Dear Dr. Y.,
Thanks for seeing me the other day. At least it was just a regular annual physical and not for some weird, random affliction like the unexplained bruising I had in May or a stubborn cough that lasts for weeks like I had a couple years back. That said, I've come to know these physicals as my annual lecture, and I look forward to getting it over with and moving on. It's not that I don't appreciate the effort, and I'm not trying to be one of those dismissive jerk patients, but sometimes I think "good enough" has to be good enough.
I feel like most doctors would be relatively happy to have a patient like me. I'm a pretty healthy weight, I have a very good blood pressure (almost always around 100/60-something), and my only chronic health conditions are pretty mild, all things considered. I exercise relatively regularly, my diet could always be better but it's definitely not a dumpster fire of crap, and by all accounts my immune system does what it is supposed to--this week's blossoming cold aside. I feel like I'd be an easy in-and-out for most doctors, a simple checkmark and on to the next. But for you, I might as well be an obese smoker with a Big Mac in my hand. I don't know if you think I'm truly unhealthy, or if you think I'm lying about my lifestyle, or if you know I'm average and just desperately want me to be even better. I truly don't know. I know you have very high standards for your life, and you are very invested in them. I know you are 110% sold on certain diet habits because they work in your life, and you truly believe most people can benefit from them. I appreciate that. But just because they work for you, that doesn't mean they will work for me.
There are two sides to my frustration--one, just because it seems plausible and could work doesn't mean that it feels worth it to upend my entire life for an issue that only bugs me a little. Two, I have three other people I need to take care of, and my issues currently do not seem concerning enough to upend their lives, as well. You've always been a proponent of a vegetarian (to nearly vegan) lifestyle. I know you don't appreciate meat, and my first memory of you will always be that you told me how happy you were to finally get your kids "off cheese sticks". Considering they were one of the few seemingly nutritional things my kids ate at that time, I knew we might be in for a bit of a wild ride.
The last time I was there, you suggested that going dairy-free would help with both my reflux and my lost smell, and yet today you strongly suggested a gluten-free diet was the answer to getting off my reflux meds. Understandable, I guess, since both meds now have concerning issues--long-term disease probability for one, and a cancer-containing substance in the other. When I asked if a probiotic may help instead, you shot that down pretty quickly. Even if it wasn't your top choice, I would have liked some legitimate advice, rather than a complete shutdown. A hesitant, "Well, it's worth a try...let's try this one," would have been much more helpful, even if you don't actually think the probability is high. But it does work for some people, studies have shown, so giving me a little guidance for an attempt (no matter how futile) would have been preferred. Honestly, I'm going to try it anyway. I could also try chiropractic care and/or acupuncture, which I've been meaning to try for my smell anyway, because at this point anything is worth a shot. I don't have the usual triggers for reflux, so either it's genetic and I'm just screwed, or there's something funky going on.
And yes, maybe that something funky would be cured by a gluten-free diet, but that is a HUGE step. You think it's not huge because I already feed my child gluten-free...but no, it's still huge. My breakfast, lunch, and snacks would have to be overhauled, and I'd have to give up so many things I love and be burdened with planning on-the-go food for the rest of my life. It's overwhelming. And with the other things you'd like me to cut down on (namely dairy, meat, and carbs), I'd be hard-pressed to come up with a reasonable plan for myself. I'd be a lot more on board with the idea if any of my bloodwork indicated I was anywhere on my way to having Celiac Disease. But as of a few years ago when it was done--with the same severity of symptoms--I was nowhere even close. Yes, it's possible I could have some sort of intolerance because bloodwork doesn't necessarily show that, but honestly, if it's not Celiac, I'm going to try everything else I can think of before I overhaul my life like that. My reflux symptoms are merely mildly annoying, whereas a full gluten-free diet would be devastating to me. I think I'll stick with annoying for now.
And when it comes to those other things you'd prefer I'd cut out, I already struggle enough with feeding the rest of my family as it is. It's nearly impossible for me to get through a week without having a night where I struggle to figure out dinner. Going gluten-free for Jacob was hard enough, and Craig's more recent lactose intolerance has thrown yet another wrench into it, because I feel guilty making anything too cheesy or creamy for fear the Lactaid won't do its job. So when you suggest cutting down meat and carbs, my brain pretty much shuts down. My kids are already thin enough--they would waste away to nothing if they were on a plant-based diet. No one likes the same vegetables in my house. Broccoli is the only one we can almost agree on. We can sort of do salads, but not without a fight. Corn and potatoes don't count because they're too starchy, but those only get 3 of the 4 of us anyway. Cauliflower, peppers, and cucumbers are also 3 of 4. Green beans, peas, and zucchini only have two fans. I'm the only one who likes carrots. I do not, however, like beans, so that makes the non-meat, non-dairy protein situation a little sketchy. And don't even get me started on tofu.
Honestly, it already costs a bunch to feed us, and if removing meat was an option, I guess that would make up for all the produce...organic, of course. But it's not, so pardon me for being a little less eager. I don't make a doctor's salary, and neither does my husband, so consider yourself lucky that this works for you. Also on the practical side, I also will not make multiple meals, nor do I have the time to cook elaborate dinners or pack fancy lunches. And even if I did, I'm not sure that's how I want to spend the precious little time I have. Life is busy, kids are stressful, and most days it takes every last ounce of energy to keep my sanity. Not for nothing, this stuff might put me over the edge.
Don't get me wrong, I trust you as a doctor and appreciate what you're trying to do. I don't switch doctors because I'd rather have one that pushes me a bit and isn't just satisfied with the status quo. But it would be nice to get a tiny little bit of recognition for the things I am doing well--mostly solid bloodwork, down five pounds, not shrinking yet, staying active enough and not plopping on the couch with a bag of chips or a candy bar. Maybe if you started with that and then launched into how you'd like to see me do better, that might help. Or maybe consider that there might be something else I could do before completely overhauling my diet for something that's currently a minor inconvenience. Yes, I'd love to get off my medications, and yes, your method may work. But might there be others that won't push me quite so far out of my comfort zone? Is there anything else that might be worth trying that isn't quite as drastic? I'd like to get rid of my reflux, sure, but it doesn't bother me nearly as much as a complete diet and life change. I'm sorry. I'm willing to give some other things a try, and if you're willing to consider them, I'd love to hear your opinion. But until then, I'm going to give a few other things a try and hope I go back to next year's lecture with some good news. Thanks for trying, though.
Sincerely,
Amy
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