I get hate mail
You might think that I’ve made an effort to keep my email (or other ways of getting a hold of me beyond commenting on this blog or tweeting at me) a secret. I haven’t. If you look hard enough and know my full name, then you should have no problem figuring it out. Other times, I email people to ask them to clarify their comments… Or, probably my biggest mistake, I email people to confront them.
As a result, from time to time, I get hate mail.
If you were around in 2011, you might remember that guy who emailed everyone at the health department to tell them how much of a meanie I was for calling him a douchebag. He even threatened to sue me. It all boiled over, but that event and others have not scared me away from being open about who I am and what I do.
The best hate mail is when someone decides that I messed up somewhere in something I said or wrote, and they point it out via email. I can almost hear them laughing maniacally as they tell me that I’m wrong, that they’re right, or that I need to hand over my financials because, surely, Monsanto is paying me to write all this.
Lately, there have been three or four people who just keep finding small things here and there that contradict or re-imagine what I’ve written about Zika (a novel, emerging disease)… So I must have lied or misled when I wrote what we knew about Zika back then. If anything has changed, it’s because I was wrong then, not because we’re finding out new things.
And don’t get me started with the anti-vaccine loons.
What really makes me wonder about these people’s lives is the amount of time they devote to do “research” into whether I’m right or wrong (not on the subject itself, mind you), and how much time they devote to emailing me. They’re not short emails with data. They’re long emails with accusations, demands, insults, and then maybe one or two sources of data.
The best emails are the ones where the author threatens to “expose” me for the “fraud” that I’m supposed to be. They threaten that they will show how my lack of caring about their “concerns” shows that my career in public health will be harmful to someone, or that I will not be “receptive” of public concerns about my work. I don’t respond anymore.
See, there used to be a time when all of this bothered me. I used to care about what random strangers had to say about me through electronic media. Lately, not so much. I don’t know if it’s because I’m older — and probably more mature — or if it’s because I have bigger fish to fry.
I think I’ve stopped caring because I’ve come to understand and consider the source. Anti-vaccine loons are never going to accept that vaccines are not the ultimate evil that they think it to be. Conspiracy theorists are not going to accept that sh*t happens sometimes, and that the correlations they see around them are in no way meaningful or, at the very least, indicative of causation.
On the other hand, if I get an email from a personal friend, one of my many mentors, my advisor, a professor at the school, etc… Then I’ll pay attention to their arguments, weigh them, and offer a thoughtful response. And I’ll do this partly because they know me personally and I know them, and partly because they don’t make it their day’s (or life’s) aim to find a kink in my armor.
So do yourself a favor, if you’re one of these “trolls” who keeps emailing and doesn’t get a response from me: Get a clue. Move on. Walk away.
EpidemioLogical 
Jugheads will be jugheads.
It is a truism that if one argues with a fool, the fool will drag one down to their level and defeat one through the fool’s superior experience in being a fool.
On methimazole for the hyperthyroid, been a week and still seeing no effect. I’m keep an eye on it, as the beta blockers can sneak up me, once the thyroid hormones start reaching normal. That’s especially true, as I’m on 300 mg metoprolol.
I also have a 2.2 cm aortic dilation, repeat ultrasound in six months to see if that’s going anywhere near sideways.
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I figure it will take it some time to go back to baseline since it’s been out of whack for a while. 2.2 cm, eh? I’ve seen bigger… But not many. I wonder if it will stabilize once everything else settles down?
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It better stabilize! If that thing enlarges enough to go boom, survival ranges from 5 – 11%.
I’ve not yet looked to see the incidence rate of ascending also dilating, when the abdominal has dilation.
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Someone in the family has been living with one slightly larger than yours for years. He lives a pretty active life. If it goes, it goes. No sense worrying about it, within reason.
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My only real concern is, is there a possible, or worse, potential dilation not observed via an abdominal ultrasound and hence, a more significant risk.
As I’m emotionally involved, I’m not reviewing the risk of a dual dilation.
For the abdominal one, yeah, it can become static and should.
I’m bright enough to realize potential bias in research and bias due to fear. I’m also sane enough to question and have others seek the answer.
As I’m also quite new to the practice, I’m not well experienced with the experience and judgement of the physician.
So, not wanting to introduce bias, I’m at a quandary.
How common are abdominal dilations or worse also accompanied with superior aortic dilation or aneurysm?
That all said, atrial flutter outside of tachycardia are concerning. Annoying.
Hopefully, that’ll resolve after probable remodeling resolves.
I’m also scratching my head over a lack of anti-TSH receptor antibodies, but a plethora of anti-TPO antibodies.
Would that my endocrinologist and I could sit down for a long, conversational dinner. I’m sure I’d learn a book full of new things to learn.
Just for general knowledge. Not my field by far, but still quite interesting.
Yesterday, I realized just how debilitated I was. We’re new and lack a lawnmower and grass is getting high.
Borrowed a lawnmower, got two 25 – 30 foot passes through, legs collapsed.
I’m pissed off over that enough to beat the Incredible Hulk down, were he real.
But, annoyingly incapable of even mounting an effort.
Paid a bright young girl to mow it for me. Leaving us with an unbudgeted loss, likely in bread.
Anyone got a breadfruit tree seed?
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Well… This was a lot to digest. Hope you feel better.
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Yeah, rage is hard to digest. That gives me hope for our species, considering our recorded history.
On antithyroid medication, hoping it’ll work and encouraging is, this morning, I read my pulse ox at 98% and PO2 85 pulse.
As the metoprolol gave me 100 pulse and lower PO2 (around 94 – 96, which is low side abnormal, despite my smoking history).
Doctor is working with me to titrate dosage, with me initiating, after explaining rationale. Increased the metoprolol last week, to relatively decent effect (closer to normal average by heart rate, as BP is a confounder in multiple ways). Informed doctor to last week’s and this week’s dosage, 150 mg metoprolol bid.
I’m anticipating lowering the dosage, as my pulse was 85 through the day.
Now, for the fun part. I’ve assisted the treatment of a female service member, to no effect. The autopsy revealed one of the “Marcus Welby” diagnoses, adrenal tumors that released adrenaline. Talk about rare and worse, she just came under treatment until sent to training. The records failed to reveal information stating that she informed command and at her death, the records were seized.
There is information to suggest that she wasn’t very knowledgeable about things medical, as her unit and her duties were far from things medical. Zero suggestion of reporting a medical problem.
More involved information is something that I do know, but various laws must put that outside of discussing.
Her cause of death, dissected aortic aneurysm.
Even today, I roar at the stars that she didn’t report it and that her command didn’t recognize a service member in physiological distress!
But, self-analyzing, she was the same age as our eldest child.
I have precisely zero desire to join her ranks, or any other terminal ranks
BTW, today, pulse has been not toying around tachycardia or hypertension. Altered the dose of metoprolol to 150 mg bid.
SPO2 96 – 98, pulse 85 – 87.
Initially, I was doubting the anti-thyroid drug, now, I’m watchful waiting.
I really don’t want to fall down unconscious in the office.
BTW, this entire conversation could’ve been trivially handled by e-mail. Due to a multitude of changes, I’ve successfully lost your e-mail address.
Now, for a fun thought.
My endocrinologist related to me, that which I already bumped into in a Google Scholar search.
Many mental patients had hyperthyroidism, which resolved upon successful thyroid treatment.
As she worked in a mental institutional environment, at a major hospital environment, I ponder how man convicts were convicted against the ADA, ignoring their short term disability.
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“So do yourself a favor, if you’re one of these “trolls” who keeps emailing and doesn’t get a response from me: Get a clue. Move on. Walk away.”
…. because Ren has set up his email to send those emails into the the “spam”, “delete” or “trash” folder.
I used to get those nasty grams when I participated in an email based listserv for my son’s speech disorder. After several because I wrote an email that chelation was a “Bad Idea”, I just quit that listserv.
I used to also get them the Healthfraud listserv, so I set it up so the offenders were automatically deleted (one was Tim Bolen). Then we switched from a phone modem to a cable modem sixteen years ago, so I got a new email address. I still lurk on Healthfraud, but I never reply.
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I like your MO.
I’ve done similar in recent life. I ignored the BS on USENET.
Today, it’s whack a mole. Times seven billion.
One has to add new adults that never experienced the insane environment.
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