Author Topic: What's Up With My Doctor?  (Read 1844 times)

Boundless

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What's Up With My Doctor?
« on: June 30, 2013, 03:29:57 PM »
Edition: 2014-04-12

FAQs:
Why is my doctor hostile about my diet?
Why does my doctor never ask about my diet?
Why can't I get a real lipid or thyroid test from my doctor?


Consensus medicine is the product of Western Civilization, which many of you are now beginning to realize has been in an unhealthy metabolism (full-time glycemic) for all of recorded history and then some. To the extent that consensus medicine is even aware of low carb (much less ketogenic metabolism), it considers it an uninteresting fringe topic, a place where people like the Inuit lived only because they had no access to Twinkies. And, to seal the deal, keto cultures, unlike even osteopaths and chiropractors, have no med schools that might represent a formal dissenting view.

In 12 years of pre-med, med and residency, your MD got between 2 and 4 semester hours on the role of diet in health, and all of that small smattering was based on science confounded by the culture's full-time glycemic diet.

Med School Lesson 1: diet doesn't matter.
How could 80% of my caseload (almost all the chronic stuff) have a root cause in something that was a med school footnote?

It's really unsurprising that consensus medicine ignores diet. In addition to the dismissive attention paid to it by med schools, what they were taught is incorrect, so the consensus diet they parrot is in fact negatively correlated with health.

Med School Lesson 2: so don't bother to read papers on nutrition
... and they don't. The original Wheat Belly book has 295 footnotes, mostly cites from the medical lit, and your MD is exceedingly unlikely to have read any of them, even though they are dead-on regarding wheat, carbs and diet generally.

It doesn't help that too many nutrition papers (not those cited in WB) are little better than junk food - hopelessly confounded, almost never isolating for low-carb/grain-free/healthy-fat, and heavily influenced by their funding sources. Most food-fright-of-the-week headlines turn out to be based on such worthless and/or agenda-driven papers.

Med School Lesson 3: prescribe a preparation
As an MD in training pointed out on the WBB, the med school focus is on pharmacology - prescribing drugs. Drug companies have excess influence in courseware, and on the "standard of care" (SoC) - the approved treatments for conditions, not to mention undue influence on the PDR. Naturally, the solution usually requires that the patient buy a drug, even when changing aisles at the supermarket would have the same result. Post-graduate visits by cute pharma sales reps, free dinners and free trips, reinforce the message. There are just enough drugs that are actually useful that this state of affairs seems credible to the credulous.

Med School Lesson 4: liability
The SoC is safe (for the MD). No MD is going to lose a malpractice case by following the dogma. In cancer, the SoC is usually fatal, and often has no material effect on lifespan, but no oncologist gets sued over it. When you suggest deviating from the SoC, the MD's inner lawyer goes to red alert, and the MD may not even realize it. Treat your glioma with a restricted calorie keto diet, hyperbaric therapy and exogenous ketones? Panic attack just due to liability.

Aside: this WFF article is about MDs. Any health care provider with a lesser rank than MD is dramatically less likely to deviate from dogma. MDs have a longer leash, particularly when their off-schedule or radical approach has demonstrable positive results. PAs, NPs, RNs, LPNs, dieticians and counselors of all kinds take a severe career risk in stepping outside the box, so set your expectations accordingly.

Med School Lesson 5: MD = matriculated diety
If the student isn't careful, formal medical education can afflict them with godlike psychology, later exacerbated by the tendency of patients to assume they have the power of life and death. The deeper into this trap the MD falls, the less open they are to being mistaken, and especially to being challenged by ordinary mortals (patients).

Post Grad Lesson 0: what that student loan implies
The young doctor is entirely unprepared to confront a situation that implies that much of their medical education, not even paid off yet, was very wide of the mark.

Similarly, the mature physician is not prepared to deal with an implication that much of their career has been in error, with needlessly tragic outcomes for many prior clients.

Post Grad Lesson 1: follow the money
Most of an MD's income doesn't come directly from patients. It comes from insurance providers, who may refuse to cover non-standard therapies.

Preventative and pre-emptive treatment is often also not in-plan (in large part because little preventative advice has been effective, and as we see with WB, effective dietary advice is pretty simple and doesn't require 12 years of training). The various medical specialties have consequently allowed themselves herded into a posture of fix on failure.

Yes, a dietary revolt by the general public is going to dramatically reduce the demand for MDs, but most of those MDs haven't seen that far ahead, and that's not what's on their minds when you bring up diet.

Post Grad Lesson 2: Fix on Failure
As Dr. Davis has said several times on his blog, consensus medicine has allowed itself to get painted into an acute care corner. It tries (and all too often fails) to fix things only after they've spun out of control. Prevention is not on the menu, both because it's not compensated by insurance, and also because the consensus guidance offered is not correlated with healthy outcomes.

Let's hit that point again: medical professionals aren't highly enthused about prevention, both because it doesn't pay well, but perhaps principally because the outcomes have not been encouraging. Hint, docs - it's not because we don't follow the advice - it's because the advice is incorrect.

Post Grad Lesson 3: I have no map for that territory
When I asked my GP (now retired) to order up proper lipid testing (that actually measures small LDL) and proper thyroid testing (that actually directly measures thyroid function, and not pituitary reaction), he admitted that he had never written such an order, and wouldn't know how to read the results.

Post Grad Lesson 4: union loyalty
It's 1850. You propose to your MD that perhaps bad humours, treated by bloodletting with leeches, or emetics, might not be an effective way to treat your chronic indigestion. Another red alert. You are asking the doc to defect from the fraternity, and join the rebellion. Is the doctor disposed to do that? They aren't all rogue gems like William R. Davis; not even a significant minority of them.

Post Grad Lesson 5: webmd.com
Any physician with an established practice now has to deal, daily, hourly, appointment-to-appointment, with patients overflowing with insights, advice, "facts" and self-diagnoses from the internet, much of it flat out incorrect. This has rapidly conditioned them that patients bearing new/contrary information are mistaken until proven otherwise by overwhelming evidence, which probably hasn't happened yet for your doc, who confidently predicts that you won't be the exception.

Post Grad Lesson 6: shock of the new
As I said on WBB:
Another aspect of this is that the problem is extraordinary. I can’t think of a precedent for this sort of thing. So in addition to the particulars of medicine vs. nutrition, we have the perfectly normal rational skeptical response of “extraordinary claims require extraordinary proof”.

OK, here are 295 cites. Connect the dots yourself.
Skeptic MD: “I don’t have time for that.”

OK, it’s been done for you in this book.
Skeptic MD: “That’s a popular best seller, with recipes! Surely you don’t expect me to take that seriously (especially when I have a vague subconscious unease about the wider implications).”

Post Grad Lesson 7: the overlooked itself has changed, and so what
Even if consensus medicine had paid more attention to diet, and thwarted the USDA's suicidal shift to low carb (1977-1992), would it have reacted to:
 - the relatively sudden rise of semi-dwarf hybrid wheat (1960-1985),
 - high fructose corn syrup (1975-1985),
 - high Omega 6 PUFA processed seed oils and
 - the only recently banned trans-fats?
Not only do these "foods" present novel issues in diet, they also, by way of being high yield and cheap, have pandemically infested the majority of prepared foods over the last 30 years.

The history of medical societies is dominated by resistance to change, even when they are paying attention, and in the case of diet, they aren't.

Post Grad Lesson 8: Too Much Too Soon
LCHF can't be correct, because that would imply ...

In the specific case of Low Carb High Fat diets (LCHF, and the WB recommendations are very low carb, borderline keto), getting your doctor to accept the benefits of LC also implies accepting that HF is at least not harmful. You're asking them to toss overboard multiple major features of the consensus diet (namely: 60% of calories from carbs, low fat is "good" and high fat is "bad").

This dot connects itself to another: heart disease dogma is also upside down. Fat isn't the problem; carbs are - de novo lipogenesis , the conversion of the rapidly-digested carbohydrate of wheat, amylopectin A, into triglyceride-containing particles like very low-density lipoproteins, or VLDL. This is the real cause, and Small LDL-P (NMR LDL), the crucial measure, is almost never measured. Instead they poison you with statins, that artificially distort symbolic "cholesterol" numbers that don't matter.

If they further take the time to figure out that WB is borderline keto (Nutritional Ketosis), they are quite apt to confound that with DKA (Diabetic KetoAcidosis), which is only a hazard to advanced diabetics who produce almost no insulin. This is quite a bit to swallow for someone taught the inverse, and that none of it really mattered to begin with.

Look at the trend chart for any of the leading chronic conditions, Type 2 diabetes being perhaps the most disturbing  - not just high, not just rising, but accelerating. You'd think that Conventional Medicine would be in a panic about this, and willing to consider quite radical theories on what the cause is, and actually try some different approaches.
Nope.
And big pharma merely sees it as an attractive revenue stream.

Summary
This is a really awful moment in history to be a classically trained MD. In addition to what a low-carb diet implies about a huge black hole in their training, they are straining under the yoke of universal health care rationing and its cookie-cutter standards of care (which care nothing for actual outcomes).

All of the above does not excuse knee-jerk resistance, denialism and general freak-out when you raise the topic of diet with your doc, but may at least explain it, and prepare you for the likelihood of encountering it.
« Last Edit: March 30, 2014, 06:46:34 AM by Boundless »

HS4

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Re: What's Up With My Doctor?
« Reply #1 on: June 30, 2013, 06:52:06 PM »
You are so 'on the money', Boundless, it's scary ;D
 
But every point you've brought up is true, unfortunately. 

Rita

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Re: What's Up With My Doctor?
« Reply #2 on: June 30, 2013, 08:40:44 PM »

And since the doctors don't take nutrition courses, they go by what the American Dieticians Association says.  The ADA is funded by junk food companies, and RD's can actually get continuing education credits by attending tradeshow classes which the junk food companies put on.   


Here's an enlightening read:  http://grist.org/food/force-fed-how-corporate-sponsorship-poisons-nations-top-group-of-nutritionists/

Linda R

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Re: What's Up With My Doctor?
« Reply #3 on: July 01, 2013, 07:18:43 AM »
You are so 'on the money', Boundless, it's scary ;D
 
But every point you've brought up is true, unfortunately.


As I read that post, I was thinking the exact same thing.


And thank you to Boundless as this member continues to give us amazing and enlightening additions to our forum.


1. When I experienced my heart discomfort about 18 months ago and ended up in the hospital for the week-end, not one single person asked about my diet. And you can imagine how many nurses and doctors were in and out of my room during that period!

2. Before being discharged, I was told I had to have a quick session with a dietitian. First thing out of his mouth? "We recommend that you begin a vegetarian diet right away." I looked at him in total disbelief and let him know that was not going to happen.

3.I was given statins of course. The cardiologist and I had quite an argument regarding the side effects and the over-all effectiveness of this pill on a woman of my age. It pissed him off, told me I was probably going to drop dead in the parking lot if I didn't follow his instructions. I took the damn pills for about 3 months, then muscle pains and aches began, the pills are sitting on a shelf, and have been since last spring. After all I have read, I'll never swallow another one.

4. I have quit seeing all cardiologists since my episode. I see no point whatsoever in having my blood work done every 3  months as they recommend. I will not sit in a doctor's office and be subjected to another lecture about statins and the dangers of high cholesterol.


« Last Edit: October 11, 2013, 04:45:01 PM by Linda R »
Why do we call our system a health care system? It's really a disease-management system, dependent on expensive drugs and invasive surgeries

Jan in Key West

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Re: What's Up With My Doctor?
« Reply #4 on: July 01, 2013, 08:24:54 AM »
Great post Boundless and as usual, you succinctly managed to articulate the whole medical/health mess in less than one page! Not a bad idea to print and handover to our doctors.....that is, if we had one!  Mine retired to become an acupuncturist over a year ago and it has taken me months of research to find a replacement and he's over two hours away.


Both my grandfathers and great-grandfather were physicians (long time ago) and much of their medical advice related to diet....diabetes, epilepsy, heart issues, etc because the drugs were not yet available to treat even infections, let alone anything much more major than that. Once pharmaceuticals entered the picture, that is most likely when medical schools changed their focus away from diet/nutritional strategies and instead implemented our current drug culture. Very sad!

Linda R

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Re: What's Up With My Doctor?
« Reply #5 on: July 01, 2013, 08:32:54 AM »



 Once pharmaceuticals entered the picture, that is most likely when medical schools changed their focus away from diet/nutritional strategies and instead implemented our current drug culture. Very sad!


Read on Twitter a few days ago.................


"We do not have a health care system in this country, it is a disease management system"
Why do we call our system a health care system? It's really a disease-management system, dependent on expensive drugs and invasive surgeries

HS4

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Re: What's Up With My Doctor?
« Reply #6 on: July 01, 2013, 04:13:02 PM »
Jan - you're absolutely right about what doctors used to know, before pharmaceuticals swept everything away. It reminds me of the 'lost wisdom' that Sally Fallon and Mary Enig (founders, Weston A Price Foundation) are constantly talking of.  I don't agree with everything WAPF recommends (especially for grains), but with them I lament the loss of so much dietary wisdom over the past 4 or 5 decades.  Everyone used to know many of the basics such as broths were always made from bones, meats and fish should be eaten, when possible, with the aspics, regard packaged foods with suspicion, and on and on.  I guess, once upon a time, physicians also knew the relationship between food and health. We're all rediscovering the wheel  :(

Loekie

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Re: What's Up With My Doctor?
« Reply #7 on: October 11, 2013, 03:18:07 PM »
The thing is, that the medical world knows that there is a disease called celiac disease. One third is diagnosed, or less. So they know that thousands of people with celiac, are not diagnosed. Why do they not advice to everyone with stomach problems for instance, to try a period of wheat free.
I think it is criminal that they don't.
Wheat free since february 2012

LibbyMe

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Re: What's Up With My Doctor?
« Reply #8 on: October 11, 2013, 04:27:54 PM »
I began WB in January.  I saw my primary a RNP in early March, who applauded me because she already could "see" results.  She introduced me to the FP she works with, telling him I was doing WB.  His comment was "oh, another fad diet!"  My primary told me my last visit to keep up the good work and instead of seeing me in 3 months, said "I'll see you in 6!"
That all said though.  I'm stuck, I think with my weight.  I've been counting carbs (eating less).  I read on the WBB something about candida.  I wouldn't be surprised that this could be a problem for me but how do I find out?  Then if so, what would I do about it??  Curious!! 
I have to say too, Boundless, Jan and Rita and others---I'm so very impressed with the knowledge you all have in this area. Thank you so much for sharing it with the rest of us!!!!!
« Last Edit: October 11, 2013, 04:34:34 PM by LibbyMe »

VibeRadiant

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Re: What's Up With My Doctor?
« Reply #9 on: October 11, 2013, 05:48:32 PM »


"We do not have a health care system in this country, it is a disease management system"


Exactly!
Strive for progress, not perfection.

VibeRadiant

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Re: What's Up With My Doctor?
« Reply #10 on: October 11, 2013, 05:50:33 PM »
If the majority of doctors were in the prevention and curing business, they wouldn't have a revolving door practice of patients coming and going, getting sicker and sicker, needing more and more meds to live.

Strive for progress, not perfection.

Loekie

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Re: What's Up With My Doctor?
« Reply #11 on: October 12, 2013, 01:26:20 AM »
If the majority of doctors were in the prevention and curing business, they wouldn't have a revolving door practice of patients coming and going, getting sicker and sicker, needing more and more meds to live.

That, ánd I sometimes hear them say: it is such an awful diet. But that is not their concern! I give more for my health than for six slices of bread a day. I don't agree that it is an awful diet. For me it is a liberation. How awful is it to have a diet with wheat while you are not knowing that there can be a connection between wheat and your often awful condition?
I heard that just one hour is spend on food in the education for medical students. While it is a knowing fact that food is an important factor not only for celiac, but also other diseases like cancer.
How is it possible that it is still one hour? Why medical students do not protest against this?
Another example, iodine. Important for your body. When I told my doctor that I used sealsalt, he said that he thought there is iodine added in seasalt. Which is not true. He wanted to give tablets for my slow thyroid while I am totally cured with more intake of iodine.
Do they know anything about food? I have a sister in law who is a family doctor. I told her about my wheat free live and how it cleared up lots of symptoms. She said: 'oh, but it's often so that after a while you can eat wheat again.' I thought, I hope not because I like this diet.
And she is not right. When I eat something with wheat, some hours later I am running to the toilet.
 
« Last Edit: October 12, 2013, 08:11:14 AM by Loekie »
Wheat free since february 2012

Lila

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Re: What's Up With My Doctor?
« Reply #12 on: October 12, 2013, 05:59:39 AM »
My PCP wouldn't even read the papers I brought him.  No effort on his part required to look anything up.  And the papers were not from obscure journals.




aspexil

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Re: What's Up With My Doctor?
« Reply #13 on: October 15, 2013, 04:24:51 PM »
I went wheat free in Feb 2013.  Just so happened 6 weeks later I had my blood work done.  Triglycerides fell to 139 and HDL hit 40.  Doctor had the data in his hands and yet he couldn't see that wheat free was good.  Then in August Triglycerides down to 113 and HDL up to 45.  Yet he still gave me a print out to eat whole grains.  Good grief they are idiots. 

Loekie

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Re: What's Up With My Doctor?
« Reply #14 on: October 16, 2013, 12:14:39 PM »
I went wheat free in Feb 2013.  Just so happened 6 weeks later I had my blood work done.  Triglycerides fell to 139 and HDL hit 40.  Doctor had the data in his hands and yet he couldn't see that wheat free was good.  Then in August Triglycerides down to 113 and HDL up to 45.  Yet he still gave me a print out to eat whole grains.  Good grief they are idiots.

They are in total denial. They do not want to know and when you tell them, they get angry and you see them thinking: don't bother me with these nonsens, I am busy! Yes, you are busy with all those patients who would not be sick if they should eat wheat free too.
« Last Edit: October 16, 2013, 12:17:10 PM by Loekie »
Wheat free since february 2012

Janknitz

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Re: What's Up With My Doctor?
« Reply #15 on: October 17, 2013, 06:06:11 PM »
WOW!
 
How do you give a standing ovation on the internet???

Jan in Key West

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Re: What's Up With My Doctor?
« Reply #16 on: March 30, 2014, 05:51:26 AM »
A short video clip from a ND who wrote a book about firing your MD......


http://tv.greenmedinfo.com/doctors-3rd-leading-cause-death/

Linda R

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Re: What's Up With My Doctor?
« Reply #17 on: March 30, 2014, 06:56:20 AM »
Wow!


Unbelievable!


My neighbor is just a few years older than me, and has a long list of medical issues ranging from CHD to osteoporosis.
I watch her gingerly using her walker to navigate down the 4-5 steps of her deck in order to reach her car that someone else now drives to take her to yet another medical appointment. I watch her light up another cig as they take off. I watch as she receives another meal from a state of Iowa program, a meal I wouldn't touch with a ten foot pole. We've talked and talked about how minor changes might help, but things remain status quo. I don't even visit in her home due to the second hand smoke that permeates the house.She became extremely ill a few years ago due to all the pills she was taking. She's had a hip replacement that didn't really help. She is also incontinent and had a procedure to "fix" that issue as well. It also didn't help.Her life is a constant merry-go-round of medical office calls. Instead of quitting smoking and changing her diet, she continues the same cycles. She's a "perfect" candidate for the tragedies referred to in this video.
Why do we call our system a health care system? It's really a disease-management system, dependent on expensive drugs and invasive surgeries

Jan in Key West

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Re: What's Up With My Doctor?
« Reply #18 on: March 30, 2014, 07:35:47 AM »
>She's a "perfect" candidate for the tragedies referred to in this video.


Maybe a new acronym.....MDID (MD induced death) 

scrupulousgirl

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Re: What's Up With My Doctor?
« Reply #19 on: March 30, 2014, 09:34:10 AM »
A short video clip from a ND who wrote a book about firing your MD......


http://tv.greenmedinfo.com/doctors-3rd-leading-cause-death/


Jan, Thank you for posting. I've sent this on to a few people.

Janknitz

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Re: What's Up With My Doctor?
« Reply #20 on: March 31, 2014, 09:45:00 AM »
I watch my sister-in-law, A PEDIATRICIAN, struggle to care for her son, who has been diagnosed with pervasive developmental disorder (PDD)--similar to autism. As my highly intelligent nephew becomes an adolescent he's harder to communicate with, he isolates himself more in his own little world and he cannot handle social situations, his neurological issues become more prominent, his behavioral outbursts are becoming more frightening.  He is developing severe anxiety.

My SIL has been told to try at least getting gluten out of his diet (I would vote for ALL grains and sugars), but "it's too hard". He has always been a difficult and "picky" eater and is one of those kids who will not eat for weeks if he doesn't get his way with food. But I think he's bright enough to
Participate in a trial of grain elimination if the family works together on this, offering him choice and participation in the process. They refuse to even consider it, however. My SIL would have to give up her Nutrasweet diet garbage and her younger child (also a behavior problem) all the sweet bready foods, pasta, candy, etc. both kids get chocolate soy milk at bedtime to "make up" for the food they don't eat (OY!!! ). Giving all this up is too hard ...

So instead she has chosen to give my nephew an ever increasing arsenal of psychotropic drugs. He has horrible side effects like inability to sleep, zombie like behavior, and increasing anxiety.  So the answer is to try yet another drug in the vain hope that the right drug or combo of several drugs will be found. How is this easier than a dietary change???

My SIL the pediatrician believes in drugs, not food, even when evidence of drug failure stands right before her. If she can't help her own son, what of her patients?

Linda R

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Re: What's Up With My Doctor?
« Reply #21 on: March 31, 2014, 10:22:41 AM »
The horror stories never end, do they?





Why do we call our system a health care system? It's really a disease-management system, dependent on expensive drugs and invasive surgeries

Jan in Key West

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Re: What's Up With My Doctor?
« Reply #22 on: March 31, 2014, 10:28:36 AM »
Jan,
Would your SIL be open to reading 'Grain Brain'? And then there's Dr. Natasha Campbell-McBride, who came to the GAPS paradigm via her autistic child. Being physicians, she may be more receptive to their conclusions.