic, as strange as that seems.
* those people would be considered to be in a hypertensive crisis, and sending you for emergency care would be the right thing to do, normally.
I love those visits. I've occasionally had sharp chest pains which go away after a number of seconds. They've never been accompanied by typical heart attack symptoms, so I usually ignore it (not smart, I get it).
After one such episode, I decided to schedule an appointment with my general practitioner. They refused to see me if I didn't go to the ER first. I was pretty certain I didn't need an ER visit, but went anyway.
I waited hours, a doctor eventually saw me in the waiting room, and was never admitted. I think it cost $2500 or so, with insurance covering only part.
Huh, that's interesting. That matches something that I get sometimes, usually after I've been driving a long distance or sitting at my desk doing mouse-heavy stuff for a long time. I put it down to poor posture.
It hasn't happened quite so much since adjusting the steering to track and centre properly so I'm not constantly pulling the car left away from the middle of the road, and raising my seat a bit by unscrewing the seat from its base, putting in about 8cm worth of wooden spacers, and screwing it back down with long studs and nuts instead of the daft wee screws, so it's not sitting at its "most extended" height.
I have a family member working in hospital setting. Electronics bairly survive a year from the amount of disinfectant they're exposed to. Everything is wiped so constantly that anything not made for the environment has its lettering stripped and rubber dissolved and cracked within short notice.
Maybe? Do they clean the shelves? Arm-to-arm contact isn't exactly a big threat.
> you think healthy people go to pharmacies?
Yes. Of course. Those free blood pressure machines are generally found in drug stores that have a small pharmacy section. The vast majority of people there are there because they're shopping. There are probably more people who come in to buy mascara than people who come in because they're sick. If you're sick, someone else goes to the pharmacy for you.
I have high blood pressure, managed with a low dose of medication. I've had plenty of advice from my PCP and other actual doctors on how to take blood pressure - how to sit, how long to sit still, how to position your arm, etc.
It is remarkable how many medically-adjacent professionals are bad at this. My dentist starts my sessions with a blood pressure reading - theoretically in case they have to numb me or something, probably because it's billable or whatever. What always seems to happen is that I get in for my appointment (driving, which can be stressful even if I'm not running late), they take me to the chair within 2 minutes max, immediately put some sort of wrist cuff on me, hold my arm at an angle that is not what most actual doctors have recommended to me and take a reading that is often high enough to surprise both the hygenist and myself.
The thing is that I have two sufficiently-calibrated Omron units, one at home and one at the office. I take my blood pressure often enough to know what it usually is (and my real doctor takes it at least twice a year). That is to say that no, it's not 200/160 or whatever nonsense the dentist thinks it is and you'd think that with a very small amount of reading they'd know better.
> Testing blood pressure after a shot seems weird.
I was at the Dr last week and my first BP reading was 154/95, a second reading a few minutes later was 141/89. The doctor asked for one more reading before I left.
The medical assistant gave me my vaccines and then took my BP, 130/81 right after a Hep B and COVID vaccine. I told the tech that needles didn’t bother me at all, she believed me after she saw my blood pressure :)
Buried deep is this gem:
Perfect summary of why AI is useful for rubber ducking. Doing this with a co-worker you always get some questions that are a few layers too shallow for what you need (because they haven't been thinking about it more than a few minutes), but it always makes you think and really helps.I’ve been wearing a heart rate monitor for a while, and after analysing the data, I noticed something interesting: my heart rate spikes in only two situations, when I’m driving, and when I’m talking to my wife.
I think we need a data point where you are driving and talking to your wife. For science.
Oura often interprets gym sessions as stress, and some people on social media argue that it's correct, that you can be stressed at the gym instead of simply listening to their bodies.
Last week, I met an experienced top swimmer who doesn't use any devices, he just listens to his own heartbeat.
Hopefully it’s love of cars and your woman.
Regarding white coat hypertension, the shot isn’t always necessary. Some people’s blood pressure just goes up from the stress of the clinical setting.
My friend went to see the doctor. A very attractive nurse took his blood pressure, which turned out to be off the charts. She goes out, comes back 5 minutes later and repeats, same results. Goes out and 10 minutes later and old bearded doctor comes in and repeats the tests.
Doctor ends up telling him that he was hoping it was just the attractive nurse, but no. He'd be starting medication today.
I had a doc appointment a couple of weeks ago. My wife was driving and we were running late, so I was getting stressed about missing the appointment on top of being stressed about going to see the doctor. There was a lot of traffic so I decided to get out at a red light and run to my appointment while my wife parked the car. I only barely made it and the first thing they did was take my pressure. They took it twice, because at the first they were like, this can't be right. When I explained, they asked if I had a blood pressure monitor at home so I could take my own pressure at a more quiet moment.
The guidelines for taking blood pressure state you should be sitting quietly for 5 minutes beforehand, something that almost never happens at the doctor's.
Mine constantly asks me questions during my measurements. I thought one wasn't supposed to be talking during the readings either?
My wife developed an autoimmune condition a few years ago that causes her to need to see a specialist every few months. For some reason, the hospital we've been going to uses these automated blood pressure readers that literally need to get wheeled around because they're four feet tall with a digital display, and during one of the early visits she had because of one of these conditions, the device bugged out or something and it kept squeezing her arm without releasing the pressure, and the person taking the reading didn't know how to disengage it manually and ran out of the room to go and find someone to help them without taking the time to rip off the velcro band on my wife's arm or anything. Ever since then, I literally get stressed every time my wife's blood pressure gets taken from one of those devices even though I'm not even the one who's getting measured!
I have an intense phobia of dentists; if I were wearing a constant monitor, I bet you could tell when I was at the dentist just by watching the blood pressure and heart rate spikes. (You'd have to find some way of differentiating them from me being in a car accident, or being attacked by a werewolf.)
Werewolf attacks usually fall on predictable dates, during night hours.
I wonder if it would show up on the heart rate (or heart rate variability) tracking from an Apple Watch or similar. My Garmin picks up stressful events all the time.
Just to be sure, the cure ain't no silver bullet.
It's interesting that you have a baseline for 'being attacked by a werewolf'.
You don’t??
“Luck favors the prepared.”
I have a mild fear of needles. Whenever my wife does acupuncture on me, I am quite uneasy in the beginning, looking away but still I end up covered in a bit of sweat till she finishes putting needles on all the points (and sometimes they are properly weird places I wouldn't imagine sticking tiny needle into... doesn't help). Don't monitor the heart rate/pressure but it must jump up significantly
Just to be clear, 'fang doctor' doesn't actually refer to a medical werewolf. :D
It's a medical vampire, for when a medicinal leech is not sufficient.
White coast hypertension isn't just about a clinical setting, it's more generally about the worry about the results of having your BP measured. [EDIT] OK, well maybe there's another type of hypertension which is related to anxiety about a high result regardless of the measurement setting.
I have to take daily BP measurements during titration for ADHD medication. (Using an _A&D UA-611 Plus_ machine at home.)
I can put the cuff on my arm and sit at my desk for 20 minutes to be nicely rested and calm, and then take 5 different measurements with a few minutes between each one. They'll vary quite wildly (anything from, say, 115/75 to 135/90) despite not moving between measurements or having any reason to be more or less agitated. I generally just ignore the low/high outliers and average the others. There's no pattern either, sometimes the outliers are first, sometimes last.
Also it's not just the monitor I have at home, the same is true of a probably more trustworthy machine in a clinical setting. I mentioned this to my doctor when I last visited and we saw the same thing with multiple measurements using a more sophisticated machine at the clinic.
I check my BP a lot for reasons, too, and this matches my experience as well. A few tips to reduce the variance (but it'll never go away):
* the position of both of your arms, and the angle your elbows are bent at matters. make sure the edge of your desk isn't pushing into your forearm.
* same goes for both of your legs. make sure you're sitting with legs uncrossed, relaxed angles, make sure the edge of your chair isn't pushing into the back of your thighs excessively.
* control your posture. slouching seems to have an effect too, but I'm unclear on the mechanism.
Anecdotally, the nurses at the doctor's offices I go to rarely (~never) bother to control for any of this other than telling me not to cross my legs. So while I fully believe white coat hypertension is a thing, I also think there's a lot of poor control of variables here. If you look up the AMA/AHA guidelines for blood pressure, the ranges they offer are predicated on some very prescriptive protocols for measurement.. which I virtually never see adhered to.
Is this a digital reader? My readings were always high both at the doctors and at home. Bought an old school analog cuff and stethoscope, now it’s like 120/70 almost every time.
It was apparently the lack of control and the whizzing motor. Having direct fine control over the pump is downright relaxing in comparison.
> I can put the cuff on my arm and sit at my desk for 20 minutes to be nicely rested and calm, and then take 5 different measurements with a few minutes between each one. ...
Doesn't it take more than a few minutes for one's circulation to return to normal after a BP measurement?
Eh, not really. We measure blood pressure every five minutes (or less) for patients under anesthesia. They're pretty reliable. Of course, they're unconscious, so they can't really anticipate the discomfort of the cuff going up on their arm and react to that, and frankly given that they are being carved open the pain of a cuff is pretty minimal by comparison.
Get on ACE inhibitors. Even a low dose cuts out the variance.
Recently I was talking with someone who speculated that "hot doctors never get accurate heart rate measurements"
It took me a minute to understand (and neither of us think this is 100% true) but it's both funny and a good point.
Yep. My heart-rate is normally pretty low (45bpm or so, 55 if I'm walking around), and my BP is on the high end of normal, but white-coat syndrome reliably brings it up to a fluttery 110bpm and 155/125 pressure. I was just in a wreck last week, so I got to see the before-and-after measurements from a few medical providers, and it's shocking how the act of talking to a new person in an unfamiliar environment spikes my BP even when I "know" that it's fine, and also how quickly it falls back down to normal.
I got it when an eye clinic wanted to do my blood pressure (which is kind of weird in itself), which they did shortly after the glaucoma test which never works for me because I have an overdeveloped blink reflex and it turned up high.
It really amazes me how people whose job it is to take blood pressure don’t recognize the stress situations that people are in might result in abnormal readings.
> It really amazes me how people whose job it is to take blood pressure don’t recognize the stress situations that people are in might result in abnormal readings.
I've had a doctor measure my heart rate right after remarking on my "elevated HR during intake" (I walked there and I was running late), after telling me some slightly distressing news on what was already a very stressful day, knowing about my white coat anxiety, and right around the time of peak effects of stimulant medication which they also know about. Wouldn't you believe it, my heart rate was high (110)!
Then I got a front seat to watch their confirmation bias kick in, and have them make some really faulty assumptions based on this bad information. They were quite sure that I had developed a certain medical condition but the lab tests quickly proved them completely wrong.
110 isn't high, though?
I tend to always have a higher heart rate whenever I'm at a doctor's office compared to when I've tested resting at home (in the 100-110 range compared to 90-95), and my experience is that anything in the triple digits will tend to get some concern from whoever is taking the measurements. It's gotten to the point that I need to preemptively tell them before they take the measurements that yes, it's going to be high, but I've seen a cardiologist about it, and they didn't consider it to be an issue given that it's consistently lower when tested in other circumstances. Without that disclaimer before hand, whoever takes the measurement often will grow concerned even a rate of something like 105 and feel the need to test again and ask a lot of probing questions. At this point I have to imagine that the level of scrutiny has only made my heart rate go up even more during those tests, making the disclaimer even more necessary to avoid my visits getting derailed.
Sorry, I thought BP, please disregard my comment.
It would be pretty high for a resting heart rate.
Oh sorry, I thought BP.
High enough blood pressure for long enough can damage the blood vessels in the retina.
https://my.clevelandclinic.org/health/diseases/25100-hyperte...
I had an astoundingly high blood pressure reading last year when I tore my bicep the day after the election and dragged myself to the ER. The staff freaked. I was like, "I had a normal reading two weeks ago in my doctor's office and I'm really in an awful lot of pain and worry right now". But it still earned me the "oh shit hypertension you must do extra pre-surgical clearance".
It was kind of interesting watching my blood pressure tick down back to normal over the course of about 4 days though.
I guess the lesson is don't rip your bicep off, it will transiently elevate your BP. ;)
If they’re doing surgery it doesn’t matter why you have hypertension, or how temporary it is. The high blood pressure causes complications for the surgery itself.
That makes intuitive sense, if blood is under higher pressure they're going to need to work harder to prevent you from losing too much blood I would imagine.
Basically, yeah, that’s one of the concerns. Drug dosages and other things are affected too, but the most simple concern is “if we accidentally hit something and you start bleeding, above a certain blood pressure it won’t stop.”
Edit: Well, it will stop bleeding… once you lose enough blood.
Beyond any clinical reason that your eye clinic might want to know your blood pressure (your vascular system is pretty important to your vision) - they may have been incentivized by the CMS to track blood pressure via the MIPS program which ties provider payments to specific documentation and screening measures.
AKA - the government might pay your eye clinic more if they screen you for high blood pressure. (Among other things).
If you've got one of these machines at home it seems you really want to run it a couple of times. Often I find the first reading I get is quite alarming but then if I sit for a bit longer and run it another 1-2 times I get a very normal reading.
FWIW, some "smarter" machines (e.g., [0, 1]) support taking three readings with a minute pause in-between and then spit out a single reading.
[0] https://www.garmin.com/en-US/p/716808/ [1] https://www.withings.com/us/en/bpm-connect
The $50 I got from the pharmacy does it too, if the reader doesn't want to spend $100+ on a device.
Actually that is what my doctor told me to do, this seems standard procedure to measure twice every time with 1-2 minutes in between.
Also, they can read high if the batteries are low.
A big reason people's first measurement is often high is the positioning while putting the cuff on, adjusting to the pose, and then settling in place, a process which can spike pressure. Ideally you prepare yourself (cuff on, in place with your arms at rest, etc) and sit there and relax for five minutes before you take the first measurement, making it legitimately reflective of the at-rest state.
This often isn't possible, but it's a reason doctor visits usually drop you in a room by yourself with a machine that will take multiple measurements with a lengthy delay between. Though that's where the white coat thing comes into play and people are stressed about a doctor coming in, etc.
My question would be… how often are you stressed?
My BP at home? 140/90. I walk into my cardiologists office, do my BP? 107/60.
It’s not the cuff position as I used multiple positions, cuffs, and sensors. All 140/90. Plus I feel it.
It’s wild. My BP/HR fluctuates alot outside of clinical, but inside clinical it drops.
I probably have this, I've had several specialists take my blood pressure during consultations and express concern. I was prescribed a 24 hour ABMS (ambulatory blood pressure monitoring system, ie. wearable monitor) test, and came back with normal (if slightly high) readings.
This prompted me to do some research, and it turns out there's very strict guidelines for how to 'accurately' measure blood pressure, almost none of which were followed by most specialists. There's a laundry list of things that can each increase your blood pressure by 10-15mmHg (eg. drinking water, sitting cross legged, recent physical exercise, not sitting with the right posture, not sitting for at least 15 minutes).
Given this lackadaisical approach to measurement, I seriously question the diagnostic validity of blood pressure tests 'in the wild'.
Yeah, my doctor said they always add some padding to the measures for this same reason.
Taking a BP in person during a medical consultation, while stressed out because I know I have a very limited amount of time to do a verbal data dump of a large amount of information in a good way never fails to give me extreme values.
It also never helps to explain that this has happened many times before and that I have a reasonably high quality BP measurement device at home (most recently the exact same Braun model) that gives me decent measurements when I'm at rest/relaxed. They just look at me like I'm an idiot. How could a civilian conceivably perform such a complex measurement?
Then I get the predictably insanely high measurement and they look satisfied. Gotcha!
Please bring on the AI doctors.
my best shot at it:
unsatisfyingly I don't have any idea what the gaps are or why parts need to be reversed, so i could be wrong. With the data from the post:Orange juice and bannas. My BP was 142/90 and is now 125/80. Eating these twice a day nets you nearly 2000 MG potassium.
"I'm pretty sure that reverse-engineering this will be good for my blood pressure."
I feel healthier after reading this.
> I tried feeding a lot of this into various Als (Kagi gives you access to a few with a nice interface) and I found that they mostly were stupid in ways that made me think
"stupid in ways that made me think" is (IMO) a really good summary of how AI is useful, as well as its pitfalls.
yup, its a decent "Rubber duck" and an ok search engine.
https://en.wikipedia.org/wiki/Rubber_duck_debugging
This would imply most LLMs on the market are decent rubber ducks. Search engines unrelated. Kagi isn't changing too much (I think) besides adding additional context from search results to your requests for XYZ LLM.
I heard it was a stuffed bear. "tell it to the bear" they'd say, and point without looking up.
So I did something similar (well less cool), but as old Software devs start finding our bodies don’t work as well after a while we will see more and more of this sort of “taking control”
https://mikado-aktiia.readthedocs.io/en/latest/
> "It will not connect to Apple Health"
FWIW the latest version of the app does export the previous day's averages to Apple Health (only when you open the app, mind, which can make it look like there's missing data.) I use BPExtract to read the PDF and export every reading to Apple Health but I'll definitely be giving your stuff a go as well (because automation >> manual every time.)
That's very cool. I wonder if sniffing the Bluetooth connection directly might be easier than reading the PDF (although not because it's easy).
At least you have more than 24 hours to find out!
I did wonder but I keep downloading to the app to “see how I am doing” Throughout the day so I would not be easily able to sniff it - and I assumed that as a highly engineered professional “medical device” it would of course be encrypted with unbreakable … oh it’s probably base64
nRF Connect for Mobile[0] could be handy here.
https://www.nordicsemi.com/Products/Development-tools/nRF-Co...
I am not even that old, but already seeing need to take some things into my own hands. I find going to a GP is more or less just a semaphore for specialists, and those specialists have wait times measured in months to years. I would be insane to just do nothing for that timeframe.
Although I think you need to be quite critical to have such a mindset, and assume you are wrong rather than right.
you missed a closing parenthesis
Would be fun to see the traffic dumps, I would love to try to figure out the protocol offline with them.
Just spent half a day reverse engineering a Windows virtual printer driver (for work) and had to force myself to stop spending the rest of the day doing it.
Las organizaciones obreras de los países petroleros mayores del mundo abusan de un derecho tecnológico q ayudara a avanzar en la extracción sin problemas e daños de los obreros o trabajadores en los cuales tienen una baja de 32 %de muertes en el trabajo
Not a single comment in here about Bottles - what exactly is it?
Bottles is essentially a frontend for Wine, it lets you put every single app to its own WINEPREFIX, so that each one can have their own settings, C: drive, etc.
If you've heard of Lutris, Bottles is essentially the same thing, but aimed at general software instead of only focusing on games
Nice, using home-brew style incomprehensible nomenclature
Well, things have to be named something. At least "Bottles" are related to "Wine" in a way that makes sense for a name for isolated Wine environments. It is also unique enough that Google will give you the answer quickly.
https://news.ycombinator.com/item?id=45894878
I use Bottles regularly and really like it.
There's nothing groundbreaking about it, but it's a straightforward way to run apps with Wine with an intuitive and pretty interface.
(They're currently working on a 2.0 release, though that's probably gonna take a while.)
https://usebottles.com/
These have been around since I last used WINE in anger on macOS. Basically think of it as a container for running an app in WINE with all the settings predefined for best compatibility. The homepage doesn’t really highlight this but you can look through the docs for more information.
Have you used it/would you recommend it?
It's been a long time since I used wine (or any windows software really... Yay!) but I'm sure the requirement will pop up again sooner or later.
Should I check out bottles the next time it comes up?
https://github.com/bottlesdevs/Bottles
https://usebottles.com
I read this entire page, it spelled out the benefits, but didn't tell me what it actually IS or DOES.
For example, "Bottles is a wrapper around WINE"
>but didn't tell me what it actually IS or DOES
It tells you right at the start:
"Easily run Windows software on Linux with Bottles!"
That's all you need to know. If Linux wants to be more mainstream it needs to drop the "Bottles is a wrapper around WINE". What's a wrapper? What's WINE? It doesn't matter. All the user need to know that you can easily run Windows software on Linux with Bottles
I guess having a look at the binary with ghidra would make this a lot easier.
The reason Bottles/WINE doesn't work with USB devices like that is likely because WINE isn't supposed to support kernel level device access. It's for running programs and just fakes enough for that to work.
I am only just learning this space but I believe you can set udev rules to get some USB devices working that might otherwise be failing. Worth a tinker.
"Turns out that when you check someone's blood pressure after giving them an injection, it's higher than normal."
Nick-Cage-You-Dont-Say.png
I have three blood pressure cuffs
They all give me different numbers, by a lot sometimes
btw you think they ever clean those devices?
you think healthy people go to pharmacies?
I won't even touch the signature pen, imagine what's on that
I had my blood pressure tested several times over the course of the month and each time it was high, weirdly high, like 160/100. If I drove in, weirdly high. If I cycled in, weirdly high. If I got another reading after sitting quietly in the waiting room reading my book for half an hour, weirdly high.
They wanted me to start on all sorts of medications immediately.
The second-last time, they got a reading of 220/130, and were going to get an ambulance to take me into hospital immediately.
Er, hang on a minute, folks.
That's beyond "hypertension crisis" and well into "incompatible with life" levels. That's the kind of pressure I see in hydraulic servo feedback channels, not living things.
They grudgingly agreed that someone with high blood pressure probably ought not to be making as much sense as I was, although what would I know about it, they're the professionals, etc etc.
The next time I noticed the automatic blood pressure cuff had a fresh new calibration sticker on it.
130/90. Not bad, for a reading taken at the doctor's surgery.
I wonder how many people are on medication they just plain don't need because of a plainly faulty sphyg though?
> That's beyond "hypertension crisis" and well into "incompatible with life" levels. That's the kind of pressure I see in hydraulic servo feedback channels, not living things.
Blood pressures at this level can be observed from time to time. It’s not an instant death level.
Getting multiple readings is a good idea, but I would caution against picking the reading you like the most as the one which you believe to be correct.
You should also know that there are some conditions where high blood pressure can be transient. Some of these are very serious (tumors which secrete hormones which spike blood pressure). Having occasional scary high readings mixed in with occasional normal readings is actually typical with some of these conditions.
If I had any measurements show up that high I would invest in a cheap at home blood pressure device. They can be as cheap as $20. Then I’d collect a lot of measurements over several days.
Agree with all of the rest of your points, but a legitimate 220/130 is something that a typical doctor's office does observe* on occasion, so that (by itself) wouldn't have made them think their instrument was faulty. Some of those people would even be outwardly asymptomatic, as strange as that seems.
* those people would be considered to be in a hypertensive crisis, and sending you for emergency care would be the right thing to do, normally.
Can confirm; had a 210/110 legit BP reading. Multiple cuffs and sensors confirmed. I felt it too.
Walked into the ER because my Dr forced me too. After walking into and chilling for a bit. 130/70. $3000 later no answers.
So, it does happen to people.
I love those visits. I've occasionally had sharp chest pains which go away after a number of seconds. They've never been accompanied by typical heart attack symptoms, so I usually ignore it (not smart, I get it).
After one such episode, I decided to schedule an appointment with my general practitioner. They refused to see me if I didn't go to the ER first. I was pretty certain I didn't need an ER visit, but went anyway.
I waited hours, a doctor eventually saw me in the waiting room, and was never admitted. I think it cost $2500 or so, with insurance covering only part.
(For what its worth, I probably have this: https://en.wikipedia.org/wiki/Precordial_catch_syndrome)
> (For what its worth, I probably have this: https://en.wikipedia.org/wiki/Precordial_catch_syndrome)
Huh, that's interesting. That matches something that I get sometimes, usually after I've been driving a long distance or sitting at my desk doing mouse-heavy stuff for a long time. I put it down to poor posture.
It hasn't happened quite so much since adjusting the steering to track and centre properly so I'm not constantly pulling the car left away from the middle of the road, and raising my seat a bit by unscrewing the seat from its base, putting in about 8cm worth of wooden spacers, and screwing it back down with long studs and nuts instead of the daft wee screws, so it's not sitting at its "most extended" height.
I don't know, it might help you too.
I have a family member working in hospital setting. Electronics bairly survive a year from the amount of disinfectant they're exposed to. Everything is wiped so constantly that anything not made for the environment has its lettering stripped and rubber dissolved and cracked within short notice.
> btw you think they ever clean those devices?
Maybe? Do they clean the shelves? Arm-to-arm contact isn't exactly a big threat.
> you think healthy people go to pharmacies?
Yes. Of course. Those free blood pressure machines are generally found in drug stores that have a small pharmacy section. The vast majority of people there are there because they're shopping. There are probably more people who come in to buy mascara than people who come in because they're sick. If you're sick, someone else goes to the pharmacy for you.
If you think that's bad, just think about what's in those finger-holes in bowling balls, between rounds of beer, bowling, and greasy bar food :)
…yup, I think I’ve bowled enough for one life!
What's flu vaccine?
Not much, what's flu with you?
A vaccination against (what they hope will be the most common strains of) the influenza virus.
Testing blood pressure after a shot seems weird.
I have high blood pressure, managed with a low dose of medication. I've had plenty of advice from my PCP and other actual doctors on how to take blood pressure - how to sit, how long to sit still, how to position your arm, etc.
It is remarkable how many medically-adjacent professionals are bad at this. My dentist starts my sessions with a blood pressure reading - theoretically in case they have to numb me or something, probably because it's billable or whatever. What always seems to happen is that I get in for my appointment (driving, which can be stressful even if I'm not running late), they take me to the chair within 2 minutes max, immediately put some sort of wrist cuff on me, hold my arm at an angle that is not what most actual doctors have recommended to me and take a reading that is often high enough to surprise both the hygenist and myself.
The thing is that I have two sufficiently-calibrated Omron units, one at home and one at the office. I take my blood pressure often enough to know what it usually is (and my real doctor takes it at least twice a year). That is to say that no, it's not 200/160 or whatever nonsense the dentist thinks it is and you'd think that with a very small amount of reading they'd know better.
> Testing blood pressure after a shot seems weird.
I was at the Dr last week and my first BP reading was 154/95, a second reading a few minutes later was 141/89. The doctor asked for one more reading before I left.
The medical assistant gave me my vaccines and then took my BP, 130/81 right after a Hep B and COVID vaccine. I told the tech that needles didn’t bother me at all, she believed me after she saw my blood pressure :)
Needles don't bother me, but being made to wait 30+ minutes past my appointment time does.
They should measure it right when I walk in, before I find out how behind the doctor is.