Traitor to the Cause

[qatarperegrine]

I just intentionally ate an animal product. :-(

So, I finally found a rheumatologist in Doha. The process mostly involved being shuffled around all three floors of Doha Clinic (helpfully labeled floors 0, 01 and 1) by people who didn't understand the meaning of "rheumatologist" despite having assured me on the phone that they had one, until after a long wait I was ushered in to an orthopedic surgeon who confirmed that, no, they have no rheumatologist, but who was kind enough to write down names and vague contact info of the three rheumatology clinics in town.

Thus I went to see Dr. Valerie yesterday. First of all, the news was mind-numbingly good. She hasn't seen X-rays or bloodwork yet, but she did a pretty thorough examination of all my joints and asked lots of questions about my medical history, and she says that though she can't make a diagnosis without the bloodwork she is "99% sure" I don't have rheumatoid arthritis. She also seemed more than 99% sure that my previous doctor is just smoking something. So I'm holding off reacting too much until next weekend, when we'll look over the bloodwork and X-rays (inshallah, if I can convince American Hospital to give them to me), but Dr. Valerie thinks I really do have tennis elbow, and Dequervain's tendinitis in my thumbs, and that may be pretty much it.

The big question marks in my mind right now are: what about the bone spurs?? And, isn't there likely to be *some* kind of underlying problem if I've had tendinitis for nine years? Other than the underlying problem of my apparently being too dumb to stop using the %*#& computer?

Dr. Valerie was absolutely insistent that I start taking cod liver oil. So insistent, in fact, that she made out a prescription for it. (It says: "Pure cod liver oil, 2 caps, BID/TID, before meal.") The conversation went something like this:

Dr.:	You should cut back on red meat...
Me:	I don't eat meat.
Dr.:	<blinks> Red meat is bad for people with arthritis, so avoid it.
Me:	That's fine. I'm a vegetarian.
Dr.:	<looks confused> But fish is good; eat more fish.
Me:	I don't eat fish. I don't eat any meat.
Dr.:	<looks baffled>
At this point it occurs to me that my next sentence could be, "Also, I'm morally opposed to breathing through my left nostril," and the doctor wouldn't think me any less bizarre.
Dr.:	In that case, you need to be taking cod liver oil.
Me:	But that's a fish. I don't eat fish.
Dr.:	No no, you can get it in a capsule!
Me:	That doesn't matter; it's still made from fish.
Dr.:	But you won't taste it!
Justin:	I don't think that's the point!

I tried to talk her into flaxseed oil instead (not that it's available here), but she insisted it's not the same. And she's right. While they both contain omega 3s, fish oil contains the usable forms, DHA and EPA, whereas flaxseed contains ALA, which has to be converted into DHA and EPA. So I'm looking into ordering some vegetarian DHA supplements online, but in the meantime I bought a two-week supply of cod liver oil.

I figure I can't pretend to be a purist, since I eat cheese made with rennet and, by eating in non-vegetarian restaurants, I probably accidentally eat meat byproducts all the time. I am also not scrupulous about checking into whether other medicine I take is vegetarian. So it's not like I've been 100% animal-cruelty-free anyway; it's not like it's possible to live without injuring other beings to some degree. I'm reminding myself that the point of my vegetarianism is to reduce suffering and my negative impact on the environment, not to hide behind a delusion of purity and virtue. But, darn it, I like the delusion of purity and virtue! Me-of-seven-years-ago would be really disappointed in me. And even me-of-today is not yet convinced enough of the more nuanced view of vegetarian morality to be able to take the cod liver oil without vomiting. :-(

Comments

[aristopheles.livejournal.com]

I really doubt that cod liver oil is any better than Voltaren.
Dr. Valerie sounds like the wrong Dr. for you. Get a second opinion.

[spider88.livejournal.com]

Omega-3s are very good for arthritis. Documented with studies and everything. :) They keep the inflammatory response in the body healthy and appropriate.

And if she's avoiding using animals and reducing environmental impact, a prescription drug violates those principles more than cod liver oil.

[aristopheles.livejournal.com]

We already know that qatar does take prescription drugs. I also have problems with some of the animal testing but that doesn't strike me as a good reason to refuse all prescription drugs.
I don't really see how environmental impact comes into it, either way: I don't think that our appetite for cod liver oil is what's depleting the fishing stocks, nor are the drug companies (as far as I know) polluters on the level of oil, many kinds of farming, or lots of manufacturing that deal in much larger quantities.
In any event, there are about 100,000 other things I'd rather do to help the environment and animals before refusing prescription drugs.
And in any event, MTX is available generically! For whatever good that is.

[spider88.livejournal.com]

Oops. Sorry. I think I gave the wrong impression. I was defending the validity of cod liver oil, not criticizing the use of prescription drugs. I'm a leather-wearing, meat-eating, pill-popper, myself. :)

[qatar.livejournal.com]

Well, she's certainly not open-minded about vegetarianism (did I mention she's Eastern European?) but I'm not ready to say she's the wrong doctor for me. I was really, really impressed by how thorough she was, both in taking my (and the family's) medical history and in examining all of my joints. She asked me questions for more than half an hour, and half the time I didn't even know what it was she was trying to rule out. I was also very happy that she's not willing to jump the gun with a diagnosis, as opposed to the last guy who was happy to give me three conflicting diagnoses in twenty minutes. So I'm very hopeful about pinning something down next week when we have lab results. If I'm not satisfied then, there are still two others clinics in town, though I'm not sure how English-speaking they are.

And I don't think she thinks cod liver oil is better than Voltaren, either. :-) I guess the orthopedist put me on an unusually high dose, and she's worried for my stomach. She also wants to see me when I've been off the oral NSAIDs for a week, to see the differences (if any).

[aristopheles.livejournal.com]

I'd just like to see you have the chance to use something that actually works!
I know what really works, and it's very well-known and it won't hurt you and it has a terrific track record. And if you're kinda like me, you may find that you don't even need to take it all the time. (Which seems to be the case anyway, given your long periods of "better" in between problems.)

[spider88.livejournal.com]

Does vegetarian DHA exist? I thought flax seed oil was the only way to do that.

[qatar.livejournal.com]

Flaxseed oil is the most concentrated vegetarian omega 3 provider, but there are actually a ton of veggie foods that contain ALAs, notably walnuts and tofu.

For DHA, though, apparently the only non-animal source is some random kind of algae.

[spider88.livejournal.com]

Do you eat eggs? Chickens fed a healthy diet produce eggs with good amounts of DHA.

[y-pestis.livejournal.com]

I'm glad to hear Dr. Valerie was so thorough, even if she didn't understand the concept of vegetarianism. Maybe if you'd explained that you were Jainist or something. :-)

I think it's great that you're looking at all the things it might be before leaping on the methatrexate bandwagon - this may sound backward coming from a depressive, but there's no point medicating if you don't know that you've got what it's treating...

And don't worry, cod liver oil grosses out even the carnivores. Abbey won't eat cod liver oil either, and she eats raw anchovies. Even the rats won't willingly eat cod liver oil. And they'll willingly eat cardboard.

Fingers crossed that she's right and it's not arthritis... :-)