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  #1   ^
Old Fri, Nov-10-06, 21:02
rabrijumo's Avatar
rabrijumo rabrijumo is offline
Journal Hoppers Club
Posts: 271
 
Plan: Dr Bernsteins
Stats: 430/382/180 Female 5 feet 8 inches
BF:
Progress: 19%
Location: Tennessee
Default My Primary Care Doc's Don't Care Do They?


Hi, I did atkins a few years ago, fell off the wagon , and recently was diagnosed with type II diabetes.
I am very dissatisfied with the cavalier attitude of my primary care group. I am nurse and discovered during a annual competency on the glucometer that my level after lunch was 300, I waited a few hours and checked again it was 228. next morning i came into work fasting and took it again still over 200, in fact throughout the day i took it and it was always over 200.
That was on a w/e first thing monday am I made an appt and went fasting to dr. The appt was with the P.A. (physicians assistant). I told her my findings she agreed with MY diagnosis ordered lab work and that was it. I asked for a glucometer she said "ok take it twice a day" she stated she would be putting me on a medication. I said I wasn't familiar with the meds except glyburide she said that wasn't a good choice to start with ( not like i was suggesting anyway). I left after my lab draw. The next day I had an appt with my cardiologist as I have atrial fibrillation . I dropped by the primary care office to check on my labs and maybe pick up the prescription for the diabetes med. The receptionist said there was a ten day turn around on labs and said I couldn't talk to anyone without an appt (another 20 bucks). I insisted on leaving a note. NO one called me back and two days later I call the triage line and they tell me the P.A. mailed me the prescription. i wait another day for it to arrive. I got a sheet of paper with a few lab result: total cholesterol abnormal 215, normal triglycerides 139, normal hdl 57 ,ldl 136-circled, blood sugar 182 and my ha1c8.9 which had a note next to it -not bad- then under the not bad she writes Quote:
recommend start with glucaphage your
liver enzymes are slightly elevated (no actual values given)
ldl is not bad but should be under 100

then it says come back in 4-6 weeks.

While she did recommend I get a "team" I have been very reluctant to go to the diabetic dietician at work because they are surely anti low carb.
I came here !

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  #2   ^
Old Sat, Nov-11-06, 06:23
spiritof72's Avatar
spiritof72 spiritof72 is offline
Senior Member
Posts: 362
 
Plan: atkins
Stats: 230/214/140 Female 5' 8"
BF:Heh. You're funny.
Progress: 18%
Location: Dallas, TX
Default

I'm thrilled to see people turning here for support. Please, however, do not turn here for medical advice. There may be a couple of actual physicians on this board, but they do not know you, your particular circumstances, or how best to treat you.

Once you're in diabetic territory, any type of diet or WOE change is no longer an autonomous decision. You have to make your decisions in conjunction with good medical advice and careful planning and forethought.

If you are unhappy with your current physician, then by all means, get a second opinion - or third or fourth, if necessary. When I had rhinoplasty last year I spoke to no less than a half dozen different surgeons before I found one that I was happy with. You have the right to feel important and listened to in your doctor's office.

In my mind, a diabetic dietician is different from your garden variety nutritionist. They are trained to treat your specific disease and they really will know the most effective ways to do so. If that means you're not going low carb per se, then so be it, although I think you'll probably end up on a diet which IS controlled low carb. But at the very least, give it a shot.
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  #3   ^
Old Sat, Nov-11-06, 07:21
Lisa N's Avatar
Lisa N Lisa N is offline
Posts: 12,028
 
Plan: Bernstein Diabetes Soluti
Stats: 260/-/145 Female 5' 3"
BF:
Progress: 63%
Location: Michigan
Default

Hi rabrijumo!

Being a nurse, I'm sure you're aware of how anti low carb most dieticians still are. There are a few that are coming around to be accepting of low carb as a dietary plan for diabetics, but they are still few and far between. In general, they still prescribe the ADA diet plan and while granted it's lower in carbs than the standard American diet, it's still too high, IMO; my experience over 9 years on that plan was to get steadily worse and my doctor accepting it as 'the natural progression of the disease'.
My first suggestion to you would be to get Dr. Bernstein's book, The Diabetes Solution. You can read parts of it online at www.diabetes-book.com and decide for yourself whether it will be helpful to you or not before you buy it. Dr. Bernstein is a Type 1 diabetic and became an MD after he discovered that drastically cutting the carbs in his diet made a dramatic turnaround in his blood sugar control and overall health and he wanted to share that information with other diabetics.
My experience with Dr. B's plan was the same as his; dramatic improvement.
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  #4   ^
Old Sat, Nov-11-06, 10:41
Cajunboy47 Cajunboy47 is offline
Senior Member
Posts: 2,900
 
Plan: Eat Fat, Get Thin
Stats: 212/162/155 Male 68 "
BF:32/23.5/23.5
Progress: 88%
Location: Breaux Bridge, La
Default

Quote:
Lisa N
IMO; my experience over 9 years on that plan was to get steadily worse and my doctor accepting it as 'the natural progression of the disease'.

--------------------------------------
Gosh, I could have written that word for word.
--------------------------------------

IMO: I think there are almost as many opinions as there are doctors when it comes to advising dieabetics. When you have diabetes and it is out of control, you need the meds, but then at a point you'll see how that leads to more meds. Turning to a low carb diet is probably the one thing all doctors should sing out as loud as they can, but they don't. If you do LC, and take gulcose medications, monitor yourself often so you don't go from HYPER to HYPO...... Eventually, if consistent, say goodbye to the meds. We all hope for that outcome.

Gaining control of diabetes is a journey of SELF-DISCOVERY.

rabrijumo: Please let us know your progress. Being a nurse, you're going to get well informed quickly then you can help us all. We need each other!!!

Last edited by Cajunboy47 : Sat, Nov-11-06 at 10:42. Reason: mis-spelling
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  #5   ^
Old Sat, Nov-11-06, 11:08
Charran's Avatar
Charran Charran is offline
Senior Member
Posts: 9,446
 
Plan: my own
Stats: 253/176.0/153 Female 5 feet 7 inches
BF:
Progress: 77%
Default

You do need to find a doctor who you are comfortable with and one who will listen to your concerns. It took me a long time to find such a doctor, but now that I have, I'm not giving him up and I surely hope he doesn't retire any time soon! Now, let me say this...when I first started seeing him, he was not a big advocate of low carb diets for diabetics, but he was willing to let me give it a try and his response was...we'll let the blood results speak for themselves. Now that he sees that this is obviously working for me, he whole-heartedly supports what I do. He still keeps a close eye on things and I do go for a full blood work-up every 3 months just to be sure. I listen to his suggestions and he listens to my concerns and between us, we come up with the best course of action. Education is the key to managing a disease. Ultimately we are responsible for our own health and we need to stay on top of things, but this does not mean making medical diagnosises, adjusting our own meds or seeking advice from people who are not qualified to give it. Read alot, do alot of research, bring your concerns to someone qualified and go from there. This forum is great for support and encouragement! Use it wisely and you'll find it very helpful!
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  #6   ^
Old Sat, Nov-11-06, 12:38
rabrijumo's Avatar
rabrijumo rabrijumo is offline
Journal Hoppers Club
Posts: 271
 
Plan: Dr Bernsteins
Stats: 430/382/180 Female 5 feet 8 inches
BF:
Progress: 19%
Location: Tennessee
Default I Got It!

Quote:
Originally Posted by Lisa N


My first suggestion to you would be to get Dr. Bernstein's book, The Diabetes Solution.

Lisa, After my first post here someone suggested Dr Bernsteins book. I went to his site then to amazon and purchased it, rush delivery! I am on chapter 8 and I wish Dr B was a bit closer, I am In VA he is in NY. I am checking my sugars according to his recommendations and while they are coming down they are not near normal (It is to soon I guess). I am sooooooooooo glad I found out about my diabetes fairly quickly before side effects could start. I am also glad to be back here for support. RACHAEL
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  #7   ^
Old Sat, Nov-11-06, 12:55
rabrijumo's Avatar
rabrijumo rabrijumo is offline
Journal Hoppers Club
Posts: 271
 
Plan: Dr Bernsteins
Stats: 430/382/180 Female 5 feet 8 inches
BF:
Progress: 19%
Location: Tennessee
Default

Quote:
Originally Posted by spiritof72
I'm thrilled to see people turning here for support. Please, however, do not turn here for medical advice. There may be a couple of actual physicians on this board, but they do not know you, your particular circumstances, or how best to treat you.

Hi spirit, I am looking into a new doctor and I came here for support not medical advice. As a nurse I feel capable of researching and making an informed decision. I am taking this diagnosis as a change of midset .
Low carb is the only diet that ever helped me lose wt while making me feel better! I tried many and they all made me feel deprived and sick. I am glad to be back here for support. thanks for your thoughts RACHAEL

Last edited by rabrijumo : Sat, Nov-11-06 at 12:55. Reason: MISSPELLING
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  #8   ^
Old Sat, Nov-11-06, 19:01
eddiemcm's Avatar
eddiemcm eddiemcm is offline
Senior Member
Posts: 1,191
 
Plan: south beach
Stats: 225/170/165 Male 70 inches
BF:
Progress: 92%
Location: Houston,Texas
Default Doctors

Some doctors are good.Some doctors are bad.
Doctors have very limited training in nutrition and
OTC solutions.They are severely ostracized professionally when they deviate from the standard line of crap that they get in medical school.
Third leading cause of death in the USA: Doctor error.
Individual people need to learn to do their own
health related research and then use your Doctor as a
tool.If the tool doesn't work,throw it away and try to find a better one.
Good night from Houston,Texas
Eddie
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  #9   ^
Old Tue, Nov-14-06, 12:13
Lessara's Avatar
Lessara Lessara is offline
Everyday Sane Psycho
Posts: 7,075
 
Plan: Bernstein, Keto IFast
Stats: 385/253/160 Female 67.5
BF:14d bsl 400/122/83
Progress: 59%
Location: Durham, NH
Default

I have to chime in.
My HMO says as long as your blood tests show A1C of 6 or less you are not diabetic.
Which is rediculous!! If you read Dr.B he explains how this should be more like 3.5! (blood sugar around 90-100)
That is my goal. One thing that does help with your primary. Tell them your goal you want for your blood sugar. They will co-operate more. Also Dont get frustrated if your doctor makes you take tests constantly. It makes them feel better
As for dieticians. At my HMO the diabetic dietician and the regualr dietician gave me the exact same diet: The diabetic diet which 5 years ago made me go from 250 to 350!!! Ok so its a sensitive point with me but you know what your needs are. For goodness sake, how can dropping sugar and white flour make you ill? (the dietician told me this - that I would be sick if I dropped them) my answer? EASY!!
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  #10   ^
Old Tue, Nov-14-06, 13:06
dina1957 dina1957 is offline
Registered Member
Posts: 1,854
 
Plan: My own
Stats: 194/000/150 Female 5'5"
BF:Not sure
Progress: 441%
Location: Bay Area
Default

Quote:
Originally Posted by Lessara
I have to chime in.
If you read Dr.B he explains how this should be more like 3.5! (blood sugar around 90-100)
That is my goal.

3.5 traslates into BG =63, a bit low for me. I think it is more 4.5, that is BG =81. Or if you want 90-100 range, it can be 5 to 5.5. Different labs show different ranges, from 4.7 to 5.7 (now when the trend is to lower everything), but 2 years ago it was <6 for non-diabetic range.
Overall, Hb1C is not tehcnically average BGs, it is factor of time also: how high for how long. I think everything <5.5 is good enough for diabetics, especially on meds and/or insulin to avoid hypos.
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  #11   ^
Old Tue, Nov-14-06, 15:58
Lessara's Avatar
Lessara Lessara is offline
Everyday Sane Psycho
Posts: 7,075
 
Plan: Bernstein, Keto IFast
Stats: 385/253/160 Female 67.5
BF:14d bsl 400/122/83
Progress: 59%
Location: Durham, NH
Default

Dina - I was guessing the number for I didn't have the book infront of me but you get my point I hope
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  #12   ^
Old Wed, Nov-15-06, 14:33
MaddyO MaddyO is offline
New Member
Posts: 6
 
Plan: Atkins
Stats: 214/184/150 Female 63
BF:
Progress: 47%
Default

Quote:
Originally Posted by rabrijumo

Hi, I did atkins a few years ago, fell off the wagon , and recently was diagnosed with type II diabetes.
I am very dissatisfied with the cavalier attitude of my primary care group. I am nurse and discovered during a annual competency on the glucometer that my level after lunch was 300, I waited a few hours and checked again it was 228. next morning i came into work fasting and took it again still over 200, in fact throughout the day i took it and it was always over 200.
That was on a w/e first thing monday am I made an appt and went fasting to dr. The appt was with the P.A. (physicians assistant). I told her my findings she agreed with MY diagnosis ordered lab work and that was it. I asked for a glucometer she said "ok take it twice a day" she stated she would be putting me on a medication. I said I wasn't familiar with the meds except glyburide she said that wasn't a good choice to start with ( not like i was suggesting anyway). I left after my lab draw. The next day I had an appt with my cardiologist as I have atrial fibrillation . I dropped by the primary care office to check on my labs and maybe pick up the prescription for the diabetes med. The receptionist said there was a ten day turn around on labs and said I couldn't talk to anyone without an appt (another 20 bucks). I insisted on leaving a note. NO one called me back and two days later I call the triage line and they tell me the P.A. mailed me the prescription. i wait another day for it to arrive. I got a sheet of paper with a few lab result: total cholesterol abnormal 215, normal triglycerides 139, normal hdl 57 ,ldl 136-circled, blood sugar 182 and my ha1c8.9 which had a note next to it -not bad- then under the not bad she writes Quote:
recommend start with glucaphage your
liver enzymes are slightly elevated (no actual values given)
ldl is not bad but should be under 100

then it says come back in 4-6 weeks.

While she did recommend I get a "team" I have been very reluctant to go to the diabetic dietician at work because they are surely anti low carb.
I came here !



I'm a low carbing PA, and I agree that care was a bit underwhelming; a phone call was in order for you. New onset DM is taken very seriously in my practice as it is a life-altering diagnosis. And it looks like you have taken the right step in re-altering your diet. And congrats on 22 lbs lost!
Madeline
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  #13   ^
Old Thu, Nov-16-06, 12:59
ReginaW's Avatar
ReginaW ReginaW is offline
Contrarian
Posts: 2,759
 
Plan: Atkins/Controlled Carb
Stats: 275/190/190 Female 72
BF:Not a clue!
Progress: 100%
Location: Missouri
Default

Quote:
I got a sheet of paper with a few lab result: total cholesterol abnormal 215, normal triglycerides 139, normal hdl 57 ,ldl 136-circled, blood sugar 182 and my ha1c8.9 which had a note next to it -not bad- then under the not bad she writes Quote:
recommend start with glucaphage your
liver enzymes are slightly elevated (no actual values given)
ldl is not bad but should be under 100


I'd first suggest finding a good endocrinologist as your primary for managing your diabetes. Anyone with half a brain knows an HbA1c of 8.9 is not "not bad" - it's deadly!

Second, begin to read all you can about carbohydrate restriction and its use in those with diabetes. There are a number of good studies showing remarkable results when carbohydrate restriction is done carefully and monitored intesively as medications will likely be reduced as weight and blood sugars decline.

A few off the top of my head - Neilsen published in Nutrition & Metabolism results of a 22-month study; Westman recently published with Vernon in same journal and presented data a conference recently (data is in my blog about HbA1c results).

Third - read Dr. Bernstein's books and Dr. Mary Vernon's book about Atkins low-carb for diabetes.

Fourth - you may want to join Bernstein's forum which is a support forum for those with diabetes who do low-carb (in addition to sticking around here) since members over there have extensive personal experience with using low-carb and can give you insights into what they've done, how they've reduced meds, what their physicians do-think-etc., and they're a good resource for some perspective on going against the grain of conventional wisdom!

Good luck!
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  #14   ^
Old Fri, Dec-01-06, 21:02
rabrijumo's Avatar
rabrijumo rabrijumo is offline
Journal Hoppers Club
Posts: 271
 
Plan: Dr Bernsteins
Stats: 430/382/180 Female 5 feet 8 inches
BF:
Progress: 19%
Location: Tennessee
Default

I had a DOCTOR appt. I gave my group another chance seeing the female dr I had previously liked. She was awesome! discussed at length my dx and goals reviewed the data I collected adjusted my meds(increased my metformin to twice a day) she encouraged me in my wol and made referrals to keep tabs on my sight and feet. I brought dr Bernsteins book and she said it was a good plan to follow.
She did say she wanted to start cholesterol med but agreed to wait until my bloodwork drawn today was back. last time I did Atkins my level were normal after two weeks, so I hope they are normal now as its been one month. now I have to go change my ticker to reflect my wt loss yeah!
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  #15   ^
Old Mon, Dec-04-06, 07:16
Charran's Avatar
Charran Charran is offline
Senior Member
Posts: 9,446
 
Plan: my own
Stats: 253/176.0/153 Female 5 feet 7 inches
BF:
Progress: 77%
Default

Sounds like your doctor is very supportive. You are lucky to have found her. Good luck on the blood test results. Let us know how that goes!
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