Distraught After Talking with Doctor.

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Distraught After Talking with Doctor.

Postby mellowmom » June 30th, 2006, 9:05 am

Poopy old doctor. (Actually, she's a young doctor, but still....)

I had to go in to discuss my lab results, this time with another associate of my regular doc. She liked the fact that I had lost so much weight, but not as quickly as I had, nor did she like the calorie intake. She said I need 1500 calories/day for a healthy loss, but I eventually got her to lower it down to 1200 minimum. Plus she felt that while 160 cholesterol was "ok", she wanted to see it lower because I'm diabetic and wants me to start taking some kind of statin, i.e. Crestor. Plus my HGa1c of 6.5 was again "ok" but she does want me to take oral meds to see if I can get it down lower! The only small adjustment she did give me in my favor was that I could cut my BP medication in half. She insists, again, that diabetics need to take lisinopril to protect their kidneys...even if their blood pressure is fine. My BP yesterday was 116/68.

I'm totally bummed over all this. Here I went in all happy about my labs, and she pretty well shot me down, or at least pulled me back down to earth. I told her that I would consider what she told me, but that I wanted to discuss with my regular doctor when he gets back from vacation in early August. She did also suggest I start taking a baby aspirin daily, which I really didn't have a problem with.

So in a nutshell, according to this doctor, and as a result of my lab results I need to:

1) Increase my caloric intake to 1200 calories. (What's that going to do to my weight loss? Am I going to start gaining until my body adjusts to the higher caloric intake? I can't find my MF diabetic manual, so I'm not sure how to go about this. Is there a copy online I can check?)

2) Go on Crestor. (I'm not going to consider this, until I talk with my regular doctor.)

3) Go on diabetic meds. (Ditto as above)

4) Take a baby aspirin daily. (No problem with this)

I feel like a little kid that handed mom a bunch of flowers and then got scolded for digging up the garden. I think I'll just curl up in the fetal position, pull the covers over my head and suck my thumb.
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Postby Prancer » June 30th, 2006, 9:34 am

I agree your doctor is poopy. I hope mine doesnt tell me the same when I go back! I cant imagine why they would want you on meds now after you have done such a great job getting your weight down without having them. Espeically the pill for your diabetes. What is the baby asprin for? I take the non generic form of lisinpril (prinivil) for my blood pressure. I hope to get rid of it one day.


Do you use MyMedifast.com? Joan posted about it and I started using it. It is a good way to monitor your calories and keep on target. It shows the break up of carbs vs. protein vs. fat which is cool so you can make sure you are getting the right kinds of foods. It might help you to up your calories but still lose weight. In addition to being fun to use!
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Postby Sarya » June 30th, 2006, 10:19 am

Carmel, *hugs* Don't let that doctor get you down. Am I right in assuming she's only seen you maybe once? I would definitely wait to talk to your regular doc and maybe even seek another opinion to be sure. It is important to remember that doctors are people too and they come with their own set of predjudices and opinions. There are many right answers to any question and hers might not be the only one.

For instance, my doctor believes that some people are just meant to be overweight and she is unwilling to prescribe weight-loss medications. However, she does believe that medically supervised diets are a healthy and effective way to lose weight. One of my former doctors felt everyone was naturally supposed to be thin and that we are overweight due to laziness and poor eating habits. He was more than happy to prescribe weight loss medications that sped up your metabolism and curbed hunger because he felt it would make me more active and I would naturally just lose the weight then. But diet? He didn't think people should diet.

Medicine is a science with many unknowns. If you are uncomfortable with something a doctor suggests you do, then by all means I believe you should research alternatives and talk to other specialists.

Twice I have had doctors prescribe something to me I couldn't have and argue with me when I told them I couldn't. To the point where I had to force them to get the physician's reference book out and look up the meds.

They try to give us the care they think we need, but that doesn't mean it's our only choice.
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Postby mellowmom » June 30th, 2006, 10:39 am

Thanks all for your support. I'm going to wait on doing any of these changes until my regular doc comes back in August. Except for the baby aspirin, which is supposed to be a good "preventitive" medication for your heart.

Looking at the Diabetic protocol (Thanks Vicki for the link), at 1200 calories I would be adding more protein, some fruit, crackers, even ...dare I say it...BREAD to my plan!

To tell you the truth I see that plan as a slippery slope for me. I don't want to have to count how many grapes I can have (17) and have a loaf of bread in the house, but only have 1 slice per day, or 6 saltines, or 1/2 banana! I really don't think I'm strong enough to handle it. That's what I like about this plan right now, the way I had been following it. It's a no brainer, easy peasy way of losing weight.

Aaargh...Are there any diabetics out there who have gone to the higher calorie count and continued losing as consistently as on the basic 5 and 1 plan??? Anyone....???
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Postby Sarya » June 30th, 2006, 11:20 am

Mellowmom, If you find you have to add more calories, maybe you can work out something with your doctor to add another supplement or two or a second lean and green instead of the "danger" items.
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Postby sidrah » June 30th, 2006, 3:28 pm

I was thinking the same thing...maybe another salad and osme proteien during the day would make her happy. You might end up eliminating snacks if you do that. BUt honestly I can't remember if you are doing a L&G so if this makes no sense, ignore me.

I think maybe more supplements might be fine as they up your calories, but also keep you on track
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Postby JKSRN » July 2nd, 2006, 8:21 pm

Hi Carmel, my only advice would be to wait for your regular MD to return and you can discuss with him what the covering doctor suggested to you. Many times, the newer and younger doctors are gung-ho, and have a tendency to 'over-treat' a patient, rather than taking a conservative approach and a wait and see attitude, especially since you mention that all your labs and your blood pressure are normal. My philosophy is: if it ain't broke, don't fix it. In other words, don't mess with what is working for the patient. Your own physician knows you best--listen to what he suggests.
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Postby Aerie » July 3rd, 2006, 3:27 am

I may be a doggie doctor but I'm a doctor none-the-less. GET A SECOND OPINION, presumably from your regular doc. Me and my associates frequetly diagree about how to handle patients and two brains/4 eyes are better than just one set. When you see your doc discuss the associates recommendations, in a non critical way, and then listen to what your doc says.
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Postby Mike » July 5th, 2006, 10:28 pm

Although I had gastric bypass in Nov 2003 and was taken off all meds, I did have diabetes and high blood pressure. I remember dealing with all of those things. Since I gained weight back my Dr. put me on prinzide (lisinopril and water pill in one) because BP got elevated, and a statin (lovistatin) to lower my hdl (eventhough my total cholesterol was great).
I see my Dr. tomorrow, and I hope that he will either lower these meds, or take them away all together. I hope that the MF has taken me back to where I was in 2004.
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Postby mellowmom » July 5th, 2006, 10:50 pm

Good luck, Mike.

I hope your doctor does right by you and is able to take you off the meds. I know it'll give me some hope when I re-visit my doctor in August.
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Postby Serendipity » July 6th, 2006, 4:38 am

Carmel,

If it was me and my doctor was talking like that, I would insist that he/she read the study results put out by Johns Hopkins. I wouldn't let them pooh pooh that. There is hard evidence that Medifast is a great way to go for diabetics.

Don't be discouraged. Even if you need to add some calories to please your doctor, you will still lose weight.
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Medifast Diabetes Study

Postby Unca_Tim » July 6th, 2006, 8:04 am

Medifast, Inc. is pleased to announce the preliminary 34-week results from its one year and 34-week diabetes study conducted by the Johns Hopkins Bloomberg School of Health.

Preliminary results of the study show that those study volunteers on the Medifast Diet for Diabetics lost twice as much weight as compared to those following basic nutrition recommendations from the American Diabetes Association (ADA).

Study results show that those on the Medifast Diet for Diabetics program lost an average of 16 pounds versus the ADA diet group that lost an average of 8 pounds. Additionally, two-thirds of those on the Medifast program lost at least 5% of their weight, which is a standard measure of the Federal Drug Administration's (FDA) threshold to indicate clinically significant weight loss, versus one-quarter of those on the ADA diet.

Compliance data indicates that almost twice as many people on the Medifast program were able to complete the weight loss portion of the study.

"These results suggest that the Medifast diet was easier to adhere to than the comparison diet," says Dr. Larry Cheskin, the principal investigator and Hopkins study examiner. "These results may be important for people who are overweight and have Type II Diabetes. We're telling people they need to lose weight and manage their diet or risk serious health consequences, so it is useful to study what weight loss method is most effective."

Medifast asked Dr. Cheskin to conduct a study after receiving numerous reports from patients that Medifast products helped control their diabetes symptoms.

"I have been a diabetic for about five or six years. As of today I am completely off all my sugar and cholesterol medications and my blood pressure is normal. My total weight loss on this program has been 50 pounds. I'll tell you; this has made the difference to me in life and death. I truly believe Medifast has been a miracle in my life," says Josephine Shaw, a diabetic patient who worked closely with Medifast's Medical Director, Dr. Wayne Andersen.

"In my twenty years as a critical care physician using surgery and medicines, I have never experienced the amazing improvement in disease that I have in the two years we have been focused on nutritional intervention as the first line defense against disease," says Dr. Andersen. "Within 4 to 16 weeks our patients are coming off their cholesterol and diabetic medication and showing dramatic improvements in the symptomentology of several other conditions."

The researchers randomized two groups of Type II diabetic volunteers. One group was given the Medifast Plus for Diabetics defined-formula meal replacement diet of soups, oatmeal, bars and a variety of shakes. The other group was asked to follow a diet based on ADA nutrition guidelines, shop for their own food and manage their own portions, but had the same guidance from the doctors, counselors and dietitians in the study as the Medifast group.

The study found those randomized to the Medifast program had an average 7.5% decrease in body fat, a clinically significant amount.

In addition to weight loss, the initial study results are that Medifast participants sustained an average 9% decrease in blood fasting glucose and an average 19% decrease in insulin levels. Medifast participants also achieved an average 12% decrease in fasting triglycerides, and an average 9% increase in HDL (good) cholesterol. Their levels of systolic and diastolic blood pressure decreased significantly.

What's more, a number of patients in the Medifast group were able to significantly reduce the number and dose of their medicines. Participants on the Medifast diet saw an average of 27% improvement in their Health Related Quality of Life, which measures such things as physical functioning, energy levels and general health.

"Until now, drug therapy has been the gold standard for diabetics. These results suggest that nutritional therapy could be more effective early on, reduce cost and provide better health for diabetics," said Brad MacDonald, Medifast's CEO.

"If diabetics are being told to lose weight, initial results show that they may be better off on a portion controlled, defined-formula diet," said Dr. Cheskin. "This is important information for Type II diabetics seeking weight loss."
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Postby Mike » July 6th, 2006, 5:18 pm

Just an update... I had my labs done and met with the Dr. He wants to keep me on the meds until it shows that the weight loss has kept things down for at least 6 months. Doesn't want to take me off BP med or cholesterol meds if they are helping keep them down. My BP was fabulous though... 112/68
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Postby Nancy » July 8th, 2006, 1:01 pm

Hi, Carmel ~

It is interesting to read the different comments regarding your recent visit to the doc's office. You have worked hard to reduce your weight and you are in a much healthier state - congratulations to you! Making healthful choices and changes in your lifestyle take effort, consistent planning and an expense - it is paying off!

Just a note for basic info here – almost all of our Type 2 Diabetic clients use the regular 5 & 1 Program for weight loss (not the diabetic menu with the higher calorie plans) and merely substitute the diabetic shakes and bars for the regular formulation 55/70 Shakes and bars. They lose weight safely and rapidly, their blood sugars are significantly reduced and many eventually switch over to the regular bars and shakes. Older people with Type 2 Diabetes often use the higher calorie levels found in the Diabetic Guide – typically, they use the 940-1050 menu.

As a Health Coach, I cannot suggest a different approach for you - your doctor is trained in areas that we are not. Physicians have their patients' best interest in mind and certainly do not intend to withhold good from their patients. Like you, I would not want to take medications and deal with potential side effects. Although Medifast products have been used by physicians for 26 years, many are not familiar with the products and meal plans. Perhaps viewing a copy of our Quick Start booklet would be of value to your physician. I’ll send you one plus some other documents that may be helpful.

Each of us are different, my cholesterol and BP numbers have been great – my cholesterol dropped 110 points and has remained at an ideal level for over three years now. Let us know how your August report goes, Carmel.

Mike, you are doing great to lower your weight – frankly, I’m surprised that your doctor did not cut your BP med. Hopefully, he indicated that it would be good for you to return for a check up prior to 6 months if you notice any changes in how you feel when you drop another 25 pounds.
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Postby mellowmom » July 8th, 2006, 1:08 pm

Thanks Nancy.

I did bring an RTD to my first doctor's appointment a couple of weeks ago and she gave it just a cursory once over before lecturing me on the dangers of low calorie dieting.

My regular doc seems to be a much more "enlightened" physician, so I think when I see him in August, armed with the Johns Hopkins abstract and anything else you can send my way, he'll at least listen.

Thanks again.
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