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DoctorTro Profile picture
@DoctorTro
Feb 19, 2022 • 7 tweets • 3 min read • Read on X
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2 years ago I was in a car accident that caused near paralysis of my right arm
Prior to that I had loved to exercise.

Throughout my life actually I love to exercise even at 350lbs
After my surgery I faced a complication, I had a collection and a possible infection

I was unable to move my arm to my head level for about 4 months after my surgery, I was finally able to move hand above my head one year later (about 16 months ago)…
I had to pivot around my disability…

I bought an assault bike and basically cut my routine to 4 15 minute sessions per week
Luckily my diet has kept me from massive weight regain

Yes I’ve had ups and downs

And yes my body composition isn’t prime time but im proud of myself
I continue to workout at home and now my kids join me as I’ve slowly expanded our home gym from just that lonely assault bike 2 years ago!
And my lifelong battle with obesity continues … now with 3-4 littles ones cheering me on

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More from @DoctorTro

DoctorTro Profile picture
Jul 23
There are 5 types of hunger that ideally should be taught to all patients with obesity

Without cultivating an awareness of appetite, hunger and cravings, a patient with obesity will not know what they are fighting against

So Let’s start!
We are going to start with some easy ones…

The Cephalic phase response aka food cues - this is hunger stimulated when in presence of food.

These signals are deeply ingrained and can be conditioned

Think of Pavlov & commercials - these aren’t going away quickly or ever
Second up is appetite triggered by Social cues to eat

our social lives, whether they are business meetings, family dinners or birthdays

Unless you are going monk mode - this cue to eat is also not going away & requires attention to manage
Read 21 tweets
DoctorTro Profile picture
Jul 16
How statisticians and researchers arrived at the conclusion that the BlueZones are a FRAUD. 🤔

🔑 Thread with key excerpts

1/n
“When these states transition to state-wide birth registration, the number of supercentenarians falls by 80% per year“

2/n
“The US data support the hypothesis that improved vital registration should reduce the number of supercentenarians, and be associated with changing patterns of old-age survival, by reducing age-coding error rates.”

3/n
Read 13 tweets
DoctorTro Profile picture
Jul 9
🚨 Thread on LDL Lowering & low carb🚨

How I approached high LDL in my patients, and how we observed a DECREASE in LDL of 480mg/dl !!!!

About my published case-series of 5 patients and clinical experience with thousands of patients …

(1/20)
As data supporting low carb diets has proliferated for weight loss, diabetes, seizures, mental health and other conditions, patients are now presenting with various issues related to the diet

2/20
For example, while it’s true that consistently a1c, triglycerides, HDL and lpa seem to improve, some patients report some adverse events.

3/20 Image
Read 21 tweets
DoctorTro Profile picture
Jul 2
THREAD: 🧵

CGMs - continuous glucose monitors

Having looked at 10,000+ CGMs let me tell you what you will learn...

1/9
Lesson 1: Hidden carbs are everywhere
- you will find hidden sugar & carbs everywhere.

You didnt know you could find carbs/sugar but you will:
hotdogs, sausage, beef jerky, spices, condiments, sauces, soups, broths, basically everywhere you didnt look.

2/9
Lesson 2: consider avoiding seed oils, vegetables oils, especially from restaurants.

Patients who switch to olive oil and avocado oil & hoke cooking seem to have improvement not otherwise explainable on CGMs

3/9
Read 10 tweets
DoctorTro Profile picture
Jun 20
THREAD ALERT 🚨

I love the curious & creative thinkers, the patients who question everything, b/c answering these questions makes me a better educator & confirms my commitment to lifelong learning & shared decision-making

1/10
I don't “kick patients out” for presenting difficult questions… a cruel, yet common, practice among paternalistic/authoritarian doctors... I instead embrace the questions

I use them as an opportunity to dig deeper, understand more and understand better.

2/10
I’ve had many of the same questions that my patients have had, why should I or why would I patronize a patient for thinking logically and asking questions?

In any case, these question have led me to the primary literature...

3/10
Read 11 tweets
DoctorTro Profile picture
Jun 13
🚨 THREAD ON WEIGHT LOSS & EXERCISE 🚨

Many patients ask me about exercise for weight loss, and getting toned.

We are often advised to exercise, however, if we are severely overweight this can be quite challenging.
I typically advise patients to focus on fixing the diet first and forgo exercise for the first 6-8 weeks of any weight loss plan. if your diet isn’t in order & your appetite isn’t controlled, exercise will increase appetite and likely stall weight loss.
While it is true that over a long enough time, patients may experience changes in body composition (ie getting toned) they won’t see the scale move and the process will be slow and this can be discouraging to patients.
Read 15 tweets

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