I'm going to start this thread by saying that I have the self-awareness that this is a very first-world problem. That said, @amazon is the biggest company in the world (or close) and they can do better - cc: @JeffBezos
Here's the story. This morning I ordered groceries from Whole Foods for dinner tonight and for food for the family for the week. I even paid $5 for a 1 hour slot from 4-5PM. I started getting messages from the shopper at 2:47. I responded to all of them
I had asked @RuthieSWeiss to listen out for the delivery as I took the dog out for a walk. She called me at 5 to day that they were not there. So I decided to look into it. Here is a chat exchange between me and the @amazon customer service agents. It speaks for itself...
OK that's it. And yes I realize I am being an entitled boob but I think it's also true that we are all a bit on edge and little things like this are kind of like chewing glass...
[end]
Sorry also I'm tired and annoyed so I am not proofreading this thread so it's probably a mess but I don't care
Post-script: the doorbell just rang. Someone is fucking with me
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A story for a Friday afternoon. Spoiler, I really don't know what to do with it.
So I have this patient. He is mid-50's & healthy aside from an ACS event a few years ago for which he was stented & is on all the right 2ndry prevention things. He is also very active
He wears an Apple Watch, & a couple of years ago the watch was telling him he had Afib. Given his CAD, this was important as it would mean adding a DOAC to his regimen which of course does not come without risk.
The watch continued to trigger frequent AF alerts and we did a Zio
He kept very careful notes and the Zio was on for a week. There was no AF at all. And the events the watch was calling fib were clearly not fib
I don’t understand why people are so bothered by the fact that metabolic disease can be treated by medicines. It’s not that lifestyle solutions can’t work; they can! It’s that they don’t work for a very large number of people…
We should celebrate that more people have solutions that can work for them. Not doing so is the height of arrogance
It also seems relatively uncontroversial to acknowledge that medicines are a life-saving solution for those with hypertension who cannot control their blood pressure with lifestyle alone
Here’s a question for @nicknorwitz & @realDaveFeldman: if I understand, your model hypothesizes that increased ApoB in lean/athletic people on low carbohydrate or ketogenic diets does not result from either 1) saturated fat or 2) genetic variation, but rather from CHO restriction
So in the spirit of n=1 case studies, I have one for you. 52 year old male cardiologist BMI 21, exercises 6 days a week, on low SFA ketogenic diet for 4+ years with ApoB ~80 mg/dl
So how do you explain this? Is it genetics? Is it environment? If so, what else besides carbs is it? Fiber?