Maybe It Isn’t

Sometimes you run across something that sounds good on the surface, but on further examination, maybe it isn’t. This is especially true when it comes to food and nutrition myths like these:

All food made from plants is good for me. Not if it’s a processed or ultra processed food. Stick with plants that remain as close to their original state and harvest date as possible. Those are the healthiest plants, especially if you can find some that are pesticide-free.

Line of dairy cows ready to be milked with yellow tags in their ears.

Raw milk is better than pasteurized. There are currently no scientific studies showing raw milk is more beneficial than pasteurized milk. While there seems to be a link between children who drink raw milk and fewer instances of asthma and allergies, scientists warn that the risk of bacterial infection is a greater health risk than any possible benefit.

I spent time milking cows as a kid. We sold the milk. I can tell you that our milk would have been at high risk for bacteria. I’ve also been to commercial milking barns. Much care is taken to clean equipment and stalls, but the milking is still done in barns that are full of cows who sometimes poop during the process.

Today, there’s a new raw milk cheese recall due to E. coli contamination that has sent 8 people to the hospital and sickened people across nine states so far.

Beef tallow is the best cooking oil. While it is true that beef tallow contains some fat-soluble vitamins, minerals, and omega-3 and omega-6 fatty acids, it is also saturated fat. It’s fine to use beef tallow on occasion, but I would choose olive oil for everyday cooking. Olive oil is part of the Mediterranean Diet that is consistently linked to longer lifespan.

Going gluten-free will make me healthier.  If you have celiac disease or are gluten-intolerant, then this is true. If your body tolerates gluten well, there’s no reason to be gluten-free. You could argue reducing grain carbs in general will make you healthier, but that means eliminating or reducing gluten-free grains as well.

One gummy will give me all the nutrients or fiber you need. If you have fresh, nutritional food available that is naturally high in fiber and you don’t have an allergy or condition that keeps you from consuming it, you can get the most benefit from consuming food. Supplements can be helpful for special circumstances and deficits.

I know there’s lots of noise everywhere right now. It can be less overwhelming to funnel information through fewer channels. The problem with that in this moment is that algorithms serve to create echo chambers. That can amplify misinformation and prevent us from getting additional information we need to make good food choices.

Every day, I see people ask good questions about the food supply, diet, and nutrition. I also see questionable assertions, claims, and advice that’s potentially dangerous. The next time you see an idea that sounds good, look further before you adopt it – maybe it isn’t.

https://www.webmd.com/diet/raw-milk-health-benefits

https://www.webmd.com/diet/raw-milk-health-benefits

https://diet.mayoclinic.org/us/blog/2023/the-mediterranean-diet-a-path-to-longevity-healthy-aging-and-weight-loss/

Communication

If you understand the importance of communication and do your best to communicate well, it can be frustrating when co-workers don’t. But the truth is, you can only control your side of the equation.

In this world of abbreviations and emojis, I’ve noticed it’s much easier to say nothing than ever before. This may work fine in some situations. In fact, it can make you appear to be more of a team player than you actually are.

But saying nothing can also be deadly. If you are a pilot, communication with the tower or other aircraft can determine whether or not you make a safe landing. If you are a doctor, clear communication of instructions to your staff and patients can make the difference between complications or smooth recovery. And closing the communication loop builds trust with clients, patients, and colleagues.

Seems like internal communication would be an area of emphasis in policy and training in all industries. And yet, communication is often the most broken system in an organization.

Two men seated. One is masked and gesturing. Blonde female with ponytail and mask leaning toward second man with gloved hands out palms up.

In healthcare systems, this is unimaginable. And yet it is problem repeated day in and day out.

Developing good communication systems is not as complicated as setting criteria for transplant eligibility, developing infection control procedures, or reducing the number of opioid prescriptions. But it can make a huge difference in morbidity and mortality.

So why do health systems focus on external communication and image branding instead of the kind of internal communication that makes patients feel seen and cared for? This would build the brand in a more significant way and get better health outcomes. Better health outcomes will further a positive view of the brand.

This is a rhetorical question. I don’t know why it’s not a priority. I’ve served in multiple advisory positions in a hospital as well as a vendor that worked with hospital marketing departments. Overall communication procedures are something that just never get much traction and, in one instance, direct push back.

In that instance, I feel like there was a desire to avoid transparency. But that’s not always the case. Often, it’s just a lack of thinking the process all the way through and spending the time to write policies.

And there’s currently a weird belief that presenting facts is somehow being confrontational. A lot of people avoid anything that resembles, or that they can imagine might be, confrontation.

Other than quality managers, it’s possible that health system leadership simply doesn’t recognize the importance of communication. Their training may include bedside manner, but most of the focus is scientific.

A pilot study of the effects of more complete communication on medical outcomes in a specific group of patients and/or patients and families could be instructive. If it shows improved medical outcomes in a group that receives more communication, it could help the issue gain legitimacy within the industry.

And all of us can let our health providers know that communication is important to us. Highlight it on every quality survey you receive. Mention it during every doctor visit. Put it in the comments in your patient portal. And express appreciation when the system gets it right.

We can’t control what the system does, but all of us together are a lot of voices. If we keep communicating, at some point, they will hear us.

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Add Foods Slooooowly

If you upset your system be sure to add foods slooooowly once you’re feeling better. The mistake I made eating smoked brisket in August, is still affecting me. No, it’s not my imagination. No, it’s not fun. It affects my everyday life, my work life, and my social life.

That’s what ingesting gluten, or triggering an IBS, or MCAS flare can do. It can disrupt everything! The results can make familiar situations so uncomfortable you have to change your routine. And, in the case of me yesterday, they can mean you have to lie down after a meal because if you don’t you feel dizzy or too tired to move.

For the next couple of days, I will eat primarily apples, eggs, potatoes, sweet potatoes, and limited amounts of chicken or turkey. These are things my system tolerates well even during a flare. As time goes on, I’ll add squash and English peas.  

The second mistake I made is, once I felt normal for a day, I rushed back to my regular diet and even tempted fate with restaurant food and a few Cheetos. The restaurant is local and uses fresh food, but still may have stretched the limits. Cheetos. I knew better.

long spread of food on wood table

Don’t worry, I won’t do that again any time soon. But I haven’t had a flare that lasted this long or put me in this much pain in a decade so I no longer remembered the effects viscerally.

If you try an elimination diet, make note of foods that you tolerate well when you begin adding foods back. This can become your go-to diet for recovering from an accidental ingestion of foods that irritate your system.

Using well-tolerated foods as your base, slooooowly add back foods that typically give you the least issues. For instance, I don’t usually have problems with beef until my system has already been triggered to overreact. In that circumstance, beef may cause a significant detrimental reaction.

It’s best if I don’t rush to eat beef once I feel better. If I do, I risk starting the healing process over to some degree. Not only will that bring physical discomfort, it will bring multiple levels of frustration.

Would I love to eat some chocolate today? Yes, it sounds yummy. But chocolate is an irritant I cannot tolerate in large quantities or often. Instead, I’ve gone back to the dietary basics I started with a month ago.

This is a great opportunity for me to practice patience. I will today and tomorrow, but as I begin to feel better, the temptation to eat something that tastes better will reappear. That’s when my resolve will be tested.

To entice myself to continue to eat safe foods, I can add small bites of relatively safe foods to jazz things up as I continue with the basics. Adding a little honey to my toast, a bit of goat cheese to my eggs, a bowl of rice with a dab of butter and raspberry jam to my breakfast, can introduce enough taste variety to reduce the temptation to eat chocolate or Cheetos.

There’s no set time frame for getting back to a more varied menu after a flare but learning from my mistake and not going back to a full diet immediately after you feel better for a day can prevent a lot of pain. After a flare, it’s better to add back slooooowly.

Playmates

Postural Orthostatic Tachycardia Syndrome (POTS) and Mast Cell Activation Syndrome (MCAS) are frequently playmates in a patient’s system. Their interaction can worsen symptoms and send patients through a maze of doctor visits trying to figure out what’s happening as their quality-of-life decreases.

When you get playdates like this going in your system (these are not the only chronic conditions that often occur together), diagnosis can be difficult and take weeks, months, or years. It’s not the kind of thing our diagnostic system is good at. And once you get a diagnosis, the only solution may be to manage the conditions.

Vignette of dice with shadow.

Have these? Want to scream? Yeah, I know. I’ve had two conversations this week with people who walk this tightrope all the time. It can be hard and exhausting. If you then meet resistance from health professionals when you request measures to avoid items that trigger a flare, it can be beyond frustrating. And, if you’re female, your concerns may be dismissed altogether.

None of this means you’re crazy. If you feel dizzy, you feel dizzy. If your right eyelid sometimes swells and feels heavy, it does. If you have rashes that will not go away even with prescription medications, there’s probably a trigger that’s causing a flare of some sort. If the room spins or you faint, it’s probably not all in your head. And yet, some physical reactions can stimulate emotional responses.

So what should you do?

Visit a physician. If you suspect you have POTS, MCAS, Ehlers-Danlos Syndrome, or Long COVID, search for physicians who specialize in these conditions. If there are none in your area and you have the ability to travel, visit one in another area.

If you can’t afford to travel, but have a medical school nearby, reach out to their research arm or see if you can get your case presented at grand rounds. The goal is to get more eyeballs on the problem.

Learn as much as you can. While it’s best to leave the diagnosing to the professionals, you are a part of your own health team. If you have information that you believe may help, it’s okay to provide that. If you have questions, ask them.

Visit the National Organization for Rare Disorders https://rarediseases.org/understanding-rare-disease/undiagnosed-diseases/

Check out The Dysautonomia Project https://thedysautonomiaproject.org/ for educational information on disorders of the autonomic nervous system.

See if the Autoimmune Association has relevant information. https://autoimmune.org/

But keep in mind that when two conditions coexist, diagnosis may be more difficult. https://www.eds.clinic/articles/eds-pots-mcas-trifecta

Follow dietary recommendations that can help. With MCAS, this means avoiding histamine containing and liberating foods. It may also mean avoiding certain medications and ingredients in personal care products. With other conditions, there will be different lists.

Talk to people. Find an existing community or compare notes if you run across someone else who experiences similar symptoms. People who are managing related conditions may be able to suggest triggers you have overlooked or symptoms that you thought were unrelated.

Finding a community that’s helpful can take some work and flexibility, but it’s rarely impossible. Stick your toe in the water and only wade in when you feel comfortable.

Establish a routine. Include eating at fairly regular intervals, drinking plenty of water, good sleep habits, and down time to let your system regroup.

Change what you can. If there are stressors you can let go of, do. A system that’s already overloaded will be more likely to have a lower threshold for triggers.

Trust yourself. I know when your gut is cramping and your vagus nerve has sent the room spinning, you may feel both sick and crazy. You are not. Something needs attention.

When something needs attention and you find yourself being summarily dismissed, you may need new playmates. A supportive community and a curious healthcare team can be just what the doctor ordered.