Article

MEMORABLE PATIENT ENCOUNTER

You deserve to thrive

About five years ago, I treated a patient at my Seattle-area clinic for an inflamed chalazion. But, upon seeing him, it was clear he had more health problems than just his eye.

This 25-year-old, red-haired man looked more like he was 50; his complexion was gray, he was bloated and he was incredibly lethargic. His facial and neck edema made him look like he had been living on a diet of only beer, like the college student who had never gotten over his binge drinking.

After incision and drainage of the chalazion — one of the biggest I’ve had to treat — I looked down the hall and fortuitously saw no “next patient” exam room lights turned on. Given this extra time, I felt the need to offer this young man a more long-term treatment. Clinically, a chalazion can be an early sign of dry eye and meibomian gland dysfunction, of which nutrition and lifestyle are known contributors.

A HEART TO HEART

When the patient and I had spoken earlier during his exam, he talked admiringly about colleagues living a “hard-driving, hard-living” lifestyle, so it seemed he would continue on this path unless there was good reason to change.

I sat back down alongside him and gently said, “I would like to talk with you about something else. I see someone who is young and is not thriving, and you very much deserve to thrive.” His jaw dropped in surprise as the words sunk in. He was very receptive and asked me to continue.

I recommended the “Whole 30” book, which involves 30 days of total elimination of inflammatory foods (meaning no grains, dairy, soy, sugar, alcohol or legumes). After that, one slowly reintroduces each food and watches for signs of intolerance in their body. I have done the program myself after recovering from major surgery.

YOU CHANGED MY LIFE

I told the patient to return in eight weeks to see if we needed to start medication. When he came back, I hardly recognized him. He had lost 18 pounds, the facial bloating was gone and his complexion was rosy instead of gray. After his first visit, he went straight from my clinic to the bookstore and had done the program perfectly with his girlfriend, and that now they were engaged. He said he never had a doctor show such interest in him before and that I had changed his life. I replied, “I’m so proud of you! If you can turn your life around like this, there is nothing you can’t achieve.”

From that point on, I have included the “Whole 30” on my patient DED checklist, and recommend it whenever I feel it is appropriate. What you eat matters for your whole health. OM

Laura M. Periman is an ocular surface disease specialist in Seattle, Wash.