Sunday, July 11, 2010

#1 Nausea 911

“Emergency call!” my trusty virtual assistant Tania informed me on during our daily check-in. “I told her you would call her back when you get a break.”

“But that is the only break I have all day,” I whined.

“Yeah, yeah, yeah, just call her,” Tania sympathized unfazed and hung up.

You would be surprised how many urgent calls I get. Some days it feels like I work in a nutrition emergency room. No, people are not calling to find out what to substitute because they ran out of sorghum gum and they need to make those gluten free birthday cupcakes before 2:00!

The sad truth is I get so many MAYDAY calls because of the tremendous gaps in health care delivery. Many doctors don’t have time for the minor-to-them, major- to-the -patient kind of concerns that come up. The overwrought patient is told to make an appointment or go to the emergency room-if they get a call back at all. For those who do not have insurance, a few questions can get expensive quickly.

One specialist, who I really like because he is thoughtful, open minded and thorough, wont’ return a call even if the patient is bleeding from the mouth. (This actually happened once to one of our mutual clients and I spent a week begging his assistant to call the patient. Shockingly, he did not and other arrangements had to be made. Still, the specialist has a long waiting list.)

But I digress. This emergency involved a woman who had been waking up dizzy and nauseous for the last few days. She put a call into her doctor but was terrified her symptoms could mean expensive tests and visits and money was tight. She was scared but wanted to talk to me first, in case the problem was nutritional.

People really do have good instincts. Personally, I would be worried about having cancer or an ulcer or something but since she asked about nutrition…….

She was waking up with the symptoms, so I asked her what she was eating for dinner the last few nights when the symptoms started. Specifically, was she skipping dinner, eating a very light or early dinner?

“Now that I think about it, I have not eaten much for dinner the last several nights”, she remembered.

“Aren’t you a little prone to low blood sugar?” I fished. She was but did not realize the symptoms of low blood sugar could get so bad, they never had before. She quickly admitted to not eating much dinner but my spidey sense suspected she may have been skipping some of those dinners.

The fast between dinner and breakfast can be 12-15 hours which is too long for some people to go without eating. I explained to her that the symptoms of low blood sugar can include both dizziness and nausea. We talked for a minute about eating enough dinner or a protein rich snack before bed if she retires late or eats very early.

She quickly calmed down, agreed to see her doctor if correcting her diet did not immediately fix the symptoms, thanked me and said good-bye.

Emergency averted.
Break over.

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