Sounds like a hostage situation, you need to find a new doc that isn’t a vegan! No vegan will ever except what we do from pretty much every angle.
Makes no difference whether she agrees to disagree or not, it’s NOT her call!
I know first hand how hard it can be to find a good functional med doctor, but you gotta keep searching. We can’t constantly jump through insane hoops for uninformed doctors.
Thanks for the comments, guys. The results of the echocardiogram were fine. But now she wants me to go for a stress test! I told her I am much too busy next week to go for another test and the following week I am scheduled to fly to the opposite coast to visit my daughter. I pushed her to tell me exactly WHAT about the EKG she didn’t like, and she replied that I’m fine to wait a few weeks on the stress test, I’m fine to fly, but that the EKG was slightly different than last year and that concerns her.
I see her again in two months and will bring the WHO charts with me. There are some things I really love about this doc and some I struggle with. She does feel very strongly about some things but she DOES listen to rebuttals, and then she seems to back off a little and compromise. And she really pushes me in some areas that I truly DO need pushing in in a way that almost always has me leaving her office feeling better about things.
Yes, I have considered looking for another doc, but then she does or says something that pulls me back in, and you all know how hard it is to keep trying new doctors, starting all over again with all your health conditions and history, etc. etc. More times than not I am pleased with our visits so I’m not ready to “fire her” just yet.
I have lots of health issues and I like her for most of them. I have to go for another bone density scan in August and she’ll probably tell me to start osteo drugs, and I will refuse (again). And I will continue to refuse statins if she ever brings it up again. Maybe I will start eating a little less red meat and eat more fatty pork, which works better for my colitis anyway. And maybe I’m being overly optimistic, but it almost seems like the more I stand up to her and the more informed I sound, the more she backs off and starts to respect my stance. Her and I still have a pretty new relationship, so we’re still doing the “getting to know you” dance. Going to give it a little more time, but definitely with all the support and information that you guys so kindly provide me with.
Sue
Ok let’s analyze this situation … I am doctor myself. EKG different than last time… u need more details… ask… is she seeing a first degree block maybe… or some st -t wave changes… can u ask for a picture or can u post it here… Many PCPs don’t even know how to read those correctly . If she feels so inclined on the fact that something is wrong u should see a cardiologist instead and he can tell u if there is something abnormal or not. Your numbers are fine. and I would worry . Post the EKG here
Sorry, do you think she should worry or not worry?
As a Dr, what’s your position on the risks of high LDL? Do you prescribe statins if LDL is high? Do you do it because you have to, or do you think people should take statins if their LDL is high?
Hi Luis - thanks for the feedback, but I’m not sure if you meant I SHOULD worry or I shouldn’t worry.
When the doc did the EKG in her office and said there was a change from the previous year and she scheduled me for an echocardiogram. I went, and the results from that came back normal, but my doc said she still wanted me to go for a stress test.
I wrote to her (through the patient portal) and told her that there was no way I could go that week and that the following week I was going to be on a cross-country trip for a week, unless she told me there was a medical reason I shouldn’t fly. I also asked her if she could give me a little more detail about what she didn’t like about my EKG. Below was the reply from her assistant:
"Hello Susan.
Dr.Feld says you are okay to fly and exercise. There was only minimal changes to ekg. Call us when ready to schedule stress test. Echo is normal.
Have a nice trip
Yany Hubert, MA
From that, I’m guessing I don’t need to worry, and when I see her again in two months for a different follow-up, I’ll try to get more information. I feel a stress test is premature and unnecessary at this time but then again I just hate that I already have so many medical appointments and tests all the time which is the main reason I would like to eliminate any testing that isn’t really called for. But, better safe than sorry?
Sue
I assume being able to bill the insurance company for unnecessary yet common-at-our-age tests is how doctors keep the lights on?
Also many docs are covering their asses so they don’t get sued in our very litigious society.
I don’t jump to prescribe statins… also keep in mind that 90% of patients are non compliant with diet and many do keto the wrong way therefore exposing them to a stroke or cad… so if her LDL was high and she strokes and they look at the records and I never put her on statins I lose my license
Yes that. I used to work as a research coordinator in a cardiovascular research clinic. Unless a physician has special training and reads these all the time, they don’t generally know how to read EKGs. There are usually automated diagnosis codes which print out on the report. My docs almost always indicated that these findings had no clinical significance. In those cases, there was no need for further follow-up required for the patient.
Yep, this is my understanding of the status quo. And I am sad to hear you confirm it. So, bottom line, if someone’s LDL is high you are highly motivated by the system to prescribe statins. You are almost forced to.
That is why when my dr told me to take them and I refused, saying I was making an informed decision, he wrote that in his notes (to cover himself).
I don’t blame you (or my Dr, for that matter). You are doing what you are being forced to do. But I still don’t think that makes it right. IMO, statins will go down in medical history as the largest con ever. It severely shakes my faith in the medical establishment.
Could you pls expand on this a little? I find this very interesting, and would love to hear some details…
HDL carries LDL to the liver to from the vessels… Many are stuffing themselves with fats and not getting enough greens… btw u are supposed to eat 5 to 7 cups of greens while on keto to prevent fatty liver since u are transporting so much fats there… then u have the ones that cheat and eat sugars here and there and drinking alcohol and going in and out of ketosis which causes a tremendous shock to the insulin spikes confusing the heck out of the pancreas… Many don’t drink enough water and many are eating salted kerry gold like nothing which causes sodium levels to increase therefore retaining water and causing the blood pressure to go up… the list goes on and on… Many mistakes are being Made since people don’t so their own research …majority don’t log what they eat … they just wing it… and u can’t… u need to make sure ur caloric intake is not going over on what u burn… maintaining high % of fat… moderate protein and low carbs… Many are eating too much protein which by the way turns into sugar when it’s more than what’s needed … etc etc
You are saying things I dont want to hear and that I have heard contradictions from other possibly unreliable sources so I want to take what you say with a huge grain of salt but you are keto and you are a doctor, so maybe, for the benefit of people who are trying to do keto right and who have done a lot of research but are getting contradictory info can you clarify the true facts as you understand them and the scientific or anecdotal sources of your claims?
. . . . which somewhat partly supports my thinking lately that perhaps I should “cool it” with this way of eating and maybe eat a slightly more diversified diet. I am very guilty of not tracking what I eat, and even though I DO read and research everything (sometimes to a fault) I often get confused by conflicting reports and opinions and don’t know what to believe. And yes, I do and always will allow myself the occasional sweet treat, and no, I don’t always balance my fat intake with the appropriate level of greens, so I wonder if I’m doing myself more harm than good.
This is NOT a way of eating to be done half-assed or haphazardly. If you’re going to do keto you really need to know all the fact and do it strictly and appropriately. Since I have other health issues (Graves Disease, no thyroid, colitis, reactive hypoglycemia) it gets even more complicated to do ketogenic eating properly. Is it possible? Yes. Is it easy and sustainable and convenient? No.
I am contemplating eating a low-carb lifestyle, trying to stay under 100 grams of carbs a day, and see how that works for my system. Granted, I probably won’t lose weight but my doctors tell me I don’t need to lose any. I fear that my fluctuations between being very strict and adherent to keto some weeks and then “falling off the wagon” at times, then getting back on, could be wreaking havoc with my body.
Sorry for the long dissertation, I’m basically just thinking out loud here. My primary goal in life is to feel the best I can, and I will do almost anything to get there, but I don’t think I’ve yet found the perfect plan.
Sue
I find these numbers next to worthless. Great to see high HDL and low trigs. But my trigs have varied wildly from test to test, while my diet/lifestyle haven’t. I reckon there’s so many variables that these numbers are nearly irrelevant.
Much more worrisome for me is my consistently “very high” LDL-P. Whilst my standard lipid panel looks ok (high LDL-C but nothing to really worry about), my LDL-P has consistently been off the charts and is getting worse. This is the only biomarker I’m worried about for me on this diet; everything else is fine.
As for the coffee – probably not. But the sweetener could well have affected your blood glucose. Forget about that test results and make sure to completely fast next time you get your BG done.
I am keto and a doctor. what specific claims do u need clarification with… follow Dr Berg on YouTube and see how many greens he says u are supposed to ingest daily… I follow Dr Berg since he is always on the right path
I say this with as mich respect as possible:
#1 Please know that I respect your credentials as a physician on keto
#2 I would like to see the science, please. “you are supposed to eat 5-7 cups of greens on keto” sounds to me a lot like “whole grains and fruits are essential for healthy diet” or “consuming saturated fats cause atherosclerosis”.
I don’t agree with everything Dr. Berg says, and he often does not cite any source for his declarations. If there is any substantive research that indicates a need for a high amount of veggies or greens, I haven’t seen it. There are people who have been eating a zero carb diet for decades who do well without any plants in their diet at all. I think each person needs to do a little self experimentation to find what works best for them.
Agree 100%, but the main challenge in try to do ones own research is all the incorrect information out there, often put out there by medical professionals who often preach what they’ve been taught without doing their own actual research. A few examples:
“Greens”, while perfectly fine to eat, are NOT required for a healthy diet. There are no essential carbohydrates. The nutrients we need, that are so often attributed to the reason we need greens, are available in animal products.
Going in and out of ketosis is natural and how the human species has survived for hundreds of thousands of years. The only difference now is most people spend little to no time in ketosis versus in generations past when people spent much more time in it.
Name any other non-domesticated (as in have had their diets influenced or controlled by humans) animal that counts calories. If we eat the way we’re meant our bodies were designed and/or have evolved to eat, caloric intake/output self-regulates. Focusing on calories (CICO) doesn’t work because what you’re taking in is an educated guess with a 20% margin of error (at best), and unless you live full time in a chamber that measures your output, you can’t possibly know what it is. On top of that, it’s a fluid number that is, for the most part, out of your control.
Substitute “always” with “generally”, and I’m with you. No one is right about everything all the time, and blind devotion to dogma while ignoring science is how we fell down the rabbit hole of the SAD to begin with.
I like a lot of what Dr Berg has to say, but he views things through a lens of a mostly vegetarian diet. He also has products to sell, so that will affect his recommendations.