Blessed by the Potato

TD has recently opened up a “store” for TD Visa customers called ShopMyAXS. The name makes no sense to me, I don’t know if the capitalized letters are supposed to be meaningful or not. Apparently it’s a discount club type store that only sells to the clients of certain businesses (such as TD).

It looks like they have a fairly decent selection of random items from TVs to movie passes, board games to sports equipment, with some very nice discounts on some things, along with larger deals of the day. Unfortunately, the only shipping method is Purolator, and that sucks a lot of life out of the bargains. For instance, they have Cineplex Night Out passes (2 admissions, 1 popcorn, 2 drinks) for $20, which is a great deal for those passes. However, the shipping charges are $7 to Toronto (and $12 to London) and there’s a limit of 2, so that makes it barely worth getting ($7 to ship a piece of paper!). An iPod was on sale (and according to Wayfare, iPods never go on sale — I wouldn’t know, they’re not an item I keep my eye on), and there was a fantastic promotion on an LG 42″ TV for $700 + shipping of ~$65. We read some mixed reviews: good picture, but apparently has an audio sync issue with HDMI. That had us on the fence, but it was hard to ignore the fact that it was $100 cheaper than the best price (even last Boxing Day) we had seen on the Samsung we were thinking of getting… so we’ll take the chance on it (especially since we don’t have any HDMI devices yet, unless the Xbox counts). Plus Wayfare’s mom got a 37″ LG TV recently and it’s beautiful — and we got some money from her parents specifically to buy a new TV as a gift (they left it up to us to pick one). I’ll do a review of the TV when it comes in.

The bargain hunters at red flag deals have discovered MyAXS, so if you’re after one of those crazy deals of the day this month, be prepared to log in early!

Happy Halloween!

There was a very bright, impressive meteor near Toronto on Friday night. It only lasted for a few seconds, exactly as the article described: a very bright flash of greenish/white light, and a break-up trail of flaming debris that only lasted a few seconds — it kind of looked like a sparkling firework, except trailing down towards the ground, and impossibly high up. I’m not an expert, and didn’t have any real data on it, but we were around Woodstock in the car heading towards Toronto on the 401, and it was east-north-east of us and looked to be perhaps above Toronto. From the size of the trail of debris, I wouldn’t be too surprised if a fragment survived, but from my point of view it looked like it was heading for the middle of Lake Ontario. Of course, from the comments in the Star article about it, some people from places as far away as Muskoka still thought it was north-east of them, so it might have been really high and really far away — which just makes how very bright it was that much more impressive! CP24 though says that someone in Ajax thought it was to the west of them, which might put it right over Toronto after all (maybe the commenter from Muskoka had his directions wrong?).

The blurb in the Star about it.
The bit on CTV, with a really terrible picture.
CP24’s story.

Douglas Adams used to say that the reason young boys had to wear short pants was because nature had perfected the self-healing knee, whereas science had not done particularly well on the self-healing pant knee.

My car, being 13 years old, seems to have started evolving self-healing features. There was the leak in the radiator: the guy at the shop said I’d need to replace it within a year, 3 years ago. It lost about 1 L of fluid, and hasn’t leaked since. Recently, they found a small oil leak in the engine (leaking around the camshaft). That lost just under a litre of oil, and hasn’t leaked since (though that’s only been a few weeks, and I haven’t driven the car much in that time, so maybe if I push the engine more it will leak again).

I didn’t think too much of the leaks closing up: it can happen, especially as parts expand and contract with changing temperatures (the radiator, for instance, only seems to leak in the winter). Or maybe some “gunk” stopped up whatever microscopic hole was forming.

However, this week my signal light burned out. Bulbs burn out all the time, and after ignoring it for a few days while I was busy, today I figured it was time to go to Canadian Tire and get a new bulb.

Except now, it was working again. That was just freaky — bulbs don’t usually fix themselves! So now I’ve either got the beginnings of an electrical ghost (which in an old car can be annoying and tough to trace and fix), and maybe I shouldn’t try to get another winter out of it… or my car is actually incredibly awesome and repairs itself.

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So I was out at a conference in Victoria, and while I’ve been to a lot of conferences before, it was the first physician-oriented scientific conference I’ve been to. I must say that the quality of the presentations is vastly different than that seen at a typical conference for scientists. The clinicians were much more confident, articulate speakers, like smooth salesmen, which stands in stark contrast to the introverted scientist reading his slides. Unfortunately, they also tended to present fairly shaky data as facts and guidance for future treatments.

For example, there were some presentations on the use of botox and acupuncture to treat chronic pain. The presentations were basically “this worked for these patients, everyone should try it.” Now, here’s the thing about research in medicine: you really need double-blind placebo-controlled studies before you can really say anything with a great deal of confidence, before you really have proof of a treatment working. When this was pointed out to one of the presenters, he countered by saying “Well, the proof is that these people keep coming back and paying for more treatments; these aren’t covered by provincial medicare. If it wasn’t working, they wouldn’t keep coming back.” A bit later in response to another question, another of these practitioners said that about 30% of the people he tried his alternative treatments on returned for more.

The thing is, there’s what’s known as the placebo effect: even if you give someone something that shouldn’t do anything to or for them, some portion of people will find some measure of effect from that treatment. The size of the placebo effect varies greatly depending on how the placebo is presented and what the placebo is acting on. The placebo effect is hard to understand, but we believe that it’s largely “mind over matter” and as such, it seems to work best on ailments that are largely in your head to begin with. If you’re sad, and a respectable looking fellow in a white lab coat hands you a pill and promises that it will make you feel less sad, you’re likely to feel less sad even if that pill is just gelatin-encased starch. Likewise with pain: from a number of studies, it seems that about 30% of people find that their pain gets about 30% better when damned near anything is tried. Pain is a complex phenomenon, but it is at least partly sensation and partly emotional, so it’s something that is easy prey for the placebo effect. Contrarily, something much more objective like a broken bone or open wound is less susceptible to the placebo effect.

So I found it rather disingenuous that when a self-selected sample of people (those who come in to a doctor’s office ready to pay for acupuncture must already believe it may work) has some measure of pain relief, that a doctor can extrapolate from that to suggest that acupuncture is a generally effective therapy for pain.

The double-blind part means that the subjects in a study must not know whether they have the real or placebo treatment: if they knew, it would really eliminate the point of the placebo. That’s blinding. Double-blinding is when the experimenter also does not know, since unconscious clues might be passed to the subjects. All important stuff in research, but let me get back to the placebo effect.

What’s interesting is that placebos are almost as effective as some FDA-approved treatments, and often with less severe side effects (though perhaps somewhat unsurprisingly, placebos also have side-effects; mind over matter cuts both ways). However, it’s generally considered unethical for a doctor to prescribe a placebo because it involves deceiving the patient.

Along with the placebo effect is the tendency for patients to lie and pretend they’re all better when a treatment is noxious. Take, for example, trepanation. Whether or not your chronic pain was cured by the medicine man drilling a hole in your head, you sure as hell were going to shut up about it or else he’d go and drill another one. I haven’t seen it reported, but I also have to wonder if there might be an under-reporting of effectiveness for some addictive treatments: could patients over-report their pain if they’re hooked on morphine, saying it isn’t working when it is in order to get an extra dose?

There was a good article about the placebo effect in Wired recently, even touching on the subtle aspects of pill design that can enhance the placebo effect.

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