Tuesday, October 1, 2013

Good News 2 – But Are Doctors Following the Recommended Protocols for Tests?

My doctor was concerned about the high BUN/creatinine ratio that showed up on my annual blood work. After looking back at a couple of years’ previous blood work results, she concluded that the number was going up. I looked back eight years in my own records and found that it had actually bounced around, although it was generally higher starting in 2008, when I amped up my exercise routines with interval work on the cross trainer. The original reading, taken on 7/19/13 was 36; a second reading, on 8/21/13 was lower but still high, 32. 

After the second high reading, I wanted to know what factors other than kidney disease could affect the test. My doctor’s office always tells me to fast before checking my cholesterol or blood glucose but does not give me any particular instructions relating to the BUN test. Yet it turns out that both exercise and diet the day before can affect its results. One website suggests not doing either cardio or weightlifting the day before. WebMD recommends not eating a lot of protein for 24 hours before the test. The day before the third test I heeded this advice; I did no exercise and ate virtually no protein. The third test showed a BUN/creatinine ratio of 19, within the normal range. Within the space of two weeks the number had dropped by one-third. If the BUN is so sensitive to extraneous factors, should it really be considered a reliable indicator of kidney health?

I’ve read that cholesterol tests too can be affected by what you eat the day before but no doctor’s office has ever cautioned me about this. Speaking of not following recommended protocols, both WebMD and Medline Plus say that, before your blood pressure is taken, you should sit quietly for at least five minutes. The medical staff I have dealt with recently never do this. Instead they take it while I am in the middle of a conversation with them. Then they tell me I have high blood pressure, which I know is not true because I take it myself at home; it’s about 105 over 60. I wonder how many people receive unnecessary treatment because medical tests are being improperly administered.