It is true they don't get much training. My doctor's advice was to eat a diabetic diet. There were no clues or information about what that was supposed to be. I have had to get some books to help with it because, as Sam said, Medicare does not cover nutritional counseling unless you are really, really sick, and nutrition counseling is out-of-pocket cost prohibitive. We are on our own to figure this all out. The Mayo Clinic provides a nutritional podcast that is pretty good, and it addresses the Mediterranean diet and how to move in that direction. I am following their advice and reading, and I am losing some weight. You also don't have to do everything radically, but incorporate more fruits and veggies, and that helps.

And researching on the Internet provides conflicting advice most of the time....

The hospital here has the local farmer's market set up once a week in the parking lot and it sells tons to patients and staff alike. Doctors from some other countries (particularly Asian, including India) are much more aware of diet than Americans. Part of it is because the American system want Drs. to have a "well-rounded education," but making them take art appreciation is not something they prefer either. Some other countries education focuses on medical subjects including nutrition and hygiene. I went to classes given by the County Health Department which were free but you had to register. Some were simple like reading labels but you could ask questions specific to you and I was able to get specific feedback in the Cardiac Rehab from a dietician which was covered by Medicare. The Drs were not helpful but suggested I go to the library and ask a librarian for books to read.

I began Repatha injections 8 weeks ago and my numbers were shocking when I reviewed my labwork from my recent hospitalization. My LDL was 29. Even going vegetarian I could not get it below 120. My cholestrol went from 205 to 105. They say the medication has no known side effects. I was told my lipids are due to genetics. I was very wary about this medication at first and there is no medication that does not have some side effects, I think it just hasn't been around too long, but as long as I can afford it and I don't have any problems with it I will stick with it. I am staying the course with keeping very low sodium and mostly vegetarian.

So, my doctor did provide a referral for a Dietician. I called after checking out Medicare's website for those near me. Spoke with one that stated if I wasn't diabetic that Medicare would not cover. Seems you need to have kidney disease or have diabetes to be covered under Medicare. So, I then called the dieticians staffed at a large supermarket chain here in San Antonio, Texas. They stated Medicare would not reimburse. So, I inquired cost, and it was pretty high for initial and subsequent appointments. Seems like insurance is reactive versus proactive. I am going to try the VA and see if I can get in. I have high Cholesterol and even with Praluent I still can't get LDL below 50. Recommendations are to do Mediterranean diet to achieve cholesterol goals. Best I have been on cholesterol is LDL 77, total cholesterol 165, Good HDL and good triglycerides. Lp(a) 50, which is high risk and my ApoB is 118 which is in the normal range as it is below 120 but my doctor wants it under 90 to reduce risk. The Lp(a) is genetically inherited lipoprotein that plays a huge role in heart disease risk. The normal range is 30 milligrams per deciliter (mg/dl). So, it's in my genes. So, getting on the Mediterranean diet is my focus and see what it does with future labs to check progress.