The Dietician

First, an update on the state of things. I am mending … slowly … but I am mending! I am on a low-residue diet and am slowly adding foods to it. So far the only bad reaction I had was to beans and perhaps an apple. I am pretty sure it was the fibre so I am going to try some soft tofu this week, because I like beans! My sister, Dr. Amy N.D. (Naturopathic Doctor) has me on a number of supplements, all of which seem to be helping, especially the very strong probiotic I was taking. I took the last dose a couple nights ago, and now am on a less intense dose for the foreseeable future. I also started seeing my acupuncturist, Dr. Li, who is working his miracles with needles and Chinese herbal medicine.

All of this means that I am slowly gaining both weight and energy. As of today I am 118 pounds (that’s 8 stone 6 for my UK friends!) and seem to be getting some curves back. I still can’t do much though. Showering is not such a chore anymore and I can sit up for longer periods of time. I have started a supported yoga practice which consists of four poses:

viparita karani (legs up the wall)
supported pascimottanasana (seated forward bend)
virasana (seated warrior)
savasana (corpse pose)

all of which are giving me more strength and energy as well.

But now, as promised, the story of The Dietician.

While I was in the hospital I figured I would take advantage of the knowledge base there and asked the nurse if I could have a visit from the dietician to talk about dietary options for colitis as well as healthy ways to put on weight. The dietician did visit me, told me that all I had to watch with colitis was not to have any whole grains, and that to put on weight I should drink Ensure between meals. Needless to say this did not impress me.

Firstly, what little I had read about colitis made it obvious that you have to watch a lot more than eating whole grains, and that whole grains are not always a no-no. Colitis is basically inflammation of the colon, so roughage will irritate it as will other heat-producing foods. However, I have since learned—from one of the General Surgery residents as well as information online—that this is different for each person. Some people can eat fruit peels, others can’t. Brown rice is okay for some but wheat bran isn’t. Some can eat spicy food while others can’t. Each person needs to figure out what their triggers are.

At the time I spoke to the dietician, I knew some of my triggers: dairy, citrus, broccoli, and pasta made from durum semolina (but not regular wheat flour). I told her this, and she was surprised by the pasta and citrus. Wheat is a common trigger for a lot of intestinal problems, and if you think about it, if you put citrus juice on inflamed skin—yowch!

So, the dietician did not know about food triggers. What she did know about, scientifically speaking in some sense of the word, was dairy. And she liked to talk about dairy. And she seemed to think that it was her task to get me to eat some dairy.

Now, dairy was the first thing that bothered my digestive system when all this trouble started. I stopped eating cheese and cream and ended up switching to goat and ewe’s milk yogurt for a while before cutting dairy completely out of my diet. But no, this did not matter, because according to the dietician, I could drink Lactaid! She explained to me that I likely did not have a true milk allergy (which I agreed with) and that Lactaid should be fine for me to digest. However, she did concede to bringing me the diary-free samples of Ensure to try instead of the dairy-based ones.

Later that afternoon she returned with various flavours of Ensure: vanilla, strawberry, mixed berry, and orange. I tried a vanilla one and found it absolutely vile. Thick mucousy overly-sweet vileness in a can. ew. It didn’t seem to bother my digestion too much except for the stomach-turning vileness of it. Did I mention it was vile? Absolutely vile? Horrendously vile? I think I did.

The next morning my cream of wheat arrived with a cup of Lactaid. The Lactaid was the only protein on the tray, the other items being apple juice, a white bun, and some apple jelly. I had been given information from the dietician saying that I could order extra bits of food from a supplementary menu and asked the nurse to order me 2 hard-boiled eggs so I could at least function for the morning!

So, I tried the Lactaid. I put it in my cream of wheat and I had a spoonful. It, too, was vile. Not in the syrupy tongue-coating thick way the Ensure was, but in a this-is-not-the-way-something-should-taste sort of vileness. I swallowed it. Suddenly I had to make my way to the washroom (a bit of a feat first thing in the morning when your potassium, hemoglobin and blood sugar are all low and you are hooked up to an IV). It was not good. Lactaid and I are not good friends. I was nauseous for a half hour after, unable to eat (not good when you are dangerously underweight). After half an hour I did manage to eat my bun and absolutely tasteless hard boiled eggs. (I suspect the eggs may have been laid by machines containing re-formed egg protein as opposed to being laid by actual chickens, but others assure me that it is because I tend to eat free-range eggs at home and that all cheap eggs taste like squooshy styrofoam [that’s Canadian for polystyrene, eh].)

The dietician came to visit me later that morning. I had complained about her to one of my roommates, who was amazed to hear the dietician ask if I wanted someone to bring me some cheese and crackers after I told the dietician of my Lactaid experience. After the dietician left my roommate said she looked like a prune. I don’t like judging people by their looks, but I do know that if you are eating a balanced diet and if your body is working properly that you don’t tend to look like a prune.

Ed and I came to the conclusion that this dietician was one of those “scientific dieticians” whose knowledge of food was based on numbers and measurements and not on experience. This was especially noticeable when we had explained the pasta problem to her, stating that the reason we knew pasta made with regular wheat flour did not bother me was because sometimes Ed made fresh pasta. The look on her face was a combination of shock, incomprehension, and “WTF?”. I know, I know, not everyone lives with someone who makes fresh pasta, but there are people in the world who like to make fresh pasta. Heck, you can even buy fresh pasta made with regular flour (it tends to be the dried stuff that is made with durum semolina). You would not think it would be a shock to hear that some people actually make pasta.

Our conclusion that this woman was one of those “scientific dieticians” was backed up when Ed saw her office door and read an article posted beside it about how one did not need to drink 8 glasses of water or juice a day. It stated that things such as pop, coffee, and the fluids in solid foods also counted towards your daily fluid intake. OK, yes, they are fluid, and scientifically speaking would count towards a daily fluid intake. But coffee is a diuretic, pop is just bad for you, and water, in my experience, has a completely different effect on the system than eating solid food.

As I mentioned above, I did ask the residents about diet, and they were much more helpful, mentioning things such as green tea, avoiding berries, EFAs, etc. One of the residents came in while I was eating a meal Ed had brought me (miso-grilled pollock, thai rice and cucumbers) and said “That will make you healthier quicker than the food they serve here!” Right she was.

So, I have pretty much given up on dieticians though have been given a lead on a holistic one in the city. However, once home Ed and I did a bunch of online research and what I am eating is working. I eat 6 meals a day, each of which consists of a grain, a protein, and a fruit or vegetable. I know it is going to take me longer to put weight on this way but I think it will be healthier in the long run. I am eating a lot of healthy fats such as avocados, olives and fish. I am also definitely not skimping on the grains. Lots of rice, light rye bread, and oatmeal. Now that my bowel is getting back to normal I need to watch my fibre intake both ways. Not too much roughage, but enough to keep things working properly. I think that is the biggest challenge at the moment. Every day I add a new food, and yesterday was the first day in a week I added something that I had a reaction too. However, I had added both a peeled apple and some arugula so I need to retest both. I am more suspicious of the apple than the arugula, but we shall see. Today the new food is mackerel, which I was reacting to before we left England because it was too oily, but other fish oils have not been bothering me so I don’t think it will be a problem.

One dietary suggestion from my Chinese doctor that is also helping is that I eat and drink everything warm. This is so that I digest food easier because raw and cold food and drink take more energy to assimilate. This makes cooking 6 meals a day a bit of a chore, but I did have some raw food at a family gathering on the weekend and noticed a difference. Dr. Li also told me not to have any tea—especially green tea. sigh. I love tea—especially green tea!— but I did notice that I had been craving it less while I was in the hospital. I’m going to ask him in a couple weeks if I can start having some tea again.

All in all the moral of the story is that not all dieticians, foodies and health care practitioners are made of the same fibre.

sorry, couldn’t resist that horrible pun…