I mean, yeah, sure, you are right. But if I'm being honest, this feels a little like when there's one of those race threads, and inevitably someone comes in and says something like, "well, yeah, but police are assholes to everyone, not just black people."
There's a fair argument to be had about how standard of care has declined for everyone. That's a different issue than having all your health concerns dismissed or solved by, "well just go for a walk."
But this isn't true. There's been decades of research that prove women, in general, get a poorer standard of care across the board regardless of weight. It could very well be the issue that she was a woman, and not because of her weight, that she received shitty advice from her doctor.
What's not true? That I haven't ever felt like my doctor dismisses my health concerns because I need to lose 50 pounds?
I understand there's been research about the discriminatory treatment of women in health care. There's also been research about the discriminatory treatment faced by minorities, and maybe the writer is black. And there's been research about standard of care just falling lower and lower, for lots of different reasons. There are lots of explanations for why what happened to the author happened to the author.
But why is she (and the rest of us) wrong for experiencing a situation first hand, and coming to the conclusion that it was weight that caused the doctor to dismiss us, not race, gender, insurance BS, hospital administration BS, or any of the other number of factors? Why can't this be an issue too?
I mean, yeah, sure, you are right. But if I'm being honest, this feels a little like when there's one of those race threads, and inevitably someone comes in and says something like, "well, yeah, but police are assholes to everyone, not just black people."
There's a fair argument to be had about how standard of care has declined for everyone. That's a different issue than having all your health concerns dismissed or solved by, "well just go for a walk."
Yeah, I just don't think that someone with a normal BMI would have been dismissed the way this author was when she described her symptoms. They would have been all, "Huh. Sudden change in energy level and shortness of breath. Something is up."
I had a normal BMI, occasional blood in my stool, terrible fatigue, and couldn't make it up a flight of stairs without losing my breath (former athlete). once blood tests revealed I was anemic, I was told to eat more red meat and that anemia is common in menstruating women.
after bouncing back and forth between doctors who didn't listen (college NP, hematologists, internist), I presented to the ED with a gross bowel perforation and required emergency surgery.
turns out I have severe crohn's which is totally manageable when diagnosed properly. it only took years to get a diagnosis
But this isn't true. There's been decades of research that prove women, in general, get a poorer standard of care across the board regardless of weight. It could very well be the issue that she was a woman, and not because of her weight, that she received shitty advice from her doctor.
What's not true? That I haven't ever felt like my doctor dismisses my health concerns because I need to lose 50 pounds?
I understand there's been research about the discriminatory treatment of women in health care. There's also been research about the discriminatory treatment faced by minorities, and maybe the writer is black. And there's been research about standard of care just falling lower and lower, for lots of different reasons. There are lots of explanations for why what happened to the author happened to the author.
But why is she (and the rest of us) wrong for experiencing a situation first hand, and coming to the conclusion that it was weight that caused the doctor to dismiss us, not race, gender, insurance BS, hospital administration BS, or any of the other number of factors? Why can't this be an issue too?
That we're (or really I'm) trying to make this some sort of tragedy Olympics by dismissing her weight.
Sure, I think it might have played a part, BUT I think it's covering up a larger issue that doesn't solely focus on her BMI.
Yeah, I just don't think that someone with a normal BMI would have been dismissed the way this author was when she described her symptoms. They would have been all, "Huh. Sudden change in energy level and shortness of breath. Something is up."
I had a normal BMI, occasional blood in my stool, terrible fatigue, and couldn't make it up a flight of stairs without losing my breath (former athlete). once blood tests revealed I was anemic, I was told to eat more red meat and that anemia is common in menstruating women.
after bouncing back and forth between doctors who didn't listen (college NP, hematologists, internist), I presented to the ED with a gross bowel perforation and required emergency surgery.
turns out I have severe crohn's which is totally manageable when diagnosed properly. it only took years to get a diagnosis
I mean, yeah, sure, you are right. But if I'm being honest, this feels a little like when there's one of those race threads, and inevitably someone comes in and says something like, "well, yeah, but police are assholes to everyone, not just black people."
There's a fair argument to be had about how standard of care has declined for everyone. That's a different issue than having all your health concerns dismissed or solved by, "well just go for a walk."
Yeah, I just don't think that someone with a normal BMI would have been dismissed the way this author was when she described her symptoms. They would have been all, "Huh. Sudden change in energy level and shortness of breath. Something is up."
I absolutely see what you're saying here, and I agree that we can't possibly know which factor (the doctor's training, time constraints, insurance bullshit, personality, prejudices; the patient's weight, age, gender) was the one that caused the doctor to be so dismissive. And that weight might well have been the thing.
I guess I would just say that I think that this type of thing is happening more to everyone, so I'm sympathetic to her situation as well as concerned about how the medical profession is dealing with these decline in patient care overall. I have a normal BMI, a steady job, excellent insurance, and a winning smile (lol) and I had to go to three doctors (one, finally, at an urgent care) to get freaking antibiotics for a severe, 3 week-long headcold/sinus infection/ear infection. Yes, it's true, Dr. McAsshole, I really couldn't hear out of my left ear and I really was down to 3 hours sleep/night due to coughing.
ETA: I'm not trying to be dismissive here, for real. I just find bedside manner to be so absent most of the time (my kids' beloved pediatrician excluded), that that's where my brain went first.
But this isn't true. There's been decades of research that prove women, in general, get a poorer standard of care across the board regardless of weight. It could very well be the issue that she was a woman, and not because of her weight, that she received shitty advice from her doctor.
What's not true? That I haven't ever felt like my doctor dismisses my health concerns because I need to lose 50 pounds?
I understand there's been research about the discriminatory treatment of women in health care. There's also been research about the discriminatory treatment faced by minorities, and maybe the writer is black. And there's been research about standard of care just falling lower and lower, for lots of different reasons. There are lots of explanations for why what happened to the author happened to the author.
But why is she (and the rest of us) wrong for experiencing a situation first hand, and coming to the conclusion that it was weight that caused the doctor to dismiss us, not race, gender, insurance BS, hospital administration BS, or any of the other number of factors? Why can't this be an issue too?
This is key. And I think it's borne out by people's experiences that show no matter the ailment, they are told losing weight is the cure. While doctors not listening to patients is a broader problem, this is a problem that is specific to obese and the overweight patients.
I think it's important to discuss that because if we want to improve doctor-patient relations, doctors probably need more than just, "Listen to patients." They need to understand the specific biases they are bringing to the table against black people, women, fat people, and so on. But because those biases are going to be different for each population, improving care the obese receive is probably going to have some different elements of improving care that women receive.
I mean, yeah, sure, you are right. But if I'm being honest, this feels a little like when there's one of those race threads, and inevitably someone comes in and says something like, "well, yeah, but police are assholes to everyone, not just black people."
There's a fair argument to be had about how standard of care has declined for everyone. That's a different issue than having all your health concerns dismissed or solved by, "well just go for a walk."
But this isn't true. There's been decades of research that prove women, in general, get a poorer standard of care across the board regardless of weight. It could very well be the issue that she was a woman, and not because of her weight, that she received shitty advice from her doctor.
And it could very well be that Mrs. Obama was asked to grab something in Target because she was tall, not because she was black, but when some people suggested that, you pointed out that this a microaggression that added up and if she was offended by it, perhaps us shorties shouldn't just ask anyway around to help grab something off a shelf. And once you explained that, I backed away from my position and decided not to ask people for help in the store anymore. In fact, I had a jar of mustard fall on my head the other day at Whole Foods because I didn't want to ask people for help grabbing something up off the top shelf and offend someone in the process.
I'm not suggesting that the discrimination faced by the obese is anywhere near that faced by racial minorities in this country. But I'm trying to point out that the obese do get discriminated against, and this seems like a great example of it. If I'm not explaining myself properly, I'll happily bow out of the discussion.
I really think a huge part of the problem is the pressure on doctors to get a million patients through the door each day. They don't develop relationships with their patients, they don't know them, and they can sometimes stop seeing them as complete, multi-faceted people.
This is a part of the whole shitty ball of wax I was talking about. The medical insurance system is fucked, therefore practices are fucked, doctors are fucked, nurses are fucked, patients are fucked, the whole system is fuuuuucked.
I mean, yeah, sure, you are right. But if I'm being honest, this feels a little like when there's one of those race threads, and inevitably someone comes in and says something like, "well, yeah, but police are assholes to everyone, not just black people."
There's a fair argument to be had about how standard of care has declined for everyone. That's a different issue than having all your health concerns dismissed or solved by, "well just go for a walk."
But this isn't true. There's been decades of research that prove women, in general, get a poorer standard of care across the board regardless of weight. It could very well be the issue that she was a woman, and not because of her weight, that she received shitty advice from her doctor.
So in other words, it could have been the clothes, or the demeanor, or the neighborhood, but absolutely not race because reasons.
But this isn't true. There's been decades of research that prove women, in general, get a poorer standard of care across the board regardless of weight. It could very well be the issue that she was a woman, and not because of her weight, that she received shitty advice from her doctor.
So in other words, it could have been the clothes, or the demeanor, or the neighborhood, but absolutely not race because reasons.
Absolutely, you have me dead to rights. The situations are exactly the same. Well done.
I have so many thoughts about this that I can't piece them all together coherently. It often feels like physicians are damned if they do and damned if they don't. It's frustrating.
I agree. Weight IS an important health issue. In some cases, losing weight WILL solve the issues at hand. But obviously it's a sensitive issue and it is just part of a larger picture of health.
All I'm saying is that doctor's have now started taking the obvious answers and running with it. In this case, she was obese, so that had to be the cause. For my daughter, she had a concussion, so that had to be the cause, despite being presented with other evidence to the contrary.
Because that is my experience, I do believe that it is a larger problem than that this woman was overweight. Why *can't* it be a larger issue?
Post by Wrath0fKuus on Jan 26, 2015 16:11:57 GMT -5
No one is saying that there aren't huge issues with medical treatment in general, but this specific story was about how not having thin privilege affects one's quality of medical care. What's with the resistance to that?
Post by AllieHound on Jan 26, 2015 19:03:58 GMT -5
Oh! Time for my favorite "my PCP sucks" story. I go to my family doc in April of 2012. He walks in, doesn't even look at me, goes into my chart, and goes "you've gained 22 pounds once the last time you've been here! That's quite a large increase, we need to make some changes before you start to feel the effects of this weight gain."
I just sat and stared at him for a minute until he looked at me, got a good look, the he apologized, said congratulations and actually attempted to address the reason I was there (seasonal allergies) and hauled ass out of the room.
My son was born 16 days after that appointment at 41w1d...so, yeah.
And, since anecdotes-mine was I was pregnant and gallstone pain. Nevermind I had sharp pain in my lower right abdomen. 24+ hours later, I had a ruptured appendix, peritonitis infection galore and then miscarried....haven't been able to stay pregnant since (not necessarily linked, but, yeah). So, my anger is likely clouding my reaction here.
Post by tacosforlife on Jan 26, 2015 20:06:25 GMT -5
I actually think the experiences of tacom and rvan0905 highlight that yes, there is the general doctors-listening-to-patients issue, but there is also a more specific issue with the treatment of the obese. They both had trouble getting a proper diagnosis for a difficult-to-diagnose condition, but the reasons behind the misdiagnosis were different.
People have particular sets of biases and assumptions about different populations, whether that population is women or obese patients or something else. So the author in the OP was misdiagnosed for reasons that appear to be related very directly to biases that doctors hold about obese patients. It seems clear to me that this goes behind saying that doctors need to listen better. We need to identify specific biases that doctors hold and address those.
Honestly, this article makes me think that maybe we should be talking about other reasons behind the mortality statistics of the obese. It's not being obese, it's incompetent, arrogant doctors who don't know how to actually listen or treat the obese.
This is a tangent but I think it's important to remember that you HAVE to advocate for yourself for quality medical care. I absolutely agree that some doctors don't listen, some rush to judgment, some apparently think obesity should be "treated" before any other issue is, etc. That's a problem. But even if your doctor is good you still have to know that the onus is on you to get yourself good care. I say this as sort of a PSA b/c until I was a young adult I didn't know this. I thought doctors were our advocates. I also had a terribly naive assumption that scientists and doctors knew everything about the body, except super rare diseases almost no one has. All it took was 1 friend having a serious medical crisis to figure out we don't actually know that much and (the majority of the time) no one in the medical field is going to hold your hand and lead the way to figuring out what care you need and who should give it to you. Since that point I've seen it confirmed time and time again, esp during the times I lived with my elderly grandparents. It's like they retained the idealism of doctors from their youth b/c they think if the doctor doesn't tell them they need it, then they don't need it. And now they're too out of it to know what information to provide, where to research or what questions to ask. With so many elderly people in the same position I can easily see why it's a fustercluck. This is not to hate on doctors. They can only know what science is available and there are aren't enough of them to allow them the time to go to bat for every patient they see. It's impossible. I think it's a waste of time to search for the perfect doctor who will always know what to do with any random collection of symptoms. Ditch a crappy doc, for sure, but find another and keep the mindset that you are in charge of your health and it's on you to figure out if your treatment is insufficient. Especially if your symptoms don't point to something obvious.
I have so many thoughts about this that I can't piece them all together coherently. It often feels like physicians are damned if they do and damned if they don't. It's frustrating.
I will sit here. Not with respect to the weight part. I just don't know about that. But for every patient that comes in and says I think I have a clot and does , there are 10 more that say they have a clot because they read dr.google and really they just need a bandaid. I think the doctor should have listened to this girl since she had one before and was flying. But it's tough.
Then we moved to DC, and I got a new doctor. Guess what? I do have Crohn's, it is primarily in my small intestine (so all of those scopes were a waste!), and now I have Barrett's esophagus and am getting bariatric surgery in April to reverse it before I end up with cancer. I've been actually treated during flares, and my quality of life has improved dramatically. Granted, Crohn's is a very hard disease to diagnose, but doctors who were trained to do so refused to consider the original diagnosis valid because I was first overweight and then obese. My current GI is of the opinion that I have gained weight due to my illness; my diet and lifestyle have been forced to change to accommodate the constant flares.
WLS (RNY?) will reverse Chron's or reverse Barrett's esophagus? Good luck with your surgery!
OK the name of this writer kept needling me until I went into my other email and remembered I "know" her and we had emailed each other about something a couple of years back. She's a fatshonista blogger: plussizeprincess.com/
She's written a good bit about her experiences as a plus size person -- dating, work etc.