‘Lying to the Computer’: Day 22 of Medical Leave

This month’s issue of Harper’s includes an article called “Starving Your Way to Vigor: The Benefits of an Empty Stomach.” In this article, journalist Steve Hendricks both reviews the history of medicinal fasting in the United States during the nineteenth and twentieth centuries and chronicles the nineteen-day fast during which he successfully lost thirty pounds. This magazine arrived in my mailbox at a time of higher-than-average frustration on my part with the medical industry, so perhaps I was predisposed to be sharply tempted to try fasting. But this predisposition predates my current complaints: back in my early twenties – when, ironically, I was in excellent health – I was a die-hard adherent of Dr. Andrew Weil, the M.D. and alternative medicine advocate who has published such books as Spontaneous Healing and Natural Health, Natural Medicine and who advocates short-term fasting as one component of an overall regime of good health. At that time I often urged myself to be disciplined enough to fast one day per week, but the bottom line was that I just wasn’t ready to give up bagels. And fresh cherries. And steak. And Starbucks lattes. You get the idea.

Things have changed since then, though. Like most other habits and routines in my life, my eating habits have become disordered since my fibromyalgia and MTBI symptoms began. I have trouble remembering the last time I really enjoyed food and felt nourished by it. Instead, my relationship with food usually falls into one of the following patterns:

  1. I wake up sore, cranky, and disoriented, usually after sleeping through several alarms. I take a shower, get dressed, and drink coffee either at home, at school, or on the way to school after a visit to the Dunkin Donuts drive-through. The breakfast options available don’t appeal to me, even though for most of my life breakfast has been my favorite meal. In fact, more and more I found myself avoiding my school’s dining hall in the mornings, not because the food isn’t good (their breakfasts are typically excellent) but because I know that if one little thing goes wrong (there are raisins in the French toast, the omelet line is too long, a student ahead of me takes the last of the coffee and I have to wait while a new pot brews) I will risk throwing a temper tantrum in front of the students and teachers I work with. I prefer to save my temper tantrums for my cats.
  2. I go to the grocery store, usually on the weekends. I buy all kinds of high-quality ingredients for meals that for years I loved to cook and consume. I stock up on plastic containers and make plans to make extra batches of each dish so I can freeze them and eat leftovers. Then when the time comes to cook, I am too tired to do so. The ingredients eventually go bad.
  3. After going to the grocery store as described in #2, I do prepare the meals I had hoped to prepare. But then when the food is finished cooking, I find that I have lost all taste for it and/or am too exhausted to eat and/or have a headache that is so bad that I can’t stand the smell, taste, or sight of food. The food eventually goes bad. Sometimes I am so exhausted that I can’t even bring myself to package up the food and freeze it.
  4. Sometimes I am overcome with a desperate need to eat. At these times, all of my rational faculties desert me, and I will consume the first food items I see, whether these are the dregs of a tray of brownies that have been sitting on the faculty room table for two days, an old candy cane leftover from Christmas, or – for the first time in my adult life – fast food. The end result of #4 is usually a nasty headache.

Last summer I experimented with a gluten-free diet. With time on my hands, lots of good in-season produce available in the markets, and the motivation of some initial improvement in my migraines, I ate homemade tarts with gluten-free crusts, huge salads topped with organic chicken and eggs, green smoothies made from fresh fruit, Greek yogurt, whey powder, spinach, and juice, and bag after bag after bag of fresh Bing cherries. At first it seemed as if I was capable of getting my old love of good food back. I never got much relief from my fibromyalgia pain while I was on this diet, but I did feel as if my migraines and my vision difficulties came very close to going away. I kept this routine up for the rest of the summer; however, when school started I found it very difficult to do everything I needed to do at school while also planning a gluten-free menu for myself. I usually eat at least one meal per day (lunch) in my school’s dining hall. Often I had no trouble finding a gluten-free option on the salad bar or even among the main courses, but too often the salad selections were limited or the area around the salad bar was so mobbed with students that I dared not even approach it (then as now, I became overwhelmed very easily), and since my life with fibromyalgia and MTBI is one long strategy session to avoid public temper tantrums, I returned to my previous strategies #1-4 above: essentially, to eating whatever was easy.

It also didn’t help that my doctor tested me in October for Celiac’s disease and gluten sensitivity and the tests came back negative. It was hard to justify staying off gluten in order to maybe have a slight reduction in headaches if my own blood was telling me that this diet was doing no good. And as my insomnia became worse and worse throughout the fall, nothing helped the migraines.

So, as I scanned the headlines on the cover of Harper’s yesterday, I let out a thoughtful Hmmmm. As I understood it from my earlier reading of Dr. Weil, fasting periodically for 1-3 days benefits the body because it allows the digestive system to rest and relax. In addition, Weil theorizes – probably correctly – that modern humans have inherited dietary habits and cravings for certain foods that do not serve us well in our current environment. For example, for many years animal fat and salt were scarce commodities in the human diet. The most successful individuals were the ones who ate as much meat and salt as possible when it was available; as Darwin’s theory of natural selection predicts, they became physically strong and mentally astute and were more likely to live to pass on their genes – including the genetic tendency for a voracious appetite – along to the next generation. In evolutionary terms, the 20,000 years or so that separate us from our ancestors who lived in these desperate circumstances amount to almost no time at all. Biologically, our bodies are still working out the kinks of having been descended from creatures who found it very difficult to find the nutrients that they needed to survive. Our modern world, however, offers us an unlimited supply of most food products – but especially fat and salt.  Imagine how bizarre our world would look to the vast majority of human beings from all time periods in history – our world in which our poorest people are morbidly obese.

In other words, when it comes to our instincts about food, we are armadillos. When I lived in northwest Arkansas, it was well known that the armadillo was the most common animal found dead at the side of highways. It turns out that the armadillo’s natural defense system against its predators is its ability to jump. When it sees a larger animal approach, it jumps, in hope of scaring the larger animal into running away. Apparently this defense mechanism sometimes works in the wild, or the individual armadillos that developed this strategy would not have survived to pass the technique on to future generations and essentially engrain it into the species’ genetic code. This strategy does not, however, help the armadillo to defend itself against one of its most dangerous predators in the modern world: the car. Most armadillos are small enough that a car or truck could pass right over them without harming them, and they are also capable of moving quickly enough to get out of the way of an oncoming car. However, when vehicles approach them, their instincts tell them to jump – to SCARE the car, you see – causing them to be hit by the car’s front bumper. Result: airborne armadillo.

Our instincts aren’t always right. Even natural selection gets thrown a curveball sometimes. Unlike armadillos, of course, humans are capable of using their intelligence to find rational solutions to the challenges in their lives. But our capacity for higher-order thinking also makes us more inclined to second-guess our instincts. Who’s right – the doctor who went to medical school? Or the gnawing voice coming from my brainstem, where animal thoughts still rumble on those occasions when the cerebral cortex lets its guard down?

It happens that on the same day that I read the Harper’s article on fasting, I had an appointment with my general practitioner. My plan was to fill her in on the details of my medical leave (which is being supervised officially by one of my specialists) and to ask her for a referral to an allergist to be tested for food allergies. My appointment was scheduled for 11:15, and I was checked in and settled in the waiting room by 11:00. The office was hopping: patients of various doctors arrived and departed or just popped in with insurance forms and various questions. The catering staff from a restaurant across the street made several deliveries of food for an impending office party. I waited. 11:15 came and went. It was a good thing I brought my Kindle.

At 12:15 I finally got up and asked the receptionist (after I extricated her from the office party) whether I would be called in soon. “You haven’t been seen?” she asked. Nope.

Meanwhile, another patient in the waiting room got up and came over to see me. I knew that this patient was a physician from an affiliated medical group because she had called an IT staff member on her cell phone about half an hour earlier, indignantly wanting to know why her password didn’t work on the wireless internet at this office. “Are you waiting for Dr. Doyle?” she asked. I said that I was. “That’s it – I’m cancelling,” the other doctor/patient snapped, invading the office party to let the receptionist know that she was hitting the road. A nurse finally appeared, balancing a laptop on one forearm and eyeing it nervously as a new father eyes his infant. She weighed me and checked my blood pressure and pulse, entering the data into her laptop. Any questions I may have had about how a doctor’s office could manage to be over an hour behind schedule before noon were answered when I saw her type. Every letter required a lengthy hunt for the correct key, and there were lots of disgruntled murmurs as she struggled yet again to locate the ‘delete’ key.

It was almost 1:00 when the doctor finally arrived, bearing her own laptop on which, apparently, she had SOMEBODY ELSE’S chart accessed. Eyes on the screen, she started asking me a series of computer-generated questions that were clearly designed for someone with a different set of symptoms. Confusion ensued for a moment, followed by a chain of rapid, flustered apologies. Buttons were pushed. A cursor was moved. Apparently my chart was located.

After I caught the doctor up on the details of my medical leave, I told her that I had stopped taking Lyrica. I expected her to be irritated with me – Lyrica is one of those medications that can cause serious withdrawal problems if one stops taking it abruptly. I was careful to decrease my dosage gradually, but I know from experience that doctors are not supposed to trust patients to do such things by themselves.

She surprised me. “Oh, GOOD!” she said, in a tone usually reserved for situations involving sorority girls and engagement rings. “I’m so happy for you that you’re off that medicine!”

Keep in mind that this doctor prescribed Lyrica for me. And once a couple of years ago when I asked to go off it, she talked me into staying on it and doubling the dose.

My doctor did not support my desire for allergy tests. In her view – and contrary to what I’ve read in a wide variety of books and websites about fibromyalgia – food allergies only manifest themselves in two ways: through respiratory symptoms (congestion, cough, sinus trouble, etc.) and through gastrointestinal distress. The idea that food allergies can cause inflammation leading to body pain and/or migraines struck her as spurious. Similarly, my question about whether I should consider taking any supplements caused her to throw up her hands and scratch herself in the face, almost dropping her laptop. At one point, we were both just screaming at each other. Me: “I KEEP HEARING THAT MAGNESIUM SUPPLEMENTS CAN HELP FIBROMYALGIA. SHOULD I BE TAKING MAGNESIUM?” The doctor: “THE MEDICAL FIELD IS SCIENTIFIC! I CAN’T HELP YOU UNLESS YOU’RE WILLING TO TAKE A SCIENTIFIC APPROACH.” And then she packed up her laptop and prepared to go, washing her hands with soap from a Prozac dispenser.

I did manage to wrench a referral to an allergist out of her, although she informed me bitterly that she had to “lie to the computer” in order to do so. “I can’t say that I’m referring you to an allergist for fibromyalgia. So I’m going to say that you’re congested. And I’ll say that you’re constipated too.”

Apparently I had that look about me.

I am going to wrap this entry up, in spite of the fact that I really haven’t explored the question of fasting yet. The Harper’s article is fascinating, and I encourage you to check it out if you’re interested in the topic at all. I think there’s a good chance that I’ll try a one-day fast sometime soon to see how it makes me feel, possibly building up to longer fasts if I have any relief. At this point, I’m considering what I’ll call the Adolescent Approach to Fibromyalgia Treatment: doing exactly the opposite of everything the medical authorities tell me to do.

But for now I’ll sign off and get on with another exciting day on medical leave. You know, just sitting around, blowing my nose and trying to poop.

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3 Responses to ‘Lying to the Computer’: Day 22 of Medical Leave

  1. Tara says:

    Hey Bethany–so funny b/c I wanted to call you today and ask about the gluten free thing and how it was going, and then I found your post. I have mountains to grade, and had meetings this morning and a haircut, my first good haircut in Richmond in ages (I’ve been going to Atlanta for a haircut–crazy…). When my desk clears I want to call or write about the gf thing. Your doc sounds really weird. I guess this is the “new approach” to anything that sounds untraditional–refusing anything she deems as non-scientific. Hmmmm–do you have access to a medical journal database? There is probably some scientific research out there. She might be surprised. Anyway–loved the post–and the next time I’m out and about, I will look up that article in Harper’s.

    Tara

    • lfpbe says:

      I think “scientific” is doctor-speak for prescribing medicine (which, just to complicate things, this doctor claims to be opposed to). She is often weird but was weirder than usual on this particular visit. The article in Harper’s is great. In the 19th century there was a guy who sold tickets to his fast. He rented out a theatre and hired a security staff to guarantee that no one sneaked him food – and then people could buy tickets and watch him not eat! He lasted for over 40 days. Sounds like a pre-worker’s rights version of medical leave – Haha! I think I’m going to try a one-day juice, tea, and water fast this weekend and then if all goes well I’ll try a water-only fast the following weekend. Of course whenever I start thinking about it seriously I get ravenously hungry. We’ll see…

  2. Pingback: Oh, and by the way… | Six More Weeks of Winter: Notes from Medical Leave

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