Thursday, August 10, 2017

                             Dr. Steve Lawenda

                         Family Physician, Kaiser Permanente, Southern California


An inspiring story from a young physician-



Late in 2012 I hit a rock bottom both personally and professionally. I had just turned 38, the same age my paternal grandfather had his first heart attack and only seven years away from the age my father suffered his first heart attack. I was so worried that I would suffer their same fate myself. I knew that one third of heart attack victims didn’t survive, and I was deathly afraid that I might not be as lucky as my father and grandfather. I was obese with a BMI of 33 and already had pre-diabetes, fatty liver, acid reflux, and symptoms of sleep apnea. Our first child was only three years old at that time, and I could not imagine leaving her without her daddy.
On top of this overwhelming concern and weighing on my mind like an extra ton of bricks was the memory of two years prior when I had witnessed one of the most tragic and horrible events that have ever happened to my family. My father, fortunate to have survived his first heart attack and coronary artery bypass surgery a few years later, underwent bilateral leg amputations (below the knee) as a result of his type II diabetes. He went from being a fully functional, working, and joyful new grandpa enjoying his first infant grandchild (our daughter), to being a disabled, unemployed, and depressed man confined to a wheelchair.
On top of all this, professionally I was burning out. I was so dejected and so frustrated not knowing what to do as I witnessed more and more of my patients gaining weight, getting sicker and sicker, taking more and more medications, all the while becoming more and more miserable and depressed. They would ask me for help and I felt I had nothing to offer them other than more pills.
One particular patient of mine, that in hindsight epitomized what was wrong with modern medicine, was a local popular clergyman in his mid 50s. I always enjoyed seeing him — I’ll never forget we had such meaningful conversations with plenty of laughter as he had such a great sense of humor. He was obese with type II diabetes, yet was a model patient — he took his long list of medications diligently and his hemoglobin A1c, LDL, and blood pressure were always at target.
Yet one day I received the most dreaded call of my career: The local ER called to inform me that this most pleasant and delightful patient of mine collapsed suddenly at home of a suspected heart attack and was taken by ambulance to the ER in full cardiac arrest. Unfortunately, the staff in the ER were unable to resuscitate him. Like that, he was gone. In spite of all his medications and his diligence in doing precisely what I asked him to do, with all his numbers at target, he died far too soon. He left behind a young family, a loving wife, and a community that cherished him. I knew at that time that something was seriously wrong with modern medicine, but I didn’t know what the answer was. Now I do.
Fortunately, four years ago, at this age of 38, worried deeply about my personal and professional future, I had discovered the incredible power of food as medicine. I was blown away by what I was learning: I was amazed to learn that there existed a way of eating, namely a whole food, plant-based diet, where one can eat until they are full, without counting calories or measuring or restricting portion size — all while losing significant amounts of weight, regardless of the amount of exercise. This same way of eating, I learned, also REVERSES our most common chronic diseases, including our number one killer, heart disease, and our most costly and complicated disease, diabetes. I was very skeptical learning all of this, especially as it was not part of my years of training. Yet soon I began to realize how much solid scientific evidence existed that more than substantiated these incredible benefits.
Before long I challenged myself to eat and live this way. Within eight months, I lost 75 pounds, and my BMI went from an obese 33 down to a normal 23. My prediabetes, fatty liver, acid reflux, and symptoms of sleep apnea went away. My blood pressure dropped twenty points. I felt amazing. Most importantly, I felt as if the huge monkey on my back was gone. I was no longer depressed or worried about my health and my future. It was obvious my next step was to implement this into my clinical practice. Doing so has brought me from burnout to now feeling a true sense of joy and deep satisfaction in my career. Before I felt as if I wasn’t really helping people.
I rarely if ever saw a patient’s health turn around completely from a prescription I wrote. Yet now I often see patients have such dramatic and meaningful improvements in their lives and health. I have seen many patients lose significant amounts of weight, in some cases as much as what we see with bariatric surgery. So many patients have reversed their chronic diseases such as diabetes; even diabetic neuropathy and erectile dysfunction, which we are taught are non-reversible. One patient in particular was able to discontinue a total of 160 units of daily insulin in just two weeks after starting a whole food, plant-based diet. Another patient was facing a below the knee amputation like my father and was able to heal his diabetic foot ulcer and avoid amputation by changing to a plant-based diet. I have seen numerous patients discontinue the majority, and in some cases all, of their medications within a matter of just days to weeks.
I have become so passionate about plant-based nutrition that I discuss it with nearly every patient at almost every visit. I realize that not all patients are ready for change, but I have been pleasantly surprised by the effectiveness of planting the seed sooner rather than later. I have also found that my patients are more receptive and encouraged by the fact that their doctor is practicing what he preaches. I now supplement my practice by teaching healthful eating classes, and I help run group-based lifestyle medicine programs. This change in my practice has given me such pleasure and joy; there is nothing more satisfying for me than to see what this can do for my patients and for the practice of medicine.

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