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Comment by vinay_ys | Hacker News Reader

I went to cardiologists for a mild burning sensation in my chest area, post recovery of my first & only covid infection, in early 2022. They dismissed my concerns. A year after recovery, I resumed my routine strenuous exercises, and I noticed I had elevated resting and walking heart-rate and my apple watch would alert me of abnormal heart rates. I went to cardiologists again and they dismissed my concerns again. Both times, they did all the usual battery of tests (Echo, TMT/EKG, cholesterol, blood markers etc) and they all came "normal". They basically told me stop googling things and to throw away my smart watch. Anyway, another thing my watch was telling was that I wasn't getting enough sleep and I focused on fixing that. A few months after that, my resting heart rate started to trend down and has come back to pre-covid levels. I don't know what to make of it all. One expensive doctor explained it to me this way – historically medical community don't have enough data about how post-infection recovery has been in large populations w.r.t heart rates. Only recently, with smart watches etc such data is available. Until that smart wearable data is scientifically studied, analyzed and concluded, the doctors won't change their diagnostics and treatment protocols, for good reason. While I understand that, I felt that their current protocols are for suited for well-advanced and well-presenting cardiac diseases that occur in old people.

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I've lost a lot of faith in medical professionals recently to the point I almost don't want to waste time with them unless I really have to. I was having issues with severe pain and tension in all of my movements. My doctor shrugged it off twice, the third time my wife came and she read him the riot act for not taking me seriously. I did a blood test same day and my rheumatoid factors were so off the charts(doctors words) he was surprised I wasn't more vocal. Dude, I came to see you two times before, I need to cause a scene in your office to get real care?

Then my wife went for hip surgery. We were told it was routine, everything is going to be great, less pain, better range of motion. My wife came out of the ER with the inability to move her leg, drop foot, nerve damage. She went in able and came out disabled. 3 big surgeries later, she can walk again. UCSF doesn't want to hear us out on anything related to that botched surgery and the surgeon has since moved to New York.

Dealing with medical professionals is like dealing with toddlers. You have to push them on everything or they simply do not care.

They're being squeezed by patient demand and administrations simultaneously, the whole system in the US has seemed on the brink of collapse since 2020.

I get all my care done in Taiwan and everything is fine and the doctors all seem to be mostly happy with their jobs, and a few regular nurses like me because I look like a famous actor, so they're always pretty chatty and seem to be mostly ok with life.

Would you care to share more on how you do this? Do you just fly out and pay out of pocket? How do you find specialists? Curious about this for my mother.

I have permanent residency in Taiwan so it's easy for me, although before that it was still easier than anything in the US, just not next to free without their national insurance.

I don't necessarily encourage medical tourism but simply fly to Taipei, find a doctor you want to see, and sign up for an appointment. It will be a little more work without the NHI card but still probably less than whatever you're dealing with. If you get medical scans, almost everyone can print a CD with them in a day or two if you ask. Getting care even without insurance was cheaper than just my US insurance premiums.

Having someone fluent in Chinese is important enough I'd say it was required but if you restrict yourself to a smaller sunset of hospitals and clinics that serve foreigners around like Tianmu you may be able to get by with a translator app.

People outside NHI are uncommon and their medical system isn't really set up to support it. You may want to consider actual medical tourism facilities of which I've heard of several in Mexico or Costa Rica.

You and your mother may also want to consider rioting, because the US system is deliberately and almost uniquely stupid.

Check out Thailand. Medical tourism is a thing. Generally, yes... pay out of pocket, but it is so inexpensive compared with insurance that it isn't a big deal.

Also, people don't realize, you can get health insurance in other countries. Prior to covid, I was an expat living in Vietnam and had very good full health coverage for about $4500 a year. I just found a local insurance broker who did all the paperwork for me.

The US medical system is such a mess. I go to get blood drawn regularly and even with an appointment sometimes the wait is over 90 minutes. There will be people who had an appointment but they were five minutes late so they got put on the walk-in waitlist, which often never gets processed so they sit for hours only to get dismissed. Everything costs too much money and the service is awful. It’s just a nightmare.

Unless doctors can see with their naked eye what's wrong they just give you the boot unless you fight hard, diagnose yourself with google, and demand tests. I used to think doctors got mad at googlers because they would find crazy wrong answers and waste their time. Now I know it is because it reveals their incompetence. I laugh whenever anyone says the US has the "best medical system in the world".

The quality of a medical system can only be reliably assessed through population level outcomes, not individual anecdotes. In some specific metrics such as cancer 5-year survival rates, the USA is consistently at or near the best in the world. In other metrics such as maternal and infant mortality we're way behind. It's inconsistent and patient experiences will vary widely based on medical condition and location.

One must normalize to how unhealthy the population is, in that case, the US medical system is doing amazingly well!

But still the little detail that of the 30 richest countries, it’s the only one where you can go bankrupt if you have medical bad luck. ;)

While medical expenses can push you to bankruptcy, more often it's the loss of earning potential that does it with severe illness (whether directly or because of need to care for family member).

That is, our general health cost picture and way insurance works is a subject of concern, but the bigger issue for this specific talking point is just general lack of safety net.

It has the best one IF you have the money that you can fly wherever you need to get the best ______________. It really is as simple as that.

I had to tell a lung specialist that my shortness of breath, which was being alleviated by antihistamines, might be allergy-related. She literally told me my symptoms were "a mystery" after I had told her that antihistamines were helping.

My optometrist said it was machine’s measurement error when I used used myopia curing methods to bring my eye diopters down exactly 0.75 right & 0.5 left and it exactly happened.

> I laugh whenever anyone says the US has the "best medical system in the world".

This isn't limited to the US. I am in the Netherlands and to the best of my knowledge Belgium/Germany aren't much better.

Unfortunately this isn't a great take either.

I'm not sure what you do, but lets say you're a programmer. You love programming and want to make the world better with it. Of course you also have $400,000 in education debt from becoming a programmer and need a job to ensure you don't end up bankrupt. So you get a job for $bigCorp that pays well. BigCorp tells you that you must push out 100,000 lines of code per day or you're out. You look around and all the jobs in what you do pretty much act the same way, and those bills are coming up at the end of the month. Now, you know you cannot turn out quality code at that rate so you cut back quality to a bare minimum to meet the metrics of continued employment.

Most doctors are in a similar situation these days, very few independent offices exist. They are parts of "GiantHealthCareCorpofAmerica,INC" that cares far more about how much the shareholders are going to make than how the patents are, even though each individual doctors would like to give better individual patient care.

That's not the impression I've developed, having been a software engineer for about 15 years. I think I spent about $100k total, and got a bachelor's and a master's degree without any subsidies. 400K in student loans for a computer science engineering degree seems pretty steep. That would have to be out-of-state tuition at a pretty nice school. (I suppose we've been in a decade of low interest rates, so perhaps folk have been more willing to borrow a lot more?) I've worked at a BigCorp, and never had lines of code as a performance metric. Lately at my current job, I practically write no lines of code per day, and instead spend most of my time designing solutions to problems and mentoring others.

>400K in student loans for a computer science engineering degree seems pretty steep

I did a little adjustment to the numbers in the sense I put them closer to the numbers actual doctors pay for their schooling, not exactly programmer pay. On average doctors pay and programmers pay is very similar. Doctors schooling and programmers schooling is nothing alike at all. Moreso, it's far easier to get blacklisted as a doctor then a programmer for any number of reasons (programmer ethics, lol funny). Where you have more risks, more regulations, and more costs the more likely the default behavior becomes to toe the line.

Oh, ok yeah 400k of debt seems relatively modest for a medical degree. I didn't pick up on your intent to make it a metaphor.

My appendix exploded while inside of me bc the doctors dismissed my severe abdominal pain as "bad diet". I then had severe infection and had an agonising week in hospital. This was when I was about 16, so more than a decade ago, it was the NHS in the UK.

I have a lot of good friends who took the path to be a physician when i opted back into tech. It's been staggering to see 100% of them say never go into medicine, at least in the US. Two are considering leaving the country to practice when their loans are paid off.

My personal side project is finding and documenting ways to get treatment while avoiding the insurance system as much as possible. IMO you really should only see a GP in the sick-care system as someone to order the most basic labs and screenings, and to receive reports you seek out on your own from specialists who take cash payments.

You can download the US Preventative Services App, punch in your data, and see the recommended screeners for your situation.

https://www.uspreventiveservicestaskforce.org/apps/

I agree that this is the best possible solution in the american healthcare system for any chronic issues.

For accute issues like getting in a car accident going through the established system is still the best option.

It is surprisingly normal in my experience to have doctors fail to mention nerve damage etc. It's absolutely wild to me.

> Dealing with medical professionals is like dealing with toddlers. You have to push them on everything or they simply do not care.

I noticed a similar problem in other fields. The other day I spent an additional, unnecessary hour at the dealership, because the guy who was supposed to notify me that the car is ready... vanished. He had three other clipboards from other customers on his desk when I arrived to ask about the status.

My mortgage application process was, simply put, a dumpster fire - my form sat idle for a month until someone finally looked at it.

I feel as if all the accumulated karma from all my botched ticket estimates is finally coming back.

“I feel as if all the accumulated karma from all my botched ticket estimates is finally coming back.”

Let us know if this is true so we can prove the simulation hypothesis.

Sorry but what does reading the “riot act” mean in this context? Never heard this before.

It is an idiom meaning she yelled at them.

Wikipedia search recommended! It comes from a UK law called the Riot Act granting officials the power to forcefully disperse gatherings if they refuse to disperse after a verbally delivered warning - the precise wording of which was specified by the Act. So an official would literally read the Riot Act to a troublesome group, and if they kept it up, the lads with truncheons would come and start cracking heads.

The idiomatic transfer is fairly obvious, although the implication of consequences if the admonished party is insufficiently contrite has become sort of optional, I think.

I'll just augment this by saying: you have to push them, but learn to push properly. This means not being aggressive (yelling), or dismissive (even if you know medical research as well as the doctor), being patient, repetitive, and sometimes even play dumb.

>One expensive doctor explained it to me this way – historically medical community don't have enough data about how post-infection recovery has been in large populations w.r.t heart rates. Only recently, with smart watches etc such data is available.

This is absolutely true and one part of the root problem. The other aspect of this is that most of the heart tracking devices we use live on the wrist and the data is of questionable quality and application. Many cardiologists know this and dismiss the devices and its uses wholesale, but that approach is wrong. The data isnt 'wholesale bad' its just bad at many things (hilariously, particularly bad at the things they advertise on the most). One of the things its GOOD at doing is noting when your heart is behaving differently from your baselines, which is why its generally pretty good at noting AFIB or pre-AFIB characteristics, for example.

This level of complexity on the issue, coupled with the relative lack of understanding with post-infection behavior/detailed immunoresponse, is definitely leading to some less than ideal approaches to patient care. and obviously the nature of COVID, being the first generally uniform viral infection of the entire population since 1918, being a huge wrench.

source: I am not a doctor in any way, my dad has a 30 year history of complex heart problems and i get to speak with his specialists a lot. like, 12 of them by this point. I work in tech and play with many types of health tracker devices regularly so it comes up in conversation.

I went to a cardiologist in 2021 and told them I am concerned that I have lingering health issues due to a covid infection months earlier prior to vaccines being available to the public. Heart pain, unexpected palpitations, racing heart rate, etc. Was previously training for a marathon.

That cardiologist told me that covid has no effect on the cardiovascular system and the heart cannot feel pain and discharged me to a PCP after running a handful of tests to rule out anything (Echo, EKG, labs, etc)

Now here we are in 2023, I have had long covid for almost 3 years and cardiologists are now admitting they are wrong. This article is pretty telling on the dismissive behavior and the truth catching up to them.

>>cardiologists are now admitting they are wrong.

Not a surprise - almost everything initially said about covid was wrong; maybe next time people saying things should be so absolutely definitive about things they clear don't know enough about (yet). I would rather doctors hedged their advice/proclamations a bit, then to be definitive when they shouldn't be.

The ridiculous truth is that we got zealous COVID absolutists as an counteraction to Donald Trump. It was purely a political phenomena.

The "it's just a cold" crowd was also a political reaction and they didn't come out look any better.

For me it wasnt even a cold, i had no symptomps whatsoever

> I would rather doctors hedged their advice/proclamations a bit, then to be definitive when they shouldn't be.

Then we'd be complaining that they're telling us two wholely different opinions.

Medicine, like science, is based on available data. I have no problem with them admitting they were wrong based on new data.

agreed - but not only did they know they didn't have all the information - so they were in effect making a guess based on the limited information they had - but they also took the extra step of discrediting anyone that held a different opinion.

That is not 'science'.

To be fair, this is something built into the average humanity. If we have learned something from young, it takes very much to change this belief. It can be anything from what is the best programming language to politics, religion or whatever. For discussions with the opposite belief, it easily goes into - "He has been brainwashed" - land. It's very hard to convince someone that they have been wrong their whole life, especially if there has been loads of studies supporting that case.

> Now here we are in 2023, I have had long covid for almost 3 years and cardiologists are now admitting they are wrong. This article is pretty telling on the dismissive behavior and the truth catching up to them.

I think this is being too demanding of doctors. Their opinion changed because the science changed. Discovery and understanding simply takes time. Practicing doctors aren't scientists, they aren't charged with the responsibility for discovering new disorders and treating them correctly on a per-patient basis. Their job is simply to understand the best available consensus about disorders and treat their patients accordingly. And... it sounds like your doctor did exactly that.

And it surely sucks terribly that the understanding was wrong. But that's not really the fault of your doctor. No one could have treated you better at the time except via dumb luck. It's OK to accuse them of being an asshole about it, but not really about being "wrong" so much.

If being taken seriously is too demanding, then I will continue to do so.

My story I hope shows this exact sentiment mentioned in this article:

> “It’s important to acknowledge that these patients are suffering,” Anagnostopoulos says. “Many of them are young and unaccustomed to being sick or held back in any way from what they want to do. They often feel they haven’t been taken seriously. And what they want to know is that the doctor sitting with them is developing a plan for improvement.”

I think I agree with you there. But being unsympathetic and being wrong are two different states, and it's important to distinguish the two. The doctor did the "right" thing according to the understanding of the time, they were just a jerk about it. And that's being a bad doctor, but it's not delivering "incorrect" treatment.

It's basically a converse take to the "You're not wrong, you're just an asshole" meme.

Cardiologists aren't exactly known for their bedside-manner. Also I did present these reputable journals this article alluded to:

> As the COVID-19 pandemic was getting underway in early 2020, doctors in Wuhan, China, began to report that many patients hospitalized with the disease had cardiac injuries. Heart attacks were frequent, especially in patients with underlying risk factors, and there were numerous cases of myocarditis, which occurs when the heart’s muscle layers become inflamed. Roughly a quarter of patients with severe COVID-19 had elevated blood levels of troponin, a protein marker for cardiac damage.

Still was dismissive of covid having any effect on cardiovascular. But you can only learn so much in 60 minutes over 3 months right?

Again, that's misstating the science. No one could "learn" about cardiovascular effects of covid in 2021 because there was simply no consensus understanding.

"Doctors report many patients [...]" framing is true of all sorts of nonsense, all the time (including about covid! Hydroxychloroquine was being boosted by the same kind of anecdotal evidence). That's... just not how medicine works. How do you know which anecdotes are nonsense and which are correct? You do the science. And they did. But not in time for a lot of people, and yes, that's awful.

This is what they call "patient-led" nowadays. It isn't misstating.

I can understand their skepticism, but these professionals should always be open to new data and should at the very least make a note of it in your records so the retrospective analyses can be done. Do you know if any of your symptoms got recorded?

American doctors are trained to dogmatically accept medical treatments uncritically. The dogma is called the "standard of care" and the entire medical, billing, and legal system will work against you if you deviate from it. They will only change their ways when they are told to do so from higher up.

"Airplane mechanic decides service manual incorrect, custom fix leads to 200 dead"

And yes, what you state is exactly what the doctor should do. Otherwise you're taking all the testing and experience of all the other doctors that have already worked on this issue and tossed it out the window. When an individual patient shows anonymous behavior your document everything you can for future investigation. You don't get to play research laboratory on your patients.

Doctors aren't mechanics. They are the engineers. Nurses are the mechanics.

Engineers run it by QA before pushing it to prod.

Oh, you wish. You frigging wish.

That lasts until someone who is the CTO's buddy gets a hair and decides to get exec override, then pushes to prod, deleting the company financials.

And the medical equivalent of QA is generally a very awe inspiring strain of nurse.

> "Airplane mechanic decides service manual incorrect, custom fix leads to 200 dead"

All airplanes of the identical model have an identical manual.

No two humans respond the same to complex (or often, even simple) health conditions/situations.

Just because we don't have enough docs doesn't mean custom solutions are the enemy.

Now, if we had an unlimited number of doctors this wouldn't be near the problem (why we have a limited number of doctors is a different question). If a huge portion of the US population wasn't old relative to the part of the population that is young, this wouldn't be near the problem. If a massive portion of the US population wasn't... um... massive, well then this wouldn't as much of a problem.

But the country we are left with has too few doctors, too many old people, and too many unhealthy people. We can argue until we're blue on why that is the case, but that does nothing to change that your doctor has about 5 minutes with you and an entire waiting room full of patients today, tomorrow, and the everyday after that to the point they are turning patients away in most places.

Custom solutions aren't the enemy, but in situations where an applicable evidence-based medicine protocol exists it would be malpractice to deviate from that without a damn good reason. Those treatment protocols produce good results for average patients (i.e. most of us).

Nonsense. That is not how American doctors are trained. Have your ever actually talked to a medical school professor, or an attending physician in a teaching hospital?

In recent years the medical profession has been shifting from being mostly an art to mostly a science. Clinicians are supposed to follow evidence-based medicine protocols rather than making things up as they go along because those produce better outcomes on average. They should only deviate from those protocols if the patient has some sort of contraindication, experiences serious side effects, or fails to respond. Unfortunately we still lack clear protocols for many conditions including post-viral syndrome.

http://dx.doi.org/10.1136/bmjebm-2023-112311

Yes, there are several doctors in my family. They are great at treating acute problems and absolutely clueless about managing chronic health conditions unless there is a drug for it.

The majority of chronic health conditions are the result of lifestyle choices. Those are largely outside the scope of medicine, and it is unreasonable to expect solutions from doctors. They have some drugs that can ameliorate symptoms in severe cases but those mostly don't address root causes. Patients might get better results from a personal trainer, dietician, therapist, or social worker.

Ok, so lets take this the other way.

The doctor says "Yep, Covid fucked you over"... What changes?

That doctor is not handing you out a candy bag of medicine to see what fixes your issues. Your "was training" is still going to be that "was". Now after some large number of people like you start showing up for the same issue, then some smaller portion of them get direct diagnosis (either post death, or during some other surgery), the doctors won't know what to do as a means of treatment. It's likely it will be years longer till we have effective means of treating long covid symptoms.

I suspect GP would find the subjective difference between "go home, it's all in your head" and "you aren't crazy, but I don't know how to help you" to be meaningful.

A lot changes.

1. I would feel taken seriously.

2. I would still be seeing them to check-up on my health.

3. I would be discussing the budding literature to try promising things (i.e. atorvastatin, AT1RB, etc) - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9520195/

4. Other patients who are young and healthy are also validated (i.e. we are seeing more of you)

5. etc

The problem with western medicine today is that if you cannot be treated, they want you out of the system. The system is starting to get much better at adapting to these novel health challenges though. I suppose that will happen when there's 65 million across the world with these issues!

The system is already overloaded by an aging population and a shortage of practitioners. There is no capacity to schedule extra office visits for the sake of making patients feel that they are validated and being taken seriously. That may seem cruel, but that is our reality. It's only going to get worse as the demographic situation continues to deteriorate.

There's absolutely a shortage, but what about recent innovations or acceptance of things like e-visits, 24/7 clinics, and even AI-assistance for clerical work taking more load off of practitioners?

For example, I'm looking at my HCP's app right now and can schedule a call with my doctors as early as next week for an e-visit. For an in-person visit, it's closer to a month. But they have absolutely been taking my extra office visits due to my condition.

Telehealth visits and expanded clinic hours make obtaining certain types of care more convenient for patients. They do nothing to address practitioner productivity and workload. It's still one practitioner working directly with one patient.

AI might eventually reduce charting workload slightly. A few vendors have launched new products in that space but they haven't had much impact yet. In the ideal case they might allow for an average doctor to squeeze in a couple more short encounters per day.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7540911/ Suggests both pros and cons depending on if the facility is at capacity already or not.

It would unlock insurance money for treating the root cause.

Long COVID's effects are so random and personalized that many people have to throw the kitchen sink at it until they find a solution that works for them.

What insurance money is being locked? If a patient has severe symptoms then insurers will pay claims that meet medical necessity criteria for symptomatic treatment regardless of whether the patient has been formally diagnosed with "long COVID" or whatever.

now that COVID has a few years to run we have new data for scientist to discover it's effect.

back then no one knew anything about COVID. it's not like the doctor was hiding the truth. people are expecting them to be all-knowing is just being unrealistic. did you expect him to just pull out a magical pill from his back pocket to fix everything.

You are your own advocate and are ultimately responsible for you.

Don't delegate the most important parts of your life.

Doctors will kill you.

Police will show up too late.

Lawyers will miss important details and defenses, and you'll be stuck with the consequences.

Accountants and financial advisors will squander your wealth.

Know how to defend yourself against violence. Read and understand legal documents before you sign them. Understand your investments. Ask questions.

And reject anyone who gets defensive when you exercise your right to control your own life.

Fire your doctor if they are offended when you advocate for yourself.

Fire your financial advisor if they get irritated when you sit and read the 40 page contract they ask you to sign.

Fire your accountant if they write you off when you ask them questions about your books or taxes.

These are your support systems, you want experts in your corner you can rely on. You want people you can delegate "sticking to the plan" to. But, ultimately, your life and freedom is yours. Do not delegate them.

I tried to pay different tax accountants twice, and get free advice from a friend that does taxes for billionaires. I'm 0/3 for having a professional get my taxes right. Luckily I've avoided any penalties over the years, though.

On the other hand, I asked my wife to give me a back massage, so she booked an appointment for me at the spa down the road. I wasn't expecting her to delegate that, but it was still nice...

Even if we don't have enough data for a causal link, from the information you've provided, it sounds like the elevated heart rates were more correlated with your poor sleep schedule than with your COVID infection.

Also consider that taking on strenuous exercise when you haven't done it in a while is going to cause elevated heart rates, beyond what your previous normal heart rate was during that exercise. Regular exercise will also eventually lower your resting heart rate. I think "starting a new strenuous exercise regimen" (because yes, after a year's break, that counts as "new") would also be unsurprisingly linked to elevated heart rates, even resting.

Certainly the burning sensation in your chest area is concerning, but did you rule out the more simple and common cause: acid reflux?

I agree that it's unfortunate that there hasn't been enough research on consumer health monitoring data, but I don't think your story says much about the cardiologists' diagnostic process. But I also expect that, with the general lack of understanding of the long-term effects of COVID, many doctors are not equipped to diagnose lingering health issues stemming from an infection.

But IANAD(octor), so what do I know.

> Also consider that taking on strenuous exercise when you haven't done it in a while is going to cause elevated heart rates, beyond what your previous normal heart rate was during that exercise. Regular exercise will also eventually lower your resting heart rate. I think "starting a new strenuous exercise regimen" (because yes, after a year's break, that counts as "new") would also be unsurprisingly linked to elevated heart rates, even resting.

Yes, that was my first thought too while reading the comment. A lower heartrate during exercise and resting is a strong fitness indicator. And pausing your exercises for a year significantly reduces your fitness. Of course you will see elevated heart rates.

DISCLAIMER: this is my opinion, obviously I am not saying "this is what is definitely happening". I assumed that was a given but the world is full of surprises.

> I wasn't getting enough sleep and I focused on fixing that. A few months after that, my resting heart rate started to trend down and has come back to pre-covid levels. I don't know what to make of it all

Of course you know what to make of it all. You were obsessing over the metrics available to you, as many have done as well (myself included), and increased your overall stress levels, bumping your heart rate and making it erratic, and messing up your sleep, which only served to compound it all. You took a year off from strenuous exercise you said, of course it takes time to get your resting rate back down to levels before you were sick and when actively exercising. Imo there is no mystery here. Focusing on your sleep calmed your mind and your body followed suite, combined with the exercise having time to improve circulation and make you more tired to give you better sleep, which helps to lower your overall stress levels, which lowers heart rate, etc, etc.

The true question is, did the heart rate elevation cause you any physical issues, or was the issue only that you had visibility into the number. Or put another way, had it not been for 24/7 readings of your heart rate, and notifications from your watch, would it ever have manifested itself physically and been something you felt, and noticed. Based on everything starting out with "my watch would alert me" or similar, I'm gonna say if you're honest with yourself, had you not had a watch the issue might have come and gone and never been noticed.

Edit: here come the downvotes for the crime of claiming some things can be self inflicted esp when it comes to fitbit/apple watches. I've watched countless friends and family members fall victim to the obsession of metrics, freaking out about their heart rates all the time, etc. I used to do it myself. It's not a bad thing, but it is a thing, and people need to acknowledge it.

There's a difference between claiming "some things can be self-inflicted" vs "your thing I'm diagnosing from your description is definitely self-inflicted".

I'd upvote the former, downvote the latter.

You must have missed the "Imo there is no mystery here" smack dab in the middle of my comment, but I added a big disclaimer at the top just now to be sure

Your tone started aggressive and maintained that most of the way, with a couple of minor disclaimers buried in the middle.

I’m mainly pointing out that downvoting isn’t necessarily “you’re wrong” but often “you’re not being constructive with your communication style”.

One man’s direct is another man’s aggressive. I can’t help how you interpret what I wrote, and I’m not one to sound overly cheerful because it’s not accurate to how I feel about the topic. I’m also not aggressive about it. I’m indifferent, and what I wrote is if nothing else just an alternative vantage point for the parent commenter to use when making an informed decision. Placebos exist, as do physical manifestations of stress from over thinking things. Heart rate monitors are pretty well known for triggering that in people, and like I said, it did that to me when I first got one.

historically medical community don't have enough data about how post-infection recovery has been in large populations w.r.t heart rates

I'd agree here. Most doctors have not really caught up to the giant data science revolution we have going on. A couple years ago I bought one of these [1] while trying to diagnose some general health/fatigue issues and after a year of data logging and life experiences it was pretty cool to watch how my HR/O2 numbers changed in response to various events - long bike rides, strength training, getting a cold, being on antibiotics, etc. The nice thing about this device was 1) it's much more accurate than smart watches and 2) provides raw time-series data vs some abstract fancy marketing UI.

At this point I now do comprehensive bloodwork panels at least quarterly and while I don't use the O2 device anymore I still have the baseline data saved. I'd recommend to anyone to start recording this type of data while you subjectively "feel good". It'll make it much easier to diagnose + press doctors on health issues if you can point to data associated with a time you felt well.

[1] https://www.amazon.com/Wellue-O2Ring-Wearable-Sleep-Monitor/...

Big data work on healthcare is stymied not only by inconsistent collection, but also healthcare privacy laws and a lack of standardization across the industry. So many medical device manufacturers are holed up in their little silos and have no interest in contributing to the general knowledge. They are in it to make money, not to advance the science.

Healthcare privacy laws are not a hindrance in the US. Basically all one needs is a business agreement with a HIPAA-compliant entity and one can send PHI data. And certainly so if the patient opts in.

So I would say it is 100% due to the siloing and proprietary enshittification endemic to the industry. They don't want to help science, they want vendor lock-in.

> I'd agree here. Most doctors have not really caught up to the giant data science revolution we have going on.

Well, compared to psychology researchers, the medical researchers are doing pretty well on data science. I‘m not joking. In psychology, data science just doesn’t exist yet. P-values still rule the day and overfitting is a term they have never heard of.

I had a very similar experience. I did measure my heart rate previously though, and the high resting heart rate notifications were new.

I was very worried at first because one of my personally prioritized indicators of fitness was how quickly I could go from say, zone 3 to 50bpm. This was quite low, then suddenly I was having 70-90bpm around 30m after exercising.

Yet it gradually went away and I never actually experienced discomfort or anything like it. I haven’t seen a high restating rate in around 6 months. I’d say it lasted around a year, in total.

I can see why this condition could kill people with pre-existing heart issues or generally poor cardiovascular health. Having your heart working nearly double time at rest is a huge task when you’re already struggling. It was a great eye opener; I really don’t want to have this again and have it be the final straw that causes a heart attack.

> they did all the usual battery of tests (Echo, TMT/EKG, cholesterol, blood markers etc)

That doesn’t sound like they ignored your concerns at all. It’s odd that you present it as such.

A doctor tried to subscripe 'medication' which came from a company in the same city and had one study regarding inflamation reduction. One! The researcher is dead, the amount in the pill is 100x less than what he tried in the research paper. The pills would have been 100$ for a month.

The other doctor has a magnetic resonanz device (doesn't work...) and suggested to me homeopathy with the sentence 'i know people say it doesn't work but it works for my patients' (come on srsly? textbook stupidity...)

Since i know how broad the spectrum is in my field of expertise (its huge and i work in it obviously) i just have to assume the spectrum is still wide enough for doctors too.

I hate this.

I hope/wish for an AI doctor

In my experience (in my non-US country) doctors don't make much use of heart rate for diagnosis at all.

We check things with a pulse oximeter when feeling unwell and quite often we see elevated heart basal rates associated with infections, uncorrelated with body temperature. These tends to correlate quite fell with feelings of tiredness/uncomfort. I found it interesting that doctors most of the times feel entirely uninterested with this.

> elevated resting and walking heart-rate and my apple watch

Glad you recovered. If you have an Apple watch be sure to also track your overnight HRV. (I have a Garmin). While many blood tests fail to be illuminating, RHR and HRV at least can indicate something is wrong. A high HRV/Low RHR is good, Low HRV/High HR is bad. And yeah, cardiologists are the worst when it comes to unexplained heart issues that are not picked up by an ECHO.

Was it a shallow pain, like almost in the surface or lining of the chest wall? Might have been something called costochondritis.

I had had it off and on since the 1990s, usually for a day or two. But, after each Covid infection I had it for several days, the worst lasting a couple of weeks. Burning sensation in the breast plate, physically hot to the the touch where the ribs connected to the sternum.

I mean. A year between strenuous exercise is a lot. It only takes several days without strenuous exercise before the body begins realigning and fitness is lost.

Interestingly, I have an irregular heartbeat just normally, and have inner ear problems that cause my heart rate to change for doing nothing at all, and my watch has never made any warning about it.

> Anyway, another thing my watch was telling was that I wasn't getting enough sleep and I focused on fixing that. A few months after that, my resting heart rate started to trend down and has come back to pre-covid levels.

There’s solid research causally linking lack of sleep to high blood pressure the next day.

I am in exactly same situation. Completely stopping coffee and sleeping better has helped.

> I wasn't getting enough sleep and I focused on fixing that.

Gotta ask, what did you do for this?

Not the person you're replying to, but I am someone who actively is trying to get more sleep due to problems with high blood pressure.

Good sleep comes with good habits.

No liquid consumption near bedtime. Caffeine intake reduction and cutoff at least 6 hours before bedtime. Having a wind down routine instead of waiting on my body to tell me to sleep. (Use phone in bed instead of a computer mainly)

I was averaging less than 6 hours of sleep a night. Nodding off at work was common, and I would compensate with caffeine.

I still don't feel energetic, but I'm less tired now, and looking to increase my nightly sleep to 7.5 hours. It just sucks sometimes to get home at 7 PM and try to sleep at 10 PM.

Alcohol has a huge negative impact on sleep quality, especially when consumed late in the day. If you have a smart watch with sleep tracking then you'll probably notice a very obvious impact from even two drinks at dinner.

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