Bloodwork improved, yet insulin sensitivity got worse?

[Meritocrat]

Neurogroot said:


Shows what I know then… Honestly, I’ve never hit the fitness side as much as I should have. I’ve been functionally strong enough, and just… ignored it. Regretting it too, the older I get and the more that functional strength that was just there begins to disappear.

Click to expand...

Everyone starts at some point. What matters is getting started at all. Later is better than never. As for arms being worked hard while other muscles ache, there is probably a straightforward reason. For the kind of exertion you performed, your arms had more development than those other muscles. This happens all the time. The body is signaling which area requires attention and growth. Nearly every power movement originates in the legs and travels through the hips, since gravity and inertia are always part of the equation.

 

[randompersonrandom]

Neurogroot said:

randompersonrandom said:

Worth keeping in mind: a physician's actual duty is to inform you as well as their professional expertise allows, respond to your questions, explain what risks come with a given choice, and then back you up as best they can once you've decided what to do next.

What a physician is NOT there for is handing down orders, assuming you'll comply, and reprimanding you when you don't. I wouldn't tolerate that from ANY physician, and I doubt many would even attempt it if I spelled out what I expected from them.

Last 2 visits, my physician pushed statins and wanted me to stop smoking. I wasn't ready to give up cigarettes, and I wasn't ready to agree that statins were needed. I told him I'd begin a GLP-1, bring my weight down, and then reassess. He replied that even if I quit smoking, he doubted it would change enough. I told him fine, I'd see how it played out. If more than 6 months pass, my weight reaches normal, and LDL remains too high, we'd discuss either quitting smoking or statins; but not both simultaneously. He explained what that does to my cardiac event risk. I thanked him. We left as teammates.

At the following appointment, if my LDL is still elevated, I'm still refusing statins. My cigarette quit date is 8/1. We'll give THAT some time, then retest after a sensible interval. If it's still high, then statins. I get what that means for my risk level right now, because he told me, because that's what my insurance pays him to do. He is NOT an authority over me, and even if he believed he were, he still wouldn't be.

I bring this up because yours isn't an authority over you either. Fine, they're glp-1 negative. That's okay, they can say so, and they can explain why. You chose to go on them. They have to accept that, and they still have to do right by you even if you didn't obey them; and you're entitled to, in a completely cordial manner, hold them to it.

Honestly, this comes down to something I need to fix in myself. I'm extremely non-confrontational, and even now, at my age, I still tie certain jobs and types of people to authority. As if there's no other physician available, or some ridiculous idea like that.

If I'm being truthful, another piece of it is that I'm on specific prescriptions. Ones that were a nightmare to get approved in the first place, and plenty of doctors these days are leaning toward prescribing them less often, or forcing me to go through the entire lengthy process from scratch again.

That said, you're not wrong. I just have to toughen up and find a different doctor. Heaven knows I already spend enough on medical expenses.

Actually, my point was the reverse: switching doctors might not be necessary at all. You could simply respond with something like, "Fine — I hear that you're against these, but I've decided to go ahead anyway. Can we shift to XYZ, since that's what I'm still unsure about?"

That said, once I went back and re-read your post, I realized I'd overlooked the detail that these are NON-GLP-1 peptides. That flips my whole response; I would never disclose non-GLP-1 peptide use to my physician under any circumstances. It would end up documented in my chart, and my insurer could later wield it against me.

 

[Neurogroot]

True. Though somehow I am already on my 3rd resident physician, with a 4th on the way. They put in their time in primary care and move on. Ideally I want a doctor who actually knows who I am.