I'm a really bad patient and now freaking out.
Alaplum
Posts: 169 Member
I have an appointment with my Dr. Tomorrow. I'm also having a panic attack right now, so, I hope I'm not too dramatic. I decided to google, "How to talk to your Dr. about a ketogenic diet". I'm type 2 diabetic and I didn't tell my Dr. I was going on this diet. I recently had blood work and I'm going in to see the Dr. tomorrow.
When I was diagnosed with diabetes I was with a different Dr. who I really didn't like. His information to me was "eat low fat meat, cut back on carbs and test your bg once a week." I left his office terrified and stayed terrified for a very long time. He didn't tell me what I was supposed to be testing it for. I didn't know what the range I was supposed to be hoping for. That was it. Of course, an appointment was set for me to see a dietician which was cancelled 3 times, and finally I gave up and thought, I'll check out the diet on the internet. My new Dr. is pretty new to me. I've only seen him a couple of times.
I knew pretty quickly that I would have to go keto from all I read, the problem is, I tried, I bought almond flour and stuff but tried to figure out macros by myself. I didn't know about macro caculators, or MFP at the time. It seemed impossible. Finding this place has made it so easy and doable.
I have been absolutely horrible about going for my 3 month check up, and getting my BG checked, I was afraid that I'd get lectured about it being too high, that I wasn't doing what I should so I just avoided it. My last hba1c was probably a good ten months ago.
I'm so ready to take charge of this and not be afraid of diabetes but I have lost 25 lbs in the past 63 days of doing this WOE. I know it's sustainable for me, and I'm absolutely thrilled about that. I also know my cholesterol will likely be high due to the rapid weight loss, I don't know what my triglycerides are going to look like but I'm sure he's going to say "you need statins" and how can I get him onside if I'm going to say nope. Should I say no? Should I simply humour him for awhile until my cholesterol goes down in maybe a year? or less? or more?
I can be a bit of an idiot with my medication as well. I have been unreliable, I worried my bg would get too low so I reduced my does to 1000mg metformin a day from 2000mg a day. Now, I'm back at the 2000mg a day for the past week or so. (I've only forgotten the evening dose once in the past couple of weeks) When I've tested my bg, I'm almost always between 4.5-6.5.
I honestly don't know what to say I want from him. My ignorance about diabetes is mostly stemming from my acting like an ostrich and sticking my head in the sand because of anxiety.
I do want to let him know about the ketogenic diet, and I think I have that part nailed down. But what do I want him to do? Maybe it's the panic, and also my own ignorance, but I'm drawing a blank as to his role in this?
I'm feeling very stupid.
When I was diagnosed with diabetes I was with a different Dr. who I really didn't like. His information to me was "eat low fat meat, cut back on carbs and test your bg once a week." I left his office terrified and stayed terrified for a very long time. He didn't tell me what I was supposed to be testing it for. I didn't know what the range I was supposed to be hoping for. That was it. Of course, an appointment was set for me to see a dietician which was cancelled 3 times, and finally I gave up and thought, I'll check out the diet on the internet. My new Dr. is pretty new to me. I've only seen him a couple of times.
I knew pretty quickly that I would have to go keto from all I read, the problem is, I tried, I bought almond flour and stuff but tried to figure out macros by myself. I didn't know about macro caculators, or MFP at the time. It seemed impossible. Finding this place has made it so easy and doable.
I have been absolutely horrible about going for my 3 month check up, and getting my BG checked, I was afraid that I'd get lectured about it being too high, that I wasn't doing what I should so I just avoided it. My last hba1c was probably a good ten months ago.
I'm so ready to take charge of this and not be afraid of diabetes but I have lost 25 lbs in the past 63 days of doing this WOE. I know it's sustainable for me, and I'm absolutely thrilled about that. I also know my cholesterol will likely be high due to the rapid weight loss, I don't know what my triglycerides are going to look like but I'm sure he's going to say "you need statins" and how can I get him onside if I'm going to say nope. Should I say no? Should I simply humour him for awhile until my cholesterol goes down in maybe a year? or less? or more?
I can be a bit of an idiot with my medication as well. I have been unreliable, I worried my bg would get too low so I reduced my does to 1000mg metformin a day from 2000mg a day. Now, I'm back at the 2000mg a day for the past week or so. (I've only forgotten the evening dose once in the past couple of weeks) When I've tested my bg, I'm almost always between 4.5-6.5.
I honestly don't know what to say I want from him. My ignorance about diabetes is mostly stemming from my acting like an ostrich and sticking my head in the sand because of anxiety.
I do want to let him know about the ketogenic diet, and I think I have that part nailed down. But what do I want him to do? Maybe it's the panic, and also my own ignorance, but I'm drawing a blank as to his role in this?
I'm feeling very stupid.
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Replies
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I'm going to send you some hugs and good thoughts... I'm going to defer to others who've had to fight these fights themselves for the specifics...
IN GENERAL...
The only thing I will ask you to really think about is this: Did hiding from reality help any of your symptoms or conditions at all?
Oh, and one argument that pretty much works for anything medical doctors will ask you to change is this, "If you can show me consistent medical arguments in support of this, I will consider the change. However, I am my own advocate. I WILL do my own research. Please let me know if you can support this."
I would ask others for the info on why cholesterol is out of whack for a while when losing weight, and why trigs and HDL matter most. Print those documents and take them with you. Mark them clearly and pull them out to combat the doctor's advice. The majority of doctors will respond hesitantly but will accept it if you say something like, "I will keep that in mind. I would like to continue 6 more months on my current program (based on my improvements of BAM - hand him numbers) before adding in more medications to my regimen. It is better for my mental health and compliance to do as much with diet as possible.)
Above all, be respectful, but stand your ground. Unless you're literally having a heart attack in his office or entering a diabetic coma, he's unlikely to force you to do anything. He might grumble, but just stick to saying, I'm already seeing improvements. If I promise to come in at the next appointment, will you agree that we can keep on this path? Be reasonable, but don't accept anything that you absolutely feel is wrong for you...and still, be realistic. Research his suggestions, provide him research into your choices, too...
Work on your self confidence to stand your ground - and to stop avoiding things where possible...
(HUGS) and good luck!6 -
Re. cholesterol, a low carb or ketogenic diet should have a beneficial effect on the triglyceride and the HDL levels.
There is an effect where, during ongoing significant weight loss, you can see a transient increase in LDL and serum total cholesterol. This is due to small amounts of cholesterol stored in the fat tissue being slowly released back into the body as the fat tissue is shrinking. The wierd thing is that this is a 'good' function (cholesterol leaving the body) but it shows up in blood tests as 'bad' LDL cholesterol, so it can scare doctors and patients. It is temporary though, and once the weight-loss has finished and you're in maintenance for a couple months, LDL and total levels will return to normal.
Full details in "The art and science of low carbohydrate living" by Phinney & Volek, pp 167-168, and the original research was published in American Journal of Clinical Nutrition, 1991, pp1404-1410.
I had this all ready to go when I saw my Dr last month, because my LDL was up, but I didn't need it.
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I had high blood pressure for years and avoided going to the doctor for years thinking I would take care of it with diet/exercise. Didn't happen. Finally in October of 2013, I got serious about my health. By that time I was overweight. My doc suggested BP Meds (that is why I was there). I took the meds, lost weight, bp normalized. I've been off meds since 6/14.
My point: I perceive you are now ready to mend your health perhaps as I was back in 2013.
Be confident and be honest with your doc. I choose to learn something during the few medical appointments I have. I don't necessarily concur with what a doc might suggest but I am there to learn from them versus tell them what I know. Encourage conversation in the limited time you will probably have at the appointment. "Why" is a very good question to ask. "Why do you suggest that, doc?" I prefer to ask the open ended questions, then listen. Research later then make your decision.
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KnitOrMiss wrote: »I'm going to send you some hugs and good thoughts... I'm going to defer to others who've had to fight these fights themselves for the specifics...
IN GENERAL...
The only thing I will ask you to really think about is this: Did hiding from reality help any of your symptoms or conditions at all?
Oh, and one argument that pretty much works for anything medical doctors will ask you to change is this, "If you can show me consistent medical arguments in support of this, I will consider the change. However, I am my own advocate. I WILL do my own research. Please let me know if you can support this."
I would ask others for the info on why cholesterol is out of whack for a while when losing weight, and why trigs and HDL matter most. Print those documents and take them with you. Mark them clearly and pull them out to combat the doctor's advice. The majority of doctors will respond hesitantly but will accept it if you say something like, "I will keep that in mind. I would like to continue 6 more months on my current program (based on my improvements of BAM - hand him numbers) before adding in more medications to my regimen. It is better for my mental health and compliance to do as much with diet as possible.)
Above all, be respectful, but stand your ground. Unless you're literally having a heart attack in his office or entering a diabetic coma, he's unlikely to force you to do anything. He might grumble, but just stick to saying, I'm already seeing improvements. If I promise to come in at the next appointment, will you agree that we can keep on this path? Be reasonable, but don't accept anything that you absolutely feel is wrong for you...and still, be realistic. Research his suggestions, provide him research into your choices, too...
Work on your self confidence to stand your ground - and to stop avoiding things where possible...
(HUGS) and good luck!
This is such excellent advice, I'm going to print it out and read it many times before I go tomorrow. You've really helped. I had to go to work this morning for a few hours but the anxiety just won't quit today.
Hiding from reality was my way of coping with the overwhelm of being diagnosed and confused. I don't feel confused anymore so I don't need it. I see the way forward and I'm willing to do what it takes to get there. I don't know if I'll get off meds but that is my goal.
Thank you so much for your kindness.
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Steph_Maks wrote: »Re. cholesterol, a low carb or ketogenic diet should have a beneficial effect on the triglyceride and the HDL levels.
There is an effect where, during ongoing significant weight loss, you can see a transient increase in LDL and serum total cholesterol. This is due to small amounts of cholesterol stored in the fat tissue being slowly released back into the body as the fat tissue is shrinking. The wierd thing is that this is a 'good' function (cholesterol leaving the body) but it shows up in blood tests as 'bad' LDL cholesterol, so it can scare doctors and patients. It is temporary though, and once the weight-loss has finished and you're in maintenance for a couple months, LDL and total levels will return to normal.
Full details in "The art and science of low carbohydrate living" by Phinney & Volek, pp 167-168, and the original research was published in American Journal of Clinical Nutrition, 1991, pp1404-1410.
I had this all ready to go when I saw my Dr last month, because my LDL was up, but I didn't need it.
I tried looking for these documents online from the AJCN but couldn't find them. Do you have the documents in any sort of file? I'd be happy to print them if I can get ahold of them. Hell, I'll even by him a book, maybe I can look for the "Phinney &Volek" book today if one of the local book stores has it.
Thanks!0 -
I had high blood pressure for years and avoided going to the doctor for years thinking I would take care of it with diet/exercise. Didn't happen. Finally in October of 2013, I got serious about my health. By that time I was overweight. My doc suggested BP Meds (that is why I was there). I took the meds, lost weight, bp normalized. I've been off meds since 6/14.
My point: I perceive you are now ready to mend your health perhaps as I was back in 2013.
Be confident and be honest with your doc. I choose to learn something during the few medical appointments I have. I don't necessarily concur with what a doc might suggest but I am there to learn from them versus tell them what I know. Encourage conversation in the limited time you will probably have at the appointment. "Why" is a very good question to ask. "Why do you suggest that, doc?" I prefer to ask the open ended questions, then listen. Research later then make your decision.
You've hit the nail on the head, I did try to control it thru diet and excercise but I didn't know what I was doing so not much help. I've learned more in the past 2 months than I did in all the time I was winging it and I realise I don't know as much as I need to but I'll get there.
I really get your point about being willing to listen and not just go there to tell him what I know. This is all good information and I sure don't want to be someone who walks in thinking I know better than the
Dr ever could , even tho a part of me does think that. I'd like to avoid the "but I researched it on the internet" conversation that I know Dr's are likely turned off to by now.
Thanks so much.1 -
Bouddie....Your doctor is just a fellow human being. He/She works for YOU. YOU are their boss as you pay them to provide you with a service. Doctors are wrong lots of times and right lots of time. Some of pompous and dont listen because they think they are Gods. Some are wonderful people who really do not always think their way is always right. Tell your doctor what you are doing and how you feel. If your blood counts are off then they will know why and you both will come up with a solution. You may tell your doctor you are not going off this WOE and if anything is off what can they do to prevent it. If you dont want statins...simply say that. It took me having breast cancer at a young age to learn that the doctor is just as human as me and they are there to assist me. No fears my dear and good luck. Be empowered. You are your own boss.
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domsis, I am absolutely certain my BG is going to be much better this round, not so sure about the fats. I really don't know my Dr. very well, so I don't know how he's going to respond. I hope for the best but the churn in my tummy is not cooperating. I am going to refuse statins, I'm 99% sure of this unless he has a super good argument in favour.
You guys are all so wonderful, you've really helped.0 -
I tried looking for these documents online from the AJCN but couldn't find them. Do you have the documents in any sort of file? I'd be happy to print them if I can get ahold of them. Hell, I'll even by him a book, maybe I can look for the "Phinney &Volek" book today if one of the local book stores has it.
Thanks!
The book is available on amazon, and probably elsewhere. I got the reference to the journal article out of the book itself, they cite all their references very thoroughly. It seems to be written for health care professionals (they say stuff like 'your patients' and 'your practice' a lot) but I found it fascinating and very informative.
Edited to add: the complete journal reference is as follows:
Phinney, S.D. et al., The transient hypercholesterolemia of major weight loss. Am J Clin Nutr, 1991. 53(6): p. 1404-102 -
@Bouddie Remember that you don't have to make any decisions tomorrow. Get your test results, share information on the dietary changes you've made and your insights on the benefits of this WOE (both from what you've read and what you've experienced), listen to your doctor's recommendations, and then ask questions about them. Then you can simply say that you will go home and consider his recommendations. This will provide you with the opportunity to think about it some more, do more reading, reach out to others for their experiences and insights, recontact the doctor if you have more questions, and then make an informed decision when you have all the information you need and are not feeling pressured.3
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domsis2816 wrote: »Bouddie....Your doctor is just a fellow human being. He/She works for YOU. YOU are their boss as you pay them to provide you with a service. Doctors are wrong lots of times and right lots of time. Some of pompous and dont listen because they think they are Gods. Some are wonderful people who really do not always think their way is always right. Tell your doctor what you are doing and how you feel. If your blood counts are off then they will know why and you both will come up with a solution. You may tell your doctor you are not going off this WOE and if anything is off what can they do to prevent it. If you dont want statins...simply say that. It took me having breast cancer at a young age to learn that the doctor is just as human as me and they are there to assist me. No fears my dear and good luck. Be empowered. You are your own boss.
I second this. I was misdiagnosed for years and given the run around by doctors so now I know to trust my own research and experience. I will of course accept suggestions and listen to their reasoning for prescribing this or testing for that but that doesn't mean I will always agree with them and if I disagree I just tell them and give them my reasoning. In the end it's my body and my money paying for these tests and meds. If they have a God complex or can't deal with me doing some research on my own then they are a bad fit for me and I find someone else.
If it makes you feel any better I did not see a rise in trigs or cholesterol during my weight loss so you might not see one either but if you do it's no big deal to refuse a statin at this time. Tell the doctor you are in the process of losing weight and you are going to wait until your weight has stabilized and retest before deciding on meds.
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@Anglyn, that's really good to know, I'll get my results from him and likely post them here as I'm still not sure how to interpret them. @Bametels, I'm going to take your advice and not make a decision right away. @Steph_maks, Yeah I'm going to order the book, I called around and it doesn't appear I can get it other than thru amazon.1
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The decision is ultimately yours. A couple years ago I politely told my doctor that I would not actually take the statins she wanted to prescribe unless my cholesterol ever breached the 350 range and she noted it in the file. 2 weeks ago my cholesterol came back at 159, she told me to just keep doing what I'm doing. If yours is high this time around don't panic, I've read that it can spike somewhat when first starting keto, just make your next 3 month appointment and let that be the true gauge. And Congratulations on the weight loss, keep it up.2
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I would not be too worried about what the doctor thinks. Don't tell them any more than you have to. All he/she will care about really is the test results. If they are OK, I don't think most doctors care how you got there. They dispense the standard canned Diabetes Association diet and give you lecture number 17 from the archive about watching sodium intake and fat. It is their role in the system.
I saw my doctor in a social setting a couple of weeks ago. Someone asked him if he had noticed I had lost some weight. He said that only about 1 in a 100 patients ever do what you tell them to do, and he was really happy to see I had lost weight.
I told him I had done it by ignoring what he told me to , so I was not really following his directions. He laughed and said, "Whatever it takes."6 -
You might want to refer to your diet as Low Carbs, Healthy Fats. My dr. responded well to that. If statins come up, tell him you are afraid of the side effects and wish to continue on your current diet and exercise plan to see if you can get any unsatisfactory numbers down.
Point out that you have lost a lot of weight recently and your trigs might be on the high side this time around but should trend downwards going forward.
You might want to listen to this podcast before you go in, it is full of a lot of info on how much of a change is possible. It is about two women who ate nothing but steak for a month and the results they saw.
http://2ketodudes.com/ The current episode. Or you can get it on your phone if you have a podcast player, this is on the website.5 -
retirehappy wrote: »You might want to refer to your diet as Low Carbs, Healthy Fats. My dr. responded well to that. If statins come up, tell him you are afraid of the side effects and wish to continue on your current diet and exercise plan to see if you can get any unsatisfactory numbers down.
Point out that you have lost a lot of weight recently and your trigs might be on the high side this time around but should trend downwards going forward.
Saying you want to see how much more you can accomplish through diet and exercise alone is perfect!
If you're genuinely committed to walking the walk, in another 6 months, the additional progress should be pretty striking.
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The decision is ultimately yours. A couple years ago I politely told my doctor that I would not actually take the statins she wanted to prescribe unless my cholesterol ever breached the 350 range and she noted it in the file. 2 weeks ago my cholesterol came back at 159, she told me to just keep doing what I'm doing. If yours is high this time around don't panic, I've read that it can spike somewhat when first starting keto, just make your next 3 month appointment and let that be the true gauge. And Congratulations on the weight loss, keep it up.
I think this is what I need to tell him, that I'd like to see if we notice positive results in 3 more months. I guess I'll see tomorrow if it's spiked. Thing is I was going to make an appointment for tomorrow but the office called me first saying the doc wanted to see me. I think that was what scared me, or one of the things.0 -
I would not be too worried about what the doctor thinks. Don't tell them any more than you have to. All he/she will care about really is the test results. If they are OK, I don't think most doctors care how you got there. They dispense the standard canned Diabetes Association diet and give you lecture number 17 from the archive about watching sodium intake and fat. It is their role in the system.
I saw my doctor in a social setting a couple of weeks ago. Someone asked him if he had noticed I had lost some weight. He said that only about 1 in a 100 patients ever do what you tell them to do, and he was really happy to see I had lost weight.
I told him I had done it by ignoring what he told me to , so I was not really following his directions. He laughed and said, "Whatever it takes."
I am expecting the canned diabetes lecture. I'll ignore it, I can see this working in my bg numbers.0 -
retirehappy wrote: »You might want to refer to your diet as Low Carbs, Healthy Fats. My dr. responded well to that. If statins come up, tell him you are afraid of the side effects and wish to continue on your current diet and exercise plan to see if you can get any unsatisfactory numbers down.
Point out that you have lost a lot of weight recently and your trigs might be on the high side this time around but should trend downwards going forward.
You might want to listen to this podcast before you go in, it is full of a lot of info on how much of a change is possible. It is about two women who ate nothing but steak for a month and the results they saw.
http://2ketodudes.com/ The current episode. Or you can get it on your phone if you have a podcast player, this is on the website.
I was thinking I'd say it's whole foods, low carb, and no polyunsaturated fats, but healthy fats does sound much better. Going to listen to the podcast now.
Thanks again, everyone, I don't think I'd be able to do all this without you.0 -
What about just saying I am working to replace processed foods by eating more whole foods.
My record has my educational background so the doctors perhaps gets more technical with me and some even ask me general questions about my major health recovery. At the VA I think there are few patients that get into healing by diet. I give the VA credit for testing for and driving home the need to get Vit D out of the low 20's. That helped me develop a mindset to get directly involved with my short and long term health. Last year I was told they do not consider statins/etc until total cholesterol hit 290 any longer. That saves the taxpayers now and long term.
I do some private pay testing like with Life Extension blood tests. Last month I had the CAC scoring, a vascular blood flow study and CT lung scan for cancer done locally on special as private pay. They cost $100, $75 and $175 for a total of $350 before running the tests. If the doctor had ordered the CAC scoring test it along would have been $249. In fact I got a bill for $149 and when I called today they said sorry but they had caught they did not give me the private pay rate and had already zeroed out my account. For $75 I ran the NMR Lipid panel from Life Extension and as part of that test they reported that my lab results shows NO IR in my case. My LDL of 208 turned out to be OK because it was made up of the fluffy large size that poses no health risk. Blood glucose fasting was 88 when for several years it had been in the 102-108 range each year.
lifeextension.com/Vitamins-Supplements/Blood-Tests/Blood-Tests
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I'm in Canada, there aren't private places to go to do these things, and I would be dependent upon my Dr's willingness to perform these tests. I do want to ask for a CAC scoring test.0
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I'm in Canada, there aren't private places to go to do these things, and I would be dependent upon my Dr's willingness to perform these tests. I do want to ask for a CAC scoring test.
Nice thing about being in Canada is you can choose whatever doc you want and don't have to get stuck with one in particular because 'that's the only one allowed by your insurance company.' If you don't know them well, give them the benefit of the doubt - maybe they will be more onboard that you might be anticipating. Mine was, and he's a vegetarian lol.3 -
canadjineh wrote: »I'm in Canada, there aren't private places to go to do these things, and I would be dependent upon my Dr's willingness to perform these tests. I do want to ask for a CAC scoring test.
Nice thing about being in Canada is you can choose whatever doc you want and don't have to get stuck with one in particular because 'that's the only one allowed by your insurance company.' If you don't know them well, give them the benefit of the doubt - maybe they will be more onboard that you might be anticipating. Mine was, and he's a vegetarian lol.
Except for specialists. I have found I can switch GP's, as long as I can find one taking new patients, but in many cases the specialist you are referred to is the specialist you get. I remember waiting 8 months to see a rheumy and when I asked about another one it would have been another 8-12 month wait. Yuck. But maybe that's just Alberta.1 -
First, congrats on your progress and your willingness to really start facing this head-on. That is the most important part.
I fired my PCP and Endo last year and found a doc who was willing to look at the science and interested in finding and treating root causes instead of symptoms (functional medicine). I have been documenting this in this thread:
http://community.myfitnesspal.com/en/discussion/10490291/interesting-dr-follow-up-with-lchf-friendly-doc-for-t2#latest
My previous doc wanted me on statins at my last appointment with him and I just said no thanks. He looked at me dumbfounded like I had just said told him the earth was flat. I simply said, based on the medical research I had read, I was more comfortable not taking them and asked him to provide me with some research I could look up to see if maybe I had missed something. All he could come up with was the JUPITER trial. I did look that up. Apparently, he (like most doctors) only read the summary written up by the pharma companies about this because if you look into the actual study and actual results, this trial does not show statins to be effective in lowering risk of CVD and what little effect it did have seemed to be related to lowering inflammation. There are many more effective ways to lower inflammation (i.e. eating keto) which do not have the side effects that statins do.
Anyway, good luck with your appointment and keep us up to date. Many of us are facing similar situations and there is power in sharing knowledge and experience.3 -
Update:
I actually had a doc that was cool! I did say I was ketogenic, and he knew about it. He was very happy with my A1c of 6.3, I think.. needs work. He wanted to prescribe statins because my cholesterol was high. My glucose fasting was 5.6 , I don't know what GFR is but that was 69.
Cholesterol 7.32
HDL C .99
LDL 4.96
triglycerides 3.03
Non-Hdl C 6.34
They did other tests like ferritin and creatinine but I don't know what they are yet. Will look up today.
They were ok with me doing a ketogenic diet, I say they because my doc had an assistant that talked to me after my appointment about my health goals. He's given me 6 months to see if I can bring my lipids lower before starting a statin. It was explained to me that the stain is for vascular protection rather than any cardiac event issue. I have been told my target LDL need to be a 2 or less. She said they have a higher standard for people with diabetes. She did seem a bit reserved about ketogenic for people with diabetes but I didn't follow that up. Sorry, maybe next time.
There are a lot of questions I should have asked and didn't. I really felt taken seriously and I was worried for nothing. I feel a bit of a goofball for freaking out. To be fair tho, goofball runs in my family.
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canadjineh wrote: »I'm in Canada, there aren't private places to go to do these things, and I would be dependent upon my Dr's willingness to perform these tests. I do want to ask for a CAC scoring test.
Nice thing about being in Canada is you can choose whatever doc you want and don't have to get stuck with one in particular because 'that's the only one allowed by your insurance company.' If you don't know them well, give them the benefit of the doubt - maybe they will be more onboard that you might be anticipating. Mine was, and he's a vegetarian lol.
Except for specialists. I have found I can switch GP's, as long as I can find one taking new patients, but in many cases the specialist you are referred to is the specialist you get. I remember waiting 8 months to see a rheumy and when I asked about another one it would have been another 8-12 month wait. Yuck. But maybe that's just Alberta.
If you research the specialists before hand you can ask your Dr. to see if he can get you in for a specific one. Otherwise, you're right, but then I'm in Alberta too.
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I You know, @Bouddie, sometimes our worst enemies are our own perceptions and fears. So glad it worked that way for you!
(PS: I think, based on the premise of your last comment, we MUST be related.....)1 -
canadjineh wrote: »I'm in Canada, there aren't private places to go to do these things, and I would be dependent upon my Dr's willingness to perform these tests. I do want to ask for a CAC scoring test.
Nice thing about being in Canada is you can choose whatever doc you want and don't have to get stuck with one in particular because 'that's the only one allowed by your insurance company.' If you don't know them well, give them the benefit of the doubt - maybe they will be more onboard that you might be anticipating. Mine was, and he's a vegetarian lol.
Except for specialists. I have found I can switch GP's, as long as I can find one taking new patients, but in many cases the specialist you are referred to is the specialist you get. I remember waiting 8 months to see a rheumy and when I asked about another one it would have been another 8-12 month wait. Yuck. But maybe that's just Alberta.
It could be.... Here in BC I got my choice of Rheumatologists. My GP asked me which one I wanted from 3 after describing their doctoring style lol. I picked the one he described as being very good scientifically but who wasn't a 'warm and fuzzy hand holder'. He had a very dry sense of humour that many people didn't get, but I loved him. Funny but businesslike.3 -
canadjineh wrote: »canadjineh wrote: »I'm in Canada, there aren't private places to go to do these things, and I would be dependent upon my Dr's willingness to perform these tests. I do want to ask for a CAC scoring test.
Nice thing about being in Canada is you can choose whatever doc you want and don't have to get stuck with one in particular because 'that's the only one allowed by your insurance company.' If you don't know them well, give them the benefit of the doubt - maybe they will be more onboard that you might be anticipating. Mine was, and he's a vegetarian lol.
Except for specialists. I have found I can switch GP's, as long as I can find one taking new patients, but in many cases the specialist you are referred to is the specialist you get. I remember waiting 8 months to see a rheumy and when I asked about another one it would have been another 8-12 month wait. Yuck. But maybe that's just Alberta.
It could be.... Here in BC I got my choice of Rheumatologists. My GP asked me which one I wanted from 3 after describing their doctoring style lol. I picked the one he described as being very good scientifically but who wasn't a 'warm and fuzzy hand holder'. He had a very dry sense of humour that many people didn't get, but I loved him. Funny but businesslike.
It probably varies a lot from city to city and province to province... I imagine the smaller towns would have it the worst - fewer choices I mean.
That's great that you got a good one. 0 -
GFR is glomerular filtrateion rate. It is a test that measures kidney function - and picks up chronic kidney disease. The fact that your doctor ordered it is a good sign. A study about a year showed that a very large number of pre-diabetic patients already have chronic kidney disease.
I just skimmed the thread - and since I didn't see anyone else address it - Metformin cannot make your BG too low. (It is not like insulin or the drugs that make your pancrease secrete insulin disconnected from incoming food, which require very careful monitoring to avoid hypglycemia.) So don't drop the dose just to avoid your bg going too low.
I also wanted to add that you can get very good diabetic control without being ketogenic. My diabetes is completely under control (for 20 months now, since I was diagnosed 10/2015) almost exclusively by diet (when I remember, I take 500 mg extended release Metformin). I eat 60-100 carbs a day. The key, for control of at least early stage diabetes, is to space the carbs out. As long as I don't eat more than ~20 grams in a 2 hour period my bg never goes above 140. (I'm not suggesting you shouldn't eat a ketogenic diet - just wanting to make sure that you know it may not be necessary to be that strict if your reasons are purely for control of diabetes.)
Good Luck!6
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