Friday, February 18, 2011

Blog #28 What the Dog Ate

“I am so disappointed in Best Foods,” my daughter Isabel fumed throwing down her gloves on the kitchen table.

“How so?” I asked neutrally.

“Their brand of dog food contains animal BY PRODUCTS as its first ingredient. Can you believe it?” she ranted. “Do you know how bad animal by-products are?” she continued. I did. Animal by-products can range from 4-D meat (animals that are dead, dying, diseased or disabled) to road kill to just about anything associated with any type of animal. (Try not to think too carefully about that last one.)

“How can they call themselves Best Foods and sell such crappy dog food?” she asked rhetorically. (Full disclosure statement: Best Foods is a pseudonym because I still want to be able to shop there despite its lamentable dog food.)

“They probably have not taken on dog food yet, honey, “ I soothed. “They may still be dealing with the ruckus from labeling untested food from China ‘organic’.”
Though a smarty pants remark designed to lighten her mood, it may not be far from the truth. Creating a healthy dog food is not only a commitment; it is a whole specialty onto itself. Interestingly, some of the issues about doggy eating are the same as they are for people.

The most important concern is that dogs are increasingly suffering from the same chronic illnesses as people. Could this be related to their diets having some of the same pitfalls as people's diets? Dogs, like people, do best eating a balanced diet of fresh meat, whole vegetables, fruits and grains. For dogs, the heaviest emphasis should be on meat as this is the basis of their natural diet while people arguably should concentrate on vegetables, fruits and grains.

Some of us (I am guilty here) actually make their dogs a diet of whole foods. My dogs eat better than most of the people I know and it requires extra work. My efforts in this regard are a source of laughter and conversation in my neighborhood. A conversation that usually starts with, “What in the world are you making for those dogs?” Yes, steaming up vegetables may seem a little over the top but I had three dogs with touchy stomachs and skin problems so I had to figure out what they could eat, just like I did for the people in my practice. When I took them all off chicken, all of their stomach and skin conditions completely cleared up. Just like removing food irritants can help people symptoms.

Isabel watched this growing up so when she got her own dog she expected to be making her food. But, unlike some children who outgrow a total absorption with animals, she did not. Through college she worked at pet stores ending up at a serious holistic establishment that does not sell any dog food that contains animal by-products, soy or corn. Now she educates me on dog nutrition. Last year, she told me the grains had to go and I should stick to vegetables, fruits and meat. One of our dogs had a bad breathe problem and it made sense to me that getting rid of grains might help as getting rid of gluten sometimes helps people with sour stomachs.

“What else do you tell people?” I asked her, curious.

“Many dogs are overweight,” she explained, “because they eat bagged kibble that contains grains. The best way for them to lose weight is to get off of dry food and starch and eat meat, fruit and vegetables.” Just like people!

Most dogs eat dry dog food out of a bag that contains low quality meat by-products, grains and sweeteners. The sweeteners are added to entice the dogs to eat food that is mainly cheap starch vs. more healthy animal protein. That sounds familiar. This is exactly what fast food restaurants like McDonald's and Taco Bell have been accused of doing with meat entrees. Allegedly Taco Bell taco “beef” filling and McDonald Chicken nuggets contain far less than 50% meat. Instead cheap starch fillers, taste enhancing chemicals and sweeteners are used to entice people to choose an inferior food. (See: concerning the lawsuit against Taco Bell for low meat content in their “beef” taco filling or Michael Pollan’s excellent discussion on McNuggets in The Omnivore’s Dilemma.)

The first veterinarian I ever saw informed me he had extra training in dog nutrition because he knew I was a nutritionist and this would be impress me. He then went on to say that the most balanced way to feed a dog was to use only prepared, expertly fortified dry dog food. “Very funny,” I said thinking he was making a joke at my expense. “And you should only feed your kids fortified dry cereal,” I cracked. He was not joking and I never went back. I had to assume his nutrition “education” was provided courtesy of the Fido Dog Chow company.

“What do you tell people who say their vets only recommend prescription diet food that they sell?” I asked Isabel knowing this situation had to come up frequently.

“Most of those prescription kibbles are the same old junky dog food at premium prices,” she opines. “ but you have to be very careful. People think their vets are experts on dog feeding when they mostly know what the dog food companies want them to know. I try to explain without being offensive that most veterinarians are not properly trained in nutrition and that they have to be informed consumers.”

Just like people.

For more information on how to choose a healthy dog food, see, “Choices, Choices: On what criteria do you base your dog’s food selection?” The Whole Dog Journal, Feb. 2011. (

Thursday, February 10, 2011

#27 The Clues in the Conversation

“No, that is not right,” Rudy said in response to my third attempt to ascertain his reason for coming to see me.

I am in trouble now I thought glancing at the clock. Twenty minutes had passed and I still had not even pinpointed the problem. What I did have was fifty pages of medical reports and test results with symptoms and complaints that Rudy insisted were not accurate.

“How can I help?” I had asked directly fifteen minutes before. Leaning across my desk he passionately described a number of vague aches and pains that appeared to come and go. I listened intently and finally at one point repeated back to him word for word his latest description starting with, “So you are concerned about……”

“No, no,” Rudy shook his head rigorously. He was not concerned about that symptom. In addition, he was upset that his doctor, who had ordered many of the tests whose results were piled up in front of me, did not seem to understand him.

As easy as it is to criticize doctors given the present state of the health care system, I could find not a single fault with the thorough way his physician had analyzed the situation. If Rudy had not been understood, it was not from lack of trying on his doctor’s part. I empathized with the maligned internist.

I had been trying to listen so hard that my eyes were watering and I still was not getting it. Talking with Rudy was not improving my understanding so I reviewed in my mind what I did know. Rudy was prosperous and productive. This I knew because I recognized his name and Daisy, the woman who referred him to me called him “a business genius”. His medical records indicated he was in his early forties and his lean and toned physique were a testament to many hours at the gym. According to the extensive test and procedure results in front of me, there was nothing notably wrong with him.

Could he just be anxious? I wondered. I hated going down this road as so many patients are dismissed as anxious when practitioners cannot figure out what is really wrong. I flipped through the paperwork again and spied his diet diary. It was a mass of scribbles squished chaotically on to the page. I had seen papers written by 3rd graders that were neater. Then, I remembered a conversation I had with my attention-to-details assistant, Tania. She had mentioned that she was having a tough time scheduling Rudy because he was hard to reach by phone and did not use e-mail. I remember wondering how such a successful business owner could function without e-mail and as I was recalling that conversation I suddenly an idea occurred to me.

Rudy was still talking and leaning against the front of my desk when I looked up and interrupted him. “Ah ha, I’ve got it,” I said pulling his papers together and talking with more authority and confidence than I felt.

He looked at me wearily. After all, I was not impressing him up to this point with my stellar detective skills.

“You obviously would like to feel better,” I stated without waiting for agreement. “And I have identified three things that you are going to have to do that will help.” I glanced up to gauge his reaction. He took a breathe, stopped talking and slumped back into the chair. We were in agreement at last. Coming up with three healthy interventions for an overly busy person was not going to be difficult.

Rudy was a fit 40 some year old guy who was experiencing some of the annoying symptoms of middle age. He needed to make a few life style adjustments to optimize his energy. He was not 23 any more but he still had some long standing bad habits that he could get away with then but were not working so well now. This is what I think he had come for but in my view, this was not the most pressing problem. The more interesting issue was what appeared to be a significant learning disability in an otherwise wildly successful person. I wondered how much of his life had been spent covering up or compensating for his learning quirks.

I was having trouble communicating with him because he could not prioritize or organize his thinking. This is why when I repeated exactly what he said he did not agree with himself. It is also why he had thousands of dollars worth of tests looking for the cause of symptoms he claimed he really did not have. The thoughts he said out loud were not necessarily the most relevant ones. His communication was a jumble of important and insignificant information all mixed together. He needed help sorting his chaotic thoughts and a plan with a clear structure.

If organizing his thoughts was this difficult, no wonder he avoided e-mail. Writing must be a nightmare for him. Yet, there were significant areas of his life around his business where he was organized and brilliant. I would bet good money that getting through high school had been pure hell. Luckily, a horrible high school experience is not necessarily a harbinger of future failure because learning differences do not have to be crippling. If a person plays to their strengths and works with or hires people to handle their weak areas, they can succeed spectacularly as Rudy had.

But heavy compensation exacts a toll, especially when people do not understand the nature of their learning differences. Every activity that requires skills in their weak area will be more stressful. They may feel overwhelmed more easily and can get frequently frustrated. To avoid failure some procrastinate while others bully those around them to divert attention from themselves, depending on their nature. The behaviors that result from poor compensation could fill a psychology textbook. I have seen people unwittingly destroy marriages and relationships, lose jobs, fall into depression, suffer from chronic anxiety and become violent.

Rudy had an intense personality and I could not help but wonder how much of that was due to the stress of working around cognitive obstacles. Did he realize how tiring it could be to communicate with him in some areas? Was it equally exhausting for him? I wondered what he knew and how open he would be to discussing his cognitive quirks Exploring and perhaps coming up with some strategies to improve some of the ways his brain worked was how I wanted to help but decided he might not see that as help.

I decided I would have to build some trust and a connection before broaching this potentially touchy subject. And my analysis could be dead wrong leaving him to wonder about what kind of learning disability I had. Consequently, I decided to address what he wanted first and then see if there is an opening next time. Assuming that is, there is a next time.

Tuesday, February 1, 2011

#26 The Case of the Dirty Dishes

I reached for a clean glass to hold my freshly pureed green sludge and there it was. Trailing along the lip were the unmistakable remnants of yesterday’s drink.

“EEEEow,” I squeaked.

“Stinkbug?” my husband called out from the other room.

Like many households in our area we had a mild stinkbug infestation. Occasionally one would fall on our heads from the ceiling or show up unexpectedly looking gross. Hilarity or screaming would ensue depending on the situation.

“No,” I called back. “Just dirty dishes. I think something is wrong with the dishwasher.”

He agreed that he was seeing too much of yesterday’s food on the silverware and suggested calling Mr. Kenny. Mr. Kenny is our personal version of the Maytag repairman that was a TV icon about a decade ago. He is pleasant, efficient and reliable. We love him.

The next day the dishwasher was dismantled with various parts strewn on the kitchen floor. Mr. Kenny looked up and commented conversationally, “that’s what I thought.” There on the floor of the machine was either a million dollars worth of cocaine or all the soap crystals I had poured into the noisy contraption over the last 6 weeks. Mr. Kenny was going with the soap crystal theory.

“A few weeks ago new Maryland EPA regulations regarding the composition of dishwasher detergent took effect, “ he explained.

I stared at him blankly.

“The manufacturers are not allowed to use phosphates any more and that is the chemical that allows the soap to dissolve and get your dishes clean,” he clarified.
It is also the chemical, I thought to myself, responsible for the death of untold numbers of innocent fish.

High levels of phosphates from domestic and municipal wastewater end up in local streams, lakes and rivers. Phosphorus is a growth enhancing nutrient for plants. A little is good but too much and you are looking at Little Shop of Horrors, the water version. As the phosphorus levels go up and up, the algae grow to cancerous proportions literally sucking the streams and rivers dry. Some regulators have recognized the utter destruction of lakes as a bad thing and sixteen states, apparently including Maryland where I live, have enacted laws restricting or removing phosphates from dish washing detergent.

Mr. Kenny informed me that the dishwasher manufactures recommended Cascade Complete with the addition of a water softening product called Lemi Fresh. He admitted the soap manufacturers had not perfected the new formulations yet and they did not work very well. I hate it when choices are reduced down to clean dishes or destroying the environment. As the dishes were getting increasingly dirtier, I had tried Cascade among several other products and was unimpressed. Now I was feeling guilty for inadvertently contributing to massive fish kill all these years when I was not paying attention to which dish washing detergent I was using.

I try to be as ecological conscious as possible by buying organically raised food in part to reduce pesticide run off that also ruins waterways. Except for dish washing detergent, most of the cleaning products in my house are practically edible. For laundry, I stopped using detergent altogether and bought Super Washer Balls ( They are plastic balls filled with ionically charged beads that clean your clothes without soap. I have no idea why messing with ionic particles gets clothes clean but my friend, Bill highly recommended them. I even wash and reuse plastic bags, much to the horror of my husband and children. Yet I never thought twice about the dishwasher. It was a dishwashing detergent blind spot.

I wondered if my clever virtual assistant, Tania, was having similar problems.

“Nope,” she insisted. “I don’t like my dishwasher so the last time I bought detergent was 1996. It was full of phosphates then, so I am good. Do you want me to send it to you?” Some people are ordering dishwashing detergent from non-phosphate restricting states to get around the dirty dish situation.

“And destroy rivers!” I countered. “Absolutely, not. I just have to figure out what will work that is environmentally friendly.” claimed 7th Generation detergent worked best while another site suggested adding a cup of vinegar to the wash cycle. I cannot figure out how or where to add vinegar so it doesn’t just rinse down the drain. There is not a “Vinegar” dispenser on my model. Besides that could get expensive. Seventh Generation has only ever made phosphate free detergent and so that is what I am using now.

“It is even cheaper and more environmentally friendly if you just wash your dishes by hand, like me,” Tania observed smugly. As much as I hate to admit it, she might have a point though I might end up using more water than my dishwasher. I can’t help but think of Kermit the Frog when he lamented, “It is hard to be green”.