Stupidity + Medical School = The Doctor I Saw (aka “I shaved my armpits for this?”)
Posted in Body Acceptance, IE, Idiots, Just Life, diets, medical on Oct 4th, 2008
Yesterday I went to a rheumatologist with the hopes of getting an “official” diagnosis of fibromyalgia. I don’t know why it mattered so much, but emotionally, I really wanted to hear, “oh, yes… you definitely have fibromyalgia.”
It’s foolish, since I *know* I have fibro. My husband believes it. My primary care physician (PCP) believes it, and so what does it matter? She doesn’t diagnose it, but she’s pretty darn sure my symptoms fit.
But I have had a major increase in pain in the past year. Undoubtedly related to the stress we’ve been coping with, as fibro is very sensitive to stress. I wanted a chance to feel human again, to sleep again… to be able to go for a walk with my husband and dogs again. Is that too much to ask for? After seven years, I’m broken… I’m so exhausted, emotionally and physically, and I was ready to make it official. Just to feel validated.
Well, it didn’t go well. She was a size two who saw a fat patient and jumped to conclusions. She didn’t do the tender point test, which is probably the single most critical diagnostic tool for fibro (fibro patients have bilateral “tender spots” and there are 18. I have pain in 14 of them). She poked me a smidge, prodded and stretched my arms, didn’t even have me stand and basically told me that my pain is from my weight. She didn’t say it that bluntly, but she made it quite clear that’s what she thought.
I told her about my costochondritis (which is an inflammation of the chest wall, and a common problem in fibro… it’s also excruciatingly painful) and she didn’t even touch there. I told her about my sore neck muscles, and she didn’t touch there, either. I told her about how pain on the side of my face and ears often wakes me up at night, and she looked at me like I was crazy.
Yes, well. Clearly, my earlobes are too fat.
She gave me Elavil, despite my telling her that even on 12.5 mg quarters, I was a zombie. She said, well, take 5 mg, since you slept that was great. Yes, but I slept for 10 hours, which is NOT so great when you have a job… and then still want to sleep more. She gave me Mobic, despite my telling her NSAIDS do nothing for my pain and upset my stomach (since fibro is NOT an inflammatory disease, NSAIDS generally offer patients little to no relief).
She ordered some blood tests. She said she wants to see me in a month, and I have no idea why I should bother when she made it very clear what she thinks is wrong.
She thinks I’m stressed out, fat and anxious. I asked if my pain is consistent with fibro in her opinion, and she said, well… most of my patients are far more debilitated and can’t work. WTF? I work from HOME at a desk PART TIME. And some days, I feel like I can barely work. I reminded her that I work from home and said I didn’t think I could work outside the home (which isn’t necessarily true, but some days would be a challenge for sure!).
I pointed out to her that I don’t have bilateral neck pain because I’m too fat, and she said that was true and even said that the costochondritis isn’t from being fat… but that was as far as she wanted to go.
It was ridiculous. She was way more interested in talking about my eating disorder than my pain. I tried to explain to her how bad dieting had been for me, and ultimately I told her, point blank, that I will never actively try to lose weight again. It is a self-destructive behavior for me. She had kept pushing that eventually my EATING DISORDER THERAPY must plan to address weight loss. I said, uhm, actually, no. I told her that my therapist uses Intuitive Eating and does not promote dieting. She said, “well, I mean… not dieting, but calorie restriction.” Uhm. Right. Where did you say you went to medical school? Cuz you are clearly a MORON. On what planet is calorie restriction NOT a diet???
UGH. I was somewhat concerned this would happen, but I thought I’d at least get a true exam out of the deal. She didn’t do the single most important diagnostic exam for fibro and she’s going to tell me I don’t have it? Or she doesn’t think it’s fibro because I’m not in enough pain?
How much more pain do I need to be in? I was sobbing this week because of how awful I felt. I have a handicap placard, because walking unnecessarily uses too many spoons and causes fatigue and pain. I wake up in agony several times a week. How “debilitated” do I need to be before I warrant some actual medical care and concern?
Oh, she also said that she wouldn’t give me Lyrica because of the risk for “water weight gain, and well, you wouldn’t want that, right?”
She was meek, and polite about her insensitivity… and I think I was sort of unprepared for that, so it didn’t even occur to me to stand up for myself. I was blindsided.
So, today I followed up with my PCP. I got lucky that she had an opening, because she’s really popular since she rocks. It can take a week or more sometimes to get in with her.
I told her the story, and she was very upset for me. I mentioned that I’m considering writing the doctor a letter, addressing why I will not be returning, and why, though I had most of the bloodwork she ordered done today, she’ll never see the results. My regular doctor supports this letter, and thinks I should do it, so I might. I doubt highly it will change the way that woman sees her patients, but it might, so maybe it’s worth the effort… if nothing else, it might help me to feel better.
When I shared with my doctor the point where I told this woman that I would rather be this fat for the rest of my life than diet again, she said, “and I think you are healthier for that.” I felt so much relief to hear her say that… to have her agree with that sentiment.
Look, dieting is what got me to this point. The chronic cycle of deprivation followed by binging was toxic for me, and potentially far more hazardous to my health. I feel much better emotionally, and I rarely binge now. Is my eating “perfect?” Of course now. I am human, and I’m dealing with over 20 years of dieting baggage. One year in therapy isn’t going to make my problems vanish.
But at the end of the day, I feel so much more human now. I feel happier. Would it be easier if I were thinner? Of course! I am not a fool. I know that my life would be way simpler if I was even 100 pounds thinner. However, at the end of the day, I know dieting isn’t gonna get me there… and I refuse to ever actively pursue weight loss again. What would be nice, though, would be to feel well enough to exercise, to enjoy outdoor activities. I tried to convey this to that insipid idiot I saw yesterday, but I think what she heard was a “fat girl making excuses.”
Whatever… that is HER problem, not mine. Like my doctor said after I shared the story, “the funny part is that she thought you were terribly concerned about possible weight gain (or should be), when the truth is that you’re so not.”
I *love* my regular doc. She gave my samples of Lyrica and we’ll see how it goes. Hopefully, I will get some pain relief and minimal weight gain… but if I gain weight and have less pain, it will be more than worth those extra pounds to have my life back.
xoxo,
Juliet
