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

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.
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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 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.

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