Trying to Talk to the Doctor (Part I)


Hello Dr. Myhill. I am an endocrinologist in Syracuse, NY. I received your name from a patient of mine with CFIDS. She is adamant that she cannot tolerate any medications. She has very poorly controlled type 2 diabetes mellitus. Her hemoglobin A1c is over 15 and her blood sugars all run from 400-500. She tried one insulin in the past but states she cannot tolerate it and declines any others. Have you ever heard of any situations like this before? I have not found any information in the medical literature in relation to this. Any advice that you may have would be highly appreciated. Thank you so much in advance for your time. Jennifer Kelly

Dear Jennifer
Gosh – no easy answers here!
Firstly your patient should do a ketogenic diet – see
http://drmyhill.co.uk/wiki/Ketogenic_diet_-_a_connection_between_mitochondria_and_diet
That will greatly reduce the glycaemic load and MAY be all that is required.
What exactly does she mean by intolerant of? Allergic?
Does she have insulin resistance or is she insulin deficient? (ie what are her blood insulin levels). The point here is that insulin resistance may result from micronutrient deficiencies (eg B3, zinc chromium) or from inhibition by toxins (either endogenous from the fermenting gut eg alcohol, D lactate etc or exogenous such as heavy metals?).
Do get back to me if you get stuck
Best wishes
Sarah

Good morning, I am forwarding to you the email I received from Dr. Myhill. Very informative and it was so nice of her to respond so quickly. You may want to try the ketogenic test that she mentions. If you’d like to have a fasting insulin test performed to further answer her question of insulin resistance, I will mail a lab script for you to have performed fasting some time at any lab. If there are other labs you’d like to have ordered, please let me know. I’m sure Dr. Myhill would be happy to answer any questions you would have also as her website was open to questions from doctors and patients. Keep in touch and have a nice weekend. J. Kelly

Dr. Kelly,

A web site says that the Keto diet is contraindicated if you have a “history of kidney failure.” I don’t know what that means. I have stage III chronic kidney disease as well as nephrogenic diabetes insipidus. Am I in or out?

I didn’t see any “ketogenic test.” Where is that?

Yes, I will do a “fasting insulin test” (fasting glucose test?). Please send script.

I would be inclined to try the ketogenic diet, but I would need help getting started. Would the Irish lass who met with me in February/March (?) be willing to take a shot at this? http://www.ketogenic-diet-resource.com/ looks like it might be helpful.

“. . . Intolerant of? (Allergic?)” I had undiagnosed ME/CFIDS and took antidepressants every day for 26 years. Antidepressants are contraindicated for ME/CFIDS. My theory is that the antidepressants on top of CFIDS for so long a time utterly broke down my immune system. The homeopaths consider this a major toxic load. I do not have classic allergies (I am not generating antibodies) but do have extremely severe hypersensitivity to all drugs.

I may only have tried “one insulin” [three times] but I also have tried many other medications for other things and I react to everything. There is no point in hospitalization to try new things. The history of my relationship with doctors is that they are always looking at the drugs and never looking at the patient. The question is not “What new drug can we try”; the question is “What’s wrong with the patient?” It is about the immune system; it is all about the immune system. (To be continued)

About annecwoodlen

I am a tenth generation American, descended from a family that has been working a farm that was deeded to us by William Penn. The country has changed around us but we have held true. I stand in my grandmother’s kitchen, look down the valley to her brother’s farm and see my great-great-great-great-great-grandmother Hannah standing on the porch. She is holding the baby, surrounded by four other children, and saying goodbye to her husband and oldest son who are going off to fight in the Revolutionary War. The war is twenty miles away and her husband will die fighting. We are not the Daughters of the American Revolution; we were its mothers. My father, Milton C. Woodlen, got his doctorate from Temple University in the 1940’s when—in his words—“a doctorate still meant something.” He became an education professor at West Chester State Teachers College, where my mother, Elizabeth Hope Copeland, had graduated. My mother raised four girls and one boy, of which I am the middle child. My parents are deceased and my siblings are estranged. My fiancé, Robert H. Dobrow, was a fighter pilot in the Marine Corps. In 1974, his plane crashed, his parachute did not open, and we buried him in a cemetery on Long Island. I could say a great deal about him, or nothing; there is no middle ground. I have loved other men; Bob was my soul mate. The single greatest determinate of who I am and what my life has been is that I inherited my father’s gene for bipolar disorder, type II. Associated with all bipolar disorders is executive dysfunction, a learning disability that interferes with the ability to sort and organize. Despite an I.Q. of 139, I failed twelve subjects and got expelled from high school and prep school. I attended Syracuse University and Onondaga Community College and got an associate’s degree after twenty-five years. I am nothing if not tenacious. Gifted with intelligence, constrained by disability, and compromised by depression, my employment was limited to entry level jobs. Being female in the 1960’s meant that I did office work—billing at the university library, calling out telegrams at Western Union, and filing papers at a law firm. During one decade, I worked at about a hundred different places as a temporary secretary. I worked for hospitals, banks, manufacturers and others, including the county government. I quit the District Attorney’s Office to manage a gas station; it was more honest work. After Bob’s death, I started taking antidepressants. Following doctor’s orders, I took them every day for twenty-six years. During that time, I attempted%2
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