Sick, Fat, and Dreading the Doctor

I almost never get sick and when I do it usually lasts a day.  I only get sick enough to need medical attention about once every five years.

Last week was the perfect storm – no sleep, tons of stress, really hard workouts, not eating enough food.  Monday I started to really not feel well.  I did what I had to do (meetings, workout, dance lesson etc.) and then went home to try to feel better. But I didn’t.  By  Wednesday afternoon my tonsils had swollen to the point where it was difficult to breathe and impossible to swallow and they hurt non-stop.  Thursday I felt like grim death.  By Friday morning I hadn’t eaten anything in over 36 hours and I was in constant pain.

I can hear what you’re thinking:  GO TO THE DOCTOR YOU MORON!!!!

It seems reasonable but there are a couple of snags.  First I don’t have insurance – I’m too fat to qualify.  I’ve already discussed the issues of health care access for fat people.   Luckily I can afford to pay out of pocket which brings us to reason number 2, the real reason for my hesitation: The horrible treatment that I am likely to face in the doctor’s office (both statistically and through personal experience).

Because I am involved in fat activism, I “know too much”.  I know, for example, that in research from Yale University  more than half of the 620 primary care doctors questioned for one study felt comfortable describing obese patients as “awkward, unattractive, ugly, and unlikely to comply with treatment” and that almost 25% of nurses said that they were “repulsed” by obese patients.

In the past doctors have tried to kill me, doubted their own numbers, and called me a liar so I’m just not that excited to go.  However about 4am on Friday my desire to breathe without pain overtook my desire to not have to be humiliated by someone who is considered a health care professional and I Googled the closest Urgent Care Center and waited around until it opened.

In actuality it wasn’t so bad.  I tried very hard to be chipper and pleasant even though I just wanted to curl up on the floor. They didn’t try to weigh me so we skipped that whole fiasco.  The nurse tried to take my blood pressure with a regular cuff, I told him that he would need an extra large. (Why do they always do that – YOU CAN SEE ME.  I’M VERY FAT.  GET THE BIG ASS CUFF PLEASE.)   He took my blood pressure (typically 117/70) and it was 135/81.  The nurse said in a stern voice “That’s borderline…” it sounded like he was headed down the fat talk road, so I cut him off and said (conversationally, without being at bitchy I swear) “only since the pharmaceutical companies successfully lobbied to lower the number.  Also, if a patient is in constant pain in a place called “Urgent Care” what would we expect their blood pressure to do? I’m typically 117/70 like clockwork so I’m not worried.”  He seemed taken slightly aback but he took my word for it, said ok, finished the exam and walked out of the room. The exact same scene repeated when the doctor came in.  But they didn’t argue and neither of them said anything about my weight (possibly because they got distracted when they  found the size of my tonsils so impressive that they brought other doctors into the room.  I had the worst case of tonsilitis that any doctor at Northwest Urgent Care had ever seen.  Go big or go home – I’m #1 !!!!!!!!  Not that I’m competitive or anything).

So I had a pretty good experience at a doctor’s office.  I don’t know if the blood pressure thing was going to devolve into an “I’m sure you’ve never heard this before but American Medicine likes to conflate weight and health” discussion.  I’m glad that I was able to cut him off and take control of the experience if that was where it was going. Maybe the secret is that I went to Urgent Care where their job is to deal with my current urgent issue. Who knows?

I do know that I deserve better than to have to worry about this. Nobody who feels like I felt should have to worry that a trip to a health care professional will involve shaming, humiliation, advice not based on sound research, or a pathetic attempt to convince me that I wouldn’t have tonsilitis if I was just 50 pounds lighter.

One of the lines of a commonly used version of the Hippocratic Oath states “I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.”   Just as a start, I think if we had a little more of that and a little less “obese patients are awkward, unattractive, ugly, and unlikely to comply with treatment” we’d have a much better health care system.

I was going back through my blog and remembered that I wrote a little pamphlet a while ago about how to deal at the doctor’s office.  You can download it here for free if you want.

So anyway, I missed you guys last week.  Lots of good comments – sorry about the lack of replies – and I’m glad to be back!

37 thoughts on “Sick, Fat, and Dreading the Doctor

  1. I’m sorry you weren’t feeling well. Hopefully things are back to normal now. =)

    I’m relatively new to your blog (actually, I’m relatively new to the FA & HAES movement in general) and I absolutely adore it. I had to share what happened last time I went to the doctor for a severe ear infection.

    Generally I don’t get a lot of attitude from my doctors, mainly because my husband is military and they don’t have time to think about extra diagnoses. But this last time I got this clueless nurse. I told her 4 times that she was using the wrong BP cuff. I told her the adult wasn’t big enough and that she would need the thigh cuff. By the fourth time, (and the fourth high reading) she agreed to switch. Well, my BP went down, but only to borderline.

    I was furious. Gee, you think my BP might be high now that I literally have LINES in my skin from the cuff squeezing my arm so tightly? It’s called PAIN, you moron.

    As a side note, I just found out yesterday that I can refuse to be weighed. That’s awesome and I’m totally going to refuse next time!

    Thanks for your blog!

  2. Sorry you were so sick, Ragen, but I’m glad you had a (reasonably) good experience at urgent care and are back! Did they wind up giving you something for the tonsilitis?

    Had my first visit with a new physician yesterday. All in all, I liked her very much. She did tell me that my current weight puts me in the “obese range,” but left it at that. My cholesterol is somewhat elevated, and I would like to get my LDL number down, but all my other stats are very good, so I’m guessing that given that, she spared me the lecture. She stressed the importance of exercise, but was respectful and sympathetic about it – how it’s probably challenging to find the time to do it, etc. Anyway, a good experience overall.

    Hope you continue to mend!

    Mary-Ellin

  3. Yay! You have the biggest tonsils! lol I’m not competetive either!

    I can sympathize with you about the doctor visit. I’m glad everything worked out and you got the care you needed!

    Happy healing!
    xo Susie

  4. i hear this!
    i recently broke my leg quite comprehensively whilst on holidays in France, and required emergency orthopedic surgery.
    firstly, the medical staff were incredulous that i had no existing health issues and that i am on absolutely no medication, and then they were constantly checking my blood pressure, pulse, blood sugar. and for all I know, my cholesterol as well
    i think i upset their notions!

    tonsils are a painful bitch.
    i hope you are over your attack soonest.

  5. I was recently diagnosed with PCOS (I had a thyroid test which came back normal).

    The doctor casually mentioned weight loss but admitted it is very hard. However, this was not stressed and I’ve never been fat shamed during any gyno visits. I was advised to take more calcium due to my age and exercise for 30 minutes 3 times a week, which is no problem. My BP always seems to be 130/70 and except for one doctor, a general practitioner, I’ve been told that reading is just fine.

    Anyway, I’m glad your experience turned out well. Usually in my experience, don’t know about anyone else, that urgent care centers and/or pharmacy minute clinics do the least amount of or no fat shaming at all because they’re known for faster service and treating the actual condition. It seems they just don’t have time to lecture you on if you weren’t so fatty-fat, you wouldn’t have that sore throat or that cough.

  6. Hey girl, Hope you get to feeling better soon.
    Just a heads up – I also have had the nurse who refuses to leave the room to get a larger cuff. They can use the reg cuff on your forearm if they don’t have an xl cuff.
    And blood pressure can be elevated by simply being sick – your body is working hard to fight an infection. That is NORMAL and has little to do with weight.
    I have heart failure that was not caused by my weight but is cetainly not helped by it either. My fuction is at 30% and I still work a 40-50 hour week and most people have no clue unless they ask me to climb a flight of stairs.
    My blood pressure is rarely as high as 110/70…I’m usually under that – so when it is “Normal” or higher I just let them know what my NORMAL is.

    1. Hey Juliana,

      Thanks for the well wishes and the info. I actually didn’t know that they could do forearm BP. For my money they can go and find the right damn cuff. I’m sorry that you’re having to deal with heart failure but it sounds like you are kicking ass!

      ~Ragen

  7. Ragen,
    Hope you’re feeling better! I’m a lot less healthier than you but my doctor has never pulled any of that “you’re fat, diet” BS on me. None of the doctors at my clinic have mentioned that. They know I’m physically active and they know that I do what I can to keep myself active–I take my thyroid medicine religiously and I have regular checkups.
    I really think that when you build a relationship with a decent doctor (and sometimes they can be hard to find) and they get to know you and what’s normal for you they really do focus on the problem. The great thing is if we’re visible in the doctor’s office and we’re connecting with physicians, we’re not leaving things up to theories in textbooks and in medical journals. If enough of us build relationships with physicians, eventually they won’t think of healthy fat people as aberrations, they’ll think of us as their patients.

    1. Laurie

      I’m really glad that you have found someone who treats you well and I love what you said about changing their view of us. You are awesome!

      ~Ragen

  8. I wish I could send this post and your booklet back in time…my just out of college self needed it a lot more than 49 yr old me. Yet, it still helps to keep all this in mind. We are the customer.

    1. Glad that you liked it, sorry that you had a difficult time earlier with doctors. You are right – we are absolutely the customer. It may be oen fo the only benefits of for-profit medicine so we should take full advantage!

      ~Ragen

  9. The only reason you have the biggest tonsils is because my daughter and I no longer have ours. Ohmygodtheylooklikemuscadinegrapes!!!!! tonsils RULE in my family.

  10. @Juliana: Forearm BP gives elevated readings in some people. For years my doctors and I thought my high blood pressure was being barely controlled with medications, and my dosages kept steadily creeping up for years (along with the shaming, “Lose weight, fatty!” lectures that went along with it). That’s because the nurses at this practice always told me there was no need to go find the larger cuff – a forearm reading with a regular cuff would do just fine. It wasn’t until I was hospitalized for an unrelated problem that we discovered that forearm measurements are unreliable for me…and all those medications were working so well that my BP was actually borderline low (100/60). Fast forward a year: My meds have been cut in half, I feel 10 times better, my BP is consistently 125/75, and I INSIST that the nurse go find the big BP cuff. “Yes, I understand that you don’t know where it is. Go find it. I’ll wait.”

    1. I didn’t know that about the forearm BP (actually until a couple of comments ago I didn’t know that you could take BP that way). I’m with you – they can go and find the extra large adult cuff (and by the way if soooooo many of us are sooooo omigoddeathfat, why is that thing not within arm’s reach?)

      ~Ragen

  11. I am fortunate to have medical insurance AND a doctor who doesn’t lecture me or harp on my weight at all. I have had to discuss being weighed with the new nurses when they come and one was really stubborn about it, but I eventually got through to her. I will only weigh when it may affect my treatment in some manner. I am responsible for my doc’s office having some loveseats and generous sized armed chairs in the waiting area and digital scales that go up to 440 lbs. I wish they’d have spent a bit more and gotten higher capacity ones, but it’s a start. My arms are so large that they have to either take my BP on my forearm or use the thigh cuff, but I don’t have a problem with them over it.

    I hope you are feeling better and back to normal soon!

  12. Doctors and other healthcare professionals can be horrible. But some are OK. I think it is helpful to choose a primary care physician who is OK with your weight and will treat what really ails you. It takes some shopping around, but sometimes you can ask a fat friend how they are treated by their doctor, and if the answer is positive, try them out.

    I have seen, to my surprise, some very, very large friends get good treatment, despite the fact that the healthcare system itself discriminates against fat people in countless ways.

    I once complimented an emergency clinic doctor in North Carolina about how well he had treated my (fat) wife after she sprained her ankle. He responded that he was aware that his fellow doctors could be very hard on fat patients, and he felt badly about that; he always assumes that if a fat patient he is seeing could have lost weight and kept it off, they would have.

    The National Institutes of Health (U.S.) has said that it is disturbed at how many doctors do NOT routinely prescribe weight loss to every fat patient!

    1. Bill,

      I agree that it’s a matter of finding a doctor who will treat you will. Of course for those of us without insurance it can cost hundreds of dollars per visit until we find someone. I think that your idea of asking for referrals is a good one. This isn’t often on my radar because I rarely get sick and when I do I use Western medicine as an absolutely last resort. I really have no words about the NIH thing (ok, I probably do but I’ll stick them in a blog eventually!)

      ~Ragen

  13. Oh my goodness! I hope you’re feeling better now. Take care of yourself and I’m glad there wasn’t a ton of fat shaming or you would have had to open a can, and I only ask that when you do so I’m present. 🙂

  14. Central Family Practice, has always treated me like a human. They do not take insurance, you have to file it yourself and will only get out of network but having a doctor I trust not to make me worse and a staff that asks if I want to be weighed and will hold conversations not interrogations is well worth the trouble.

  15. Wow Ragen, I’m sorry you were so sick, I hope you have someone to take care of you! I figured you were just busy. I hope you are feeling much better! As far as the “fat patients are non-compliant” thing goes, I had a doctor drop me for non-compliance once(not coincidentally the only one who has ever given me a fat-shaming). To this day I have no idea what I didn’t comply with…they notified me by certified letter which I couldn’t be there for ’cause I have an actual job, didn’t findout until I called for my next appointment.I suspect though that it my have been because I didn’t lose weight. As it turned out, he did me a huge favor–I found a wonderful gynecologist who treats me with respect, and she referred me to my current fabulous primary care doctor(her name is Kavorkian– how I love telling people who my doctor is! 🙂 ). She has never mentioned my weight and actually listens to my opinions and has really worked with me to optimize my health. I have to drive across town to get to her but it is so worth it.

  16. I’m fat and have chronic physical health conditions. Sorry you’ve been sick!

    Realistically, I can’t *not* see a health care provider, but the process of finding one who works with me is really, really nerve wracking. Yes, I know my blood pressure at initial visits is high: I’m deathly afraid yet another doctor is going to blame endometriosis/pelvic floor dysfunction on my weight or my insufficient pain tolerance. (Newsflash: I do not have insufficient pain tolerance. I have extra-sufficient pain.)

    But I am way not a fan of being told that my issues would Magically Disappear if only I would lose weight. I am even less a fan of being presumed a liar when I explain that I’ve had the same issues at various weights (and stages of nutrition and physical activity).

    Fortunately, I do have insurance and have been able to shop around in my area for a good practitioner, but there has been an extensive (and expensive! even for someone with group insurance) amount of shopping.

    I was going to get kind of cynical for a minute there. Instead let’s talk about the time I broke my foot and was told to lose 50 pounds. It remains, I believe, the only time I’ve uttered the sentence, “I slipped on a vibrator, you asshole!”

    1. Sorry that you’re dealing with chronic heal conditions but I am glad that you have insurance and that you’ve found a good practitioner! If only you had a picture of his face when you said that. I would love to see it!

      ~Ragen

    2. OMG, that is the greatest response EVER to a fat-phobic doctor! Tori, you are my HERO! 🙂

  17. You know, it makes me so very glad I have such a good doctor.

    I went to her yesterday, I am suffering unexplained anxiety attacks again, and it has been awhile since we had a full check up. She weighed me and saw that my weight is still the same as it was 8 months ago (still Super Fat) and said “Your weight hasn’t changed, that’s good.”

    She automatically got out the large cuff (which she keeps right there at her desk, not stashed gathering dust in a cupboard somewhere) to take my blood pressure.

    She then ASKED me if I was ok with her adding cholesterol, blood sugar and a few other tests on a blood test she was ordering me, since we haven’t done it in awhile.

    It is so refreshing to be treated with respect, to not have the lazy diagnosis of “You’re fat, lose weight.” and to work WITH a doctor to optimise my health.

    What I will do when my beloved Doc Jo retires (actually despite the fact that she probably could retire soonish, she’ll probably be practicing until *I* retire!), I have no idea.

    I’m sorry that you’ve been unwell and that you’ve had the added stress of worrying about dealing with a doctor. It just has to change, doesn’t it?

    1. Maybe you could ask your wonderful doctor to give you a referral before she retires. With her experience she probably has a lot of connections in the medical community in your area.

  18. So glad you’re feeling better!

    If you ever find yourself needing such services in South Austin, I cannot recommend this place enough:

    http://www.victorymed.com/

    Staff is super nice, the docs are awesome and they have never brought up my weight. When I tore a muscle earlier this year I went there and basically said look dude, I do a lot of kung fu so heal me as fast as humanly possible. The doc said right on, let’s give you steroids and high dose ibuprofen and see how it goes. 🙂

  19. Kudos for this thoughtful discussion of a way-too-familiar feeling and experience. 🙂 I’m printing it out and sending it to my sister’s doctor, who just harassed her for a long ol’ time while she (my sis) was worried and in pain. Sigh. I also have a 10-page HAES booklet I compiled (from other people’s websites and citing them, of course) that I’m going to send her. 🙂

    1. Hmmm I don’t think it’s worth getting upset over. It sounds like most doctors (even in FL) aren’t following this asinine policy. This is one of those sensationalist stories with little substance.

  20. After being in recovery from an eating disorder, I was accustomed to being weighed backwards and not knowing my weight and in fact having professionals go out of their way to keep me from knowing it; in good ED treatment, no amount of begging will get your dr/therapist/nutritionist to tell you the number.

    So when I was back in the “real world” and at a doctor’s office, when they’d ask to weigh me, I would tell them that I was going to stand backward and didn’t want to know my weight. Some responses I got include:

    – “I’ll only tell you if it’s good news, how about that?” (WTF is “good news?”)
    – Saying “okay” but then handing me my chart with my weight written on the open page.
    – Showing me the computer screen while they enter my weight.

    After years of this, I finally realized – at a Body Positive workshop – that I could actually REFUSE to be weighed and that is my perfectly legitimate right. This was sort of revolutionary to me and so when recently I was at the doctor, I declined to be weighed and felt very empowered.

    But then, because apparently they just can’t handle not entering anything, after deliberately turning the computer screen toward me so I could verify that my medications were correct, the nurse pulled up my weight from a previous appointment to enter it.

    Just for fun, my BMI was right next to my weight – showing me that I am in the “overweight” category and closer to “obese” than “normal.” For the record, I am training for my third full marathon in the last year and a huge believer in intuitive eating. I also still consider myself in recovery from an eating disorder, still see a nutritionist who wouldn’t tell me my weight if I bribed her, oh and my whole eating disorder history is carefully detailed in that very medical chart.

    Overall I still consider the act of refusing to be weighed an empowering experience, I’m glad I did it, and I’ll do it again next time. But I guess next time I’ll say, “I don’t want to be weighed and I also don’t want you to tell me my past weights or BMI or discuss my body shape or weight with me in any way. Not only is it irrelevant to my appointment, but it is also damaging to my health and recovery and while I understand that people make mistakes, if this happens again, I will choose to find another doctor’s office.”

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