I hate notebooks. I really hate notebooks. It seems like a rather innocuous item, one that shouldn't inspire such awesome dread and ire. But these notebooks that are brought to my office all have one thing in common: they are filled with questions.
I tried to ignore the notebook and instead asked how she was doing, and she reported some minor digestive difficulties (mainly gas and mild bloating), which isn't terribly uncommon after gallbladder surgery. She wasn't having any pain or nausea, and her appetite was ok, but she was having a lot of gas and cramping after eating.
Her incisions looked perfect (if I do say so myself), and her abdominal exam was completely benign. But the look on her face quite clearly told me that she felt uneasy about . . . something. I always finish my followup visits by asking if my patients have any unanswered questions, and this time was no exception, but I did it with obvious trepidation.
"Oh, oh yes I do," Trudy said confidently as she reached for her notebook.
Sigh. Ok, let's just get this the hell over with.
"Well," she started, turning to page 1, "I was wondering why I've been having so much gas discomfort after eating. It's really very strange, because I've never had this problem before. Is this normal after surgery?"
While gas and diarrhea can certainly happen after gallbladder surgery, my Inner Pessimist told me that something else was going on. I asked if she was eating and drinking normally. Her face went into a slight scowl.
"No, I've been eating mostly vegetables. I stopped eating chicken and fish and bread and eggs and milk and sugar and all the other things I usually eat."
My Inner Pessimist started laughing. He seemed to know something I hadn't quite caught onto yet.
"Why?" I asked her. My Inner Pessimist started laughing even louder.
"Well, because I was reading online that you just can't eat that other stuff after having gallbladder surgery, and you need to just eat vegetables. I was also wondering if I actually needed the surgery and if I should have just gone home and done a gallstone flush."
A flush? Oh for fuck's sake. Really? She couldn't possibly have read the bullshit in Mercola.com, could she? My Inner Pessimist was nearly peeing himself laughing now.
I very slowly and carefully explained that there's no such thing as a gallbladder flush, as I remembered an article I had discussed on Twitter recently about that exact thing. Something about drinking a mixture of olive oil and something else I couldn't quite remember. My mind was on that and trying to figure out the next thing to say when I heard her say,
"Oh my god, REALLY? Because I read that olive oil and lemon juice can flush the stones out naturally without surgery! Maybe I should have just done that."
Fuuuuuuuuuuuuuuck! Shut the hell up, Inner Pessimist.
Lemon and olive oil. While these two things are vital for cooking a piccata, they are not so useful for removing gallstones. And by "not so useful", I mean completely and utterly useless.
To explain I drew her a little picture of a 2 mm duct leading out of a gallbladder next to a 2 cm gallstone, and I tried to explain why it would be absolutely impossible to get that stone through that duct. She kept shaking her head in disbelief. I didn't know exactly where she had gotten her information, so I told her that most of the stuff she saw on sites like Natural News and Mercola.com was bullshit (though I think I used the term 'bunk') just as an example. And I reminded myself to Tweet "Fuck you, Mercola" when I got home for good measure.
"NO, NOT DOCTOR MERCOLA! I LOVE DOCTOR MERCOLA!" Trudy nearly screamed.
Fuck you, Mercola.
Yes, Trudy had actually gotten her medical information from noted quack and bullshit artist Dr. Joe Mercola. My resultant myth busting with her went on for a full 10 minutes as I obliterated every question she had in her notebook in order. "So I can really eat whatever I want?" Trudy asked finally.
"Yes," I said. "You don't have to be careful with what you eat, you just have to be careful where you get your medical information. Try Medscape and webmd. And for god's sake avoid Mercola. Oh, and Dr. Oz too."
Her eyes nearly bugged out of her head.
"OH MY GOD! NOT DOCTOR OZ TOO!"
My Inner Pessimist shit himself.
It took another 10 minutes, but I eventually convinced her that while Dr. Oz was a brilliant cardiothoracic surgeon, his general medical advice was like homeopathy or a palm reading or a diaper pail: full of shit. She seemed shaken but relieved at the same time that she could go back to eating normally. She left about 10 minutes later with a smile on her face, probably looking forward to stopping at a fast food joint on her way home for her first opportunity in two weeks to eat some actual food.
She emailed me a few days later to inform me that her digestive issues had resolved pretty much immediately. Shocking.
If you follow me on Twitter you know that I rail against "alternative medicine" regularly. If you don't follow me on Twitter, why the hell not? It's just like this but only 140 characters at a time. Actually, Twitter is stupid and you probably shouldn't do it. Just forget it.
Oh, and one more thing;
Fuck you, Mercola.