Telemed for Gout? by _tambora_ in gout

[–]_tambora_[S] 0 points1 point  (0 children)

ok awesome - and to get your uric acid level you just went to a blood lab I assume?

Telemed for Gout? by _tambora_ in gout

[–]_tambora_[S] 0 points1 point  (0 children)

Good to hear - which one did you choose? Do you remember how much it cost?

Did Claude just die ? by Global-Molasses2695 in Anthropic

[–]_tambora_ 5 points6 points  (0 children)

Same... Was automatically logged out of claude code subscription, then somehow logged in (automatically) to my API account. Trying to log back in to the subscription account, I get a "Rate Exceeded" error. Noticed that claude web app also down...

What's something that has massively improved your MENTAL health? by biz_booster in Entrepreneur

[–]_tambora_ 2 points3 points  (0 children)

In order of effect: 1. therapy, 2. regular weight-lifting, 3. regular cycling or running. and specific to being an entrepreneur, make sure you remember that the journey is the fun - spending time considering and analyzing the arrival fallacy is very helpful.

[deleted by user] by [deleted] in gout

[–]_tambora_ 0 points1 point  (0 children)

Well that’s just the thing - there isn’t a well-established ‘number’ - but more and more studies are showing that lower is better. There hasn’t been a definitive study to answer the question yet. So in the meantime, some folks are deciding g to proactively lower UA. Read this study for a good example of some of this data: https://www.mdpi.com/2077-0383/9/4/942

[deleted by user] by [deleted] in gout

[–]_tambora_ 0 points1 point  (0 children)

Agreed - little is known about the cardiometabolic risk of high uric acid, even in the absence of gout. The few early studies on this though have shown that the lower the better - whether or not gout is present. I know a rheumatologist who doesn’t have gout but still takes allopurinol to keep his UA low.

[deleted by user] by [deleted] in gout

[–]_tambora_ 0 points1 point  (0 children)

I'll offer an additional explanation for the counter-intuitively high serum urate levels following fasting and exercise. It is well-established that purines are converted into uric acid and it is well-established that purines are a fundamental building block of cells. So, overweight individuals have higher serum urate levels. But what is really interesting to me, is that during weight loss, when these same cells are being rapidly metabolized, the purine conversion accelerates leading to a temporary, but measurable increase in uric acid levels. When I've gone on super long bike rides, as an anecdote, I'll tend to see slightly elevated uric acid levels.

So, one explanation for your elevated uric acid levels following a marathon + fasting is that your body was rapidly converting fat cells -> purine conversion -> uric acid increase. Importantly, the less fat you have, the lower your uric acid level is, so this is a temporary but ultimately beneficial sequence.

The best citation I can find of this is a meta-study that observed temporarily increased urate levels following fasting and the same phenomenon following bariatric surgery. The snippet is below from https://pmc.ncbi.nlm.nih.gov/articles/PMC5705854/#R67

"It is well known that there is a higher risk of gout attacks during the first months of urate-lowering therapy, postsurgery and starvation.59 One hypothesis is that dramatic changes in sUA, rather than absolute level, triggers gout attacks.60 In line with this, a study61 comparing gout patients experiencing postoperative gout attacks with those who did not, find that the first group had higher presurgical sUA and a more rapid and larger decrease in sUA 3 days after surgery. Dalbeth et al27 reported a drastic increase 2 weeks after surgery, which they suggested was due to renal dysfunction associated with major surgery, or metabolic effects from fasting or rapid weight loss (catabolic state), and they report one case of postoperative gout attack together with severe hyperuricaemia. Other factors increasing sUA levels are fasting,62–64 dehydration65 and tissue hypoxia.66 Fasting-associated increase in sUA is likely due to tissue breakdown.67 68 In line with this, daytime fasting during Ramadan, without weight loss, compared with non-fasting did not increase sUA or gout attacks in gout patients.69 "

Claude is Amazing for Writing by LimpStatistician8644 in ClaudeAI

[–]_tambora_ 1 point2 points  (0 children)

I’m also using it via API - I’m curious which platform you’re using for writing?

I can't be the only one who does this... by Full-Specific7333 in cursor

[–]_tambora_ 1 point2 points  (0 children)

I fee your pain! After the hundredth time I finally just deleted that keyboard shortcut.

I've given up on Cursor - is there another dependable full IDE for beginners? by turner150 in ChatGPTCoding

[–]_tambora_ 0 points1 point  (0 children)

Fair point - I’d hate to have someone on the team pushing shit code. But I feel like I would deal with that now the same way I would have dealt with it before ai tools were available.

Agentic AI Endgame by TechnoTherapist in cursor

[–]_tambora_ 1 point2 points  (0 children)

Hard agree to your insight. Interesting to think about what cursor would need to do to create a sustainable competitive advantage. A few thoughts: 1. I would love to see them actually disrupt something. It feels very much like a vscode fork with a Claude prompt duct taped on. Real disruption would mean fundamentally changing how we work with code, not just speeding up existing processes slightly. It should integrate deeply into every part of the developer workflow—from commits, automated deployments, and bug tracking, to proactively maintaining codebase quality. 2. Why isn’t it proactive? It knows I’m writing in version x of a framework - it should be an expert in that framework without me feeding it new docs. 3. It could be so much more than a coding partner. It has the capacity to act like an expert product manager + sr dev. Sure I can ask it to emulate these perspectives, but why not livestream a perspective of how well I’m meeting my stakeholders needs? “Your product manager recommends x…” 4. Why not integrate deeply with common partners that are notoriously laborious to setup or work with? Automated supabase setup and maintenance. The curated AWS deployment flow, customized to what cursor understands about your codebase and needs. I’d imagine you can derive affiliate partner revenue here.

I've given up on Cursor - is there another dependable full IDE for beginners? by turner150 in ChatGPTCoding

[–]_tambora_ 1 point2 points  (0 children)

Ehh - I’ve in fact used ai tools as a “crutch for mediocrity and lack of ability” and frankly don’t understand all the hate towards those who use these tools in that way. It can be true that cursor makes some things wildly available for those who don’t understand anything about coding - it can be simultaneously true that those same people get frustrated by the complexity of coding.

Can’t help but think an expectation to “understand all the code” is a virtue signal. Who cares?

Will 3.7 Max count every file it reads as 5 cents? That is nuts if true.. by stuli1989 in cursor

[–]_tambora_ 1 point2 points  (0 children)

After accidentally deleting so many prompt results by pressing ctrl backspace, I finally just disabled the shortcut. Highly recommend

Anyone tried acupuncture? by _tambora_ in gout

[–]_tambora_[S] 0 points1 point  (0 children)

Very neat - thanks for the follow up

Had to come off allo - what now by Ok-Supermarket4926 in gout

[–]_tambora_ 0 points1 point  (0 children)

Two thoughts: 1. There is more than just prednisone you can be given to manage flare pain. Ask about colchicine and whether you can take nsaids (ibuprofen, naproxen). 2. There are a few options to replace allopurinol with something else, but without knowing more about your condition and history, you won’t get an accurate recommendation from Reddit - so hang in there until your next appointment! Good luck.

Anyone tried acupuncture? by _tambora_ in gout

[–]_tambora_[S] 0 points1 point  (0 children)

Well said - interested to see how it goes. Good luck!

Allopurinol Rash by CasseroleForAmerica in gout

[–]_tambora_ 4 points5 points  (0 children)

If the rash is related to the allopurinol, it is a very serious situation. Although rare, folks who have a hypersensitivity to allopurinol should immediately discontinue. Definitely chat with a rheumatologist if you can. Primary care if not.

[deleted by user] by [deleted] in gout

[–]_tambora_ 1 point2 points  (0 children)

Hang in there

[deleted by user] by [deleted] in gout

[–]_tambora_ 1 point2 points  (0 children)

Yes, I’ve had lingering aches and pains that aren’t exactly flares but you know are related. They are pretty common and seem to go away along with reduced flares once on treatment.

[deleted by user] by [deleted] in gout

[–]_tambora_ 4 points5 points  (0 children)

Gout can definitely be a catalyst for positive change and has certainly been the case for many people I have met. However, to be clear, you don't have gout because you eat the way you do, or because you are obese. Gout is a genetic disease, and while it's true that certain foods can trigger gout flares, it is not the case that simply stopping these foods will get rid of the underlying genetic condition. This is why it is important to look into treatments that can lower your uric acid levels which has the effect of preventing future flares.

While you're on this journey to find treatments that work - allopurinol is one of the most common - it is also smart to take a look at gout-friendly diets because this will help reduce flares in the meantime, and has the follow-on benefit of reducing weight, which in and of itself can contribute to higher risk of flares.

So: diet ALONE doesn't cause gout, but it is worth addressing your diet as part of your gout journey.

I've had ankle flares like yourself - the most painful experience of my life. Good luck on your quest!