Concerned call from PCP's nurse

(Chuck) #21

That conversation was awesome! It truly helps to be armed with facts. I find myself having a hard time articulating the science behind the KETO WOE when I am face to face with someone. That is why I usually tell them “I’ll send you a link to the 2KetoDudes Podcast or the Ketogenic Forums”.

#22

I’m with you… I’ve listened to all their podcasts and now am working my way through the obesity code podcasts. I needed to hear this over and over so it would sink in:)

(Linda) #23

I know I’m old, but I can remember when the doctors didn’t go to such extraordinary lengths to avoid interacting with us. I stopped going to one because his office only did robocalls and certified mail. He was the phantom that did my colonoscopy. I couldn’t even tell you what he looks like. As for the primary care doc, getting a weight, a BP reading and listening to me breathe and taking a temp and pulse and then spending the rest of my visit watching them type in the computer is not confidence inspiring. I could have a tumor hanging out of my navel and they’d never know it.

Thank goodness I have my own scale, BP cuff, BG monitor, and an excellent feedback system to let me know how I’m doing. I call it “How I’m Feeling.”

#24

This is flippin awesome!!!

(Anthony ) #25

Awesome. Did she pay you for your time?:sweat_smile:

#26

I have an advantage. I’m a physical therapist and I’ve been pitching this to patients for a few months now. You might say I’m practiced in the lingo:)

(Kee) #27

Wowed

(Sandra R. Case) #28

Excellent! I wish I was that quick on my feet. I wonder if you would’ve had a different reaction from the doctor.

#29

I’ll find out tomorrow when I see him:)

#30

Many medical assistants describe themselves as the doctor’s “nurse.” They say it’s because the patients are less confused by it, and many doctor’s go along with it. It’s rare for LPNs or RNs to work in a doctor’s office, although I worked for a group of retinal specialists as an RN, because I did all the IVs.

(Bacon is a many-splendoured thing) #31

In the doctors’ offices I’ve been going to over the past 20-odd years, there have always been a number of nurses. A friend of mine is a nurse-practitioner in an office with one doctor, my friend, and three other nurses, plus the receptionist and the secretary.

(Empress of the Unexpected) #32

I had no idea. How can one tell? I always assumed a doctor’s nurse was an RN.

(Milton Alvis, MD) #33

LDL particle concentration is the primary driver of atherosclerosis, as first published 1950: http://goo.gl/QMpZiI. LDL values are always expressed in nmol/L.
So pay attention to the units; crucial.

BUT LDL is NOT LDL-C, the 147 mg/dL which your mentioned.
The two similar sounding issues are VERY different; routinely in marked discordance, as I have seen for over 2 decades since NMR lipoproteins have been clinically available are low cost (and has ALWAYS been fully covered by Medicare though not so many private “money accumulator plans”).

LDL-C is a guessed at calculated number, not measured from your blood. Even when it is measured, it is not the correct issue but only the cholesterol in ALL LDL particles within a 10th of a liter of blood plasma, which the units refer to.

(Ryan Ashton) #34

Where did you get all this information?

My last checkup was a scare!! My LDLs were elevated.

Every week I check my blood glucose and I’m a bit worried because it’s often between 100 and about 106.

I thought I was doing something wrong with the keto diet.

Would love to know what you know.

#35

Listened to every episode of two keto dudes and now the obesity code podcast. Listen to the cholesterol episode and read the studies they mention.

#36

It doesn’t really matter. She was calling for the doctor not on her own behalf. Today will be the tough part

#37

Almost never. Just ask them if they’re an RN or LPN. They’ll usually tell you that they’re an MA(medical assistant).

#38

Read this from Dr Fung re high fasting glucose:
https://idmprogram.com/dawn-phenomenon-t2d-8/

#39

OK, yesterday was the big day when I got to see my primary care physician. I knew what my lab numbers were and was able to prepare. I listened again to the 2ketodudes cholesterol show and printed off some of the studies they cited in the show notes.

My doctor walked in, sat down and asked: “So you lost 40 LBS”?
Then he kept staring at his computer and back at me (doing the old David Letterman pen twirl:)
Finally he spoke: “so I’m looking at your lab results, you were fasting when you took these right?”
Yes…
“Your LDL’s were high and so was your total cholesterol. But I’m looking at your HDL’s. This is unbelievable how much you’ve raised those. And your triglycerides were cut in half…”
Pause while he stairs at me and back at the computer.
Me: "do you mind if I explain a bit what’s going on with my LDL’s?
PCP: “Absolutely, chime in here! PLEASE!”
At this point I went on to tell him how the LDL’s are high now (and why) and how they’ll come down in a year or two. I briefly explained sugars (minding not to offend his expertise) and how they are the culprit and not fat. I explained how there’s no science behind LDL’s being linked to CAD.
At that he said “well I’d have to take exception there but I’ll look into it”.
That was when I whipped out the study that showed lower levels of LDL’s in patients hospitalized with CAD. He literally read it for five minutes right in front of me:). More discussions led to me showing him the study that found statin’s increase your risk of diabetes by 46 percent (these are all linked in the show notes). We looked at a few more studies and we talked about diabetics going into remission on this. He stared at me for what seemed like forever and asked: “would it be ok if I kept these studies? I’d like to look at them again tonight”.
He then told me he couldn’t wait to see my blood work in one year! It’s amazing how many people this one doctor will be able to help if he sees the light!

One thing he did say was that he wondered how much of an effect the weight loss had on improving diabetes rather than the keto diet. I mentioned the low retention rate on the standard low fat diet and how diabetic patients usually can’t make that work for extended periods. I didn’t get a chance to talk about the sugar build up in the liver (Dr Fung) or how some skinny people get diabetes and some fat people don’t… I also didn’t get a chance to recommend the podcasts to him. However my wife (who also lost 40 pounds and cured her hypertension) will be seeing him soon so she’ll put the plug in for the show. Also interestingly for her, she was put on Lisinopril for high blood pressure BEFORE she had gained all that weight (so her reversing of HTN couldn’t have been due to the weight loss-as she was a TOFI). Also he accepted my friend request on FB where I"ve plugged the show a few times as well (and will continue to do so). I can’t wait till next year!
PS, shout out to @carl for reading my “concerned nurse” encounter last week on the podcast… I’m anonymously famous:)

(Eric - The patient needs to be patient!) #40

This is great news. Sounds like you were very prepared. What are the urls of the reports you presented to your Dr? Thanks for the details above.