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Dana McMahan

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Listen to Your Doctor (Unless You're an Athlete)

Posted: 08/10/2012 12:51 pm

Most of us grow up taking what the doctor says as gospel. They went to school for all those years after all, studying relentlessly in college when the rest of us went to a class or two between parties and part-time jobs. And when we started eeking out livings with that fresh diploma, they trucked on, cramming their brains with evermore knowledge. Even now, when we're kicking back watching Top Chef, they're probably poring over a text in a medical journal, all the better to instruct you and I what to do.

And with all the respect due to a profession that demands the youth of its practitioners, here's what I know: They don't know everything. When it comes to things that I've paid attention to myself, like food and fitness, many know remarkably little. When I told my family physician that, after nine years as a vegetarian I was eating meat again, she didn't blink, much less make a note on my chart. That was my first inkling that doctors may not take a holistic view of health that jives with mine.

Later, when a nagging pain in my back grew unbearable, I saw the same doctor. Her exam included a strength assessment. She pronounced a back "tweak." An MRI the following week (after I saw a specialist) showed an acute herniated disc that soon sent me to surgery. She didn't think my strength was impaired during her test because she didn't know how strong I am. She didn't understand powerlifting or expect her slightly-built, 37-year-old female patient to even be strong.

I've spent more time with doctors than I'd have liked lately due to that weightlifting injury -- the result of a sudden and all-consuming desire to become a champion powerlifter -- and when the orthopaedic doctor told me to drop that dream, a new plan hatched: I'd learn a new sport every month for a year. After all, if a macaron-loving female food writer could transform into a 99-pound record-breaking powerlifter, why not rock archery like Katniss? Kick arse at Krav Maga? Or climb rocks like a ninja? So I did. Then after sprinting recently I aggravated a pain in my big toe that had intermittently tortured me for nearly a year. After hobbling about for two weeks in increasing agony I saw a podiatrist. I answered his questions, including what kind of physical activities I engage in. Eyebrows raised higher and higher as I listed them.

The doctor furrowed his brow and peered at me through his glasses. "You don't have to do such intense workouts," he said. "It's not like you're overweight."

I gaped at him and stammered, trying to funnel the swirling fury in my brain into words.

"I see. My TOE hurts, and I'm not fat, so I should consign myself to the couch? Never mind strengthening my bones through weightlifting to protect them as I age -- I'm sure as a thin white female I'll have no problems there. Forget the profound impact reaching physical goals has on confidence -- don't bother improving on that bodyweight bench press. Never mind the myriad diseases that keeping a heart pumping can avoid, my TOE hurts, and I'm so slim I needn't worry about ANY of that."

None of those words emerged; instead, I only managed to squeak that I competed.

He frowned. "What, like in the Olympics?" I couldn't begin to formulate a response. Instead I stared at my lumpy big toe as he talked blandly about bone spurs and arthritis and overuse injuries and progressive degeneration. I didn't mention the rock climbing trip I have coming up in Vietnam. Why bother? I let him inject my foot with a wicked needle full of a steroid meant to reduce inflammation and set an appointment for three weeks.

I made a beeline for Facebook to marvel at the experience. A friend commiserated, sharing a TNation article by a med student who outlined why doctors don't get athletes. "As a member of the medical profession and an avid weight trainer, Nik Rao is forced to deal with the 'idiocy and ignorance of medical professionals' ... when it comes to weight training and muscular individuals," the intro explains.

"We don't learn the basics of healthy nutrition. We don't learn about cardiovascular and musculoskeletal adaptations and responses to exercise. ... We don't even learn what all of those muscles in the body actually do. Heck, most doctors aren't even aware of the concept of High Intensity Interval Training, let alone how much more effective it is than steady-state cardio." Rao says. "And yet doctors think that their opinions on eating right and exercising actually matter. I honestly don't know whether to laugh or cry ... All of those years of school, and everything I know about exercise and nutrition I had to teach myself."


He shares an example that set the cartoon lightbulb over my head into neon overtime. Sedentary most of my life, and with a fairly-alarmingly-low blood pressure, at around the time my biceps started popping buttons on my shirt sleeves and my body fat dropped into the low teens, my blood pressure shot up above "normal." Though this perplexed me I didn't worry much -- I eat cleaner than most of the country and work out more days that not. Still, I wondered at the paradox. Rao solved it for me. With spurious systolic hypertension, an arm with very little fat, but a lot of muscle, gives an inaccurate reading, he explained. Oh! But had I broached a doctor with concerns about suddenly high blood pressure, they'd have doubtless sent me out clutching a scrip for hypertension meds.

So, about that three-week followup with Dr. Olympics? I'll use that time to do my own research, find a physician that understands athletes, and go in equipped to make an informed decision of my own, thank you.

For more on fitness and exercise, click here.

 

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Most of us grow up taking what the doctor says as gospel. They went to school for all those years after all, studying relentlessly in college when the rest of us went to a class or two between parties...
Most of us grow up taking what the doctor says as gospel. They went to school for all those years after all, studying relentlessly in college when the rest of us went to a class or two between parties...
 
 
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03:46 PM on 10/01/2012
Just as I suspected, docs just don't get "Us". However, we should not degrade them for lack of education. That's not the issue, just a different way of thinking about a problem. The problem with many health and fitness pros is that they have that lack of education and pretend to know about problems of which they have no idea. Quoting a study they heard about in a cert as gospel, when it's just theory. It's just a shame that we don't have enough of the highly intelligent, highly skilled fitness pros as readily available as docs. Or the fact that insurance won't pay for a session with a good trainer, because of the former.
11:04 AM on 08/21/2012
Love the article and you're absolutely correct. This is one reason I decided to become a chiropractor instead of a M.D. I wanted to understand the body as a whole and what made us function. Pharmacology is taught in med school not biomechanics or functional movements. Thank you for posting this. Check out the article I wrote below:)

http://breakingmuscle.com/health-medicine/how-crossfit-makes-me-better-doctor
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urkiddinme
Former fatty turned fitness freak
11:30 AM on 08/12/2012
Couldn't agree more. I am a middle-aged (43) female, formerly obese, who is now a competitive athlete after maintaining a 70-lb weight loss through clean eating and intense (some would say extreme) exercise for over four years. In the last six months, despite no loosening up of my eating regimen or decrease in my fitness regimen, I've gained about five pounds and the tweaks I've done with the sports nutritionist and personal trainer haven't been able to take the weight off (and a body fat analysis showed a 3% increase over the same time period, so none of that "maybe it's muscle" BS flies with me). When I saw my physician a few weeks ago for my physical, she told me "that's just part of perimenopause, there's really nothing you can do" (um...so I should just sit back and be 'okay' with gaining a pound a month through no fault of my own going forward?) and that I was 'obsessive,' and should 'relax' and 'enjoy' life. Utterly ridiculous. I nodded and smiled and will continue to work with the people who understand nutrition and fitness to lean out again, no matter what it takes.
01:13 PM on 08/11/2012
i WISH doctors were more willing to work with other health care professionals such as trainers and dietitians. they'd have so much less to do...
but i must say i'm noticing a slight change in this already. i've got clients that were referred to me by doctors for their high blood pressure or because they are severely overweight and trying to conceive a baby. they were told to WORK it OUT or at least try before starting popping pills.
02:08 PM on 08/10/2012
Thank you Dana for that wonderful commentary on shifting the paradigm from disease-oriented medicine to health practice. As a trained conventional doc with 20 years I've come to understand that doctors are simply the automatons of a system gone horribly wrong, and are in a 'shock-like' state as the world pushes to change a paradigm of medicine that's been steeped in disease for too long. The new model people are asking for (but don't know it yet) is a patient centric model, entirely controlled by "you" with a network of providers in health (massage, acupuncture, herbalist, etc,) and the doctor as a niche provider in disease. not health. It doesn't make sense to have health controlled by doctors who spend 20,30,40 years studying disease. They come up with recommendations like Dr. David Agus who gives blanket advice on taking statins drugs for health if you're over 40, never mind the fact it can give you cancer or liver damage. We need to put disease oriented doctors to the side, begin with behavioral coaches who can guide us to the appropriate provider in our customized network of health-oriented providers and use doctors for the rare instance of managing disease.More information on my article at http://www.globaltrends.com/component/content/article/56/157-whats-in-your-healthcare-future-america. This is how America is going to get healthy; forging the way to health practice, not by listening to disease paradigms under the disguise of health.
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11:59 PM on 08/10/2012
What does the herbalist do, exactly?
11:26 AM on 08/13/2012
It’s sort of like business-networking. For some reason, business people get it. They niche themselves, and then refer to many other people who are experts in many other fields. Robert Kyosaki, Rich Dad, Poor Dad describes the creation of this personal network the best. But for some reason in healthcare, we feel that the doctor has to ‘do it all.’ They have to be a disease-oriented doctor and go to a weekend seminar to know all there is about vitamins, nutrition, herbs, vibrational energy medicine, meditation, you name it. That’s a disservice to patients. The creation of a truly personal ‘health’ network, not a bunch of disease-oriented doctors, will enable you as a patient, to find total health. What does a herbalist do? They will not solve all your problems for health, just as one doctor cannot solve it all. But, they will add to health and healing in amazing ways, once your mind is open to accept. I don’t pretend to know what an herbalist does because I’m quite happy being niched in disease, but I also don’t condemn them from very personal experience. And believe me, my new body, mind and energy was well worth opening my mind to it!!