by djsnjones (38 Posts), Mon Nov 19, 2007 02:08 pm
--"Joy, I am not sure why you would feel muzzled...we have asked you questions, yet we have gotten no answers."
*I feel muzzled because you decline to allow me to correct the incorrect information posted here about the Brewer Diet and viewpoint.
*I feel muzzled because you only want one kind of answer. I do understand, however, that this perspective is the focus of your forum, so it is understandable.
*I have given you many answers to your questions.
*Now that I have heard more about where you all are coming from,I understand better why you're so strong about what you want.
--"In my opinion, it is worth the energy to make sure it is safe and everything is claims to be, which if it really were, it should not be that hard to prove."
*I agree with you. It is simply not the role given to me in this life.
*In the role that I have been given, the Brewer philosophy has proven to be safe, and so I have no reason to look elsewhere for myself, for the purposes of the role that I have been given. I hope that others who may have had this role will come to light soon.
--"I was reading one of the PE stories on your website where the lady developed high blood pressure in her pregnancy and it was blamed on stressful relationships that she was involved in...once again blaming the mother for the problem. Around here, we never blame the mother for PE, particularly when it comes to the mother inducing her own high blood pressure, or not eating the right foods."
*I entered this discussion hoping that the blame card would not be played. I am disappointed that you are using it now. At the same time, I am very sympathetic to the pain that is caused when it feels as though someone is laying blame in this direction, and I think that the professionals need to be much more sensitive about how that feels and learn to be much more careful to not come across in this way.
*In my opinion this is not blaming the mother. Part of the proper use of the Brewer Diet involves doing a thorough assessment of the mother's life, just as taking a thorough history is vital to every medical, or nursing, or midwifery assessment. Unless we take a proper and thorough history and assessment of the client's life, we cannot fully see where changes can be made to help that client achieve the level of health that she desires.
--For Caryn and others...
*I'm not sure that I'm allowed to answer specifics here, since that would be in the category of answering from the Brewer perspective, as defined by Onesock, and I do know that I do not have the time or energy to answer each member's story individually, at least not today...but I will respond to this question...
*Did you follow the Bradley version or the Brewer version of the diet? The Bradley version can be rather confusing, because it is taken from the earliest consumer book by Brewer. The servings are not standardized, and it calls for only 2 servings (3 oz) from the protein-source group, where later books call for 6-8 servings (1 oz.)
*Was a detailed history taken to ensure that the basic Brewer Diet fit your unique needs, including your daily activity level and personal habits (TBMDFNHRP, p. 106-133)?
*When your BP spiked, were you given IV albumin? If not, were you given the IV albumin substitute--52 eggs and 6 qt milk in 3 days?
--"I *own* all three of those Brewer books you mentioned, and have looked at the research articles he references. They have since been superceded by new research. For starters, I provided you with a link, in my first post, to the Cochrane review of studies showing that protein and protein-calorie supplementation does not affect preeclampsia rates."
* I simply respectfully disagree.
* I also have no reason to trust the Chochrane review, especially since I have no way of knowing what biases they may have brought to their review.
--"You yourself suggested that anyone who hadn't had success with the Brewer Diet was doing it wrong -- we had the wrong care providers, we didn't eat more eggs when our symptoms began to appear, or whatever."
*I cannot begin to address each story individually, even if I did have access to them. So I generalized, which is all that I'm left with.
--"Joy, I too want to say that most of our posters would never intentionally be condescending, and I'm sorry if things have seemed that way.
I, like many other women here, researched everything - and I mean everything - I could find on this disease after my first train wreck pregnancy. Please believe me when I say that if I had found an ounce of concrete evidence to support this diet I would have been elbowing my way to the front of the line to try it. I can attest that if this diet were truly the cure-all that it claims to be the women of these forums would be it's greatest champions. Unfortunately we have yet to see any concrete evidence, so please forgive us for not jumping for joy - no pun intended."
*Thank you to all of you for your thoughtful, compassionate responses to me. I'm not sure that I can respond to them all, and at some point I will need to get on with the rest of my life for today, but I will take a stab at responding to some of them.
*I am also truly sympathetic to all of the pain that all of you have experienced, and I admire all of the work that so many of you have put into understanding what has occurred for you, and how to prevent it in the future.
--I am sympathetic to the huge amount of work that many of you have put into your website and your publications. Thank you for telling me more about that.
--"The classic example of Dr. Semmelweis has little to do with modern publishing and peer review. Publishers and reviewers generally jump at the opportunity to take on unpopular or untested views, if only to reveal their flaws. There will always be examples of closed minds and narrow views, but can you seriously claim that Brewer has been unfairly shut out of hundreds of peer-reviewed publications consistently for 40 years? That none of them are interested in being the first to publish groundbreaking results?"
*I respectfully disagree with the notion that Semmelweis's experience has little to do with modern experience, although I do hear where the differences may lie.
*Brewer was published in many professional publications/journals which I presume were all peer-reviewed. In many other situations, he was shut out unfairly.
--"Brewer's site promotes the diet as straightforward and foolproof. Are you now saying it's too complex to be used except by doctors with special training?"
*No, I am not saying that. What I am saying is that the BD and philosophy is often misinterpreted and incompletely used, and that there's no way of knowing off-hand in which of these situations represented on this board it was interpreted and used correctly and in which ones it was not.
--"Keep in mind that many of the women here have been followed very closely by OBs and perinatologists--often experts in hypertensive disorders of pregnancy--with extra blood work, urine tests, ultrasounds, NSTs, Doppler, you name it. What further training and monitoring would you suggest to detect our critical dietary deficiencies?"
*I would suggest that each of those experts study Brewer's original thesis thoroughly, complete with case studies and prescribed tests and description of test results. I would also suggest that they apply those suggestions, especially when nothing that they are trying is working.
--(Anyone who knows the story of Stone Soup will see where I'm going with this.)
*I do know the story of Stone Soup, and I don't see the connection.
--"And isn't the diet supposed to PREVENT preeclampsia? If so, why wouldn't a doctor prescribe it to ALL pregnant patients--no judgment calls required?"
*Yes, it does claim to prevent PE. And yes, many practitioners do prescribe it to all pregnant women. But each woman's metabolism, activity level, lifestyle, history, and stress level is unique to her alone, and sometimes some adjustments need to be made in order for the diet to be the most effective that it can be for her unique self.
--"With all due respect, the claims you've presented hinge on guesswork and nihilism. In the absence of controlled trials or at least a compellingly plausible mechanism of action, the Brewer diet doesn't even measure up to the many well-balanced pregnancy diets available from any OB or dietician. To claim otherwise IS victim blaming: It implies that blind faith in one particular, untested approach would have succeeded where all our best efforts failed."
*I respectfully disagree with this viewpoint and characterization.
--"We now know that many underlying disorders such as certain clotting disorders etc, can contribute to PE (it is suspected that I have one of these by my doctors due to my multiple miscarriages, though I have not been tested yet but will be before TTC again). How does the Brewers diet propose that by following it it can stop a person who has an underlying disorder that predisposes them from developing PE? It seems like if the Brewer's diet could cure PE in even before mention women, then why is it not being used to treat those underlying disorders by themselves sans pregnancy?"
*The Brewer Diet is primarily designed for pregnant women who start the pregnancy with no pre-existing disorders, if I understand him correctly. The reason that a non-pregnant person develops hypertension, for example, is completely different than the reasons that a pregnant person develops hypertension, so it would not be appropriate to try to use the BD in a non-pregnant hypertension . By the same token, the clotting mechanisms that go awry with HELLP, which can be addressed with the BD, are different than those that go wrong in a non-pregnant situation, so they cannot be addressed with the BD. Other pre-existing clotting abnormalities are unrelated to these physiologic mechanisms of pregnancy, so they cannot be addressed by the BD, but often other treatments for various pre-existing conditions can be augmented in pregnancy with judicious adjustment of the BD, to the advantage of the mother and baby.
--I hope that you will forgive me if I don't make this post any longer than it is already, by taking on more of the individual points made here. I hope that the responses that I've given here covers them all generally, without leaving anyone feeling overlooked or slighted.