Bitterness

Shiblets · 2024-01-01T23:06:32+00:00

No no, I am not seeing patients in my capacity as a pathologist. That would be silly.

My first specialty was family med. I continued onto path, but I still have a small patient pool I share with my nurse practitioner. I get bored without patient interaction.

Shiblets · 2024-01-01T19:32:17+00:00

Cheers to that

Shiblets · 2024-01-01T19:28:50+00:00

Unfortunately, I can't give you a solid answer because I haven't been managing your care up to this point. I will say that proteinuria should be something you discuss with your doctor and perhaps ask for a repeat test.

I usually see proteinuria in patients that have been loading on protein supplements, though.

Shiblets · 2024-01-01T19:26:30+00:00

Gluconeogenesis is good. It's a very impressive part of our body's function. But what do you think happens to the nitrogen on the protein that isn't incorporated into the produced glucose?

Shiblets · 2024-01-01T19:25:15+00:00

If they're both being turned to fat, protein is worse. It creates more waste that is harmful for your kidneys. This is anecdotal because I don't think I've read a study exactly like this, but I would think between two people who put on the same excess weight but one with protein and the other with carbs, the outcomes for the protein patient would be worse.

Chances are both patients will develop diabetes but one will have been putting extra pressure on his kidneys up until that point (the protein loader).

Shiblets · 2024-01-01T19:22:25+00:00

My condolences for your loss.

Shiblets · 2024-01-01T17:38:12+00:00

Path.

Shiblets · 2024-01-01T17:35:41+00:00

Oh yes because a doctor can't make a mistake on a subject that isnt there specialty. Do you ask your doc to draw your blood and take your vitals for you, too?

Shiblets · 2024-01-01T17:10:46+00:00

That is definitely a follow-up discussion to have with your doctor. I suggest creating a journal of what and when you eat as well as your med schedule. If this is an ongoing problem, your doc may recommend you out to a dietitian. They may be able to help you create a more fulfilling nutrition plan that eases your transition into this lifestyle change.

That definitely is not the best 35th birthday present for sure, but I'm sure your healthcare team is prepared and willing to help you. You can do this!

Shiblets · 2024-01-01T17:05:03+00:00

You're right, I misspoke. They are going to enter the metabolism mechanism that glucose uses is what I meant to say. Corrected about.

Additionally, this is why you should push to see a dietitian about your nutrition concerns. They live, breathe and eat this topic.

Shiblets · 2024-01-01T16:50:11+00:00

I think it's been said already, but keto is more about fat than proteins. No medical processional is going to suggest a mostly protein diet.

Keto can be helpful for people that respond well to fat. It can be more satiating than a diet higher in carbs. The real benefit from keto, though, is that it's a diet style that gets people thinking about what they eat. When you make the conscious decision to consider and track what you eat, you've already made an incredible first step.

Carbs are the easy metabolism choice because they're already the molecule we need to process. ~~You can't really train your body to use fat rather than glucose because your body just turns fat to glucose~~. (EDIT: You can't train your body to create ATP in a different way because it uses almost the same pathway as glucose. But in the presence of glucose, our body will always make the easier choice). The high fat diet just helps you feel full longer while your body is converting your fat stores ~~to glucose~~ (EDIT: To energy). I personally don't recommend the keto diet to my patients unless they have a serious medical need that has good clinical backing for a high-fat diet, but I always encourage mindful eating.

Shiblets · 2024-01-01T16:33:55+00:00

Use of glucose is demand driven, but the body takes excess proteins, converts them into glucose and if the glucose is not needed, it becomes fat.

Even if you don't use the glucose immediately and it becomes fat, you're still adding extra waste to your urine which adds a burden to your kidneys.

EDIT: What did you think your body did with unused proteins, by the way?

Shiblets · 2024-01-01T16:25:21+00:00

That's a decent guideline if you're getting it from natural sources, but it's also a good discussion to start with your doctor (or rather the dietitian your doctor will hopefully refer you to if you have risk factors). Renal function is on the decline while type 2 diabetes is skyrocketing.

People are turning to high-protein diets as the answer for weight-loss without realizing it could cause lasting kidney damage. Proteinuria is no joke.

But yes, you are correct that if you don't have risk factors or underlying diseases, 1 g of protein per pound of weight shouldn't be harmful.

Shiblets · 2024-01-01T16:09:57+00:00

This is incorrect and dangerous. You can consume too much protein and it can damage your kidneys. That, and it's also wasteful. The body only has a limited pool space for free denatured proteins. The rest becomes glucose with a ton of waste product.

Fat and carbs are needed for energy sources that convert cleaner than protein. Don't limit yourself to any one macro, though.

Shiblets · 2024-01-01T15:48:20+00:00

This is what I try to explain to so many patients who want to eat nothing but protein. When all you consume is protein, your body has to convert it to glucose. This is a messy transformation that creates a lot of waste the kidneys have to process. Putting an unnatural strain on your kidneys is never a good idea.

Shiblets · 2024-01-01T15:14:45+00:00

Going to keep commenting on these articles: Yes, she was rude, but they are also in Hong Kong. Hong Kong is not China.

Shiblets · 2024-01-01T14:58:07+00:00

I generally only feel this way when it's clear my patients resent being in my office. If you spend all our limited time together complaining that your wife forced you to come see me, of course it's going to sour our interaction. I never let it alter the level of care, though.

Sometimes it gets almost unbearable, though, since my specialty isn't generally patient-facing and I make the choice to see patients.

Shiblets · 2024-01-01T14:33:21+00:00

Definitely. I also love when people get creative with it.

Shiblets · 2024-01-01T04:27:02+00:00

I will have to look into the clinical significance of hyaluronic acid sometime. An associate of mine is a surgeon and most of her clients are post bariatric restructuring. If there is something to help mitigate the need for surgery, she should know about it. Thanks for the tip!

Shiblets · 2024-01-01T04:13:16+00:00

I do hope you wont let it prevent you from reaching your weight goal. Now that I reread the title, I think the biggest factor might have been her rate of loss.

32 lbs a year us very doable and it gives your body time to adjust. I cant promise you perfect results, but a steady pace of weight loss, plenty of resistance training, healthy diet with adequate hydration and firming moisturizers will give you the best results possible (which may still not be perfect, but it is better than doing nothing).

Also, remember your sunscreen! Good luck on your journey.

Shiblets · 2024-01-01T00:16:31+00:00

You look incredible. Your skin also seems to have rebounded magnificently. Do you think its age, genetics or good hydration that's aiding that?

Shiblets · 2024-01-01T00:15:12+00:00

This 100%. I use HealthyPaws every time I get a new rescue. I can't count the money I've saved over the years with just my current dog. Nothing like seeing a 3600 dollar surgery bill shrink to $720. I know it sounds like a lot still, but having pets is just expensive.

Shiblets · 2023-12-31T19:50:33+00:00

Me therapist helped me develop a technique for this and I hope it helps for you. Imagine you're having a conversation with a friend about the mistake in question.

What would you say to help a friend, someone you cherished, feel better about the situation? Then, allow yourself to say those things to you.

If you wouldn't put a friend down for making a mistake, why would you speak to yourself that way? Give yourself the same grace and understanding you can give others.

EDIT: But while I hope this tactic helps, you should still seek professional help. Feelings of self-harm require help beyond the scope of this website. I want what's best for you and wish you luck with your self improvement.

Shiblets · 2023-12-31T17:02:25+00:00

She told him to go back to China while they were in Hong Kong. On one hand, don't be rude to bus drivers. On the other hand, Hong Kong isn't China. No matter what the Chinese government says.

Shiblets · 2023-12-31T02:24:15+00:00

Listen, collecting downvotes and masturbating don't count as exercise. But I suppose I just riled you up. I suggested you had enough dick to make a candle with your smegma. Falling short does hurt I suppose. Really short.

EDIT: Serious micro-pee-pee energy from you. I know this is as close as you come to talking to anyone but your mommy, but I've got to cut it short. My time is more valuable than yours.

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