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I work for CW doctors and sometimes their advice makes me cringe

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  • I work for CW doctors and sometimes their advice makes me cringe

    I do medical transcription remotely for oncologists. I just finished a report that seriously had me cringing. It was for a moderately overweight female patient who is recovering from the treatment for acute myeloid leukemia and has the symptoms of fatigue and lack of appetite. Patient has recently lost 11 pounds but claims that she is eating the same.

    The nurse practitioner counseled the patient that not eating is not a good way to lose weight because she will continue to feel fatigue but then counsels the patient to use Boost or Ensure in addition to possibly protein powders. She actually used the words Boost and Ensure in the same sentence as healthy eating.

    They recommend Boost or Ensure quite frequently and have also recommended Carnation Instant Breakfast on more than one occasion.

    These are really good, well-respected oncologists, too. It just makes me sad that they are so smart about one aspect, but not about the nutrition part of it.

  • #2
    Ugh... so sad

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    • #3
      I think it's common for most docs to recommend Ensure to cancer patients...I agree, it makes me cringe too.
      Check out my blog on nature and nurture!
      http://thewoodsygal.com/

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      • #4
        I think it is common, Solstice, but it's just so sad. The occasional report I've seen from the nutritionist on staff has also advocated the use of supplements like that. CW at its finest.

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        • #5
          It's devastating because the right nutrition could be the key to these patients survival and they're drinking Ensure. It just makes me sick. It's just hard to believe that we live in such a time that this is the norm and that it's considered the right practice... the right advice.

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          • #6
            It's amazing that they don't know about bone broth. Oh yah...I forgot...it's not marketed by a pharmaceutical company.
            Female, age 51, 5' 9"
            SW - 183 (Jan 22, 2012), CW - 159, GW - healthy.

            Met my 2012 goals by losing 24 pounds.
            2013 goals are to get fit and strong!

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            • #7
              I work in a pharmacy and patient's come in occasionally asking where to find the Ensure for themselves are a family member because the doctor recommended it. The pharmacist and I discourage them from purchasing it and show them the ingredient list of total crap, then recommend something like greek yogurt or even ice cream if the are lactose tolerant and non-diabetic. Seriously, do the doctors that recommend this crap have any idea what is in it? Would they even care?

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              • #8
                I think jojohaligo has it right in that the greek yogurt, etc., is not marketed by Big Pharma so it's not going to be recommended. I'm not usually one for conspiracy-type theories (if this even qualifies) but I really believe that the propaganda that Big Pharma has been pushing for years has become so entrenched in CW that typical doctors are unable to move away from it.

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                • #9
                  Originally posted by RobinNM View Post
                  These are really good, well-respected oncologists, too. It just makes me sad that they are so smart about one aspect, but not about the nutrition part of it.
                  Being clever does not make you wise.
                  Primal/Paleo is not for everyone, it's for those who have committed to understand.
                  READ THE BOOK! ...as Robb Wolf says: "Trying to convince people to save their own ass will burn you out."

                  Vegetarians are the enemy of everything good and decent in the human spirit, and an affront to all I stand for -- the pure enjoyment of food. Anthony Bourdain

                  and yes, calories DO count my little piggies

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                  • #10
                    Nix on Ensure and Boost as well, but this is the part that caught my attention:

                    The patient is losing weight while eating the same.
                    The NP tells her 'not eating is not a good way to lose weight', completely disregarding what the patient is telling her: that she is eating the same.
                    Obviously something besides calories is going on.

                    How about investigating that?
                    But it is so much easier to assume that the patient is lying or 'just doesn't know'.
                    While this may be the case, is it something to assume?
                    How about starting with the idea that the patient will tell her NP the truth. After all, she's there for help, right?

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                    • #11
                      Originally posted by Sabine View Post
                      Nix on Ensure and Boost as well, but this is the part that caught my attention:

                      The patient is losing weight while eating the same.
                      The NP tells her 'not eating is not a good way to lose weight', completely disregarding what the patient is telling her: that she is eating the same.
                      Obviously something besides calories is going on.

                      How about investigating that?
                      But it is so much easier to assume that the patient is lying or 'just doesn't know'.
                      While this may be the case, is it something to assume?
                      How about starting with the idea that the patient will tell her NP the truth. After all, she's there for help, right?
                      We're also assuming that medical practitioners actually listen. After four years of doing these kinds of reports, I am NOT a fan of nurse practitioners. A couple of them in this practice sound very good from their reports, but they've got a couple who can't even pronounce the chemo medications correctly and this is an oncology practice.

                      My mom was 5' 2" and overweight her whole adult life. About 5 years before she died she started gaining weight and gaining a lot of weight. She said something about this to her doctor. She also told him very specifically that she was not doing anything differently with her eating habits. He completely ignored her and just said she needed to lose weight. This went on for a couple of years and she got more and more uncomfortable (and bigger) and finally ended up in the ER having a paracentesis. That's where they basically stick a tube in the side of your stomach and drain out all the fluid that has accumulated. I think that day they took of something crazy like 6 to 8 liters of fluid. But she just needed to lose weight...

                      She also needed to get a better doctor but no one in this town was accepting new Medicare patients. The fluid was ascites and that is generally (and was indeed in Mom's case) a sign of the liver not working appropriately. Mom was a diabetic and none of this raised a flag for her idiot doctor.

                      I work for doctors and they provide me a decent living, but some days ...

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                      • #12
                        Originally posted by healthy11 View Post
                        It's devastating because the right nutrition could be the key to these patients survival and they're drinking Ensure. It just makes me sick. It's just hard to believe that we live in such a time that this is the norm and that it's considered the right practice... the right advice.
                        Completely agree. I'm also appalled by the lack of nutrition classes/training it takes to become a doctor! We literally are what we eat - shouldn't that be the biggest component of diagnosing and treating illness? It seems almost impossible that the nutritional aspect of medical training will improve, as it is completely antithetical to Big Pharma...and I find that sad beyond belief. These poor people go to their doctors looking for help, and instead they get a good dose of whatever watered-down death will benefit these multi-billion dollar industries.

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                        • #13
                          Originally posted by Sabine View Post
                          How about investigating that?
                          But it is so much easier to assume that the patient is lying or 'just doesn't know'.
                          While this may be the case, is it something to assume?
                          How about starting with the idea that the patient will tell her NP the truth. After all, she's there for help, right?
                          So true. And so frustrating.

                          A person can be unaware, of course, or lying, but why not just take them at their word? I don't know.

                          I remember when I had a pituitary tumor, the doctor kept asking me over and over how much marijuana I used. I didn't (and don't and never have) used any. The symptoms that I had could be caused by that, and he wanted to rule out whether or not I needed an MRI. He said "you have to be honest with me. there's no reason why a young woman like you should have this problem, unless you're using too much marijuana." and then, when I left his office, he said "try using less marijuana and maybe it will go away."

                          I was so frustrated. He then ordered an MRI which he said "I'm sure will show up with nothing, as this is probably caused by your excessive marijuana use."

                          Jerk.

                          Turns out it was a pituitary tumor, and thankfully it healed itself after I went vegan. I haven't had any problems since, and I've been unmedicated for the issue since the day it was discovered, but in all honesty, I was really, really annoyed that he figured that I was lying the whole time.

                          Because it's not like a 19 yr old girl could be telling the truth about that, right?

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                          • #14
                            I hear you there, RobinNM.

                            My friend's mother went through hell in a similar situation. She was older, but not that old really (she was in her 60s for goodness sakes), and she was complaining of stomach pains. She would go to the doctor and say that she had pains, etc. He diagnosed her with depression!

                            Three years later, she was hardly eating, and her belly looked like she'd swallowed a basketball. She was in so much pain she couldn't stand anymore, and I happened to get a good look at her when I helped her bathe and dress for a special event that she wanted to attend.

                            I suggested to her son (my friend) that they go and see a different doctor, because this was not "depression." He made an appointment, and they saw a different doctor who asked her about her symptoms and then asked "why would your other doctor think you were depressed?" She didn't know.

                            He sent her to the hospital immediately, where they discovered a massive stomach cancer. It was the size of a small basketball! Once they had that removed, she was able to eat again, but my goodness, she needed so much physical therapy just to manage her muscle atrophy from not walking for a long time. She was back on her feet in about 6 months, and very normal. She then got another cancer, and went through chemo and another surgery, and ultimately died about 2 years after the initial cancer had been finally "discovered."

                            Her new doctor said that if her original doctor had sought out what was wrong with her before, then she likely would have had a better quality of life over that time, and possibly better treatment early on would have kept her from needing treatment later.

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                            • #15
                              Re Zoebird's experience

                              A couple of years ago, I collapsed in a public building, EMT's told me that since I could not sustain my BP to stand I needed to go to the ER.

                              After tests, ER doctor diagnosed 'pancreatitis' and asked me about my alcohol consumption--which is miniscule. I will have an occasional glass of wine with a restaurant meal, and that occurs about once a month. But what I didn't know at the time is that 'pancreatitis' is common among alcoholics, so doctor and nurses kept at me about my 'drinking'--and no one would believe that I don't have a 'drinking problem.'

                              The next morning, my own GI arrived and told me that he suspected that I'd passed a tiny gallstone that had 'tipped' the pancreas, which is apparently super-sensitive [I had had an intense stomach pain just prior to passing out.] Everything had resolved, and no further treatment was necessary.

                              I remain furious with the ER personnel who insisted on fitting me into their 'textbook' knowledge. Someone told me once that to earn an MD, you don't have to be smart; you just have to be able to memorize. That's why there are so many medical people who can't go beyond their basic textbook info.

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