Doctors

[francesco.decaro]

While this doesn't apply to lifting, to does apply to doctors not knowing what the hell they're talking about.

Uncle Sam moved us back home finally and I decided to "find a doctor." Found one within walking distance and set up a physical appointment. During the appointment, he decided to go over nutrition. On his screen, the POS USG nutrition pyramid. He started "You should be eating 4-5 servings of vegetables a day. How many do you eat?" I stopped him there, said I'd like to start this relationship out honestly and said: I don't eat like that. What followed was his shock that I eat my first meal of the day at 10:00 to 11:00. And it mostly consists of animal products. And my second (and last) meal at 6-7:00pm and again, mostly meat with a chance of salad or maybe potatoes.

Of course he pointed to my blood panel as a concern for him. Note that my total cholesterol was over 200, but my HDL was 72. My glucose that day was 108, which was marked high, but every other measurement was in what medical science apparently considered ideal. He started talking statins. I said, No! He expressed concern again, based on my diet. I said: OK, set me up for that heart MRI thing (CAC: coronary artery calcium test) and if I get any score other than zero, then I'll talk to you about statins.

He sets me up and I go see the cardiologist. He looks at my blood panel numbers and seriously asks me: Why am I seeing you? I explained what his colleague was concerned with. He laughed, revealed to me that he's a "low-carb eater and runner," and set me up for the CAC. You guessed the ending: I got a zero. I'm looking forward to my April physical when I get to see the original doctor again.

When I told this story at work, fully half of my colleagues were shocked that I'd question my doctor. And that there is the problem with US medicine. Doctors are not infallible and patients have rights.

Oh, and the original doc did tell me I was overweight. Because I'm 5'8" and I weigh 180 pounds. And because the NIH site says I'm overweight based on their BMI calculator. Sorry doc, I've been calipered before and got 17%. The BMI calculator is BS.

How old was this doctor?
What I'd be concerned about is if shit like this still applies to younger doctors. If a 70 year old MD still uses BMI, the food pyramid and cholesterol levels to give you statins, that's fine, the guy has been doing that for half his life, how can you get him to believe he's been fucking up for that long when everyone has been telling him he's been doing a good job, or even worse don't tell him he's doing a bad one?

[Buddy Rich]

My Primary told me my testosterone was too high at 741 and could potentially cause heart and prostate problems along with “thick blood.” At the time I was on 100mg/week injection. I was having erectile dysfunction issues and my Primary sent me to a Urologist who never once mentioned hormones, but said a penile implant was probably the way to go. No, I’m not making this shit up. I came on this Forum and started a thread entitled, “Penile Implants.” The responses were amazing, funny and very informative. You people essentially saved my dick from being cut. I contacted Dr. Keith Nichols and he increased my testosterone, put me on the cream and 5mg of Cialis/day. Guess what? I’m a new man and performing like a college kid. Thanks again to Rip and this Forum. Caveat emptor.

[Alexander Dargatz]

I'm obese too. At 5'7" ~ 190 lbs. A recent ortho visit had a BMI warning on it. It was an automated report.

Congratulations!
As a former skinny fucker (140lbs at 6'1") I was so proud to finally reach official obesity! I am now 225 lbs. It took a lot of hard work on the eating front (I laugh when gym dudes talk about "bulking phase" - my whole life is a bulking phase!).

And as a medical doctor - I hate doctors. Most of them are arrogant idiots. I try to never visit one, which luckily I can mostly avoid due to being able to buy prescription only medication myself. But when I have to, for diagnostics, I invariably get advised to "lift in moderation, not too heavy" (if it's too heavy, I can't lift it, duh), "don't eat too much protein" (Do you have a reason for this recommendation? No?), "lose some weight" (because of my BMI... after admitting I'm not fat) etc.
It's liberating to just ignore them.

To the original query: people have to make their own decisions. I'm talking about your clients. You can give them your reasoning, but it will depend on what kind of persons they are.
On the other side of the desk, most of my patients don't want to hear what I'm telling them, too. Eat healthier, start moving more, less screen time, start lifting, get out of the chair or sofa, find a hobby, meet people, sleep better, get out of the comfort zone, do something for others, etc. DO HARD STUFF, CHALLENGE YOURSELF. They just want a 3x1 prescription for a pill to fix their problems. Some patients get angry with me if I don't prescribe medication. That's the kind of person most doctors treat as patient patients. That's the kind of person most patients have as doctors. They want and deserve each other.

[IlPrincipeBrutto]

I never had to deal with doctors in my life and I hope by the time I will have to, doctors won't be so full of bullshit as I've heard from this forum

Given the direction and speed of the current trends, I can't see that happening easily, or at all.

When I told this story at work, fully half of my colleagues were shocked that I'd question my doctor. And that there is the problem with US medicine. Doctors are not infallible and patients have rights.

+1 on that.

I don't think this is a specific US problem. In almost every society, doctors have always been considered a category apart, like priests, and literally a law onto themselves (only doctors can judge other doctors). You would not question a doctor on medical matters, just as you would not question a priest, or a shaman, on faith issues.

This special position of doctors descends from the assumption that medical expertise is founded on scientific principles, and as such is neutral and value-free, which means not influenced by moral habits, or the beliefs of the practitioners. This is a shaky assumption, and I think the CoVid story has basically demolished it (or should have, for anyone who paid attention).

The bottom line, as you said, is that medicine is a social construct, doctors are fallible and patients have the right to question them. Especially now, that a lot of medical practice seems to be reduced to checking boxes on a screen and had out the result of obscure risk-assessment algorithms.

IPB

[dalan]

Doctors get a feeling of superiority because the average person doesn't know anything except what they've been told by doctors so they believe that since it comes from a doctor that it has to be right. When someone questions their opinion, they get all "You dare question me? I'm a DOCTOR!"

Concerning blood work, I believe it was Dr Nichols who said it perfectly - along the lines of, doctors don't see patients, all they see are numbers and numbers are not wrong. They look at individual numbers and fail to take into account the totality of it or how the person actually feels.

I don't know. To me, most PCP's are pretty useless most of the time.

[AndrewLewis]

I have heard from a couple people that their young doctors advised in favor of lifting weights and getting stronger, in a very broad way. But this is probably the exception to the rule.

I've had doctors as clients before and this seems to be the typical case. In science, there's an expression that, while crass, is true: ideas advance one funeral at a time.

The doctor clients I had were so sick of the old doctors who were basically an extension of the pharmaceutical companies, and had all these old ideas that were so clearly wrong, but they grew up with it, and they're the ones with the medical power and authority. So, the ideas were still the paradigm.

[david strecker]

Rip,

Currently dealing with three of my clients who have been ill-informed by their doctors about strength training.

Two pieces of advice were "Don't deadlift more than 25 pounds", "Don't deadlift more than 110 pounds". Both pieces have been ignored by my clients.

In a third case, doctor has told my client to only do moderate weights to "not cause inflammation" (she has supraspinatus tendonitis), to do "rotator cuff exercises", and to go down on her deadlift weight so she doesn't get sore in her hips (which - more than anything else - is a recovery issue).

Client would obviously believe her doctor than anyone else.

I am curious to know how you've dealt with such situations in the past where your clients were ill-informed by doctors - and where it was challenging to make them understand the importance of building up their strength, rather than following unfounded claims by their doctors.

Thanks

Regarding client #3...make it relatable. One would assume that #3 has been down the path of PT. How did PT make you feel? Most likely, sore, etc. followed by the short lived panacea and exhilaration of "feeling better", but then that all ends after no more PT visits and the multi colored bands reached their limits. Soreness and pain are two different symptoms and that definition also needs to be addressed. Like most things in life, some people cannot be convinced, but sometimes if you frame the questions with a dose of critical thinking the light bulb hopefully will start to flicker.

[Satch12879]

+1 on that.

I don't think this is a specific US problem. In almost every society, doctors have always been considered a category apart, like priests, and literally a law onto themselves (only doctors can judge other doctors). You would not question a doctor on medical matters, just as you would not question a priest, or a shaman, on faith issues.

This special position of doctors descends from the assumption that medical expertise is founded on scientific principles, and as such is neutral and value-free, which means not influenced by moral habits, or the beliefs of the practitioners. This is a shaky assumption, and I think the CoVid story has basically demolished it (or should have, for anyone who paid attention).

The bottom line, as you said, is that medicine is a social construct, doctors are fallible and patients have the right to question them. Especially now, that a lot of medical practice seems to be reduced to checking boxes on a screen and had out the result of obscure risk-assessment algorithms.

IPB

In other words, doctors have been come to believe that they traffic in revealed truth. They, obviously, do not.

[IronMike]

How old was this doctor?
What I'd be concerned about is if shit like this still applies to younger doctors. If a 70 year old MD still uses BMI, the food pyramid and cholesterol levels to give you statins, that's fine, the guy has been doing that for half his life, how can you get him to believe he's been fucking up for that long when everyone has been telling him he's been doing a good job, or even worse don't tell him he's doing a bad one?

If he's 40 yet I'd be surprised. The beauty was my luck getting the maybe-40 year old cardiologist (in the same practice, bonus!) who exercises and eats low-carb.

I did have a good experience about 10 years ago, right after I retired from the service. I went on base to get a physical, and the computer had all my previous (mandated) annual blood draws. The doc saw my current blood panels (about a year into low-carb) and asked: "Wow, your HDL is so high now and your LDL is lower compared to your last few years. Did you become a vegetarian recently?" I thought she'd be shocked when I told her "the opposite" then described my typical day's meals. She didn't scoff, in fact she asked me what the diet was called and wrote it down, said she was going to look into it.

[Gilead]

Rip,

Currently dealing with three of my clients who have been ill-informed by their doctors about strength training.

Two pieces of advice were "Don't deadlift more than 25 pounds", "Don't deadlift more than 110 pounds". Both pieces have been ignored by my clients.

In a third case, doctor has told my client to only do moderate weights to "not cause inflammation" (she has supraspinatus tendonitis), to do "rotator cuff exercises", and to go down on her deadlift weight so she doesn't get sore in her hips (which - more than anything else - is a recovery issue).

Client would obviously believe her doctor than anyone else.

I am curious to know how you've dealt with such situations in the past where your clients were ill-informed by doctors - and where it was challenging to make them understand the importance of building up their strength, rather than following unfounded claims by their doctors.

Thanks

You can either convince them or you can't. It's really up to them whether they will listen to you over their doctor. Some cases are a lost hope and it's better to just move on.