You’re not sick, you’re just fat

Jack writes:

When I was in college, I’d started seeing a doctor at the university clinic for migraines. I was finally prompted to get help for them after self-medicating with OTC pain killers to the point where I burned a hole in the lining of my stomach. At the same time, I was hit with several concurrent stressful situations (grandfather’s death, relationship ending, etc.) and a bout of stomach flu that left me lactose intolerant. The doctor that I saw was wonderful and, though we discussed me being overweight, it was only because I brought it up. She focused on the problems that actually needed to be addressed.

Fast forward to several months later. A nasty sinus infection had been hanging around me for weeks. I was finally able to see the visiting ENT, who put me on a high-dose decongestant and recommended sinus surgery. Shortly after, I began feeling dizzy at weird times and found it much more tiring to climb stairs. I hadn’t gained or lost any weight and was actually taking better care of myself, thanks to the advice of my acupuncturist. So, thinking there must be something wrong, I made an appointment with my regular doctor. Except she was out on indefinite personal leave, so I got to see her replacement instead.

The doctor took one look at my chart and informed me that I was obese. I’m about 5’9″, male, and at the time was probably around 200-210. Most nurses make me get on the scale multiple times because they don’t believe what it says. Especially at the time, I looked relatively fit, though a bit overweight. So to hear, in an extremely annoyed tone (because of course it was wrong of me to be so) that I was clinically obese was quite a shock. She then proceeded to go over my blood pressure results (something like 130/80) and tell me that I was on the fast track to heart disease. At 20 years old, I left the office over an hour later with an appointment for an EKG, a cholesterol test, and a prescription for blood pressure medication. I broke down just outside the clinic.

I went back for my EKG, which was normal, made an appointment on my own with the clinic’s nutritionist, and never went for the cholesterol test. I was too ashamed. I filled the script and dutifully began taking the medication. I convinced myself that the doctor was right, that years of being overweight had finally caught up with me and I was going to die sooner than any of my fat family. This did wonders for my depression and anxiety, mind you.

Being that my life was going through a lot of stress, I sometimes forgot to take my medication on time. This sparked a chain reaction that had me living in terror of what I’d done to myself for the next year and a half. If I didn’t take my medication daily, I’d notice my pulse starting to race while lying or sitting down, weird dizzy spells or lightheadedness, or extreme waves of fatigue. I assumed this was because my bad, fatty body was trying to kill my heart and I would reach for the BP meds. As long as I took them regularly, these spells were kept to a minimum.

After a few months, I was finally able to see my regular doctor. I filled her in on my experiences on the medication and she paused and stared at the chart. She then asked me to clarify when I’d taken the decongestants for my sinus problems. What the other doctor had blatantly ignored was that the meds the ENT had given me were frequently responsible for huge spikes in blood pressure and occasional dizziness. The diagnosis of hypertension was almost entirely based on the symptoms I had from that medication – that, and being fat. What happened after, however, still confounds me.

We decided that, because I felt okay as long as I took the BP meds, that I should continue taking them. I came in for regular BP checks, which were always normal. Still, it took my regular doctor over a year to say, “Oh, by the way. That BP medication you’re still taking? A side effect of withdrawal is heart palpitations, erratic pulse, and BP fluxuation.” The meds were so fast-cycling that even going 12 hours without them could start these symptoms. I immediately threw the bottle in a cabinet and decided to wait out the symptoms. After a few days, I felt just as good as I had on them – better, even, because even the occasional spells were gone. And my subsequent BP checks remained in the perfect range.

For over a year and a half, I took a medication that made me sick, for a condition I didn’t have, because of a diagnosis based on side effects of another medication. And all because a doctor refused to put down the BMI chart and look at the scared patient sitting directly in front of her.

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9 Comments

  1. abby

     /  October 15, 2009

    I am so sorry, Jack. Your last line gets to the heart of the matter perfectly.

    Reply
  2. Lillian

     /  October 15, 2009

    I had that happen when I was pregnant with my second. I was barely overweight, but the nurse insisted that I was obese. She told me not to gain weight with my pregnancy. I didn’t listen to her and gained as much weight as I could (22 pounds) and delivered a heavy baby on his due date.

    Reply
  3. inge

     /  October 15, 2009

    Doctors seem especially keen on taking blood pressure right after saying something that makes one want to whack them with a dead halibut.

    Reply
  4. tanz33

     /  October 16, 2009

    Jack – you did not deserve to be treated that way. It was uncalled for.

    I am pregnant for the second time, and it wasn’t planned. We were using a form of birth control other than my preferred one; the combined pill. Why? They refused to give it to me, because I tested really high with my blood pressure last time they took it. When did they take it? Immediately after an extremely uncomfortable smear test administered by a new Doc I didn’t know. And when I raised the issue of why the reading was so high (the way it was taken, not my fat) I was dismissed.

    Hello baby.

    Reply
  5. I’m so sorry that you had this experience.

    Unfortunately I do not think it is entirely unique.

    Reply
  6. bloomingpsycho

     /  October 16, 2009

    These doctors deserve to have their license to practice medicine revoked.

    Reply
  7. Jack

     /  October 18, 2009

    @bloomingpsycho: While we need to speak out about actual discrimination and work toward a community where people are seen as ‘people’ and not a conglomeration of health problems, I don’t think it’s effective to take such a hard line against them. In the case where they actively do harm, such as with several of the more heart-rending stories on this blog, yes, they should be subject to a medical review board.

    It’s also important to remember, however, that many people aren’t conscious of fat pride, fat awareness, or similar movements. Doctors may assume that overweight women want to lose weight; many probably don’t realize that these assumptions contribute to the insecurity about weight that makes that stereotype so prevalent. While it doesn’t excuse them for their ignorance, it should give us caution about how we react to them.

    In the case of my bungled medical situation, I dealt with a doctor who was obviously lacking in compassion, tact, and any shred of a good bedside manner. Her medical training told her that the BMI was a good standard to use, but her lack of empathy prevented her from seeing that it probably didn’t apply to me. Both doctors neglected to consider medication side effects, but fortunately the physical harm was kept to a minimum. It’s the emotional harm that persists and it is because of that that I feel we need to approach these situations with a more mature and compassionate demeanor than that in which our doctors approach us.

    Thank you everyone for your words of support. It’s been several years, but I’m sure most of you are well aware that the shame and self-hate take a long time to go away.

    Reply
  8. Maggie

     /  October 28, 2009

    Wow…this is the most irresponsible handling of blood pressure I’ve ever heard. I’m Canadian, but I used to live in America while my parents were being treated for blood pressure there, so I know my experiences with blood pressure treatment aren’t unique to Canada.

    I have deadly hypertension on both sides of the family, so I’ve had my blood pressure monitored since I was in college. A few years ago (in my mid-20s) my blood pressure started rising at the same time that I started having other health problems (migraines, vomiting, etc.) and I gained enough weight to officially push me from overweight to obese. My family doctor said it was probably in reaction to my stress levels with the vomiting and he wouldn’t assume I was hypertensive yet. Then I moved, my vomiting got better and then came back, and I saw a number of doctors about it–gastro guys, gynos, etc. None of them saw anything wrong with me except an elevated blood pressure, but they all said the same thing about it–“talk to your family doctor, have him monitor you for hypertension, but it’s not causing your vomiting.” Over the last 8 months my family doctor’s taken my blood pressure with a variety of meters and had me monitor it at home, until a few months ago he finally went for an ambulatory blood pressure test (where a meter is hooked up to you all day and takes your BP every half hour). When he got those results, he told me my ambulatory wasn’t really raised and he trusted that more than individual readings in his office or at home where I was worried about being hypertensive. He decided not to put me on BP meds, and then recommended me to an internist about the vomiting.

    This is what I was put through as someone who’s fat, ill, AND has lost many family members to hypertension. Do you know why? BECAUSE BP MEDICATION IS REALLY F’ING SERIOUS. Once you’re on it, you’re generally on it for life, and they need to MONITOR you when you’re on it to make sure it’s working right (dosing can be very difficult and side effects can be severe).

    So you were 20 and not feeling well so some replacement doctor just threw BP meds at you? And your doctor came back and didn’t want to take you off them–you had to take YOURSELF off cold turkey and risk all the complications? Your doctors should face the med board, because that was dangerously irresponsible.

    Reply
  9. LadyGrey

     /  November 8, 2009

    Damn. You’re not supposed to diagnose someone with high blood pressure unless you get elevated reading on two separate occasions (unless it’s _extremely_ high). Starting someone on medication for it being 130/80 is not in line with any guidelines for treating hypertension.

    Reply

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