So...what the hell's wrong with you, Shooter? - <AUTHOR> [NOTE: This post is both personal and medical in nature and only about hacking in the sense that it is about searching for a solution to a complex problem.  Some of the "HN is for hacking only"–types may not want to waste their time reading it.  It's also extremely long, but I don't have or want a blog right now.  You've been warned.]
This is my answer to apu's question to me on another thread about ALS (and, specifically, my misdiagnosis with ALS and other illnesses):
Q: "If you don't mind me asking, what was the final diagnosis? How was it discovered? And how are you coping?"
A:  Basically I had multiple infections (both viral and bacterial) that were slowly eating me alive.
I started having migratory shooting pains, chronic joint pain, extreme fatigue, and rapid weight gain years ago.  (I gained 100 pounds in about 4 months, with absolutely no change in my diet or exercise program.  I went from somewhat athletic to fatigued fat-ass that slept 20 hours a day after a brief flu-like period.) They initially tested me for thyroid and pituitary tumors.  That first MRI is how they found the first spots on my brain - before they were full-fledged lesions.  They were just hyper-intensive spots and 'plaques.'  It's more common, by the way, to lose tons of weight with infections, but the infections affected my hormones in a way that made me balloon up.
I kept getting new symptoms over the years.  Sleep disorders, aphasia, tremors, severe chest pains, left arm paralysis, left side of body paralysis, neck-down paralysis, memory loss, tinnitus, passing out, chemical sensitivity,  etc. etc.  In the end, I probably could have been Stephen Hawking's stunt double appearance-wise.  As I said in the other thread, I was (mis)diagnosed with Parkinsons, Alzheimers, MS, CFS/FM, and ALS along the way - each time based on my symptom progression and test results.  Technically, I still have many of the other things I was diagnosed with based on symptoms and test results -  by clinical definition - but they were not the underlying, causative issues. They were just the icing on the cake.
I saw at least 22 doctors over the years, including some at top hospitals (Mayo,etc.)  A few of the doctors thought I was nuts, because of the sheer number of symptoms.  One doctor didn't even finish the exam and commented that it was either all psychosomatic or else I was the unluckiest bastard ever and I had 25+ different diseases. Most doctors would just space out at some point and start treating whatever their specialty (or first thought) was.  I had enough symptoms and bad test results to keep them all busy.  If I was seeing an endocrinologist, for example, she would try to treat just the endocrine issues (the infections affected my endocrine system, so my hormones were waaaaaay out of whack.  One endocrinologist said I should be in medical textbooks because of my crazy high/low hormone levels.)  I tested positive for some autoimmune disorders, so the rheumatologist kept busy.  I have sleep disorders (again because of the infections), so I was given a CPAP and sleep meds by a sleep specialist.  I have severe migraines (lesions!), so migraine specialists put me on migraine meds.  Etc. etc.  Not all these meds at once, of course.  The infections were playing havoc with my brain, heart, and nervous system...and my endocrine and immune system were along for the ride.  I had a 2-3 year period where it felt like I was having multiple heart attacks every day.  I'm amazed my wife didn't leave me.
The multi-systemic nature and the fact that certain symptoms tends to reinforce or mask each other made it very difficult to figure anything out.  When you have certain infections, for example, your body will naturally retain heavy metals and toxins from the environment - all on its own - in a self-protective attempt to kill off the invaders.  So I tested off the charts for toxic metals and the 'environmental specialist' thought that was the underlying problem.  But, of course, it wasn't. They cleared most of the metals and I still had all the symptoms. I had all of these heart symptoms, but most of my tests came back normal.  Normal stress test, normal basic EKG, etc.  They didn't find any heart issues until they did less-common tests (tilt-table testing, etc.) I had enormous trouble finding a physician who was willing to really try to figure out the underlying cause of everything instead of just treating individual symptoms.  I didn't want to be on 80+ meds for the rest of my (possibly short) life and not even know what the hell was wrong with me.
I eventually narrowed down what I personally thought I had, based on my own research and background.  Neuroborreliosis (neurologic Lyme disease) was one of my guesses, because I had done an extensive forestry research project at one point before my illness and I knew I had been bitten by ticks that may have been infected.  I had never had a rash, though. And I didn't think any of my 'guesses', individually, could explain my vast array of symptoms.
I finally went to this doctor that was supposed to be an amazing diagnostician  - "Dr. House without the 'tude", I was told .  I started reading him my list of symptoms - in chronological order.  (It was one of the ways I had learned to cope with the discouraging doctor visits...if I was staring at a sheet of my notes, I couldn't get pissed because the doctors were rolling their eyes at me.  I also needed the notes because my memories, and sometimes my speech, were completely shot.)  Usually, the doctors would stop me fairly quickly when I started listing symptoms.  This guy listened intently, and then started accurately guessing the next symptom on the list before I could even say it. He did that for about 7-8 symptoms.  He gave me the most accurate description of some of my symptoms...more accurate than I could even muster.  ["Does it feel like someone is squeezing your heart with their hands and won't let it expand?"  "Does it feel like you're being stabbed with a cattle prod right here?" etc.] I often had trouble choosing the proper words to convey certain symptoms, in part because I knew it sounded crazy.  But he was nodding the whole time and seemed sincere.  He said he thought I had a major environmental toxin problem (heavy metals, chemical sensitivity, etc.) OR I had one or more vector-borne infectious diseases.  He said either thing could potentially explain all of my symptoms, and that he leaned toward the latter because of the migratory nature of some of the symptoms.  He was amazed I had never been tested for some infections, despite having been to some of the top hospitals in the country.  The fact that my shooting pains were often migratory was one of the main things that had made some of the doctors think I was a loon.  This doctor says, "Uh, DUH, it usually feels like the pains are moving around because they are - the things that are causing them are moving around, both in your body and in your brain!"
I had already been down the toxin path, so I was tested for a range of vector-borne diseases.  I had almost all of them that I was tested for.  Lyme, Babesia, Ehrlichiosis, etc. etc.  Plus a liberal dose of virii at very high levels.  I had had some of them so long that I was no longer showing a normal antibody response, but I had other telltale markers (specific cell parts on tests, etc.).  [The accuracy, availability, and expense of these tests is another tangent I'll avoid right now.]
Oddly enough, once this doctor correctly diagnosed me he refused to treat me.  The insurance companies really give doctors who treat chronic infections a hard time, because the long-term treatment of certain infections is more expensive that treating a late-stage AIDs or brain cancer patient.  Some doctors - including at least one Nobel laureate nominee - have lost their medical licenses or been forced to stop treating infected patients because of insurance company influence.  It's a very complicated, political issue.  Very frustrating.  Too complicated to get into here.  Anyway, this doctor said he wanted to treat me, but was literally scared to do so for fear of losing his medical license or his ability to offer insurance plans.  [There is an award-winning documentary called UnderOurSkin (http://underourskin.com/) that explores "chronic Lyme", and it gets into the insurance, political, and patent issues, etc. It also explores a theoretical link between Lyme and other diseases.  It's very good.  It doesn't go into the co-infection issue much, because it is Lyme-specific - but it gives a great overview.  The documentary trailer is at:  http://underourskin.com/watch.html   One of the guys in it is a physician that was also misdiagnosed with ALS,  and there's a baseball player that was misdiagnosed, Amy Tan (Joy Luck Club author) is also in it.
Anyway, I tested positive for at least a dozen viral and bacterial infections, but they could have potentially all come from one tick bite.  I think the estimate is that 30% of all infected ticks carry at least one other co-infection.  So, theoretically, I could have been bitten by just one really 'sick tick.'  Or I could have picked up other infections once my immune system was compromised by an initial infection.  No way to know for sure.  [Oh, and the fact that I never had a rash didn't mean anything because 50% or more of infected ticks don't cause a rash at all.]   Only a certain percentage of people that are infected with some of these diseases develop chronic issues, so I may have had a weak spot in my immune system due to genetics or something.  That's one area of research they're exploring.  I know they've found at lease one statistically significant genetic anomaly that predisposes you to getting sicker with at least one of the viruses.
Some people - even lauded medical professionals - think that most infections can be killed off fairly easily with short-term antibiotics or antivirals (which is part of the debate in that documentary I mention.)  That's one of the arguments the insurance companies use.  There are many mitigating factors, though, and most animal studies/vivisections say something else entirely.  Some infections have biofilms that protect them. Some form cysts that protect them.  Some infections grow drug-resistant.  Some meds don't cross the blood-brain barrier.  Different people have different immune responses. Etc. etc.  The medicines themselves are very dangerous long-term, and you also have the serious problem that the infections release toxins as they die off...so by killing them you usually get worse in the short-term.  The toxins released can kill additional tissue or trigger a stroke or heart attack because of the other symptoms.  It's a weird balancing act between getting a medicine to work without making the infections resistant or triggering too much of a toxin/autoimmune response.  It's drug hacking, in a way.  I've had two strokes.  One because of a misdiagnosis when they put me on steroids and I had a major inflammatory response and once after I was properly diagnosed because I wasn't fast enough on the trigger to recognize a change in symptoms when I was pulsing between two antibiotics.
By the time I was properly diagnosed, I had permanent damage to my brain (lesions, some may heal), heart (cardiomyopathy,etc.), mitochondria (extrinsic mitochondrial disease - the infections ate the lipids from cells, among other things), and central nervous system (advanced neuropathy, etc.)  I also have the hormone, sleep, and autoimmune issues.  I've been on various antibiotics, antifungals, and antivirals for about 15 months.  And pain meds.  I only decided I had my final, correct diagnosis because this was the first logical answer that explained literally everything, had confirming test results, and allowed me to actually start getting better over time once I started treatment, toxin setbacks aside.  Some of my symptoms have completely disappeared, but some remain. Mobility-wise, I've went from a wheelchair to a walker to now only needing a cane sometimes.  I still have some memory loss, some aphasia, some numbness, some shooting pains, etc. - but I'm 80-90% better than when I started treatment.  Not only in frequency of symptoms that remain, but in their actual intensity. I mainly see an infectious diseases specialist now, and he keeps warning me that I will not continuously get better but will instead have a rollercoaster ride until I level off at my final "condition" – because of the toxins, immune response, and residual damage.
They're not sure exactly how much of the damage is permanent.  Some of the lesions are, for sure, and the mitochondrial damage is fairly severe (I technically have a small fraction of the energy, literally, of a normal person.)  I'm amazed by the improvements already, so I'm still hopeful.  My wife is pregnant with out first child, and everyone is scared/nervous how I will handle it.  I still pass out occasionally, so some family members don't want me to hold my own kid.  (Admittedly, I've fallen down stairs a few times after passing out.)  Insurance has already stopped paying on certain meds and will most likely eventually stop on others.  One of my antibiotics is $2500 a week, because the stent goes directly by the heart and you have to have a home health nurse change it to (ironically) reduce the risk of infection.  I'm relatively fortunate that I've been able to get and afford my treatments thus far.  I'm very fortunate that I didn't have a completely untreatable disease.  I also think this post should win an award for biggest "TMI" (Too Much Information) ever in the history of HN. <comment><USER5> I am assuming you are an American citizen. If you haven't already, you need to:

1) call your Congressperson's local office (not DC) and ask for someone in constituent services who works with health care issues. Do this tomorrow. If your insurance company is denying you _any_ care, and you have a paper trail, they should help. If your Rep can't help, then contact your two Senators' offices. Generally, Reps are much better with this sort of constituent service.

2) call your local Fox affiliate and tell them your story. (November sweeps are coming up, and this is a perfect post-House nighttime news story).

3) put up a web page that has your story, pictures, and easily found contact information for the follow up press stories that will occur.

This is your best path to making sure you don't get denied coverage from your insurance company (and it's amazing they haven't found a way to drop you yet) for the benefits that you are entitled to.

<comment><USER6> It seems awful to me that all of that effort is needed just to make sure your not screwed over by the insurance company :(

Or is it just the norm and Im not used to it?

<comment><USER7> Speaking from personal experience, it is the norm.

In the US you are completely on your own, and your insurance company is not your friend; no matter how dutiful you were in paying your premiums. If you have a chronic, treatable condition, expect to fight it out with your insurance company 2 to 3 times a year over whether or not they will live up to their contractual obligations.

It is my considered opinion that if Obama wanted to lever the healthcare debate around to actual change, the only tool he would need are the RICO statutes. And I don't think his prosecutors would find it difficult to bring cases.

<comment><USER8> Perhaps a solution to the problem of chronic, treatable conditions is to make health insurance not pay for them.

In short, turn insurance back into insurance (protection against low probability, high cost events).

<comment><USER5> Wait, WTF? Isn't getting bitten by SuperTick exactly the sort of low probability, high cost event insurance is for? Just because something is chronic doesn't make it low cost.

<comment><USER8> I'm not seeing how getting bitten by a supertick is chronic. I was responding to the meta-problem (insurance not paying for chronic conditions), not the OP's specific problem.

<comment><USER9> It sounds like you work for an insurance company. If you start along this path, they will find an incidental causation for every chronic affliction.

</comment></comment></comment></comment></comment></comment></comment><comment><USER10> Shooter, how did you find this Dr. House? You neglected to talk about this. And I think this is an important piece of information that can benefit us trying to get a resolution for our own mystery illnesses. How do you go about hunting a good doctor?

<comment><AUTHOR> I feel some people are focusing on the wrong thing, most likely because of my poor presentation. I'll try to answer your question, but I also want to elaborate a bit:

In relaying my story, I kind of 'cast' the diagnosing physician(1) as the hero, in part because it was such a relief to me for someone to finally listen and think logically, because it was relief to me to finally have an answer...and also because I was trying to shorten the post. But remember, by the time I saw this doctor, I had my condition narrowed down to a couple things already, and one of my guesses _was correct_. A search engine could have had equal billing, diagnostically. This guy didn't have a halo on his head when I found him or a neon sign saying he was "The One." He was _not_ the first person I was told was an amazing diagnostician or "like House." He was just one in a long line of doctors, albeit one of a small number that was compassionate, open-minded and listened. I never brought up _my_ ideas about what I had until I gave the doctors a chance to give me their ideas, because I didn't want to bias them. This doctor was just the first one that hit on the actual problem, and was willing to order confirmatory testing. It was largely odds. If you see enough doctors, it will probably happen eventually...a million typing monkeys and all that. The _real_ heroes are the doctors who will actually _treat_ you once your diagnosed, even at great risk to their livelihood. The real heroes are the ones that will fight the insurance companies and help you while you're _going through_ treatment.

The final diagnosis wasn't really magical, or the act of an amazingly brilliant doctor. Yes, having the diagnosis was a psychological relief, but the most important could be this: the big, insurmountable problem for most people will not be getting a diagnosis but finding - and paying for - <USER2> treatment. There is basically a witch hunt in this country for doctors that diagnose and treat complex diseases. Complex means expensive, and insurance companies don't like that. Getting a proper diagnosis can be an enormous problem, but it is often just the start of the journey.

(1) Um, I'm getting tons of emails asking for my specific diagnosing doctor's name - which I simply can't give out. If you have any of these particular diseases, he will not treat you anyway. Remember, he turned me away. He would not even _start_ a battle with the insurance companies. If you have something unusual or that is complex or that is outside of the insurance company parameters, he would send you elsewhere for treatment anyway.

<comment><AUTHOR> That all said, here is how I found "the doctor":

1\. I was persistent. I saw lots of doctors. The 22 number I mention in my post is mostly just the _specialists_ I saw - not even all the general practitioners I visited.

2\. If I were to rank the doctors I saw, the better ones were either members of IFM (functional medicine), they were DOs (shady origins, but a more holistic viewpoint), and/or they were internal med doctors. Rheumatologists only seem capable of seeing certain things. Neurologists only seem to see certain things. In general, specialists were unable to see or care beyond their specialty. Which, I guess, is somewhat understandable. [The specialists did find clues, however, like the lesions and the hormone issues that eventually helped me find the underlying cause.]

3\. I asked around for someone who had a good reputation as a diagnostician. I asked doctors, business leaders, and hospital administrators. Unfortunately, many doctors seem to pride themselves on their amazing diagnostics skills, whether they actually possess them or not. So, I also asked for "open-minded" and "compassionate." Compassion implies a good listener, which is probably the most important thing because you can't find a pattern if you didn't hear about it. Some of the worst doctors I visited were the famous ones. They were too busy to listen. IIRC, I think the final diagnosing doctor had been trained at a podunk med school in Cuba or something.

4\. I was an informed patient. I used to work in the medical field (piss- collector, clinical drone, researcher, and software developer.) I researched extensively on my own. (This can backfire for some people, because they develop cyber-hyperchondria.) In any case, I knew - or learned enough - to get a lay of the medical landscape and I used that to my advantage.

5\. I kept a 'journal' that listed what symptoms I had on what day, etc. - <USER3> helped me find patterns. Some organisms have a specific lifecycle, so that helped me in my own search. Sometimes the only pattern was that there was no pattern, but the journal exercise was still very helpful. Just be careful about looking like a nutjob if you carry a handwritten book of your woes into a doctor's office.

6\. I was an inpatient patient. I know doctors are just average schmucks like the rest of us and they make mistakes, because I've worked with them. So, if a doctor didn't listen or was a jerk, I never went back. Some people think doctors are holy or something, and they continue going to visit a jackass in the hopes that something will change. That can kill you. That tendency is especially prevalent in older people.

7\. I acted professionally when dealing with doctors. Enough of them thought that I was nuts that I didn't need to confirm their suspicions by acting too emotional or unreasonable. Even though I _was_ often emotional, I kept it under wraps.

8\. I tried to find doctors that kept up on the latest research, or that at least seemed to _care_ about new research and treatments. To be honest, I knew more about the most current medical studies than _any_ doctor I visited, including the final diagnosing physician. I was more motivated and I had more time on my hands. But I used my knowledge to separate out the doctors who read the bare minimum for their CEs from the ones that were genuinely interested in their field and read broadly for their own benefit.

9\. To restate an above point: I never brought up _my_ ideas about what I had until I gave the doctors a chance to give me their ideas, because I didn't want to bias them. I had to remain open-minded too. You may not like the answer you get, but if there is compelling proof about it you have to accept it.

10\. Read and know your insurance policy if you're in the US, and fight for your rights.

</comment></comment></comment><comment><USER11> This is an amazing story. I'm glad you're onto the road to recovery.

For hacker news -- this is actually a perfectly reasonable amount of information to provide.

Having worked in many facets of systems engineering (in addition to an eye- opening stint in tech support) I can see many analogies between the medical diagnosis you had to obtain and computer diagnostics.

Just like medicine, a lot of computer problems aren't even diagnosed. A computer reboot is the way of fixing some problems without bothering to diagnose them, like antibiotics.

Generally, a hard computer bug getting fixed happens best if -- a LOT of people encounter it OR someone takes a personal interest in the problem OR there is meticulous documentation that makes it easy to pinpoint what is happening.

People don't notice that this is the same in the medical profession. You helped yourself by carefully documenting what happened, and I believe that's what helped you in the end.

All the best to you (and congratulations on fatherhood!)

</comment><comment><USER12> Dude, that well and truly sucks.

I work around hospitals some and every once in a while I get the odd feeling after watching a specialist scratch his head over a fuzzy black and white "slice" made by in imager with a magnet the size of a garbage truck that its all still so _primitive_.

Medicine has a long way yet to go.

<comment><USER13> Yeah MRI machine are definitively cavemen technology ([http://en.wikipedia.org/wiki/Magnetic_resonance_imaging#Phys...](http://en.wikipedia.org/wiki/Magnetic_resonance_imaging#Physics_principles)) you should help

<comment><USER12> Well, yeah, I know, magnetic resonance is a mighty cool hack. I was just hoping that it could be maybe, you know, a bit _smaller_. Not costing as much as a first class ticket from NY to Tokyo for a trip through one might be a nice touch as well.

Hell, lets just go all sci-fi and get right to the part where there's an iphone app for waving over a person and seeing their insides in full color in real time...

<comment><USER14> Isn't it much cheaper in countries like in Japan? I heard it was under $100 to get scanned.

<comment><USER15> In Japan MRI is covered by public insurance. You only need to pay around $60-$80.

<comment><USER8> For a low quality scan (resolution about 1/3 what you get in the US). A 2 tesla scan (what you get in the US) will cost the same as in the US (though the government may subsidize it).

I've heard it suggested that Japan got "scan-happy" (patients want a scan, kind of like how US patients want antibiotics for their virus), so they built cheapo MRIs to give them what they want.

<comment><USER15> Thanks for the info. I didn't know.

</comment></comment></comment></comment></comment></comment></comment><comment><USER16> You present well.

I've thought it would be difficult to become a good doctor because the turnaround time between tests is long, you don't know if patients are lying to you, and if you're not working properly then your patients won't come back so you lose your feedback loop. This clashes with the hacker experience where the turnaround time for problem solving is often very rapid, and the problem sticks to your desk until you've solved it. Unlike with hacking, you have no opportunity to improve the system to make it easier to diagnose future problems with.

I love the show 'House' because I identify with all the ways he works - leonine work habits, putting career interest ahead of body, largely unsuccessful attempts to modify energy levels with caffeine and alcohol, deliberately breaking things to see what happens, lupus ("It could be a threading bug!"), difficulty relating to normal people who don't orient around career obsession. I've fallen in love with supporting clients through API integration because it has a whole social dynamic that adds to the complexity. As with patients - when the other side tell you they've done something how can you be sure? "Everybody lies" / "Trust but verify".

</comment><comment><USER17> Firstly, thanks for sharing, and what a shit thing to have to go through (and continue to go through!)

I didn't really understand half of what you wrote because I don't have a medical background and I don't think watching House now and again qualifies me to have an opinion. With that said, I did want to comment on your last paragraph regarding having your first child... My partner was born with mild cerebral palsy, has major balance issues and little to no temperature sense. I'm 35w2d pregnant with our first and he's already had comments (right down to "I didn't know people like you could have kids") on his ability to raise children. My point being - you're not alone. There will always _be_ doubters. Please don't let those people, however nice their intentions, get in the way of what should be an amazing experience for you and your wife.

On that note, congratulations & good luck :)

<comment><AUTHOR> Thanks for that. We're nervous about the baby, but I've improved enough I think I'll be fine if I'm very careful. And I've asked the biggest 'doubter' to buy us a helmet for the baby ;-) Congratulations to you and your husband.

</comment></comment><comment><USER18> This might be way out there but have you investigated what the cost of going to another country and getting treatment there would be?

You already have a correct diagnosis. You sort of know what needs to be done and only need docs qualified but unafraid to do it and cheaper meds. You might be surprised how comparatively cheap all that can be outside US and the local laws in other countries might mean that the docs there don't have to worry about treating you there like they have to in the US. (Anecdote: A friend of mine once calculated that despite what the insurance covered for him, if he had come to Bombay and gotten treatment at the best facilities staying in a 3 star hotel all the while, it would have cost him less and he would have received way better treatment from more qualified docs.)

Good luck to you. Hope you get well soon.

</comment><comment><USER19> Shooter, I wish you the best of luck for your continual recovery.

I've been ill (dizzyness, almost passing out, weak left arm, chest pains, burning throat, swollen glands, twitching muscles, burning/pinching at joints) since June and I just fell out with my NHS (UK) doctor this week and went private.

The NHS doctor has been telling me its a virus and it'll go away on its own, and the muscle twitching was normal for a few days. I finally went back last week (have been back 3-4 times before that) when he was promising me a blood test to check for an infection and he is refusing me, he says we only have 10 minutes and I have too many symptoms, and even that he never said it was a virus infection.

So the few symptoms that he will look at are sending us down completely the wrong path, I don't want to keep chasing symptoms when we should be going after the cause.

I called the NHS directly and they told me to demand a blood test, but the doctor still declines. He even went as far as to tell me I don't have the symptoms I was telling him I had.

So on Wednesday this week I called a private doctor, got an appointment two hours later, she looked at my entire list of symptoms (15~) and checked me over, confirmed I have an extremely high temperature, inflamed throat and swollen glands. Had my blood tests today and I'm going in for the results tomorrow. That's more action in 3 days than my NHS doctor managed in over 3 months. I just hope it'll all be over now, as I've been trying to launch a business throughout this.

Before contacting the private doctor I felt like id slipped through the net and it was useless. I've not even been checking HN much lately so it was pure randomness that I stumbled upon this thread.

I still have a referral for neurological tests and a brain scan with the NHS if required. But I have been adamant that its not a family running disease because both my Mother and Sister have the same symptoms, all occurring since roughly the same date. If it wasn't for that id possibly still be following a (hopefully) less likely route.

A drop in the water compared to what you've been through, but I think I can relate at least a little to some of the initial frustrations that you've had to deal with. Thanks for sharing your story and I'm glad that you eventually pulled through all the confusion and are getting the treatment you need.

</comment><comment><USER20> I really appreciate you sharing this. Reading a story like this doesn't have a direct applicable impact on my life at this moment, but I feel I am better for having read it.

</comment><comment><USER21> Thanks for sharing.

Public health care is sorely needed in the US IMHO. Whilst it doesn't magically mean everyone gets expensive treatments, at least it takes away some of the problems. The last thing you want to do when sick is have to deal with money/insurance.

Really hope things get better for you, and enjoy the new baby!

</comment><comment><USER22> This is terrible. Is there any question left as to whether private healthcare is a disaster? I have known a few people who have been denied healthcare coverage when it is quite clear that it is due. Either there needs to be a regulatory board that can overrule insurance companies or we need to implement public healthcare.

<comment><USER23> Public healthcare is not inherently better than private, it has its own problems. I think it is easier and cheaper (both technically and politically) to fix private healthcare incentives than to go the public way.

<comment><USER24> How might you resolve the conflict of interest that private insurance companies are better off if they refuse your treatment and you die than if they pay for it?

<comment><USER25> The problem is not in the conflict of interest - other types of insurance work mostly OK. The problem is that the health insurance companies can somehow get away from their obligations without being sued to death. Maybe that's because of vague contracts, or maybe something else. I don't know the exact reason.

</comment></comment></comment></comment><comment><USER26> Thanks for sharing this story. I'm always amazed how much faith Americans have in their medical system, which seems more-or-less completely unjustified if you actually look at the statistics. There are multiple problems, too many to list really, but I think the root of it all is that the medical school system is designed to choose candidates with zero intrinsic motivation to learn. That's why the vast majority of doctors can't name a single finding in their field in the last year, and it's why the average chronic disease takes 8 years to diagnose. 99% of doctors don't learn or think about anything they aren't made to by the government. It's pathetic. And sure, the fact that our government as a whole is super corrupt makes it worse, but really the best place to start would be throwing out and replacing the entire school system-- which is responsible for both destroying intrinsic motivation, and also selecting those who have none to run the medical system (and everything else).

</comment><comment><USER27> Best wishes for a complete recovery. A comment: even good physicians often don't have a good handle on nutritional approaches to wellness, things like vitamin D/sunshine and vitamin C and the immune system, for example, and avoiding anti-nutrients. If this is the case with your health professionals, it might be an area worth researching.

<comment><AUTHOR> Thanks. I did have a severe Vitamin D (hormone) deficiency and a B12 deficiency, etc. Both are apparently very common with many diseases...more often as a result rather than a cause (immune modulation, etc.) The Vitamin D supplementation actually helped with the pain very slightly early on.

</comment></comment><comment><USER28> I know someone who was incorrectly diagnosed as having MS but it turned out (apparently) to be Lyme disease. A couple factoids:

* Lyme tests can often give (even repeated) false negatives. The bacterium can lie dormant or hide. This is why it's a good idea to get a lyme test as a baseline if you're going to be doing a lot of outdoors stuff.

* Most doctors are not educated about Lyme disease, so if you think you might have it, it is important to find a specialist or a doctor who is "Lyme-literate".

Also, how is this not on the front page with 300 points in 17 hours? Flagged too much?

</comment><comment><USER29> Thanks for sharing your story Shooter. It's clear from your story that your own research had a major influence on your eventual diagnosis, someone less educated or intelligent would have merely gone along with whatever their doctors were telling them, so for that I congratulate you!

It's gratifying to hear that you've already had such an improvement of your condition.

You have my best wishes! I hope that the rest of your recovery goes smoothly and that the insurance companies don't give you too much trouble!

</comment><comment><USER30> Thank you for sharing your story. I hope this serves as a wake-up call to anyone who doesn't believe that someone can be misdiagnosed many times by medical professionals.

Perhaps this is related to what marze said, but based on your experience it sounds like you looked into some CAM approaches (especially from the documentary you mentioned). If you don't mind sharing this with us, I am curious to know if the doctor who came up with the correct diagnosis would fall under this category? Also, your experience with all the different doctors with their own specialties reminded me of functional medicine, an alternative approach. (For anyone who is not aware, "Functional medicine reflects a systems biology approach because it includes an analysis of how all components of the human biological system interact functionally with the environment over time. The Institute for Functional Medicine contrasts this approach with an organ system biology broken down into modern medical specialties.")

Best of luck to you, and I'm glad you now at least know what the problem is. Not knowing why this was all happening must have made it even worse.

<comment><AUTHOR> Thanks.

I had to Google "CAM" because I wasn't familiar with the acronym off the top of my head. The diagnosing physician was definitely a member of IFM...I distinctly remember a certificate on his wall from them for something. In retrospect, the IFM-affiliated doctors and the DOs were all more compassionate and slightly more helpful than most of the 'traditional' MDs. I guess because they emphasize the more holistic approach/perspective, which is what was needed. The diagnosing doctor was not a New Age-y, 'alternative' type doctor, though, in the way people normally categorize them. Too much touchy-feely, pseudo-scientific stuff makes me nervous.

The documentary I mention mainly contrasts those who believe in chronic Lyme and long-term antibiotic treatment with those that do not. There is one doctor, mentioned fairly briefly, that is what I would call normally call an 'alternative' doctor as it has come to be described in the common vernacular. Long-term antibiotics, while controversial, are not really an 'alternative' treatment as I commonly think of it...? It's a controversial application of a traditional treatment. (Even though, frustratingly, they are happily used for longer periods for things like acne without the outrage.) Maybe I'm reading too much into the word 'alternative' - it's become a fairly loaded term. In any case, I do like a more comprehensive approach and am glad I found it. Otherwise, I'm sure I would still be very ill.

Yes, not knowing what I had was definitely one of the worst parts of the whole thing.

<comment><USER30> I agree, "alternative" does seem to have a negative connotation at this time, maybe because so many things now fall under that term. Thanks for letting us know the doctor was IFM-affiliated; it's good to know that option is available.

</comment></comment></comment><comment><USER31> I've been helping a friend research her medical issues. They're not as severe as yours, but she's had similar problems with doctors acting as little more than expert systems with partial data sets and unreliable memories. I was the first person to suggest an effective long-term treatment for her problem[0] after a number of doctors failed to come up with anything aside from the well- known treatments, all of which failed, some making the problem worse.

I'm not sure if there's an easy systemic solution to this problem. Somehow, doctors need to get in to the habit of _thinking_ and looking at the whole picture. There's also a tendency for doctors to not listen to patients, which is exacerbated by a tendency for patients to lie.

[0] The major symptom is menorrhagia, and the successful treatment was nafarelin, a GNRH agonist. This appears as a standard treatment on websites updated this year, but I could find no information about its use for that purpose in 2007.

</comment><comment><USER32> I have a friend who has the exact same condition, he went everywhere but was diagnosed with Lymes disease from a local doctor, the heavy metals put her onto Lymes and it has changed his life. His story is very similar in length so TMI as well but firstname.lastname@example.com is his email.

<comment><USER33> My roommate also had similar conditions. He was at the hospital every week. Always fatigued, extreme migraine, gaining weight, muscle pain and tons of other symptoms. He was super healthy and just started deteriorating. Unfortunately and sad ending, He passed away because he overdosed on pain meds about a year ago.

I wish you the best of recovery in the near future. Thank you for sharing this story.

</comment></comment><comment><USER34> You are extremely brave. Not a lot of us would go through crap seeing so many doctors and hospitals without going nuts. I hope you recover completely soon. Thank you for sharing - somedays I think my life is tough, but these are reminders that I'm way off the mark.

<comment><AUTHOR> Thank you for your kindness, but I'm not brave. Guys like Hal Finney - in the original HN post that I'm ashamed to have drawn attention away from - <USER4> brave. I was just persistent...and then very lucky.

</comment></comment><comment><USER35> Thank you, David, for this. It's a heart-breaking story but it's consoling that you're now on the road to at least a partial recovery. It makes me respect the fragility of it all: that it was potentially all due to a single tick. It's mind-boggling.

</comment><comment><USER36> Have you consider about Ayurvedic treatment [<http://en.wikipedia.org/wiki/Ayurveda>]? It's based on the philosophy of Balancing the senses.

Compared to western medicine, where focus is on attacking the infection and thereby causing other ailments, Ayurveda treatment will help to keep the balance of the system, which would be more comfortable.

Just give a thought on it. In this part of the world, there are lot of cases that were miraculously cured through Ayurvedic treatment.

Hope you will get better soon!

<comment><USER37> why the downvotes? I don't understand. laktek is making a suggestion.

As someone who has gone thru the whole onslaught of visiting several doctors for my sciatica plus degenerating lumbar discs - I was told by many doctors in the US that I am at the risk of being paralyzed . To put it mildly, I was scared. I then went for 2 months to India(kerala) where they diagnosed my problem as something that was the result of digestive problems. I had no faith in the daily treatment; I questioned the rationale of what they were doing(eg- enema with herbs and medical oil) to morning-medical-castor-oil treatments. But after 2 weeks, I was not limping.After 3 months, I was walking normal as anyone. At the end, I was told by the ayurvedic doctors that any more chemicals(by that they meant allopathic medicine) and my body would have made slower progress.

I also went thru the insurance drama- doctor 'adviced' me to take an x-ray so not to get into insurance troubles. So a whole 2 weeks later - I get my mri to know which of my discs have problem. There was this pain specialist who was so eager to take me 'once more' to the operation theatre to chip out a part around the disc(which he did twice). The nerve specialist was another story - interested in my occupation and annual salary over my pain.

</comment></comment><comment><USER38> I just heard about a new research study which indicates that some cases of Chronic Fatigue Syndrome are probably caused by a retrovirus infection. If you haven't already done this you might want to get tested for XMRV. It seems possible that could be somewhere in your mix of multiple infections.

<http://www.sciencemag.org/cgi/content/abstract/1179052>

</comment><comment><USER39> I recently saw a demo of a case-based reasoning system (some simple AI) that diagnosed illness based on symptoms. I have a feeling it would not have had any idea what to diagnose you with. I'm glad you found the doctor who was able to get you on a path to better health.

</comment><comment><USER24> Is there any software or standard methods for helping to keep track of symptoms, tests and hypothesis and identify causes of problems, when there are too many symptoms and too long a time period to hold it all in working memory?

</comment><comment><USER40> Were you able to keep working?

<comment><AUTHOR> No. I had to stop working for some time, including resigning from all advisory and board roles. I was basically an invalid for a couple of years, and operated in a very diminished capacity for several years beyond that. Fortunately, I had a few successes with startups previously and still had enough equity/income without working to survive. My wife also has a good job. I was very lucky.

</comment></comment><comment><USER41> If the financial aspects become too much, I would highly recommend doing some "medial tourism" to panama, costa rica, thailand or somewhere similar to get the treatment you need at a significantly lower price.

</comment><comment><USER42> > My wife is pregnant with out first child, and everyone is scared/nervous how > I will handle it.

I hate to ask this, but as an infectious disease that could be spread by a tick bite, isn't it potentially communicable?

<comment><AUTHOR> That's actually a really good question, although the answer is controversial.

There is great debate about whether any/all of these diseases are communicable, especially Lyme (because of its prevalence.) Anecdotally, there are many doctors who argue that they _are_ based on their own patients, and there have been a few medical studies that have also shown that they _are_ , but the status quo maintains that they are _not_. Even though syphilis (which is caused by a very similar, but less insidious, spirochete like the one that causes Lyme) is _obviously_ sexually transmitted, the insurers and their cronies say it's impossible. There is a woman in the documentary I mention that battles with that issue (and miscarriages) and you can also find information online. In my case, my wife had no symptoms, we had her tested for some of the scariest bugs, and we took some other precautions.

</comment></comment><comment><USER43> Sounds like a terrible ordeal. Thanks for sharing and good luck with the treatment, getting better and the baby!

I am really curious to find out who "Dr. House without the attitude" is. Mind sharing?

<comment><AUTHOR> Thanks. Sorry, but all of the doctors - both good and bad - must remain nameless. Some specifically requested privacy for obvious reasons (targeting by insurance companies, etc.) The final diagnosing physician isn't nationally prominent, to the best of my knowledge. He was just recommended to me based on a regional reputation (my wife and I have both worked in healthcare. She still does.)

If someone thinks they may have some of these infections, I would be happy to refer them privately to doctors I'm familiar with that treat them...or to organizations that can provide assistance. Otherwise, I don't want to bring any doctors unwanted attention.

</comment></comment><comment><USER44> That's an interesting story. Sorry about all your troubles, but you seem to be handling yourself well and you have a family so it is not all that bad.

It's a shame about the insurance companies.

</comment><comment><USER45> Thanks for the post. Hope you get better soon!

</comment><comment><USER46> Did any doctor ever say it might have been lupus?

<comment><AUTHOR> Yes. Several. (And I, of course, shouted, "It's _not_ lupus. It's _never_ lupus!") Seriously though, lupus and rheumatoid arthritis were some of the early diagnoses. Autoimmune stuff often fits the bill in these complex, mult- symptom cases. That's why it (and a few other diseases) make an appearance on almost every episode of House as a possible diagnosis.

</comment></comment><comment><USER47> Holy crap. All I can say is: I'm sorry. You have my sympathy.

I too have had problems with lazy, blinkered, doctors and "recurring" multi- faceted infections, but my experience is a cakewalk compared to yours.

I wish you the best, and applaud your strength (and your wife's), and thank you for sharing your story.

Oh, and one potential tip... have you checked out the public plan in states like Maryland? AFAIK, Maryland is one of the few states with good public plans. They aren't cheap (the best one costs almost $300/mo for an individual), but from my experience, they cover EVERYTHING. A broke friend of mine got on the plan for 2 mos to get his hernia fixed (he was 25! nobody would cover him, even if he had the money), and they fixed it. No pre-existing condition BS.

The only thing you have to have to qualify is being denied coverage in the past 6 mos. You may qualify, based on what your insurance co. is doing to you. Certainly if you applied for other coverage, they would deny you.

I hope you are able to continue recovering and that you don't have to deal with too much more bureacratic bullshit.

</comment><comment><USER48> Possible to get a compressed/TLDR version?

<comment><USER49> Shooter was probably bitten by a tick that carried a ton of diseases. Most doctors didn't believe that any one person could have so many symptoms, and treated Shooter's individual symptoms instead of trying too hard to figure out what was wrong with him. Finally one doctor figured it out. Shooter is slowly getting better.

<comment><USER50> Thanks. Now who is Shooter?

edit: Before I get downvoted because of emotional responses I want to clarify that I really have no idea who Shooter is and neither do I know about the relevance for this site.

<comment><AUTHOR> I'm nobody, dude. I put my username in the title because I was asked a question in another thread and couldn't think of a good title for my long answer. Sorry for the confusion.

<comment><USER6> Your not a nobody for certain. I'd say you were an Everyman. :)

<http://en.wikipedia.org/wiki/Everyman>

Nobodies dont speak up about their experiences.

</comment></comment></comment></comment></comment><comment><USER51> Congratulations on the baby, If you're afraid of passing out while holding the baby - you can do it in a safe place like sitting in a sofa.

On another issue - research on 811 raw vegan or juice feasting. Nutrition can have a great impact on your body and you can support your immune system by feeding your body nutritious meals instead of burdening it with hard to digest cooked food.

Check out bee pollen and raw honey. From personal experience I can tell you that 10 days of 2 to 3 liters of apple and carrot juice a day really improved my energy levels.

</comment><comment><USER37> I think this note deserves a posterous page - whether you add more stories or not. Just for it's online presence prominence.

imho, you putting your story on the web will help many who are at the initial misdiagnosed stage.

if you don't, I am going to do it (and put your email in the contact). I don't know if I am threatening you or pleading wit you. But please create a posterous - copy the content and email to email@example.com.

Edit: of course - i won't do it. it was just a push for Shooter to do it. I would email him if at all I decide.

<comment><USER52> _This post is both personal and medical in nature..._

Posting this story elsewhere is something only Shooter should do.

<comment><USER30> Also, HN seems to have excellent PageRank.

</comment></comment></comment><comment><USER53> You should definitely try fasting (no food, water only). After a couple of days there should be visible results (You will feel Yourself different).

Another possible advice is to limit carbohydrates (partually replacing them with fats). There is a whole host of possible problems from excess carbohydrates (starting from diabetes, high blood pressure and overweight).

Your health is in Your hands, the doctors can only help if You are fighting disease Youself.

<comment><USER51> I agree, you've been very proactive and persistent in finding the root cause, why not go ahead and experiment. Of course you should read more about the subject before starting human trials but you have an enormous advantage over the establishment, you are allowed to conduct experiments in humans! At least on one human - you. Fasting for a few days and drinking only water is a great way to let the body heal itself and the worst is that nothing will happen.</comment></comment>


TRACEMAIL: Visualize the path of your emails, and know who else might read them - <AUTHOR> https://tracemail.eu/ <comment><USER2> Pity there isn't a Linux version</comment>


Does each founder have to submit a separate YC Application? - <AUTHOR>

I see that some fields require a joint response, while others ask for individual responses. Should the individual answers just be submitted on the same application (separated by a paragraph space, for example)? <comment><USER2> one app per company/idea - use HN user names to identify team member's responses.</comment>


Show HN: Corporate Vitamins - <AUTHOR> https://www.corporatevitamins.com <comment><USER2> Curious as to how you see as the value proposition for the site's users.</comment>


Online privacy is dead... if you let it die. - <AUTHOR> http://blog.securityinnovation.com/blog/2011/10/online-privacy-is-dead-if-you-let-it-die.html

<comment><USER2> In chrome I run Ghostery, Adblock Plus, and Disconnect.

Any other plugins recommended?

<comment><USER3> I wish I had a better answer for you but I actually switched away from Chrome to use this extension. Not only do I not have any helpful plugin recommendations, I'm actually going to poke a few holes in two of your helpful recommendations (sorry). If anyone else has good plugin suggestions I would love to look at them myself.

RequestPolicy is the only plugin I've seen that actually preemptively blocks all third party requests. (I'd love to hear of more.) There is a request to get it ported over to Chromium, but that hasn't been done yet as far as I can tell. The extensions you listed are better than nothing, however none of them will achieve the same result as RequestPolicy.

Ghostery is probably the best of those plugins, but it's still blacklist instead of white-list basted. Working the way it's intended Ghostery can make requests you don't want made, and you will only find out those requests have been made after. It fails open. This is better than nothing, but I don't feel it's optimal.

Disconnect on the other hand, if I understand it correctly, does nothing. Despite honestly good intentions it does not actually protect your privacy at all, it only creates the illusion of protection. As Panopticlick showed cookies are the easy way to track you, not the only way. By removing cookies you remove one method of identification, but you do not actually become anonymous.

Finally, none of these protect against CSRF which is a nice secondary effect of RequestPolicy. Sorry I couldn't help more.</comment></comment>


Bounding the speed of 'spooky action at a distance' - <AUTHOR> http://arxiv.org/abs/1303.0614 <comment><USER2> So what they actually measured is something that appears to go faster than light in the reference frame of measurement. This does _not_ mean they measured the actual speed of the interaction. Instead, the point of this experiment is to lose a loophole in Bell test experiments: simply put, Bell experiments had previously proven that this seemingly-"non local" (bear with me) state exists and preserves dntanglement over long distances. The loophole was that it previously wasn't possible to time the ecperiment well enough to make sure that the whole thing didn't occur in some unexpected, _subluminal_ way. Now we know it couldn't have occurred by some sort of classical interaction between the entangled qubits.

So how fast is the interaction, really? Well, it turns out that if something moves even 0.0001% faster than light, we can always find a reference frame in which it moves a million times faster than light, or infinitely fast, or even in which it appears to move at some huge negative velocity: back in time. See "tachyonic antitelephone". In other words, once something is faster than light, it is, essentially, instantaneous. This is in accordance with standard predictions of quantum mechanics.

Source: I'm a physics grad student.

<comment><USER3> You might enjoy these then:

[http://blog.rongarret.info/2011/09/faster-than-light- probabl...](http://blog.rongarret.info/2011/09/faster-than-light-probably-not- but-you.html)

<http://www.flownet.com/ron/QM.pdf>

<comment><USER2> My favorite interpretation so far:

<http://en.wikipedia.org/wiki/Relational_quantum_mechanics>

It's sort of like many worlds with a whole lot of unnecessary baggage stripped away.

</comment></comment></comment><comment><USER4> Suppose you and a distant friend both agree to wave a flag at 1200 GST.

To an alien observing Earth, it looks as if the "human flag-raising interaction" is an instant effect that "travels" faster than the speed of light, since the flag raising happens at the same time in two places.

But really, nothing is travelling. You and your friend just pre-agreed to do something at the same time at different places.

If energy or information is not transmitted, then what is? I'd argue nothing.

(-A physicist)

<comment><USER5> Almost, but spooky action is quite a bit spookier. Suppose you and your friend both agree to MAYBE wave a flag every day at 1200 GST, then communicate no further about it. The alien would always observe that either both flags are being waved, or both are not.

<comment><USER6> (My physics education is limited to some undergrad level classes, so sorry if my interpretation is erroneous)

Could it be that spooky action has underlying causes that we can't tell yet? For example, reusing the flag metaphor- you and your friend decide to MAYBE wave a flag every day at 1200 GST, and then in practice it happens that every sunny day you both wave it (because hey it's sunny, everybody likes to go outside) and on rainy days no one does (because it's warm and dry inside in your house).

An alien with no knowledge of meteorology and our reaction to it observing this would always observe that either both flags are waved, or both are not, in a seeming random matter, where in fact it is not random at all.

<comment><USER7> I believe that would be labeled a hidden-variable theory, which have apparently been mathematically eliminated from consideration.

<comment><USER4> Only local hidden variables has been eliminated (as opposed to nonlocal), and even local hidden variables can logically exist with some tortured reasoning.

</comment></comment></comment></comment></comment><comment><USER8> Everyone here is getting confused by the fact that you cannot control the polarity/polarization of the qubits before/as you send them.

This means that one __cannot __send information faster than light.

What is useful however is the fact that when you send entangled qubits very far away, and measure them is the fact that the results of the measurements are always correlated/anti-correlated.

As an example.

Alice has a pair of entangled qubits, they are in a superposition of 1 and 0 (lets say they are an correlated pair, such that when measured both quibits will always agree).

She sends one to Bob.

Bob and Alice now hold one qubit each out of the entangled pair. They both measure their qubits. The measurement is probabilistic, you have a 50/50 chance of getting a 1 or a 0, but Bobs quibits and Alices quibit will agree everytime.

Since you can't control the outcome of the experiment you cannot decide which bit to send and hence cannot send information.

The useful result is that Alice and Bob have a string of bits which __only the two of them __know the arrangement of. They can use the string of bits as a one-time pad for encryption.

I have simplified this immensely but I think the point gets across.

Source : I currently undertake research into generating qubits for quantum computation and communication purposes.

<comment><USER9> Can you explain the one-time pad application a bit more? It seems to me that if Alice and Bob can share a bunch of entangled qbits, they could just as easily share a classical one-time pad. What am I missing?

<comment><USER8> Im not explaining it very well and its difficult to condense, perhaps I'll write a blog post that goes into more detail for a layman reader.

<comment><USER9> Let me know if you do; I'm certainly interested.

</comment></comment></comment></comment><comment><USER4> It's like you and a friend have a deck of cards.

You each take a card from the deck, and then travel a million miles away.

Then, at the crack of noon (synchronized to GST, of course), you both look at your cards. Your card is the 3 of Clubs.

You travel back to meet your friend, and discover that his card (which he measured at noon, just like you) was the 7 of Diamonds.

You repeat this experiment a gazillion times and are amazed!! No matter how many times you run it, you and your friend never get the same card!!!

It's as if the cards are sending spooky signals to each other!

And after you double check that you and your friend are both looking only at 1200 GST, you realize that this spooky signal travels faster than the speed of light (since the it takes no time to "travel" a million miles).

It's like magic, eh?

Not really. The fact there is one of each card means it's impossible for you and your friend to have the same card. No magical spooky signals are being sent.

(The real question is whether the quantum mechanical case is analogous to this contrived example. I think it is. The important difference in quantum mechanics it that you really don't know what card you have until you look at it. However, that doesn't mean that your card is sending a faster-than-light spooky signal to tell the other card what to be. And you certainly can't use it for signalling or anything useful.)

<comment><USER10> What you're describing is a hidden-variable theory, which has been ruled out by Bell's Theorem. Sorry.

<comment><USER4> No need to be sorry. :)

The point of my post is to convey the sense that this article headline has when it says that "spooky action" has a speed.

Then, in the last paragraph, I ask whether the example I gave is actually analogous to quantum mechanics. I think it is, particularly if you see things through the many-worlds interpretation.

In the many-worlds interpretation, you and your card exist in a superposition of 52 states, 1 for each possible card. When you look at your card, your wavefunction separates into 52 different experiences and that effect propagates out into the universe at a speed less than the speed of light. Nonetheless, when you compare your results with your friend, you find that you never got the same card, even though you looked at the same time.

Nitpick: Bell's Theorem doesn't rule out hidden variable theories. Only local hidden variable theories.

</comment></comment></comment><comment><USER4> Physics works as we already thought it did. Move along, folks. Nothing to see here. :)

</comment><comment><USER11> This is ignorant speculation, but what if the interaction doesn't depend on distance, and instead always takes the same fixed amount of time? What if that delta t is equal to 1 plank time, one tick in the cosmic 3D simulation? Of course that's an advanced experiment to run, but the implications would be fun.

</comment><comment><USER12> Watch out for arxiv.org, these papers may or may not have passed peer review. A lot of junk is deposited there.

<comment><USER13> This same group research group, including the same first author, published in Nature last year.

<http://arxiv.org/abs/1205.2024>

Since it's common practice to first post to the ArXiv before submitting to a journal (note, for instance, that the first version of their Nature paper was posted to the ArXiv 4 month before being published), I'm confident this paper is or soon will be submitted for peer review. It's always possible they made a mistake or are overstating their findings, but I don't think these guys are a bunch of hacks.

</comment></comment><comment><USER14> I sent this to my friend who has a phd in physics and is a post-doc at Cambridge and he said it's bogus.

<comment><USER15> Then he didn't understand what you were asking. It can easily be faster than the speed of light because no information can be transmitted through this phenomenon.

<comment><USER16> > Then he didn't understand what you were asking. It can easily be faster than > the speed of light because no information can be transmitted through this > phenomenon.

If its observable then how could information not be transmitted?

I'm the furthest thing from a physicist but if quantum entanglement causes an atoms polarity to change because millions of miles away another atom it is entangled with did the same, that would seem like an excellent way to encode information into bits, supposing you can change the atoms polarity at a whim.

<comment><USER17> Because just observing the polarity changes it, so you can never be sure what position it was in originally. So you can affect an object that is light years away from you instantly, but it's useless for transmitting information, because while you know which state it is in, the party on the other end does not,and has no way of finding out without affecting the information and making it useless.

<comment><USER16> > Because just observing the polarity changes it, so you can never be sure > what position it was in originally.

That does put a crimp in my universal router plans, but that's really interesting by itself that just looking at the atom affects its polarity.

<comment><USER17> Well it does not _really_ change the polarity.

Think about it this way:

You have two cards(A and B) - you and your friend pick one randomly. Until you look at yours, it's both A and B at the same time. It's the same with your friend's card. So you both own cards that are in a "mixed" A/B state. And then, when you and your friend look at them, the state is "decided".

Therefore, you could send your friend and his card on a rocket million years away from Earth, and then look at the card. Then,you can tell with 100% guarantee which card your friend has. Is that information useful? No,not really. You were able to instantaneously find out the state of an object millions of light years away,but you can't use it to communicate.

</comment></comment></comment></comment></comment></comment><comment><USER18> This would be helpful for intergalactic domination. Kidding.</comment>


How do you write a privacy policy for an app? - <AUTHOR>

I have an app the runs on the user's desktop but sends identifying information on my server. Is it best to hire a lawyer to write it or are there services that someone can recommend to do this? <comment><USER2> [http://www.iubenda.com/en](http://www.iubenda.com/en)</comment>


Free localization of your product by a pro localization team? - <AUTHOR> Greetings, devs! Our localization team wants to localize (translate) an awesome game into several languages (up to 15 languages!) and do this for FREE / pro bono.
We are an indie team of professional translators, each one of us has at least a couple years of translating professionally. So this is a chance to get a pro quality localization for your game for free. We are a young team and so we need to spread the word bout us - that's why we're doing this.
Note: Certain limitations as to our generosity and capacity do apply - see here: https://goo.gl/jKlKA0
Here's our website: http://indielocalization.com
Chat/email from the website! <comment><AUTHOR> Not only your awesome game but web app or chatbot as well</comment>


America's poorest white town: abandoned by coal, swallowed by drugs - <AUTHOR> http://www.theguardian.com/us-news/2015/nov/12/beattyville-kentucky-and-americas-poorest-towns <comment><USER2> Beattyville is near/in the Red River Gorge area, depending on exactly where you draw the boundaries. I've spent a lot of time nearby on climbing trips, and yes, the area is astonishingly poor. Climbers rarely get that far south of Mountain Parkway, but the whole area is in pretty rough shape.

I think one of the things that's interesting to consider about this is that there is a large stream of people coming into the area, and it isn't just climbers. The area is full of recreation opportunities. What isn't clear is how to ensure that the money works its way out into the communities. In all of the trips I've made, I've spent money in just a handful of businesses: 3 campgrounds, 1 pizza place (which also happens to be a campground), 1 other restaurant, the much loved beer trailer, and the Shell station in Slade.

It's not clear that tourism is a viable replacement for resource extraction in an area where there are established communities. Tourism, and eco-tourism specifically, is something we see pitched as a way to save undeveloped land in the developing world, but based on what I see in the Red River Gorge area, it hasn't brought much prosperity to the region as a whole. Perhaps if there isn't an established economy and population based on resource extraction it can be made to work, but the hard reality seems to be that resource extraction employs a lot more people.

I love getting outside, and the Red River Gorge area is a beautiful place to do it. I want to see the country (and the world) make a shift towards renewable energy. I work to reduce the amount of waste I generate. But when you get right down to it, there are a lot of places where the economy is based on resource extraction, and I have a hard time envisioning what the people living in those places are going to do if the brighter, greener future comes to pass.

Beattyville may be struggling because the cost of coal mining locally can't compete with the cost of coal mining in Wyoming, but making a shift towards greener energy is going to put a lot more communities in a similar situation.

<comment><USER3> Rather than try to bring _coal mining_ back to this community as a form of _social subsidy_ \- why not just institute a basic federal income?

These folks are not alone - they are just the canaries in the mine. They have literally no useful modern job skills. And while they are the first to fall to this trend, as coal miners in 21st century america, millions of jobs are soon to follow, from fast food workers, to call center employees, to a huge number of accountants, lawyers, salespeople, factory workers - jobs of all kinds.

Rather than struggle with trying to give jobs to people who have no skills, and then trap them into working at these jobs in order to sustain themselves, why not just give them a guaranteed basic income that keeps them above poverty? Is that so hard?

<comment><USER4> We're talking about a government that hasn't even been able to get its own annual budget in order for years now, remember. So a guaranteed basic income might indeed be a big lift.

</comment></comment></comment><comment><USER5> Last year, I had a half-day in a place that went through a similar transition:

[https://en.wikipedia.org/wiki/Raton,_New_Mexico](https://en.wikipedia.org/wiki/Raton,_New_Mexico)

Made an impression on me. Wrote a poem about it on the train --

      Raton Station

      It's flat
      Flatness rolls for miles around
      Mountains in the distance
      Flatness approaching the peaks

      Scenic clouds dot the sky
      Looking perhaps painted on
      The place is rather idyllic
      Except for, well, you know

      Every store is having a sale
      Of the stores still open
      If you want to lease a building
      The local Radio Shack is also town landlord

      The people are friendly enough
      7,000 of them are scraping by
      The waitress loves it here
      Despite saving money to move to Omaha

      We hitched a ride in the bed of the pickup
      To the stretch with restaurants and hotels still open
      I asked what had happened here?
      The coal mines shut down

<comment><USER6> Nice poem, but I thought the part about it being flat was strange, since there's a mountain pass into Colorado just north of town, called Raton Pass. Maybe that was symbolism?

<comment><USER7> If you're not familiar with Raton, go check it out on Google Street View. There's mountains in the distance, but not otherwise a whole lot of geography.

<comment><USER8> I did have a look at Raton and surrounding roads on Street View earlier and actually thought it looked rather pleasant.

</comment></comment></comment></comment><comment><USER9> For those interested in learning more about the erosion of the American heartland by the widespread use of prescription narcotics, particularly Oxycontin, I strongly recommend the book "Dreamland," a nonfiction text weaving together the narratives of the opiode boom in American medicine and the spread of Xalisco black tar herion cells throughout American cities that had seldom seen heroin: [http://www.amazon.com/Dreamland-True-Americas-Opiate- Epidemi...](http://www.amazon.com/Dreamland-True-Americas-Opiate- Epidemic/dp/1620402505/)

Very readable and educational. I couldn't put it down, and it tied together a lot of disparate threads that I have noticed over the past two decades but which I was unable to connect myself.

<comment><USER10> The erosion is not just isolated to the heartland. Grew up in a suburban area and the epidemic was just as bad. Highschoolers were getting hooked at a very young age and some elderly people were selling their Oxycontin as well.

This has since changed as the laws/regulations regarding filling Oxycontin perceptions changed. Now Heroin is becoming an epidemic. Some friends in law enforcement have told me there is a big increase in high schoolers and young 20s using Heroin, which causes an increase in them becoming thieves or prostitutes (15 and 16 year olds from somewhat well off families running away from home).

</comment></comment><comment><USER11> Try any mining town in the south west - Trona comes to mind. That was a town ruled by meth, with mining as its main bread winner. [http://topdocumentaryfilms.com/the-city-addicted-to- crystal-...](http://topdocumentaryfilms.com/the-city-addicted-to-crystal- meth/)

</comment><comment><USER12> Australia needs to learn this lesson. Eventually coal will be phased out significantly enough that mass mining don't be economical. In the meantime we ruin our ecology in the pursuit of the almighty dollar.

<comment><USER13> Mining coal in Australia in the 21st century is not lawless. It does not "ruin the ecology." It has CO2 impacts to be sure, but does not ruin the ecology.

On the plus side it provides indispensable, low-cost, electricity for poor people in Asia--people who wouldn't have electricity if not for coal.

<comment><USER14> Coal's only cheap when you don't bother to count all it's negative effects, which will predominately be borne by the poor people you're (slightly bizarrely) claiming to serve.

Coal isn't something worth celebrating, it should be phased out as quickly as possible. Every unit of coal not burned will let us burn twice as much natural gas in terms of CO2, and with far less pollution. And we have more gas than we can burn without blowing our carbon budget anyway.

</comment></comment></comment><comment><USER15> On that note: [http://www.twodollarsaday.com/](http://www.twodollarsaday.com/)

</comment><comment><USER16> I find this kind of "in depth" news series frustrating. The problem here is not lack of coal business; it's lack of ability or motivation for these people to pull up stakes and move to a better area.

I would suggest North Dakota, or would have up until a year or two ago when the price of oil dropped drastically. The jobs up there were paying crazy wages, truck drivers pulling six figures, restaurant dish washers making $15-20/hour etc. It's a temporary boom but the fact is, that's where the jobs are, or were. Still better economy up there than in Kentucky, even now.

Thus, what's really missing from these backward areas is education. With good education, even just K-8, people will have the ability and resources to understand that they can vote with their feet and move to where the economic opportunities are. Someone with mining experience might do OK as a roughneck in west Texas, Oklahoma, or North Dakota. If you're a hard worker and have been in the mines, or driven trucks, or done back breaking work outdoors, you're going to be able to find something.

But as for people who just sit around their cabins, the classic backwoods hillbilly stereotype, addicted to opioids or other chemicals and unable to or unwilling to do something about their situation -- sorry if this sounds hard hearted but it's hard for me to dredge up a lot of sympathy. Someone who's _not_ sitting around feeling sorry for himself and abusing drugs -- that's the one I have sympathy and respect for.

<comment><USER17> The thing is, people _do_. That's part of the problem. Who leaves? The most able, the most motivated. Those left behind? Less able, less motivated. Which makes it worse.

This was my own father. He came from a little west of that belt, the tobacco farms of south central Kentucky. He got up and left as soon as he could. He never even graduated high school. When I was a kid, we'd visit my grandfather's farm. I thought it was heaven - Kentucky is extraordinarily beautiful. But they didn't have electricity or running water. Not really something a five year old notices, but an adult remembers.

Incidentally, the exact same problem has happened to inner city black neighborhoods. In the pre-civil rights era, blacks simply weren't allowed to live in white neighborhoods, so the doctors, lawyers, business owners, and other talented and determined black leaders lived in the same neighborhood as the poor. Once they got the ability to live somewhere nicer, they left, leaving ghettos full of addicts, gangs, the uneducated, the disabled, basically people unable to leave.

It's really difficult for people who have grown up with the privileges of middle/upper class to comprehend what it's like to live in poverty. It's not just that you're poor. It's that you're surrounded by losers, because all the people with talent have already left. When I was a kid, I didn't know _anyone_ wealthy, except those men my father worked for, whom he hated. I didn't know anyone well-educated, except teachers. The most successful adult I knew owned a motorcycle dealership, and not a very big one.

And as soon as I was old enough to live on my own, I left. I went to a great college and met a whole new class of people. But mostly, I was running. I got up and ran, and kept running until the stupid racist redneck bikers were long behind me. Because when you have talent and you live in crap, that's what you do.

<comment><USER18> I don't come quite from your background, but my social circle growing up overlapped with that world a bit. There's a _huge_ gap between the bone-in poverty world and the "rest" of the US; ambition, expectations, mobility, money, interactions with authority, etc.

It's the case that able and motivated people _leave_ , and they _better_ themselves, and the people left behind are, sadly, less able, less motivated, less _something_. This accelerates the cycle. It's not just city/country (although that seems to be a big part of it): out West there is still a lot of money in industrial farming of wheat, potatoes, etc. Those communities are chugging along. It's the communities which have no industry that fail.</comment></comment></comment>


Itavia Flight 870 - <AUTHOR> https://en.wikipedia.org/wiki/Itavia_Flight_870 <comment><AUTHOR> Context: it's 40 years since the "Ustica massacre", as it's known in Italy.

TL;DR: there is controversy around what caused the disaster, but the most commonly accepted is that a war between NATO and Lybian forces ultimately led to a missile to hit this civilian aircraft.</comment>


Ask HN: Co-working space in Delhi, India - <AUTHOR>

Does anyone here know of any good co-working space in Delhi, India.<p>Or, would anyone be interested in sharing office space? <comment><AUTHOR> Delhi or even Noida/Gurgaon...

</comment><comment><USER2> You would do well by asking Jon over at Slideshare.com. Their dev offices are in Delhi.</comment>


Group Opposing Sex Work Gave Money to Prosecutors: Got Stings Against Johns - <AUTHOR> https://theintercept.com/2018/03/24/demand-abolition-sex-work-nonprofit-prosecutors-king-county/ <comment><USER2> This is extremely troubling. Imagine if groups could give money to police and prosecutors in exchange for vigorous enforcement of marijuana laws or gun laws. Then imagine a scenario where police and prosecutors will not enforce laws unless a group gives them money.

<comment><USER3> It gets even worse: the prosecutors agreed to a quota of a particular number of prosecutions, which presumably translates into an arrest quota for the police:

> _" King County prosecutors again agreed to meet particular prosecutorial > goals in exchange for funding. They signed a written agreement promising to > achieve a total of 14,800 "direct buyer disruptions"..."_

When police start arresting people to make their quotas, they can end up arresting innocent people.

Also, the prosecutor's behavior goes beyond accepting money to enforce laws:

> _" A legal scholar interviewed by The Intercept said he thinks that by > calling consensual prostitution "trafficking," the prosecutors' behavior > doesn't only appear to violate those rules of professional conduct, > subsequently hurting the right of the accused to a fair trial."_

The group that's financing this, which was founded by a Texas oil heiress, is operating in several cities across the U.S.:

> _" Demand Abolition has also provided millions of dollars in funding to law > enforcement agencies and other organizations in local jurisdictions around > the country, including Boston, Chicago (a part of Cook County, whose > Sheriff's office received $92,145 in funding from Demand Abolition between > 2014 and 2016), Denver, Oakland (a part of Alameda County), Houston, and > Dallas, according to tax documents."_

I find it kind of disturbing that one person with millions of dollars to throw around can influence the running of local law enforcement all over the country. There is significant potential for abuse in a system that allows this.

</comment></comment><comment><USER4> There seems to be a group wanting to decriminalized sex work ie sex for money? How far do you want to take that.

Should a man be able to place a wanted ad for a sex worker?

Should a business be able to employ sex workers to provide services for employees, just like how some companies will employ cooks, personal trainers, etc now.

Should sex work be part of an employment contract? Should expected duties include having sex with the boss along with more traditional duties?

I think that decriminalizing and de-stigmatizing sex for money will have far greater follow-on social effects than people think.

<comment><USER5> Prostitution has been legal in Nevada for a long time and none of these things have happened. Just because something is legalized, it doesn't mean it's appropriate for a professional context.</comment></comment>


Google blocks Extensions/UserScripts from origins other than Chrome WebStore - <AUTHOR> http://support.google.com/chrome_webstore/bin/answer.py?hl=en&answer=2664769

<comment><USER2> Someone had suggested me to use TamperMonkey [1] for installing scripts on Chrome. It worked for me.

[https://chrome.google.com/webstore/detail/dhdgffkkebhmkfjoje...](https://chrome.google.com/webstore/detail/dhdgffkkebhmkfjojejmpbldmpobfkfo)

</comment><comment><USER3> To install an off-store script download it an drag it onto Chrome.</comment>


Non-pharmaceutical Interventions Impact on the Outbreak of Covid-19 in Wuhan [pdf] - <AUTHOR> https://www.medrxiv.org/content/10.1101/2020.03.03.20030593v1.full.pdf <comment><AUTHOR> Look at the Figure 4. It shows that they could decrease reproduction number to under 1 only after implementing "centralized quarantine and treatment of all confirmed and suspected cases, those with fever or respiratory symptoms, as well as close contacts of confirmed cases in designated hospitals or facilities."</comment>


Show HN: All entry level jobs and internships at one place - <AUTHOR> http://www.entryleveljobs.me <comment><AUTHOR> Four years ago, I came to the United States as an international student. As a student, one of the biggest problems was to find an internship and entry level job in the field of study.

Most of the students start with the companies they know in their field. They start to find internships and jobs on well-known sites like LinkedIn, Indeed, AngelList etc. Going through each of these sites and filtering out relevant positions take lots of time.

But, there are lots of small and medium-size companies and startups they have never heard of before. Also, not all the companies post the opening on these job board. Most of the openings are in the career section of each company. To find these openings, students have to go on the website of each company, look for the career section, filter openings relevant to you and apply for the position.

This whole cycle takes a lot of time every day. This is the extra burden for students along with whole semester work. For international students, it is even harder. International students have to find jobs within 3 months of graduation and many companies do not hire international students because of visa sponsorships issue.

With this site, I have put all the jobs and internships opening for college grads in the United States at one place. So you don't need to waste your time looking for openings in your field.

You can find jobs and internships in the field of Software engineering, Data science, Business, MBA, Electrical engineering, Mechanical Engineering, Analyst, Hardware Engineering, Marketing, Customer Support, Product Management, UI Design, Research, Legal, Nursing, Medical and more.

300+ companies are hiring for more than 1000+ internship and entry level positions. so start to Apply!

</comment><comment><USER2> I tried the site on Firefox focus and the interface is poor [https://i.ibb.co/fnrk3vZ/Screenshot-20190114-083539.png](https://i.ibb.co/fnrk3vZ/Screenshot-20190114-083539.png)

<comment><AUTHOR> Thanks for informing. Will fix it.

</comment></comment><comment><USER3> I searched my city and the entry level job suggested 5+ years of experience.

<comment><AUTHOR> Which city name and job position have you look for? can you share more details so I can check out.

<comment><USER3> I'd like to keep it private but I will say the job title contained "junior".</comment></comment></comment>


Are 'Flatliners' Really Conscious After Death? - <AUTHOR> https://www.livescience.com/60593-flatliners-movie-death-resuscitation.html <comment><USER2> Url changed from [http://nypost.com/2017/10/19/after-you-die-your-brain- knows-...](http://nypost.com/2017/10/19/after-you-die-your-brain-knows-youre- dead-terrifying-study-reveals/), which points to this.</comment>