Operations, Patient Care, Training

Eat Right to Make Sure You Don’t End Up a Patient

Issue 12 and Volume 39.

Recently I got married and did the typical bride-to-be thing by going on a diet—I exercised my butt off. I felt all the benefits you hear about: increased energy, decrease in back pain, better self-esteem. I loved it! So let’s look at this month’s theme—injury prevention—and take it a step further: food.

Throughout my career, I’ve known many medics and firefighters who have dietary restrictions. These usually come with very serious consequences if the wrong types of foods are ingested. The three most extreme examples of special diets I’ve encountered are ulcerative colitis, hereditary fructose intolerance, and the exacerbation of autism.

Ulcerative Colitis
My current intern, Donald, has ulcerative colitis (UC), which he told me about after I taught a lecture on gastrointestinal issues. I learned far more from him than he did from me, so I asked him to write about it.

“I refer to my colitis flare-ups as my ‘man period’ I live with six months of the year because the symptoms resemble just that—severe abdominal cramping that often radiates to my lower back, bloating, moderate loss of blood that sometimes puts me in the ED for IV fluid replacement (as water is no longer efficiently absorbed through my ulcerated colon), and
more-than-frequent trips to the bathroom or closest bush. There’s also irritability and orthopedic issues that arise because the only treatment is high doses of the corticosteroid Prednisone.

With UC being an autoimmune disease in which my immune system attacks unfamiliar bacteria naturally occurring in my colon, I’ve found that an array of foods can either land me in a flare-up or worsen an existing exacerbation. Alcohol is the main culprit in putting me in the fetal position for days on end. I’ve also found sensitivity to gluten, and know that some folks with my condition lead a fairly asymptomatic life without it. Foods high in saturated fats also tend to irritate existing flare-ups. I’ve also found staying away from lactose seems to lessen symptoms.

The main foods I strive to avoid are leafy greens and fruits with rinds, which have a higher nutritional value than other foods. Though there’s no cure and flare-ups are inevitable, maintaining a bland, organic diet seems to lessen the blow. An understanding preceptor is always appreciated when I’m on my man period.”

Fructose Intolerance
My old partner Debbie confided in me she was in stage 2 liver failure. She doesn’t drink, is physically fit and had no predisposing issues—what could’ve caused this? I guess I can say she was too sweet, because it was sugar.

She was very proactive in finding the cause of her liver problem. She researched endlessly and discovered one article about hereditary fructose intolerance (HFI), so she contacted a doctor on the east coast who helped confirm her diagnosis through a DNA test. It’s a disorder in which the patient is missing an enzyme in the liver that processes any form or combinations of fructose, sucrose and sorbitol. It would cause her pain and liver damage.

When we were partners she never had a sweet tooth, but as a child she loved Pixie Sticks. These are made of glucose, one of only two sugars she can properly digest because they aren’t processed through the liver. She had to go on a radical diet to try to halt the progression of her liver disease. Most HFI patients die as babies due to rapid liver failure or severe hypoglycemia when introduced to food.

She now eats protein only: meat, cheese, fish and chicken. She can have a little salt and pepper, but no other seasoning, fruits, vegetables or carbohydrates. She lost 20 pounds in three weeks, and she was very trim to start. She’s happy with the overall good health she’s in as a result and her liver enzymes have returned to normal. Even without sugar, she’s still very sweet.

Autism
My former student Jeri Ellen has a beautiful 4- year-old son named Soren. Soren is autistic. Searching for any possible way to help her son, she removed all processed grains, sugars and non-organic foods from his diet. However, she took it to the next level when she discovered a documented link between glutamate and autism.

Glutomate, commonly seen as part of MSG (monosodium glutamate) is a flavor enhancer added to an insane amount of everyday foods. Jeri Ellen played a video for our station by biochemist Katherine Reid describing the clear link between the symptoms of autism, and the exacerbation glutamate causes. My jaw dropped. The video had clips of the speaker’s daughter as a very young girl showing classic autistic tendencies—inability to focus, echolalia and becoming inappropriately upset with minor changes. After the presentation her daughter met her on stage. She was approximately 5 years old, and was able to stand on a stage with bright lights and loud clapping, which is basically unheard of for an autistic child. She smiled and interacted and lit up the hearts of everyone in the room.

My friend took that example and ran with it. Now, mind you, she was already insanely fit, with the most health-conscience diet I’ve ever seen. She turned her front yard into a completely organic garden and cut out any possible source of glutamate from Soren’s diet. Three weeks later she was rewarded with her first ever clear interactive conversation, including eye contact, with her son. It just doesn’t get any better than that.

In Short
After hundreds of hours of didactic training in anatomy and physiology, pathophysiology, disease processes, and congenital abnormalities we’re pros at picking out our patients’ problems. We’re usually able to pinpoint the etiology and risk factors, and compose a treatment plan based on our education and experience. That “once removed” position makes it fairly easy to arrive at a differential diagnosis.

The wrong foods can have far greater consequences than a few extra pounds. They can be as debilitating, or deadly, as an injury. It’s important to monitor your diet seriously and always keep in mind: you are what you eat.

Columns, Operations, Training

Eat Right to Make Sure You Don’t End Up a Patient

Issue 12 and Volume 39.

Recently I got married and did the typical bride-to-be thing by going on a diet—I exercised my butt off. I felt all the benefits you hear about: increased energy, decrease in back pain, better self-esteem. I loved it! So let’s look at this month’s theme—injury prevention—and take it a step further: food.

Throughout my career, I’ve known many medics and firefighters who have dietary restrictions. These usually come with very serious consequences if the wrong types of foods are ingested. The three most extreme examples of special diets I’ve encountered are ulcerative colitis, hereditary fructose intolerance, and the exacerbation of autism.

Ulcerative Colitis
My current intern, Donald, has ulcerative colitis (UC), which he told me about after I taught a lecture on gastrointestinal issues. I learned far more from him than he did from me, so I asked him to write about it.

“I refer to my colitis flare-ups as my ‘man period’ I live with six months of the year because the symptoms resemble just that—severe abdominal cramping that often radiates to my lower back, bloating, moderate loss of blood that sometimes puts me in the ED for IV fluid replacement (as water is no longer efficiently absorbed through my ulcerated colon), and
more-than-frequent trips to the bathroom or closest bush. There’s also irritability and orthopedic issues that arise because the only treatment is high doses of the corticosteroid Prednisone.

With UC being an autoimmune disease in which my immune system attacks unfamiliar bacteria naturally occurring in my colon, I’ve found that an array of foods can either land me in a flare-up or worsen an existing exacerbation. Alcohol is the main culprit in putting me in the fetal position for days on end. I’ve also found sensitivity to gluten, and know that some folks with my condition lead a fairly asymptomatic life without it. Foods high in saturated fats also tend to irritate existing flare-ups. I’ve also found staying away from lactose seems to lessen symptoms.

The main foods I strive to avoid are leafy greens and fruits with rinds, which have a higher nutritional value than other foods. Though there’s no cure and flare-ups are inevitable, maintaining a bland, organic diet seems to lessen the blow. An understanding preceptor is always appreciated when I’m on my man period.”

Fructose Intolerance
My old partner Debbie confided in me she was in stage 2 liver failure. She doesn’t drink, is physically fit and had no predisposing issues—what could’ve caused this? I guess I can say she was too sweet, because it was sugar.

She was very proactive in finding the cause of her liver problem. She researched endlessly and discovered one article about hereditary fructose intolerance (HFI), so she contacted a doctor on the east coast who helped confirm her diagnosis through a DNA test. It’s a disorder in which the patient is missing an enzyme in the liver that processes any form or combinations of fructose, sucrose and sorbitol. It would cause her pain and liver damage.

When we were partners she never had a sweet tooth, but as a child she loved Pixie Sticks. These are made of glucose, one of only two sugars she can properly digest because they aren’t processed through the liver. She had to go on a radical diet to try to halt the progression of her liver disease. Most HFI patients die as babies due to rapid liver failure or severe hypoglycemia when introduced to food.

She now eats protein only: meat, cheese, fish and chicken. She can have a little salt and pepper, but no other seasoning, fruits, vegetables or carbohydrates. She lost 20 pounds in three weeks, and she was very trim to start. She’s happy with the overall good health she’s in as a result and her liver enzymes have returned to normal. Even without sugar, she’s still very sweet.

Autism
My former student Jeri Ellen has a beautiful 4- year-old son named Soren. Soren is autistic. Searching for any possible way to help her son, she removed all processed grains, sugars and non-organic foods from his diet. However, she took it to the next level when she discovered a documented link between glutamate and autism.

Glutomate, commonly seen as part of MSG (monosodium glutamate) is a flavor enhancer added to an insane amount of everyday foods. Jeri Ellen played a video for our station by biochemist Katherine Reid describing the clear link between the symptoms of autism, and the exacerbation glutamate causes. My jaw dropped. The video had clips of the speaker’s daughter as a very young girl showing classic autistic tendencies—inability to focus, echolalia and becoming inappropriately upset with minor changes. After the presentation her daughter met her on stage. She was approximately 5 years old, and was able to stand on a stage with bright lights and loud clapping, which is basically unheard of for an autistic child. She smiled and interacted and lit up the hearts of everyone in the room.

My friend took that example and ran with it. Now, mind you, she was already insanely fit, with the most health-conscience diet I’ve ever seen. She turned her front yard into a completely organic garden and cut out any possible source of glutamate from Soren’s diet. Three weeks later she was rewarded with her first ever clear interactive conversation, including eye contact, with her son. It just doesn’t get any better than that.

In Short
After hundreds of hours of didactic training in anatomy and physiology, pathophysiology, disease processes, and congenital abnormalities we’re pros at picking out our patients’ problems. We’re usually able to pinpoint the etiology and risk factors, and compose a treatment plan based on our education and experience. That “once removed” position makes it fairly easy to arrive at a differential diagnosis.

The wrong foods can have far greater consequences than a few extra pounds. They can be as debilitating, or deadly, as an injury. It’s important to monitor your diet seriously and always keep in mind: you are what you eat.