On the other hand, if there are 100 places in the shoulder where you can have an abnormality, and most people have just one or a couple but the other 98-99 are normal, then each one individually really is abnormal.
So it's complicated, and then it becomes important to figure out which abnormalities are medically relevant, in which combinations, etc.
From the article:
The language in particular should change given that “abnormalities” are ubiquitous—thus normal—and shouldn’t be described in terms that indicate a need for repair, like “tear.”
Doctors use to think that the degree of it that I have meant I'd have problems with it. After all, people who came in with the symptoms and then had an MRI or CT scan tended to show that level of herniation. Thus, it was assumed, that level of herniation was considered a diagnostic indicator. And then MRIs became cheaper and more accessible, and patients had them for all sorts of other reasons — like I did. Doctors discovered that the degree of "malformation" I have is very common among asymptomatic adults. In fact, you're many times more likely to be perfect fine with it than to experience symptoms.
Well, huh. That doesn't sound like much of a malformation anymore. Or at least, by itself it doesn't mean anything, other than that perhaps you're more likely to have problems than otherwise. On its own? It's more of a normal variation.
I find this an interesting take on the story
Tool companies manufacture claw hammers despite some people wanting a nail gun. You don’t try to make a thing flexible enough to be both a nail gun and a hammer.
I’m a power user and I do all of my customization on my Linux desktop/laptop. I use an iPhone specifically because it’s locked down and don’t want a keyboard that has gone through no code review stealing all of my banking credentials.
Even then when I was a kid I knew a guy who wanted to join the air force and he had a growth spurt that made him too tall.
But seriously, the article addressed that
> The authors argue that the findings suggest clinicians should rethink MRI findings, changing not just how they’re used, but also how they’re explained to patients. The language in particular should change given that “abnormalities” are ubiquitous—thus normal—and shouldn’t be described in terms that indicate a need for repair, like “tear.”
But if 99% of adults today have an abnormality that 99% of adults historically didn't, it's abnormal.
Presumably, some of this is just it's pretty damn inevitable you're going to accumulate at least some level of detectable injury that doesn't completely heal over the course of 40 years. I needed shoulder reconstruction because I fell off a skateboard trying to bomb a hill a year and a half ago and it's healed to the point there isn't any functional impairment, but given there's metal in there now, it's obviously going to look abnormal on an image. There's just an impedance mismatch here between what imaging finds and what people actually care about. Any detectable deviation from expected tissue configuration is going to show up and get reported, but there is no reason for a patient to give a shit. Functional impairment and/or pain is what they care about, though those are both also universal if you live long enough. No 90 year-old walks without a limp but it's still completely fair to call a limp an "abnormal" gait.
https://theonion.com/report-aspirin-taken-daily-with-bottle-...
Source?
Doctors mostly tell you not to drink because it’ll fuck with the anesthesia math and bad anesthesia doses can kill you just as dead as a surgical mistake and probably moreso. But it’ll also make you bleed more.
If you need courage to show up to surgery they’ll give you a prescription for a single dose of a benzo. Which is better than liquid courage anyway.