The KHIT Blog: My personal G20 Summit

Thursday, December 19, 2019

My personal G20 Summit

ICD-10, that is.

On December 10th I wrote a post entitled "dx: Parkinson's?"

Just got back from my Kaiser Neurology consult.

Yep. From my visit notes: "Your exam is consistent with clinical diagnosis of Parkinson's disease..."

ICD-10 code G20

There're no direct bioassay nor imaging dx indicators. No cure. Not fatal, just progressively debilitating. Meds are problematic. They ordinal-rank "stage" it I - V. I feel like a 1.5, subjectively. Elevated fall risk is my particular priority concern.

Had a tangential lab draw (thyroid indicator), came home, put on a slow-cook pot of chili, and I'm shortly off to another KP facility for a 3:45 CT brain scan.

To see if they can find one (wocka-wocka), and to rule out any tumor(s)--one would hope.

What-EVER!

Guess I'll have to launch a support/info podcast. This is how you learn. Throw stuff out there--after doing your onset due diligence, so you don't look foolish.

Down in the basement family room. Pulled up one of my old Vegas Logic Pro X podcast tracks onscreen, put one of my mics in front of it, shot a pic with my iPhone, uploaded it to Photoshop, added the text, then took another iPhone pic of all that, with my mug in the shot (with Ranger sitting by, just out of the shot).

I've been told that I have a great face for radio, so this will be a natural.

Called my amazing musician-singer-songwriter friend Doug Brons in Grant's Pass, Oregon, asked his permission to use one of his tunes as my chase tune, segue and v/o-bkg music, a song called 'Dance." Granted.

Sometimes you're up,
Sometimes you're down,
Life can spin you
Like a merry-go-round.
Best way to chase it
Is to face it, you see,
Just get up and dance...

'eh?

Registered a blog name. Will fire stuff up and get to it ASAP.

Gotta run. Back at'cha later. Stay tuned.

UPDATE

CT brain scan was negative for any pathology (or much else, some might say). Good news. Plan hereafter for now includes stepped-up regular vigorous exercise, which I've already begun (my hoops Jones, to which I'm gonna at least add therapeutic "shadow boxing" at the Y):

Various studies in the 1980s and 1990s supported the notion that rigorous exercise, emphasizing gross motor movement, balance, core strength, and rhythm, could favorably impact range of motion, flexibility, posture, gait, and activities of daily living. More recent studies, most notably at Cleveland Clinic, focus on the concept of intense “forced” exercise, and have begun to suggest that certain kinds of exercise may be neuro-protective, i.e., actually slowing disease progression...[link]

And, more more concerted daily guitar practice, which I need anyway. If I lose my guitar chops, that will be way bad for my headspace.

Not gonna do the Sinemet Rx, for now. Gotta be a better way to elevate the dopamine.

Lots to learn. Lots to try to contribute. Props to my KP physicians thus far.

And, [Bleep] Parkinson's.

SPEAKING OF LEARNING

Add four more to the endless reading pile.

Stay tuned.

WEEKEND UPDATE

Friday cardiology post-SAVR px annual follow-up. Everything looking great there. Really like my new KP cardiologist. Onward to confront my "G20" head-on.

GUITAR THERAPY

Posted this on Crackbook.

If I lose my chops... I don't wanna think about it.

OK, enough boo-hoo'ing. How about a few laughs?

_____________

More to come...

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Brave New Health

Commonwell Health Alliance

Another important read (pdf)

I love this kind of stuff. It sustains and humbles me. "As politicians, advertisers, salesmen, and propagandists for various political, economic, moral, religious, psychic, environmental, dietary, and artistic doctrinaire positions know only too well, fallible human minds are easily tricked, by clever verbiage... Common language—or at least, the English language—has an almost universal tendency to disguise epistemological statements by putting them into a grammatical form which suggests to the unwary an ontological statement. A major source of error in current probability theory arises from an unthinking failure to perceive this."

Quotes

"An economist is a person who sees something that works in practice and tries to figure out whether it will work in theory."

- J.D. Kleinke, medical economist
___

"The only person who enjoys change is a baby with a wet diaper."

"Every misspent dollar in our health care system is part of somebody's paycheck.

- Brent James, M.D., M.Stat

“We could do healthcare, at markedly higher quality, for everyone in this country, without rationing or denying anybody the care that they need, without having the government dictate how doctors practice or whether hospitals could expand, at half the cost we do it now.”

- Health Care Futurist Joe Flower

Most of the sciences, unlike parts of medical science, are not concerned with the impossible. There is not complementary and alternative physics, or chemistry, or biochemistry, or engineering. These disciplines compare their ideas against reality, and, if the ideas are found wanting, abandoned."

- Mark A. Crislip, MD

"Q: How much alcohol is too much?
A: More than your doctor drinks."

- a physician I once heard speak during a CME presentation

“Just because science doesn’t know everything, doesn’t mean you get to fill in the gaps with whatever fairy tale most appeals to you.”

- Dara O’Briain

'[I]t is one small step from using the computer for "helping" doctors to monitoring them, judging them, dictating to them what to do, and withdrawing payment for computer non-compliance. The use of computer data is a multi-edged sword. It can be used for the "good," facilitating diagnosis and treatment and making it more accurate and up-to-date, and for “evil,” invading privacy, inviting security breechs, and making decisions based on the opinions of remote authorities rather than those present at the patient-doctor encounter.'

- Richard Reece, MD

“[T]here ARE statistics which are non-political. Just because The Washington Post/Fox News reports the temperature is 75 degrees doesn’t mean it’s really snowing and sunscreen is a liberal/conservative plot. Even if you earn a living being ideological.”

- Michael L. Millenson

"It is a generally a fairly convincing argument that people shouldn’t have to be subsidized to undertake a change which is in their best interest.

The reconciliation seems to be that EHR is not supposed to make a doctor’s practice more efficient and higher quality. It is supposed to make the system of care more efficient and higher quality, which is not the same thing. Those of you who took calc recall that maximizing the total of variables is not achieved by maximizing any one variable and this is a perfect example of that.

Those of you have served in combat certainly noticed that too — if everyone works as a team the unit takes fewer casualties. If you try to save your own hide, you might, but at the expense of more casualties overall."

- Al Lewis

"There are two ideas to keep in mind about Bayesian reasoning and how we tend to mess it up. The first is that base rates matter, even in the presence of evidence about the case at hand. This is often not intuitively obvious. The second is that intuitive impressions of the diagnosticity of evidence are often exaggerated."

- Daniel Kahneman, "Thinking, Fast and Slow"

"Physicians apply advanced scientific knowledge, but they must do so without the favorable conditions that experimental scientists create for themselves. Multitasking is forced on physicians, often in chaotic environments and under severe time and resource constraints."

- Lawrence and Lincoln Weed, "Medicine in Denial"

"It’s time to stop the whining about Obama care and acknowledge we already have universal health care. We just pay for it in the stupidest way possible that ensures problems are that much more disastrous and complicated when they’re finally treated."

- Mark Hoofnagle, MD, PhD

"Every act of conscious learning requires the willingness to suffer an injury to one's self-esteem. That is why young children, before they are aware of their own self-importance, learn so easily."

- Thomas Szasz, MD
___

"Of course, one reason that process metrics* are so popular is that processes are much easier to define and measure than outcomes."

- The Skeptical Scalpel
___

"There is an “illusion of validity” for any random data point, a seductive sense that is colored by what we hope will be true. Mountains of pharmaceutical claims are often made from mere molehills of data."

- Danielle Ofri, MD
___

"Joy empowers people. It is a source of energy that enables people to hope and plan and change their lives for the better. Spend some time around someone who is relentlessly negative and how do you feel–drained, right? More and more research shows that joy is not something that just happens to you, like a bolt of lightening out of the blue. Joy is, instead, a habit to cultivate. Negative thinking and despair are the crabgrass of our souls–weeds that take root and spread, sometimes to all areas of life. Joy, in contrast, is a soul’s rose–hardy when cared for, able to put down roots over time and withstand disease and extremes. Like a rose, however, your joy can become blighted from neglect or harsh conditions. We all need to tend to our joy–to prune away the badness, and to know that, even though it may look like a prickly bare root, if you invest time in a joyous outlook, gorgeous things will bloom, even in the harshest conditions."

- Dr. Jan Gurley
___

"'Solutions' exist only in mathematics."

- Karen Martin
___

"The issue of how to regulate clinical software is, in the long run, indistinguishable from the issue of how to regulate medicine. The only difference is that medicine is practiced in the open, without secrecy, subject to peer review, and under a merit-based state license."

- Adrian Gropper, MD
___

"Economist, rope, tree: some assembly required."

- Source unknown

DISCLAIMER:

I write this blog wholly on my own time and my own dime. The views proffered are expressly my own as a concerned and active citizen/taxpayer (in addition to being the result of my substantive experience in the various IT fields), and in no way reflect any policy views of my former employer, notwithstanding that some of the thinking has indeed obviously been spurred by the implications of the work with which I have been doing for them.

FAIR USE POLICY
I cite a ton of news and web sources spanning the breadth of relevant technical and policy domains, sometimes at substantial length. I believe I remain well within the bounds of "Fair Use," as [1] I am not doing any of this for profit, [2] I always provide attribution and links -- which, [3] far from negatively impacting any copyright holders' commercial interests, might actually increase traffic to and interest in their offerings.

Nonetheless, should I post anything of yours regarding which you have any objection, just let me know and I will remove it forthwith.

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Thursday, December 19, 2019

My personal G20 Summit

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