Article
Doctor de Niro: So, you’ve been feeling tired and short of breath recently? Have you changed anything in your everyday habits?
Ms Rypoli: Well, yes, my husband and I decided to stop eating meat about 8 months ago after we saw a documentary about how slaughter houses operate. It was absolutely nightmarish. In fact, we’re trying a vegan diet.
Doctor de Niro: I see. So, no meat, no poultry, no fish, no eggs, no dairy produce?
Ms Rypoli: That’s right.
Doctor de Niro: And does your husband have any of these symptoms?
Ms Rypoli: No, not at all – he’s in great shape.
Doctor de Niro: Tell me, Ms Rypoli, what are your periods like, are they regular, heavy or light; do you find that you bleed a lot?
Ms Rypoli: No, Doctor, there are no problems in that area.
Doctor de Niro: I’d like to check your pulse and blood pressure, if I may?
Ms Rypoli: Go ahead.
Doctor de Niro: Your heart rate is rather high – it’s 110 beats per minute, but blood pressure’s OK. Are there any other symptoms you’ve noticed recently?
Ms Rypoli: Well, now you mention it, I sometimes get a bit of tummy ache, but I think it’s just hunger pains because it goes away after I’ve eaten. Or it could be the change in diet – all those lentils and vegetables, perhaps.
Doctor de Niro: What about your husband?
Ms Rypoli: No he hasn’t complained about tummy ache.
Doctor de Niro: I’d just like to palpate your abdomen. Can you lie down on the couch and lift your jumper, please?
Ms Rypoli: Ouch – that hurts.
Doctor de Niro: Sorry about that - a bit of tenderness there. Tell me, have you noticed any changes in your stools, in recent weeks?
Ms Rypoli: Actually, I have. They’re rather dark, almost black sometimes. I noticed it, but again, I thought it was just the new diet.
Doctor de Niro: Do they ever have a tarry appearance?
Ms Rypoli: No, not like tar, but just very dark.
Doctor de Niro: Just one more question, Ms Rypoli. Do you often take aspirin or ibuprofen or any painkillers like that?
Ms Rypoli: No, Doctor, I try to avoid taking any form of medication.
Doctor de Niro: Right, Ms Rypoli, I’m going to have to make an appointment for you at the hospital to have a look inside your stomach - it’s called an endoscopy. I think it would be wise to do this fairly soon. Would the beginning of next week suit you?
Ms Rypoli: Yes, I could go in on Monday. How long will I have to stay in hospital?
Doctor de Niro: It’s an outpatient examination, so you’ll go in first thing in the morning – no breakfast and nothing to drink, I’m afraid, and you should be out by lunchtime.
Ms Rypoli: What do you think it is, doctor?
Doctor de Niro: I suspect that you have a gastric ulcer that’s bleeding, and this may have caused iron deficiency anaemia, which explains why you’re pale, tired and short of breath. The fact that you’re not eating any meat may be exacerbating the problem. If it’s a gastric ulcer, it could be due to an infection with H. pylori – you’ve probably heard about it. So, you may need to take a course of antibiotics.
Ms Rypoli: Will I have to give up my vegan diet?
Doctor de Niro: Perhaps we can talk about that once we’ve sorted out the ulcer. Right – I’ll call the hospital now. Just one more thing – if you happen to vomit blood over the weekend, call the emergency services immediately.
Source:
*Professeurs d’anglais médical `a l’université de Dijon