I delivered a large wad (0.25"/6mm thick) of studies with a covering letter to my mum's new GP on Monday 17th Jan 2011. Here's what I wrote in the covering letter:- Personal information deleted.
"Dear Sir/Madam,
I have some requests concerning Mrs *****.
1) Please monitor Mrs *****’s serum B12 & homocysteine. Until Jan 31st 2010, Mrs ***** was receiving 1,000ug/day methyl B12. This was stopped by the management of Lashbrook House after I complained too much. Long-term use of PPIs in old people can adversely affect B12 absorption (evidence attached).
2) Please advise the staff at Acacia Lodge to walk Mrs ***** using the 3-wheeled rollator that I bought for her as often as she is able. Prolonged inactivity results in Insulin Resistance (IR) in skeletal muscle (evidence attached). IR results in hyperinsulinaemia on eating sugars & starches. Hyperinsulinaemia results in drowsiness and stupor (which makes it more difficult for Mrs ***** to do anything).
3) Please advise the staff at Acacia Lodge to reduce Mrs *****’s intake of sugars & starches. A low-carbohydrate/ketogenic diet is beneficial for people with impaired cognitive function (evidence attached). I have recently persuaded Acacia Lodge to give Mrs ***** cooked breakfasts and have supplied Acacia Lodge with Burgen Soya & Linseed bread (12g carbs/slice). This has resulted in improved cognitive function in the mornings.
I don’t want to impair Mrs *****’s quality of life, so she can still have chips or mashed potato (not both in the same meal as happened on Fri 10th Jan, after which I found Mrs ***** asleep in her wheelchair slumped over with her nose squashed against the arm of the chair). She can also have desserts and the occasional chocolate and/or biscuit.
4) Please allow Mrs ***** to have 5,000iu/day Vitamin D3 (provided by me), as UVB cannot penetrate window glass. 5,000iu/day is much greater than the RDA of 600iu/day but it’s a safe amount (evidence attached). That amount of Vitamin D3 has many beneficial effects (rather a lot of evidence attached!) other than bone health (for which 600iu/day is sufficient).
Thank you,
Nigel Kinbrum (son & attorney)
01252 ****** (24-hr Ansafone)
07768 ******"
The GP phoned me on Friday 21st Jan. He's taking my requests seriously and has asked for a week to read all of the evidence that I provided. Here's hoping!
5 comments:
Hi
Good luck with your GP. My bet is that he won't read it, though with luck he'll weigh it. Which reminds me. Probably an apocryphal tale, but I once heard how final year theses were / are ( ? ) graded at Oxbridge. It seems the tutor would pile them up, go to the top of the stairs outside his garret ( they all live in garrets of course - it is de rigeur for a don ) and throw them all down, The ones that went furthest got a first, then back up the stairs, going 'second', 'third' and then 'fail' to any still at the top.
I guess he wil agree to your requests, having weighed ( ouch ! Sorry !) the evidence, but I doubt he’ll read it. Though I have been called cynical in my time….
Best, in my experience, is to build a rapport with him, such that he knows that you know what you are talking about, and evidence always helps in this. It can be fun, and I recall more than one amusing conversation with my GP.
But who cares long as you get what you want ?
I like the quirky recent postings BTW. Though I get the distinct impression you may simply be a wholly unrepentant thief.... :)
Thanks
When mum's GP rang me for the first time, I said "As this is a phone conversation, there are no visual cues. Have I annoyed you with what I've done?" to which he replied "No, but I was surprised.
We had a good chat during which he asked my background as I was very sciency.
I just want him to O.K. the Vitamin D3. I've already got the care home on-side with mum's diet.
My next plan is to make some tasty treats for mum out of flavoured whey powder and coconut oil. This combination is very ketogenic.
RE Scrumping: Shame to waste good Asian pears/Crabapples/Quinces etc.
RE Recent posts: Having been a bit depressed for about 6 months, it's nice to be slightly hyper now.
Doctors are often surprised when their patients make assertions that cannot be dismissed as 'anecdotal' . Since they all ( at least nominally ) subscribe to EBM, when you present evidence it rather forces them to listen and consider what you are saying.
I take D3, and my GP readily agrred to get my levels checked when I told him what I was planning / just started doing. He asked why, with a somewhat quizzical eyebrow raised, to which my reply was ’ I read it in the Times, so it must be true’. I did go on to quickly list the reasons, and he was fine. You are correct, they do like science. So do I – if only it were applied more widely e.g nutrition guidelines, statins, five a day – I could go on,sadly.
It sounds like you have already built some credibility with him ( Pubmed always helps, doesn’t it ? ) so your Mum should be fine. If you didn’t tell him already that there is eveidence that doses up to 40000 iu are not toxic ( so 5000 is fine ) – which would surprise me – then he may see it in yur pile and agree to it.
Mums are very special, and, stating the blindingly bleedin’ obvious, you only have one. Keep looking after her.
Re depression. I suffered a bit. Nothing serious, but…. I found exercise helped a lot, which hacked me off, since it was something the nannies are always recommending but hey ho, it works for me. Just saw a great quote: "I hate exercise. But I like the results." (Jack LaLanne. Whoever he is – Sorry ! - and I can’t be bothered to Google him ). So keep up the walks.
The Vieth safety study was part of his information pack.
I think I impressed him with my reading list (two books by Jack Salway, Senior Lecturer in the School of Biomedical & Molecular Science at the University of Surrey and Biochemistry by Stryer).
RE Jack LaLanne: Some of the blogs I link to have commented on his recent death at the age of 96.
Exercise definitely helps, though. I never thought I'd hear myself say that!
Result! See Keep 'em tight.
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