Wednesday, January 13, 2016

Doctor 'Smith'

49


Ever searching for a new doctor to take on my health issues, I stumbled upon a new type of doctor: A Clinical Ecologist. Effectively he was a souped-up allergist who tested for more than just the basic set of allergies and I thought, Why not?
He had an office directly across the street from 'the other hospital' in town and I made my initial appointment where we talked about my health issues and decline over the previous years and while he wasn't sure my weight loss was a result of allergies per sé, he was more than willing to test me. A subsequent half day was set aside for testing and I returned. The very first thing they did was test the 'control' substance that they used, glycerin, and I immediately reacted to it. At that moment Dr. Smith knew I was going to be an interesting case, so he told me. I was also found to be allergic to red food coloring #3, corn, rice, household dust, etc. These all became revelations as we later discussed them and I thought about them and my lesser health history.
In the case of glycerin, I had been having problems with toothpaste, mouthwash, and shampoo all my life, ending-up just having to live with the symptoms even if I didn't like them. Now I discovered that all of these had glycerin in them, now explaining my bad reactions to them. Once I found variations without glycerin, all these associated problems went away.
I had been having muscle cramps since my preteen years and gained joint pains by the mid Nineteen Eighties. Once I cut corn out of my diet, these things went away. Avoiding this was more challenging as corn had become one of the biggest occult food additives over the preceding decade under various names like 'modified food starch', 'maize starch', 'maltodextrin', and so on. With this one, I had to start reading all of the fine print on processed food and suddenly much of what I had been eating without thought became things I should avoid. And by avoiding them I felt much better, at least when it came to moving my muscles and bending my limbs.
Since my late childhood years, I would get these itchy patches that I would unthinkingly scratch. Yet doing so only made them worse and they developed into fully fledged rashes that would defy treatment with steroidal based creams. Now reflecting that these might have been times when my exposed skin had come into contact with household dust, mostly made up of dust mite droppings, instead of scratching my skin when these happened I instead rinsed the area off with water or a wet paper towel. Within a minute or two all itching would go away and no rash would form. In reality all the scratching had been doing was break-open the skin and embed the dust even deeper into it, increasing the allergic reaction and thus the itching.
By the early Nineteen Eighties, I had begun to periodically have inner body itching problems, as if the organs themselves were irritated. But how do you scratch an itch inside your body? I couldn't and would just have to wait for the all encompassing sensation to eventually fade away. For the times when I couldn't wait it out, I'd take a cold shower as a last resort, letting the icy water numb my whole body. Yet once I started avoiding red food coloring #3, these issues disappeared as well. On the rare occasion when they'd happened again, I'd check the ingredients and sure enough there was red #3, buried in the list. I was fortunate that it was banned a few years later... Then less fortunate that, as part of the free trade deals of the nineties, it was reintroduced into the country, forcing me to stay on my toes for it ever since.
Though Dr. Smith didn't test me for it, when I talked to him about my bad reaction to the C.T. contrast dye I had recently had, he said, ''You mean iodine?'' It turned out that the common contrast dye was iodine and suddenly something else clicked into place. My entire life, as part of eating, the roof of my mouth would often blister and peel. As this most always happened, I grew up assuming it was just a normal part of eating. It never occurred to me to compare notes with my family members or friends. In the early Nineteen Eighties, after years of public health warnings about too much salt in our diets, I had reduced the amount of salt I added to foods and for some reason the occasions of the blistering and peeling became less frequent. At the time I just assumed I was growing out of that problem but now, in retrospect, I realized it was likely the iodine in the salt that was causing it. Since I've cut iodized salt out of my diet, I've rarely had the problem since. When I still do it is most often at restaurants and I assume they added some iodized salt of their own for flavoring.
When I tell people of that last one they get nervous as they've spent their entire lives hearing that iodine is a necessary nutrient... Actually it was added to salt to reduce the chance of it caking into solid lumps in areas with high humidity. While iodine is needed for some thyroid based functions, we in America get plenty of micro doses from our existing diet and typically don't need the additional dose provided by iodized salt. In the past twenty-eight years being iodized salt free, I've not had any thyroid related problems and I've been virtual free of the inner mouth blisters & peeling that were common place for my first twenty years of life.
For all of these, Dr. Smith offered antigens I could pay for to reduce the adverse affects of each one of these allergens, but that was not to be. After a number of very productive and helpful appointments we discovered that my health insurance wasn't going to cover me seeing him as 'Clinical Ecology' was not yet an accepted field of medicine. Had he just labeled himself 'an allergist', as that was the majority of the work-up he had been doing for me, it would have been covered in full. Instead his appointments weren't covered at all and I was ending up with a huge bill that was beyond any savings I had. All I could do was make little payments each month from my state stipend and in return he told me I could just avoid these various allergens rather than worry about getting the antigens for them.
Given the vast amount of progress we had made, he didn't want to immediately drop me just because my insurance wouldn't pay, there was one more thing to try. Now that we knew of so many allergens to avoid in my diet, he wanted his on site dietician to create a planned diet for me and see if I could now regain my weight while on it and resolve the emaciation that was the major impact to my daily health and routines. I agreed and when I saw her, the diet she recommended was pretty much identical to the canned diet the hospital dietician had recommended six months earlier, without any tailoring for my allergy issues or other diagnosed intolerances. When I noticed this and pointed it out to her, she said it was for me to figure out what things I needed to avoid because of my allergies and intolerances and in her presence I crossed out about half of each daily meal she had provided me.
She couldn't think of alternatives and talked to Dr. Smith about it. He theorized that since I would be avoiding his diagnosed allergens, that my fructose intolerance and fat malabsorption would go away on their own and I no longer needed to avoid those. This put about half of the things I had crossed out back on the menu and the rest was made up for with larger portions of the stuff I didn't have problems with. This new diet now set, there was a new problem. It was more than twice the cost of my monthly food stamp allowance... But Dr. Smith was so sure that the allergen free diet would make a big difference that I would be back to work and off food stamps in no time. So I agreed, spending my full month's worth of food stamps on two weeks worth of food.
Given that this new diet would include more fresh food that needed to be kept cool, I begged my mother not to throw away my food items from the refrigerator for the next two weeks as my new doctor was trying me out on a special diet. She reluctantly agreed. I was on this new allergen free diet for two weeks and could tell within two days that it was doomed as the frequency of massively painful bowel movements, which I sometimes had, now became a daily experience. After the first week, I called his office and told him that I thought we should stop the diet given the side effects. But he felt it was just the brief adjustment of my system to the new diet and these problems would go away by the second week.
When I returned to his office at the end of the second week, I had lost another five pounds. The fastest rate I had lost weight in all these years. He concluded that I shouldn't go with the official diet and instead return to what I had been eating before, but this time avoiding my known allergies as I went along. As a final bit of advice for me before we parted ways, he told me to stay aware of what I ate and came in contact with when I started to have new repetitive bad reactions. If I did, I should check for something new that I was being exposed to and see if eliminating it from my environment or diet made the symptoms go away. This was golden advice that's saved me time and again during all the subsequent years of my life.
As I couldn't afford to keep on seeing him, he asked if there was anything else he could do for me. As my six month stipend of state aid was coming to an end, I asked if he could fill out the medical evaluation part of the forms to renew it for another six months while I waited to hear from Social Security. While he would have normally not done that given that he wasn't a primary care doctor, in my case he agreed to, perhaps feeling guilty that we were ending our doctor patient relationship without him finding the root cause of my weight loss problems. He completed the paperwork and I received notice that the stipend would be extended for another six months.
In just three more months, he would have to leave the state as a number of local physicians, outraged by what they saw as his 'voodoo medical science', went to the state's medical board demanding that his license be revoked. Rather than go through the emotional and financial turmoil of fighting it, he decided to pull up stakes and move to another state where he could practice in peace.
Of all the doctors I have ever gone to, I've felt he was one of the most important ones I met.




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