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I talked with my GI PA (physician's assistant: almost a doctor but not!) yesterday and became royally annoyed with her. After the hospital scare on Tuesday, I realized that I haven't really made an effort to follow up on the possible ways to keep myself healthy. For instance, I still eat cookies. Granted, cookies are very important to me on a reward basis and baking them is a nearly-ritualized destressing mechanism. But cookies and sugar in general are one of those things I overindulge in.

"So," said I to the PA, "I've been reevaluating and I think I would like to try changing my diet to see if that helps."
With horror in her voice, my PA said, "Don't stop taking your medications!"
"Um, I wasn't planning on stopping my medications..."
"And this is a serious problem (the stricture), which requires western medicine, you're just going to get yourself in trouble.""
"Um...I just thought maybe I should look at diet as something helpful...just, do you know a nutritionist I could talk to?"
"No. I don't know any nutritionists. I suppose I can look into it." And my PA ended the conversation rather quickly.

Upon reflection and a friend's helpful explanation of the difference between the terms "nutritionist" and "dietitian", I suppose I can understand why my PA thought I was going crazy...

"wanting to talk to a nutritionist, yep, she's going all holistic on me..."

Still...What the heck is a GI specialist doing not knowing any dietitians? Even if you don't want to endorse hippy-dippy alternative medicine, your patients could probably still use advice now and then on things like: what exactly am I supposed to be eating for the next month? Seeing as the clinic is taking its time on seeing me for the next urgent round of western medicine?

I pride myself on being in a medical field and understanding the science behind a lot of it. I am very aware of how hope and ignorance fuel a lot of false claims. I am also very aware of how there are gaping holes in our knowledge. The most common statement about IBD is "we don't really know anything about it." The second most common thing you hear is "there aren't any studies showing that diet affects it." Well, fiddle-dee-dee, there haven't been that many IBD diet studies done in the first place. It's one of those undertakings which terrifies researchers because of the sheer unwieldiness of the task. But as far as I can tell, the way the medical community has decided to handle it by dismissing out of hand anything that does not have a good scientific trial attached. As opposed to saying, "Ah-ha, here is an opportunity for a good scientific trial."

More to follow once I'm done with exams and can do some actual research and talking with people.

June 2014

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