Monthly Archives: July 2016

Deprescribing

IMG_2802Writing up drug medication charts is not something I am fond of. Those poor staff who then have to interpret my writing will vouch that reading my writing is not something they are fond of either.

The number of drugs that are prescribed to patients is growing every year. This has been concerning me for some time.

Many of the drugs are there for lifestyle related disease.

Essentially people would not need to be on them if they had a better relationship with their eating, smoking and exercise habits over the preceding years. Addressing nutrition NOW means taking back control of health TODAY.

I see those people taking back control of their nutrition every week and reducing their medications. They are happy people.

Only yesterday I saw a gentleman with 27 years of unstable diabetes control, grin from ear to ear, telling me that he had reduced his insulin requirement by 25% in just 3 weeks of taking on Lower Carbohydrate Healthy Fat living. He was happy. His wife was happier. Happy wife = happy life and even happier surgeon.

A real food change sees potential reductions in blood pressure medication, diabetes drugs, pain killers, anti-inflammatories, reflux medication and those statins.

It fascinates me that most doctors find it easier to add medications to patients rather than reducing them.

I wonder if that is a fear factor of a patient succumbing to a supposedly preventable condition.

Or is it the collateral damage of the multi doctor clinics where people can be seen by different doctors each time. The medical record is the same but there is less continuity of care and it takes time to educate people to reduce medication.

The same thing happens in hospitals where many teams may see a patient and add in their medication. Once patients leave hospital they can often head off with enough tablets to sink a ship.

Good doctors do good prescribing.

Great doctors do deprescribing!

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Healing takes a lot longer than most people believe. But how long?

HealingThis is probably the most important thing I can teach my patients and my students. I think it applies to both physical and emotional damage

We live in an impatient world. We are constantly bombarded by quick fix solutions. We want everything now. We want pain to be gone now. We want the easy path to lots of things. Healing however will go along at Mother Nature’s pace and we can slow her down but not speed her up.

What we can do, however, is observe healing in action.

I would like to have this written in the front pages of every medical textbook. Just a small goal of mine.

Healing has finished when the scar goes from pink to white.

If it’s pink on the outside it’s pink on the inside.

Healing takes a long time.

What does that mean to my patients? Look at the scar. If it’s still pink, then they are still healing, and it’s therefore okay to have some aches and pains.

This simple message that empowers the patient with knowledge allays many concerns in this impatient world.

It often takes 12 to 18 months for that scar to heal and finally matures over about 3 years. That’s a long time but that’s healing maturation and scar turnover.

If anyone has had a serious injury or major surgery and reflects on the ‘recovery’ time, then they will know that it takes a long time to get back to normal.

I think the same goes with emotional damage. It takes a long time to recover. Try considering the early period of recovery as a raw scar and it’s only with time that we recover. Rushing it does not help. It only makes us impatient, adds to stress and that doesn’t aid recovery.

Doctor in Latin means ‘to teach’. Teaching my patients and my students something they can use every day makes it all worthwhile.

God’s interpretation of making the brain dependent on glucose.

BrainI am told over and over that the brain is dependent on glucose and its dangerous to run low carb. This is the primary concern of doctors, medical students, dietitians, midwives and most people, but not biochemists.

Let’s explore some religion to break a myth.

Is God (in whatever form that is) stupid enough to make our most important organ, the brain, dependent on only one fuel source of glucose? Surely not.

On my recent trip to Vanuatu I was looking through a 1996 textbook of physiology. There it all was on page 22 of a 1148 page textbook – in the Introduction to Physiology chapter. We are not even in the ‘fine print’ area!

Here’s some basic biochemistry, and it’s not even new. Continue reading