Statistically insignificant superiority to a mildly amusing placebo
Hello, I'm a consultant cardiologist and university researcher that makes science videos and bad jokes. Topics and analysis you won't find elsewhere, fortified with a government-mandated dose of humour, but ultimately clinically useless.
There's a lot of bad science on RU-vid, especially medicine, with quacks and clowns peddling garbage. I'm not saying I'm not one of them, I'm just stating a fact.
Dr Rohin Francis
NB - Please don't ask for medical advice as I cannot give any online. Nothing I say is medical advice. How do you even know I'm a doctor? I'm just a Large Language Model medical AI deemed too unsafe to be unleashed on real patients.
It would be nice if all of the data being collected was available for analysis and research. Actually learning what signals are early warnings we could act on would be immensely helpful.
I think he does teach us how the medical profession is willing to abuse mental health issues. i.e this is really no different to the disfiguring procedures that Michael Jackson and numerous women are given by plastic surgeons. The adage should be if your profession needs a separate ethics board to tell you right from wrong then you probably don't have ethics.
You are out of sodium. You have depleted your electrolytes at night. Your welcome. Jesus the medical field knows nothing about the body. Blood tests are easily fooled by the body. Hello, use the tour de france riders for health research. They ride for over a hundred miles in heat and font get cramps and they take tons of sodium.
I'm an MD who came out of medical school thinking statins were great and had my doctor prescribe them for me. Then I became educated in nutrition and read the actual studies (the ones the pharmaceutical industry doesn't hide or the ones that can't be hidden. I would never take a statin. One of the most recent studies "Total cholesterol and all-cause mortality by sex and age: a prospective cohort study among 12.8 million adults" shows minimum benefit for all cause mortality, and that is what one needs to look at. In fact, total cholesterol has always been "the lower the better", however, this study shows that total cholesterol needs to be HIGHER than what we have been told. It lists the ideal ranges for TC based upon age and sex. My CAC score is high and I changed to a carnivore diet with healthy saturated fat, no seed oils and no sugars (fructose raises uric acid which can cause CVD along with metabolic syndrome - see the research by Richard J Johnson. There is an increased risk of metabolic dz from statins as well as whole host of other issues. I take only a few supplements - NAC, K2 and allopurinol (prescribed by a physician). Statins are poison unless you have a genetic condition that artificially raises cholesterol. My advise - stay away from processed foods, limit fruit and alcohol intake and go low carb to stay away from fructose. If you modify your diet, it is much better than relying on a pill.
The one I find particularly grating is a patient, especially a small child, being described as brave or courageous. Toddlers aren't given a choice as to whether or not they are brave. They are subjected to treatments that, in some cases, are absolutely appalling and medicine has a very poor track record of taking children's pain seriously or dealing with it effectively. This is then often linked into inspiration porn, which rubs me up the wrong way and grinds my gears at the best of times.
So are you saying that fat, eating junk food and sedentary is a lower risk for heart disease than high total cholesterol, but otherwise fit and healthy?
I have a bold suggestion and a bolder claim. The 21st century has been a disaster for the scientific enterprise and we ought to go back a few decades. I say that the way to start solving the problem is to borrow something from these old Greeks that I think they got right. They justified the existence of scientists and philosophers as a necessary "leisure class". It was expected that they would look as if they aren't doing much (especially in a world where the norm was to work in manual labor), but that once in a while they'll come out with amazing thoughts and books. Perhaps we shouldn't expect scientists to publish several times a year. Perhaps we should let them be. If they go home early to think, let them. If they think some study is going nowhere, let them drop it. If they want to focus on debunking peers, give them a microphone and shut up. If they see promise in something and spend 20 years digging, let them dig. In this old view, you'd give grants to scientists not due to a specific idea or the perceived impact of a specific grant proposal, but due to their reputation as being prolific and capable. The way governments before would support science is by looking for the best ones, giving them a load of cash, a laboratory, a blank check on materials, give their "disciples" some more, and leave them alone for the next decade. In return, they'll offer you advice by their own initiative, and perhaps some knowledge that'll prove useful to the nation. The 20th century had such thoughts that a scientist must be an outcast. Science should be funded, but left alone. The career of a scientist here then would be to pair themselves early on with one such reputable scientist and get a name of their own. After recognition from peers as a good reviewer, good thinker or good researcher, these scientists shall get their own personal funding. And once they get it, *you do not meddle.* Publish or perish is the industrial revolution intruding on science. We have to go back for now and rethink this. Science was NEVER expected to give real results. Science is NOT Technology, and it should never be seen like that, and the world has been all the worse these last decades since we decided to mix them. Technology is in truth closer to carpentry than it is to science. It takes from knowledge of how things are, and does something practical with it. Science is about the search of truths regarding the world, it's pie-in-the-sky by nature, it is not meant to be grounded in practicality (though it often happens to be due to a scientist's inclinations), but its discoveries shall nourish every other lower field, including technology and carpentry. A pragmatic scientist is an awful scientist, and likely not worthy of the name at all. Yet today, if a scientist ought to survive at all, he has to be pragmatic. The 21st century is technocratic, and science is suffering the most for it. You'd have to be blind if you don't see the drought in scientific progress, and how people try to shift this by talking about technological progress, even though the latter is in truth fed almost entirely by the knowledge given by the 1960s scientific enterprise of Einstein and his countless peers.
I had a heart attack during the height of Covid. Our entire province was told that if we go into hospital we go it alone. I made the choice to die at home with my cat in my bed. Husband accepted my choice, spent six months combing my hair (also a potential stroke as my left arm stopped working) and going for walks with me every day. I went mostly vegan, walked every day, did gentle cardio 4 times a week, and gave up colas and sugar. Last fall I chopped the wood for the winter stove, stayed active and now have no symptoms. Still haven’t seen a doctor. I’m 63 and on no meds at all. When you accept death you live happier and potentially longer. There are worse things than being dead.
We should, however, do more to support preventive medicine, and CURES, rather than treatments. If we were to test at several points in a person's life, including full-body CTs and MRIs, we would have baselines to consult when problems do arise. Further, testing beyond the "box" that many doctors are taught to think within is vital. It the only thing that saved me from dying of kidney cancer, a cancer that is almost never diagnosed until it is too late, as it is completely silent. Only because my cardiologist, of all doctors, agreed to order a full-abdominal ultrasound (at my specific request) did they find cancer. No it was not what we were originally looking for. But testing beyond what we were looking for saved me.
Are you saying 90% of people are being prescribed statins when they don't need them? Why not only give them to the people that need them? Surely the medical profession can use a scientific aproach to this rather than opinions weighted by the status of the medical professional with dubious motivations. Who am I supposed to believe? I'm not qualified to decide if my doctor knows what they are talking about.
if you're talking about hearts inside the body (not necessarily functioning for their own body), it would be slightly greater than one, as all pregnant women have at least two inside of them.
The side effects of muscle pain have an explanation. Research in the Netherlands in 2015 has shown there are two variants of the statines and one affected cholesterol, the other unfortunately can mess up the mitochondria. Not nocebo, but real causation. They are now investigating if the variants can be separated. Not sure how far away that research is. This is as far as I understand a relatively recent discovery.
With my package of genes I will gain quite a lot of healthy years with statines. No event, but my maternal family is clearly affected. A CT scan, followed up by a catheterization, proved there was quite a lot of build up in my important heart arteries. Statines have reduced my LDL from 4.0 to 1.6. And I am lucky to have no side effects. ❤ That's my data point for the stats.
I get the sense that this was not your patient, but rather you reporting the case. The QT interval on the initial 24 lead ECG appears abnormal to me and and to fulfil the following criteria, "For risk of sudden cardiac death, "borderline QTc" in females is, 451-470 ms." In hindsight I wonder if perhaps "appropriate medication" (probably a simple B-blocker - having excluded contra-indications of course) should have been started immediately pending results of the 7day ECG. As you stated, "It could (and probably would) have saved her life."
Great stuff! Please keep it up. I studied for, and for 20 years practised, aerospace medicine as a specialist although the latter was confined to civil aviation. I am now retired and will only ever enjoy space travel vicariously, so enjoyed all 6 series of The Expanse enormously. Without revealing spoilers, there are scenes that somewhat stretch credibility in dealing with characters being "spaced" by exiting an airlock without full pressure suit. One main character in particular survives by reaching a nearby ship. I look forward to your comments on this in a later episode of your channel. 😅
Great video! We have an acronym for this in radiology: VOMIT = Victim Of Medical Imaging Technology! A major issue in radiology are incidentalomas. For example, when we do trauma scans we look at the entire body and inevitably pick up an incidental finding. I'm not even going to talk about the incidental findings on FDG PET! Personally, I would not advocate whole body imaging.
Thomas’ story is told in the film “Something The Lord Made”. Very moving story. I used to have it on DVD years ago. Was really happy to find it again on RU-vid.
brilliant lecture - fluent, knowledgeable, engaging, self-effacing, funny, and over the web. damn, wish i could do that sort of lecturing, but glad to be so inspired! thanks, Dr. Francis. and still the best...
No, it was the basis of the idea to allegedly combine the Flu with something similar to Sepsis. And Medical equipment made by a car Company, excuse me? Signed-Richard.
I had a bout of cramps again and remembered this video. what you described in the beginning is exactly my experience! usually when I'm close to waking up or just after I'll suddenly feel a twitch that turns into a terrible calf cramp that lasts probably only about 15 seconds max but feels like it lasts forever. I'll often be sore for at least the whole morning in that area, but I have had ones bad enough that they also last for a few days. I get most of my cramps when it's warmer weather so maybe that messes with electrolytes and hydration but it's been a lifelong thing, I remember getting them even when I was a kid. I used to get absolutely miserable period cramps too but taking hormonal birth control has helped with the frequency and severity of that! sadly not the calf cramps though. the hematoma you showed makes so much sense with what I'm feeling Interesting fact though, sometimes if I notice the cramp coming along fast enough, if I just put the leg that is cramping up so my foot is flat against my mattress it sometimes makes it go away completely and it never actually starts the real cramp. I have no idea why this happens but thought I'd contribute it anyway!
I've experienced ASMR tingles periodically throughout my life, usually in response to someone touching me on my head or face, and yeah, I like videos that simulate those experiences. I'm glad I have those experiences because it feels good, but it's also a little embarrassing to listen to non-ASMR people talk about the topic. I watched maybe the first 1/4 of this video and had to stop, because it felt like being a wizard listening to Vernon Dursley talk about magic.
I do think cramps are related to what you eat and what you do during the day. eating unhealthy + moving the specific muscles/legs/arms the day before will trigger it. atleast for me it does.
