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Comment by Fomite | Hacker News Reader

There's a difference between chronically infected (which is true) and that the source of CF is an infection, which is the part of your theory that's unsupported.

"the way it works vaginally and in the lungs ought to be consistent." - not necessarily, and especially not when you're describing symptoms (vaginal dryness resulting in uncomfortable sex), because the mucous of your lungs and sexual lubrication serve very different purposes.

And other symptoms of CF in women, such as more difficulties conceiving, are consistent with mucus overproduction.

The discharge might not be mucus, but that doesn't mean that's not the root of what CF is doing.

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and that the source of CF is an infection, which is the part of your theory that's unsupported.

I don't think I've said that anywhere and that's not what I'm trying to say.

CF is a genetic disorder. It's root cause is a malfunctioning cell channel, the CFTR, that is defective due to a genetic defect.

But I do think a lot of what we think of as CF is really a consequence of being sick and malnourished your entire life. If those issues can be addressed, outcomes can change.

Having more difficulties conceiving is also consistent with uncomfortable sex.

I found this article [1] that seems pretty consistent with the dehydrated mucus hypothesis. I don't know if it's reputable, and I only read the summary, because it quickly got over my head.

[1] https://insight.jci.org/articles/view/89752

"Having more difficulties conceiving is also consistent with uncomfortable sex." - Difficulties exist in women with CF who don't report pain during sex.

I did not realize the degree to which I suffered vaginal dryness until I was like 40 or something. Vaginal dryness was my "normal." I didn't realize it was quite abnormal.

I generally did not have pain during sex because I got married at 19 to my "high school sweetheart" and he and I accommodated my vaginal dryness without making a big deal of it and I didn't realize how much we were doing to accommodate it until after I finally had a diagnosis and was getting divorced. It was our "normal" and we were oblivious to the fact that it wasn't normal at all because neither of us had much experience prior to getting together when we were both 17.

So I will suggest that lack of reports of pain during sex may say more about a woman's sex partner than about how much vaginal dryness she is experiencing.

That's possible - but there's also a perfectly explainable mechanism of action (thickened cervical mucus) that doesn't involve you dismissing the experience of other women who don't report vaginal dryness as a problem but do statistically experience lower rates of successful conception.

See, I wasn't dismissing anything. I post as openly female on an overwhelmingly male forum. I routinely try to add information to the discussion that seems unlikely to occur to most men.

I said in another comment -- one you replied to, so presumably you read it -- that reproductive issues in CF are likely more complicated than just this one factor, so I think this characterization of my remark is completely unfounded.

I haven't paid much attention to the reproductive issues typical for CF, but I'm sure they are more complicated than thick mucus. IIRC, something like 97% of men with CF lack a vas deferens and are thus unable to deliver sperm when they ejaculate.

I think there is a lot more going on with CF than lack of adequate mucus. I was merely trying to provide a fairly straightforward example of what seems like an obvious error in logic for a biology mental model.

Since mucus has an immune function and people with CF have a terribly compromised immune system, the assumption that we overproduce it seems flawed on the face of it and fails to be consistent with widespread reports of vaginal dryness.

Thank you for the link, but this kind of argumentation is usually not helpful.

"The immune system" is not actually a single system. It's entirely possible for a condition to cause both the overproduction of a single aspect of the immune system and also harm your general immunity overall.

This is no more a failure of a mental model than the fact that autoimmune diseases, which also involve a heightened immune response, can leave people more vulnerable to certain infections.

But, as noted elsewhere, I don't particularly think this exchange is going to leave either one of us content. I wish you the best in finding a treatment that works for you.

"The immune system" is not actually a single system.

I'm well aware of that fact.

I'm not really a fan of the entire concept of autoimmune disease. There are things that go on with CF where they also claim that "overreaction" of the immune system is a factor, though I can't recall a specific example because I left all the CF lists years ago. I don't think ideas like that are helpful, so I made no effort to remember the specific examples.

Cystic Fibrosis is a misnomer rooted in an older mental of the condition which has since been abandoned. It was descriptive of the state of the pancreas in autopsies of people who died of the condition. I think in French they call it mucoviscidosis, which would be medically more accurate.

We have a terribly poor understanding of a lot of medical conditions. "Gulf War Syndrome" just meant you were sick in some mysterious fashion and had served in the Gulf War. Last I checked, they had distinguished three different syndromes, still without identifying an exact cause.

Malaria just means "bad air." It was so labeled because of it's association with swamps. It was only later that it was determined to be due to a parasite where mosquitoes are the vector.

Medicine is shockingly imprecise and organic and a lot of fancy labels in medicine are not as informed as laymen sometimes assume.

When I was asking a former RN one time "So, what exactly does this medication do at the cellular level?" She told me "We don't actually know. That's not how studies are done. You are asking questions that medicine can't answer."

But, as noted elsewhere, I don't particularly think this exchange is going to leave either one of us content. I wish you the best in finding a treatment that works for you.

What I'm doing for my health is working remarkably well. As stated elsewhere, I'm not seeking agreement from the entire world. I'm seeking meaty engagement. So I've been quite content to talk with you, overall.

But you have zero obligation to engage me further. Have a nice (whatever time of day wherever you happen to be).

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