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Furious at my "doctor"? A little.

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  • Furious at my "doctor"? A little.

    To give some backstory. I had a VAP test done after about 6 months of being primal. My total was pretty high at nearly 400 with my LDL being almost 300 and a 49 HDL and 63 trigs. I was in the middle of the pattern A range. This was in April so I figure maybe I'll see if anything has changed after few more months and being that my weight has now stabilized after losing 40 lbs during the first 6 months. I asked my doctor about doing another VAP as well as a CRP and vit D test because I've been supplementing 5k iu per day. This is what I got back:

    By the way, I only find VAP testing useful in people with borderline cholesterol panels. It helps decide if medication treatment is needed. Your cholesterol is nowhere even close to borderline. It's high, high, high. A typical cholesterol panel is all you need.

    The CRP is also an interesting test to help guide treatment in borderline cases. It won't be helpful in your case as you are already in the high risk group.
    Although an elevated CRP level is known to be associated with an increased risk of heart disease, no clear consensus exists regarding when and on whom to use hs-CRP testing. In January 2003, the Centers for Disease Control and Prevention (CDC) and the American Heart Association (AHA) published a joint scientific statement recommending when this test might be useful.
    The CDC/AHA recommendation states that the evidence supports the use of hs-CRP as an independent predictor of cardiac risk when evaluating individuals of intermediate or moderate risk for cardiovascular disease. However, the statement does not recommend use of hs-CRP testing for widespread screening of adults to determine risk or to monitor treatment.

    I don't recommend you measure vitamin levels.

    Any recommendations on what to respond with, if at all? I'd only seen him that first time and at the time he seemed to be trying to impress me by simply knowing what VAP stood for after I asked. I'd think a VAP would be even more pertinent if he's worried about my high cholesterol since it'll tell him what my pattern A/B is. He said last time that my pattern A was good but having too much cholesterol floating around in there can't be good. Almost his exact words. And he doesn't recommend testing vitamin levels? Wtf.

  • #2
    Get a new doctor?


    • #3
      I know, and I am. I was actually just hoping to get the tests to check my levels, but I wanted to vent a little as well.


      • #4
        Completely undertand the need to vent! Here's what I would do (take it or leave it! ). I'd find a new doctor. then I'd email the old doctor and say,

        Dear Dr. __________________,

        I appreciate you explaining your thoughts about the testing I had requested. I have decided to go with another doctor that was a little more up to date on the current research regarding how vitamin and mineral levels (specifically Vitamin D and magnesium) have a direct effect on metabolic functioning (specifically thyroid, cholesterol and inflammation).

        Thank you for your time,

        Sign it.

        I think it's very nice for a letter firing your doc, don't you?
        sigpic "Boy I got vision and the rest of the world is wearing bifocals" - Butch Cassidy and the Sundance Kid


        • #5
          Don't even bother with a letter. He'll just dismiss it as "doctor shopping."

          He wouldn't have brought up the defensive justification for rejecting the testing request if he wasn't already raising his eyebrows, anyway.

          Just get a different doctor. (Yes, go doctor shopping! In a manner of speaking.)
          "Trust me, you will soon enter a magical land full of delicious steakflowers, with butterbacons fluttering around over the extremely rompable grass and hillsides."


          • #6
            Wow. I hope my results come back good. I am waiting anxiously to see what my labs show that they took on Monday.


            • #7
              Find a new doc then respond to the old doc that you want your medical records transferred to your new doc.
              “It is a truism that almost any sect, cult, or religion will legislate its creeds into law if it acquires the political power to do so, and will follow it by suppressing opposition, subverting all education to seize early the minds of the young, and by killing, locking up, or driving underground all heretics.”
              —Robert A. Heinlein


              • #8
                Thanks for the replies. I'm still trying to hold myself back from sending a scathing letter. Minxxa, the one you suggested is pretty good. The first time I went in I spent my entire time there convincing him about the VAP test as opposed to the regular one. He finally consented and then when it was high he came up with the "too much in floating around in there can't be good" comment. I decided then to drop him so in my email I asked if he could write the order so I could just come in for the bloodwork without seeing someone. I thought he might like the idea of the cRP test to determine if there was an actual issue with inflammation, but I guess not. I do kind of want to email to ask about the vitamin levels at least as he seemed to just flat reject the idea of ever needing to test. From the impression I got of him it could even be that he has no idea what the results should be so he wants to avoid the embarrassment.

                Just as a side question; does anyone know if inflamed gums can increase cholesterol/cRP readings? When I last went to the dentist they said my gums seemed to be infected in some parts because they bled when they flossed and I usually don't floss. Could this lead to a high cholesterol or is it totally unrelated?


                • #9
                  If you don't floss regularly, your gums will bleed when you do.


                  • #10
                    I know. My dentist just mentioned that it looks like they're inflammed and they were bleeding when doing so so I was wondering if this was indeed indicative of inflammation and if it could skew cRP or cholesterol?


                    • #11
                      I have an impertinent question that is really more philosophical than personal - If you aren't going to change your diet, and you aren't going to take a statin, then why get the test done at all?

                      (I realize there are reasons, and decent ones, like tracking progress coming off SAD or proving to Mom the diet isn't completely crazy or whatever. But cholesterol tests cost $$, VAP tests more money - maybe we are all much better off getting calcium scores of our coronary arteries because at least you see the pathology instead of the inflammatory markers. From a public health perspective.)

                      Your doctor is following standard evidenced-based medicine AMA protocol to the letter (except I can't follow the vitamin level thing. On that he's an idiot). His lawyer would be happy.


                      • #12
                        Get a new doctor before obamacare sets in
                        MDA PRIMAL LIBERTARIAN GROUP


                        • #13
                          As it is a little high by most standards I'm curious to see if it's come down and if it hasn't come down if I have other inflammation that could be a problem. While I don't think it's a huge problem, there's not much literature on cholesterol being that high that I've found so I'd rather it be a little lower even if I'm not terribly worried. I've seen a couple places state that a VAP test isn't much more than a regular cholesterol test and I'd have to think knowing the pattern size of LDL is still important. Of course he's following standard protocol, but if all doctor's did that and didn't think for themselves...well I guess we'd be where we are now with doctors being behind on knowledge. If a doctor doesn't keep up with new information and barely knows old info they're kind of worthless. From seeing him and talking to him, I'm completely convinced I could do his job better than he can without any medical training.


                          • #14
                            Get another doctor--but you've already decided to do that--good.

                            About CRP. My understanding that it is a BETTER predictor of cardiac issues than cholesterol, and it will reflect inflammation anywhere in the body. So if you've having some gum problems, you might wait until they're cleared up, but keep in mind that gum disease is also related to cardiac issues. My primary ran a CRP a while ago without my asking for it at all. Most doctors ignore it because they've all been brainwashed by Big Pharma. You see, if your cholesterol is high, they can put you on meds. But the 'cure' for a high CRP is only lifestyle changes, so the drug reps are not pushing that test at all!

                            About VAP. The problem is your low HDL. I had a VAP test and it showed 100% Pattern A LDL, and my doctor said that he typically sees that in patients with a high HDL (mine is always 75-90) and low trigs (I'm usually 50-60). If I were you, I'd try to raise that HDL with a focus on getting enough omega 3s.

                            By the way, even with my VAP results, I still have doctors 'questioning' my 'high' LDL--which is about 130, and I don't consider it high. Just more Big Pharma nonsense.

                            Not wanting to test your Vit.D is the reason I'd change doctors because it shows he is totally unaware of current knowledge about the importance of Vit. D. Again, the drug reps aren't telling him about this because D supplements are OTC.

                            You'd be surprised at how many doctors, especially primary care, get there ongoing medical info from the drug reps.


                            • #15
                              Thanks Emmie. I have been trying to get the HDL up through exercise and I've been taking Slo-Niacin. Though I've read mixed things on whether 500 mg a day does very much. I can't exactly up the dose if my current doctor isn't willing to run any tests to see if I have any issues with it lol Are you saying people that have gum disease many times already have cardiac issues or the inflammation from it leads to them?