Sunday, January 24, 2010

Doctors and Weight

I recently saw an article in CNN.com titled: “The surprising reason why being overweight isn’t healthy” (see http://www.cnn.com/2010/HEALTH/01/21/obesity.discrimination/index.html?hpt=Sbin). Of course my curiosity was piqued, and I felt a sense of vindication when I actually read the article. This was the first time I had ever seen anyone state that heavy people are discriminated against in doctor’s offices, and often receive poor treatment or misdiagnosis as a result.

The reason I felt vindicated is because I experienced this first-hand when I went to college. As I wrote in one of the early chapters in my book:

“[Just a month] after I started [college]I noticed a hard red bump swelling on my chest, literally the middle of the top of my breasts (but not on them). I was terrified, having just heard a woman talk about breast cancer. If it hadn’t been for that, I might have ignored it since it didn’t hurt too much, but as it was, when I went home for Columbus Day Weekend, I asked Mom to arrange an appointment for me with the family doctor.

“To his credit, he didn’t blame it on my weight, not that he was happy about my weight. He said it was a cyst, and he gave me a prescription that he hoped would bring the swelling down. If it didn’t, he said I’d have to get it drained in Boston. I was relieved on the cancer front but still nervous, and it turned out with good reason. The prescription did nothing for me, and so I had to go to the Lane Health Center (what we liked to call the Lane Death Center). They proceeded to send me to a hospital on Mission Hill, and due to the ride arrangements and time of day, I didn’t even have time to go home to pack a bag.

“It was a nightmare scenario. I was all alone in a strange city, checked into a hospital for the first time ever, with no friends to call to help me out. I was ale to get in touch with [one of my roommates], and she put a bag together for me that Jeremiah brought, but he wasn’t able to stay. At least he could tell Mom and Dad what was going on, but then I was alone again.

“What made it so much worse was my doctor’s bedside manner. The first thing he asked me was how long I had been overweight, as if my current problem was a direct result of my amount of stored fat. He definitely treated me as an inconvenience, an operation to get done and out of the way before the end of the day, hardly telling me what he was doing although I was conscious during all of it….

“Then [after a week or two] the wound got infected. The surgeon, still not winning any points for personality, implied that it was because I wasn’t hygienic; the further implication was that anyone as overweight as me must be completely negligent in taking care of her body at all. I was upset and ashamed, wondering if it was something I had done. It reminded me of why I hated going to doctors at all, and why many overweight people I’ve met avoid them at all costs.

“Mom was furious with him and consulted [our chiropractor] Dr. Norris, who said that was ridiculous; staff infections are common in hospitals. Feeling only marginally better, I nevertheless had to go on antibiotics. That cleared up the infection, and the wound healed. But it left an ugly scar, physical as well as emotional.

“I thought I was okay, but shortly after a lesion appeared on my right breast, a red swelling that started small but quickly grew to the size of a nickel, swollen and painful. I flipped out again. I went back on antibiotics, and it started to improve. As soon as I went off them, though, another appeared on my right knee. To make matters worse, all the antibiotics had resulted in a topical yeast infection on my chest…..

"I finally went to see a dermatologist, only to almost lose it yet again. He also said all this was happening because of my weight, that my skin was chafing against my clothes! Never mind that I had been overweight for years and never experienced anything like this. I was again humiliated and furious, but not surprised. Doctors are often this way, blaming everything they can on the obvious excuse of weight without bothering to look deeper.”

I did finally improve after following Dr. Norris's suggestion that I take Echinacea, but I found it incredibly ironic that it was my chiropractor, who was generally focused on the structure of my bones and muscles, who saved me in this case. Adding to the irony is the fact that I often hear about how much of a burden overweight people place on the medical system; I was in fact denied extra long-term health insurance because of my weight when I was 23. Yet I’ve visited doctors so much more after losing weight, due to hormone imbalances, problems with my knees (yes, those started post-weight loss), MRIs and mammograms, and just general check-ups that I never used to have. Admittedly, had I reached this age without having lost weight, I could have started having other problems, but I might never have done anything about it, being too ashamed to go to a doctor to begin with, even though I have health insurance (certainly not a given). And that would have been a true tragedy – one that is reality for too many people.

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