Snippy doctor comment (resting heart rate question)
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@blambo61, I don't have a blood pressure cuff on hand, but yesterday my BPM was 57 after I sat down, having been in the kitchen cooking. Right now, it's at 53 BPM (just woke up, haven't eaten yet). Think I may have something little and go back to bed, 4 hours of sleep just doesn't cut it.0
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some information about heartrate
actually there are two types: normal(low)-pulser and high-pulser
as you can see in my avatar, i am a high-pulser. my max puls is 208 (picture was taken after a MTB-marathon from a Garmin device, and correspond with my Polar-watch)
while the morning BPM varies wide, there exists no "aerobic heart rate level for some age"
so, if you reach very easy 140 or even 150, you might be a high-pulser
for normal-pulser, 140 BPM is already some "work"
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Freischuetz wrote: »some information about heartrate
actually there are two types: normal(low)-pulser and high-pulser
as you can see in my avatar, i am a high-pulser. my max puls is 208 (picture was taken after a MTB-marathon from a Garmin device, and correspond with my Polar-watch)
while the morning BPM varies wide, there exists no "aerobic heart rate level for some age"
so, if you reach very easy 140 or even 150, you might be a high-pulser
for normal-pulser, 140 BPM is already some "work"
Idk. I just know the machines at the gym have target heart rates based on age for aerobic or fat burning and I know your basically supposed to be working pretty hard to maintain in the "aerobic" range. But I don't even get to a slow jog ... so that's what I was referencing.1 -
MzLazyBones wrote: »I don’t like my doctor, no secret, I just worry about things like this (I'm a worrier, it's what I do). My husband, who’s fairly laid back, doesn’t like my doctor, either—she’s made comments in the past about my weight that were more jabs than helpful. “You’d recover faster from your knee injury if you were half your size”, to which my husband said “No *kitten*, really?” then asked her to snap her fingers and make it so, otherwise it would take time.
I guess I should have swapped doctors then, but I’d just had a serious injury, and it felt like a lot of effort to find someone new when I could barely walk and she was my link to not only refilling my prescriptions (which was SO important at the time, I was in bad shape!) and the physical therapy I was starting. I’ll take a look at that list, no excuse now that I’m at a gym for my physical therapy and can get around pretty well again.
BTW, for those asking, my resting (sitting down, watching tv etc) BPM is between 55 and 61 (I know 60 is the lower end of normal), and yes it definitely goes up when I’m working out. I just sat down (I was making dinner in the kitchen) and its 57BPM right now.
Those numbers are very close to mine, I am shorter, older, live at altitude (CO Front Range area), and while I walk daily, I am far from super fit cardio status. My dr. thinks my resting heart rate is fine, and has never mentioned it effecting my calorie burn. Not sure where your dr. came up with that one.
I hope you find a good dr. if none near you are on the list posted above, look for someone who treats epilepsy. At least they will be well aware of keto dieting.
Good luck on finding a good one.0 -
I'd say I support your choice to look for a new doctor as well. I think doctors have to recommend that we lose weight if we are obese. I think they'd be negligent not too, however, they also need to look at the way you as the patient presents. Your labs are great, you are active, vitals are great. I have to say, I was in the same boat up until a year ago. I think living an active lifestyle does so much for our health. (I'm living proof, a year ago, my A1C was 5, my LDL was less that 100, my bp was great, then I had a stroke after an intense work out due to a congenital malformation in my brain the work out spiked my bp and cause a bleed. I had to give up the activity and within 3 months my labs started to look bad. Now, please take into consideration that I have PCOS and have insulin resistance.) The point of my post is to say that my doctor and I always attributed my activity level to my good health and we discussed my labs and activity at every physical to keep on the right track. You absolutely have to have a doctor you are comfortable with and supports you but still educates you about the risks of obesity. Good luck with your search.6
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@kristelrn, a pearl of wisdom. Welcome!1
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I once had an endocrinologist who told me that he couldn't help me with my thyroid health until I stopped being fat, that it wouldn't ever make a dent. And he said it in quite a spiteful/blame the patient way. Needless to say, I fired him.
And it's sad, because I took part of what he said to heart and actually stopped the thyroid meds I hadn't realized were helping behind the scenes... I should have realized if he was a moron enough to get it backwards within his own darned specialty!!!! that he would never be able to help me, and was probably "backwards" about more than just that one thing.
You've gotten some incredible advice above. I just wanted to pop in and let you know some doctors are just judgmental because they truly don't understand the causes of underlying health issues. Just listen to Dr. Attia's TED Talk if you wonder about that...I may not agree with all of his conclusions, but even doctors who think they KNOW...can be wrong.
https://www.ted.com/talks/peter_attia_what_if_we_re_wrong_about_diabetes
"As a young surgeon, Peter Attia felt contempt for a patient with diabetes. She was overweight, he thought, and thus responsible for the fact that she needed a foot amputation. But years later, Attia received an unpleasant medical surprise that led him to wonder: is our understanding of diabetes right? Could the precursors to diabetes cause obesity, and not the other way around? A look at how assumptions may be leading us to wage the wrong medical war."2 -
True story: I went to my local practice and saw a new Doctor, a lady from Denmark. She is, shall we say, well-rounded and 'Rubenesque'. I spoke to her about weight-loss and we discussed white/yellow fat cells (so she knows what she's talking about) and then she told me, "You know, when I arrived here, I said to my Husband, 'darling, I really need to lose a bit of extra weight, you know, if I'm going to set a good example, and advise my patients...' and then, I took a look around the town and thought to myself, 'you know, I'm actually not that bad'....!"
I like my Doctor, she's great fun!
ETA: The region I live in is not particularly affluent; we have a sadly high proportion of low wage earners, and of course, as with many other locations, the salary is never commensurate with the ACCL*. So they thrive on crap-laden foods. Which are of course, high-carb, cheap and plentiful.....
(ACCL = Actual Current Cost of Living)0 -
I was once told that without other risk factors, my weight was irrelevant. My reaction was to say that the doctor had just shot down my last motivation to lose weight.1
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I have a closet full of motivation (clothes I'm hanging onto like a hoarder), also women who are trying to conceive have a much easier time doing so if they're at a healthy weight (according to my OBGYN). So there's that. Motivation is not my problem, it's a combination of willpower and breaking seriously bad habits, like using food as therapy.1
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The right doctor with an open mind, who takes the time to listen to their patients and treat the patient not the symptoms, who is not judgemental about who they see in front of them and doesn't make assumptions about how they got there is sooooo important! If your doctor isn't right for you you have the right to change doctors! I've been incredibly lucky myself, but I also choose not to go back to someone who doesn't take the time to treat me as a whole....
on the flip side I guess we all have to ensure that we treat those doctors with respect, we have to approach things with an open mind and a willingness to really give treatment plans a go....
Luckily, for the most part from what I'm seeing in this group, we're all committed to having an open mind and really committing to getting it right for our health's sake! *awww warm fuzzies for all*
Anyway, choose your treatment provider... with the same care you would treat any other provider of services!2 -
rsmorton3086 wrote: »I was once told that without other risk factors, my weight was irrelevant. My reaction was to say that the doctor had just shot down my last motivation to lose weight.
That's terrible. I understand that accumulation of bodyfat is actually protective to a degree but it's not benign. It is, in itself, a symptom. To accept it as anything less is turning a blind eye. Eventually, it will become apparent that there is an issue. It's just a matter of time. Whether or not the connection is ever made to the future health condition is another story.
Someone may be overweight and have good blood work and end up with cancer and nobody ever sees that the weight gain was he first sign that there was a glucose metabolism issue involved all along.
Someone, like my sister, that had an injury that put her on steroids and started her gaining weight, eventually leading to hyperinsulinemia, which was only seen as hypoglycemia that NEEDED a higher carb intake to treat, resulting in even more weight gain... eventually resulting in T2D when her high insulin levels could no longer keep up. Her weight gain was blamed solely on steroids and seen as a simple inconvenience. In the beginning it was a symptom and nobody recognized it. Or any of the other symptoms for that matter because bloodwork was all "normal"... until it wasn't.3 -
I liked my doctor’s online profile; she seemed warm and friendly and she had spent some time in the states, so I thought maybe that would bode well. Unfortunately, her bedside manner is terrible and she blames everything on my weight.
Migraines? Nope, it’s sugar crashes according to her…specialists disagreed, made suggestions (stress reduction) and prescribed me some pills; I swapped from a stressful job to a low-stress job and I haven't had one in a long time - and I've only ever taken two of the pills out of a ten pack.
Strange rash on my face? Nope, she says it’s just acne…skin specialist prescribes antibiotic cream and antibiotics and poof, the “acne” is gone in two weeks. Turns out it was a bacterial infection (gift from my dog, gross but true).
I also had trouble getting her to refill my oxycodone, she claimed I was going to get addicted because apparently fat = addict? I guess, but food is my drug. Still, for anyone who’s ever torn their ACL, you can’t do the physical therapy (or sleep...or exist) on over-the-counter painkillers. My knee specialist had to take care of it for me, and set up a plan for me to ween off of it as I got better.
She's just...not a good doctor for me. The search is on for another, but it's really hard to find a heavy-person-sympathetic doctor. If anyone knows one in Copenhagen, Denmark - let me know.1 -
MzLazyBones wrote: »The search is on for another, but it's really hard to find a heavy-person-sympathetic doctor. If anyone knows one in Copenhagen, Denmark - let me know.
Obesity clinics at med schools or hospitals might have some leads.... ?? (For example, Eric Westman and Sarah Hallberg are both attached to university obesity programs.)
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Freischuetz wrote: »some information about heartrate
actually there are two types: normal(low)-pulser and high-pulser
as you can see in my avatar, i am a high-pulser. my max puls is 208 (picture was taken after a MTB-marathon from a Garmin device, and correspond with my Polar-watch)
while the morning BPM varies wide, there exists no "aerobic heart rate level for some age"
so, if you reach very easy 140 or even 150, you might be a high-pulser
for normal-pulser, 140 BPM is already some "work"
Holy *kitten*! I must be a high-pulser, I had never even heard of this... my pulse is just fast and always has been, I'd be at 180bpm when exercising and not even feel particularly winded... when friends were dying at 150. I gotta read up on this, got any suggested resources?1 -
MzLazyBones wrote: »I liked my doctor’s online profile; she seemed warm and friendly and she had spent some time in the states, so I thought maybe that would bode well. Unfortunately, her bedside manner is terrible and she blames everything on my weight.
Clearly you're not familiar with US general doctors.
To be fair, not all are that bad, but it's common enough to be despairing and frustrating.
There's this ongoing thing where many of the doctors here have gotten high and mighty about their position, but haven't been keeping up with research to support their position of authority in the long term. They expect their patients to just listen to what they say, without question. Others are just overwhelmed by the demands of the system we have here to keep up and research properly. Those ones mean well and often do care, but their ignorance and tied hands tend to do more harm than good.
The problem is that "just listen to the doctor, they know best," hasn't worked for decades. Before, it would just kill people (Dr. Bernstein's story is a fascinating example of this). Now, it's easy enough to research on one's own and bring that information to the doctor.
Thankfully, changes like patient empowerment and tech advances are starting to push the former out, and many of the latter are starting to go into their own practice and not take insurance (this one sucks for lower income people right now, but this kind of "doctor revolt" should be good in the long run if/as it picks up momentum). The bar is slowly starting to be raised, which should help in the future.1 -
I chose her because I prefer communicating in English, sometimes with Danish I feel very limited on how to express myself properly. So the fact that she'd worked with Americans before, and presumably had no issues communicating, was a big factor for me. I had some communication issues with my last doctor, so when I couldn't remember the words or express myself properly, I couldn't just switch to English to explain it. I'm very leery of being in that position again.
As for doctors in the states; my dad is quite heavy and his doctor has been helping him fight his diabetes (he's tall, but he's over 300lbs). His doctor seems really nice. Unfortunately, there's a six hour time difference for phone consultations, and I don't think his doctor would take Danish insurance 0 -
Eons ago when I was living in Germany, I ate something pernicious, resulting in GI fireworks (easily on par with my later generic metformin days) and decided I'd better go to a doctor. I went to the nearest GP, a dour, disapproving old coot in a pure white coat, with a nurse who cowered before him.
"Bier!" I looked sideways at the nurse, who didn't dare roll her eyes. "Good healthy German beer will restore your digestive health!" (Yeah, the beer was good. Did it help? Only my mood.... It eventually took activated charcoal to release the demons.)
I mentioned this to a friend from Tennessee, who said the advice was rather tepid in comparison with what the older docs would have told him back home....
After that, I sought out the youngest docs I could find, hoping they still might have a few neurons that wouldn't fire dogma.0 -
MzLazyBones wrote: »breaking seriously bad habits, like using food as therapy.
My "story" is a bit unique though I'm certain others have experienced the same. I started "binge eating" AFTER I lost my weight (via non-keto) at the ripe old age of 60 something. I was always hungry. Of course, to offset my binges, I would limit/restrict and created an awful eating cycle. That's not my point. I digress.
I started eating keto in 2016 for a reason other than weight (or eating behaviors). The BEST thing that happened to me with Keto was that I finally did not feel like I was "starving" all the time. Being able to distinguish "hungry/not hungry" allowed me to see how poor/compulsive my eating habits had become. Bored? Eat! Commercial break? Eat! Need to think through a business situation? Eat! Half time? Eat! On a shopping trip and see a particular restaurant? Eat! Go to a movie? Eat! None of those...require eating.
Hopefully you will also benefit. Your awareness is the key. Good for you!0 -
I'm going to say heart rate does not correlate to calorie burn. I have tachycardia so my heart beats really fast so by her metric I should be able to eat 3000 calories and weight about 90 lbs. I burn calories like a normal person. I actually used to wear a polar loop which is kind of like a fit bit but pairs with a heart rate monitor for exercise. Well when I'd workout and eat the calories the Loop told me I could I would gain weight. So anyhow I did a complex analysis of the data and realized that if I zeroed out all the extra calories for workouts then my weight progress made perfect sense. So then I started reading up and apparently oxygen uptake has more to do with calorie burn during workouts. The heart rate monitor assumes that because my heart is beating so fast that I'm breathing super hard but I'm not because that's my normal. So anyhow I'd say the reverse would be true for you.1
