Commonly used arm positions can overestimate blood pressure readings: study

I am not a doctor and this is not advice. This is a standard medical test I have completely given up on any doctor to perform accurately. I do it myself at home once or twice a month. I do it with the same device, in the same chair, at the same desk, the same time of day, after I’ve ate and drank the same thing. Yes, I still let everyone take it because it’s typically a precondition of receiving care but my readings at home are completely different and give me a more accurate data point that actually makes me feel good about the progress I’ve been making on my health.

I’m actively looking for more healthcare I can do this way. I trust my data and it all coming together on the safety of my personal device. We don’t need doctors with extremely limited datasets to do this and try to find obscure correlations for us.

> typically a precondition of receiving care

I've achieved exciting results by flatly refusing vitals checks at each and every medical appointment. Especially psychiatrists. The PCPs always gamely admire my self-reported histories and graphs, commenting how nicely the trend line goes down, and then completely dismiss the results in their clinical notes.

However, I did lock horns with a particular chiropractor. I filled out the "pre-existing conditions" form with candor and honesty. I permitted a BP check. (His method was 100% manual sphygmomanometer.)

Then he informed me that he wouldn't touch me until my BP was controlled and normal. Yes, a chiropractor, not a cardiac surgeon. Geez.

In the past, I've tried to avoid submitting to blood draws and labs, because those are 100% fishing expeditions, and not actually attempting to diagnose a complaint or symptoms. (They love to misdiagnose hypothyroid or diabetes so they can begin destroying your endocrines.)

Unfortunately, clinics do these orders on a schedule, so if you avoid labs for a while, the orders simply pile up until they contrive to get them all done. I couldn't win. Still putting off colonoscopy: 2.5 years late, and counting!

> after I’ve ate and drank the same thing

My doctor recommended doing it first thing in the morning, before eating or drinking anything. That's probably an easier way for the general population to establish a consistent baseline

>This is a standard medical test I have completely given up on any doctor to perform accurately. I do it myself at home once or twice a month. I do it with the same device, in the same chair, at the same desk, the same time of day, after I’ve ate and drank the same thing.

You are assuming the average patient is this careful about measuring their BP, or anything about their health. You are also assuming the average patient measures their BP correctly, which is obviously untrue as evidenced by some other comments on this post. You are also assuming patients always tell the truth about their own measurements.

>We don’t need doctors with extremely limited datasets to do this and try to find obscure correlations for us.

I don't understand what you mean by this. None of us finds obscure correlations with limited datasets. We don't diagnose someone over a single BP measurement.

It's not only easier, but the actual correct way of doing it. That's why your doctor recommended it.

But why go to these practitioners if you don't trust them ? Nobody should be forcing you. Is it because you want access to treatment solely on your own terms ?

>Still putting off colonoscopy

I hope you won't regret putting it off.

>They love to misdiagnose hypothyroid or diabetes so they can begin destroying your endocrines

Yes, my favorite pastime when I'm bored of treating "actual" diseases.

I fail to understand how a well-educated group of people (aka. HN) can be this against the scientific method.

> We don't diagnose someone over a single BP measurement.

Yeah I feel like no doctor of mine has ever been the type to do that. My current PCP wouldn't prescribe meds for hypertension until after I took my own BP at home for a month (it was not catastrophically high when measured at his office, he might have taken a different approach in that situation).

Even with a catastrophically high measurement, no doctor would diagnose with a single data point. At worst, they would ask the patient to measure at home multiple times a day, after teaching the correct method of measurement. At best, they would do an ambulatory monitoring.

Every single health related thread is like this. Dude thinks because he's been programming JavaScript for 10 years he's a literal genius. It's pathetic.

Lol.

Hopefully you get lucky. Why address cancer, insulin resistance or stroke risks early?

He's intentionally refusing care and just living his life. I don't agree with that, but I do understand it.

We all shuffle off someday. What's the worst that can happen? He dies?

False. I went into a first visit at a doctor office one time and after spending about five minutes total with me he sent me home with a BP Rx. No mention of verifying it with home readings to make sure I really need it and he didn't even bother giving me standard advice like lose weight. Most other doctors did only slightly better. Insurance only reimburses for like 10 minutes of their time, half of which is spent updating records, so it's unsurprising they don't have time to properly handle your problem.

Amazing it’s like you’ve figured out the optimal strategy of still spending the same amount of time going to the doctors but getting as few benefits as possible.

I’m pretty sure you can decline care and get second opinions no matter what.

I don’t know your family background, but I have quite a few older male relatives who died from cancers that if caught early have high survivability. They were all suspicious of the profit incentives of the medical system and felt they knew better or were tough enough to not care. My grandfather had a heart murmur, so he used that as an excuse to never go to the doctors. “They just want my money I already know my heart will kill me soon so why bother”. He died of colon cancer. I’m sure they all regretted it.

Nobody is "forced" to get health care in the United States, [except once you're unconscious, insane, or incarcerated, and the ambulance arrives] but what are the penalties if we don't? A PCP is the only one who can route me to a specialist if I really needed one. If I broke my leg again, or had some other emergency, it'd be nice to have a followup with someone who already has us on file, rather than trying to get past all the gatekeepers for an initial visit.

Every insurance company will urge their customers to establish and visit the PCP on the regular. Every social services agency simply assumes... demands... that citizens have a relationship with medicine and that we dutifully visit the doctor to keep up on health issues. It's outright heresy and treason to say that you won't participate at all.

A physician is the only one who can keep records relating to disability cases. A physician is the only one who can write me a note if I'm unable to work. Eventually you'll need to release medical records to a third party in order to access benefits or qualify for something, so those records had better pre-exist! A physician is the only one who can diagnose or treat any disease, so what else would we do if we got truly sick?

John 6:68

Maybe not a diagnosis, but dependent on history if my patient is throwing repeatable >200 systolic that's probably not one I'm going to just sit on waiting for repeat measurements.

I got started in BP medication after like 2 readings.

Modern civilized countries pay for healthcare with taxes. That costs everyone more with his decisions.

> They love to misdiagnose hypothyroid or diabetes so they can begin destroying your endocrines

Im sorry but as a doctor this made me crack up. I don't know what it is about HN that makes people jump into every medical thread and say really absurd things. Skipping screening tests isn't one-upping your PCP. You just get to play harder with specialty when stuff starts to break. Good luck buddy.

Super preventable stuff too. "Itchy mole, prob nothing." Ope, it's a melanoma and has spread everywhere. You have 6 months to live.

If it wasn’t actually bothering him, I doubt he would be spending so much time and effort dodging it. Either ignore it (actually), or just do it, eh?

Instead he seems to be intentionally playing a high stakes game of chicken. Weird.

I understand what you say, and there is some truth to it. However it's also justified that society asks something in return for societal benefits. That's pretty much the foundings of insurance. The extent to which that should go is debatable, of course.

If those involved are in the US, it’s a trust thing.

This isn’t the fault of medical professionals, but rather a system optimized for minimum risk and maximum billing.

For example, my adult son recently went through a bout of rectal bleeding. He sits a lot in his job and we assumed it was hemorrhoids.

It was a Saturday so rather than wait we met up at the local urgent care. They did an external exam and decided he needed to go to the ER. No, it couldn’t wait. We had to go right away.

So we went across the street to the ER and took up a bed for seven hours waiting for a CT scan and results. The CT scan showed no active bleeding or any other cause for concern.

At this point, it was 2AM. The ER doctor suggested we allow our son to be admitted so that they could accelerate a colonoscopy on Monday or Tuesday. Yes, that’s 2-3 days in a hospital room just so we could avoid outpatient delays.

Now, keep in mind, there are no other symptoms. He feels perfectly fine. The CT scan shows no active bleeding.

To us, admission seems like overkill. The doctor isn’t much help. They are mostly exhausted and also exasperated at “the state of health care in this country.” We try to be empathetic but more or less it feels like they are holding back.

So what to do? Well, my son made his own decision - we left. The next day, I called in a favor with a GI doc I know. We were able to get a colonoscopy 10 days later. Guess what? Internal hemorrhoids.

This is irritating enough, but what is even better is that we could have had that answer in 15 minutes if someone had pulled out an anoscope. Sure we’d likely need an colonoscopy as a follow-up but we could have been out of the system very quickly. We could have freed up that bed in the ER. Heck, we didn’t even need to be in the ER at all. Oh, and 10 days of needless worry would be gone.

I asked a hospitalist I know why no one thought to just have a peek. The answer? Oh, they definitely thought about it, but no one uses anoscopes these days. The preferred route is a colonoscopy. Why? Well, a colonoscopy is a better diagnostic tool, but frankly it also happens to allow for better billing.

And boy, oh boy is the billing good. For the hospital alone, we’ve got upwards of $6K in billing. Who knows what the colonoscopy will run. We have good insurance but to cover the deductible I’ll likely be out $2K.

Naturally, I’ve already called the hospital and asked them to conduct a billing review, which will be followed by a medical review. The result will likely be a claim by the hospital that all procedures were followed correctly, which is technically correct. They did it all by the book, wasted an enormous amount of time and money, and irritated all humans involved.

Anyway, this anecdotal story might explain why well-educated people are suspicious of modern medical practices (at least in the US).

FWIW, I’m in my mid-50s and I’ve not had a colonoscopy either, and I won’t be getting one. It isn’t that I don’t want to take care of myself but rather I can’t afford to actually know if I’m sick. In the end, squeezing a little extra life out isn’t worth the financial tradeoff for my family in the long run.

Dying young six months after diagnosis might be cheaper for society than a long malaise during old age.

I intend not to die of chemotherapy. And no, I shall never regret being a prudent steward of taxpayer resources. Let's consider the collective good over an individual's selfish longevity.

What would Mr. Spock say about "The Good of the Many"?

No, his quality of life and mental state is severely impacted for years if not decades at a time and he slowly, and very painfully, dies.

My father said the exact same thing about smoking. What's the worst that can happen, I die? Oh no - the worst that can happen is you living far too long.

How does your adult son feel about his father posting extensive public comments about his anus?

Same here. I feel like the type of physician who comments on HN may not be representative of the average PCP.

Perhaps I'll go for "Cologuard" instead?

https://youtu.be/Mu12X2cu6Y0?si=bn17f2Lbx9SQUE9y

It's not just medical threads, it's tech too. You (probably, I'm assuming) just don't know the tech as well as you do the medicine, so it doesn't stand out as absurd to you.

Given that he is also an engineer I doubt he cares. Everyone has one.

I have expertise in both. I think the difference is that when moving from the highly rigid world of medicine into tech, I expected the varied level of skill and knowledge that exists. It just throws you off seeing people in tech with no background in medicine talk about medicine like they know it.

Most of my closest friends are docs. A couple of times at a brewery I've had them read some braindead takes from here for laughs. The people here making wild comments on the architecture of o1 or whatever don't get the same reaction from the crowd.

Fair (and very cool!), sorry for the assumption.

I see people speaking complete falsehoods about things I have material knowledge of here, and either don't have the energy or the latitude to correct them.

And those reactions to (e.g.) o1 speculation are happening in (e.g.) OpenAI, I'm sure, haha.