Today Show Lie

[geebee]

Ok everybody,

Here is Dr. Madelyn Fernstrom's email address at the University of Pittsburg Medical college. [email protected]

Go ahead and bombard here with emails about the Today Show segment
The emails to the msnbc/Today show probably won't get the attention they deserve. The above email goes directly to her.

Done.

 

[Missy]

Is there something that I have been missing? I hate to show my ignorance but I have always thought that foods that have a high vitamin k content need to be adjusted with the coumadin intake. I know that one does that by measuring the INR.
I understand about dosing the diet and all that but still, isn't the information the same. Maybe she just meant that if one eats it to make sure you are anti coagulated.
If I listened to what you are all saying here I would think I didn't have to be anti coagulated to eat lots of greens and heavily loaded vitamin k foods.
I wouldn't want to do that.
Please explain, please.
That show this morning was just a brief on interactions and effects of medicines and other things. I don't think it was meant as a lesson in anti-coagulation and warfarin therapy. I just took it at face value. It is better for an inexperienced coumadin user to be safe than sorry. We all learn as time goes on. I would assume that she is talking to inexperienced people about those interactions. She just briefly mentioned it as she did others. Maybe she said it wrong but sometimes people don't understand any other terminology. It would be more complicated than what I saw today.
Thanks for any help here.

 

[warrenr]

saying things wrong is the whole point. If you can't say it right then don't say anything especially on national TV.

 

[Guest]

Green, leafy vegetables contain vitamin K. Vitamin K does counteract warfarin. People who eat a lot of green, leafy vegetables may need a higher warfarin dose than people who do not eat as much. However, this is not necessarily bad.

Some studies have shown that people who consume fairly large amounts of vitamin K are able to better control their INRs. This is similar to the effect of entering a dark room and turning on a three-way light. The first increment of light seems a large change. The second increment may be the same change in wattage that the first increment was, but it appears smaller because the percentage change is smaller. Going from the second to the third increment appears to add little even though in absolute numbers the change is the same. However, the percentage is much smaller. Applying this to warfarin, the person who eats no green, leafy vegetables is greatly affected by even a small change. Whereas, the person who routinely consumes a fairly large amount of vitamin K is little affected by the same absolute amount of change.

In addition I do not believe that is wise to counsel someone who already has a health problem to avoid healthy foods.

Warfarin managers who tell people to avoid green, leafy vegetables are in effect saying to the consumer, ?Now look!! I have chosen the correct warfarin dose for you and it is your duty to take whatever measures are necessary to prove me right.?

My philosophy of warfarin management is to say, ?Eat a healthy diet and I will simply adjust your warfarin dose to fit your lifestyle.?

In addition, Dr. Fernstrom used the term ?blood thinner?. This seriously calls into question her understanding of warfarin. Warfarin is not able to lower the viscosity of the blood. Instead, it slows the formation of clots. The term blood thinner is archaic. It dates from the 1950s when President Eisenhower was given warfarin. In those days they had no technology to determine how most medications worked. All they knew was that when someone taking warfarin got cut, they bled longer. The logical conclusion in those low-tech days was that the blood was thinner.

When someone presents themselves as an expert and uses the term ?blood thinner? you have to be very suspicious that their level of understanding of warfarin is rudimentary.

 

[Ross]

Is there something that I have been missing? I hate to show my ignorance but I have always thought that foods that have a high vitamin k content need to be adjusted with the coumadin intake. I know that one does that by measuring the INR.
I understand about dosing the diet and all that but still, isn't the information the same. Maybe she just meant that if one eats it to make sure you are anti coagulated.
If I listened to what you are all saying here I would think I didn't have to be anti coagulated to eat lots of greens and heavily loaded vitamin k foods.
I wouldn't want to do that.
Please explain, please.
That show this morning was just a brief on interactions and effects of medicines and other things. I don't think it was meant as a lesson in anti-coagulation and warfarin therapy. I just took it at face value. It is better for an inexperienced coumadin user to be safe than sorry. We all learn as time goes on. I would assume that she is talking to inexperienced people about those interactions. She just briefly mentioned it as she did others. Maybe she said it wrong but sometimes people don't understand any other terminology. It would be more complicated than what I saw today.
Thanks for any help here.

Missy she outright said that green leafy vegetables should be avoided. WRONG!WRONG! WRONG! Do you know how many people have stopped eating green vegetables completely because of this statement? They are denying themselves and their bodys needed nutrients and there is no reason for it. Yeah she wasn't saying adjust anything other the don't eat them.

Yes it seems kind of critical that she's being pounced on, but so long as these people keep going around saying things like this, it's never going to change. It's misinformation being spread like cow manure. I just want to see it all change in my life time.

 

[Rich]

She is just another mis-informed 'expert' who joins a very long list.
It reminds me of the peridontist I saw last year regarding the possibility of a tooth implant.
He told me all I had to do was keep my INR exactly at 2.0 for three days, then he wouldn't have to ask me to stop my coumadin for four days (yes he said four days).
It was very hard to keep from laughing until I got out of there.
Needless to say I never went back there.
Rich

 

[Karlynn]

I'm just wondering if she going to be a doctor (be it a PhD) that thinks they know it all and the email she gets from us is from lay people who don't know anything, or if she takes the suggestions to educate herself, and contact Al. I hope she renews my hope that there are some doctors that admit they may not know it all.

 

[tommy]

It irks me is that a person with such credentials should know her limitations and know when she is not on solid footing. That is the mark of a professional.

Another concern is that NBC either cannot or simply did not screen this expert for validity. Is it incompetance or apathy by the show management? Is this an isolated case, or a systemic flaw? Makes me question the credibilty of other guests that are billed as experts.

 

[mntbiker]

ex·pert (ĕk'spûrt) - Noun - A person that is convinced that there knowledge on a certain subject is complete and irrefutable regardless of the facts or data to the contrary.

 

[Guest]

I'm glad that I change my opinion now and then!!!

 

[hensylee]

Missy she outright said that green leafy vegetables should be avoided. WRONG!WRONG! WRONG! Do you know how many people have stopped eating green vegetables completely because of this statement? They are denying themselves and their bodys needed nutrients and there is no reason for it. Yeah she wasn't saying adjust anything other the don't eat them.

Yes it seems kind of critical that she's being pounced on, but so long as these people keep going around saying things like this, it's never going to change. It's misinformation being spread like cow manure. I just want to see it all change in my life time.

Ross, my brother was one of those. He had a standing order at the assisted living dining room - no greens. I kept telling him he could have some, limited tho it be, but he flatly refused. Even though he loved a lot of them.

Then one day he had a salad in front of him - and ate all of it!

 

[warrenr]

here in lies the problem

here in lies the problem

I thought that I had posted the following article a while back. I searched all my post's and could'nt find it. It is a study conducted by Harvard about older physician's (not age but time in practice) and not following current standards. Most of you will find it very shocking.

HERE IN LIES THE PROBLEM
http://www.hms.harvard.edu/news/releases/2_14Soumerai.html

The article is dead on and I think all of you Valver's will understand much better why it is so hard to find physician's that understand anticoagulaiton management.

 

[Rich]

Warren,
Thanks for that article, my wife and I have certainly seen examples of it.
Rich

 

[Missy]

I understand about coumadin therapy. I have been on it for years. But new users and home health care givers usually don't. The comments I was seeing on here was not explanatory. If you were confusing me, what about the new ones on here who didn't know all of that, if there are any?

Anyway, thanks for the update on everything. I appreciate the feedback.

 

[warrenr]

confusion

confusion

Missy,

As you are aware, there are hundreds of unsubstantiated myths about coumadin/warfarin management mostly brought on by uneducated physicians in the arena of anticoagulation and problems associated with the past when coumadin/warfarin level's were measured in pro time only, prior to the INR system we have today. The point being is that most of these myths start out by people in the medical community making statements that are not correct no matter how minor it may seem such as the comment that Dr. Madelyn Fernstrom made about green leafy vegies. When you start adding up all the unfounded statements made by the medical profession over the years concerning this subject it is no wonder there is confusion and lack of continuity between physicians. Hence, all of this info gets passed down to the lay person and a lot of info is believed to be true. Doctors are alway's right, right!!!!!!!!! If it weren't for all of these myths, even the new person starting coumadin/warfarin would not be nearly as confused. The whole problem lies in the Harvard Study. The Harvard Study hits the nail right on the head.

I hope this was more explanatory Missy.

If it were a perfect world, no physician would be authorized to manage anticoagulation unless they were nationally certified.

 

[Karlynn]

Thanks for the article. Those of us that have taken Coumadin for a while are very aware that many doctors and others operate off old, outdated information. And they make valve recommendations based on this outdated information. But I see a fair amount of messages here on VR that we aren't supposed to question a doctor's valve recommendation because they obviously must be operating off all current information. We obviously see it the most with the warfarin issue. But just recently some doctor told a 70 year old man that a tissue valve would only last him 10 years. Now there may be specific reasons the doctor said that, related to the person. But we all know that in general, that's not a correct piece of information. These are cardiologists were talking about. Shouldn't it be safe to assume they know all the current info and have kept up on all of it. In a word - No.

I realize that I can be pretty critical of doctors in general. But it's because I've had experience with the really bad ones. And I've had experience with the really good ones. But now I don't assume a doctor knows what they need to know for my case, I require them to prove it.

And so much for a well-known doctor knowing everything. I'm assuming the Today show picked this Dr. Feldstrom because she has a good reputation. And maybe she does know a lot about a lot - with some exceptions. So the moral of this story - it's not wrong to question a doctor that is well-respected. It's just good personal-healthcare oversight.

 

[Susan BAV]

saying things wrong is the whole point. If you can't say it right then don't say anything especially on national TV.

Hi Warren -

I was reviewing some of your posts but don't see what valve surgery you had; there's none listed in your public profile. Have you had OHS yet or is it pending surgery? Do you take Coumadin or Warfarin?

(edit - I just found the thread about your dad dying. Very sorry, Warren. My dad died six years ago today, first day of spring. It's still painful, but not as bad. May time and happy memories bring you peace.)

I was only on it (Coumadin) for three months post-op because of A-fib and my numbers were never in range, although I had studied everything carefully and tried to do everything correctly. I found what Al wrote, about people being more stable when they ate lots of greens regularly, very interesting.

 

[Harpoon]

I really should be watching more television, it looks like I've been missing a LOT of good material........



Sad to say though, "Doctor" for most people means medical, even if it REALLY only means they got a doctorate degree in basket weaving...

On the other hand though, there will ALWAYS be a group of people who get their medical information from non-medical (and therefore, usually, non-qualified) sources.

Patient education is the best defense but you won't catch all of them either.


Besides, the Today Show (and NBC News in general) has done a LOT of irresponsible things in the past, so has CBS and ABC. It's junk, once peope recognize that, we'll all be a lot better off.