3588: Cranky and Laid Back w/ Carrie Gravenson

[Keith]

Keith’s brother is trying to gaslight Keith over sucking his father’s thumb, and Listener Bananas is trying to gaslight Keith into thinking Call Me by Your Name was a sweet love story and not a manipulative perverted creepshow. And you know what happens when Keith gets gaslit; HE GETS FAKE ANGRY!!! Carrie Gravenson joins in to sarcastically help calm him down as the trio discusses Yom Kippur, Tom Brady and Gisele Bündchen’s divorce attorneys, and Chemda’s latest doctor visit.

Guest:
Carrie Gravenson



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[Apia resurrected]

As someone who speaks with physicians for work for the last 17 years:
Not all doctors know best.
Unfortunately you can't really judge if your doctor is one of them as a regular patient.

[joslingeneva]

Chemda,
I am going through the same thing. It's called perimenopause. Dr. Lara Briden is doing some cutting edge research on this. Her book The Period Repair Manual saved me. I am now off both birth control AND wellbutrin. I am also very angry with my doctors cause none of them are interested in functional medicine. They just want to hand out prescriptions. Check out Dr. Briden's blog here. https://www.larabriden.com/progester...od-treat-pmdd/

[joslingeneva]

Also ask your gyno which one of her colleagues is really into functional medicine and hormone management. Those doctors are out there but they are few and far between.

[shoebootie]

Keith is merely showing how much his dad has misrepresented the slovak tradition. It's a thing, but of course since FM is a priest of his own cult, he Made It Weird.

[DeathInGrasp]

Nurse practitioner here. I wouldn’t mess with the birth control if you consume nicotine. The reason blood clots are a concern is that if you get a blood clot in your blood vessel it cuts off circulation and is painful and emergent and requires treatment - that’s the best case with blood clots, that it’s in an extremity and you can treat it before further complications. Worst case, having a blood clot somewhere like in your leg can cause fatal outcomes when the blood clot dislodges and travels to the heart, lungs or brain because it’ll cut off circulation in a blood vessel in your brain causing a stroke, or in your heart a heart attack, or in your lungs a pulmonary embolism.

Plus from the provider perspective, even if a patient puts pressure on us to prescribe it against our best judgment, if we cave in and prescribe it, and then the patient ends up hospitalized with a stroke that leaves them bedridden and permanently affected, the patient can definitely still sue the provider for prescribing something unsafely and we can’t say in court “hey, but they made me feel bad for not giving it to them and really really wanted it” to get off the hook.

So not only is the patient’s life on the line but also the provider’s career.

So at least in this case your doctor was correct.

[thirteen]

Dancing with the Stars leaderboard for the past week (from best to worst)

Wayne & Witney (tied for 1st place)
Charli & Mark (tied for 1st place)
Gabby & Val (tied for 1st place)
Heidi & Artem
Daniel & Britt
Shangela & Gleb
Joseph & Daniella
Jordin & Brandon
Selma & Sasha
Trevor & Emma
Jessie & Alan
Sam & Cheryl
Vinny & Koko


Wayne and Gabby are usually at the top, so it's going to be a close race for Keith and Chemda. Thoughts and prayers.

[shoebootie]

Originally Posted by thirteen

Dancing with the Stars leaderboard for the past week (from best to worst)

Wayne & Witney (tied for 1st place)
Charli & Mark (tied for 1st place)
Gabby & Val (tied for 1st place)
Heidi & Artem
Daniel & Britt
Shangela & Gleb
Joseph & Daniella
Jordin & Brandon
Selma & Sasha
Trevor & Emma
Jessie & Alan
Sam & Cheryl
Vinny & Koko


Wayne and Gabby are usually at the top, so it's going to be a close race for Keith and Chemda. Thoughts and prayers.

I think Vinny could win or be in the top 3. He had a Chippendales vegas show after all!

[thirteen]

It could happen, but he's very up and down. First week was bad, second was great, third was not good.

[MongoMike]

Originally Posted by Apia resurrected

As someone who speaks with physicians for work for the last 17 years:
Not all doctors know best.
Unfortunately you can't really judge if your doctor is one of them as a regular patient.

Your health is still ultimately your responsibility and if you can arm yourself with a good deal of information prior to contact with your doctor you should be able to at least glean if they know the current "literature" and if they are any "good" by your standards. 7/10 in my experience are horse shit pharma salesmen in white coats. This ratio increases to around 999/1000 in government captured fields and systems.

Originally Posted by joslingeneva

Chemda,
I am going through the same thing. It's called perimenopause. Dr. Lara Briden is doing some cutting edge research on this. Her book The Period Repair Manual saved me. I am now off both birth control AND wellbutrin. I am also very angry with my doctors cause none of them are interested in functional medicine. They just want to hand out prescriptions. Check out Dr. Briden's blog here. https://www.larabriden.com/progester...od-treat-pmdd/

Good for you for getting off the drugs. However this referenced blog has some grains of truth but also some odd conclusions that aren't exactly inline with the observed phenomonology nor the research data. Dosing both progestins and estrogens at the same time are abnormal biologically and cause a couple crazy cascades that appear to manifest in a lot of harm. Low dose progestin locally (IUD) hasn't shown the same side effects of the dual hormone oral treatments that seem to be erroneously attributed to progestins.

Originally Posted by DeathInGrasp

Nurse practitioner here. I wouldn’t mess with the birth control if you consume nicotine. The reason blood clots are a concern is that if you get a blood clot in your blood vessel it cuts off circulation and is painful and emergent and requires treatment - that’s the best case with blood clots, that it’s in an extremity and you can treat it before further complications. Worst case, having a blood clot somewhere like in your leg can cause fatal outcomes when the blood clot dislodges and travels to the heart, lungs or brain because it’ll cut off circulation in a blood vessel in your brain causing a stroke, or in your heart a heart attack, or in your lungs a pulmonary embolism.

This is spot on. One piece of nuance here is that a single does of nicotine daily would have an acute vasoconstriction reaction through the sympathetic response system that also plays an important role in clotting. However that acute response at that dose should be transient and should only present a chronic clotting risk if that nicotine dose is increased or continued for years. The constriction and antagonistic response on top of taking a dual hormone oral contraceptive would most likely be manifested negatively in renal deficiencies. You may want to keep an eye on your glomerular filtration rate numbers if you choose to continue down this path. Of note, renal deficiencies are a potential cause of blood clots chronically.

DeathInGrasp,
In your estimation how are blood clots/plaques naturally cleared? How does that relate to daily single dose nicotine use and estrogen levels?