E.R. Doctor
kschwab0203
Posts: 610 Member
So, I went to the ER yesterday. Turns out I have high blood pressure. They gave me medication for now.
Of course I had to hear the lecture on smoking and alcohol consumption and my diet. I was prepared to tell him all about MFP and how I have lost weight using it and how it also allows me to monitor my sodium intake not just calorie consumption which has an effect on blood pressure. He disregarded everything I was trying to tell him. He said no carbs/ no sugar is the best way to lose weight. That everyone of his patients that have lost a significant amount of weight have all gone on a no carb/ no sugar diet.
I was quite annoyed! I don't believe this.
I saw my primary care doctor this morning and she thought MFP was awesome!
Of course I had to hear the lecture on smoking and alcohol consumption and my diet. I was prepared to tell him all about MFP and how I have lost weight using it and how it also allows me to monitor my sodium intake not just calorie consumption which has an effect on blood pressure. He disregarded everything I was trying to tell him. He said no carbs/ no sugar is the best way to lose weight. That everyone of his patients that have lost a significant amount of weight have all gone on a no carb/ no sugar diet.
I was quite annoyed! I don't believe this.
I saw my primary care doctor this morning and she thought MFP was awesome!
8
Replies
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I mean, if you eliminate carbs and sugars from your diet, the majority of your foods will be really low in calories, so it's not necessarily bad advice. He's just missing the whole picture.8
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Doctors aren't above letting their personal biases influence their recommendations. Combine that with the fact that many doctors get absolute minimal nutritional training in the first place: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2430660/5
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He is an ER doctor doesn't he just stabilize patients then send them home? How many of these patients has he followed long term?12
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_Justinian_ wrote: »I mean, if you eliminate carbs and sugars from your diet, the majority of your foods will be really low in calories, so it's not necessarily bad advice. He's just missing the whole picture.
1) Sugars are carbs.
2) Carbs have 4 calories per gram, fats have 9 calories per gram. So if you eliminate a lot of carbs and replace them with a lot of fats, you've more than doubled your caloric intake.2 -
I'd trust an ER doctor to deal with acute issues, but he's not someone I'd consult for weight management. Your PCP is probably more reliable.
I think every specialty has their habitual blind spots. My experience with orthopedists, for example, is 2 for 4 when it comes to a willingness to treat beyond their own personal competence. The one ER doctor I've personally known was an arrogant son of a kitten, so grossly overconfident in shooting from the hip (so to speak) that no one who knew him personally would allow him to treat them. He was probably an extreme example -- I understand he no longer practices medicine -- but if a doctor doesn't know his limits, then you're going to need to learn them and be accordingly cautious.
Edit: Although, @Gisel2015 has a good point. If you do smoke, you should stop, and if you drink more than 1-2 drinks a day you might want to think about curtailing that. On the other hand, if he was just lecturing you without first asking about your drinking and smoking habits, he may just have been in a preachy mood.1 -
kschwab0203 wrote: »So, I went to the ER yesterday. Turns out I have high blood pressure. They gave me medication for now.
Of course I had to hear the lecture on smoking and alcohol consumption and my diet. I was prepared to tell him all about MFP and how I have lost weight using it and how it also allows me to monitor my sodium intake not just calorie consumption which has an effect on blood pressure. He disregarded everything I was trying to tell him. He said no carbs/ no sugar is the best way to lose weight. That everyone of his patients that have lost a significant amount of weight have all gone on a no carb/ no sugar diet.
I was quite annoyed! I don't believe this.
I saw my primary care doctor this morning and she thought MFP was awesome!
That is not a "lecture," it is good advice and something that MFP doesn't preach or doesn't require you to "log." It is the doctor's responsibility to let you about the things that may influence your high BP since that is the reason that you went to the ER in the first place.
I don't care to comment about the rest of your conversation with the ER doctor, so carry on.7 -
_Justinian_ wrote: »I mean, if you eliminate carbs and sugars from your diet, the majority of your foods will be really low in calories, so it's not necessarily bad advice. He's just missing the whole picture.
Most low carb folks eat high fat...dietary fat is pretty calorie dense...
But yes, but cutting back on or eliminating an entire macro, it's likely that you're going to be in a calorie deficit.1 -
cwolfman13 wrote: »_Justinian_ wrote: »I mean, if you eliminate carbs and sugars from your diet, the majority of your foods will be really low in calories, so it's not necessarily bad advice. He's just missing the whole picture.
Most low carb folks eat high fat...dietary fat is pretty calorie dense...
But yes, but cutting back on or eliminating an entire macro, it's likely that you're going to be in a calorie deficit.
Agreed, but it's not the only way to create a calorie deficit. I was just a little put off by it.0 -
Hope you're feeling a lot better, OP.2
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_Justinian_ wrote: »I mean, if you eliminate carbs and sugars from your diet, the majority of your foods will be really low in calories, so it's not necessarily bad advice. He's just missing the whole picture.
1) Sugars are carbs.
2) Carbs have 4 calories per gram, fats have 9 calories per gram. So if you eliminate a lot of carbs and replace them with a lot of fats, you've more than doubled your caloric intake.
1. Yes, absolutely.
2. Not necessarily. Some people find fats much more filling than carbs, so the replacement rate is not exactly gram for gram. And some people are insulin resistant or predisposed to IR, and so the blood glucose spikes (and subsequent drops) lead to more hunger when eating a higher carb diet.
Calories do matter, of course. But playing with macros can help with satiety, and can help with long term adherence.
I've been low carb well over three years. Lost 50 lbs without counting calories. My blood pressure averages 110/60 (actually had a doc appt today, follow up to a tubal ligation I had two weeks ago; bp was 108/60. the day of my surgery they took my bp upon intake - it was 117/68; the nurse said, "that's normal; like perfect normal. We never see that in this room!". I told her I was a bit nervous and that I'm usually 110/60, lol).
That said, I only drink moderately, and I gave up smoking for vaping about three months ago. But I saw the improvement in blood pressure after I lost the weight (I used to be 130/80 pretty consistantly, when I was 50 lbs heavier).
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Doctors don't know everything. Most of them are reasonably aware of that, but some are not. And there is a culture which encourages them to act omniscient and not admit to ignorance. Pay the low carb advice no mind, but take the other advice seriously.2
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He is an ER doctor doesn't he just stabilize patients then send them home? How many of these patients has he followed long term?
This is sometomes the case, but the ER doctor also has more knowledge about how the body works and diet (even though the Med school curriculum typically does not include much on nutrition) than probably 99%+ of the population.0 -
He is an ER doctor doesn't he just stabilize patients then send them home? How many of these patients has he followed long term?
I don't know about all hospitals, but the one in my town the doctors rotate shifts in the ER. When they aren't working in the ER, they are running their office in the medical building where they have long term patients.1 -
I would ignore his "advice" as it is not very helpful. A calorie deficit is all you need.3
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Why did you go to the ER? Were you having chest pains? Shortness of breath?
Having worked in an ER (as a clerk, not a nurse or Dr.), I find there is a massive misunderstanding of what the ER is for. Generally, ER doctors keep you alive until you can get to a specialist. They are not there to 'fix' you permanently. Broken bones- call in the orthopedic doctor, heart attack- you get stabilized and sent to the cardiac floor (or transferred if the hospital doesn't have a cardiac floor), cancer- you get sent to an oncologist.
He gave you advise on what he saw in that short, short time period that he saw you. If you disagree, fine! Make a plan with your PCP, but the ER doctor's job isn't to debate the best way of losing weight. He made sure you weren't actively dying, and told you his medical opinion. That's his job.7 -
Why did you go to the ER? Were you having chest pains? Shortness of breath?
Having worked in an ER (as a clerk, not a nurse or Dr.), I find there is a massive misunderstanding of what the ER is for. Generally, ER doctors keep you alive until you can get to a specialist. They are not there to 'fix' you permanently. Broken bones- call in the orthopedic doctor, heart attack- you get stabilized and sent to the cardiac floor (or transferred if the hospital doesn't have a cardiac floor), cancer- you get sent to an oncologist.
He gave you advise on what he saw in that short, short time period that he saw you. If you disagree, fine! Make a plan with your PCP, but the ER doctor's job isn't to debate the best way of losing weight. He made sure you weren't actively dying, and told you his medical opinion. That's his job.
My blood pressure was very high and I was instructed to go the ER. I have since seen my PCP and am doing well. I do disagree with his advice on no carb/ no sugar which was the whole point of this thread. At no point did I say he was not doing his job. I was simply pointing out how narrow minded I felt his advice was. That's all.5 -
Packerjohn wrote: »He is an ER doctor doesn't he just stabilize patients then send them home? How many of these patients has he followed long term?
This is sometomes the case, but the ER doctor also has more knowledge about how the body works and diet (even though the Med school curriculum typically does not include much on nutrition) than probably 99%+ of the population.
I would say it's fairly rare to find a doctor who really knows nutrition (there are some exceptions). My friend is a University of Penn (top rated med school) Pediatric Cardiologist and admits to knowing crap about diet and nutrition. She just says she has people for it if she needs to know. And would recommend going to see a dietitian or qualified nutritionist.
OP, If you are concerned, I would probably talk with a specialist liek a dietitian. But typically, if you have high blood pressure, I am not sure you would want to follow LCHF since they tend to require higher amounts of sodium to balance electrolytes.2 -
Packerjohn wrote: »He is an ER doctor doesn't he just stabilize patients then send them home? How many of these patients has he followed long term?
This is sometomes the case, but the ER doctor also has more knowledge about how the body works and diet (even though the Med school curriculum typically does not include much on nutrition) than probably 99%+ of the population.
I would say it's fairly rare to find a doctor who really knows nutrition (there are some exceptions). My friend is a University of Penn (top rated med school) Pediatric Cardiologist and admits to knowing crap about diet and nutrition. She just says she has people for it if she needs to know. And would recommend going to see a dietitian or qualified nutritionist.
OP, If you are concerned, I would probably talk with a specialist liek a dietitian. But typically, if you have high blood pressure, I am not sure you would want to follow LCHF since they tend to require higher amounts of sodium to balance electrolytes.
I know the OP isn't the least bit interested in a low carb diet but, for what it's worth, in RCT's blood pressure is lowered on low carb diets. I just read an abstract the other day that was pretty interesting - they found that people who's blood pressure responds to sodium were insulin resistant (IR increases water and salt retention) which might explain it.
Of course everyone should consult with a doctor for any health conditions -- unless they recommend a low carb diet. Then they don't know what they're talking about and you should see someone else.
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AlabasterVerve wrote: »Packerjohn wrote: »He is an ER doctor doesn't he just stabilize patients then send them home? How many of these patients has he followed long term?
This is sometomes the case, but the ER doctor also has more knowledge about how the body works and diet (even though the Med school curriculum typically does not include much on nutrition) than probably 99%+ of the population.
I would say it's fairly rare to find a doctor who really knows nutrition (there are some exceptions). My friend is a University of Penn (top rated med school) Pediatric Cardiologist and admits to knowing crap about diet and nutrition. She just says she has people for it if she needs to know. And would recommend going to see a dietitian or qualified nutritionist.
OP, If you are concerned, I would probably talk with a specialist liek a dietitian. But typically, if you have high blood pressure, I am not sure you would want to follow LCHF since they tend to require higher amounts of sodium to balance electrolytes.
I know the OP isn't the least bit interested in a low carb diet but, for what it's worth, in RCT's blood pressure is lowered on low carb diets. I just read an abstract the other day that was pretty interesting - they found that people who's blood pressure responds to sodium were insulin resistant (IR increases water and salt retention) which might explain it.
Of course everyone should consult with a doctor for any health conditions -- unless they recommend a low carb diet. Then they don't know what they're talking about and you should see someone else.
I support this message
, jk. 4 -
My grandfather suffered through bad high blood pressure and I will say that if you are smoking you should stop immediately. Tobacco and the meds they give you do not mix well.
And personally, I would listen to my PCP before an ER doctor because they know your medical history a little bit better. *hugs*0 -
AlabasterVerve wrote: »Packerjohn wrote: »He is an ER doctor doesn't he just stabilize patients then send them home? How many of these patients has he followed long term?
This is sometomes the case, but the ER doctor also has more knowledge about how the body works and diet (even though the Med school curriculum typically does not include much on nutrition) than probably 99%+ of the population.
I would say it's fairly rare to find a doctor who really knows nutrition (there are some exceptions). My friend is a University of Penn (top rated med school) Pediatric Cardiologist and admits to knowing crap about diet and nutrition. She just says she has people for it if she needs to know. And would recommend going to see a dietitian or qualified nutritionist.
OP, If you are concerned, I would probably talk with a specialist liek a dietitian. But typically, if you have high blood pressure, I am not sure you would want to follow LCHF since they tend to require higher amounts of sodium to balance electrolytes.
I know the OP isn't the least bit interested in a low carb diet but, for what it's worth, in RCT's blood pressure is lowered on low carb diets. I just read an abstract the other day that was pretty interesting - they found that people who's blood pressure responds to sodium were insulin resistant (IR increases water and salt retention) which might explain it.
Of course everyone should consult with a doctor for any health conditions -- unless they recommend a low carb diet. Then they don't know what they're talking about and you should see someone else.
Generally speaking, most DO's have several years of nutrition because they attend a medical school that has osteopath programs. Most continue on after med school for two to six more years learning the more natural side of things for health conditions (ie. diet, chiro manipulation, supplements, etc). But, I don't think there are ton of DO's in this world. DO's have both an MD and DO degree/designation.
Personally, I have found the low carb/blood pressure/sodium/insulin resistance thing to be true. I have PCOS and am very insulin resistant (also have pancreas damage from pancreatitis) and my blood pressure is very dependent on how much sodium I get. Until this year, I've always had very low blood pressure. Now I have to really watch my salt intake because it rises a decent amount if I'm holding too much fluid (I tend to hold fluid VERY easily).0
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