Wednesday, January 20, 2010

Go see your doctor, often

As I blog about health issues, and talk with people about them, I often notice that there is a growing contempt for the medical profession.

This comes in part from the fact that many MDs are still providing advice based on the mainstream assumption that saturated fat is the enemy. Much recent (and even some old) research suggests that among the main real enemies of good health are: chronic stress, refined carbs, refined sugars, industrial trans-fats, and an omega-6/omega-3 imbalance caused by consumption of industrial vegetable oils rich in omega-6 fats.

Because of this disconnect, some people stop seeing their doctors regularly; others avoid doctors completely. Many rely exclusively on Internet advice, from health-related blogs (like this) and other sources. In my opinion, this is a BIG mistake.

A good MD has something that no blogger who is not an MD (like me) can have. He or she has direct access to a much larger group of people, and to confidential information that can clarify things that would look mysterious to non-MDs. They cannot share that information with others, but they know.

For example, often I hear from people that they did this and that, in terms of diet a lifestyle, and that their lab tests were such and such. Later I find out that what they told me was partially, or completely, wrong. That is, they distorted the truth, maybe subconsciously.

I have never met an MD who completely ignored hard facts, such as results of lab tests and common health-related measurements. I have never met an MD who tried to force me to do anything either; although I have to admit that some tend to be a bit pushy.

I see a doctor who does not agree with me; e.g., he wanted me to take statins. No problem; that is the way I like it. If my doctor will agree 100% with all I say, do I need to see that doctor?

My doctor does not question lab results though, and maybe I am changing a bit the way he thinks. He wanted me to take statins, but once I told him that I wanted to try a few other things first, he said: no problem. When the results came, he had that look on this face - maybe u wuz royt eh!?

Many, many patients are under the mistaken assumption that they need to please their doctors. A subconscious assumption for most, no doubt. I guess this is part of human nature, but I don’t think it is helpful to doctors or patients.

Patients actually need to work together with their doctors, see them often, do their own research, ask questions, and do those things that lead to health improvements – ideally measurable ones.


ET said...

My primary care doctor sounds like yours. However, after my older brother had his second heart attack, I went to a cardiologist to get evaluated, trying to be proactive. An EBCT showed minor calcification, which was not surprising.

He put me on a statin, on top of the niacin I had been taking for years. Several months later, I had to discontinue both due to elevated liver enzymes. I paid out of pocket to have an NMR lipoprotein analysis performed, and I had primarily small, dense LDL particles. After a month, I saw my primary care and she asked me which medication I wanted to go back on, and I said niacin. She was OK with that.

Two months later I saw my cardiologist for a follow-up and he was adamant that I go back on a statin, since my LDL was elevated at 80! I pointed out to him that there's no studies showing the benefit of lowering LDL and I reminded him that ezetimibe was a total bust, He admitted that any benefit of statins may come from other effects. I also pointed out that I had raised my HDL from 42 to 62 on my own. He didn't know what to do with this information.

I'll have a second EBCT performed this year. If my calcium score has not increased or has gone down, he's fired. My most recent cholesterol test showed an HDL of 70, and when I told me doctor how I did it, she didn't even blink.

22 years ago, as a pharmacist, most of my clients simply stopped taking medication if they suffered any adverse reactions. They didn't tell the doctor since they didn't want to disappoint them. My primary care realizes our relationship is a partnership, and that the patient is free to make their own choices.

Ned Kock said...
This comment has been removed by the author.
Ned Kock said...

Thanks for sharing your experience ET. A belated thank you, I admit. The blog has been so busy lately that I ended up neglecting some comments in response to older posts.