The apparent sympathy is due in part to the fact that the legal limits are very low. A man who splits a bottle of wine with his wife at dinner may very well have a BAC above 0.08%, but very few people would consider the guy drunk at the time. In addition, there is no legal distinction made between someone with a BAC of 0.10% (who would have been a legal driver at the dawn of the DUI age thirty years ago, when the first limits were set around 0.15%) and someone with a BAC of 0.30% (who is a menace to society).
The problem is generally not the average guy; it's a relatively small pool of chronic drunks who drive.
The rental companies will just get tags for each of their cars and put it on your account when you return the car. That's what I was told the last time I was in Houston.
It wouldn't affect the cost of an employee, specifically, but American corporate tax rates are quite a bit higher than in much of the rest of the world.
You're confusing the everyday understanding of "that's private, only me and my friends know" with the legal term of art entitled "reasonable expectation of privacy". The two are quite different.
Actually, it's just two: your spouse and your lawyer. Your conversations with your doctor and your priest may be private, or may not, depending on how a judge rules. Be careful out there.
I think he meant to say "something in which you have a reasonable expectation of privacy" is something that you've told to nobody else. In which case, he'd basically be right. As a broad rule (and IANAL, so it's going to be a broad rule), as soon as you tell someone - anyone - some piece of information, you can no longer have a reasonable expectation of privacy in it. Exceptions may exist between you and your lawyer, but don't count on them applying between you and your doctor or priest.
Terry Pratchett. He writes humor. Humor infused with a lot of fantasy elements, much in the same way that Douglas Adams wrote humor with some sci-fi elements. His statements may not be literally true in all cases. Work with me here.
Unless you're really loaded, forget it. Your insurance company won't pay for your experimental surgery, nor for the 3D high-speed CT and ultrasound you'll need to identify the precise dimensions of your aorta, nor for the prototyping. You might try to gin up some interest at Texas Heart. And it still won't get you away from frequent monitoring. I've seen too many people die of these when they rupture. (In fact, we just had a guy die this week of a ruptured aneurysm right in that spot.)
Having said that, however, a pressure of 140/90 when your baseline is 120/70 sounds more like a new onset of high blood pressure that has caused the dilation. If your primary issue was aortic insufficiency (a leaky valve between ventricle and aorta), your pressure should have been more like 150/50 - the diastolic falls because blood is leaking back into the heart, and the body increases the systolic pressure in order to maintain the same mean arterial pressure.
"Seeding"; the concern is that an infection will land on the valve, set up shop, and spit off little blobs of bacteria throughout his system - the seeds. Bone infections are quite serious, and very difficult to eradicate, but because the entire blood volume of a human being doesn't pass through every bone, people generally don't get an infection there if it doesn't set in immediately post-op. Joint replacements are done in rooms that have laminar flow systems to make sure that the only air hitting the surgical field has been filtered - i.e., there's no way for lint to float in.
The aorta is more like a balloon, less like a pipe. The graft is not very large, maybe 5-6 cm in length. In effect, you have moved the beginning of the aorta downstream a few cm. The aorta is supposed to expand with each beat and absorb the blood squeezed out by the heart, then shrink back down to size during diastole. This graft means that the first part of the aorta can't do that, and so the next part will have to. Soon, it too may need a jacket...
I'm not sure what you mean by this, but OK. Dead wrong about what? You don't think your kids are anything like who they were when they were 5? I'm curious to know.
Living tissue (like a vein) is the most infection-resistant substrate. Infection is a major worry when using artificial graft material, because there isn't and won't be any blood supply to the graft. Synthetic grafts would be grossly inferior to venous grafts, which themselves are poor substitutes for arterial grafts (but there are remarkably few redundant arteries, so the question is generally moot).
That's not a graphic photo. Try looking up Fournier's gangrene. THAT is graphic. (No link, it's up to you. Googling the images is NSFW, but mainly because it's disgusting.)
There's no need - and hasn't been for a long time, at least 15-20 years - to put in a mechanical valve just for aortic valve disease. There are cadaveric (organ-donor) valves and porcine (pig-heart) valves available. They don't last as long as the mechanical ones, but they don't need anticoagulation. Given that he had Marfan syndrome, however, it's quite likely that the problem was a valve-and-aortic-root problem, just like the Bentall procedure I did the anesthesia for today, which does better with a mechanical valve. His solution is impressive: no quibbles on that here. Imaging a heart to get dimensions is hideously difficult. Getting a 3D model of the aorta is some fine engineering in itself.
However, he has mostly transferred the problem downstream - the root of the aorta is the most elastic part of a very elastic vessel, and transmitting the higher pressure downstream (which his aorta-corset will do) will lead to increased ballooning of the segment closest to the heart. The hard part is to make sure that that segment can handle it for the remainder of his expected lifespan.
I suspect that parenting has little to do with it. People are who they are, and very little that parents do will fundamentally change it. Yes, you can be a really bad parent. Yes, you can be a really great one. But the vast majority of us will be neither, and won't really change who our children are. Talk to people who have children in their 30s - and they'll tell you all about how Susie was "always like that".
It's New Zealand. They already have that. Try again. Here's a better answer for you:
Some people are just bad protoplasm. Ask a doctor or nurse (or anyone else who sees everyone in society, from top to bottom - but I can't think of another field that does) about it. If your genes are bad, nothing about you will work right: you'll be dumb, you'll be ugly, you'll be unhealthy. By contrast, good looks, good health, and good intelligence tend to go together, because people who have good genetics will express all the right genes at the right time during development and end up symmetrical and well-wired (barring some freak accident).
Slashdot Mirror
The apparent sympathy is due in part to the fact that the legal limits are very low. A man who splits a bottle of wine with his wife at dinner may very well have a BAC above 0.08%, but very few people would consider the guy drunk at the time. In addition, there is no legal distinction made between someone with a BAC of 0.10% (who would have been a legal driver at the dawn of the DUI age thirty years ago, when the first limits were set around 0.15%) and someone with a BAC of 0.30% (who is a menace to society).
The problem is generally not the average guy; it's a relatively small pool of chronic drunks who drive.
The rental companies will just get tags for each of their cars and put it on your account when you return the car. That's what I was told the last time I was in Houston.
It wouldn't affect the cost of an employee, specifically, but American corporate tax rates are quite a bit higher than in much of the rest of the world.
They've got your credit card number and your signed authorization for them to charge you for it.
This, FTW.
You're confusing the everyday understanding of "that's private, only me and my friends know" with the legal term of art entitled "reasonable expectation of privacy". The two are quite different.
Actually, it's just two: your spouse and your lawyer. Your conversations with your doctor and your priest may be private, or may not, depending on how a judge rules. Be careful out there.
some other legitimate basis laid down by law
That's a legal loophole big enough to drive an articulated lorry through.
I think he meant to say "something in which you have a reasonable expectation of privacy" is something that you've told to nobody else. In which case, he'd basically be right. As a broad rule (and IANAL, so it's going to be a broad rule), as soon as you tell someone - anyone - some piece of information, you can no longer have a reasonable expectation of privacy in it. Exceptions may exist between you and your lawyer, but don't count on them applying between you and your doctor or priest.
Terry Pratchett. He writes humor. Humor infused with a lot of fantasy elements, much in the same way that Douglas Adams wrote humor with some sci-fi elements. His statements may not be literally true in all cases. Work with me here.
Unless you're really loaded, forget it. Your insurance company won't pay for your experimental surgery, nor for the 3D high-speed CT and ultrasound you'll need to identify the precise dimensions of your aorta, nor for the prototyping. You might try to gin up some interest at Texas Heart. And it still won't get you away from frequent monitoring. I've seen too many people die of these when they rupture. (In fact, we just had a guy die this week of a ruptured aneurysm right in that spot.)
Having said that, however, a pressure of 140/90 when your baseline is 120/70 sounds more like a new onset of high blood pressure that has caused the dilation. If your primary issue was aortic insufficiency (a leaky valve between ventricle and aorta), your pressure should have been more like 150/50 - the diastolic falls because blood is leaking back into the heart, and the body increases the systolic pressure in order to maintain the same mean arterial pressure.
"Seeding"; the concern is that an infection will land on the valve, set up shop, and spit off little blobs of bacteria throughout his system - the seeds. Bone infections are quite serious, and very difficult to eradicate, but because the entire blood volume of a human being doesn't pass through every bone, people generally don't get an infection there if it doesn't set in immediately post-op. Joint replacements are done in rooms that have laminar flow systems to make sure that the only air hitting the surgical field has been filtered - i.e., there's no way for lint to float in.
I am not a gas passer. I am a drug pusher. Get it right.
A Marfan aorta can't handle normal pressures; that's why he got in trouble.
The aorta is more like a balloon, less like a pipe. The graft is not very large, maybe 5-6 cm in length. In effect, you have moved the beginning of the aorta downstream a few cm. The aorta is supposed to expand with each beat and absorb the blood squeezed out by the heart, then shrink back down to size during diastole. This graft means that the first part of the aorta can't do that, and so the next part will have to. Soon, it too may need a jacket...
Yes. Even worse, really, since it's outside the bloodstream (and therefore will have minimal exposure to immune cells).
I'm not sure what you mean by this, but OK. Dead wrong about what? You don't think your kids are anything like who they were when they were 5? I'm curious to know.
Living tissue (like a vein) is the most infection-resistant substrate. Infection is a major worry when using artificial graft material, because there isn't and won't be any blood supply to the graft. Synthetic grafts would be grossly inferior to venous grafts, which themselves are poor substitutes for arterial grafts (but there are remarkably few redundant arteries, so the question is generally moot).
But they do need immunosuppressants
Organs, yes. Cadaveric valves, no. Porcine, yes. That's why the cadaveric valves have become more popular. Sorry, I should have made that more clear.
Reminds me of the greatest Pratchett quote ever:
"Give a man a fire and he's warm for the day, but set fire to him and he's warm for the rest of his life."
Don't stop with the first page. You need the pre-op AND the post-op.
That's not a graphic photo. Try looking up Fournier's gangrene. THAT is graphic. (No link, it's up to you. Googling the images is NSFW, but mainly because it's disgusting.)
There's no need - and hasn't been for a long time, at least 15-20 years - to put in a mechanical valve just for aortic valve disease. There are cadaveric (organ-donor) valves and porcine (pig-heart) valves available. They don't last as long as the mechanical ones, but they don't need anticoagulation. Given that he had Marfan syndrome, however, it's quite likely that the problem was a valve-and-aortic-root problem, just like the Bentall procedure I did the anesthesia for today, which does better with a mechanical valve. His solution is impressive: no quibbles on that here. Imaging a heart to get dimensions is hideously difficult. Getting a 3D model of the aorta is some fine engineering in itself.
However, he has mostly transferred the problem downstream - the root of the aorta is the most elastic part of a very elastic vessel, and transmitting the higher pressure downstream (which his aorta-corset will do) will lead to increased ballooning of the segment closest to the heart. The hard part is to make sure that that segment can handle it for the remainder of his expected lifespan.
how we are raised before we are 3
I suspect that parenting has little to do with it. People are who they are, and very little that parents do will fundamentally change it. Yes, you can be a really bad parent. Yes, you can be a really great one. But the vast majority of us will be neither, and won't really change who our children are. Talk to people who have children in their 30s - and they'll tell you all about how Susie was "always like that".
socialized medicine is not optional
It's New Zealand. They already have that. Try again. Here's a better answer for you:
Some people are just bad protoplasm. Ask a doctor or nurse (or anyone else who sees everyone in society, from top to bottom - but I can't think of another field that does) about it. If your genes are bad, nothing about you will work right: you'll be dumb, you'll be ugly, you'll be unhealthy. By contrast, good looks, good health, and good intelligence tend to go together, because people who have good genetics will express all the right genes at the right time during development and end up symmetrical and well-wired (barring some freak accident).