Sunday, February 24, 2013

Six Month-ish Update

Yeesh, has it really been since July that I last posted? Will have to remedy that. I'm also considering retitling this blog, perhaps something along the lines of "Evidence-Based Musings", an admittedly somewhat lame play on "Evidence-Based Medicine". Anyway. I do want to write more about urban issues with perhaps the odd intervening medicine topic.

As for some of the things I've been up to:

  • Returned to NYC in August and visited the High Line and numerous sweltering subway stations
  • Did a bunch of medicine and some anesthesia rotations
  • Travelled to exotic locales such as Saint John, Hamilton, and Ottawa, and this winter Saskatoon and St-John's
  • Finished watching the first four seasons of Breaking Bad
  • Become obsessed with Community

I suppose that doesn't sound so impressive. Two weeks ago I did go to a fairly uninspiring presentation on gluten given by a pair of local naturopaths, though. It started out well enough with some basic descriptions of GI anatomy and function, but eventually betrayed the usual focus on "Health by Restrictive Diet" that advocates eliminating or reducing gluten intake due to the non-inflammatory "inflammation" of "gluten sensitivity". In other words, gluten is evil in itself, and clearly you must avoid wheat and barley and stick to rice and quinoa (though they weren't too keen on carbs in general). Certainly that's true if someone has Celiac disease, but otherwise one wonders if they ever decide that phenylalanine is similarly unhealthy. (They'll soon discover that the required diet for PKU includes absolutely disgusting unpalatable supplements.)

Later on in the Q&A period they demonstrated what was a disturbingly limited understanding of sarcoidosis, a disease they listed as among those supposedly associated with Celiac disease (it isn't). They said it was "autoimmune" and that it might affect the lungs. Probably. Ugh. Earlier they had missed the rather more significant associations with liver and (very serious) biliary disease. But whatever. At least they made sure to warn an apparently skeptical man about the anticoagulation dangers of omega 3 supplements. I can't say I put any instructions about *that* in any of the perioperative consults I dictated this week.

In any case, I couldn't really bring myself to be the jerk who asks vaguely hostile questions from the back. I did give them many disapproving looks, however, and overall I was actually disappointed that they didn't provide better information and how lacking their knowledge seemed to be on basic topics. It was well meaning, but it didn't give me a lot of confidence in the kind of nutrition advice they give.