Monday, May 08, 2017

My Old Nemesis

Monday morning in rounds two weeks ago, we heard the tale of a horrible accident suffered by a patient. “Blech,” we thought, or at least, I did. Delia and I went to visit this patient, who was quite charming and who recounted in detail what had happened. For the first time in a while, I felt queasy and overheated and mainly that I really, really needed to leave the room. I have never before left a hospital room under such circumstances, and I really didn’t want to do it while on a joint visit with Delia, my palliative care mentor, but it got to the point where it was imperative. I decided to go get the folding chair that is in most rooms and sit down on it, and if the chair was not there, I was just going to depart.

The chair was there, so I unfolded it and brought it to near the patient’s bed. Delia said, “Why, thank you,” and sat down on it, which even in the moment struck me as quite funny. She kindly pointed out a second chair, and I sat down on that. Just sitting down might have done the trick, but fortunately, all this chair-getting had caused the patient to lose her train of thought.

I told Delia about it later and she said I was experiencing secondary trauma. I asked what she does if she hears something she can’t stand to listen to, but she said she has a very high tolerance for that kind of thing. She advised putting my attention my feet; that sort of thing. She also said that if this happens when I’m alone with a patient, it’s fine to say, “I’m sorry, I’m suddenly feeling unwell. I will have to be going.”

We went to offer blessings to two patients who had died that morning, and we went to see a fellow on life support, eyes half open, with a huge hole in the center of his chest with a flimsy piece of material stitched over it as a cover. That kind of thing doesn’t bother me at all. I told Delia that I could have looked at that all day. It’s just hearing someone describe an injury that sometimes gets to me.

About seven weeks ago, something suddenly changed with my intestinal health. I’ll spare you the details, but a couple of weeks ago, I found myself feeling angry at my own body part: “Just do your job, people.” Eventually it occurred to me to try a different tack. Striking a conciliatory tone, I inquired, “Intestines, what’s wrong? What can I do for you?” That very day, while searching online for an answer, I realized what the problem was: Satan! That is, the seitan sandwich—a slab of pure gluten encased between two pieces of gluten-loaded bread—that I have had nearly every single day for lunch at work for eleven straight months. The symptoms listed for an allergy to gluten seemed to match mine quite well.

Accordingly, that evening, I took several loaves of bread and nine packages of seitan—I buy it on sale—up to Tom’s, announcing, “Here’s your shipment.”

“Shipment?” he asked politely.

A few days later, I saw a doctor who thought that gluten could indeed be the culprit, as in a gluten allergy, which she said can grow over time. She said if I had out-and-out celiac disease, I would have been diagnosed with that long ago. She sent me to see a dietician, whom I liked a lot, who said possibly I have irritable bowel syndrome (IBS), specifically IBS-C, the one that comes with the constipation enhancement. (If you must know.) She gave me several pieces of paper about how to follow a low-FODMAPs diet. We agreed that I would get rid of the most glaring high-FODMAP foods in my diet—apples, avocados, mushrooms—and check in after two weeks. If things aren’t better, she will recommend an actual elimination diet.

Accordingly, that night I schlepped two avocados and an apple up to Tom’s. A couple of days later, I realized that gluten itself is a low-FODMAP food. The trace amount of garlic and wheat that are in my particular seitan seemed unlikely to cause major problems, so I went up to Tom’s and demanded my seitan back:
“Unhand my seitan.It’s good to have a very, very easygoing friend who lives right upstairs.

As for Hammett, my beloved cat, he has been steadily losing weight for the past several months and has had all sorts of tests, none of which has found anything. In the end, of course it turned out to be his thyroid, and so his methimazole dosage was increased. His vet also told me to start giving him Miralax, for his constipation. For a while, I had on my desk, next to each other, “Hammett’s Poop Log” and “Bugwalk’s Poop Log.”
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