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Dealing With Doctors

17K views 61 replies 22 participants last post by  TheNamelessPoet 
#1 ·
I went through a stage where I stopped seeing the doctors all together for about a year. I had reached a point of total frustration. It got to that point for 2 reasons. (1) I truly believed I could reverse my diabetes as long as I followed a LCHF lifestyle and got plenty of exercise. Although many people CAN make that work, I have complicating issues, so it did not work for me. (2) My doctor was beyond rude and condescending. One time he screamed at me so loud that the nurse came in to check on everything. Granted, I do not make a great patient because I question everything but screaming in my face is just never going to be okay with me.

Following that long break from seeing doctors, I finally went back and was blessed to get a new doctor in the clinic. He was actually pretty amazing in that he LISTENED to me and allowed me to feel in control of how I choose to treat my diabetes. I felt like I finally had him "trained" not to fuss at me about things like LCHF.

Now, to make a long story even longer... :vs_coffee:

I have called several time over the last week to make an appointment with him and kept being told he didn't have any openings coming up. Finally this morning I called again and was told that he was no longer with the clinic. No explanation was offered, even when I asked. This means I have to go back to the other doctor in the practice, at least until I can find a new one because I don't have any refills and will need medicine soon.

So, here comes my question....

How to you deal with doctors who are hung up on ONLY following ADA recommendations?
 
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#42 ·
I had a patient tonight who in in the hospital where I work. She is overweight. BG's are in the 200-300 range mostly. He endo wants her to eat 45 grams of carb / meal. he tells her a set dose to take / meal instead of giving her a way to calculate how much she needs. I felt sorry for her. Her endo crinologist is in the group who took care of my MIL years ago and I had thought that is who I would use for Ronnie if anything happens to his dear old endo. Guess I'll re-think that. I hate this : "older people don't need to be on a controlled carb diet. They aren't going to die of long term effects of diabetes." My husband and I are in our 60's and if we eat and exercise right we could live on a while. Besides, Ronnie can't think right if his BG is high or low.
I am interested to the over the counter insulin at walmart. Will it work in an insulin pump???
When Ronnie got sick, I quit listening to idiocy spouted by my physicians.
 
#43 ·
This is what terrifies me. Two weeks ago, I wouldn't have worried about talking to my Dr about this, but since she missed my BG level at my 2015 physical, she is in knee jerk mode trying to overcorrect. I am thinking glaze over the "HF" part of the LCHF, and let it go at that, she only wants me testing twice a day, but I will plan on discussing "eat to the meter" with her as it logically makes sense to me. I don't think she will give me a fit about that. (I hope not)
 
#44 ·
Can fully understand not asking for trouble by touting HF :) Perhaps one day down the road.

My endo looked at my logs and said, 'you know, you don't need to test so much.' I answered: I'm doing it to gather information; otherwise I can't know what foods are doing, how to close in on a better insulin:carb ratio, etc. She said nothing.

The only argument I could anticipate you getting about eat-to-your-meter is the line that you need carbs, and if you are eating x carbs, and your bg goes up too much, then you need to cover those carbs with oral meds or insulin.

My endo was pushing bolus insulin on me on the basis that I could then eat more carbs. She has given up and accepts the way I do things, so ... I like her now! :D

Here's what I've learned about (most) docs: they like to see the results. They become miraculously less invested in how we got there as long as we did. The grief we got at first is replaced by congratulations, and next time there's a difference of opinion, they become a bit less argumentative, more flexible.
 
#45 ·
The only argument I could anticipate you getting about eat-to-your-meter is the line that you need carbs, and if you are eating x carbs, and your bg goes up too much, then you need to cover those carbs with oral meds or insulin.

My endo was pushing bolus insulin on me on the basis that I could then eat more carbs.
I think this statement hits the nail on the head. MOST people want to compensate so they can continue their behavior, NOT adapt their behavior to cope with the issue (this can apply in many aspects of life not just diabetes) Dr.s are used to working to allow their patients fit the "norm" allow them to still eat stuff that will negatively affect their BG levels, and then "control" it by medication. I would rather adapt my behavior to control the problem than use medication to mask it.
 
#46 ·
The more I read about the awful experiences people have with their doctors, the more grateful I am for mine. He was the one who encouraged me to go very low carb (as low as you can get! he said), encouraged me to join MyFitnessPal to track all my foods, as well as test frequently (how are you going to know what's going on otherwise? he asked), and while he is less enthusiastic about the high fat side of things, he doesn't nag.

He's got his flaws and we butt heads every now and then, but thankfully he has never been condescending or demeaning. I'm SO sorry there are many patients who are treated this way; those doctors are absolutely not worthy of any kind of respect.
 
#48 ·
Fangirl, I looked for a lowcarb endo in north Alabama and they do not exist.
We love our endo, not a low carb LCHF follower, but as long as we manage Ronnie's diet so he stays out of the hospital and as long as his a1c is below 7 he pretty much lets us do as we please. He is a dear older fellow with Type 1 diabetes and no complications, His wife is an RN and diabetes educator and his daughter is type 1 diabetic and a diabetic educator. They have people who drive over 100 miles for a regular visit. We are blessed but I wonder where we will go when he retires. He no longer sees patients in a the hospital. Most of the hospitals around us have gone to using hospitalists to take care of the in patients.
 
#50 ·
My favorite medical is one from Albert Schweitzer (see below) and one that we as patients desire from our doctors.

Within every patient there resides a doctor, and we as physicians are at our best when we put our patients in touch with the doctor inside themselves." Albert Schweitzer, M.D. -- Swiss physician, theologian and humanitarian; winner of the 1952 Nobel Peace Prize. (1875-1965.)
 
#52 · (Edited)
How to you deal with doctors who are hung up on ONLY following ADA recommendations?
It helps to ask the office staff to funnel you toward a provider who doesn't preach about the ADA recommendations. Ask for one of the nurses if you need to. They usually know their doctors pretty well. Mostly though, if you ask for a doctor who has added training in diabetes, that is usually your best bet because they tend to already have a healthy distrust for the ADA recommendations. :)

Start by telling the doc that you follow a diet with a 90 gram daily cap on carbs (or 50, or 120 or whatever range you follow). I can almost guarantee you that they are not going to start preaching at you. For one thing, it tells the doc that you know about carbs, know how to count them, and you are AWARE of what you are eating. If they do preach, simply say, "I think we are not going to be a good fit. I came here for medical advice, not menu advice."

Now, many docs still are concerned about the high fat in low carb diets. I choose to eat little red meat, but have full fat dairy and peanut butter. Otherwise, all my protein sources are lean and the result is actually nearly normal cholesterol levels in a family where high cholesterol is the norm. You'll have to decide if you even want to bring that issue up.

The ADA recommendations aren't totally crap. They recommend what, about 150 grams of carb a day? The average American diet is from 250-350 grams, so any cut is good. The thing though, is that you are doing something that is helping you and you shouldn't have to defend something that has a lot of scientific proof. If it helps any, you should know that Atkins developed the low carb diet for his patients who weren't responding well to any medications and certainly weren't being helped by the then ADA diet.
 
#53 ·
I was part of the teaching staff at USC LA county Hospital. It used to fry me big time whenever a student would say those words to a patient. "Who is the doctor here?" I consider this the ultimate disrespectful stupid response.
Sadly many insensitive jerks love to pull this ****. In my experience anyone who line does not deserve respect. It is my hope that a good doctor would explain his position and not act like he is right "because I said so". Please let me apologize to you for him. If he said that while I was in the room, he would regret it. cocky *******.
 
#54 ·
we had a six month review with the diabetes clinic, when the dietician asked about my carb consumption i told her about keeping it under 30 a day not 45 to 60 a meal. then i pulled out my laptop and showed her my spreadsheet showing meals, exercise, sugars and fasting... even my eliminations. she swallowed like a surprised, trapped groundhog.
then, the nurse asked me into her office for a private interview where she asked questions and complimented me on my success appearing to me to be genuinely happy with the results.
 
#56 ·
My doctor did not like me eating less than 100g of carbs per day, but since my weight was dropping, my A1c was down, as was my blood pressure. He really did not harp on it.

He said I needed to be very careful that I don't have a dangerous low BS! I questioned him saying if I am taking metformin and Lantus....how could I have a low....he could not answer that and just said be careful.

Now that I am into my second year of LCHF....he calls me his "Poster Child" for other retired guys....he now is asking questions and really seems to be impressed with the LCHF model....

If he had not come around, I would have changed doctors....!
 
#57 ·
I have to say this is frustrating. I went to my endo once (I go again next week)

I had lost 35 pounds at the time since I saw my regular doctor and my BG went from 396 to 86 ( 3 months) doing a ketogenic lifestyle and the doctor still said the ADA does not recommend that and that I should be eating the 'good carbs'. whole grains, sweet potato, etc.

you should have seen her face when I told her I use coconut oil. :vs_shocked:

so my wife sees what the doctor recommended and says I should listen to the doctor because she knows best...:vs_blush:

ummm no. I got this.
 
#60 ·
So many Endo's lean heavily on their med school books and follow a hard set of rules for treatment that they often overlook the patients keen awareness of their bodies and what works for them. It seems Dr's fear low blood sugars more than the patient and often recommend patients to keep their glucose between 140 and 175
(a1c of 6.5 to 7.5). I also see many Dr's relying on ADA and diets that contain far too many daily carbs.
 
#58 · (Edited)
Tell your doc that the ADA does support low-carb diets and has for almost 10 years.

UPDATE: Here's the wording that has worked well for me "I've worked with a dietician and have found a balanced diet that works well to stabilize my blood sugar." Then don't go into details. :D Most won't care much more beyond that you worked with a dietician. If you read what I said carefully, it doesn't say anything about carbs, if the dietician approved of the diet, what balanced actually means, etc.
 
#61 ·
I have very rarely needed to see a doctor...until now. I avoided them unless I Absolutely had to go. For me to sit in a doctors surgery for an hour or so after my appt time was a huge complete inconvenience to me.. Thinking of all the things I could get done..in that time! Unless it was for my kids. Reluctantly..because I had to, I seen a doctor here in Oman, Being out of my own country that's a little scary, but, I have to say, she was just beautiful. I thought, I'm not mucking around here, I'm going to tell her what works for me.. Tell her what I need help with.. So I've gone in there with prolly an attitude, armed with what I've learned so far from you guys, BUT, she was actually interested in how I've been handling things for myself so far. She took blood test and explained to me after listening to my concerns, what these test would tell us and make a plan from there. She actually asked me how I felt after being so LCHF, she did say it's not been long time researched but didn't discount it. I told her I feel the best I ever have. Search for these doctors. They are there for sure. My doc at home in Oz couldn't even answer me if the natural remedies I was taking would help my diabetes. Age old natural herbs used for centuries, she did not know about. Cmon! That was in my early days before I Found you guys and learned to test test test. I've stopped taking some of the natural remedies but still take some and have discovered more I can take from the test method. I'm a true believer that God has put on our planet everything we need from plants etc to help with any ailment we have. Admittedly modern medicine has its place. I just try to find the balance that works for me.
 
#62 ·
It looks like I am a little late to the party here, but figured id put my 2 cents in.

I had a similar fight with the insurance company about basically the same things. They were refusing my Dr recommended pump (type 1) and said my bs was too high so I needed to see a nutritionist. They told me I needed to eat more carbs and argued with me when I said no, I need less because my sugar is going to high. They fought with me for nearly a year as my a1c sat around 7.2 or so. They made me go to my Dr every 3 weeks (my work was NOT amused) and my Dr recommended nearly all of their suggestions.

Well once I got my pump I was at 5.6, 5.7, and last time 5.8. If its possible, ignore the Dr and do what YOU think is best. When your Dr sees your improvement tell them what they want to hear, or do what I did, and say "Hey its working, does it matter how I got here if my physical's all show I am healthy?"

Thankfully I have a really good dr, that once she saw my results (which I will be honest, are 75% from the pump) she literally told me; "Well, I don't understand it, but whatever you are doing, keep it up. I don't understand how you are getting down to 5.6 and I don't really care. As long as your Physical comes back that everything is fine do whatever you find works best." That was after the 1st visit of 5.6. After my last visit at 5.8 she said jokingly I should come in and teach her other new pump patients what I do lol.

I couldn't imagine a Dr. like you have yelling at me. I hope you can find another one because like another poster said, you shouldn't have to pay to have someone yell at you, ESPECIALLY when you are trying to get healthier!
 
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