How Docs Don't Know Dick?

Well to a large extent, in their defense it comes to providing services that large numbers of people want and will pay for.

Most patients are totally unwilling to follow even the simplest lifestyle change advice that would make radical improvements in their health problems. General practitioners are already quite frustrated by this. While in an ideal world everyone would know everything, in the actual world people have to focus what they do to what is called for. Most people not only don’t go to their GP for advice to how to change their lifestyle, dietary practices, etc, but what little advice the doctor tries to give them is ignored near 100% of the time. So why would these doctors beat their heads against the wall trying to develop the knowledge for more complex advice in such areas?

It isn’t what their patients come to them for.

You personally were an exception. But there will always be exceptions.

[quote]GusBus07 wrote:
Quite Frankly the Truth? I dunno, just a guess.[/quote]

Okaaay,I usually resist forum bashing(so easy to be a tough guy on the internet) and I don’t say anything I wouldn’t say to someone’s face,but did you just use an abbreviation,without knowing what it meant?

[quote]Ace Rimmer wrote:
jehovasfitness wrote:
Why do you type like that? Really annoying to read

type like what? using my fingers?
I find it easier than a big clump of words…[/quote]

why do…
you…
type…
2 words…
then hit enter… or is it your computer?

[quote]Bill Roberts wrote:
Well to a large extent, in their defense it comes to providing services that large numbers of people want and will pay for.

Most patients are totally unwilling to follow even the simplest lifestyle change advice that would make radical improvements in their health problems. General practitioners are already quite frustrated by this. While in an ideal world everyone would know everything, in the actual world people have to focus what they do to what is called for. Most people not only don’t go to their GP for advice to how to change their lifestyle, dietary practices, etc, but what little advice the doctor tries to give them is ignored near 100% of the time. So why would these doctors beat their heads against the wall trying to develop the knowledge for more complex advice in such areas?

It isn’t what their patients come to them for.

You personally were an exception. But there will always be exceptions.[/quote]

As I said,I am not an exception,many people ask for advice or an OPINION in this area.
I know because myself and other PT’s/coaches (often begrudgingly) send them to their GP’s to give them clearance.
It’s a basic guidleine.I’m not asking for advanced knowledge just a BASIC knowledge,or at the very,very least,if they don’t have that knowledge…STFU.
Unfortunately,many GP’s are in a kind of limbo,with outdated government guidelines more suited to feeding cattle,yet many give unsolicited uninformed advice ANYWAY,or take no action to become informed.
There should be a system in place-a system of co-operation and more GP/PT referral,an information sharing service,or a database of info updated more regularly.
Don’t give me the f**king sob story about non-adherence and ignorance,I am a PT,I see that every day in the gym! I know for a fact that about 7 out of 10 people many PT’s give a fitness test,induction or free PT sampler to,I won’t see visit the gym again.If 2 or 3 people do HALF the stuff we told them to,it’s a good week.I don’t give up studying all areas of wellness though…

\My train of thought goes something like this A) talk to a psychiatrist since they are more apt to give out meds for depression and then ask them what the meds might interfere with if they don’t know/

What’s quite interesting, is that most psychiatrists don’t even know the effects of 5-HTP, tryptophan, etc. It’s kinda sad considering the amount of sertonogenic drugs the constantly prescribe. Most doctors still haven’t come around to the concept of functional medicine yet.

[quote]jehovasfitness wrote:
Ace Rimmer wrote:
jehovasfitness wrote:
Why do you type like that? Really annoying to read

type like what? using my fingers?
I find it easier than a big clump of words…

why do…
you…
type…
2 words…
then hit enter… or is it your computer?[/quote]

I don’t know,I never noticed? I have A.D.D. that could be a factor.I tend to ramble on like a motherfucker,I can’t concentrate too well on large clumps of text,hence I read textbooks and articles better than I read actual books,asthey tend to be broken into sections/graphs/pictures/tables more.
I find T-Nation’s especially easy to read,whereas,say,Bodybuilding.comoften has a large clump of text,often with terrible spelling/grammar,and it looks like it’s been copied and pasted.

Strong words:

[quote]Dr. Jonny Bowden:
Doctors don’t know dick about nutrition[/quote]

There was a doctor (GP) who used to post here a few years ago that pretty much corroborated what Bill is saying though. I had a few long conversations with him about preventable lifestyle induced maladies. His method was: Dietary and lifestyle changes first and when they wouldn’t do it, which was just about every time, out came the pad on their next visit because it was that or nothing.

The greatest evil about this in my opinion is that the public is now convinced that drugs and surgery are now practically viewed like taking an aspirin was 50 years ago. Just routine. It’s almost automatic to assume that anything “wrong” with you is an instant prescription.

I’ve told my story 1000 times here how I took my blood sugar from routinely over 500 and blood pressure that was 180 over 110 both down to normal completely on my own without a single dose of any drug of any kind.

Ace, you are a crazy mofo, eh :slight_smile:
I chuckled at the title of the thread and the nick, nothing like a thread about dicks and rimmers!

[quote]MODOK wrote:
Ask a pharmacist ;). Or just log on here and send me a PM. I’ll give you the straight skinny. Call me your E-pharmacist with a sports supplement subspecialty. lol

FYI- Bill Roberts is a genius pharmacoligist. You could just ask him too.

The rest of the world doesn’t give a damn about alternative medicine and supps. Ask us and we will give you the best information and a professional opinion (if we have one). [/quote]

Cheers…will do.
Incidentally,does smoking a kipper affect it’s health impact (for me,not the kipper!) nutritional content or digestive effect?

Serious question.

I really am starting to feel bad for medical proffesionals. You goto school for years no end, work really hard, then someone walks in off the street and assumes their knowledge trumps yours because they read some article on the internet.

My father has skin cancer, just had his prostate removed, has type 2 diabetes, high cholesterol, high blood pressure and is rapidly gaining weight. He refuses to take his doctors advice. I don’t particular LIKE his doctors prescriptions (lipitor, etc). But its the best we can get him to do because of the situation.

Dad won’t excercise and suggesting it creates one hell of shit storm, dad refuses any medication or dietry changes for his type 2 diabetes because “I don’t have diabetes, the doctor doesnt know what he is talking about! diabetes requires insulin!” nothing like really bad rhetoric arguements to rationalize and avoid treatment.

We can’t convince him, the most i can get him to do is take some of my fish oil, and give him aspirin when he experiences mood crashes and gets really angry, flushed and tired. He assumes he knows more then the doctor too. But it just gets worse.

Your doctor doesn’t know preventative medicine because nobody comes to him until they have a problem that they have let fester for months. Then they provide the simplest approach they can because frankly no one follows it. The patient will be back next week with a copy of one of oprahs books to explain why they don’t follow the advice.

They find the most obscure supplements (which are of unknown quality) then get angry when the doctor says to just “start with the advice i gave you”. There is more information on prescription drugs then supplements. its medical minutae for your gp. His advice is probably the best he can do for the patient. Yours is all your ignorance and ego can do for the patient.

Doctors don’t know shit about nutrition or training. Forumite’s don’t know shit about health, medicine, and if the experts here are to be believed nutrition, supplements, and training. But probably believe they do. Rather then posting this shit on the net why don’t you take what you know and take it to a medicial proffesional who is capable and ready to intergrate it into their protocal. Don’t laugh if they tell you the box of pills you just bought of the shelf of your supermarket are shit. They probably are.

ps: i like 5-htp. I think it helps with your problem.

[quote]bushidobadboy wrote:

Good luck with that. I created the GP Exercise Referral Scheme in Nottingham, from scratch. Did the qualification, met the local Drs and nurses who would be referring to me and my team of instructors. Organised the exercise sessions and activity sesions and waited for the first person to walk through the door.

However for every 7 people admitted, that were unwilling or ‘unable’ to change their ways, 3 people embraced the concept and reality of changing their habits. And for every one of those 3, one or two actually effected lasting change and dragged themselves out of their rut and experienced lasting improvement in health, weight, body and mind.

And let me tell you, there are few things that make me buzz as much as a previously ‘damaged’ person healing themselves under your guidance and tuition and thanking you at the end of it all, as they walk tall, out through your doors, to face the real world with a new outlook and positive mindset.

So I do wish you luck with it. It can be an increadibly frustrating, yet increadibly rewarding job. Poor people might not have all the tools to effect positive change, but they can be some of the most genuine, lovely, giving individuals you’ll ever meet. Well worth the hassle of dealing with some of the most stubborn, deceitful, selfish individuals you’ll ever meet, lol!

BBB[/quote]

You creatd the whole scheme/ for the whole of the UK? or just your area? really?
good work fella!
Those dropout rates sound about right for any gym’s members anyway,in my experience!
I’m ready for all the bullshit,I see it with people now anyway.
They tell me ‘yeah,I’ve been coming 3 x a week’ and their fitness test results are the same and they smell of cigaretes or weed,lol.
I think to myself ‘No you haven’t you lying bastard!’ I know I’ve never seen them in there,and I know they look exactly the same.
Further investigation,such as checking their attendance via the card swipe system reveals this is the first time they have been in all month.
They concede,in the light of such evidence,that they have ‘been busy’,which I don’t accept.the same people will still find 5/6 hours a day to watch TV and surf the net-you can’t give me 3/4 hours a WEEK? to start you off?
Anyway,I am currently enrolled on a behavioural psychology course,and reading books on behavioural change,NLP (Neuro-Linguistic Programming) and planning to do a course in this also.
I see PT’s and instructors working more closely with medical professionals and more of a trend towards Life Coaching/Mentoring,rather than simply instructing,actually proactively motivating and changing lifestyles.
Already more serious facilities are using the term ‘Wellness Coach’ or similiar,instead of ‘Fitness Instructor’ or PT, to portray a different image.
Shit,if I could get 4 out of 10,that’s a start.
I’m ready for the hard work,your approach sounds proactive and I can tell you are/were passionate about helping people succeed,not just making a fast buck.
That’s my philosophy too.
I want to be in their kitchen,take them shopping,teach them to shop and cook real food,you name it.

[quote]The geek wrote:
I really am starting to feel bad for medical proffesionals. You goto school for years no end, work really hard, then someone walks in off the street and assumes their knowledge trumps yours because they read some article on the internet.

Yours is all your ignorance and ego can do for the patient.

Doctors don’t know shit about nutrition or training. Forumite’s don’t know shit about health, medicine, and if the experts here are to be believed nutrition, supplements, and training.

ps: i like 5-htp. I think it helps with your problem.[/quote]

As I’ve said,this isn’t a doctor-bashing thread-Many doctors are hard-working and professional,that’s a given.Many others are ignorant,arrogant quacks who appear to have barely scraped through medical school.It’s a profeesion like any other,but some profeesionals are UNprofessional.The very fact that all doctors are ASSUMED by the majority of the general public to all be wise,saintly professionals alllows doctors to find a comfort zone and only learn the minimum required.A doctorate is prestigous-it’s not a badge of honuour that implies they have the keys to the universe,inner or outer,yet many act like they do.

What ignorance and ego? I am sorry if I come off emotional about this,but how do you expect me to feel? I was prescribed pills known to have a high rate of worsening my condition,increasing mood swings,depression and suicidal tendencies-and they made me want to go on a diet of shotgun pellets,along with a whole host of other side effects I suffered from,when a widely available supplement has improved my condition beyond belief,with no side effects,in 2 days.5-HTP has very few side effects and is far safer by comparison.The one well-known major side effect is to not take them with SSRI’s which the doctor gave me,and the doc’s opinion on 5-HTP amounted to a shrug and ‘give them a try I suppose’
Do you not think he-
A) should know something or FIND OUT about something which took me 30 seconds to look up,to advise?
B) should know or FIND OUT about this as it would not merely fall into the area of nutrition,but into the area of Wellness/treatment,as it is beneficial to weight loss,insomnia and depression?
C) Should know or FIND OUT about possible interactions with what I’m taking?
D) Should know what it is without me having to explain what it is,GIVEN THAT IT STATES THE CHEMICAL NAME ON THE FRONT OF THE BOTTLE-A CHEMICAL PRECURSOR TO SEROTONIN???
E) should have access to a government approved database,reference book,or forum to check it against???

What do you mean by ‘forumites’? the peeps on this forum come from all walks of life and some ARE ‘experts’.

[quote]nikinine wrote:
Ace, you are a crazy mofo, eh :slight_smile:
I chuckled at the title of the thread and the nick, nothing like a thread about dicks and rimmers!

[/quote]

Indeed,nothing like tossing a salad to cure what ails ya!

[quote]The geek wrote:
There is more information on prescription drugs then supplements. its medical minutae for your gp. His advice is probably the best he can do for the patient.
(edited)
[/quote]

Precisely-I agree.
This is exactly why I said that doctors should have a system in place to get info like this,or be more ready to refer or find out,network,or be sent on a course,etc.
Some of them may well do,many do not.That’s what this thread is about-is it ignorance? arrogance? lack of support? funding?
They can’t have it both ways,if this is not in place,then take it out of their hands and forbid them from UN-educated UN-informed guesses and unsolicited,outdated advice.
take the power out of their hands for medical clearance if it’s a burden they don’t want and save me and other PT’s and the client the hassle,encourage education if they do want ot help.
In addition to the stated example of me sending clients,sometimes with pre-existing medical conditions or hereditary problems or injuries to a doctor for clearance for a diet plan or exercise programme,and getting a non-commital ‘yeah,why not’ or some such comment-thanks for the input doc,
Here’s an example,if a member/client came to me and said he had say,knee pain in one knee,but was gonna do his workout anyway,I would try to diagnose it as best I could,I may,depending on the circumstances,try to get him to take a day off,refer to a website or textbook,and/or refer him to a physiotherapist or similiar professional,apply ice,take a painkiller,etc. or if he is adamant,I may recommend alternatives to work around the injury-an alternative to his workout,or the exercises with the least risk or some mobility work that is prehab/rehab related.
I am not a Physiotherapist/Physical Therapist.I am not an expert in sports injuries-but if he will still train,will not go elsewhere and wants MY opinion,I will do my best to examine the problem,monitor it,inform them of my limitations and area of expertise,refer and/or consult with physios,trainers,coaches and sports massage practitioners where possible,and give a carefully considered,educated,informed opinion and advice.
Why? I’m not a physio,it’s not my field!
Because,as you stated-my advice is probably the best I can do for the patient (client)
What I WON’T do,which I have seen many doctors do,is pretend I know everything,or give a non-committal ‘Yeah,why not’ or ‘give it a try I suppose’ while writing your prescription out.
That kind of nonchalance can do more harm than good-suppose as soon as the aforementioned member had mentioned his knee pain and said he was gonna work out anyway,I simply shrugged and went ‘Yeah,give it a try,I suppose’ or ‘yeah,why not?’ with no further investigation or input.If that guy went on the treadmill and aggravated it,or tore/twisted/sheared something,how does that reflect on me?
‘Not my problem,mate,it’s not my field’ is that what I’m supposed to say?
he could be out of action for MONTHS now,and if he wanted to take it further,he could possibly sue me,claim from my liability insurance,I could be struck off the exercise register and fired.
Well,this is what the doctor said to me,and he had MY LIFE in his hands,not my ACL.
I self-study as much as I can on injuries/rehab,but I know my limitations.I plan to study for a Diploma in Anatomy & Physiology,Sports Massage,and a Certificate In The Theory Of Sports Injuries,to give me a deeper understanding of this.
Why? I’m a Personal Trainer,not a physiotherapist!

This annoys me as well, but there’s no way doctors can know everything about everything. At the end of the proverbial day, one must do research the best they can, talk to their doctor for what it’s worth, and then make the most informed decisions possible. Like anything, it’s pretty much a crapshoot.

Every time I take a new supp I wonder if I shouldn’t be taking it. I started on Fexofenadine again last week, and HRX again this week. Should I be taking these things at the same time? Hell if I know. Not dead yet.

It can be frustrating, especially when one doesn’t like to simply accept some prescription for all of their ills. I can’t even get my doctor to stick around long enough to discuss my medical conditions with him. He just throws scripts at me and makes follow up appointments with his PAs. But who the fuck else can you go to? When I do ask questions, he acts all smug and smiley and shit. I think I want to hit him in the face. Bastard.

I am going to start by providing a little information about 5-hydroxytryptamine (aka serotonin). Serotonin is a monoamine neurotransmitter whose main purpose (in humans) is to regulate intestinal movements. In fact, approximately 90% of the body’s serotonin is located in the enterochromaffin cells in the gut. The rest is sythesized in serotonergic neurons in the CNS which, among other things, control mood, appetite, and aggression. Now in the brain, messages are sent between two cells via a synapse. This occurs in a few stages.

First, the presynaptic cell releases neurotransmitters (like serotonin) into the gap between the cells which are recognized by the receptors on the surface of the postsynaptic cells which in turn relay the signal. A small portion of the neurotransmitters are lost in the process, but the rest are taken up by monoamine transmitters and sent back to the presynaptic cell (this is called reuptake). SSRIs inhibit the reuptake of serotonin so it stays in the synaptic gap longer so it can keep being recognized by the receptors.

If your body has low levels of serotonin, this is a great way to combat the symptoms of depression. If your body has normal levels of serotonin, however, the relatively large amounts of serotonin will cause the receptors to shut down (this is particularly bad in the case of the 5-HT(2A) receptor) which will actually cause the symptoms SSRIs are meant to combat. Now, on to the use of 5-Hydroxytryptophan (5-HTP) to combat depression. 5-HTP is a direct intermediary in the metabolism of serotonin and ingesting it does increase serotonin levels.

Most if this serotonin will remain in the gastrointestinal tract, but a very small amount will cross the blood-brain barrier (serotonin does not cross the blood-brain barrier so only the 5-HTP that has not already been metabolized, which will be a fairly small amount since the metabolism of 5-HTP is fairly rapid, will make it’s way into the brain and form serotonin.

So, looking at this from a biochemical standpoint, the idea of using 5-HTP to combat depression does not hold up to the facts. A better answer to why 5-HTP seems to work for fighting depression is the fact that we, as a society believe drugs are the answer to every problem. If someone is feeling a little sad so they go to a doctor and BAM, prescription for SSRI’s.

Not long after starting the meds, they feel worse and google other depression cures and come across something like 5-HTP and read the website which has several referenced studies which he/she does not check and wouldn’t know how to tell if it was a good study or not and stops taking the SSRIs and begin taking 5-HTP. Not long afterward, voila! no more depression! 5-HTP is a miracle cure! In reality, the fact that you stopped taking medication for a condition you didn’t have is what cured you.

This is a message to everyone out there: Stop taking pills for every problem you have. Everyone gets sad sometimes. It does not mean you are clinically depressed. Body building supplements will not turn you into a top athlete. There is no magic pill to reach any goal. Hard work is key.

[quote]Ace Rimmer wrote:
Lordcliff wrote:
Did you look in the aforementioned PDR to look at the percentage of people who actually experienced these side effects? If during the clinical trials, someone has a side effect, it gets listed, even if the percentage is small.

Drugs get tested on volunteers. I read an article in MH (i know, i know) about people lying and doing more than one study at a time, so that brings into question the actual validity of the studies that side effects show up in.
You as a consumer have an obligation to yourself to research things ahead of time. Did you in fact experience any of those side effects? If not what’s the problem. If you looked a majority of medications, they come with a long list of potentially real fun side effects. Tylenol has the least I’ve come across, but can still kill you. Drugs approved by the FDA go through a testing process and are required to list side effects, supplements not approved do not have to list side effects, but you can find them, and they are just as fun as prescriptions. Supplements are not regulated like prescription drugs are, they aren’t held to the same standard.
The side effects of depression aren’t good either, weight gain (which can lead to heart attack, stroke, diabetes, the list goes on), possibility of suicidal thoughts, lethargy,
etc, etc.
Everything you put in your body can potentially do you harm, even water.

I didn’t even know what a PDR was,do we have them in the UK too?
Did you read my post fully? Yes,I experienced MAJOR side effects-even worse depression and even worse suicidal thoughts than before.
I bought extra painkillers just in case I went for it.
The insomnia was excruciating-I was up for days with a couple of hours sleep.
I fantasized about ventilating my head with a shotgun,and researched applying for a hunting licence so I could buy one…I even wrote a suicide note and made some worrying late-night phone calls.
Before the anti-depressants,it was more like a fleeting fantasy of suicide rather than an actual gameplan.
What I was saying was on this anti-depressant,and many other SSRI anti-depressants,this is a VERY common side effect,it is the first one listed,with it’s own section taking up half the leaflet that comes with the pills.
I got many others,including weight gain,bloatedness,puffy face,etc.
I took th 5-HTP and was like a new man,I’m still on it,with no side-effects.The side effects listed on websites are much less common,as are interactions.
Depression and increased suicidal thoughts are not listed and most anecdotal AND lab studies are positive-(in some studies,they were shown to be just as effective if not more effective than SSRI’s) this is important,given what you and I already know about how lab studies are not always conclusive,etc. why can a supplement not be given a status or rating based on BOTH?
I don’t think we have the equivalant of the FDA here in the UK,but we should,and ALL supplements should be subject to scrutiny.

[/quote]

I must have misunderstood, I thought you were referring to potential side effects, not side effects you actually had. I stand corrected

[quote]MODOK wrote:
There are some brilliant guys, and some absolute idiots…just like every other profession in the world. Just yesterday, I had to stop this genius from giving 25 mg/kg of gent to a patient…a 10 fold overdose which would have destroyed the patients kidneys, made them deaf in all likelihood, and may have eventually led to their death. But he was DEAD SET on giving it, until I had to go visit with him. Something like that happens to me two or three times a WEEK. And there are 30 pharmacists doing the same, so you can imagine.
Whats scary is the physicians are pushing hard to get rid of pharmacist’s prospective review of their orders in a hospital. If they get that, there would be no way of stopping things like I just mentioned…[/quote]

It’s interesting what you have to say about pharmacists in a hospital setting. I’m going to school for a pharmacy technician right now all of what I’m learning so far has been eye opening. Our teachers are pharmacy technician themselves and have been for the past 10+ years.

A pharmacist has a specific role in medications/pharmacology (although they cannot prescribe them in Canada) tend to know more about it then say a average doctor. A pharmacist is necessary in any hospital setting to consult with a doctor and the patients. Your examples MODOK are why we need to have pharmacists in hospitals.

[quote]mcook123 wrote:
This is a message to everyone out there: Stop taking pills for every problem you have. Everyone gets sad sometimes.[/quote]

This is the best message I’ve read in a long time.