A pill for an ill – it works occasionally.
In Sydney, when I was in general practice, my office was situated at the top of a steep flight of stairs. One Saturday afternoon, as I waited for my next client to arrive, I could hear something of a laboured attempt to climb them.
When David finally reached my office, I hardly needed to ask what the problem was. “It’s my joints”, he explained. “They are fine most of the time but not on Saturdays, and the doctor says it’s not arthritis.” I wondered what could be unique to Saturdays?
David had been a keen football player during his thirties. He was now married and had two boys, eight and ten years old. They had followed in their father’s footsteps and were keen on football, which they had been playing at school, on Saturday mornings. I still waited for further enlightenment, but there was no hurrying David.
“The problem is that the sports teacher at the boys’ school is not much interested in football, and the school has no one else who will take over”, he explained. David’s boys had pleaded with him to volunteer as the football coach which he did for a while until he found that his joints began to ache and it became unbearable to the point that he was barely able to keep up with the plays or move down the sidelines to follow the ball. “I need a pill to fix the problem”, he stated.
I explained that my approach was not to ‘treat and illness’ or ‘fix a problem’ by prescribing one pill.
“Oh, but you fixed the French teacher at the school by giving her vitamin C, and that is why I am here”, he said. He was adamant, and there was no changing his mind.
The most likely explanation was that he had a nutrient deficiency that was affecting his joints. I considered a Calcium, however, if this were the case he would need more than one calcium tablet per day (and he insisted on only one pill per day!), so that was not an option. Magnesium was unlikely as he didn’t suffer from muscle cramps and there were no white spots on his nails which would indicate a zinc deficiency. I had decided that he likely needed more manganese due the fact that his knees seemed to be the joints that were affected the most. I was feeling under pressure because I knew much was expected of me, and there were severe restraints on what I could offer! I recommended Manganese that came in one 17mg tablet, which was an appropriate dose and hoped for the best.
“Take one of these per day”, I said. “However, you really should consider changing your diet (which was dreadful), and take a complete multi-supplement to account for the many nutrients missing in your diet to improve your general health.”
“No, no, I’m sure I’ll be fine”, he said. “You fixed our French teacher with one pill, and I am sure I can trust you.” His voice got fainter as he fled down the stairs seemingly terrified I would try to foist more pills on him.
A few weeks later David came back to see me, this time nipping up the stairs like a 20-year old!
“I don’t need to see you”, he said. “My legs are fine now with what you gave me, and the pain is gone. I can run the length of the football pitch on Saturday mornings, and as a matter of fact, I have just successfully refereed a full match!”
David insisted that I had fixed his problem with just one pill and that there was no need for all of this dietary change and general health stuff. Truth be told, I was almost sad I had been successful because I knew that the errors of his diet would most certainly catch up with him sooner or later.