C’mon, Tourette’s-like fits?  Yes; indeed.  And I’m still pissed.  So much so that I’m gettin’ ready to go all Richard Nikoley on some serious mainstream ignorance.  Okay, so my man Richard is the undisputed king of the verbal beat-down, and this post won’t come near to his standards, but you get the point.

And the point is this: I just don’t understand the reluctance, on the part of mainstream healthcare practitioners, to at least consider the benefits of a Paleo diet.  I guess it’s too much to ask that all healthcare practitioners be as open-minded as, for example, Kurt Harris and Doug McGuff, but seriously… I mean, I fully understand and appreciate the day-to-day time demands placed on these folks, and I realize the seriousness of even the perception of incompetence or malpractice on a doctor’s livelihood.  That said, though, doctors are (or, in a perfect world, should be) in the business of healing, not in the business of, well…business — or dancing unquestionably to the AMA‘s ossified, dictate-fiddles.  I realize, too, that I come at this more from an idealistic point-of-view — I don’t have, amongst a host of other problems to deal with, the repayment of student loans, and insurance and business-related worries to contend with; and yet…

And yet, I want to scream at the top of my lungs to these people to get off the fuckin’ stick, and do some independent study already! People are suffering — dying, even — and the nation is slowly drowning in a quagmire of healthcare-related costs, in large part because you, the “healthcare practitioners” of this great nation, consistently give the wrong friggin’ advice on the very basics of health maintenance.  Wrong on diet, and wrong on exercise prescription.  I mean, damn, this isn’t rocket science, folks.

What is it precisely that’s got me so spun-up?  Well, two things in particular.

First up, check-out the correspondence that Meesus TTP had this week with a mutual friend of ours, a friend who has a young daughter who has recently been diagnosed with — yeah, you guessed it — diabetes.  What follows is a snippet of our friend’s (let’s call her “concerned mom”) most recent chat with Meesus TTP.  I’ve truncated, edited (denoted by parentheses) and/or dropped names due to privacy concerns, but the string of the narrative I’ve left intact.  And that thread is really what it important here, because it is repeated God-only-knows how many times each and every day.  Now tell me if this doesn’t just piss you the hell off.

Michelle,
About (April), she has been on the Paleo diet for about two weeks. She was diagnosed with Type 1 diabetes on January 6th. She is heading to (mainstream healthcare hell) tomorrow to spend a few days, which a nurse called to confirm today. To make this short…I got an earful about the dangers of the Paleo diet. Sugars are not bad, (April) cannot thrive on a low carb diet, and she STILL has diabetes even if this diet “artificially” lowers (April’s) glucose by an average of 100 points. I was told to feed her a “normal” diet, so they can figure out how much insulin she needs in order to eat like her friends.

Emphasis mine. UGH!!!! Anyway, continuing on…

(April’s) comment to this was,”But I don’t want to feel like that again, and I have no pimples now.”

Before she was the one scared of the hospital, but now we both are. Why can she not be on the Paleo diet and simply take less insulin (which she still needs)? Another issue is how (April) spikes in the hundreds about an hour into dance. They better not tell us to quit dancing…

I am nervous. People are rude, and we are trying to keep our girl healthy.

(Concerned mom)

Meesus TTP responded, in essence, by telling “concerned mom” that she was obviously dealing with what was essentially a pack of clueless, Alpha-male-dominated baboons, and for God’s sake to get (April) to another, more open-minded (at the very least) facility.  We reinforced the need for her to absorb — and pronto — whatever she possibly could from Robb Wolf’s and Sarah Fragoso’s web-sites.  We’ve also put “concerned mom” in touch with Steve Cooksey, of Diabetes Warrior fame.  If you’re not familiar with Steve’s story, be sure to check him out.  He told the mainstream, in essence, to pack sand up their friggin’ poop-chutes, and in the process, saved his own life.  Too bad that it really has come to this, but alas, it has.  If you want to be healthy, you better take matters into your own hands.  To be sure, there are some fantastic practitioners out there; you’ll just have to do some vigilant, ass-busting research to find them.

What follows now is “concerned mom’s” response to Meesus TTP.  I include this interlude because of these numbers she refers to below — (April’s) blood glucose readings — which are, well…frighteningly off the charts.  Think the doctors have a clue?  Read on — that is, if you can overcome the urge to put your fist through your monitor.

Thank you, Michelle.

I hope we can work with the doctors. We need to enable (April) to dance without hitting 300 an hour in (it was off the charts the first time she spiked, which is when we found out she had a problem). But I still think going from 250 to 140ish throughout the day otherwise is an improvement worth noting.

And we all really love the food 🙂

Hugs.

The first time she spiked:
-Rice Crispies with goat milk for breakfast.
-Tuna with mayo on whole grain bread for lunch.
-An apple with green tea (lightly sweetened with honey) for snack at
about four pm. She hit over 500 at about six PM, an hour into tap.

This diet was before we gave Paleo a shot. I thought it was healthy.

(April) just called from (mainstream healthcare hell) to say they had her eat sugar, and her glucose is 344, but the nurse said,”That can’t be right.”

I’ll keep you posted.

No matter what, we’re keeping the Paleo diet. We just want to make sure we find out why (April) got to be like this to begin with.

Care to take a wild-assed guess as to who recommended this “healthy diet”?  Dammit, this pisses me off to no end!  Look, I take the ins-and-outs of my profession with the utmost seriousness.  I read every-frigging-thing I can get my hands on, and talk with anyone I can on items that are even remotely relevant to the subject of health, fitness and exercise science — whether or not, mind you, that I think at the onset of that read/conversation that I’m going to agree with the subject matter. Hell, I embrace my preconceived notions being pushed and tugged.  Simply put, that is what you do if you expect to be an honest representative within your field of expertise. Now I don’t expect anyone else to do anything more than what I do as a representative within my field of expertise — which is to say keep ahead of the learning curve.  Healthcare practitioners are, by and large though, dropping the proverbial ball, here, and the sad fact is that people are suffering unnecessarily — dying, even — as a result. Those of you in the healthcare delivery system presumably entered this field to heal those in need — I say to you this: get off the fucking stick, and honor the profession you trained for, and agreed to do.  Be a help to humanity, versus being a damn obstacle to patient health.

______

Okay, so this next instance is laughable compared to the above, but it just highlights — once more — the mainstream’s utter friggin’  ignorance in all things health and fitness related.  No need to repeat what my Efficient Exercise brother-in-arms has already written, so go check out his piece, You Can’t Get Fit Lying on the Couch All Week, Apparently.

So yeah, sake your head, have a good laugh, and continue on in your own outside-of-the-box, primal pursuit.  And remember, we wouldn’t want people to think that they can get fit lying around on the couch all week  😉

______

Selected workouts from last week

Wednesday, 1/26/11

(A1) Nautilus pull-over: 255 x 12, 9, 9 (41×1 tempo)

(A2) Cuban press: oly bar x 15, 15, 15

(A3) Bradford press: 95 x 12, 12, 11

What’s up with the weak shoulders?  Well, 10+ years of being wielding my head and shoulders as a weapon in the course of being a defensive hit-man took a serious toll on (especially) my right shoulder; couple that with some ill-advised (and extremely ungraceful) mountain biking face-plants and a couple of recent fixie near misses and, well… welcome to shoulder prehab/rehab land.  I’m trying to swallow my own medicine here and not push through the pain of continued overhead work; attempting to bypass my natural inclination of letting surgery and surgery alone dictate my lay-off periods (Dan John knows what I’m talking about here — and so, I’m guessing, do many of you)  🙂  So yeah, now that I have this in “print” now, maybe I’ll actually follow through with a “cease and desist” on the overhead work until my shoulder quits yelling at me.  Or, I may just resort to cortisol/Novocaine cocktail and just keep on keeping on.  Juuuuust joking…   🙂

Thursday, 1/27/11 –

Two rounds of the following, with each round separated by approximately six hours, during which time I did a frac-ton of fixie riding.

(A1) breathing squats: 225 x 21

(A2) bicep curls (EZ bar): 105 x 21 (clusters x 3s)

(A3) “ski jump” shrugs: 305 x 21 (clusters x 3s)

“Breathing squats”?  Think extended rest-pause, without racking the weight.  Trap bar deadlifts/RDLs are good candidates for this technique as well.  Clusters?  Many, many ways to manipulate the “cluster” technique, but in this case I performed three regular tempo (3o1o) reps, then paused for approximately 10 seconds (weight still in-hand) before hitting the next “cluster” of 3.  Wash, rinse, repeat…

Friday, 1/28/11

(A1) Russian leg curl: bw x 10, 10, 10, 10

(A2) weighted dips: 45 x7; 90 x 5, 5, 4+

(A3) T-Bar swings: 100 x 30, 30, 30, 30

34 COMMENTS

  1. I look in at diabetic forums from time to time to get ideas for keeping my blood sugar low. These forums are huge.

    Not only do these diabetics ignore their doctor’s advice, they laugh at it. They only use their doctors as tools to get their meds.

    As most intelligent diabetics have done, the parents must become experts in the disease. It is fairly easy to know as much as the doctors but you have to know more. You have to know enough to give the child a long and healthy life.

    The diabetics on these forums who keep their carbs low and watch their diets are having amazing success. Most of the type II diabetics no longer need their meds and type I diabetics have dramatically reduced their insulin usage.

    The diabetic medical industry seems to have a goal of making their patients as sick as possible. The only solution to the problem is not participate in their insanity.

  2. There is no reason – no reason at all, she should stay with this physician.

    We get bullied into thinking they know everything. Its the mythos they like to perpetuate. When, in fact, they are simply another a service provider. You don’t like the service, don’t show there!!

    There are a surprising number of dieticians who are coming wise to the low carb/paleo lifestyle – and much of that has been an inadvertant result of telling patients to cut glutten… they react fabulously and then when their diet is analyzed, they go “huh.”

    If, for whatever reason, the doctor HAS to stay, find a paleo friendly dietician – most MDs will defer to dieticians as they actually study diet, not MDs.

    But yes, this gets me steamed. It took me a while before I could simply vote with my feet and find a less asshatish medical office. My only concern wiht my new health plan is there’s a whole lot of emphasis on “health screening data” like BMI, blood tests (if it ain’t fasting, I ain’t believing the TG #s btw) and we are being encouraged to seek treatment for anything “out of the norm.” This is the first year – I imagine it will become a REQUIREMENT to seek treatment at somepoint.

    Fortunately, I like in a large metro area where my DR options are wide. Someone in a more rural area (like our old stomping grounds) may simply be screwed or forced to drive hours to find a doctor who doesn’t have their head up their ass.

    Good luck to the Missus’ friend and her daughter – and encourage them to get their medical care elsewhere!!!! Even if it means an out of pocket premium.

  3. Staying ahead of the curve can be a tough thing to do sometimes. I feel like with a lot of people in professions where knowledge is always already preliminary and constantly emerging it is easy to just take what you learned initially as gospel so that you have no further responsibility for research and development but things derived from hard science like medicine cannot afford to do this without putting people in danger but, then again, being rigorous in your profession can sometimes backfire when your employer is a shill for the pharmaceutical industry for instance. Science, business, and ethics usually do not fit together into a harmonious whole.

    • No doubt docs are between a rock and a hard spot on this issue. The fact that some are able to navigate this issue well, though, means that it is doable — tough, yes; demanding, yes — but doable. The science behind Paleo is easy to understand, even for a layman, and very straightforward. It would seem that this would be an easy sell to those “in the know”, but alas, it is not.

  4. Kurt,

    This may sound like foolishness, but if the U.S. for example switched to a paleo lifestyle I don’t believe enough cattle, chickens and hunter gatherer type foods could be produced to feed the main stream. Perhaps this was figured out long ago and that is why the proliferation of a grain based society emerged.

  5. This is a sincere question from someone who has been researching the Paleo way of eating for about a month now. How can this way of eting be justified as the cure all, answer, god’s gift to man when peoples of other countries are much healthier than Americans and do not neccesarily eat in this manner?

  6. Hey – did you see the news story that a doctor has come out and blamed rice pudding that kids are started (solid food wise) on as babies as the cause of the obesity epidemic??

    He says that its equivalent to feeding babies sugar and basically hot wires them for carb preference.

    The uproar has been huge. And so the compromisers are saying, “Well, ok, he might have a point about the sugar, so instead feed your baby rice pudding made from iron enriched BROWN RICE to make sure its better for them. But there’s no science that says that babies food imprint.”

    I’m all – ugh, if you fed eggs or puree’d meat, you wouldn’t need to feed an iron enriched food… but ok. what ever.

    sigh.

  7. I’ve honestly never heard of the Paleo diet before. I’ve believed for years that the food that we eat today causes many of our common ailments. Is this diet designed to rid us of food-caused health ailments? I will continue to read up on this, but just thought that I’d ask. Thanks.

  8. I strongly encourage your friends to buy the books, check out the website, and watch the videos for the great diabetes researcher hero, Dr. Richard Bernstein. I drove from DC to NYC to hear him speak last year, and it was worth every mile of traffic.

    He really busts the myth that living like a wreck so you can eat like everyone else is foolish and dangerous for someone dealing with diabetes.

    http://www.diabetes-book.com/

    http://en.wikipedia.org/wiki/Richard_K._Bernstein

    He literally pioneered the use of blood sugar meter techniques with the relationship of carbohydrates and foods. Great post, Keith, but now you passed on your Tourette’s to me as I want to run around the house shouting at the stupidity in this world. Thank goodness for the paleo remnant.

  9. I TOTALLY agree, it is all so messed up.
    I am a med student, (i hope to be a doc with a holistic/complementary approach – I went to med school to get a decent education and the right credentials to be taken seriousely.)
    But it’s still maddening when what little nutrition we are taught is all BS.
    We recently had a lecture on diabetes, and were told the lifestyle advice for a diabetic would be to “eat more complex carbohydrates, like rice, and eat less energy dense food (less fat). basically the same ‘healthy’ diet we should all be eating”. I’m not kidding this is basically what they said. The only thing they told us that made sense was to “cut down on refined carbs”.
    I decided to send the lecturer an email just asking what he thought of other methods such as low carb diets (and linked to a few studies i’d seen) but he pretty much blew me off, saying it is true they used to treat diabetes with a low carb approach but patients survived and ‘that was about it’. He also said fat causes insulin resistance, so a low carb diet may improve blood sugar but over time it will worsen IR, glycemia and lipids.

    *face palm*

    it is so fustrating, i just wish the medical profession would care more about prevention, and realize how wrong they’ve been about a ‘healthy’ diet”!!!!

  10. I agree wholeheartedly with the article Keith and thanks again for the ‘mention’.

    * For ALL Type 1 Diabetics… PLEASE read Dr. Bernstein’s book, “Diabetes Solution”. He’s THE MAN. 🙂

    The three main reasons for this nutritional debacle… are NOT excuses and should not be tolerated.

    1- greed
    2- intellectual laziness
    3- willful ignorance

  11. Keith,

    It is so much worse than you even know. The governmental third party payors reinforce a lot of WRONG approaches. If you fail to follow these “guidelines” the amount you get paid is decreased or eliminated. The hospital you admit to will also be financially penalized, and this is where the real pressure on physicians comes from. There are full time “case managers” (usually nurses) whose job is to go in behind these doctors and make sure they are following these guidelines (currently termed “core measures”). The government’s core measures also get adopted by commercial insurance because it is such an effective means of denying payment (the real goal).

    Many of these core measures are in direct contradiction to some of the best scientific evidence out there. For instance, beta blockers administered durning the acute phase of a heart attack have been shown to increase mortality, but this is a core measure for chest pain. Blood cultures to direct therapy in pneumonia has been shown repeatedly to be a waste of time and resources, but is also a core measure for pneumonia. A core measure for chest pain/MI is that the patient gets discharged on a statin.

    The problem is much bigger than individual behavior. It is a result of the top down control of medicine that gets worse with each passing day and will become much more intense under Obamacare.

    An individual’s only hope is to find a private concierge doctor and pay out of pocket to avoid 3rd party (insurance) interference.

    • I can only imagine just how frustrating this must be for those doctors who *do* know better and who *do* want to do the right thing. Top-down Soviet-like command-and-control (hat tip to Art DeVany) never works out in the long run.

      • In that case, what’s keeping them from doing the right thing? Money. I always thought it was weird that we put so much trust in doctors, I mean, why would we think that the practice of medicine is any different from other fields? Most of the time, people’s actions are influenced by their own best interest.

        Disclaimer: by no means am I speaking about ALL doctors, but I have friends in the medical sales field, and you’d be surprised (or maybe you wouldn’t) to see or hear what goes on.

  12. Keith,

    As a (nearly done) resident physician, I completely agree with your stance. That said, in my practice, those patients who follow a paleo, or paleo-ish model of diet and movement so out-perform and out-heal the others, that I cannot help but to think that it is only a matter of time before other physicians start to catch on.

    Further, the fairly straightforward model of neolithic agents of disease, especially in regards to cholecalciferol deficiency, n:3/6 ratios and absolute amounts, fructose consumption, etc, makes so, so much sense that it is hard to deny that it is at least very possibly an accurate model.

    In addition, regarding exercise, it is appalling how little other physicians know of the basics, but the neuroendocrine/neuromuscular adaptation to a stressor model is also so much more effective and theoretically consistent, that I don’t see how this will be long ignored nor neglected.

    I recently gave a whiteboard talk to several of my colleagues about some of these topics and to say that they were very receptive would be a gross understatement. They were very, very interested and had follow-up questions for weeks thereafter. They also thereafter started PubMeding the topics and doing their own research.

    In short, I am optimistic. We’ve been screwing up our diet and exercise recommendations since about WWII or so but I sincerely think that we’ve about gained critical mass and the pendelum is starting to swing the right way.

    Cheers,

    Matt Smith, MD

    • Thanks for you (optimistic!) insight; good to hear some positives from the inside. This will be an interesting clash of currents, when the eventual (yet inevitable) Paleo/Primal/Evo Health groundswell crashes against the established “orthodoxy” in the healthcare provider arena. The sooner the better!

  13. My dad’s been suffering from diabetes since 8 years ago. He’s already undergoing dialysis twice a week due to his renal problem as a complication. I just hope the medical society get better researches about all these stuff especially convincing their patients to be obedient. I just wanna ask as well what you say about joining forums like: http://www.slowcarbrevolution.com/forumdisplay.php/5-Slow-Carb-Diet-Recipes which discuss about slow carbs to get more knowledge about this. Hoping for your feedback.

  14. I have a sense of humor. And I often laugh about TS, as you can see if you read my blog. But that’s not funny and you don’t get why, either. I enjoy your blog and will keep reading but I am just letting you know that myself and others definitely find it offensive.

  15. @TicTic,
    You’re brave for blogging about this, educating others and letting folks know that you have a sense of humor about it. If bringing up TS in an analogy of being frustrated with lowfat government market/life interference is offensive to you and those dealing with TS then this is a learning moment for folks like me who wouldn’t have thought that. You’re right to assume you’re among friends on Keith’s blog, his posts and generally folks who comment here have nothing but good intent, you’re correct in recognizing that.

    Not to be facetious, but in place of TS, is it ok to say a freaking conniption? Maybe just the standard “lose my s$!t”….?

  16. You can say whatever you want. We all have a right to say or post what we want on the internet. I’m not sitting here, crying into my bison stew. It’s just that the use of TS, here is a generalization and simplification of a very complicated and frustrating syndrome. Tourette Syndrome is much more than coprolalia (Keith’s implication), a mere symptom which effects less than 30% of touretters. It is offensive for it to be simplified as such.

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