The Things My Patients Teach Me

Today I was back in my family medicine clinic seeing patients for the afternoon. After the past few weeks of internal medicine it's hard not to think that their complaints are petty and insignificant sometimes. When I'm still thinking of the woman on the floor with end-stage COPD gasping for breath, it's hard to muster up sympathy for someone's itchy elbow.

But this nearly killed me. I have a patient whom I'll call Mr. E. Mr. E is an elderly guy whose first language is something eastern European that I most definitely do not speak. Mr. E is full of complex medical problems ranging from lichen planus (a skin condition-- see lovely picture to the left) to atrial fibrillation and everything in between. Currently we are battling Mr. E's high blood sugars (he is a poorly controlled diabetic) and his high cholesterol. This is complicated by communication problems-- the last time I asked him to check his sugars four times a day so that we could identify more specifically when they were high, he dutifully did so. When he brought me in his record book it was hard not to laugh when I saw that he had checked them at 7am, 8am, 9am and 10am. I had explained at the time that I actually meant to test upon waking and then before each meal, but he apparently hadn't entirely understood (in spite of assuring me many times that he did).

Today, Mr. E forgot his record book but was eager to tell me that his sugars were finally under good control. They had been steady all day, usually around 5 or 6. Lovely. I told him how glad I was that things were finally getting better-- his chronically high sugars had previously left him feeling nauseous and fatigued. He decided to share his secret with me. Salt and vinegar potato chips.

Um... pardon you?

Yup. Ladies and gentleman, the secret to diabetic control. Mr. E noticed one day that his sugars were good when he ate salt and vinegar chips after every meal. I asked him if such a high fat food was a good idea to be eating three times a day. Oh no, he informed me. No fat. Just salt and vinegar. Apparently, in the mind of Mr. E, they only put fat in the 'fat flavoured' chips. So he had decided to continue to eat the chips after every meal in order to keep his sugars down. I'm choosing to attribute the 'miracle' of normal blood sugars to the fact that we started him on Gluconorm at his next appointment.

I can't wait until his next cholesterol test. We may have to filter the fat globules out of his blood to test it. Sigh.