Ignoring doctor's orders

[kayaker]

Meh, he’s lived to be 87, he must be dong something right.

[BobBitchin]

@Flyer

The piece you’re missing is that sometimes “experts” actually know less than some other people, and sometimes their advice can be downright harmful.

Not that many years ago, the doctors were telling everybody to avoid eggs like the plague, because of all that deadly cholesterol. Guess what? It turns out that eggs are actually healthy. Some years before that, doctors were saying to avoid that “unhealthy” butter and use “healthy” margarine instead. Oops–they got that one backwards.

Currently, a lot of doctors are still following the fad that cholesterol is bad for you. Guess what? Cholesterol is absolutely essential to the proper functioning of the body, and furthermore, most of a person’s cholesterol is manufactured by their body; I think roughly 20% comes from diet.

There are other examples of the so-called experts knowing less than somebody who knows how to observe things properly and has basic reasoning skills.

And might I add to this great post…

By the time you’re 87 you have been lied to by so many authorities on so many topics, it must be hard not to be distrustful in some ways.

[RivkahChaya]

Once my cousins who are doctors were bitching together about people who come to them for advice, and get told to change their diet and get specific advice about motion-- not just “get exercise,” but specific things, and they get ignored. Then the person gets essentially the same advice from a “naturopath” who took an internet course, or the guy who works an GNC, or the co-op, who has no education at all, and they follow it to the letter, and then tell everyone how the doctor couldn’t help them, but this other person did, and they are a miraculous healer.

People don’t want practical advice from doctors, for some reason. They want pills, and maybe an appliance, but gawd, not advice, especially on lifestyle changes.

I don’t know the reason; people just want something from doctors that they can’t get elsewhere, I suppose, and “rest,” seems like something you shouldn’t have to pay for, I guess. Albeit, I love hearing that from my doctor, because it usually means I can get my husband to do everything around the house for a couple of days. It also means I have to return the favor when he is sick, but that’s OK. I tend to get sick more than he does.

[Voyager]

@BobBitchin

And might I add to this great post…

By the time you’re 87 you have been lied to by so many authorities on so many topics, it must be hard not to be distrustful in some ways.

First, I hope you realize that reporting on the results of a study is not lying, even if other studies produce contrary information. Especially since almost any study will have lots of information on what the limitations are, stuff ignored by the news media.
Second, people convinced authorities are lying often ignore all evidence to the contrary. I’ve seen anti-vaxxers - anti polio vaccine - claim that the massive decrease in polio cases after the Salk and Sabin vaccines were the result of better water treatment, not the vaccines. I was alive then - this is bullshit.
Remember, the people who think they know the most are the people who know the least.

[FairyChatMom]

@kayaker

Meh, he’s lived to be 87, he must be dong something right.

Like the time he was way up on an extension ladder, chain saw in one hand, leaning out to cut down a branch?? :eek: :eek: :eek: He was in his 60s at the time.

Or the time he blew his fingertip off firing a homemade cannon? He was a teenager at the time.

And other things that I’m not going to list…

He’s not a stupid man by any means. But sometimes I have to wonder. And I don’t know if it’s genetic or a learned behavior, but I see similar choices being made by his firstborn. Maybe it’s a guy thing that I don’t understand.

[kayaker]

Heh, I have to defend your FIL, since I’m pretty similar. I’ve had a close call or two with a chainsaw, and recieved some avoidable injuries during recreational activities. I’ve kayaked potentially risky waters, solo.

My attitude is that I’d rather live 40 fun-filled years than 80 quiet ones.
ETA: for all we know, his working the Achilles early on might lead to less scarring and he’ll wind up with better mobility.

[kiz]

@kayT

And then there’s the conflicting experts issue. My cardiologist in California told me the ratio of cholesterol is more important than the individual levels and mine was wonderful. My Texas cardiologist says I should take a statin, because. He had a couple of reasons to do with plaque and keeping it hard and blah, but after I had a bunch of tests he admitted the plaque issue doesn’t really apply to me, yet he still wants me to take lipitor. Guess what. I am not taking a statin despite what the expert says. See why we don’t always trust the doctor?

Are you my husband in disguise by any chance? His reason for not taking Lipitor is exactly the same.

I think, in some cases, doctors want certain people to start taking it to prevent something happening. There’s a history of heart issues in my husband’s family. He has never shown any symptoms of inheriting such. But, because the history is there, his doctor wants all bases covered “just in case”.

[kiz]

@Patx2

I think for a lot of people, not being able to do exactly what they are used to doing, or having to use a walker, wheelchair, take medications, the list could go on makes them feel as though they are showing a weakness.

I had foot surgery back in July. I’m not back to work yet because there were complications during the surgery and more of my foot had to be broken/reset than initially anticipated. I was put in a cast that went up to my knee immediately afterward. I had that for the first thee weeks. Why that particular cast? Because it purposely slowed me down so I couldn’t prove to the world that hey, I’m invincible! My surgeon knows me too well, LOL.

Even though in the long run, following a doctor’s orders and using a cane or taking all of a medication has its benefits usually, it’s often, imo, a psychological or image related reason that makes people refuse or question a course of treatment. Some people are just damn stubborn, too.

I’m a food service lifer and physically being able to run around doing a zillion things is par for the course. It’s how I’m wired. “Relax” never existed in my vocabulary until this particular surgery and only because I’ve been forced to (nope, can’t go back to work until X time, don’t bother asking, says my surgeon, if you go back now you’re going to screw up something by virtue of what you do.)

And you know what? My surgeon is correct. I had a very bad fall the other night walking our dogs. I fell because my repaired foot no longer pivots the way it’s supposed to, nor can I forcefully push off it if I were running. I managed to hang onto the dogs, though, and totter home. I’ve just pushed back a few weeks of healing because I had to prove to myself that my foot was strong enough to withstand walking our dogs :smack:

[Broomstick]

@kiz

I think, in some cases, doctors want certain people to start taking it to prevent something happening. There’s a history of heart issues in my husband’s family. He has never shown any symptoms of inheriting such. But, because the history is there, his doctor wants all bases covered “just in case”.

And sometimes it’s the doctor being lazy…

There is some very severe heart disease in my mom’s family and I’ve had one or two docs want to immediately start treating me as a cardiac patient despite no evidence of cardiovascular disease (low resting heart rate, blood pressure low end of normal, low cholesterol levels, general fitness, etc.) Turns out most of the heart disease in mom’s family is genetic, it’s down to one bad gene that you either inherit or you don’t - and I didn’t. I do not have the bad gene. I do not have mom’s heart disease. There is no way I will spontaneously develop mom’s heart disease. It is entirely inappropriate to treat me for a disease or condition I do not have.

Statins are not harmless. They can cause muscle damage that, untreated or with delayed treatment can cause kidney damage. They put the patient at risk of liver damage. They can trigger or aggravate Type 2 diabetes. While some people tolerate them administering them to people “just because” or because they’re a certain age without examining the patient and evaluating the risks and benefits is flat out bad medicine.

Of course, most of the time the doctor is right, especially in the case of acute injuries, but not always. But, crazy me, I usually consult another doctor for a second opinion. Not everyone does.

Then, of course, you have the idiots who just won’t listen even if the doctor is right. In some cases - deciding you want to maintain a lifestyle rather than live longer - it is arguably the right of the patient to make that decision. Other times… well, it just looks stupid to me. Maybe it’s denial. Maybe it’s cultural/social programming to never show weakness.

[Patx2]

@kiz

I had foot surgery back in July. I’m not back to work yet because there were complications during the surgery and more of my foot had to be broken/reset than initially anticipated. I was put in a cast that went up to my knee immediately afterward. I had that for the first thee weeks. Why that particular cast? Because it purposely slowed me down so I couldn’t prove to the world that hey, I’m invincible! My surgeon knows me too well, LOL.

I’m a food service lifer and physically being able to run around doing a zillion things is par for the course. It’s how I’m wired. “Relax” never existed in my vocabulary until this particular surgery and only because I’ve been forced to (nope, can’t go back to work until X time, don’t bother asking, says my surgeon, if you go back now you’re going to screw up something by virtue of what you do.)

And you know what? My surgeon is correct. I had a very bad fall the other night walking our dogs. I fell because my repaired foot no longer pivots the way it’s supposed to, nor can I forcefully push off it if I were running. I managed to hang onto the dogs, though, and totter home. I’ve just pushed back a few weeks of healing because I had to prove to myself that my foot was strong enough to withstand walking our dogs :smack:

I’ve had foot surgeries, too. After two of them, one on each foot, I was in a cast to the knee for 8 weeks and then in a boot for 6 because my surgeon was concerned about my bones setting properly because I have rheumatoid arthritis. He literally said to me, if we are doing this, we’re doing it right, we are not going to waste each other’s time. Was it a picnic? Hell, no, but I followed his orders to a T. I had dealt with foot pain for so long, I was happy to do whatever it took to get to a better place.

[kopek]

@FairyChatMom

Or the time he blew his fingertip off firing a homemade cannon? He was a teenager at the time.

If I had a nickel for everyone in the clan who ----------- wait! You know, we could just be related! :eek:

[FairyChatMom]

Talked to my husband today - FIL is now using a wheelchair. Getting around on a walker was just too much for him - he’d be exhausted just going from the living room to the bathroom. (Cardiac issues and very low BP) So now he can roll all around the house.

So maybe my sweetie will be able to come home soon. Fingers crossed…

[Gatopescado]

@FairyChatMom

Is there something unclear about doctor’s orders - as in the orders given by a doctor? I’m not an English major but I’m pretty sure that’s correct usage.

Nah. Just a joke. My way of saying, “I don’t go to doctors”.

[kiz]

@Patx2

I’ve had foot surgeries, too. After two of them, one on each foot, I was in a cast to the knee for 8 weeks and then in a boot for 6 because my surgeon was concerned about my bones setting properly because I have rheumatoid arthritis. He literally said to me, if we are doing this, we’re doing it right, we are not going to waste each other’s time. Was it a picnic? Hell, no, but I followed his orders to a T. I had dealt with foot pain for so long, I was happy to do whatever it took to get to a better place.

I have osteoarthritis from the knees down, including both feet. I also have a history of Achilles tendon issues. My doctor declared similar, adding that she’s had patients who’ve had to go back into surgery for repair because they didn’t follow her instructions to the letter, and do I honestly want to join them?

Yep, I’m following her orders, loud and clear. And you’re right, it hasn’t been a picnic.

[BobBitchin]

@Voyager

First, I hope you realize that reporting on the results of a study is not lying, even if other studies produce contrary information. Especially since almost any study will have lots of information on what the limitations are, stuff ignored by the news media.
Second, people convinced authorities are lying often ignore all evidence to the contrary. I’ve seen anti-vaxxers - anti polio vaccine - claim that the massive decrease in polio cases after the Salk and Sabin vaccines were the result of better water treatment, not the vaccines. I was alive then - this is bullshit.
Remember, the people who think they know the most are the people who know the least.

I said authorities have lied and do lie and that may influence how people act on advice from authorities.

[aruvqan]

@kayT

And then there’s the conflicting experts issue. My cardiologist in California told me the ratio of cholesterol is more important than the individual levels and mine was wonderful. My Texas cardiologist says I should take a statin, because. He had a couple of reasons to do with plaque and keeping it hard and blah, but after I had a bunch of tests he admitted the plaque issue doesn’t really apply to me, yet he still wants me to take lipitor. Guess what. I am not taking a statin despite what the expert says. See why we don’t always trust the doctor?

Pretty much this … Look, I get bloodwork done quarterly, I am diabetic and that is all there is. One of the things we track is my cholesterol, I love grapefruit and I want to eat the damned stuff, if I take statins, I can’t have grapefruit. My numbers are good so my regular doc is fine with me not taking them. WHen I popped with serious chaotic evil malignant hypertension, we spent 3 months trying to figure out what the hell was causing it. When one of the top cardiologists on the east coast can’t figure out anything more than ‘something in the brain seems to have gotten wired wrong’ then it isn’t an issue with my arteries [hey, at 315 pounds, diabetic for over 25 years and about as athletic as a slug and my echocardiogram is textbook perfect then it obviously isn’t plaque related … and I am now 100 pounds lighter, still diabetic and still as athletic as a slug …] SO what does my cardiologist focus on on my annual checkup? Not taking statins … sigh So I tell him that my doc is fine with me not taking them, my numbers are fine according to him [hey, he is the one that went to med school and knows the right numbers ti hit] so the cardiologist grumps at me, and orders me to go and pour out a couple vials for immediate bloodwork to check my cholesterol numbers, and by the way he is telling me this he is assuming that because ‘he has a more strict set of numbers to hit’ that he will be calling in a scrip for statins … oddly enough, I never actually got a scrip for statins …

[this is the same cardiologist that way back when I started seeing him was grumpy at my diet log full of milk, butter, eggs, heavy cream - because my numbers were better than his, and he was an exercise nut. What can I say, I would rather have limited real food that all the low fat, low sugar, non-food that people try ti substitute in. I have been doing the 1800 cal a day nutritionist approved deal since 1980, I know what I can cook and eat safely for a diabetic, and it is actually pretty damned healthy.]

[Qadgop_the_Mercotan]

@aruvqan

I love grapefruit and I want to eat the damned stuff, if I take statins, I can’t have grapefruit.

Just FYI, it’s fine to consume grapefruit with statins like atorvastatin and rosuvastatin.

[aruvqan]

@Qadgop_the_Mercotan

Just FYI, it’s fine to consume grapefruit with statins like atorvastatin and rosuvastatin.

So why the blanket ‘don’t eat grapefruit’? mrAru is on atorvastatin and was specifically told not to eat it. He does have cholesterol issues, so actually needs statins.

[I really detest the shove a pill at someone because they have *disease and might need it … just because I am diabetic and fat does not mean I automatically have bad labs … do the damned test then decide what to give me based on the numbers!]

[FairyChatMom]

@Qadgop_the_Mercotan

Just FYI, it’s fine to consume grapefruit with statins like atorvastatin and rosuvastatin.

Really? I love grapefruit but I’m on atorvastatin, so I avoided it. This is good news!

[Qadgop_the_Mercotan]

@aruvqan

So why the blanket ‘don’t eat grapefruit’? mrAru is on atorvastatin and was specifically told not to eat it. He does have cholesterol issues, so actually needs statins.

[I really detest the shove a pill at someone because they have *disease and might need it … just because I am diabetic and fat does not mean I automatically have bad labs … do the damned test then decide what to give me based on the numbers!]

No idea.

As for DM and statins, evidence is really very, VERY strong that taking a statin if you have DM reduces risk for stroke and heart attack quite significantly, no matter how good nor how bad your cholesterol labs are off the statin. Hence the recommendation. It’s been shown to reduce morbidity and mortality (save health and lives) in well-controlled diabetics with low LDL and high HDL. Probably by reducing plaque formation directly.

And it’s a good recommendation. And like all good recommendations, patient may opt out, but opting out ought to be after a reasonable discussion about ‘why not take it’.