Eric Engstrom, co-creator of DirectX, has died
venturebeat.com
venturebeat.com
I have a little anecdote to share that probably only I remember now, but it has always made me laugh and shows what an unusual thinker he was.
When he was first working at Microsoft around 1991 or 92, he was talking to a manager who had a problem. There was a program written in assembler language, about 50k in size or so. The program had a problem that needed to be fixed. The author no longer worked at Microsoft. The manager had repeatedly assigned various programmers the task of fixing it, and they'd all given up after days of effort.
The trouble was the author had used the macro language that came with the assembler to invent his own quirky, weird, undocumented and thoroughly impenetrable language. None of the programmers could figure it out. He was lamenting that he'd have to assign a programmer to recreating it from scratch, which would take months and cost a lot of money.
Eric says "I can fix it".
In 2 hours, he had it all fixed and checked back into the system.
The manager, astonished, asked: "how did you figure out the author's language?"
Eric: "I didn't. I disassembled the binaries using Walter's disassembler [a disassembler turns binary code back into source assembler code]. The problem was then obvious, I fixed it and checked the new source code back in!"
Eric then laughed uproariously, and so did I. Nobody but Eric would have thought of that shortcut to solve the problem. If he couldn't break through the wall, he'd go over it, under it, or around it. He was always like that.
I'll miss him a lot.
Edit: non native speaker. I meant to say „what an absolute unit!“ to praise his skill. Be gentle to the ignorant please.
I'm glad hn isn't like /r/programmerhumor (i.e. if I argue a point I don't want to explain what a pointer is) but the delusions of grandeur are in equal parts tragic and hilarious sometimes.
BTW, this anecdote is one of the reasons that I've strongly resisted adding macros to D.
I also purged my own C and C++ code of macro usage.
In other tasks, consider different data structures or representations that fundamentally represent the same data, but in different ways that offer different guarantees. Representing a graph with a matrix may let you answer some questions very quickly, but it may make others harder to answer, for example.
To often we simply reach for our trusty hammer, and it's not always an efficient or usable tool.
Eg in school we learn as kids derivatives, rote routines to solve a type of problem, and we plug and chug, but we are not shown (necessarily) by govt education the underlying theories that may create a solution. This/my opinion is of course dependant on how expert an instructor is ...
The best anecdotal example I can give off the net offhand would be: https://www.google.com/amp/ask.metafilter.com/105309/Tao-thi...
Thanks for your feedback
Edit: Also in the usa we're taught do your own homework for example. In asian cultures often students band together to succeed in classes (I work in higherEd and this is culturally visible in peers in classes). This is another example of this philosophy being different between cultures.
In contrast to eastern education which tends to greatly focus on memorization through repetition.. (i.e https://en.m.wikipedia.org/wiki/Rote_learning)
The quote you have included is based on Taoism. Is that common? I was under the impression that Confucianism has the more dominant influence on values and thought.
Anyways, at least that's one thing we can agree on - Taoism's philosophy encourages an open mind and awareness.
Wouldn't quite say that is true. People use a variety of techniques to get scored higher and there's always a certain percentage who will use such rote learning techniques, be it eastern or western.
I think what what's missing in the discussion is the western focus on individualism as compared to east asian communitarianism. Both have their pros and cons and mutual dislikes.
There was a book by 2 high level western/eastern women managers in Hewlett Packard that highlights this dichotomy. It's a great read.
Again, that's because of a deep rooting in Confucianism. Also, "Communitarianism" is a western (Christian) philosophy. It may have been borrowed from Confucianism? I'm not sure. A lot of religions and philosophies share these kinds of values, so it's not unique to just one region / culture, IMO.
Anyhow, neither is better or worse, and probably a balance between communitarianism and individualism is best. All cultures can learn from each other.
Hm probably a better word would be collectivism
I went to a mix of 7 private and government schools between K through 12th grades in the US, and I don’t remember any of them not having group projects. Some, or most of the homework is individual, but there’s plenty of group work too.
There isn't anything special or insightful, mystical or different or "eastern" about cooperative learning. I'm thoroughly "western" and had plenty of homework groups in both undergrad and grad school. Nor is there anything special about the cooperative cheating I described: "certain groups" applied to plenty of western peer groups I saw in undergrad especially, though they didn't claim what they were doing was some "cultural" thing, as they knew it was simply cheating.
When debugging a web app, you can debug the code (and add print statements / breakpoints). Or look at the HTTP queries its making in the inspector. Or debug the server - look at what queries its receiving and returning. Or experiment with different values in the database.
Last year I was trying to track down a memory leak in some wasm code. The tooling for that sort of thing in wasm was/is quite primitive, so I did some work to compile the module natively then ran valgrind on the resulting executable. That didn't work - the C code executed differently from the wasm and didn't exhibit the bug! So I added print statements randomly through the program and ran it both natively and through wasm, then diffed the text output to track down when the execution traces diverged. (It wasn't a compiler bug, fwiw.)
I wanted more information about the memory leak. So I wrapped all the malloc/free calls with a replacement that stored all outstanding allocations in a list, with the stack trace when malloc was called. When the leak happened, I could ask for the stack trace of all outstanding allocated objects[1]. That was fast and effective, and I added a memory leak check in my CI.
At one of my first programming jobs we were using visual source safe (oh god, kill it with fire). I ended up losing some changes I'd made in a ~3000 line java class that we'd already deployed to production. I didn't want to do my work over again (or admit the mistake to my boss!). So I ran a decompiler against the class file we deployed to production - but it was huge and unreadable. To find the changes I'd made I took the current version of the java file, then compiled it and decompiled it again. So then I had two ugly files - but I could diff them, and that highlighted immediately the dozen or so changes I'd made. Then I just manually rewrote each change back into the original source file. Importantly, I had complete confidence that I didn't miss any of my changes.
[1] Its not pretty, but the code looks like this if anyone's curious: https://github.com/josephg/mime-to-jmap/blob/2a7429f7b805cb0...
Did you have merge week too? Often stretching into a second?
Have also used this technique to compare build logs when you have a version of a project which will compile and one which doesn’t (eg when trying to integrate a second project into an existing one, or battling CI issues), useful if you aren’t an expert in that particular tool chain especially.
Personally I use VS Code’s diff these days, since they added support for word wrap recently, it’s the easiest to read.
@Jtsummers puts it as “Map the problem into other domains”; another interpretation (or a variation on the same) is “look at it from a different angle” or “look at it in a different light”. Do both -- move around with your light source, shine a torch/flashlight at your problem, and different shapes will be “projected” onto the wall behind it. Kind of like, if you are familiar with Hofstadter's _Gödel, Escher, Bach_ -- remember that “G,E,B” cube pictured on the cover of many editions? A more or less abstract “thing” or idea can be “projected” into different practical views depending on perspective. In actual practical work talking about “projections” can of course feel a little highfalutin’; to me it's a bit like always talking about your RDBMS tables or views as “relations”.
But in a more philosophical sense it is of course perfectly valid. And AFAICS it's an age-old idea in Western philosophy; what I described above is essentially precisely what is known as _Plato's Cave_. (Which incidentally is why @tenken’s identifying it as “Eastern” feels quite peculiar to me.)
I would certainly add "looking at values vs looking at differences" and "looking at the generator vs looking at what's generated" (which the top level story is an example of).
It may take a little squinting, but we can see the common mathematical practice of reducing one problem to an example of another as an instance of this. There are also tweakier math examples where treating something as topology or something makes it easy to solve.
Consider, for example, the impact of anti-vaxxer's perspective that "chemicals are bad for the body".
The bulk would answer "Um, better sound quality? Maybe an address book?"
Eric just couldn't believe those responses. (Remember, this was in the 90's when a phone was just a phone.) He was always boiling over with ideas.
Turn it in to a cube maybe an octagon. I'm sick of rectangles.
less snark comment (but also true), just jaw dropping that these pocket PC's do so much. on the down sides, I think the main think that floors me, just stabs me in the heart, is that they are still almost totally trash at communicating with those around us. Google dropped Project Eddystone, that sucked; totally straightforward sensible way to broadcast a url to the world about you. Apple has their file sharing AirDrop, which Google continues to make floundering attempts at (Beam, then Fast Share/Nearby Share), & never via any open protocols or specs. amazing personal communicators... totally reliant on completely centralized infrastructure. The couple Bridgify/Open Garden alternatives, it all seems too stack specific & lacking the layering of protocols & extensibility that allows communication tech to grow over time, become of enduring value.
I forget what it is but someone was telling me the Bump competitor in Japan is still used, that you still have a physical little ritual with your devices that causes them to exchange contact info. That kind of real.world connectivity seems like it ought be just the start, for how tech can augment the real world, versus us needing to start & navigate the digital to connect. We're doing little favors, entrenching connectivity so reservedly in the digital all space.
I think Bump happened a year or two latter, which was also fun. But it felt far more intermediated, like it was pulling down much more data. Looking at who in the area also bumped at just that instant to triangulate who to put in contact with each other.
I remember back in the 90's wear(able)-comp(uting) world, PANs were going to be a thing. Personal Area Networks. Your skin itself would be a low-baud rate modem, so you could shake hands & transmit your contact information. Definitely pre-covid. ;)
I really think Project Eddystone has many of the answers for how we ought to make ourselves visible to the world. It was mainly focused on commercialized entities, and people are scared of the internet, but I think there's still great potential. Alternatively, it seems weird that NFC, which is much more tightly coupled, 1:1, "safe", is so under-utilized. I'm not sure if there are good open standards for data-exchange over it. Meanwhile proprietary AirDrop and FastShare/Nearby Sharing are some of the few, tightly controlled offerings for offering files. All these manners of tech needs some champions to drive good protocols, enable more interesting futures. Sorry, I think I'm repeating myself again. Thanks for the fun comments dcsan.
Probably because corps don’t want us communicating with each other in any way they can’t know about.
Plus easier-access hardware kill switches and a faster GPU and RAM: https://shop.puri.sm/shop/librem-5/
And how's the app store? When some random game goes viral and I want to play with my friends, am I going to be able to? Are the apps vetted for security and safety?
Does it integrate with my car? One of the primary uses of my phone is for navigation. Being able to plug it into my car and say "navigate to 123 main street" as I drive is pretty key.
Is their store only online? If they don't have their own retailers can I at least see them at a carrier store or BestBuy? Will Verizon activate the phone on their network? A decade ago they wouldn't approve the Nexus 7 tablet, so this is something I think about.
These phones are not for many people.
> How is it?
In development. The pinephone can take still shots. The Librem 5’s camera isn’t functional yet AFAIK.
> Can it compete with the current phones from Apple and Google?
No. It’s not playing the same game. I would pay money not to have one of those.
> Does it do all the standard things like include filters, portrait mode, night mode, etc...?
AFAIK, no.
> Can I search for "dog" and get all my dog photos or search for a city and get all the photos taken there?
I don’t know of any apps for them that do that at the moment.
> And how's the app store? When some random game goes viral and I want to play with my friends, am I going to be able to?
Probably not. It probably has about 6 orders of magnitude fewer users, and 5–6 orders fewer devs. You can virtualize Android, but I wouldn’t be surprised if it was a much worse experience than Proton on desktop (it doesn’t have Valve behind it. Anti-cheat might get you banned).
> Are the apps vetted for security and safety?
Yes, in some repos. Most of the distros will let you use Debian’s, which IIUC have had z-e-r-o zero malware (not counting systemd ;)) in their decades-long history.
> Does it integrate with my car? One of the primary uses of my phone is for navigation. Being able to plug it into my car and say "navigate to 123 main street" as I drive is pretty key.
I’m confused why it needs to integrate with you car to give directions. Do you mean connect with Bluetooth to use your speakers?
> Is their store only online?
Yep.
> If they don't have their own retailers can I at least see them at a carrier store or BestBuy?
Nope.
> Will Verizon activate the phone on their network? A decade ago they wouldn't approve the Nexus 7 tablet, so this is something I think about.
Nope, not as far as my crystal ball can see. The pine wiki says you can activate a SIM on a burner phone and swap it into the pinephone, and Verizon shouldn’t care.
That would work. Integrating like CarPlay or Android Auto would be better, but bluetooth or aux out works too although it's a little primitive.
As long as I can do something like say "hey pinephone, navigate to 123 main street" and it does the obvious thing.
Another idea is to make a walkie-talkie mode, where you could communicate with nearby cell phones without needing a cell tower.
When the very first phones had physical buttons, less sophisticated UIs and T9 text entry, I remember being able to send an SMS from my phone without ever taking it out of my pocket. All from muscle memory.
> Eric just couldn't believe those responses.
If only a phone could be invented that had sound quality as good as we had in the 90s. I can barely understand people anymore. I'm not losing my hearing in my old age. (much) In person is fine. Other recordings are fine. Even video conferences are fine. But phone calls sound unaccountably terrible.
On the phone-line side I wonder if that is a degradation due to digital switchovers & compression, a lack of allocated resources, or just pure rose tinted glasses.
EVS are very good at 16-32Kbps bitrate, possibly better than even Opus. But generally speaking Social Apps uses higher bitrate you get better quality. Although latency tends to suffer a bit.
If you have two candidates equal in technical aspects, then a point of difference is in problem solving and dealing with the unexpected.
Possible answers, all valid, all tell you absolutely nothing
* I'd change nothing, it works "AS A PHONE' just fine. There are better things to to work on
* I'd attach it to the side of a rocket so you could use it as a handle. I'd much rather ride a rocket than use the phone
* I'd double the speakers and mic and offset them at 45 degrees so two people could hug cheeks while talking to the same person
* I'd give it a display, add a computer, and have it pocket size and it would annoy you all day long with notifications and distract you from getting anything done. People would stop using it as a phone and mostly only write text messages to each other which would be way less efficient than voice. Oh wait, you said "improve". Yea, ok, bad suggestion
For example, possible takeaways from your answers:
* Lacks critical thinking, takes things for granted, doesn't show initiative or not comfortable with it.
* Elevated smartassness, possibly as a defense mechanism or due to inability to read between the lines. Maybe just nervous at the moment.
* Better. At least this solves some specific problem based on one's personal experience. It's possible to discuss that and see what else surfaces.
* Also good. Miraculous even if you'd managed to produce all that in the early 90s. Again, this also opens things up for further discussion.
See the point? It's a meta question.
On the assumption that not many people being interviewed by Microsoft in the 90s had an iPhone style plan or a desire to revolutionize cell phones, "leave it alone" is the most realistic, objectively useful answer a candidate might give. Sure, it demonstrates zero creativity, but it's totally unfair to say that person lacks critical thinking skills as their answer is the most rational.
To pass that question, you need to know the interviewer is looking for creativity and be able to make something up on the spot. That's obvious to many of us, but depending on the role I wouldn't fault someone for not being in tune to that question or ready for it.
The job interview gets debated endlessly, week after week, on HN. There isn't one interview method or question that numerous people would consider unfair, irrelevant, broken, etc.
Eric was interviewing people for very high paying jobs. A decision has to be made about the candidate based on something. A person who wants such a job should go in eager and ready to convince the employer that they're a great fit for the job, and do what it takes.
And yeah, Eric's question was pretty obvious. It's open ended, and you can interpret it as you like, which is part of the point. But being a smartass and/or complaining about the question isn't likely to leave a favorable impression. A "faster horse" answer isn't likely to, either.
As an aside, IMO smartphones are not an improvement on phones. They are an improvement on PDAs. As phones they've utterly failed. People called each other (as in use a phone) way more before smartphones. So smartphones are not better "phones". They're worse phones and better something else.
That can be helpful in hiring.
If you’re looking to hire someone for a technical role on some big hairy project that might not work or seems crazy, it’s helpful to select for people who won’t say “this idea is dumb”.
Using your tool, hah!
A few years back one of the systems I ended up inheriting stopped working on January 1st. As most people, I had taken the day off, but my manager called me to fix the issue in prod.
After much researching, I found out the assembly causing the issue. Similarly, the original dev had left and the source code was lost. So I used ildasm and found out the year was hardcoded. I patched the binary and went home.
Rest in Peace, Eric.
This seems surprisingly common, I hear it a lot from my customers.
Deliberate time bomb or honest mistake?
Ironically, the two men arguably most responsible for the success of the Xbox were strongly opposed to the entire “Manhattan” project at the time.
Eric was instrumental in the DirectX runtime design that Microsoft ended up porting to the original Xbox hardware with shared high level components.
The other guy was Dave Cutler, who led the NT and hypervisor groups at the time. Xbox v1 borrowed heavily from Dave’s work on modular, stable-userspace NT. 360 was basically running a full-fledged NT iirc. Dave, like Eric, hated the Xbox project early on.
In today’s terms, it would be like Facebook deciding to make a search engine or mobile OS, so their reactions were hardly surprising. Word was that even BillG was hesitant, but Ballmer really wanted more product lines.
Eric will be dearly missed.
Remember that there's HN'ers who never worked at Microsoft :-)
At the time Japan dominated video consoles with the last western attempt being the disaster which was the 3DO. Thus Microsoft was going "nuke the japanese industry" and gain a foothold.
For further irony the Xbox was in effect was a spiritual successor to Sega's Dreamcast. That Microsoft went with such a distasteful name despite partnering with Sega highlights their cultural issues. Issues which have continued to prevent Xbox from building relationships with Japanese studios.
He actually comes across a mix of interesting and unpleasant in this interview. It takes me back to the nineties when he and St. John were routinely pissing off people including myself.
But in the end people are complicated.
It wasn't about consoles but gaming in general. Programming Games for DOS required a lot of assembly knowledge (at least, if you wanted something fluid) and deviation from industry norms only increased development cost (thinking things like High res support necessitating VESA code, to say nothing of sound support in DOS.)
Devs hated dealing with all this extra work, extra compatibility, extra libraries (old gamers may recall MILES or DMX setup screens in some titles.) The libraries for Windows 3.1 were... not at all up to the task.
Thus, DirectX was created. Not so much to create a console competitor, as to show PCs as superior to consoles overall.
Which, when one thinks about it, may explain why Eric/etc were not big fans of the XBox; in some ways it conceded defeat on a level.
Of course, I mean the 16 bit opcodes. The SIMD ones, no freakin' way!
It's like the Wizard of Oz. I know most of the dialog, though I never made any attempt to memorize it. A friend of mine knows all the dialog for all the Star Trek TOS episodes. He just realized one day he knew it.
> WalterBright
Was it your disassembler?
As sad as it is to lose a person at age 55, it's even harder to digest the tylenol induced liver failure part until you experience foot injury/pain. I spent last December in excruciating foot pain that came out of nowhere and the thought of wanting to guzzle down entire bottle of Advil/Tylenol touched my mind at least couple times.
Anyway, RIP. Old interview with him - https://www.youtube.com/watch?v=rjZWUweIIEU
Protip: have some N acetyl cysteine handy. It's freely available on amazon, and it protects your liver from acetaminophen abuse (and helps rebound faster the next day after a night of heavy drinking, but the FDA absolutely hates when people mention that :-)
EDIT: replying here as HN things I'm "posting too fast"
Whenever in doubt, by default, you take it due to its extremely good tolerance.
There are no bad side effects at usual doses, even after 50+ years on the market (well, at very large doses, vomiting, which I think is good in case of acetaminophen or alcohol poisoning)
https://en.wikipedia.org/wiki/Acetylcysteine
Don't let the FDA make it illegal:
https://www.sgtreport.com/2020/08/use-n-acetylcysteine-the-f...
https://fda.news/2020-08-21-fda-trying-make-n-acetylcysteine...
Liver damage can occur after a single incident. People have died from single time overdoses of paracetamol. There is a quick fix in an ER of giving NAC which can help eliminate most of the damage, but there is a small window(a day or two) where it is effective.
>Therefore, it may be beneficial to administer APAP(Tylenol) in combination with NAC routinely to reduce rates of liver failure and death. Because NAC's main role is to reduce the accumulation of APAP's toxic metabolites, the concomitant administration of NAC should have no impact on the efficacy of APAP as an antipyretic and analgesic.
I don't blame him for the choices he made, having been there.
And the way pharmacies were handing out opioids it's quite possible. Wasn't called a crisis for nothing.
1: https://www.drugabuse.gov/drug-topics/trends-statistics/over...
If true, it's interesting, and genuinely disturbing. I'd like to learn more about how something like that can happen at that scale.
If not true, it belongs on some other site where people don't care about what's true and not true.
I mean, I'd argue they're serial killers, but what they're doing is legal.
That pretty much leaves you with OTC pain meds - I know in these cases probably narcotics of the right kind in restricted doses sound much better but I am just truly afraid of side effects because of what we saw earlier in life.
Once I was lucky enough to get a steroid prescribed and it worked wonders compared to a dose of Ibuprofen every 4 to 6 hours.
It must have been really quite painful. Still, I'd strongly recommend keeping drugs of all manner handy if you've got good self-control around them. They have high utility.
Individual risk isn't exactly high, but OTC painkillers are ubiquitous.
Both accidents and suicide attempts are/were frequent. It's a rather terrible way to die, IIRC, with excruciating pain and entirely too much time to regret the decision/accident.
I think people often get confused because you can typically take a bunch of ibuprofen pills for pain and there are rarely serious side effects. But ibuprofen and tylenol are much different in this regard, despite the fact that both relieve pain and both can be easily bought in a drug store.
Huh? To actually think that taking 6 extra strength pills in 24 hours isn't enough margin of error? I mean maybe if the person is completely clueless and doesn't read the medicine instructions.
Honestly, if you're in that much pain that you're gobbling up 6-8 extra strength pills per day, every day, you should be in the hospital with an IV hooked up, or addressing the chronic pain issue that's causing it. Or have the doc prescribe you something way stronger.
On the other hand, UK has OTC ibuprofen+codeine which can fix essentially anything.
OTC painkillers are usually not meant for moderate+ pain, at least the stuff available in USA.
They're meant for taking you from 3/10 to 1/10. I know most people don't think about it in-depth, but surely we can expect at least some basic logic from them?
Like don't swallow pill #6 if the first 5 extra strength pills did nothing.
-take 2 caplets every 6 hours while symptoms last. -do not take more than 6 caplets in 24 hours, unless directed by a doctor.
It's not too crazy that someone in pain or feverish could think "maybe if I just take an extra pill or two I'll feel better and it will be totally safe..."
As such, Tylenol overdose is more common. The labels are very clear about how much to take, but when you're in chronic pain, you may not be thinking much about the warning stickers or labels.
Yet we only talk about the evil of drugs, and the opioids epidemic.
But really a doctor/nurse is critical if the pain is going on for more than a day or two.
Do you know that Ibuprofen can cause morphological changes in the testes? I wouldn't call that much better...
The bigger danger is people mixing it with other cold and flu medication that ALSO contains paracetamol.
The two don't interact with each other which helps to keep the pain (or fever) relief going strong without ODing on either.
But yeah, be careful either way.
Also, make sure you are only taking one NSAID (acetylsalicylic acid/asprin, ibuprofen/Advil/Motrin, naproxen sodium/Aleve) if you are alternating painkillers - if you take excedrin/generic “migraine” formula you are already getting a dose of asprin and should not take anything else with it.
You should absolutely read the labels of your pain medications and know what's in them. If you aren't sure about interactions, Don't screw around. Just take one and follow the directions.
Be particularly aware of cold medicines as they very commonly like to do the mixing for you.
I think it's so weird (different English speaking) countries having different names for drugs, you'd think it would be something worth standardising. Well, acetaminophen is the standard/medico name I believe (paracetamol to Britons), but why don't we just all use that? Weird.
While I'm at it, Advil = ibuprofen. The latter being both the common UK and 'standard' name I think.
Now you can trace where all the names come from :)
Do other brands of 'Tylenol' and 'Advil' even exist inside the US? It amazes me because branded medicines are so much more expensive as well. Like 5 to 10 times more
The only (non-supermarket/chemist) brands I could name even would be e.g. Lemsip, where the paracetamol isn't the main constituent (it's a lemon flavoured sore throat/cold soothing drink, if you don't have it there) but an additive in some SKUs (also caffeine).
So you can get generic brands of 'tylenol'? People just trust/think better of Tylenol?
Did you identify the problem? Was it gout?
It seems awfully silly for a random internet stranger to diagnose your issue from "excruciating foot pain that came out of nowhere" but...
I had basically that off and on again for seven years before it was correctly diagnosed and treated. (As a healthy, active, relatively young person, gout wasn't suspected, but eventually an MRI gave a clue, and blood tests confirmed it.)
Does gout come and go - I have not had trouble since then. If it returns I will be sure to do a blood test - and I really appreciate you asking. I am always for problem solving with or without strangers help :)
In my case, the initial pain was relatively sudden, throbbing, enough to keep me awake at night. I also got an x-ray which doesn't tend to indicate gout, but did show some mobility issues (hallux limitus/rigidus) which were treated with increasingly expensive orthotic inserts.... and it went away after the initial issue for five years. Then it came back, new custom inserts (and some naproxen), went away for another twenty months. When it came back, it kind of stuck around, not the full on pain, but a dull aching that just wouldn't quit, thus the more thorough investigation.
In my case, I think the causes were a combination of gout triggers - not enough hydration, alcohol intake, high protein diets, etc.
Yes it does!! I want to shout here very loudly!
(I guess we're off topic now, but please please please don't do what I did and ignore it.)
Me, age 29, I've mentioned before that I'm a lifelong medium endurance cyclist (4-8hrs, 75-120miles): started to get foot pain. Went to the doc (Stanford Hospital GP), doc says you have gout, here's the pills you will take for the rest of your life. Me: nah, I'm healthy, I'll eat better. I was already eating better. Long story short, moved to a rural area, and had probably 30 attacks over 20 years, and none of the 5 (or was it 8?) docs diagnosed it correctly, or prescribed the pills, which are allopurinol. Take the pills. As you might imagine from my preferred exercise I have a very high tolerance for pain. Or did. I am not suicidal, but there have been several two week stretches where I became quite understanding about how people could be made suicidal from chronic pain.
Gout is not necessarily a virtue test. Take the pills. And you don't want advil/tylenol, you want indomethecin for the pain. For the last 5 years I take a half dose everyday and I've not had a single disabling attack, hallelujah. My joints still hate low pressure weather systems though.
If taken in large enough doses to have a therapeutic effect it absolutely can have side effects, some not dissimilar from over the counter analgesics.
A few days ago I got out of bed and couldn't straighten my leg without insane knee pain. It lasted about a day and now it's absolutely fine. Yesterday I was vacuuming and my ankle just starts hurting like crazy. Fine in about 15 minutes. The other day I was bending over the sink washing dishes and my left shoulder blade gave me 7/10 pain. Seemed to be caused by an aggravated neck extensor but IDK.
Getting old sucks but I suppose it beats the alternative.
Fortunately gout can be controlled fairly well with diet but in the midst of a flare up, it is excruciating.
I came close to seeing that first-hand some years ago: My (widowed) dad suffered a long, agonizing death from a form of leukemia. I was with him, at his house, for his final week, with a hospice nurse checking in periodically. He refused morphine and instead took a fair amount of acetaminophen; for calories, he drank a lot of beer and V-8 juice mixed together. I warned him about the danger of mixing alcohol and acetaminophen; he immediately perked up, thinking that would be a way for him to end things. He was disappointed when I explained that it wouldn't be a quick death: he'd just wreck his liver and be in even more agony. (He died a few hours later.)
[1] Shortland Street
Just take some tylenol.
At the right dose, Tylenol may well be the safest pain medication we have, even compared to Advil, which can occasionally cause problems if taken regularly over a lifetime. However, the gap between a useful dose of Tylenol, and the amount of Tylenol which will kill you, is relatively small compared to similar medicines.
My parents say they've watched a lot of people die in the hospital from Tylenol overdoses. There is an antidote, but only if you get it in time.
Amazing how effective those child proof containers are at vexing adults, and how ineffective they are for children.
Having said that, given I am not a doctor/clinician/pharmacologist/pharmacist, you can usually alternate them to take a higher dosage of pain relief.
Indeed, but I think it's better to just not post such medical advice at all.
Meanwhile, doctors I've been to offer out prescriptions for 800mg ibuprofen pretty freely and don't seem too worried about side effects (IMO it's easier to just take a bunch of the smaller ones instead of a single horsepill)
That seems a little suspect to me. It's a very useful medicine, and a better choice than Advil for some people. And it really is safe at the right dose.
That seems much more likely—but, very few drugs are approved for OTC use out of the gate! They generally want OTC drugs to have been in use for a long time.
If you have a regular doctor, it's probably a good idea to ask which of a few different options are safe for you for occasional use, and probably check in if you find yourself needing something for longer than a few days. (And if you don't have a regular doctor, find one... If you lack insurance, it's still probably worth the money to pay once a year for a physical, and also have a resource that knows your health history that you can consult with. For basic questions, like "does my medical history rule out acetomenophen", most doctor's offices will take a message for the doctor and then call you back with an answer)
The answer is "it depends" on your history and any other meds you're taking and also your home situation.
Also that was 38 years ago.
I'll switch to Ibuprofen now. They didn't give me any prescription meds because there were no broken bones, but my chest and left shoulder are in so much pain, specially when I wakeup. Airbags were deployed, and I went from 84 mph to zero when the crash happened (dashcam had the speed on it).
In some ways it's a relief to hear from someone else with that experience (this was 20 years ago for me).
Maybe it also increase stomach acid production, but my understanding is that the primary problem is that it thins the protective stomach lining.
Ibuprofen is a non-selective inhibitor of the COX enzymes. Inhibiting COX-2 reduces pain and inflammation. Inhibiting COX-1 inhibits stomach lining growth and the clotting process. Pharma has created selective COX-2 inhibitors, but some of those have run into their own problems (blood clots leading to myocardial infarctions in the case of Vioxx patients who weren't also on aspirin, IIRC... though, an increase in MIs would seem to be the natural and obvious side effect of intentionally reducing COX-1 inhibition. IIRC, the increase in MIs was in contrast to the traditional Ibuprofen treatment, not compared to an unmedicated baseline.)
Food also helps but not 100%. IME it does not seem to "soak up" all of the excess acid. Vitamin C is also not 100% but IME more effective than food.
I'm not a frequent or high dose user of NSAIDs, I just seem to have an easily irritated stomach.
There's a protocol where you switch between them which is okay, but you should get the good stuff if you need it.
Ibuprofen is awful for your kidneys. You should go back and demand more appropriate pain relief instead of CYA bullshit from a doctor.
If you're taking Tylenol, one thing you can do to help protect against liver damage is to take a milk thistle supplement.
Problem is, NAC can be quite rough to take - nausea, vomiting, etc.
They work in different ways, so using them together can let you stay well away from a harmful dose of either and still get better pain relief that taking a maximum dose of just one.
I somehow injured my rotator cuff, an injury normally associated with athletes but that I somehow got while sleeping?! With my doctor's permission, I did 1000 mg of acetaminophen every 8 hours and 400 mg of ibuprofen every 4 hours. The later was originally going to be 800 mg every 8 hours, but I asked if I could do it 400 mg every 4.
I’m curious why no one here mentioned aspirin though
Both have very tight margins between normal dose and overdose. If I remember correctly overdosing is 50% over the normal dose. So take couple more pills a day than it says on the label - and you can land in the hospital.
I was super glad for that info, because I treated instructions more as a suggestion. Now I am much more cautious. _Never_ go above what's instructed, use them as instructed (before/after a meal, etc.), do not mix drugs unless explicitly allowed by your doctor and for the love of god do not mix medicine and alcohol. It's too easy to overdose these common drugs.
I don't want to downplay it, I just felt like "50%" sort of suggested a single extra Tylenol might kill you, which is very unlikely.
Once you’ve depleted your liver’s glutathione stores (too much tylenol, too much alcohol, not enough food to replenish glutathione) then the Tylenol becomes very toxic to liver tissue.
From what I’ve gathered, you can detect some liver damage as you get close to 10g per day, but we’re talking mildly elevated ALT/AST enzymes. But if you’re sick, or drink a lot or not eating, you could see serious toxicity at 200% of the maximum daily dose.
No, it's closer to 100% over the maximum daily dose. (maximum daily dose is 4g, toxic dose for a single ingestion is 7.5-10g.)
https://www.health.harvard.edu/pain/acetaminophen-safety-be-...
https://www.medscape.com/answers/820200-27208/what-are-the-m...
Paracetamol is usually the safest option. I only take Ibuprofin in serious cases or when there's infection.
Hope you get well soon
One of the common causes is that many medicines contain Tylenol/acetaminophen, but don't have it in the name [1]. For example, DayQuil or Alka-Seltzer Plus Cold and Sinus.
People take something like that, then they layer Tylenol on top of it thinking that is the first Tylenol they are taking, and it pushes them into the danger zone.
[1] https://www.healthgrades.com/right-care/chronic-pain/5-medic...
opiates are insane in their physiological response and addiction; it's hard to understate the power or explain if you aren't or don't know an addict
What should be banned IMO are products which combine acetaminophen/Tylenol with something else.
We'd rather make something poisonous than miss out on taxes
For others, the recommended dose of extra strength Tylenol is two 500mg tablets; but if you only have a minor pain, you don't need to take two tablets, or you could take regular strength (325mg), again the recommendation is two tablets, but you can take less. More than 1g in one dose, or 3g over a day is extremely inadvisable. Acetaminophen (paracetamol) is toxic at a small multiple of the recommended dose; prescription strength acetominophen products add other active ingredients, they don't add more acetaminophen; as opposed to ibuprofen where prescription strength is just more ibuprofen. I'm not a doctor, this isn't medical advice, etc.
In that case, she got into a car accident and started taking Tylenol for some chronic pain related to the accident. A few months later, she was dead.
Thank you!
Do you know what's a good alternative to Tylenol? My chest and shoulder are hurting like hell.
The nurse said the pain should improve within a week, but its been so already and I am still in pain even when I breath or move my arm up.
I'll tough it up for another week before seeing a Dr. I can handle the pain (had double kidney stones, one in each kidney before).
Ah, also, FYI for folks in the US: Do not reject Personal Injury Protection. The insurance agent told me my primary insurance will cover me, but then the hospital and my lawyer said that's false and insurance companies reject to pay hospital bills for auto-accidents. Later, they said they'll try to get a formal denial from my auto-insurance first and then try and see if my primary insurance will pay for it.
As a contrast, any time I've had even the most simple dental or other procedure, the doctors give me a prescription for pain meds without me asking for them (and in many cases not really needing them). So this seems to be specific to ER docs. I suspect it's a reaction to having to deal with people who are drug-seeking, but I don't really know for sure.
In the UK you can get cocodamol (paracetamol and codeine) over the counter for lower dosages, but pretty sure that's prescription only in the US, and more likely to lead to dependence.
That's a very unfortunate typo.
My understanding is that if you stay below the warning labels, Tylenol is safe. But if you need doses high enough that you start bumping up against the recommended dose, DEFINITELY talk to your doctor about long-term use and possible kidney / liver damage. They may know of a safer solution (possibly an opioid: which has risks of addiction but... its the doctor's job to weigh the risks / rewards and your various options. Figuring out the right medicine probably requires a decent interview with you).
Getting addicted to an opioid might be "lower overall risk" than dying to kidney failure. Its bad options all around, but that's why we have doctors to help navigate your options.
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Good luck. I've never experienced chronic pain myself. I just know that being in that state means that you're probably not thinking through all your options 100% (just focusing on the pain-relief side of things). Which is why its important to get consultation from a doctor.
I know the urgent care facility in my neighborhood does primary care. Search around for urgent care facilities, they accept walk-in appointments. Ideally, you'd talk to a primary-care physician who has your medical history... but not everyone stays up-to-date with their doctor. (I certainly don't, and instead rely upon the urgent care walk-in appointments)
If the doc already declined stronger painkillers, it's probably not without reason. I dont get why you would suggest opioids being the less evil in this case. I once got 60 pills of codein for a torn off toe nail while visiting over in TX. Needed maybe 2 of them.
I would say, though, that this is something to talk through with your GP or a pain relief specialist.
For instance there are Codein (an opioid) laced versions that are more efficient at lower doses (with other obvious aspects to watch for), or better identifying the source of pain can help target it more precisely (e.g. direct application gels).
There can be other mon drug related actions that help, if your doctor doesn’t give a shit finding another one would be your safest option IMO.
https://en.m.wikipedia.org/wiki/WHO_Model_List_of_Essential_...
A great man, a crying shame.
https://www.propublica.org/article/tylenol-mcneil-fda-kids-d...
Later that night, I was in so much pain that I literally could not walk at all. I was laughing and crying at the same time, it was ridiculous that I was in so much pain over a TOE. Not even the big toe at that. I had to crawl to the bathroom to pee. Luckily it just took another day and I could hobble on it again.
For non-USians, Tylenol is a brand of paracetamol. The recommended maximum daily dose for an adult is three to four grams. Paracetamol toxicity is the foremost cause of acute liver failure in the Western world.
It is very depressing that, on top of the pain, I feel like I'm constantly making excuses why I can't do things with my family. Often times I will "power through it" and just make things worse.
Nowadays I am quick to get on my crutches and keep my foot elevated at any hint of a flare up.
I did not know of Eric but can certainly understand taking too much Tylenol for foot pain.
I should ask my doctor for a non-NSAID alternative painkiller.
PSA: don't drink and take tylenol, please. The warnings on the bottle aren't a joke.
The BNF provides some accessible guides to all pharmaceutical drugs:
https://bnf.nice.org.uk/drug/ibuprofen.html
https://bnf.nice.org.uk/drug/paracetamol.html
I don't mean to be insensitive RIP to what sounds like an awesome guy
I have a box of this in my drawer - it's 20 pills totalling 10g - that's enough to damage a healthy liver if taken in the span of 24h.
I can't imagine the pain this man must have been going through to do this and mind you, I had kidney stones.
Some versions of Tylenol have codeine in them as well. I got some stronger ones (Tylenol 3) after oral surgery and I had a few pills left and when a few months later my back was acting up and I was eyeing those pills I immediately flushed them down the toilet because I don't want to get addicted to that shit.
See also: https://blog.epa.gov/2016/04/29/dont-flush-why-your-drug-dis...
Jeez, is that a pill bottle, or the Headpiece of Ra from "Raiders of the Lost Ark"...
Sympathies to the family. 55 is far too young.
He sounded like every bit as great a programmer as John Carmack or any of the relatively famous linux maintainers
https://venturebeat.com/2020/12/07/friends-remember-microsof...
Engstrom was happiest working in his lab. His death came from medical complications related to an accident in the lab, after he dropped a monitor on his foot.
His friend, St. John, managed to get permission to visit Engstrom and deliver some blood collection kit vials to him so he could extract his blood and DNA for cryogenic cold storage.
“We’re going to get a full genetic sequence of Eric’s DNA,” St. John said. “Eric’s going to live on forever.”
St. John played Viking music at the end of the service.
Nightmare :)
https://books.google.com/books?id=FTbctntiaHgC&lpg=RA3-PA320...
http://www.azillionmonkeys.com/windoze/OpenGLvsDirect3D.html
https://en.m.wikipedia.org/wiki/Fahrenheit_(graphics_API)#Hi...
https://softwareengineering.stackexchange.com/questions/6054...
There was another blog with a detailed rundown on the politics behind the Fahrenheit drama but the site wend down 10 years ago and I can't remember what the link was.
We should all be so lucky to be remembered this way.
I didn't know the man, but very grateful for DirectX and all the amazing experiences it's allowed myself and others to have. For many of us, games are an escape from things that are not so pleasant. As a kid/young man, they definitely got me through some tough times.
I can still remember playing Pitfall on Windows 95 like it was yesterday, due to DirectX.
Thanks Mr. Engstrom, for being one of the crazy ones.
My recollection of the genesis of DirectX was in fact a skunkworks project create their vision of the next generation web-browsing experience. I think it was demoed and they had begun touting to developers/publishers with work with, but was axed.
I think it had a 3D aspect to it -- perhaps all 3d, I can't recall. But my memory was that they needed a significant 3D library, and they didn't want to go down the OpenGL (I think it was fundamentally political and personality disagreements with themselves and the maintainer(s) of the OpenGL implementation within MS) They convinced their boss to acquire a company that had a 3d engine product and hacked together a more comprehensive library, that ultimately became DirectX.
He was abrasive to most, but if you clicked, you clicked. We clicked.
RIP Big guy.
Thanks to Eric and team.
RIP Eric.
Tech people... why are we so lame at living a long life??
That's tragic, but come on... if you were in decent health a frigging monitor on your foot isn't going to kill you.
In my short 47 years I've known a professor of CS to die at 52 while running. I've known a computer friend to die at 32 from colon cancer. Steve Jobs at 52 from pancreatic cancer.
The computer world is not that big, so there should not be so many of these outcomes.
Programmers seriously need to focus a bit on health. I've been studying how not to die for the past year, since my own father allowed his prostate cancer to go from lamb to lion. Maybe I'll write an ebook & call it "how not to die".
The parent refers to is:
http://blog.wolfire.com/2010/01/Why-you-should-use-OpenGL-an...
See FUD part.
As a society, where else could you show that people shouldn't ignore negative consequences when they seek their success?
For one I recommend you read John Carmack interviews from the time directx was being developed. Straight from the horse's mouth. I can assure you, things before directx were not pretty.
And as everyone is saying, there are better things to remember and look on a person's life work that is sadly no longer among us.