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STL comments on Living Forever is Hard, or, The Gompertz Curve - Less Wrong

46 Post author: gwern 17 May 2011 09:08PM

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Comment author: [deleted] 19 May 2011 06:16:02AM 2 points [-]
  1. Have you tried aspirin specifically for headaches?

  2. I'm not a doctor, so I can't diagnose anything, especially over the Internet (unless the patient is a C++ program), but it's possible for headaches to have a root cause that should be addressed, instead of the symptoms. In my case, getting a plastic nightguard from my dentist to prevent unconscious teeth grinding at night, also alleviated jaw clenching at night - so much so that when I make the effort to brush my teeth and wear my nightguard (which is unfortunately not all the time) I almost never wake up with a headache anymore.

  3. I can't think of a way to say this without sounding snarky (and I really liked Luminosity/Radiance, so I especially don't want to be rude), but I'm going to say it anyways:

Which do you dislike more: headaches, or cancer? Choose carefully.

Back to being non-snarky: I assume/hope that debilitating, world-shattering migranes aren't the issue - faced with them, "screw cancer reduction, I need to be able to function day-to-day" would be an entirely rational response. Interestingly, I just noticed this (and a typo) at Wikipedia: "There is some evidence that low-dose asprin has benefit for reducing the occurrence of migraines in susceptible individuals.[67][68][69][70]"

Comment author: Alicorn 19 May 2011 06:44:28AM *  4 points [-]

I do not have debilitating, world-shattering migraines. I just get headaches. More days than not. I have one right now. My mom once had a headache for an entire year. (This remains a medical mystery.) I have on occasion had headaches that lasted so long that I expected to imitate her, although so far I don't think I've actually broken a full week (with breaks provided by ibuprofen).

I actually don't usually medicate them. I do that when they are so bad that they wake me up in the middle of the night, or when they occur early in the day; otherwise I let sleep take care of them.

The one time I tried aspirin for pain relief, I don't remember what it was for, although a headache was likely. I do remember that it gave me a stomachache which was worse than whatever it was supposed to get rid of for me. I wouldn't expect a tiny dose to have this effect, especially if I took it with food or something, but if I were forced to rely on it as my only analgesic, I would be in something of a quandary.

The question is not, "Which do you dislike more: headaches, or cancer?" It's, "Which do you prefer: effective pain relief for your extended, commonplace pain, or a risk-reducing drug which has not actually been extensively tested in your gender or age group?"

Comment author: [deleted] 19 May 2011 06:57:14AM 2 points [-]

Fair enough - if I were in your shoes I would probably make the same decision as you.

Comment author: Alicorn 19 May 2011 07:13:21AM 0 points [-]

All that said: is taking aspirin regularly and an ibuprofen once a week inferior to not taking aspirin regularly and an ibuprofen once a week?

Comment author: [deleted] 19 May 2011 12:09:30PM 0 points [-]

I don't know. Wikipedia says:

According to the U.S. Food and Drug Administration, "Ibuprofen can interfere with the antiplatelet effect of low-dose aspirin (81 mg per day), potentially rendering aspirin less effective when used for cardioprotection and stroke prevention." Allowing sufficient time between doses of ibuprofen and immediate release aspirin can avoid this problem. The recommended elapsed time between a 400 mg dose of ibuprofen and a dose of aspirin depends on which is taken first. It would be 30 minutes or more for ibuprofen taken after immediate release aspirin, and 8 hours or more for ibuprofen taken before immediate release aspirin. However, this timing cannot be recommended for enteric-coated aspirin. But, if ibuprofen is taken only occasionally without the recommended timing, the reduction of the cardioprotection and stroke prevention of a daily aspirin regimen is minimal.[19]

Which of course doesn't mention the cancer effects, but there you go.

My intuition suggests that regular low-dose aspirin and weekly ibuprofen still has benefits that outweigh the risks, as compared to weekly ibuprofen only. However, my intuition didn't expect the effect, mentioned in the study's full text, where alternate-day low-dose aspirin appeared to have no effect on cancer.

Comment author: jimrandomh 19 May 2011 01:28:42PM 1 point [-]

I do not have debilitating, world-shattering migraines. I just get headaches. More days than not. I have one right now. My mom once had a headache for an entire year. (This remains a medical mystery.) I have on occasion had headaches that lasted so long that I expected to imitate her, although so far I don't think I've actually broken a full week (with breaks provided by ibuprofen).

Based solely on this description, this sounds like a pretty big deal. It also sounds like the sort of thing that might have a subtle but simple cause, which might be discovered by taking sufficiently detailed notes. I haven't tried it myself, but I recall seeing references to software for this purpose, which might suggest specific things to investigate as possible causes. Are your headaches by any chance related (positively or negatively) to eating choline? Would you be able to detect if there were other relations of that type?

Comment author: Alicorn 19 May 2011 06:38:21PM 0 points [-]

I tracked my headaches for about a month and a half once and then stopped, but I didn't correlate it with food (particularly not choline, which I don't even know what foods it comes in). I haven't noticed any decisive correlations between various foods and the headaches. I got one yesterday evening (a rare overnighter, which I'm waiting for the ibuprofen to chase away now) and that day I had leftover vegetable strata and juice and toast with hummus and some ice cream, none of which are or contain unusual foods for me.

Comment author: jimrandomh 19 May 2011 06:58:24PM 1 point [-]

There's lots of choline is in meat and eggs, and there're smaller qantities of it in various other things. I've heard of headaches from both too much choline (when taking choline supplements) and too little (especially when taking piracetam, which depletes choline. I take both piracetam and choline citrate). Being a vegetarian is listed as a risk factor for deficiency on the wikipedia page.

Comment author: Alicorn 19 May 2011 07:03:10PM 2 points [-]

I've been eating a lot of eggs lately. Should I try eating eggs every day for a week and then no eggs for a week and see what happens?

Comment author: jimrandomh 19 May 2011 07:12:56PM 3 points [-]

That sounds like a worthwhile experiment. I would also suggest keeping a headache log and a food log (there are cell phone apps to make it easy; you photograph things instead of writing them down) and analyzing them after a month or two.

Comment author: Alicorn 19 May 2011 07:47:21PM 1 point [-]

I'll restart the headache log and combine the food diary. (Is it worth including times of eating various things?) A cell phone app will not help, since I don't have a cell phone.

Comment author: wedrifid 19 May 2011 07:54:16PM *  0 points [-]

A cell phone app will not help, since I don't have a cell phone.

Wow. That's a rather significant divergence from culture! Tim Ferris would be impressed.

Comment author: AdeleneDawner 19 May 2011 07:59:45PM 4 points [-]

Or maybe just one that people don't talk about much.

I only own a cell phone because I needed a way to have contact with the rest of the world while my internet access was down when I moved a few months ago. I don't think it's actually useable at this point - I haven't added minutes to it for quite a while.

Comment author: Alicorn 20 May 2011 12:53:42AM 3 points [-]

I had a cellphone once for about a week, but then I gave it back.

Comment author: LukeStebbing 19 May 2011 04:39:07PM *  0 points [-]

There's also paracetamol (secret identity: acetaminophen (secret secret identity: tylenol)), which is not an NSAID, but I would guess you've tried it too. Fun snacks and/or facts:

http://en.wikipedia.org/wiki/Paracetamol

Until 2010 paracetamol was believed to be safe in pregnancy (as it does not affect the closure of the fetal ductus arteriosus as other NSAIDs can.) However, in a study published in October 2010 it has been linked to infertility in the posterior adult life of the unborn.

recent research show some evidence that paracetamol can ease psychological pain

ETA: I just remembered two important contraindications: Don't take more than 2g/day if you drink alcohol, and consider not taking more than 650mg at a time, since that's the FDA's revised recommendation after the old max dosage was shown to alter liver function in some healthy adults.

Comment author: Alicorn 19 May 2011 06:29:09PM 0 points [-]

Tylenol works about as well as other non-ibuprofen analgesics, which is to say it makes the headaches fade rather than go the hell away.

I don't drink alcohol ever, so that's not an issue.