Diagnosis: Shut your mouth once in a while

Emily writes…

I went to the doctor because I had gained 70 lbs in a year (without changing my diet or activity level) and had stopped having my period.  I’m currently 5′ 7”  220lbs.  At the time, I weighed about 240.  I had always been curvy, but had never had belly fat or lots of flab.  I made an appointment with my sister’s gynecologist to see if we could get to the root of these problems.  I wasn’t very nervous about the visit because my sister (a svelte 5′ 7” 150) raved about this doctor, saying she’s the best doctor she’s ever had and how she really helped when my sister had ovarian cysts and other female problems.

I walked in and the nurse took my vitals.  I changed into the paper robe and blanket and waited my turn. When the doctor walked in, she could’ve been a replica of my sister with a different face.  She took one look at me and asked me what the problem was.  When I told her that I hadn’t had a period in three months and that there was no possible way I could be pregnant, she immediately came back with “It’s because you’re overweight.”

She then told me to “shut my mouth once in a while” and to lay off the junk food (I never snack and can’t stand potato chips and pretzels.  If I do need something, I go for unbuttered popcorn or an apple).  She methodically did my exam, only complimenting me once on the tattoo I have of my alma mater’s insignia…turns out she is also an alum of my school.

At the end of the exam, she reiterated that I needed to stop eating so much and lose some weight.  I had to tell her a few more times that I had gained so much weight in a year without any change to diet or lifestyle before she really understood.  She grumpily agreed to run some blood tests to check for diabetes, thyroid problems and hormone levels.  I fasted and went to have my blood drawn.

When she called me back with the results, it was like I was a different patient and she was a different doctor.  It turns out that my recent weight gain and lack of menstruation was caused either by Polycystic Ovarian Syndrome or a tumor on one of my glands.  She referred me to the best endocrinologist in the area and apologized for having to deal with either illness, though she never apologized for how she treated me in her office.

Thankfully, [the endocrinologist] diagnosed that it wasn’t a tumor and that it wasn’t Cushings and we proceeded with the treatment for PCOS.  I lost about 40lbs in the first year of treatment.   My body basically needed hormone shock therapy to get itself back on track.  I have since had regular periods on and off the pill and feel a lot better.

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25 Comments

  1. Laurie

     /  February 18, 2008

    This stuff makes me so angry.

    Extreme weight gain is a symptom.

    Extreme weight loss is a symptom.

    Weight is not a symptom, nor a disease.

    Reply
  2. I had an almost identical experience when I was initially diagnosed with PCOS. I was already an ‘inbetweenie’ when the rapid weight gain started, and it took forever to convince the doctor that this was about more than just sitting around the house eating chips.

    Reply
  3. Same on that doctor! She should not have been so quick to mis-judge you.

    I’d write a letter to her expressing how she made you feel as a patient, and I’d send a copy to her administrative manager if applicable.

    I was dismissed 16 years ago over a lump in my breast. Turns out I had breast cancer. My diagnosis was delayed by one year, and then I only got the appropriate tests and biopsy because I insisted. I’m lucky to be alive.

    I often wonder who else my doctor “abused”. While he may not have intentionally meant me any harm, his negligence was harmful to me.

    From that day forth, I’ve never allowed another doctor to dismiss my health concerns. If they can’t treat me like a thinking knowledgeable person, they don’t get my business. Who knows my body better than I do?

    You are so fortunate, that because of your persistence, you got the labs that revealed your problem.

    Reply
  4. And if you hadn’t repeatedly told her that the weight gain was in spite of no change in eating habits and exercise, she probably would have brushed you off and you would have had to find another doctor and go through it all over again. It’s a classic case of refusal to look past the fat for the actual cause of a problem. I’m sorry she was so rude and couldn’t be bothered to apologize for her lack of professionalism, but I am glad you finally got her to listen and run the appropriate tests. At least you had a good endo and have are having good luck treating the cause of your problem.🙂

    Reply
  5. I ask you. When people go to the doctor with symptoms of carpal tunnel syndrome, does the doctor just automatically cut right to “you have to quit texting so much”? Or do they actually bother to ASK if you do a lot of texting instead of just assuming? And if you say you don’t text all that much do they keep telling you you shouldn’t text so much anyway?

    Or, if you have symptoms of possible lung cancer do they automatically tell you you have to quit smoking without ever asking if you smoke, and when you insist that you have never smoked, do they continue to insinuate that you must have been sneaking a pack a day for the last 30 years?

    That’s the kind of stupidity this is. You tell them over and over again that you do NOT do what they assume you’re doing and you basically get told you are a liar, because there’s “no other way” you could possibly have Symptom X. I’m so glad you at least got a referral to a specialist who “got it.” Really, I can’t believe a doctor would be so dismissive of a 70-pound weight gain in a year. You’d pretty much have to be force-fed around the clock while being tied to a chair the whole time in order to have even a chance of this NOT being linked to an endocrine disruption of some kind.

    Reply
  6. lynnie

     /  February 18, 2008

    What sort of treatments have you had? The same thing happened to me, but it was back in the 80’s and all they did for PCOS (if you could get a diagnosis) was put you on BC pills. I’ve tried metformin, but can’t tolerate it.

    Reply
  7. thoughtracer

     /  February 18, 2008

    That’s fucking dumb. At 260 and 5’9, I am still bleeding regularly. Good god, you don’t just stop bleeding all of a sudden because you got fat. And you don’t just gain 70 pounds in one year, even if you do start enjoying Little Debbies Zebra Cakes. For the Love. If either were true, I would be twice as fat and not having to buy tampons anymore.

    Reply
  8. Good god, you don’t just stop bleeding all of a sudden because you got fat.

    Actually, weight gain or loss can result in amenorrhea. I didn’t get my period for about five years because I was extremely obese, and then after I lost weight via an ED, I didn’t get my period because I was suffering from malnutrition and a loss of body fat.

    Still, as Emily’s story shows, while doctors may suspect weight might be a factor, they are ethically and legally obligated to fully investigate the matter fully before making a diagnosis.

    Reply
  9. yellowhammer

     /  February 18, 2008

    Yes, Emily, please tell us what the doctor did for your PCOS! Most doctors I’ve seen are kind of dumbfounded and are all like “we don’t know… need the pill? No? Ok… ummm….”

    Reply
  10. Mindy

     /  February 18, 2008

    um I was told my carpel tunnel symptoms were because I was fat and I should loose weight to take care of the problem.

    Reply
  11. yellowhammer

     /  February 18, 2008

    Also, it doesn’t matter if you HAD gained weight by over-eating– that is no way to talk to some one. Ever.

    I mean, what if you had PCOS and you DID eat junk food? Can you imagine your frustration when you did change your eating habits and nothing helped, nothing changed? I know I’ve had this experience, personally, trying to manage my PCOS with just diet did DIDDLY SQUAT for me.

    Reply
  12. stefanie

     /  February 18, 2008

    So sorry to hear of your treatment at the Gyn’s. That type of medical ignorance is really scary, when you think about it.

    Someone in my family just had a recent PCOS diagnosis. Her practitioner is treating it conservatively, with exercise and a low-glycemic, low-carb, no refined sugar or flour eating plan. She doesn’t want to take medication at this point. She has lost some weight and while she still has cycles that are too long, the time in between periods is getting shorter. She is also learning fertility signals, to be able to chart and keep track of any ovulation.

    Reply
  13. AnnieMcPhee

     /  February 18, 2008

    After I had my daughter I gained about 70 pounds in 9 months or so, with no change in eating habits. I saw two pictures last night – one when she was maybe two months old and I was still thin, and one several months later, and fat. I have no idea what caused this; though I do wonder if even then I had early signs of the hypocalcemia that eventually crippled and almost killed me. I thought at the time that it was strange, but it didn’t scare me. Reading all this, I guess it should have.

    Reply
  14. Mindy

     /  February 18, 2008

    Meowser! I was told my carpel tunnel symptoms were because I was fat and I should loose weight to take care of the problem.

    Reply
  15. Although it’s not listed as an official symptom, this sudden unexplained wt gain seems to be very common among women with PCOS, either in late teens or early-mid twenties. Very alarming when it happens to you!

    PCOSers often have borderline thyroid issues too but it’s difficult to get doctors to take that seriously if you’re fat. If you are symptomatic for hypothyroidism, get your TSH measured, and preferably your T3 and T4 as well. Get the EXACT results and the scale they used to determine what was “normal.” Don’t just accept the dr telling you it was “normal” or not.

    Research the topic and realize that different docs use different definitions of “normal” for TSH and you might get a diagnosis with one doc and not another. Some doctors will do a “trial of meds” if you are symptomatic and have a borderline TSH.

    Annie, please get your thyroid levels tested. It is *very* common to have postpartum issues with your thyroid, but often overlooked by doctors. I don’t know anything about hypocalcemia and whether this could be caused by that….but given that you had a recent pregnancy, thyroid issues are definitely something that should be ruled out as well.

    kmom
    http://www.plus-size-pregnancy.org

    Reply
  16. What did they tell you to do, Mindy, quit walking on your hands?

    Reply
  17. Last time I got on a scale (which was a while ago) I weighed 320 and I’ve never stopped having a period. I’m 5 ft 9. Regular as anything most of my life but getting a little flaky now that I’m approaching 50. So if being fat made you stop menstruating, I must be doing something wrong.

    Reply
  18. Mindy

     /  February 19, 2008

    HA! Nope, just loose weight and it will go away.

    Strangely it didn’t, not until I broke my arm and had all those bits traumatized and immobile for six weeks.

    Reply
  19. lilacsigil

     /  February 19, 2008

    I had the same experience, only gaining 55kg (121 pounds, and no, that is not a typo) in 18 months. No tests were run by any of the four doctors I saw until an audiologist, looking at an unrelated issue, picked up that I had a giant lump on my thyroid. Turns out I had thyroid cancer. So much for eating junk food and not exercising.

    Oh, and the reason I started out as an “in-betweenie”? PCOS, not diagnosed until after the cancer was dealt with and I started having periods again.

    Reply
  20. So if being fat made you stop menstruating, I must be doing something wrong.

    Being fat may result in amenorrhea; obviously this is not an absolute statement for everyone. I think it also has to do with where body fat is stored on your body. Those with more body fat around their midsection will be at a greater risk for this.

    Reply
  21. penguinlady

     /  February 24, 2008

    After 8 years of trying to confirm a PCOS diagnosis (I was positive I had it, but no doctor ever actually did anything exceot tell me to lose weigh), I have finally been given both Synthroid for mild hypothyroid and Metformin for my lack of cycles. And when I went to the doctor last week for the Metformin, I was loaded for bear if he told me to lose weight – my cycles were equally as screwy when I weighed 75 pounds less. Unfortunately, it’s taken an infertility diagnosis for me to finally get the treatment I’ve been asking for since 2000. Maybe if I had been diagnosed earlier, I could have been pregnant already.

    Reply
  22. stillwaitingforchikens

     /  March 12, 2008

    Oh penguinlady, I am so frustrated for you. My doctor told me to eat better until I brought my family in on one visit. I showed him how in our family hormones have no mercy as puberty hits early and hard. My 14 year old could pass for 19. My husband backed me up when he told the doctor about how my family picks on me for only serving the family healthy foods.

    Reply
  23. Tara

     /  January 14, 2009

    The same exact thing happened to me (Extreme weight gain of over 50 pounds in less than a year, and losing my period) except it’s been years since that happened and I am still untreated. I’ve not been to a doctor lately (because I suspect I have PCOS) because I lack medical coverage, and my weight keeps me from getting a stand-up job. Catch-22! Lovely!

    Reply
  24. Emily

     /  April 11, 2011

    It’s been over three years since I wrote this note. My endo put me on the pill and metformin. The metformin made me incredibly sick and unable to eat, but I still did not lose weight. When I told my endo that it wasn’t working and asked if there was something else we could try, he said “no” and basically told me I was out on my own.
    My dad is on metformin now for diabetes and it turns out I was taking FOUR TIMES the dosage he takes for diabetes. When I called my former-endo to let him know, I never got a call-back.

    I’ve yo-yo’ed a lot over the past three years and my period has come and gone. I am now up to the heaviest I’ve ever been – right around 300lbs. I’m afraid to go to the gyno b/c some of my college friends are now gynos and I know how they talk about their overweight patients. I don’t want anyone talking about me.

    Reply
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