What happens when Patients know more than their Doctors ?

[walkerwally1]

I thought some would be interested in this.  The study reported in the BMJ was about T-1 patients but I think it applies to all. 

http://bmjopen.bmj.com/content/3/11/e003583

The conflict comes when the patient has to interact with doctors or hospitals that just do not understand, or refuse to understand, that there are reasons to listen to their patients and try to understand what they are saying.

[Grammabear]

I have found that for the most part the patient has to "play the game" by the medical communities rules.  My doctor is supportive of lchf and Paleo, but because of the healthcare system she works for - she isn't allowed to advise me on either of the above ways of eating.  Yes, she can and does advise me "off the record", but never officially.  She also doesn't advise me on diabetes self management even though she has an MD behind her name.  She knows a lot about diabetes, but not too much about tweaking basal and bolus rates.

[Shanny]

I know my doc paid attention & took notes when I went on LCHF, because he later used it himself to lose weight (and possibly his diabetic wife uses it now too). What I don't know is whether he recommends it to other patients.

[bigskygal]

I am positive my pcp does not mention lc/hf to any of his diabetic patients. I am the only one that controlled my diabetes with lc/hf. On the other hand, my Oncologist fully supports it and actually follows it himself. I don't know if he recommends it to other patients though.

[walkerwally1]

People may be familiar with Dr. Eric Westman who is the director of the Duke Lifestyle Medicine Clinic at Duke University.  He is an advocate of low carb for the treatment of obesity and diabetes.  I have seen several presentations from him and he is a co-author of the New Atkins Diet along with Jeff Volek and Stephen Phinney.  In one interview he was asked how he got started into using low carb as a treatment and he said that it was his patients that got him started.  Two of his patients were not happy with the conventional methods he was using and they discovered low carb and tried it and it worked.  The point is that he listened to his patients and found out that this was a far better way to treat the problem that what he was taught.  This is now how he runs the clinic.

[Em_P]

I am positive my pcp does not mention lc/hf to any of his diabetic patients. I am the only one that controlled my diabetes with lc/hf. On the other hand, my Oncologist fully supports it and actually follows it himself. I don't know if he recommends it to other patients though.

my dr has never mentioned a lchf diet to me ever. just been tryna shove meds at me. i'm fighting to stick with a diet and get over craving sweets to start off with and he's not really helping me figure that out. i'm kinda on my own. trying to avoid insulin if at all possible. mainly cuz i'm pretty sure i won't be able to afford it. he looks to see if i'm allergic to certain meds but doesn't look into whether or not i can take them with my other meds or with my copd. it's very frustrating.

[bigskygal]

In my experience very few drs will ever recommend lc/hf because of the unwarranted "fear of fats" that have been ingrained in their teaching and in the perception of the general public.  Of all the people on various diabetes forums that I have participated, by far most controlled their diabetes with a lc/hf diet. 

My own experience: when I was diagnosed in 2012, my bg was 243 and A1c was 9.5%. I did take metformin for a couple years after dx. I did lots of research and read books and on forums and went to lc/hf about 3 weeks after diagnosis. Check my signature and see how long it took me to bring myself down to a normal bg range. And in the process, I lost 50 lbs!  All while eating high fat/low carb. Good fats! Read some of the article here, they may help you feel more comfortable with the fat component of the method.

I have been off Metformin since early 2015, and never took any other diabetes med, ever.

[skb]

This is a thread from 2017 and I have no clue how or why I missed it but thanks to Em_P I have a chance to put my  in.

What happens "when patients know more than their Dr." My take is who is to tell who knows more. I think that neither "they" know nor do we. The body is so complex and complicated. And then YMMV (Your Mileage May Vary) makes it more difficult to assess. But generally speaking it p1sses them off. Nobody likes being "told" about something that they think they know best.

Em_P, for COPD, I think the best solution lies with high dosage of Vitamin C. The Liposomal version would be best. 

[walkerwally1]

I never told my doctor that I thought I knew more than him, it would not have gone over well at all, but after he had no solution to why my A1c was increasing every time it was taken and just shrugged his shoulders I fired him and started to see my present doctor.  She had no solution either but she was happy to let me do my own thing and supported me.  How to treat my diabetes was found by doing research and from forums like this.  I learned from other diabetics that were successful treating their own diabetes and used their knowledge.  I don't know how many patients my doctor has with diabetes but I am sure it is quite a few and she has said that none of her other patients have an A1c as low as mine but she has not questioned what I do although she knows I do restrict carbs.

[bigskygal]

I too never told my dr I knew more than he did. Same as Wally, I researched, read forums and learned from other successful diabetics able to control their diabetes. My then dr basically did what Wally's did, shrugged his shoulders, strangely enough, as my numbers got better, to the point he said I was no longer a diabetic. I think somewhere in the back of his mind he thought he somehow was responsible for it.

Once you are diabetic you are always diabetic, the difference is if you (with or without meds or with diet) control it, you can get into the normal range and be relatively healthy, or if not, there are severe consequences you can suffer. The earlier you can address it, the better. Yes, you may have other medical issues to contend with and that will take further research in how to work to the betterment of all issues, but it can be done.

Em_P, you might want to seek out a COPD forum too. There is a  lot to be learned from people in the same situation as you. When I had breast cancer I also joined a breast Cancer forum and found it tremendously supportive along with the diabetes forum.

[skb]

She had no solution either but she was happy to let me do my own thing

That reminded me of my Chief Instructor when I was doing the Nutrition course. From Day One I had made it clear that my views on the mainstream medical dogmas was very different from theirs. She was a Renal Nutritionist and probably had encountered or believed in LC, so she was pretty OK with me doing my own thing so long as I didn't put it in any of my assignments or test papers.

[walkerwally1]

Most dieticians follow the dogma that they are taught and don't ever pay attention to the fact that there are other methods that may work better or they are bound by policy to stick to the idea that what works for one works for all. 
One that has bucked the trend is  Franziska Spritzler, the low carb dietician:
https://lowcarbdietitian.com/
and it just shows that there are some professionals that do have an open mind.

[bigskygal]

Thanks for reminding me of her. So many resources we used in the beginning all contributed to our wellbeing now. So many incorporated into our own unique methods, I admit I have most likely forgotten more of them than I remember by their names!

[skb]

Maybe a decade ago I had compiled a list of doctors who were in favour of LCHF. I think it was around 300 at that time. Should be much higher now. If I can find that list, maybe I'll share it.

[walkerwally1]

Yeah I also have a list of a lot of people I have learned from and some were doctors, some dieticians and some researchers.  We started this quite a while ago so the three of us have been at this for a long time and have adopted a routine to deal with the diabetes we have.  Having someone new to diabetes is refreshing to me in that it gives me a reason to re-visit those again and reenforce what I am doing.  I hope that Em_P sticks around and keeps asking any questions that come up.