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Thursday, June 23, 2011

Do Patients Really Listen?

Am I wasting my breath when I suggest eating better, exercising, and losing weight?

A lot of doctors think so.

I was discussing this with another physician this evening.  Often, our solutions are pills -- you have high blood pressure, you get a prescription for amlodipine.  You have high cholesterol, you get a script for simvastatin.  You have palpitations, you get atenolol scribbled on a prescription pad.

But, what about diet and lifestyle?  If, to lower your blood pressure to a normal range, you could cut back on the sodium in your diet, eat less fast food and more fruits and vegetables, would you do it?  Or what if cutting back on (or better yet, eliminating) animal foods would slash your LDL cholesterol drastically without the need of a pill?  Or, if cutting out your morning latte would eliminate your palpitations, would you do it?

True, many patients are set in their ways, or have emotional barriers that keep them from living a healthy lifestyle.  But, I think patients are more motivated than we give them credit for.  If the option is lifestyle change or a pill, I don't believe that most people will chose the pill.

14 comments:

TooeleTwins said...

Thanks to your blog and a bunch of my own research, I recently eliminated animal proteins. I've been a vegetarian since May 1. Last year, my doctor told me that my cholesterol was creeping up and on the verge of being unhealthy. Earlier this week, my cholesterol was "excellent" according to that same doctor!
So, yes, some of us do listen! It might take a long time, but we do listen.....

K said...

curious.. how long does it take for cholesterol readings to become "normal" after switching to a vegan diet? A couple of days? Weeks?

VeganHeartDoc said...

@K -- it takes a few weeks to notice a significant difference in cholesterol levels with lifestyle change or medication.

Jennifer said...

I did it! I was 300 pounds and I am only 5'2".. Although I never had any health problems, I did have gestational diabetes with 3 of my 4 pregnancies..not with my first, I was only 130lbs then! But I went in for a diabetes fasting recheck and I was borderline diabetic. This scared me. I got serious about what I was eating and went on the south beach diet. I went from 300lbs. to 170lbs in one year. I did gain some back with a couple pregnancies, I got up to 200lbs. But have gone back on the south beach diet, eating healthy and walking and I am back down to 180lbs, and am working towards 150lbs...my cholesterol is 85! yay!!! I did it and i've never been happier!!! I spent all of my 20's and some of my 30's weighing 300lbs.. I am now 38 and healthier than Ive ever been!!! Not to mention much more attractive to myself and others!

VeganFit blogger said...

Against my doctor's orders to start medication, I lowered my cholesterol from 298 to 182 by switching to a plant-based diet and getting active.

If I took all the meds docs prescribed over the years - I'd be on an entire medicine chest full! Oh yes, I also REVERSED my osteopenia without taking calcium :o)

BZ said...

If one person follows your advice and loses weight, cuts out salt and eats less or no meat, you will have done that person a tremendous service.

Amanda said...

I think there is also the misconception that doctors dont listen to patients either.

Anonymous said...

i wish more docs would be interested in stuff like that. i am from germany and i gained around 60 pounds (from beeing on the border to a little overweight to beeing really overweight) not knowing were it came from. the docs just kept telling me that i was healthy and there would be no reason to worry about it.
now that i know, that my thyroid has gone crazy, still nobody has asked me if i was doing any workout or how i eat. very sad.

Anonymous said...

If they appear not to be listening it is because you can hear everywhere and every day that you need to eat more fruit and veggies, exercise more and lose excess weight. If I waited several hours and payed a co-pay as high as a month of gym membership I would be completely pissed if that's what my doctor chooses to focus on. I can assure you that there isn't a single patient that comes to you who does not already know they need to exercise and eat well and hasn't heard it times and times again, just like people who are smoking are fully aware they are increasing their chances for various illnesses. You should go far beyond for your services to be worth it. And keep the eating and exercise talk to a minimum.

VeganHeartDoc said...

Anon -- diet and exercise isn't all I do. I diagnose and treat heart disease with testing and medication when needed. I do coronary angiograms, stress tests, heart rhythm monitoring, cardioversions, and other tests.

If "everyone knows" about a healthy lifestyle, why aren't they doing it? Lifestyle is the key to preventing and reversing many diseases of the heart, and if I didn't discuss these things, I would be remiss.

Anonymous said...

Simple: it's the effort and resources it takes to do all these things and all their other commitments. If most people could sleep as long as they need to, go for some yoga after waking up and grab a glass of fresh squeezed carrot and spinach juice as easily/cheaply as they could grab a latte they would do it. But instead they need to get their kids to school, go to work, etc. If a pill can offer similar benefits and requires minimal effort it's a no-brainer. Now I agree with you that it isn't a good substitute, but it's better than nothing. And the best thing you can do for your patients is save their time and money, so they could maybe dedicate some of it to a healthier lifestyle. Which they already know they should.

By the way you consistently fail to mention sufficient sleep on the list of lifestyle changes that could improve your health. Any doubts about that?

VeganHeartDoc said...

Anon -- No pill can entirely replace good diet, exercise and lifestyle. And, how is it that you suggest I shouldn't waste my patients' time by discussing diet and exercise, but I should tell them to sleep more?

Anonymous said...

You shouldn't tell them to sleep more either. They know. I was just wondering why you aren't as passionate about advocating sleep.

Diet for Heart Disease said...

Patients do listen. At Montgomery Heart & Wellness, we have a nutritional boot camp where every month dozens of patients change their lifestyle and have great results. A lot of doctors seem to think that a fully plant-based approach is too strict, and that patients won't follow it. We've found that many patients do make these lifestyle changes. Even if they don't they should at least receive accurate information and make that choice for themselves.