Doctor’s medical chitchat violates patient’s privacy

been violated, and you are right to be upset. A medical professional discussing your medical issues with a family member without your explicit permission is a breach of medical ethics. The Health Insurance Portability and Accountability Act allows your physician to use his or her best judgment about notification of family members, but it seems to me, based on what you are telling me, that he should not have shared your information. If you had objected to sharing your information, what he did would have been a clear violation of the law. If you still wish to continue with the same provider, you should make your wishes for your privacy clearly known.

Dear Dr. Roach: I have multiple myeloma in check on Revlimid, but it causes diarrhea. Can you suggest any dietary treatment or foods I should stay away from? I’m a conscientious patient and a senior citizen in my late 80s. —

A: Generally good advice on treating diarrhea includes avoiding milk products, as the gut can temporarily lose the ability to digest milk sugar. The classic BRAT diet (bananas, white rice, peeled apples and dry toast) remains a useful short-term solution. Long-term diarrhea deserves evaluation. Lenalidomide (Revlimid) is an effective treatment for many people with multiple myeloma, but diarrhea is present in 40 to 50 percent of people who take it. A 2014 study identified that many people treated with lenalidomide lose bile acids, which are necessary for proper digestion of food. Because of this, the investigators used a bile acid binding drug, colesevelam (Welchol, often used for high cholesterol), which was completely effective in half the subjects, and improved symptoms in the other half.