A reader writes:
I feel like this is nearly insignificant compared to some of the horror stories up on the site. In fact, I nearly didn’t send it. In the end, I am, because I feel like it’s significant for several reasons – it has made me much less likely to seek medical attention, it’s made me much more body conscious, and it’s an indication of how little some practitioners trust their patients – to tell the truth about their diets or their bodies or their experiences.
I was diagnosed with migraines when I was twenty. I have classic symptoms, although only occasionally do I get an aura. Migraines differ dramatically between people, and mine vary dramatically between episodes – sometimes I can grit my teeth and bear through, and sometimes they are incapacitating, and very occasionally I can only rock back and forth and weep. I’ve always, always been uncomfortable around doctors, and this got much worse after several bad experiences in college, where the doctors at the health clinic refused to prescribe cough medicine for me, despite my nearly retching coughs, because they were afraid I’d sell it on the black market. Combined with a lack of health insurance, this made it much easier to avoid doctors.
When I got my current position, it took 6 months for health insurance to kick in, but I scheduled an appointment and went anyway. I chose a nurse practitioner, because I believed they were generally less blinded by their own egos. I wanted drugs for my migraines, and I wanted to discuss my difficulty with weight loss. I was 192 at 5’2″, my highest weight.
When I told the nurse practitioner I had migraines, she nodded, and told me that “of course” they were caused by my obesity, and triggered by certain foods and overeating. She used the word “preventable.”
In real life, my migraines are actually not triggered by foodstuffs – I’ve kept a journal, and food is not one of the things that triggers them. So I told her that, no, my triggers are mostly barometric pressure changes, fluorescent light overexposure, sun stroke-type conditions, where I exercise too hard in hot conditions, and exercising very strenuously. Some of these things are easy to avoid, but good luck with barometric changes and fluorescent lights.
She didn’t acknowledge this, and repeated advice to stop eating chocolate, red wine, and cheese. These *are* triggers for *some* migraineurs. Just not me. But I think she assumed that because I was giant size 16/18, I couldn’t knock off the dessert, booze, and cheesesteak long enough to see if that would stop the blinding pain behind my left eye. (Fish can also trigger migraines in some people, but notice this wasn’t on the list. Hmmm.)
I told her I’d worked myself down to 1500-1800 calories a day, and anything less than that and the hunger was overwhelming. I thought about food all the time, and I felt miserable about my weight. I was also exercising some, although less since I’d started my restrictive diet, because I was hungry and tired all the time.
It was clear she didn’t believe me, but she let it go for a while. Then she asked if I was eating greens. I told her I was trying, even though I’m not really a big fan. She told me I was going to get osteoporosis, “especially with your body”, and instructed me to start drinking 2-3 glasses of milk a day. Apart from the fact that I don’t really like milk that much, I was concerned about the increase in calories.
“Well,” this medical professional said, “just cut back on the desserts.”
After I agreed, and begged her for drugs, she gave me a prescription for the migraines, but urged me to “move more, eat less.”
I walked three miles home in 95 degree weather (developing a severe migraine), and didn’t eat for a day. I also did not go back for blood tests on cholesterol and pre-diabetes.
I’m exercising much more now – and eating more, including bad food and good food and green food (but no milk – I may never drink the stuff straight again). I have a doctor who doesn’t discuss my weight unless I bring it up, and, despite suggesting Weight Watchers, nods understandingly when I tell her I’m afraid it will only exacerbate my already disordered eating. Despite the fact that I should have been losing weight then, it’s only after eating more like what I want that I’ve begun (very very slowly) to lose weight. I’m 186 now, and every time I have a migraine, I wonder if it’s my fault, even though I know it’s not.