Health? Fantastic, thanks. Ability to speak up to doctors? Still nil.

Well I finally buckled down and got myself a physical this Monday.  The doctor is amiable for the most part.  Mostly I’ve been avoiding him because he’s the back-up that I got shunted to after my fabulous female PCP decided to drastically reduce/stop her practice.  I’m not keen on a male physician and so have been sticking with my annual GYN appointments as my markers of health; saving any other appointments for when I really have something troubling me.  (What is that again about fatties costing us tax-payers from all their use of health resources again?  Right.)

Anyway.  I went and even managed to avoid being weighed (despite guff from the nurse who was all “But…it’s a physical!  You need to get weighed for that!”  Huh.  Funny but until the very last 5 minutes of our session, the doctor didn’t even notice you hadn’t weighed me.  Necessary my ass.)

Again, anyway.  Those last 5 minutes were the tough part.  When, after all the talking and few pokes/prods/thumps to check my innards like a wine cask, the doctor goes, “Well, I guess the last thing is just the weight.”  And here is where I partly win, and partly fail.  I win because I stayed calm, rational and didn’t even get that stinking feeling behind my eyes prompting me to cry.  I fail because after a token effort to explain that if all my other numbers are good, AND I’m exercising 2.5+ hours a week; then no I DON’T need to “reduce calories”; I just gave up and gave him “Glaze-eyed-patient-stare” until he was done proselytizing about how even with 2.5 hours of dancing that’s only a few hundred calories which, as we know, can be quickly eaten with just a bag of chips.  *sigh*.

Did I bring up HAES?  No.  Did I fight harder to let him know that, “Uh, why are you focused on calories all of a sudden?  I never said that I’m somehow overeating?  Oooooh, right.  That’s the instant assumption from seeing me and working to believe that if I DO dance so much each week then obviously I must be overeating to compensate and remain at my current weight.”  No.  Did I speak out and ask what advice he gives to those he treats for diabetes/heart disease/other Fatty-Linked illnesses who AREN’T labeled as overweight (or above)?  No. I was silenced.  It pisses me off; but does little good right now.

Mostly I’m angry at myself.  I give myself credit for the progress made; namely in being strong despite sitting on an examining table in my knickers and the gown* while he and I basically talked for 45 minutes.  But I am upset that I couldn’t/didn’t/wouldn’t do more.  Like all the progress I’ve made by being outspoken here, digitally, has had a far reduced impact in my ability to speak out verbally in-person.  *more sighs*

On the good/funny/frustrating note: my health numbers are all looking fabulous… except for an HDL that is 5 points lower than the desired minimum of 40.  The doctor’s advice in the digital letter he sent along after the results?  Diet and exercise!  *headdesk*  Perhaps I’m reading too much into it but honestly it felt like the doctor was almost HOPING that there would be all this stuff wrong with me so he could be all “HAH!  See, Fatty?” and was almost a bit disappointed to see that I’m still otherwise a very healthy woman. (Who just danced for 2 hours in ONE DAY this past Sunday, I might add, at a local fundraiser for Lymphoma and Leukemia.  Take your “calorie theories” and stuff-them!!)

A new black and silver dance costume; top cut to make a crop-top

Showing-off my "Look at this, a healthy Fatty!" attitude with a new black and silver dance costume; top cut to make a crop-top

*What is with that?  A power-trip?  Why can’t we do all the discussing and THEN he leaves for 2 minutes and comes back to me in my knickers/gown for the few minutes of prodding?  I’m very much convinced it is a ploy to make the patient feel the vulnerability of their position during that nearly hour-long “exam” while the doctor remains dressed and “in-charge”

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26 thoughts on “Health? Fantastic, thanks. Ability to speak up to doctors? Still nil.

  1. I am SO SORRY this happened to you …again. It’s funny. I moved recently and we had to choose a new PCP. I was worried about the same thing.
    My hubby has a chronic health condition, and is just not good at advocating for himself. So I always go along and present his history, meds, needs, etc.; it feels very natural to do it. He’s just not a people person and generally goes along to get along.
    But when it’s time to advocate FOR ME? Usually a big fail. I was laid off a few years back, and went for the last paid physical ‘just in case”….that MDs comment was that I could use the time off to do my own private “biggest loser” and exercise 2+ hrs a day. The staircase wit was in full effect after that one!

    I was pleasantly surprised by the reaction in the new MDs office. I just said ” I prefer not to be weighed”….and the nurse just asked for my height. Then the same for hubs. She was surprised when I asked for the big BP cuff…but did it. And surprise-normal BP, not “white coat hypertension”. MD asked if I had labs done recently, I said within the last two years, she asked if any other changes, I said no. That was all. I told her despite my size, they were all good……and she said she had patients larger than me who had great numbers. No total disrobe, either, just lifting up clothes here and there.

    Not that this was a total love fest. We arrived 20 min early for our appointment, which started …..1.25 hrs after the scheduled time. But hearing your story makes me more OK with that. I don’t want to spend forever waiting to hear or deal with her office, but to be respected once I am there. Worth waiting and driving 2 towns over.

    I feel ya! I did about 20 calls over the phone before one of the receptionists of another MD (not taking patients) recommended this one. Then interviewing office over phone. It’s still a crap shoot. Keep trying! Hope you can find one better next time…..it’s so HARD.

    • Chutti I dread the time I have to work on getting a new doctor. I keep telling myself this one isn’t so bad and the woman I see for GYN appointments is great (and who I see 1x/year anyway) so I think I’m just constantly putting it off. Though, I did look for another female practitioner but there are none accepting patients (STILL) in my area. *sigh*

  2. I know you’re disappointed that you couldn’t do the entire FA onslaught with this doctor, but keep this in mind: you knew he was blathering at the end and you kept your cool.

    This whole thing is a process. We inch along the road as best we can, fighting the battles we can. And as we do that, we get stronger and better able to handle more battles. But none of us can do it every single time in every single situation. Self care and self advocacy are frowned upon as mere selfishness in our society – especially among women. And among FAT women… well, that’s just crazy talk!

    But you didn’t cry, you didn’t buckle under, and you’re building up more gumption every day. The time will come (and I’m betting it’s not that far off) when you can tell the doctor precisely what you think. When that day comes, please let me be a fly on the wall. I’d love to see his face when confronted with facts and statistics that turn his world upside-freaking-down.

    Not that he’d be likely to listen or anything.

    • Twistie, thanks for the kudos. I’d love to be positive and believe that if I sent an email letter through our new online health system to the doctor about HAES he’d actually at least skim it…but I’m feeling a bit negative the last few days so….I feel that he’d only even do that much to find talking points against my desire to avoid weight-talk. 😦

  3. The last time I saw my doc was the time he wanted to talk about my weight. I pretty much shut him up and have not been back to see him since then. I think for the next time I go to a doctor visit I will go well armed with HAES information and perhaps even a copy of the actual published study, not argue with them but just hand it over and say, if you really care about health rather than a disguised disgust about fat… read this.

    • Jenna (and Chutti): I also thought about bringing materials; maybe next time I should. Or actually give myself to fully calm and send something through that new online system.

  4. Yeah…..I thought about bringing in something printed as well. Might next time, as the lobby was literally so full of various med, diet and other brochures there was no where but my lap to put my hands.

    And ditto on the kudos for NOT breaking down and crying, getting ‘irrational’ or generally giving in.

    I think that’s how we’re supposed to increase the numbers of MDs who WILL actually treat us as we deserve to be treated.

  5. Well, I had a major fail today because I was seeing a new doctor today and I totally started crying. I was seeing a hemotologist because I want to get iron infusions due to low ferritin. I can’t tolerate iron supplements, they make me so sick, I’ve tried several different varieties of them and it’s just not going to work.

    Anyway, I was really nervous going in and my bp was 30 pts higher than normal and the doc starts telling me I’m not anemic, but I probably have sleep apnea, and I say I use a CPAP, so that’s not it. Then he says it’s my thyroid, and I say no, I’m being treated for that (another horrible story of crappy doctoring). Then I start crying. He took blood, but I don’t think he’s going to do anything for me, but I plan to come prepared with documentation regarding low ferritin levels.

    He didn’t mention my weight specifically, but the initial run to sleep apnea put me on the defensive.

    I used to never see the doctor, but now I have to see 3 different ones regularly for psoriasis, psoriatic arthritis, and hashimoto’s, and I’m pretty comfortable with them, but I still hate seeing new docs.

    • Kate I wonder if seeing a new doc ever gets easier? I’ve certainly never felt it to be anything but a stress bringer myself! I already find myself mentally prepping for convos that I fear will happen with CURRENT docs. A new one would make me really nervous I think. I’m also wondering about the sleep apnea thing for myself. My mother (who is MUCH smaller than me) has it and uses a CPAP machine. I just took the home version of the sleep test and now they want me to come in again to “discuss the results” (Translation: We refuse to just tell you over the phone or email because we want you to blow another hour or two of Sick Leave so we can get some more co-pay and “speak with you in person”. *eyeroll*). I just have this fear already that it is going to be a “Well, if you lose some weight” talk. 😦

      Not feeling very forgiving of medical run-around right now. Especially after calling back this afternoon about 1 hour after I got one of those “Call us back” messages; and having to wait 10 minutes before I hung up to call again and say, “Find out why you called me!!!” I mean, seriously! You shouldn’t have to beg the folks on the other end, who CALLED YOU AND LEFT A MESSAGE, to let you know why the frick they called… >.<

      • I have to say that I LOVE my CPAP. I had horrible nightmares my whole life until I got a CPAP, then they magically went away. The joy of sleeping 8 or 9 uninterrupted hours is still magical to me, 10 years after starting to use the CPAP. I know some people with CPAPs that never use them, and all I can think is that their sleep must not have been as disturbed as mine. I fall asleep and wake up in the same position every single day and night.

        What I’m really sick and tired of is begging docs to treat me for stuff they want to write off to my fatness. Yes, I’m fat, I get that, but that doesn’t mean there’s not something else going on. It also doesn’t mean that I don’t deserve to be treated.

        What really frustrated me with my GP, who treats my hypothyroidism, is that he’s the one who diagnosed the low ferritin, but told me that since I can’t tolerate iron pills, I have to suck it up. During that same visit, I was reported back that the physical therapy for my hip bursitis was ineffective and that the whole time I was doing the PT, they told me not to exercise and he’s getting on me for not exercising. Anyway, the PT didn’t help in the least and his answer to that was to suck it up. So basically, even though I am in a significant amount of pain and even though I’m so tired I can barely hold my head up, I just have to learn to deal with it. I’ve heard this story before and that was regarding my subclinical thyroid problems and it took several doctor visits and years of begging and cajoling to be treated for that and the result was that I was right all along. (FYI, I tested negative for Hashimoto’s until I went off the immunosupressents I take for psoriasis.)

      • Oh, and yes, actually talking to someone in the doctor’s office is incredibly difficult. My doctor also has a sketchy email system that I often tussle with.

        I have to find a new OB/GYN, mine is retiring. I didn’t really think much of him as a doctor, but he was quick and didn’t lecture me on my weight. It’s so sad that that’s enough for me.

  6. Perhaps this experience at the doctor will be a learning experience that teaches you how to never sit by meekly and take that crap ever again. You could frame this as a learning experience.

    I like to visualize how I could’ve done things differently in deep detail… and then visualize doing things differently next time (especially right before heading into the situation where I didn’t perform as well as I had liked before). This works for me… dunno if it will for you, but there it is.

    Maybe the next time you see this doctor it won’t be a 100% win for you, but you might progress. It’s something to shoot for anyway.

    And, remember: if you’re not failing, you’re not trying.

    • Angrygrayrainbows I think that visualization technique might actually help out. I know I was able to make the small progress beyond instant-tears this time because of a similar technique of going in KNOWING that I am healthy and otherwise fine and would not be jerked around. I’ve always had a problem though with being assertive vocally and think I might see about, if not finding a public speaking course, practicing saying “Actually, I practice HAES: Health at Every Size. Have you heard of it? I’d be happy to send some information your way.” Think I need to stick with simple and do it so often I have it memorized so it, too, becomes as easy as smiling and nodding.

      • Oh yay! I hope it does work for you.

        In situations where I know I might get triggered, this technique has been a lifesaver for me.

        You’ve been growing with body acceptance for a long time (as witnessed through your blog). I am sure that in time you will master this and no matter what kind of whacko doctor you are faced with that someday they will not be able to rattle you.

  7. After years of doctor’s appointments where I was pushed and intimidated into various unpleasant and painful examinations and testing I didn’t even need just because they needed to check off an x for that for all patients my age and gender, I finally learned how to say ‘no’.
    If you don’t want to do that, don’t want to take that ‘medical’ advice or suggestion, or if you just don’t agree with what the doctor is saying and don’t want to listen to that anymore, you don’t need to be an expert or lecture the doctor. You just need to firmly say ‘no’ and keep saying ‘no’ until they get that you will not be meekly complying with whatever they want to railroad you into ‘for your health’. ‘No, I will not take that medication’, ‘No, I will not let you run that test’, ‘No, I will not go on any diet or lose any weight’, repeat ad nauseam until he/she shuts up about it.
    In your case I’d also suggest adding something like ‘It’s against my personal beliefs to do anything like that’ and say it very firmly. If the doc asks for details, you can then tell him about practicing HAES. If not, request that he put a note in your file to never talk to you about weight or dieting. Honestly, there’s probably very little chance of changing a doctor’s mind if they believe in the dieting + thinness = healthy crap; the main point here is to get him to stop harassing you about it at your appointments. The person in the exam room clad in their underwear and a gown is the one who employs the doctor and pays for his services, and as such can stop doing so at any time if the doctor doesn’t measure up. You don’t need to feel in any way obligated to let someone who works for you lecture you about anything that makes you uncomfortable.

    As a side note, I once heard that flaxseed oil supplements can make your hair grow better, so I started taking 3 a day. Sadly, it did nothing for my hair, but my next blood test showed that my HDL jumped to 100. Not kidding. I have no idea why this isn’t well known. I realize there’s no guarantee it’ll have the same effect with other people, but I’d bet it would give anyone better results than the unproven all-cure ‘diet and exercise’.

  8. I was lucky that the last time my doctor started in on me about my weight, I was fully dressed. After she got done with her spiel, I gave her a piece of my mind, told her I was done listening to her weight loss advice that didn’t work for me, and walked out. Then I sent her a two-page letter explaining to her why she was fired. That was 9 months ago, and I’ve never been back to see her. When I have a problem and need to see a doctor, I call the clinic, tell them what the problem is, tell them I need to see a doctor – any doctor but Dr W (the one I fired). When I see my ortho, my endo, or any other specialist, they send any files to be added to my records to the last doctor I saw (not the one I fired). So far, that’s worked for me, I haven’t run into any problems with being told I need to lose weight in order to cure my strep throat (the only problem I’ve had since then), but I haven’t gone in and asked for a referral to a pain clinic for my back pain or a rheumatologist for my fibro either (Dr W wouldn’t give me referrals for those, she was just positive that losing weight would cure my back pain and fibro, even if the weight loss wasn’t permanent, yo-yoing was perfectly acceptable in her book). But it took me years of being browbeaten by doctors to be able to give Dr W a piece of my mind and walk out on her (and I was really pissed, it was either walk out or throw something).

  9. April, I join others in saying it’s very, very hard to stand up for yourself in the situation you were in, and you can be proud that you are making progress. My only additional thought is this: it’s not too late. You can respond to your doctor’s digital letter with a more personalized equivalent which says that you didn’t appreciate the consult part of your appointment being held when you were unclothed, and that in the future you will have the consult first, while dressed, or after your exam, while dressed. Then explain your stance on weight, exercise, nutrition, HAES, whatever. You’re a very talented writer, if your blog is any evidence, so it should be easy for you to put your thoughts into words. State clearly what you do and what you do not want. It helps, in my experience, if you sandwich it between things you DID like (“That was the gentlest pelvic exam ever!” or “Your receptionist/nurse/PA was so professional/welcoming/efficient” or “I’m so happy you have evening appointments.”)

    It’s wonderful if you can ask your doctor if he will be able to accommodate you in your wishes, but obviously, you have to have the financial and logistical wherewithal to walk away to another doctor to do that, and lots of folks (sadly) don’t have that.

    But certainly before your next appointment, you could send a note reminding him what you’re interested in exploring, and what is off-limits. Things are a lot easier to do in writing, I find, and it helps if the doctor doesn’t feel ambushed by something so out of the ordinary as a fat woman at peace with her body, who insists on being treated decently.

    And – I can’t finish without saying – your dance outfit is amazing. You have PRESENCE!!!!

  10. Kate, low ferritin is often seen with chronic hypothyroidism. Treating it involves getting those thyroid numbers into their optimal zone (where YOU feel best, not necessarily what the lab considers normal) and building your iron stores. One won’t be effective without the other.

    I don’t tolerate iron pills either, so when we diagnosed low ferritin for me, I went to a naturopath who helped me with some herbal tinctures for building the blood. That seemed to be the thing that helped the most…..that and optimizing my thyroid numbers. I am *almost* back to normal now, which is pretty good considering how bad my numbers were. If you can’t afford a naturopath consult, there is an OTC herbal preparation called “Floradix” that can be very helpful to some.

    As far as OB-GYN stuff goes, try picking a midwife instead. It’s certainly not a guarantee of size-friendliness, but midwives in general tend to be more size-friendly (or at least size-neutral). And they’ll take more time with you in appts. A CNM will be on most insurance lists. Or many docs have nurse-practitioners or PAs in their practices. All do well-women care as well as GYN stuff.

    Sometimes there is no way to avoid the “wt loss” talk because many doctors are now being monitored on whether or not they brought up the topic at your appt. If they don’t, some insurance companies dock them. So they feel they have to bring it up, whatever you say.

    I’ve done the HAES talk with my care provider; she’s very understanding yet the subject does come up at each major physical. This last time I finally caught on and said, “Okay, you can check off that you talked about that with me. You know how I feel about it.” That shut down that discussion faster than usual and avoided some hassle. Try it and see if it works for you.

  11. I’d call this a win. Yeah you didn’t get in all your points, but you made it out of there pride in tact with the important bit covered.

    This is actually one of the reasons I advocate for team sports. They teach you that you can prepare and practice all you want but what happens on the field is what matters. You drill and you prepare and you practice in the hopes that all this practice will make what you are learning second nature on the court.

    You’ve done your prep work reading up on FA and HAES and you’ve practiced thinking about it and writing about it, but have you practiced talking about it? For some of us talking to those around us about FA and HAES is so much harder than reading and writing about it. If you try talking about it more in everyday life the doctor suddenly stops being this big intimidating boss and morphs back into another person to talk about HAES with.

    So getting back to that sports analogy, you didn’t lose. You just won by a lower margin than you wanted.

    • “you didn’t lose. You just won by a lower margin than you wanted.” Sara A you’re awesome 🙂

      Well-Rounded Mama I think your idea bout acknowledging the need/desire to bring up the topic to quickly shut it down might be a really workable solution for me right now for those in-person moments until (as Sara A points out) I’ve practiced enough out-loud to be comfortable.

      nsv: Thanks about the outfit 🙂 Also, I am thinking about drafting a digital response as you suggested so we’ll see how that pans out!

  12. This isn’t directly related to doctor visits, but I thought I’d share with you that my 5-year-old son was completely transfixed when we passed by a performance by fat belly dancers today. We stood and watched them for a long time, and he couldn’t believe how beautiful the women were and all the amazing ways they could move their bodies. I’ve found this kind of reaction a lot in my experience as a teacher, and it really gives me hope for the next generation!

  13. Standing up to authority needs some time and practise. Next time, you will be maybe be less exhausted (you already stood up to the nurse, willpower gest worn down) and have a better idea about how the talk will be going, and you can do and say more.

    HDL: My doctor gave me a long lecture on that culminating in “eat less fatty meat”. (I eat about an ounce of meat a day, and usually it’s not bacon.). I found out the next day on the internet that having eaten 12 hours before the examination might fudge the results. The doctor only asked, “did you have breakfast” and never considered that, for me, it was six hours after dinner.

    Sigh, doctors.

    I suspect that fatties are said to use so many health resources because doctors spend so much time preaching at them. Those five-minute-guilt-trippings accumulate, you know… :-/

    • Inge I was wondering about the possible fudged results from eating previously. It had only been 5 hours since my lunch at 11 (I go to work for 7am!) but while the nurses about to draw my blood were hesitant to do it; the doctor basically “pooh-poo”ed and said it would be fine. Maybe it is, maybe it isn’t but I’ll be looking to get a re-test of that at least next year if not in a few months depending on insurance. Especially since any site telling me how to raise HDL is all “Just don’t be fat and do all this other stuff you already do”. *sigh*

  14. I still have the same problem sometimes. I’m ok with my own doctor and therapist, I know them well and we have a good relationship. But if I have to see any other health practitioner… it makes me so vulnerable I just struggle to even get through the appointment, let alone challenge that sort of thing.

    Be kind to yourself hon, it’s hard, and you’re not at fault for not being able to educate people who should already be educated on this stuff!

    • Thank you sleepydumpling! I think that it is sometimes hard to recognize the efforts we ARE making when surrounding by how far there is still to go. And I hate feeling vulnerable.

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