Work frustrations

(AnnaLeeThal) #1

I’m standing outside a patient room overhearing our dietician counsel one of our post open heart patients about a low fat low cholesterol “heart healthy” diet. She’s talking all about low fat cheese and other terrible things. It just makes me cringe, especially when most of our patients are diabetic.

I asked one of my surgeons yesterday when we were going to eliminate the low cholesterol part of the “heart healthy” diet orders since it is not backed by evidence and is not recommended by US dietary guidelines anymore. He is one that doesn’t want his patients over 70 on statins, but he was getting in trouble for not having his patients on statins.

Our system is broken and we are doing our cardiac and diabetic patients a disservice.

(Richard Morris) #2

Hear Hear

We’re committed to doing something about this by starting a grassroots revolution of just regular people armed with the science, supporting their doctors using a dietary intervention to relieve them of the disease of civilization.

Sorry we can’t change dietitians directly, but we can change their market so they have to adapt or become extinct.

(G. Andrew Duthie) #3

Topic - Low-fat cheese is not cheese.

Discuss.

(AnnaLeeThal) #4

Truth. Let’s please all eat real food.

(Alix Hayden) #5

On Dec 16, 200 Canadian doctors and allied health professionals signed a letter sent to Health Canada, the federal health minister, all provincial health ministers, and the CBC. It provided recommendations for the current review of the Canadian dietary guidelines, including low carb/health fats, reducing sugar, etc. They are trying to lead the way. http://www.foodmed.net/2016/canada.pdf

(AnnaLeeThal) #6

I really hope I see the change that needs to happen within my lifetime. Until then I will be the change that people need to see.

(Jake P) #7

I have only been doing keto for a month, my doctor ran labs for me and between October and December my cholesterol has improved my triglycerides are lower and my HDL is higher. My A1C dropped from 8.7 to 7.8. I can’t wait to see these numbers three months from now.

#8

Nice work TacoRobot!!

(AnnaLeeThal) #9

@TacoRobot you are literally saving your own life right now. Congrats!

(Meeping up the Science!) #10

@AnnaLeeMI When I did my bariatric nutrition consult I was diabetic and eating 30g/carbs a day at the time. The diabetic nurse who reviewed it told me to eat 75g a meal because it would help my diabetes. The bariatric surgeon was like, no.

(AnnaLeeThal) #11

Well goodness, that dietician wanted to keep you diabetic now, didn’t she!

(nicolerecine) #12

What about the fact that we pump type two diabetics with insulin when they come into the hospital after feeding them “diabetic” meal trays…which are full of carbs and fat free substitutes. Makes no sense.

This is why I can’t work as a nurse on the floors anymore. I do educate other nurses when the want to hang IV dextrose just because a diabetic patient has a blood sugar that is normal other than sky high. When dm2 patients have to fast for surgery they come in with normal blood sugars (surprise). My coworkers always want to hang IV dextrose for blood sugar in the 70-100 range because they’re afraid of it dropping during the procedure. It never does. Usually it’s a bit higher post op with just normal saline.

#13

Does benchmarking data exist between hospitals in regards to diet and cardiac health? In business, companies benchmark to see who performs better in certain areas (i.e. Order to cash cycle time, profitability rates, manufacturing defect rates, etc). Any data out there comparing hospitals?

(Karen Fricke) #14

Hospitals use benchmarking for lots of things, but the problem is they’re confined by “standards of care”. If the standard says diabetics get 3 carb servings per meal, that’s what they get. Doctors who want to do something different are taking a big risk. Benchmarking doesn’t mean much if everyone has to do the same thing.

(Stephanie Hanson) #15

I’m an RN and I use their food trays and carb counts to teach. As in, this tray has 60-75g of carbs. I’ll test your blood sugar again later, if it’s still high, we know this is more than your diabetes state can handle. Then I encourage them to try fewer carbs. Usually the BG drops as they scale back. It takes several meals to get the idea rolling around in their heads. I’ve tried talking to the dieticians. I’ve had no luck yet.

(AnnaLeeThal) #16

One of the big things is JACHO core measures for hospital certification. But for post cardiac surgery it mostly pertains to medications: statin, beta blocker, aspirin, etc… we get fined or not reimbursed for certain things if patients are not on these meds when sent home after surgery.

I am unfamiliar with any core measures pertaining to diabetes, im sure there are

(Glenn Graham) #17

@AnnaLeeMI

This is one of the most frustrating parts of this Life Style. My Doctor is recommending I stop the being fat adapted. It is not because of any noticeable harm but because he has read so many things bad about past low-carb diets. He would also like me to go on statins because they will lower my cholesterol. Many people would say educate or switch your Doctor, but that is so hard to do. I work as a contractor and getting time off is tough. So, for now, I am ignoring his advice and hoping that I can find or educate him later.

Please keep Strong and Keto On.
thanks
Glenn

(G. Andrew Duthie) #18

There are many things in life that are hard to do, but we still must do them.

Fighting an uphill battle with your doc is fine if he’s given any indication of openness to learning more about LC/Keto. If that’s the case, then keep an eye on the Show Me the Science category and bring him evidence. Or invite him to join the forum!

But if your doc has shown no openness to learning more about keto, I personally would start looking for a new doc. Especially given that he wants you on statins. Everything I’ve read about statins says that they are bad news. And I’m skeptical in general of physicians who are quick to reach for the prescription pad.

(AnnaLeeThal) #19

How long have you been doing Keto? I am a firm believer in not treating Cholesterol numbers with statins while your body composition is still changing. Once things have plateaued for 3 months or so the Cholesterol can be re-evaluated.

(G. Andrew Duthie) #20

Lowering total cholesterol is not demonstrably tied to good health.

Total cholesterol isn’t the issue. Triglycerides and LDL particle size is. If HDL is high and trigs low, generally LDL particle size should be large and fluffy. Statins, to my knowledge, have no effect on LDL particle size at all.

Given all that, I would never take statins, particularly given their side effects: