I’ve been a little under the weather for the past four days. I think I’m experiencing an episode of acute diverticulitis – an inflammation of outpouchings in the descending colon (left side of the lower abdomen) that is very common among members of societies that consume a highly processed (low fiber) diet. Of course, I am very aware that any doctor who diagnosis and/or treats himself has a fool for a patient.
I called my PCP’s office yesterday, and they couldn’t fit me in that afternoon. They suggested that I come in at 8:30 this morning. Fuck that; I’m not even awake until 9:00 and rarely showered and ready to face the world before 11:00.
This morning around 10:30, the office called back to check in on me; that was nice. I told the nurse that I had had a low-grade fever last night but was afebrile this morning. He offered me an 11:30AM appointment, and I accepted. Time to gulp some coffee, shower, and dress.
I didn’t get to see my PCP. Instead, I saw his PA. We went through the usual acute H&P routine. He went off to talk with his supervising physician and came back to propose that I spend the next 48 hours on a BRAT diet – a diet that is low in residue. I was told to report any change in symptoms that might occur between today and my scheduled annual visit seven days hence.
Let me say that when Susan and I were second year medical students, we learned about the BRAT diet during our Pediatrics rotations. BRAT is a diet intended for children who are experiencing a severe diarrheal illness that threatens dehydration. BRAT stands for Banans, Rice, Applesauce, and Toast. If you have been the parent or caretaker of a child under the age of 5, you know that children of that age have very narrow and often inflexible food preferences. They are all picky eaters. The BRAT diet caters to the palate of the young child and has a very low residue – it is a diet that delivers very little residual matter to the colon. This has been thought helpful in stemming diarrhea.
Here’s the deal. I’m 73 – not a child under the age of 5. Worse yet, there is little evidence that supports the use of BRAT in diarrheal illnesses. So much for medical dogma! Worst of all, as an upcoming octogenarian, I can attest to the fact that there are few pleasures in life greater than a good meal. BRAT wasn’t going to cut it. I politely responded to the PA that I would be mindful to adhere to a Low Residue Diet and keep the clinic apprised of my progress.
Tonight, I had some tortilla soup broth followed later by a pan-fried Halibut fillet smothered in lemon butter sauce. It was all quite satisfying.
Bananas, rice, applesauce, toast and Pedialyte? Fuck that!
Have you tried Atole ?
My grandma’s solution for stomach problems when I was a kid.
No funcionaba…but I loved her Atole so I always told her I felt better.
I haven’t had atole in decades. Mexican atole is traditionally made from corn – maybe your grandmother made it that way. It can also be made from rice or wheat or other grains. My mother made cream of wheat for me when I was a child – in milk and sprinkled with sugar and cinnamon. It was my favorite breakfast for a time.