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Comment by pen2l | Hacker News Reader

I know of 2 guys who had a case of "sudden death" in the valley, both from heart attack, both were using stimulants and working very long hours in their startups. I know from previous threads that a lot of folks in the valley use stimulants to get through nights without sleep, to work with high focus, but guys you have to be careful. Stimulant use aside, keep in mind cardiovascular diseases is one of _the_ bigger killers out there. Cancer gets a lot of attention, and it's a big killer, but most people don't realize how many people are beaten by cardiovascular diseases. Eat healthy, and exercise to prevent these problems. Get a comprehensive exam from your physician annually for good measure.

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I'm a retired radiologist with a huge experience performing coronary CT angiography (CCTA). This is an amazingly accurate exam, superior to cardiac catheterization and stress tests. Radiation dose from this exam has been dramatically reduced in recent years,

Having seen thousands of these studies I can state that many people have severe coronary artery disease at young ages (in their thirties). They are at risk for sudden death. Often they come in for the exam because a parent or sibling died prematurely either recently or at the same age as they are now.

What's interesting, in my experience, is that very often when siblings get the exam, the one with obvious risk factors such as obesity, smoking, diabetes, etc has a normal exam result and the sib with no risk factors (other than maybe sharing a bad family history) has severe disease.

Read about CCTA http://goo.gl/o1RvD5

Presumably the ~5 mSv radiation exposure is worth the benefits?

I picked up a full Rad working at a nuke. No tumors yet.

We often use coronary CTA to rule out coronary disease in low risk chest pain, but I can't say I would recommend it as a routine test due to the radiation and the dye load. We know that the fatty streak begins in childhood and it must be true that there is a lot of clinically undetected coronary disease. When it comes to sudden cardiac death for a young man, I'd also be concerned about electrical abnormalities such as the Brugada syndrome / channelopathies / accessory pathway syndromes. Drug use is another important factor in general, not that I would think it to be relevant here.

May the family of the deceased find peace.

If I have a CCTA test done and it shows early signs of heart disease, what can I do about it? I am 31 healthy, eat relatively good, exercise everyday, don't drink or do drugs. I'm just wondering what you can even really do? Are there (or will there be) drugs that can dissolve the hardened fat (and whatever else) in your arteries?

uhm, by all accounts (especially the video in this thread where he says as much) this guy was far past the working-long-hours phase - the company was mature and he stressed work life balance. i think mentioning stimulant abuse here is a little ... shitty of you, to be honest.

some people just die young/young-ish of natural causes. i personally know several people who have had freak heart attacks or brain conditions and passed away. it's sad, but a fact of life (and death).

Generally places stress work life balance because the organization doesn't actually afford its members a work life balance, so the perception of it existing has to be constructed through propaganda.

i.e. If you already have work life balance, there's not need to stress it.

This is just not true. Tech culture is rife with long days, nights, and weekends. In my experience, companies that truly care about work life balance often have to remind people of this just due to the fact that so many people are used to this culture and often have a difficult time escaping the mindset.

This is completely wrong. In our area (Silicon Valley) it is common and expected to push hard and work long hours. It is an extremely competitive environment and unless you're forced to go home most people work late into the night.

Not making an effort and letting your employees know that you don't expect them to work nights and weekends means you are ignoring the societal norms in our field and most likely have engineers working their way towards burnout.

why is it shitty? I didn't take it as him implying that's how the CEO died, just that it's an issue that happens a lot in silicon valley and it's dangerous because you can die unexpectedly due to a heart attack.

Worst case, he's implying that illegal drug use is a factor in the death of somebody known to people here. Best case, he's bringing up something irrelevant on a thread where people are paying their respects and/or dealing with a deep and sudden loss and is doing it in a way where he's oblivious to the possible implication. Either way, I think shitty is a reasonable word.

If he wants to talk about an issue in Silicon Valley, he can do it pretty much anywhere but this one page.

No, what's shitty here is you twisting my words. I never said anything about illegal drug use. I have friends who were getting ADHD medicine (subscribed by a licensed psychiatrist), but had to stop because of heart problems. THIS IS COMMON. As I said, cardiovascular diseases are an amazingly big killer of life. That is what I'm talking about. I think it's an apt time to mention this -- people are emotionally engaged, it's this time to be informed of actions we can do to care for ourselves: be cautious of stimulants (not just illegal ones), eat well and healthy, and make time to exercise.

I did not twist your words. You also never said anything about legal drug use, so when I said "worst case" I was pointing out one end of a scale of possible interpretations. That you were talking about technically legal abuse of drugs is on the scale I describe.

I stand by my point: either you were suggesting that drug abuse might be a factor here or you were bringing up something approximately irrelevant. Either way, that's shitty. Let people have their time to pay their respects and mourn without you jumping in with your kids-eat-your-veggies hobbyhorse.

Of course you stand by your point, how often do you see people online not stand by their point. That would be the unusual thing.

It's been observed many times before that when someone online starts describing another persons stance as "either you X or you Y" they're generally involved in a false dichotomy.

So congratulations wpeitri, you're just like almost everyone else on the internet. You have an opinion and nothing will convince you otherwise.

Are you happy about that?

I am often convinced otherwise. Just not in this case.

By the way, your I-am-the-superior-intellect pose would be more convincing with better spelling. Note also that "It's been observed" and "they're generally" is classic weasel wording. [1] If you think the truth lies outside my constructed dichotomy, by all means make it clear what you are claiming the truth is.

[1] http://rationalwiki.org/wiki/Weasel_word

Why keep on going wpietri?

You know, I never said anything about 'illegal drug use'. Maybe I chose poor words that would have one think I meant that? But I made several comments elaborating that's not what I meant after having made the initial comment. You made your posts after I made those comments. And I'm telling you now too that's not what I meant -- and I told you that before too -- it's just not what I meant. So there's really no reason to keep going on about this, do we agree?

Maybe take a break and smell the fresh air? I hope all is well with you.

Whether or not it was about illegal drug use, I believe your comment was still inappropriate. That it could be read as implying the recently deceased guy was a junkie made it especially so, but even without that I think it was woefully inconsiderate.

I don't have any need to keep talking about it, and you seem unwilling to come to grips with my actual point, so if you'd like to be done with it, I'm not stopping you.

And if I had responded with an absolute you would have attacked that instead.

It isn't really about me using weasel words or swapping the i/e in your name, it's about you using character assassination in your head to convince yourself I can't possibly have a point.

Good day to you.

It must be so nice to be able to read minds and see the future. But surely there's a better use for your superpowers than snide HN comments?

man, you just totally shut me down, good job bro!

Recently there's been a bit of discussion about "downvote to disagree".

This is an example where I'd far rather people just downvote each other and move on than post these bickering threads.

Maybe I'm wrong though.

It's just another variation of the "intelligent discourse" idea that gets bandied about quite often on these sorts of boards.

We have every right to communicate, no one has verbally attacked anyone else, if it really bothers you just skip on by instead of taking the time to make sure we're aware that you're judging everyone involved in the conversation.

Is that unfair? Well, so where you :)

Oh no, sorry, I did not mean to imply it was stimulant abuse. But you know even normal use of stimulants is a sudden killer for some people with cardiovascular problems. I mentioned it mainly because I've read many threads on HN indicating that stimulant usage is kind of high in this field... and that's fine, as it's prescribed to folks with disorders like ADHD. You just have to be very careful with it though, because again, cardiovascular diseases are one of the biggest killers. Easiest way to prevent is to eat healthy and exercise, it's really as simple as that.

Hard to believe this was just death by "natural causes." It's dangerous to speculate, yes, but I think we can all safely assume that he had access to the best of the best in terms of healthcare. To die suddenly at his age with no warning signs at all is very strange.

Even if you can afford it, you've got to ask for it, if you're in the tech field. A professional basketball player, and probably also a coach, is going to have their physical health watched over, whether they take the initiative or not. Wealthy people in many other fields are free to go to the doctor as rarely or as often as they want.

That said I think his wife probably made sure he got good access to healthcare, if he didn't take the initiative himself. But it probably is somewhere between every three months and every year. Major sports players, top celebrities or Paul Atreides have the level of access that make it extremely rare, but a well connected tech executive just has a level of access that reduces the risk somewhat.

>>> Even if you can afford it, you've got to ask for it.

This. A thousand times.

So many people in the valley just lose track of time, or they put their health on the back burner for just one more month, or miss that yearly physical, and then suddenly it catches up with them.

Saying he was a proponent of work life balance does not mean his job was a walk in the park either. You're in one of the most competitive markets, with a successful startup. I can easily see why executives at his lever would start to cut corners on their health.

It's too bad really. He sounds like one of the guys you would really root for to be successful. At the very least, I'm glad he was able to achieve some of his dreams - something a large portion of the population never get a chance at.

If anything it should remind everybody. Take a break, call your family and tell them you love them, hug your kids and tell them you love them. You never know man, you just never know when your time is going to be up.

Dave was an inspiration for people like me who work at SurveyMonkey and try to achieve a work life balance. He encouraged us to keep reasonable hours and to be home to spend time with our families and he did the same.

I wont try to speculate what actually happened out of respect for him and his family but I can assure you that he was not the standard silicon valley go hard all night type of CEO.

Adderall raises one's blood pressure to a dangerous level. It is smarter to avoid such drugs and at most rely on caffeine. Work smartly, not like a maniac.

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