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Comment by toomuchtodo | Hacker News Reader

The greatest invention would be a body debugger.

Imaging + Genome Sequencing + Blood Tests

Still pretty barbaric compared to what we'll see in the future, but useful while we drag ourselves forward.

Anecdote: I was bit by a tick about 2 weeks ago. To get a lyme disease/meningitis test done, I had to pay my copay ($30) at my primary doctor (for him to approve the tests) and then had to make another appointment to have my blood drawn and tested by Lab Corp (~$200). I then had to wait for my doctor to call my back because Lab Corp would not provide my results directly to me (!!!).

Like I said. Barbaric.

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This seems less an indictment of medical science than of the healthcare system you have to live with.

Because where I come from, if I was bitten by a tick I could book my primary doctor's appointment online, get the blood test done the same day at a walk in clinic without an appointment, and then phone the doctor's surgery two days later to get my test results...without paying anything.

I agree I have comingled two things: Medical technology and healthcare systems. My apologies.

Unfortunately over half of Americans don't realize the current healthcare situation is a problem, and actually believe it's good, because it gives them more freedom.

I almost thought that once, but it's really easy to run through the facts:

1. Since the primary purchasers of health insurance are companies, the insurance companies grossly tilt their plans in the direction of companies. Individual plans are lackluster. The individual plans where I live don't even cover mental health services. Not even one.

2. Since companies are fallible, we cannot depend on them to honestly offer insurance to every worker who deserves it. For example, in Massachusetts, there is a mandate for companies with full time employees to provide a health insurance plan: http://www.rawstory.com/rs/2013/03/29/companies-cut-hours-of... naturally, companies schedule for .1 less hours and leave you in the dust.

It seems that this is a total mess. Companies cannot be put in the crossfire of the health insurance debate with these unimplementable laws.

The only reasonable solution is to pay for it with the federal income tax. Competition and free markets are good, but not in this space. Would you like to find out the free market price for an ambulance after you were involuntarily hit by a bus and woke up in an ICU?

We live in a strange land of "freedom"

"The only reasonable solution is to pay for it with the federal income tax."

Pay out of property tax. Follow the money and keep the money loop as small as possible to maximize return on investment and minimize accounting losses.

99% of your lifetime medical expenses are going to be at the hospital closest to your home, most likely. Makes closing the loop simple and obvious.

If for political reasons you have to go county sales tax to pay for the county hospital, that works too.

Much like the most effective way to fund a local school system seems to be local prop tax rather than the feds or the UN or something.

"Companies cannot be put in the crossfire of ... with these unimplementable laws."

Its never slowed down any other regulation for any other reason in the past, ever, so may as well not start slowing down with health care.

Property tax makes sense, yeah.

If that happens my new home is going to have to figure out their property tax situation, though (NH property tax is one of the highest)

> We live in a strange land of "freedom"

It's an empty word at this point. Freedom from what?

Can you please share the name of the country in which you live?

That sounds like the UK, where I live.

Unfortunately, because the Conservative party have frozen NHS funding, you'd have trouble getting that doctor's appointment, and the walk-in clinic would potentially bugger up your blood test, forget to put your NHS number on the sample, then call your doctor who would contact you a week later to tell you to go in again and have it re-done.

There's no good reason why we shouldn't be spending more to make sure that the service works properly, just right-wing ideology.

Yes, I currently live in the UK. I have simplified somewhat, because as the above post suggests provision does vary from health authority to health authority.

Don't know where the OP is from, but that's more or less how it works in most of northern Europe.

> without paying anything

directly.

Whether it's better/cheaper to pay directly or indirectly is a separate issue worthy of its own debate, but either way TNSTAAFL.

Had the tick been on you for a while? Did it have the target rings around the bite? I can't imagine getting tested every time I was bit by a tick.

What's barbaric?

Labor and materials cost money. Someone has to pay.

LabCorp is not staffed with people trained to divulge and discuss your potentially serious diagnosis.

All but the smallest independent medical clinics have phlebotomists on site. If you want faster medical service, move to a more dense/develeped town. Most of us live in cities, for reasons quite like this.

I live in Chicago. Are you saying I'm not living somewhere dense enough? Also, they're my lab results. There is no reason to withhold them from the patient.

Seems like much ado. If I was bitten by a tick (or twenty, as has happened before) I would pull it off and flick it, then immediately forget about the whole thing.

Do you see a doctor after every time you get into a car? Because that is far more likely to kill you than just about anything you can think of.

It really depends on which area you live in. Some are high-risk for diseases, others are fine.

Additionally, though, a deer tick will not transmit Lyme disease until it has taken its blood meal, usually 24-36 hours after first biting. If you take it off right away, and it hasn't "inflated," you're almost certainly safe.

as a person who spent 20+ years fighting lyme disease, which ended up attacking my CNS, i can tell you this is absolutely not a good idea.

I'm sorry about your experience, it wasn't my intention to be flippant about the disease, but rather to point out that people's paranoia is often misdirected.

no problem - paranoia is sometimes excessive. however, "Just because you're paranoid doesn't mean they aren't out to get you," is also true, in my experience :)

Haha, indeed!

Here's what the CDC says about Lyme Disease.

(http://www.cdc.gov/lyme/)

> If left untreated, infection can spread to joints, the heart, and the nervous system. Lyme disease is diagnosed based on symptoms, physical findings (e.g., rash), and the possibility of exposure to infected ticks; laboratory testing is helpful if used correctly and performed with validated methods. Most cases of Lyme disease can be treated successfully with a few weeks of antibiotics.

Thanks?[0]

[0] http://xkcd.com/903/

I was coming down with symptoms that were flu-like, and had extremely painful muscle tension on my neck. Both of these can be attributed to either lyme disease or meningitis. I operated under the assumption that $200-300 was cheaper than long-term (years) health problems or death.

You obviously don't live a region that's at risk for Lyme disease. The disease is seriously bad news if it is left untreated, as the bacteria invade the nervous system.

I have some family experience with Lyme and meningitis. I'm confused.

A blood test is not useful for a recent tick bite. It takes 4-6 weeks for the antibodies to be present in detectable quantities. For Lyme, you observe the possible site of infection for a few days, if it is swelling or reddening (with or without the characteristic "bulls-eye" pattern), then you get antibiotics. Doxycycline is popular, but it's a long (21-day) course, so a good doc will not prescribe it casually.

Meningitis is either bacterial or viral. The true test is analysis of spinal fluid (this one goes to 11!), but it's a very fast-moving and dangerous infection. Regardless, a blood test is unlikely to be conclusive.

You can save the tick and send it off to a local lab for analysis. That'll tell you with a high degree of certainty if the tick had the spirochette. In some parts of the country, most do. It won't tell you if it has been transmitted to you, of course.

Disease transmission typically happens after the tick has been attached for 36-72 hrs.

Those of you who haven't lived in deer tick country might not realize how tiny the things are this time of year. Pinhead sized or smaller. Easy to miss even if you're diligent. No solution for it except to be more diligent, however.

Good luck with the doxycycline. I don't understand why your PCP ordered a blood test, but the meds make sense.

Do you still have the tick? You can send it to a lab for analysis, it costs just $60. The human lyme tests are very inaccurate, especially within two weeks of the bite-- you might not have formed antibodies yet.

I kept it for a few days, but disposed of it after I had blood test done. I found a lab that will accept my own blood sample for a western blot, so in a week or two I'll send them a 5ml EDTA test tube for processing (I can draw my own blood at home).

"Do you still have the tick? You can send it to a lab for analysis, it costs just $60."

This is the most important lesson of the whole discussion, having gone thru this. There's a direct analogy with rabies, if you know the animal is uninfected you can save yourself quite a bit of time, pain, and money. If you know its infected, well, treatment usually is wiser than waiting for death.

Bit by a dog? Eh, make it let go, and then walk away, no need to check for a rabies vaccination tag. After all, what are the odds? LOL

> Bit by a dog? Eh, make it let go, and then walk away, no need to check for a rabies vaccination tag. After all, what are the odds? LOL

I don't know where you live but it is pretty standard to get a few vaccines (rabies included) when bitten by an unknown dog as a precaution.

Same reason people get tetanus shots with puncture wounds.

Are there lyme tests that are accurate in less than a month? I also got bit by a tick a couple days ago, but I just went to the doctor and got a doxycycline prophylaxis. I'll probably also send the tick in for analysis.

Just do the antibiotics and don't worry about it, it will kill the bacteria if it exists. The standard lyme test looks for the antibodies, which won't exist if you take the antibiotics within a few days of the bite.

"Just do the antibiotics and don't worry about it, it will kill the bacteria if it exists."

There's still a chance of having it even after the antibiotics. The chances of getting it even after taking a prophylaxis go down from around 3% to perhaps a little under 1%, but there's still a chance. And there are also other tick diseases that doxycycline doesn't work for. The most likely case is that mine was only attached for a little under 24 hours, which reduces the chances even further, but considering that if not treated right away it's basically as bad as AIDs it's still kind of alarming.

> I was bit by a tick about 2 weeks ago. To get a lyme disease/meningitis test done

Why do they even test for it? Don't they just start antibiotic treatment for it?

You've just defined the recipe for developing antibiotic resistant "other things". Doxocycline-resistent... donno UTI or STD or gum disease or whatever. That would suck if STDs became resistant, now incurable.

To a crude first approximation, a new antibiotic gets a fixed number of uses in the environment before it becomes ineffective in the environment. Its bad medicine to "waste" a valuable use of a fixed supply of an expensive product. You can save 50 million lives of actually sick people, or just provide 50 million placebos.

Also most dr. have a huge aversion to making people sick, and there are very few antibiotics indeed (none?) that don't have a measurable chance of killing the user or making them sick. Amoxocilian makes me pretty sick. Doing a course of it "for fun" would be incredibly unwise. Of course if it were "take the amoxocilian and get sick, or the infected leg has to be chopped off" well maybe that's worth some puking and fever.

So if your odds of infection are 0.5% but the odds of horrendous digestive system meltdown are 5% and death is a 0.1% likelihood, you're better off getting tested.

This is like the old "why not remove everyone's appendix?" question. Because removing everyone's would kill more people than appendicitis currently kills for a net negative.

> So if your odds of infection are 0.5% but the odds of horrendous digestive system meltdown are 5% and death is a 0.1% likelihood, you're better off getting tested.

Except when you get bitten by a tick and have stage-1 Lyme disease symptoms like a huge swollen bulls eye, your odds of infection are more like 99.9%. If someone is getting tested for getting bit by a tick, they most likely have some sort of symptoms.

> You've just defined the recipe for developing antibiotic resistant "other things". Doxocycline-resistent... donno UTI or STD or gum disease or whatever. That would suck if STDs became resistant, now incurable.

I thought that was more likely from the hundreds of millions of pounds of antibiotics used in factory farming, not preventative medicine.

When a bunch of us were exposed to a person who 48-hours later came down with severe meningitis (coma), they dosed us all with cow pills of antibiotics. I'm sure they could have waited until we all got 105F fevers by the time the tests came back, but they took the risk of antibiotic resistance and pre-treated us all.

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