‘ve been pudgy, if not downright fat, my entire life. At my thinnest, I was 125 and a size 10/12 – after months of starving myself because I couldn’t afford to eat. When I stopped growing in fifth grade, I went from 110 to about 135 for the rest of my adolescence. My first sign of trouble was my pediatrician, who poked me in the belly and said kindly that he thought it was probably just “baby fat”.
Since then it feels like nearly every interaction with a doctor involves a “conversation” about my weight. I’m five feet tall – actually, just under – and somewhere around 250 pounds right now. I have stopped allowing myself to be weighed in the doctor’s offices, no matter how much the nurse wheedles me. So I don’t know exactly what I weigh. About eight years (and sixty pounds or so) ago, I was referred to a reproductive endocrinologist. Since my periods began, they’ve been irregular and miserable experiences. I can’t plot myself on a 28-day chart like “normal” women can. Because of my weight, they assumed I had PCOS. I was told to lose weight, that being fat caused PCOS. I was put on Glucophage, which reacts very badly with me. If I eat it with food, it all slides right out the other end inside of a few hours. So I stopped taking it. I allowed the doctors to lead me to believe that I had PCOS and it was because I was fat.
It’s always the same song and dance with doctors – “You eat too much sugar. Too many starches.” But if a calorie is a calorie, and we have to expend more than we take in, why does it matter WHAT form the calories take? The more I ponder these issues the more I am led to believe that the majority of doctors simply parrot what they’ve heard from others.
I have had issues with my gastrological health for about 15 years. I am easily made ill by foods, either in the form of vomiting or diarrhea. I was referred to a specialist, a gastroenterologist, who looked at my labs and announced I had fatty liver disease. She said it was because I ate too much fat. She poked me in the belly and said, “Your liver is fat because your belly is fat. Our organs on the inside look like how we look on the outside.” She was, of course, tall and thin. Humiliated, I haven’t been back to see her.
The worst treatment so far has been from a gynecologist. He was an old-school type, not far from retirement, and somewhat stout himself. I asked him about the Essure alternative to tubal ligation, which puts metal coils in your tubes to create scar tissue to prevent eggs from moving down. He had never heard of it, and assumed I was asking for a uterine ablation, which he told me “didn’t always work” and that pregnancy was still possible. (Not like I’m fertile, but I don’t like to take chances.) I let him talk me into an old-fashioned tubal ligation. We scheduled the procedure in their in-office surgical center. When I woke up after the procedure, my throat was raw and I had phlegm in my throat – my asthma had kicked in, and I had to remove the oxygen mask to cough it up. As I was coming to, the doctor let me know the procedure had “failed”. As I was in the recovery room – filled with other patients – he outright told me that his instruments were not long enough to reach from my belly button (point of entry) to the tubes because I was too fat. “Lose 100 pounds and come back,” he advised. I was sobbing, and my husband was trying hard to comfort me, but all I could feel was failure. It failed because of me, because I was fat. Then the hot anger bubbled up – not only was this asshole telling me he was too incompetent to deal with some belly fat, but he was doing so in front of a room full of other people who by now were ALL staring and listening to my doctor tell me how fat I was and how everything had failed because of that.
I have a wonderful new gynecologist, who never makes me feel like a second-class patient because of my size. I chatted with her, and she expressed sympathy for my dealings with the “old-school” ob/gyn. She is a relatively recent graduate, and keeps current in her field. Even though I am childfree, she suggested that a Mirena IUD would be the best of both worlds – it would stop my periods and be solid, dependable birth control that I wouldn’t have to worry about pills for. She was even able to perform the insertion the same day, saying, “You’re doing very well, and when I say ‘you’re doing very well’ I mean ‘you have an amazingly high pain tolerance’.”
She’s been sympathetic about my fibromyalgia as well, which was only diagnosed in 2007. I suspect I’ve been “coming down” with it for quite some time. Joints, muscles, tendons ache for no reason. My muscles turn into knobby hot-spots of pain. Recently I was having a lot of what I suspected was uterine pain, and I went to see my wonderful gynecologist about it. She poked around, did an ultrasound, and showed me that my IUD was in the correct place, the strings were also in the correct place, and then she took a look at the muscles of the pelvic floor. When I nearly jumped off the table, she popped her head up and announced, “I know what the problem is!” (That’s the first time I’ve heard that phrase in, ever, I think.) She explained that I was having myofascial muscle cramps, and referred me to a local physical therapy location that has a specialization in pelvic pain.
I was in such a good mood after seeing her, that I went to go get blood drawn for my labs that had been ordered by my rheumatologist. For the past several years, I’ve been trying to take care of my liver. I’ve stopped drinking, and I cannot eat fatty foods anymore. Anything with grease runs right through me. I subsist on yogurt and granola bars, trying to keep probiotics in my intestines. I work a full-time job as a UNIX systems administrator, and am exhausted when I come home from work. I snack, and lie down by 8pm every single night. My blood sugar, my blood pressure, all my labs are usually normal. But then I got diagnosed with fibro, and have been on vicodin ever since. Vicodin includes paracetamol both to increase the efficacy but also to “safeguard” against taking too much; you’ll screw your liver. I was in so much pain when I had my blood drawn, I had taken four vicodin the day before. I also had not eaten in 18 hours. But my doctor sent me this note on the online service yesterday:
I saw on your recent labs blood sugar and one liver function test were minimally high.
As a reminder, try to should exercise 1/2-1 hour most days of the week, lose some weight, and limit sweets and starches such as bread, potatoes, rice, and pasta to keep the blood sugar down and avoid diabetes in the future. We should recheck these tests in 3-6 months.
Let me know if you have any questions.
I was utterly livid. I left a profanity-laced voicemail for him, blasting the “doctor boilerplate”, and reminding him of what he had told my diabetic husband a couple weeks ago – if you don’t eat, your liver will pump out sugar to keep you UPRIGHT. I even made it into bullet points:
1) I’d love to be able to exercise like a normal person. Please tell me where in the working a full-time job, being sick, and being so exhausted I go to bed at 8pm I can schedule an hour of exercise every day.
2) Lose some weight. How about you… grow some hair? Extend your penis size? Can’t do either of those permanently? Gee I wonder why.
3) EATING SUGAR DOES NOT CAUSE DIABETES FFS.
4) I CAN’T EAT ANYTHING ANYWAY. I eat yogurt and granola bars and anything with FAT in it causes me to be on the can for 18 hours afterwards.
5) In this particular incident I had hardly eaten the day before and hadn’t eaten at all that day, and after a while the liver does a desperate dump of sugar into the blood so as to help the body remain upright.
6) I take paracetamol EVERY DAMNED DAY and you think it’s my WEIGHT causing my liver enzymes to go up?
7) To sum up, FUCK YOU VERY MUCH.
I am not sure I can go back to this doctor. Originally he had been saying things like, “We’ll get you working on your weight when you can exercise,” so the bullshit he sent me was even more of a slap in the face. I wistfully asked my gynecologist if I could just see her as a general physician; she suggested my current doctor would be better than her. After this, I don’t think so.
I am sorry for the length of this. I’ve been dealing with this for so long, FatHealth is one of the only things that keeps me from believing that it’s “all in my head” or that if I bought into the FOBT everything would be okay. I’d still be a clinically depressed fibromyalgiac, I’d just be a thin one.