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Doctor effectiveness: which works better, tell patient to make lifestyle changes or just treat increasing symptoms with more pil

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 Superesse (original poster member #60731) posted at 2:59 AM on Friday, December 30th, 2022

Seems the (male) doctors my H sees don't come down too hard on his lifetime dietary problems: morbid obesity, hyperlipidemia with age-related rising hypertension and glucose intolerance levels, GERD, sleep apnea and now a possible gout issue. It's always been vividly clear to me where all this is leading: early incapacitation or a shortened life span.

We attended a year-long weekly hospital support group with a diabetes educator and each have a large binder of reading materials to help us learn how to manage weight, get enough exercise and make right food choices, so it isn't like my H hasn't been warned by a professional of the risks of his uncontrolled weight; he just never has been warned BY HIS DOCTORS. So to him, his health must not be that bad, or the doctor would have said....whereas I see what I see, and I have a longer-range viewpoint; like I know I will not be able to lift a 330 lb. man if his feet break down.

I'm wondering if this is a real thing: doctors not wanting to confront a heavy middle-aged guy with his growing health issues? My medical peeps are often quite frank about anything I need to change, but H says he never hears any warnings (perhaps due to 'selective hearing'). I know his doctors, we see some of the same ones, and when I've been with him, they've never said anything to him about what will happen as his chronic illnesses progress. Even his paper records never note a need for him to make any lifestyle changes - like my docs have done! He always just walks out satisfied with yet another prescription. Now they want to try Prednisone and he's all for starting on it, so long as his big toe stops aching OMG.

So is this maybe some guy thing with the doctors? It's just so easy for them to write another 'scrip, and for him to think that's the end of it.

Thoughts?

posts: 2202   ·   registered: Sep. 22nd, 2017   ·   location: Washington D C area
id 8771371
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zebra25 ( member #29431) posted at 3:58 PM on Friday, December 30th, 2022

I have had those same thoughts. My H is overweight, has gerd, sleep apnea, high cholesterol and his A1C is just in the diabetic range. He had a consult for a hernia repair and the surgeon told him he was in very good health. shocked His PCP never says anything about his weight. His paperwork states his BMI but there is no discussion about it. He needs to lose 30-50 pounds. Maybe the doctor's feel like their words fall on deaf ears? I know the last thing my H needs to hear is that he is in great health.

I have high cholesterol that is genetic. I have tried very hard with diet and exercise to lower it and have had very little success. The statins give me unpleasant side effects. I will say, the doctors I see have no problem telling me I am going to have a stroke or heart attack. Not the best thing to keep reminding someone with severe anxiety. They don't care that I try to do things good for all my health issues. When I tell them about the side effects from the statins they just tell me it's in my head and to keep taking them anyway or I am going to have a heart attack.

It's frustrating to watch someone you love not take their health seriously. I'm not sure my H would listen to the doctor but acting like there is no problem and telling him his health is good just gives him the green light to keep overeating and eat garbage.

"Don't let anyone who hasn't been in your shoes tell you how to tie your laces."

D-day April 2010

posts: 3680   ·   registered: Aug. 25th, 2010
id 8771461
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number4 ( member #62204) posted at 10:15 PM on Friday, December 30th, 2022

I've been fighting this battle with my H for years. After that day which shall not be uttered in this forum, he lost a lot of weight due to losing his appetite. But he has slowly put it back on, and then some. His issue isn't so much the weight, as it is where that weight is... all in the middle.

About a year and a half ago, I talked him into switching to my doctor (his was a joke), who has a concierge practice, so he really takes time with his patients, and spends a lot of time translating all those blood test results he orders 1-2x/year from the Cleveland Heart Clinic. He looks at so much more than just cholesterol and A1C numbers. Our doctor basically plants seeds from early on, that we would age better with certain lifestyle choices and taking certain supplements. H is good about the supplements (because his numbers started improving when he took them), but has basically turned into a sloth when it comes to exercise. He used to play golf and ride his bicycle on a regular basis, but hasn't really since our move four years ago. Honestly, I'm kind of happy he doesn't ride around here because we don't have the dedicated bike paths (not lanes... paths) like we did back in IL.

About a year and a half ago, when I switched trainers to a male, I started working on H to give him a try. H was doing nothing to strength train, and mobility and being strong are just so incredibly important to aging well. Every few months I'd suggest he give the trainer a try, and he'd say maybe, then never follow through. In the meantime, I've watched his mobility decrease, and I know the further it goes down, the harder it is to get it back. We are in our early 60s, have a new grand baby and want to be actively involved in his life. I think that's what finally got H's needle moving to the right side. Two weeks ago, he finally agreed to start working with my trainer. I think he was dumbfounded when he realized in the first session just how weak he was. He only made it about half way through the three sets our trainer walks me through. He hit a wall, and could do no more. And I know the trainer wasn't pushing him that hard. Each session he's had with him since, has been a tiny bit easier, and they've gotten through more, so hopefully he'll see the upward trajectory as a motivator.

I work with the strength trainer twice a week, and do Pilates twice a week. While I could be stronger, I'm not doing too bad for someone my age. I see a lot of friends my age that don't even get out for regular walks, much less any workout. And maybe this a co-dependent way of thinking, but I don't want to be a burden on people if it's due to my own self-neglect. Do I eat perfectly? No (just popped some M&Ms in my mouth before I sat down), but I do pretty good - limit processed food greatly.

My doc is into genomics and wants me to get my genes tested. I know my hyperlipidemia is genetic - nothing I can do about that. As well as my blood pressure. A1C is manageable, but again, all genetic. Lots of heart disease at a young age in my family. Just my two cents, but I think that, to a certain extent, people who don't make some sort of effort to make changes as they age, are selfish. They aren't thinking about who is going to have to take care of them when they become more and more immobile. Again, accidents happen, genetics happen, but there are many things we can control.

Regarding doctors, I've found the ones who take good care of themselves are better about talking to their patients about healthy lifestyle choices, even when the patient continues to ignore them. Our doctor works out, eats healthy, maintains his weight and takes care of himself via annual routine screenings. Come to think of it, my concierge doctor back in IL also did the same. Maybe the doctors who aren't pressured by a practice or insurance to rush through visits are the ones who take the time to discuss lifestyle choices, and why they are important. Of course, people who spend the money for a concierge doc are more likely to heed their advice, because otherwise, why would they spend the extra money? I remember interviewing one doctor when we moved out here, but he was really obese, and I thought, "How is he going to encourage me and motivate me to make healthy lifestyle choices, when he isn't doing it himself?" So I passed on his practice.

So I think whether or not a physician spends time educating their patients, a lot depends on whether they take care of themselves. It's kind of hard to keep offering suggestions to your patients if it constantly reminds you of what you're not doing for yourself. Again, just my opinion and experience with myself.

Me: BWHim: WHMarried - 30+ yearsTwo adult daughters1st affair: 2005-20072nd-4th affairs: 2016-2017Many assessments/polygraph: no sex addictionStatus: R

posts: 1372   ·   registered: Jan. 10th, 2018   ·   location: New England
id 8771537
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Lionne ( member #25560) posted at 5:20 PM on Saturday, December 31st, 2022

My husband doesn't listen either. Add that to the fact that he cannot hear, even with hearing aids, and maybe has a aural processing issue. His cardiologist insists that I go with him to each appointment.

He is a smart man. But after all this time still doesn't get that any starchy food breaks down to sugar and will affect his A1C.

After his heart attack he lost a ton of weight, then had another crisis. He gained back some and went back to his ways. My son yells at me for buying the occasional sweet but I am not responsible for his choices. One donut every 3 months won't hurt him but he never stops at one. Not my circus.

BUT- the granddaughter has made a difference. She adores her Grandpa and we keep telling him that she will be wildly benefitted by having him in her life.

He's walking almost every day and not binging as much.

Me-BS-65 in May<BR />HIM-SAFWH-68<BR />I just wanted a normal life.<BR />Normal trauma would have been appreciated.

posts: 8529   ·   registered: Sep. 18th, 2009   ·   location: In my head
id 8771620
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Luna1115 ( new member #82456) posted at 6:38 PM on Saturday, December 31st, 2022

IDK, as an obese female, I can maybe see all sides. I have doctors that prescribe me medications. I have a chiropractor that wants his clients to control their own destiny with healthy choices and not relying on prescriptions. It's the chiropractor that I think about quitting monthly when I have to face him for my appt and I haven't been successful adjusting to healthier habits.

My primary care doctor that told me 20 years ago when I started taking Lipitor that people start with heredity, my heredity had me start with high cholesterol. Others start with high BP or Diabetes. He said that if I don't get it under control I will end up with all three, high cholesterol, high BP and diabetes. I think of that conversation often as now, 20 years later, I am very close to needing BP medication and insulin.

This life as the wife of a SA, has me eating as a way to cope. It's my way of coping and I own it. It's become my addiction. I weighed 105 lbs on my wedding day and now I'm at 230. I should have divorced my husband, but instead I ate and ate.

As I sat at the gyn office last week with my bp 164/88, I felt defeated. I have ruined my body and my health, but for me it's more about my mental health than any doctor telling me what I need to do. I just had one major surgery most likely due to obesity and I'm heading for another one. None of it motivates me enough to change.

So I guess, the doctors have a lose lose situation on their hands. Everyone over the age of 25 in this country should know what they need to do to lose weight and be healthy. A doctor telling you about it, really only changes if you will go back to see that doctor. My chiropractor has information and statistics about all of the medication doctors give you and how horrible it is, but it changes nothing for me. I know what I need to do and most of the time, I plan to start tomorrow, but tomorrow never comes.

Hope that give you a little perspective.

posts: 9   ·   registered: Nov. 27th, 2022
id 8771628
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zebra25 ( member #29431) posted at 6:38 PM on Saturday, December 31st, 2022

I think neglecting one's health comes more from a place of denial than selfishness. I think my H thinks nothing is going to happen to him. That's the way he lives life. He is not a worrier. He is great at taking what is thrown at him and without getting the least bit rattled just handling it. I hope he wakes up before something bad happens.

Our health system sends out patient satisfaction surveys. They used to tie those to the physicians bonuses. Maybe the physicians don't want to get a low score from somebody because they told them their health problems were from being overweight? I don't know, just a thought.

"Don't let anyone who hasn't been in your shoes tell you how to tie your laces."

D-day April 2010

posts: 3680   ·   registered: Aug. 25th, 2010
id 8771629
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zebra25 ( member #29431) posted at 6:45 PM on Saturday, December 31st, 2022

Cross posted with you Luna.

Thank you for adding your insight.

I used to not eat at all when I was stressed, now I grab something to munch. It's a very hard habit to break.

"Don't let anyone who hasn't been in your shoes tell you how to tie your laces."

D-day April 2010

posts: 3680   ·   registered: Aug. 25th, 2010
id 8771631
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Luna1115 ( new member #82456) posted at 9:23 PM on Saturday, December 31st, 2022

Zebra - YES, when I was thin and anxious, I couldn't eat. Then once I started gaining weight, it all changed....

posts: 9   ·   registered: Nov. 27th, 2022
id 8771645
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EllieKMAS ( member #68900) posted at 2:53 AM on Sunday, January 1st, 2023

It's kind of a double-edged sword though. As an obese female, I can't tell you how many times I have gone to a doctor for an issue that's actually not related to my weight, and my weight is ALL they see.

Case in point, I have been going to my PCP for damn near 20 years. In those years, she has seen me weigh anywhere from 165 to 285. My BP/cholesterol are both normal (thank goodness) and always have been. Couple years ago, I pinched a nerve in my neck and I went to see her to get some meds or some tips or something to treat it, as it was severely impacting my life and my normal functioning. They took my BP - which mind you for all these years had been textbook perfect, and it came back high and I was treated to a lecture about how I needed to 'manage my lifestyle' because this was a 'chronic problem'. When I tried to tell her that, NO, I suspected my BP being slightly higher than normal at that moment was probably due to the fact that I was in a blinding amount of pain, she sat there and argued with me about it. I finally shut her up when I told her to produce records showing any high BP I'd had in the past and she couldn't do it. Her response, "Hmm, well you're lucky that your BP is so good normally. I wonder why it's high today?" Because doc, I am in PAIN. Can you do something doctor-y about that please??

Is interesting that your H gets no mention of his weight, when that's all I ever get from doctors. I swear I could go in for a hangnail or cus my hair hurts and I'd get a lecture about my lifestyle.... rolleyes

"No, it's you mothafucka, here's a list of reasons why." – Iliza Schlesinger

"The love that you lost isn't worth what it cost and in time you'll be glad that it's gone." – Linkin Park

posts: 3919   ·   registered: Nov. 22nd, 2018   ·   location: Louisiana
id 8771675
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nomudnolotus ( member #59431) posted at 5:11 AM on Sunday, January 1st, 2023

For anyone struggling with weight and type 2 diabetes but not yet on insulin, ask your doctor about ozempic. It's a game changer. Nobody talks about how blood sugar highs and lows actually make you crave more carbs like a drug addict. Ozempic not only lowers your blood sugar it does something I can't explain. It makes bad food taste a little gross. You become full very quickly. I've gone from 260 lbs down to 150 since last May. (I've done more than just take ozempic) Worked up to walking 10k steps a day, yoga, weight training, going for physical therapy, chiropractor and massage therapist for pain issues. Natural suppliements for pain. Eating a low carb diet (about 50 carbs a day) Off processed foods as much as possible. I still have a bit to go and I've worked really hard, but the ozempic made it all possible. This is truly a wonder drug. (Some doctors will prescribe this even if you aren't a diabetic)

posts: 498   ·   registered: Jun. 30th, 2017
id 8771687
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number4 ( member #62204) posted at 5:45 AM on Sunday, January 1st, 2023

Our doctor not only mentions weight to both H and me, but educates us about where that weight is sitting on our bodies, meaning the belly fat. That’s when you have to start watching for metabolic issues. He does not treat either one of us differently when it comes to educating us about healthy aging.

Me: BWHim: WHMarried - 30+ yearsTwo adult daughters1st affair: 2005-20072nd-4th affairs: 2016-2017Many assessments/polygraph: no sex addictionStatus: R

posts: 1372   ·   registered: Jan. 10th, 2018   ·   location: New England
id 8771690
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DragnHeart ( member #32122) posted at 6:45 AM on Sunday, January 1st, 2023

Our doctor is all into going all out for wh but brushes me off all the time.

I had a uterine suspension in 2006. I have had bladder issues ever since. Not just leaking but severe, bent over pain.

I go to see the doctor and get told well it's a woman thing once you've had kids.

Ummmm dd didn't arrive until 2008... rolleyes

He also just loves to prescribe pills.

Me: BS 46 WH: 37 (BrokenHeart911)Four little dragons. Met 2006. Married 2008. Dday of LTPA with co worker October 19th 2010. Knew about EA with ow1 before that. Now up to PA #5. Serial fucking Cheater.

posts: 25836   ·   registered: May. 10th, 2011   ·   location: Canada
id 8771694
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sisoon ( Moderator #31240) posted at 4:25 PM on Sunday, January 1st, 2023

Since I claim to be an ADD male, I'll respond.

Telling me to do something usually does not get me to do it. Twenty-two years ago, I asked my doc how to lose weight, and he gave me a simple rule: cut out bread, pasta, potatoes, and rice. I did and lost 40 lbs. And 9 years later I had gained 30 back. At that point, in a shambles after d-day, I started to understand what triggered emotional eating, and I was able to drop 40+ lbs, for a total weight loss of 50+ lbs. I've kept that off for years, but I really need to lose another 30, and that's still with me. Worse, I'm afraid of what will happen if I can't ride a bike.

But I think it was pure luck that my doc gave me a simple rule that I could actually follow. Other docs have given me actual meal plans, and that had no effect. Similarly, It was only after I had given up on weight that I gained the ability to control some of the emotions that control my eating.

For me the question is:

Superesse,

What makes you think it's normal to do what one's doc tells one to do?

fBH (me) - on d-day: 66, Married 43, together 45, same sex ap
DDay - 12/22/2010
Recover'd and R'ed
You don't have to like your boundaries. You just have to set and enforce them.

posts: 30462   ·   registered: Feb. 18th, 2011   ·   location: Illinois
id 8771710
Topic is Sleeping.
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