theantichick

Ok so I went in for my first post-op blood work up.. The tests are done for free where I live. So I went to the GP with the doctors list of tests needed post-op which includes Iron levels. The GP said she will do a CBC first and only in case my HB was low then she will do an Iron level test(to cut cost). However she did ordered for all Vitamin levels test in the doctors list. My Hb levels came back @12.4 so she said there is no need to test for iron levels. I have not been taking an iron supplement and my Multivitamins does not include iron. Does this mean that I'm still absorbing iron well from my food?! Do I really need an iron level test?!

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Some people have good iron absorption and don't need any, ever. I have, most of my life, had a Hb of 12-14 which is really on the high side for a woman. My hemophiliac half-sister dreams of having an 8.

While anything is possible, I can't remember any situation from nursing school where someone could have a Hb of 12 and be iron deficient. I wouldn't think an iron test would be all that useful if you don't have any symptoms of iron deficiency and your H/H stays high.

The bottom line on transmission for c.diff is that poop particles (and they can be microscopic) have to be transferred from one person to another to catch it. It's very hard to keep the particles contained when the patient has explosive and incontinent watery stool. But that's the transmission route. Coughing, sneezing, other physical contact, blood contact - none of these things will transfer c.diff unless there's poop particles in it. I worked with a nurse who didn't bleach her shoes, and her dogs ended up with c.diff. Now THERE was a mess!!!

Something a lot of people aren't aware of - if you leave your toilet seat open when you flush, microscopic particles of whatever you're flushing get sprayed up to 6 feet. So it's scary easy to get those microscopic particles on your clothes, towels, sinks, toothbrushes, etc.

But unless you've had incontinence that soiled your furniture, the main place people can come into contact with it is in the bathroom. Transmission for casual contact like for the movers would require that you had gotten those particles on the boxes and furniture. AND that they touched those things with their bare hands AND that they ate something that they touched with their hands without washing their hands. And note that c.diff doesn't infect most healthy people. Usually people who get c.diff infections have their immunity compromised in some way - age, illness, medications, etc.

If you do have soft furniture (couches, mattress, etc.) that has been soiled, you'll need to find out if there's any cleaning agent you can use that will be effective without ruining the furniture. If possible, I'd consider just chucking it, frankly.

This link has some information about cleaning:

https://cdifffoundation.org/c-diff-infection-%E2%99%A5-home-care/

As for the antibiotics, yes, you are technically more susceptible to a return of c.diff after taking them, but you'll never clear the infection on your own without them. All you can really do is do as much as you can to get your Protein in (which will be easier after they stop the diarrhea) and all the little things to try and stay as healthy as you can otherwise. It may very well take several rounds with the meds to stop this. And it may even take a fecal transplant.

I can't comment on the handling of your samples without getting unladylike. I understand that things are handled differently in the UK, but here in the US, I'd be speaking to an attorney and filing a complaint with JCAHO, CMS, and the state hospital board (basically all of the licensing and certification organizations). If they're that casual with stool samples, then they're not doing due diligence in preventing infections all the way around. I wouldn't be surprised to find a number of hospital-acquired infections in every one of your friends who are also having problems.

Bleach is your friend. It will kill the c.diff, so use it on every bleach-safe surface, especially in the bathroom. There are a couple of other cleaners that can be used on surfaces that can't be bleached, but I'm pretty sure they're not standard cleaners, it's special stuff we had in the hospital.

Alcohol gels WILL NOT KILL IT. Make sure everyone who comes into contact with you knows that. Soap and Water, with the soap being used for 30 seconds before rinsing, is the only way to get it off your hands. Even if someone wears gloves, they still need to wash their hands.

I don't know what to advise as far as moving house, unless you can put it off until the c.diff is cleared, or if you can have other people do the packing and moving after you have someone come in to do a deep cleaning of the house?

And I was playing with dermablend, this is the lightest shade they make. My skin is too light for foundation, it's always been a problem for me.

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Here's today's pic. Looks worse than it is.

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My baby factory is closed, period, end of discussion. LOL. But as a nurse, I am distressed many times by the attitudes of doctors when it comes to patient education. It's a pet peeve of mine to not give patients all the information they need. With repetition, since what we know about learning is that most people don't retain information well until they've heard it several times. I'm glad KP is responding to this problem. As a medical professional, I have never been impressed with KP, but I'm hearing a lot of things recently that indicate they're improving the things that concerned me.

I do know personally several people who have had successful healthy pregnancies after WLS - they were bypass patients not sleeve patients, so if they can have healthy pregnancies after I'm certain sleeve patients can. The biggest thing I've seen is absolutely do not let yourself get pregnant during the first year, preferably 18 months. Certainly as long as you're still losing weight. That's where the danger period is, and so many people who are overweight have had fertility problems, so they think they can't, but losing the weight fixes the fertility problems, and BAM, they're preggers. Have patience, and it'll all be OK.

Most women here who are a couple of years or more past surgery are reporting diets with intakes over 1,000 calories with many taking in 1,200 - 1,500. That's sufficient for supporting a healthy pregnancy, especially if you're able to bump it a few hundred without difficulty.

As with everything else, listen to your doctors. It sounds like you don't have a choice with the surgeon, but after surgery you can find someone knowledgeable with this area, who can guide you through it.

Good luck!!!

Wow.

I worked long-term acute ICU, so I had my share of c.diff patients. You have a tough row to hoe, definitely. But at least you now know that your diarrhea can be resolved. Most patients can get c.diff cleared with a round or two of the strong antibiotics. If yours does not clear, as gross as it sounds, I strongly recommend looking into a fecal transplant. The remission rate for c.diff with transplant is over 90%. They don't do it right off the bat because most will respond to the antibiotics, and the transplants are a lot more difficult and people are resistant to them.

I would want to find out if there is a cluster of c.diff in your bariatric unit. If so, then there have been some lapses in the cleaning and isolation protocols at your facility, and this may be a contributing factor to why so many of your friends in the same center have had problems. If c.diff is colonized in that facility, other bugs may be as well.

C.diff is certainly highly contagious, but if your family isn't experiencing that horrible watery diarrhea then they probably have not contracted it. The labs at my facilities wouldn't even run the test on samples we sent if the stool was formed, because if it is, it's not c.diff (at least that's their position). It's really only contagious through handling the stool, so if your family hasn't been cleaning up after you, they likely haven't been exposed.

I certainly wish you the best of luck in dealing with this!!

I'm sure she thinks I should just postpone it till better time for her.

I've never worked in the field, but, given the nature of a hospital, it seems that there will be no "better time" for the hospital or for her.

Having worked in hospitals, the only "better time" will be after she's been there a year and has FMLA protection. In relation to staffing and the manager putting herself in a bind, it will never get better.

Ok, thanks for that information. , I didn't know there were coping mechanisms. I will look at the meal plans as well, thank you so much!

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Oh, yeah. Head injury patients have all sorts of challenges, and we're learning more and more about head injury every day almost. Anyone with a memory issue, short or long term, usually has to learn to rely on a planner of some sort to keep track of just about everything from taking medications, eating, chores, appointments. Some people do better with paper planners, some people do better with applications on smart phones. post-it notes are also very useful tools I've seen used. Since it's not my area of expertise, I'm sure there's hundreds of things I don't even know exist.

I don't know where you're located, but here's one site that came up on a search that seems to have some resources that might get you started finding the right kind of specialist and therapist.

http://www.headinjury.com/rehabcognitive.html

I refuse lidocaine for IV starts. My experience is that it makes the veins more liable to blow. I don't think it hurts bad enough to mess with it. I had an anesthesiologist ask one time "what, do you LIKE pain??". LOL.

Ok, I'm dumb and clueless here - what's this about lidocaine and IV starts?

Some places will offer you lidocaine to theoretically make the IV start hurt less. They take a teeny teeny needle and inject lidocaine (which is a topical anesthetic, deadens the nerves) under the skin into the tissue around the vein. It's basically the same thing they do before putting in sutures for a deep cut. Then they start the IV. Anesthesiologists in particular love this, I'm not really sure why. We never used it in the ER.

I don't have any studies to back it up, but in my observations when I was doing surgical rotations, as well as my own surgeries in the past, lidocaine tends to make the veins easier to blow. I also heard this from a number of Paramedics back in the day.

Also, I personally feel that the lidocaine burns worse than the IV start itself. So I'd just as soon do without it. Though you have to watch them... I had one start at me with the little needle, and if I hadn't been a medical person I wouldn't have known what he was about to do. They are supposed to tell you before they do it, but sometimes they miss it.

Now, they also have a new thing that they spray on the top of the skin. That started in pediatric hospitals and has become more common. I had them try it on me with my EGD a few weeks ago, and I didn't see much difference in pain with the IV start, but there's nothing with that which would mess the IV start up, that I can see. So if they offer that, you may want to try it.

@@northstar9148 Have you gotten any neuro therapy after your head injury? The therapists are usually really good about helping clients find or develop coping mechanisms for whatever deficit they have.

There are places online that will give you planned meals for each week, along with the shopping list of what to buy, and prep instructions for each meal. I don't know how much they cost, but that might be one option. Or have a family member or friend help you develop the same. A planner system can help you keep track of these things, and more that you're probably having issues with.

But if you're having that much difficulty with executive processing, you really need to see a neurologist and specifically request some occupational/neuro therapy.

@@theantichick

Reading your post about veins rolling and hitting valves really ticks me off. Everytime they miss, that is what I am told. My vein rolled or they hit a valve.

To be stuck 6 to 8 times to get an IV in is ridiculous. I know when I was fat, I was a difficult stick but now? I am half of what my body weight was and I can see my veins so if they really have technique to stop the rolling veins why don't they use it?

I am always very gracious about it but honestly after the 3rd or 4th time I start to get really frustrated. It's not like I don't warn them.

I mean really, during my one blood draw for adrenal testing, they had to go get some guy who had a vein finder that lit up my whole arm.

During that, I was absolutely NOT dehydrated like for surgery.

Some people's veins are truly harder than others. You may have something going on that makes you truly a hard stick. I've run across a couple of people in my career as a Paramedic and ER nurse who I just COULD NOT trap their vein. I'd have to feel your arm to be able to judge.

It also ticks me off, because there are nurses and techs that are just flat out bad at the skill, but instead of learning how to get better, they tell the patient that it's [fill in the blank] of the patient that's causing the problem. So there's lots of patients out there who are NOT hard sticks who think they are. When they go in, they tell the nurse "I'm a hard stick" and it actually sets the nurse up with the expectation that they're hard and like many other delicate skills, confidence is everything. So it becomes a self-fulfilling prophecy, and it harms patients. Anything that harms my patients, frankly ticks me off.

Try not telling them next time. Don't say anything other than if you have a place you don't like being stuck like your hand. If they specifically ask, shrug and say "I'm about average, probably." See if it changes the dynamics.

And if you truly are a hard stick, you can request that they use a vein finder or a sono site right off the bat. Sono sites are only for IV's, so it won't help with blood draws. If they only have one nurse trained for sono site (for us it was the shift supervisors who were trained), it may increase your wait significantly, and in an urgent situation you may not be able to wait. Cheap-o vein finders are about $30 on Amazon. If I was a particularly hard stick, I'd bring my own.

If you have a chronic condition where you have to get blood draws all the time, find out who's the best tech they have and specifically request him/her. We had frequent flyers at the ERs where I worked who had 2 or 3 preferred nurses or techs who had a history of good results, and they'd ask for them by name. If we could, we'd try to accommodate.

My poor hubby. My kiddo has bipolar and wanted to try to go off her meds for the summer, so she's been tetchy, and I'm apparently about to get mondo PMS-y. He may want to strike a tent in the backyard or move into the garage.

But someone who only knows how to put IV's in AC's will mess up a forearm because it's less forgiving.

Yes, our radiographers are usually only placing needles into the AC - and most of them need to see the vein to place the needle. Most of them also fear the hand and the bigger needles that are needed for higher flows and would never use the forearm.

I always shake my head when they get one of the radiologists because the patient said "I'm getting chemotherapy", I get there and I see veins in which you could throw a needle into while still standing at the door of the room. They assume that all patients getting chemotherapy automatically have bad veins without even looking. Ugh.

Yeah, I understand that you need a big pipe for dye because of the pressure injector. Interestingly enough, I had a chance to chat with a rad tech one night in the ER and he said that his preference is actually high on the forearm, because the AC's are positional enough that sometimes a slight bend in the arm will cause the pressure injector to blow it, or push it off the hub which makes a HUGE mess. I started going down onto the forearm if I could find a vein that would take an 18ga or 20ga (our rads said min 20ga) and having fewer restarts on the CT table. Heck, I've had patients that I could put a 16ga in their hand.... not that I'd do that to anyone unless they'd bit me or peed on me already. Ah, good times, good times. LOL.

FOr the most part I have not had any issues with blood draws or giving blood. They have always found my veins on at most the 2nd stick. When I had my surgery, they kept giving me lidocaine or whatever to dull the pain of the stick for the IV. I had never had surgery before so I didn't know what to tell them. They'd give me a shot of pain killer and then try to stick me and my vein would shrink up! They stuck me 8 times to get me into surgery (the eighth time they didn't give me painkiller) and then I got out of surgery and my site had blown so they had to stick me again. (They didn't notice that my site had blown until I complained about the huge lump on my arm!) I told them not to give me the pain killer and it went in on the first try. The sticks weren't that painful to begin with so I would have been fine without the pain killer, I was more frustrated with the 9 bruises on my arms! I looked like I had been in a fight!

pam

I refuse lidocaine for IV starts. My experience is that it makes the veins more liable to blow. I don't think it hurts bad enough to mess with it. I had an anesthesiologist ask one time "what, do you LIKE pain??". LOL.

I haven't had a knee replacement, but had autologous cartilage implantation with a tibial tuberosity transfer (Fulkerson's) which was an open knee operation with 18 months total rehab (4 months at PT, 14 months on my own at the gym). Here's my advice, FWIW.

• Use the CPM machine religiously. It can be a PITA, but it's worth it in the long run.
• Learn to love those sadists at PT, and do what they say even if it hurts.
• Get someone to write a script for an IceMan (http://www.djoglobal.com/products/donjoy/donjoy-iceman-classic) and pay for it out of pocket if you have to - price match online, there are a few discount suppliers where it's reasonable.
• Get in the pool as soon as they clear you for submersion. Nothing helped my ROM more than getting in the Water and either deep Water jogging or just water walking (I wasn't clear for the kicking needed for actual swimming to start, but just moving in the water was easier and gave resistance to help push the ROM.)
• I don't know if you'll have issues as long as I did, but a riser on the toilet and a shower bench were lifesavers.

I don't work bedside anymore, because I have auto-immune arthritis, but if you have the option try to go back on shorter shifts. 12 hours on a post-op knee is sheer hell for quite a while.

I don't have PsA but wanted to say for the oral birth control I had to stop a couple weeks before surgery as well and was cleared to go back on it 6 weeks after surgery - at that point the threat of blood clots was reduced enough. Your surgeon/nurse should be able to tell you how long you'll be off each med.

Oh, trust me, when you have an auto-immune condition, you work through all of this with multiple specialists. It's a balancing act. Depending on what kind of med you're on, the time off before and after surgery changes. It's because our meds depress our immune system and slow down healing. The PsA meds are the reason once I decided on the surgery, I needed to get it done ASAP to reduce how long I'm without my PsA meds. But there's no way around time off at least some of them.

After they blew my hand, they made the switch to piggyback. But, I had to drink one dose as I didn't have IV access for a few hours between those forearm sticks...I'd rather blow every IV site on my entire body than drink another dose of that foul stuff. It was like drinking salty, weird, thick blood. I shudder to even think about it.

Gag. Yeah, when I was a rookie nurse, I gave that crap to a patient to drink, and she puked it right back up. Another nurse taught me to mix it in orange juice. Apparently it cuts down on the burning and makes it a little easier to get down and keep down, but I don't even want to know that that tastes like. Even the pills for K+ are awful because they are HUGE. And of course they take longer to take effect, and if your K+ is really messed up they need to correct it fast.

Hugs for having to go through that.

I am a hard draw. It takes someone who is more of a specialist to find my veins. So whenever I get blood drawn, I warn them, and if the nurse who initially tries to draw blood fails, she gets someone who has the knack.

Now that I am 3 years post-op, I have noticed that the nurses seem to be able to find my veins easier because I have lost the excess fat.

This is important because after RNY gastric bypass surgery, I have an annual blood workup and they take almost 10 viles of blood with each workup.

There are definitely people who are hard draws. And excess fat makes it really hard to feel the veins and get a good stick. If we can't feel the veins, we're sticking blind. We generally know where stuff should be, so it's an informed blind stick, but it's still blind.

Unfortunately, I have had WAY more people in the ER tell me they are "hard sticks" than actually are. There are a lot of nurses out there who try to blame the patient when they miss or blow a stick than to own up to it. They'll tell the patient that their vein rolled, or they've got valves. News flash: EVERYONE's veins roll, and EVERYONE has valves. Now, an athletic person (especially runners) will have more valves and sometimes it adds a level of challenge, but learning to "trap" a vein so it can't roll away from the needle is just part of developing the skill.

And, certain treatments like dialysis and chemo, absolutely destroy veins. What we can find is fragile as spun glass. IV drug users get their veins scarred up and it's a real challenge to start one (but ask them, they'll know what's still accessible). People who donate blood a LOT or sell plasma tend to get their AC's scarred up badly, and we need to go somewhere else for it. Elderly patients' veins tend to be more fragile and also more engorged, there's a few tricks to sticking them without blowing up the vein. There *are* challenges. But if I had a nickel for every patient who told me they were such a hard stick, and I had zero trouble getting it on the first try, I'd be able to buy a car.

When I would miss or blow a vein, I tried not to blame it on the patient, and just owned up to it. And I let the patient decide if they trusted me to try again or if they wanted me to get someone else.

Excellent rant! I've got vessels like fire hoses, when I had surgery the night nurse insisted on restarting a blown IV in the middle of my forearm instead of the antecubital space. Here's the outcome of that:ImageUploadedByBariatricPal1470798253.662731.jpg.

And 7 weeks later, I still have copper staining in the area.

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I actually prefer forearms to AC because the AC tend to be so positional. But someone who only knows how to put IV's in AC's will mess up a forearm because it's less forgiving. The ones I absolutely despise are in the hand. I had one transected in my hand and bled so much it was like instant arthritis in the joints for a couple of weeks after!!

Oh, absolutely if it's a primary or even the second site. But this was my 4th IV site (I was getting IV potassium, so I was shredding veins every 8 hours or so) I finally ended up with one in the elbow that lasted for my last bag of K. They started with my hand, which blew ugly and big, then forearm, another forearm, then finally AC. Those smaller veins clearly weren't designed to withstand potassium, at least in my body! And isn't it amazing what it feels like to have to absorb all that blood? My IV issues were by far the most difficult part of my hospital stay

Ugh. I didn't realize you were getting K+. I'd never try to put that through a hand vein. Ew, ew, ew, ew, ew. Did they at least dilute it by piggybacking it to some regular IV solution? I think doctors should have to endure some of this stuff in medical school. They don't stop to think about how hard it is on the patient sometimes when they write orders. If the patient can tolerate volume, K+ comes pre-mixed in a very dilute solution that isn't nearly as hard on the veins, but the docs will order the tiny concentrated bags without even thinking about it. When I was bedside, if a doc ordered that, before I even went to get the meds, I'd ask him to order an additional volume of saline or whatever the patient needed so I could dilute it a bit into the veins.

A butterfly did that? I hope that she was just having an "off day" that is terrible!

Yep, and it was a blue one, so it was probably a 25ga. And she wasn't having an off day. She flat out told me she can't really feel veins, she needs to see them. She couldn't even feel them by popping the tip off her glove on one finger. Anyone who's done this knows you have to feel them to get proficient. She had the tourniquet on both times for about 3 minutes to find the veins in the first place. It's only by feel that you know what direction they're going, how deep they are, generally how big they are, and if they feel healthy or fragile. If she can't feel them with her fingers, then she's likely not feeling when she pops through the wall, which is why she transects.

The one on my forearm you can see a mile off, she just went straight through it and then backed up until she got return. That's sloppy technique, and won't work for IV's, only blood draws. I knew as soon as she stuck that I'd bruise. I'm actually glad she missed my AC because she'd likely have transected it as well, and that makes a HUGE bruise for weeks.

Like I said, I'm not upset for me. I just know enough about it to know that this is sloppy and she needs to look for a mentor to help her learn the proper technique. Who I really feel sorry for is people who have needle issues or feel the sticks more severely than I do, or who are hard sticks. I really and truly am an easy stick. I just hope she can recognize when she flat out won't be able to get it, and calls for help often.

Excellent rant! I've got vessels like fire hoses, when I had surgery the night nurse insisted on restarting a blown IV in the middle of my forearm instead of the antecubital space. Here's the outcome of that:ImageUploadedByBariatricPal1470798253.662731.jpg.

And 7 weeks later, I still have copper staining in the area.

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I actually prefer forearms to AC because the AC tend to be so positional. But someone who only knows how to put IV's in AC's will mess up a forearm because it's less forgiving. The ones I absolutely despise are in the hand. I had one transected in my hand and bled so much it was like instant arthritis in the joints for a couple of weeks after!!

This is from yesterday's blood draw. With a butterfly.

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I just have to rant a little.

I had my pre-op testing done this morning. The nurse was very nice and competent. Until it came time for the blood draw.

I was a Paramedic. I used to start IV's bouncing down the road in the back of an ambulance with poor lighting. I was an ICU and ER nurse. I have worked with patients who are VERY difficult sticks with teen-einey little fragile veins. I wasn't a vein whisperer like some of the people I've worked with, but I was pretty darned good. Co-workers would ask me to take a look if they'd already tried a couple of times and hadn't come up with anything.

It's a skill, yes. But it is not rocket science. I hadn't started an IV in 20+ years when I went back to nursing school, and didn't get much opportunity to practice in school. But it wasn't very long on the new job before I got my groove back. Like riding a bike so to speak.

Basically, I have a lot of experience to back up this rant.

I have good veins. I was the one everyone wanted to practice on in Paramedic school (by the time I went to Nursing school, they'd stopped allowing practice on fellow students). They aren't all that visible, which is a little surprising considering my skin is incredibly light. But they palpate (finding by feel) VERY easily.

Drawing blood isn't nearly as difficult as IV sticks, for a bunch of technical reasons I'll spare you. If anyone misses my veins, either I'm dehydrated, or they need more practice. Blowing the vein, or going through it, that happens a lot. So I know exactly what the bruise pattern looks like for each. Blowing it can't always be predicted. Going through (transecting) it, that is usually sloppy technique with normal sized veins.

Lady COMPLETELY missed the vein in the bend of my elbow. That vein is a HUGE pipe, it's the go-to spot for most emergency medicine providers because it's a gimme. Mine is not overly large, but it's a good solid vein. She had the tourniquet on my arm a good 3 minutes trying to FIND the vein. She even admitted that she wasn't any good at feeling veins, that she needed to see them. (Gotta say, more times than not for whatever reason - skin color, scars, tattoos, hair, etc, you CAN'T see the vein. Anyone worth their salt doing IV's or blood draws needs to learn to feel them.)

THEN she managed to get the blood draw on the second stick in my forearm, but she went through the vein. I knew watching her she'd done it, but I wanted the draw over so I didn't say anything. The bruise tells the story though. And it'll still be there next week when I go in for surgery, since I bruise like fruit.< /p>

She's been a nurse for a long while, so it's not a newbie error. She just hasn't had the opportunity (or taken the time) to get trained in good technique and practice. But she does this many many times a day as a pre-op intake nurse. There are videos on YouTube teaching how to have better draw/IV technique, and tips and tricks all over the internet. I even have a half dozen on my Pinterest board.

Sticks, especially with the little needles for blood draws, don't hurt me very much at all. I didn't care that she took two sticks on me, it's an eh kinda thing for me. But the whole drive back to the office, I thought about all the patients who don't have good veins that she's sticking over and over. She did say she won't stick anyone more than twice (most hospitals have a policy of two or three sticks, then find someone else), so that's good. But some people find needles traumatizing and incredibly painful.

There is even technology that illuminates the veins for more accurate sticks, but it hasn't become widespread. Heck, I can go on Amazon and by a cheap-o vein illuminator for $30... won't be as good as some of the ones made for hospitals, but if I were as bad at it as she is, I'd do anything to get an edge.

I don't know what the purpose of this rant is... people who want to get better at blood draw/IV sticks generally can. She apparently doesn't. Which saddens me as a nurse and as a patient.

@@CowgirlJane

I totally agree. People have really varied nutritional needs. Based on blood type, age, ethnicity etc.

Years ago I read Eat Right for your Blood Type and it outlined some of these differences not just by blood type but also ethnicity.

Yes it's not politically correct, but I do tend to agree. It's amazing that certain drugs work better in one race than another. We are all people and deserve the same rights and protections, but we have to recognize biological realities too.

And something to keep in mind is that, at least from the evidence I've read, the distinction seems to be where someone's ancestry developed and evolved. So regardless of the amount of skin pigment, someone whose ancestors did a lot of evolving on the African continent may have different dietary needs that one whose ancestors did a lot of evolving on the European continent. I have a friend who has a lot of Central American heritage, and she has lactose intolerance likely because her ancestors evolved to get their Vitamin D from the sun. Virtually all of my ancestors are Scandinavian and Northern European, and they evolved to get their Vitamin D from milk instead of the sun. We both have very light skin, eyes, and hair. So the "racial" divides when it comes to things like dietary tolerance and benefit, is a lot more than skin deep, and should be treated as such instead of being subject to political correctness.