Jaundiced? Weight loss will cure that, no need to look for a reason.

Reader A writes:
This touches on fat health a bit but also queer health and mental health. This was all in one thirty-minute whammy of a visit.

I made an appointment for a pap smear because I have been going through a lot of tests and pokes and prods trying to figure out why I have been jaundiced for years, and where my near-constant abdominal pain is stemming from. Also, this is the first time I have had health insurance as an adult (I’m twenty-four) so I wanted to cover all of my bases.
I had never been to a gynecologist before, and as a rape survivor, I feel that I should have at least googled what to expect. After having done said googling post-visit, however, I know that no amount of background knowledge would have prepared me for this encounter.
The receptionist didn’t know what “PCOS” stood for (my GP had suggested screening for poly-cystic ovarian syndrome due to my irregular periods and weight gain) so I waited in the lobby while she asked the doctor what that would fall under in terms of “reason for visit”. I decided to ignore the gospel radio station and hope for the best. After pulling me into a back room, weighing me, and asking me the usual questions about medications and illnesses, the doctor turned to me and asked “so what is this business about PCOS?” I explained that my GP had suggested getting checked out just in case. With a laugh she informed me that doctors try to use PCOS as a catch-all for overweight women. She asked me about my other symptoms, and after I explained about the abdominal pain and jaundice, proceeded to tell me that every one of my symptoms would go away if I would just lose a little weight.
At this point, I am no longer taking anything this woman says seriously.
When she asks me what type of birth control method I am using, I inform her that I am in a relationship with a woman and that we do not use birth control. “Oh, Lord,” she responds. “Let’s just get you looked at.”
Remember when I said that I have never been to a gynecologist before? Keep that in mind when asking yourself why the hell I stayed through what happened next.
Wearing my paper shirt and blanket, hunched over the edge of the table, I had an idea of what was coming next. I explained that I have never had a pap smear before and that I was nervous about the procedure. She laughed and told me there was nothing to be nervous about. She inserted the metal thingy into my vagina thingy and I immediately froze because of the pain. I stopped responding to her nonsense questions about what I do for a living and whether or not I exercise. Instead of checking to see what was wrong, she just stopped asking them.
When it came time for her to use her fingers to complete the exam, I was feeling numb and dissociated. That ended abruptly when she inserted FOUR fingers into me, causing me to emit a low-grade shriek. After this she giggled, said “I guess we just need one, huh?” and proceeded with the exam with one finger. I could already tell that I was bleeding- this was confirmed for me when I dressed myself and cried after she had left the room.
As the final segment of the exam, the doctor handed me an ipad with twenty or so questions on it regarding my emotional state. After I answered, she looked them over and said: “If you want to have any kind of quality of life, you should really get on a medication. It’s obvious that you are bipolar.”
This has made me so much more cautious about selecting physicians. I know that it’s going to take some work to set foot into any gynecologist’s office again, but I also know that not all of them are like this.

Migraines, PCOS – “caused” by being fat

SW writes:
About six years ago I moved to a new area with my (now) husband and got a new job. It was my first time living so far from where I grew up, and the first time I had to be totally self-supporting, so I was pretty stressed at the time. I had been having panic attacks, although at the time, I didn’t know that’s what they were, and when I was having them, I thought I was having heart attacks.

I went to a new doctor, who ran tests to make sure my heart was operating the way it’s supposed to (it was), and surmised that I was having stress induced panic attacks. She suggested mindfulness exercises, and other ways to do relaxing self care, which has helped me manage stress in my life. I remember feeling satisfied with the level of care at the time. She suggested I make an appointment to do a full physical workup and a Pap and pelvic exam, since I hadn’t had one in two years. I made the appointment.

What happened at that appointment was vastly different from what I had previously experienced with this doctor. I am not sure why she didn’t fat shame me at the first appointment, but at the second one, she made a point of telling me over and over that I needed to follow the plate diet (eating food off of smaller plates, and portioning the plate with veggies, a small amount of meat, and an even smaller amount of grains), needed to exercise more, and that she was very concerned about how much I weighed (190lbs., 5’7″). I had actually tried talking to her about migraines, but she didn’t seem interested in hearing about them, and expressed that if I just lost weight, I would have less “headaches”. I had also asked her about birth control options, since my partner and I wanted to have sex without condoms. I explained to her that I had been on the pill in the past, and that the ones with estrogen made me feel very sick, and that I didn’t like taking them. She prescribed a pill to me that has estrogen in it.

On subsequent visits, this doctor would not listen to me about any health issues I was having. Even though my sex drive had diminished to nothingness, my migraines had gotten more frequent (from about 6 a year, to one every month, like clockwork, around the time I got my period) and more intense, I was feeling depressed and anxious, and had a high level of fatigue a good portion of the time (all side effects of the estrogen based borth control pill). None of that mattered, she just wanted to talk about ways I could lose weight. No matter that I told her I ate a well balanced diet, and exercised on a regular basis; she just thought I was lying.

Anyway, fast forward a year and a half. I had lost my health insurance because I quit my job to finish my Masters degree, so I had to stop seeing that doctor whether I wanted to or not, and I had run out of BC pills. I ended up going to Planned Parenthood to get a new prescription, because they have a sliding scale of fees for people who are low income (the appointment ended up being free). The doctor asked me about my migraines. The ones I have tend to be accompanied with an aura, which, as it turns out, means I should not have been taking birth control pills that had estrogen in them. Because they can significantly increase my chance of stroke. So the first doctor I saw was so blinded by my fat, she prescribed me medication that could have killed me, or caused devastating brain damage. Awesome.

I have a new job and different health insurance now, and a couple of months ago, my husband and I decided to start trying to get pregnant. I went to the doctor to make sure all my stuff is healthy. The new doctor asked me many questions and was suspiocious of my infrequent and irregular periods, and decided to run some tests. She suspected I may have polycystic ovary syndrome, and wanted to check things out to make sure. Welp, my test results came back, and yes, I do, indeed, have PCOS. Which is a big reason why I am fat, and why I carry most of that fat in my midsection. She has started to treat my PCOS, and has never once shamed me for being fat. In fact, she was sympathetic to me, and even contemptuous of the treatment I had received because I am fat (she rolled her eyes when I told her how the last doctor had treated me). She expressed that she knows it must have been difficult for me to not know what was causing all my strange symptoms that all suddenly made sense, but have people just assume it was because I was fat. I am 31 years old, and have never had a doctor treat me as kindly as the one I have now. She even gave me a hug when I cried over my diagnosis (because it can cause infertility and I was very upset by that)!

I am still angry at the incompetence and fat-shaming of the first doctor, but I am really grateful to finally have a doctor who seems to understand and actually care about me, the person, rather than my fat.

Lots of strange symptoms? Nothing that weight loss won’t cure!

Kae writes:

I have always been heavy for my height. However, as a child and teen I was also very active and generally healthy and so for a long time I only weighed 15-25 lbs more than I was “supposed” to. However, around the time I turned 16 my family’s regular doctor (whom we all loved) was preparing to retire and her office hired a new doctor to replace her. Unfortunately, this new doctor had a bad reputation for being dismissive and impatient. One friend whose mother used to go to him at his former office had nothing good to say about him. He had misdiagnosed her and the medicine he put her on made her illness worse. She switched doctors and warned everyone to avoid her old doctor if they could. Sadly, our insurance gave us limited options as far as primary docs were concerned and so we had to see him until we were eventually allowed to change providers.

My father hated him. He said he was rude and arrogant toward him. My mother disliked him because he never fully listened to her and basically ignored what little he did hear. Then I met him. At the time I was experiencing some strange symptoms. My periods were irregular and very heavy and painful, I was growing hair in unwanted places, and I was losing the hair on my head. Worst of all, I began to gain weight rapidly even though my eating habits and mobility had not changed. At the time I also suffered from terrible allergies that made it impossible to breathe through my nose. It was primarily because of the allergies that I went to see him. He took one look at me and suggested I lose weight. I then explained about all of the things I was experiencing and he dismissed it all, saying that all I needed was to try harder to lose weight and that everything would magically right itself.

His dismissal of my symptoms dismayed me, but as he didn’t indicate anything else might be wrong, I let it go. However, his blithe attitude also made me wary of doctors and I only ever saw one after that if I was really sick. Fast forward five years. I was 22 and newly married and I had just learned that I was pregnant. Because I now had different insurance I had to scramble to find a new OB/GYN. After a few let-downs I ended up with the nicest of doctors. During my first exam my new doc shook my hand, looked me over (while I was still fully clothed) and said, “I want you to get your thyroid checked.” When I asked why, she said that I had several very obvious outward signs of hypothyroidism and she was very surprised that no doctor had had me tested for it yet. We talked for a while about my symptoms: Unusual body hair growth, thinning head hair, painful and irregular periods, abrupt weight gain, and the fact that exercising wasn’t helping to take it off. She ordered the blood work and I had it done the next day.

Sadly, it was not quickly enough. I had a devastating miscarriage a week later, and although my doc said that anything could have triggered it, she surmised that my severe hypothyroidism was an attributing factor. The blood tests came back the day after the miscarriage and I was immediately put on thyroid medicine. Within three months my periods became lighter and more regular, my hair became thicker, and I dropped 30 lbs. I also became pregnant again and 39 weeks later I gave birth to a healthy baby girl.

Still, whenever I think back on it I get angry. If that bastard doctor had actually taken the time to listen to me or to see more than my weight, would my first child have survived? I do know that if I had been properly diagnosed when I was 16 I wouldn’t have had nearly as many problems as I ended up with.

Health problems? They’re all caused by your fat, even the ones you had BEFORE you were fat!

Chai writes:

My problems began when I was involved in a gymnastics accident, that left me with recurring back, neck and left shoulder pain (still not officially diagnosed to this day). It left me unable to do anything more than mild exercise without pain. Two years later, I got an extremely bad flu which left me bed-ridden for 4 months. Over those 4 months I gained weight. I went from malnourished and underweight to overweight fairly quickly. From there on, I gained weight.

I will state now, that I am not yet morbidly obese, but I am fairly overweight.

I walked a lot, and used public transport. I couldn’t seem to lose any weight. After a long battle with Irregular bleeding I was referred to a gyno. The first lady was awesome. The problem was officially diagnosed as PCOS and she advised me to lose 5% of my weight, but understood that putting a number to my weight would do me more harm than help. My theory is that I could work on losing weight more effectively if I didn’t have to feel bad about the number that is my weight. She tried putting me on the pill to help with the PCOS, it didn’t help, it just made my problems worse.

In between appointments (which was a number of months due to the public health system) I changed GP’s. I found an awesome GP who understood my problem and didn’t judge me for it. She re- referred me to the gyno. I still see this GP.

The next appointment, I had this young registrar. I told her how bad things had gotten for me over the period between the first appointment and the current one. My life had gone to shambles. I’d gained more weight, been miserable, had no sex life (at this point I had been married just under a year…. No sex is sooooo not cool for newly weds) and was always tired. She gave me an exam and made the comment that I seemed to be so hairy. Then she asked if this was a recent thing. I answered truthfully and told her that my grandparents and parents had always said I used to be a hairy child (a fine blonde layer of hair (also co-incidentally a symptom of PCOS)).

Then this doctor changed tactics. First she accused me of not trying the pill (uh hello! its on my file that I tried it!), then she moved onto saying ALL my problems were caused by my weight. My lack of sleep, my bleeding, my pcos, my injury…. everything! Yes that’s right folks, EVERYTHING is caused by my weight. Now, I’m the first to admit that, yes, I need to lose weight…… But to be told my a medical professional that all my problems were caused by my weight (even my prior to weight gain problems), I cried on the inside. When I got home after the tests she ordered, I cried in my husband’s arms, not really understanding how a doctor could be so mean and dismissive of my problems, when I’d been referred there for a reason.

I went on to get mirena prescribed and I hope to god that I never meet this doctor again. Because I never want to feel as horrible as I did the day that doctor decided that because I wasn’t skinny, that my weight was the cause of all my problems.

Enlarged thyroid nothing to worry about – Get a 2nd opinion!

Hello, I’m vesta44, I moderate First do No Harm, and this is my story about mismanaged medical care and the 4 years I waited to get it taken care of.
Backstory is that I’ve been fat for 30-some years of my life, my blood pressure, blood sugar, and cholesterol have always been in the normal range (I’m 57 now, soon to be 58). In 1997, I had WLS that made me fatter, made my mobility issues worse, and did nothing to make doctors look past my fat for the real reasons for those mobility issues. I was told they were caused by my fat, follow the Nightmare on ELMM Street (eat less/move more) and I would be magically cured.
So for years, I stayed away from doctors unless I had a sinus infection or a serious cold that needed to be treated. After all, who needs to be constantly told that every ailment they have is caused by their fat and that dieting, which has failed so many times in the past, is the only cure?
Then 5 years ago, I met and married a wonderful man. He said I really should get a physical, see how my health was, make sure everything was ok. I had moved to where he lives, so I found a doctor there and made an appointment. Everything checks out normal, other than my thyroid is enlarged, which Dr W says is nothing to be concerned about. Okay, I believe her, until 2 years later, when I’m at my dad’s house for my mother’s memorial service and we’re talking about family health history. My mother has a history of thyroid problems (hypothyroidism), and my dad’s dad had an enlarged thyroid removed that was cancerous. They couldn’t remove all of it – it was so large by the time they got around to removing it that if they had taken it all, they would have cut the nerves that controlled speech and swallowing – he wouldn’t have been able to talk or swallow. They gave him 3 months to live (he was 87 at the time), and he lived to the age of 90.
So I come back, and at my next appointment with my doctor, I tell her all of this family history, and that I’m concerned about my enlarged thyroid. She still says it’s nothing to worry about, and then says I’m using this as an excuse for being fat. Now she and I have had our words about my weight before, several times. I’ve told her my weight is not a topic for discussion unless I’ve gained or lost a large amount in a short period of time (which has never happened). Still she pushes ELMM, still I tell her diets don’t work, diet drugs don’t work, and WLS doesn’t fucking work, what the hell else am I supposed to do? STFU and give me a referral to an enodocrinologist who knows what they’re talking about when it comes to this kind of thing. Dr W refuses. I get mad and walk out on her, go home and think for a week, find my own endo, then go back and demand that she give me a referral or I’ll find another doctor that will. She reluctantly gives me the referral.
I see the endo, we have an ultrasound done, and yeah, my thyroid is enlarged. Dr A says it’s pretty big and it should come out. I’m not real hip on surgery, but she gives me the name of a surgeon who does thyroidectomies all the time and she’s good. I talk to Dr M, we decide to wait 6 months, do another ultrasound, see if my thyroid is staying the same or growing.
Well, the 2nd ultrasound showed that my thyroid was growing, so we decided it had to come out. Scheduled the surgery, was supposed to be 3 hours, took 4 1/2 hours. My thyroid was so large, it had almost wrapped around my wind pipe, and my esophagus. Dr M said she was surprised I could swallow anything other than liquids, it was compressing my esophagus so much. She also says it should have come out when it was first found that I had an enlarged thyroid.
Just goes to show what you know, Dr W, nothing to worry about, right? I guess I should have just let it keep growing until I couldn’t eat at all, then maybe I’d have lost weight like Dr W thought I should (I am so glad I fired her). So my enlarged thyroid is gone, I’m started on Levoxyl and following up with my endo on that. Everything turned out fine, but only because I finally demanded that my doctor take my concerns seriously and give me the referral to someone who knew more about my condition than she did. (and I’m still avoiding general practitioners, I can’t find one in this area who isn’t fat-phobic and practices HAES).

Hypothyroid? Nah, just eat better, move more.

DW writes:

I hadn’t been feeling right for many months and went to see an
endocrinologist at Columbia Presbyterian in NYC who was highly
recommended. I explained my symptoms – fatigue, restlessness,
thinning hair, and inexplicable weight gain despite the fact I am
active. I was pretty sure I was suffering from some thyroid
malfunction as there is a history of thyroid disease on my
mother’s side of the family. My mother is hypothyroid, her mother
was hypothyroid, HER mother was hypothyroid. See the pattern?
After poking, prodding, blood work, etc. he finally calls me and
tells me nothing is wrong with me hormonally; I should eat better
and exercise more. Excuse me? I paid you $500.00 out of network
for THAT? I was so angry that my symptoms were dismissed because
of mere numbers on a page of lab work. Fast forward eight months.
I see ANOTHER physician at the same hospital who looks at the
SAME EXACT lab work and tells me that YES, my thyroid is
under-functioning at the sub clinical level (the gray area where
treatment is not usually prescribed) and, hey, isn’t that far too
much insulin in your blood? Turns out that I am pre-diabetic
(also my mother’s side of the family), have a mildly
under-functioning thyroid, and produce no progesterone. HELLO –
did I mention she read the SAME LAB WORK? She told me it was no
wonder that I felt terrible all the time, my body was producing
way to much insulin and I was on my way to diabetes. Which for me
is a GENETIC, not a fat, disease. As per her, a diabetes
researcher, there is little I can do to affect my inherited
genetic makeup. I am now on a medication for insulin resistance
and will be considering taking meds for thyroid disease at my
next appointment.

What angers me the most is that she could tell all of this by
looking at the existing blood work her colleague had drawn and
read. Did he fail to notice the huge discrepancy between normal
insulin production and thyroid function or did he just see me as
another complainer about my weight looking for a fix? What a
jerk of a doctor. I am 5’3, 180 pounds, a bra size of 36 DD, a
size 12 Gap jeans and a BMI of 30 (I think). In medical terms,
obese. Never mind that I am a massage therapist, a former dancer
& cheerleader, a trained yoga instructor, and my blood pressure
is great. I walk 3-4 miles 2-3 times a week and I eat all organic
fruits & veggies, lean meats, etc. NO fast foods EVER. No pizza,
no chips, no fries, no candy. Every doctor tells me to lose
weight, that my BMI is too high. What a load of crap. I am a size
6 at the high “normal” range of the BMI for my height. I look
like a skeleton at that weight. Totally unattractive and
unhealthy for me. I went to him because I felt awful and the
best he could tell me was to go on a diet. Gee, thanks. My
husband and his sister are both physicians and they cannot
understand why I dislike and mistrust doctors OH SO much. They
have never had to endure these “just lose wait” pat answers to
just about every ailment they have ever had, including a freakin’

It’s not a tumor – You’re just lazy and eat too much

Lilacsigal writes…

At the start of 1998, I was a large but healthy postgraduate student, aged 24 – I was a pear-shaped 90kg at a height of 169cm, (a BMI of 31.5) I didn’t own a car and cycled everywhere, and had no health issues. Over the next few months, I started to feel depressed and lethargic, and started to gain weight, despite eating less because I was too tired to eat. I exercised less, as I was too tired to cycle, and was gaining huge amounts of weight.

I went to the University Health Clinic again and again, telling them I was exhausted and depressed, and after six months of three doctors telling me I was just overweight (and one telling me that if I didn’t lose weight I would die), the doctor I saw most often put me on antidepressants and sent me to the counselling centre. By the end of 1998 I was so exhausted that I would spend days at time in bed, unable to move, and was still gaining large amounts of weight. At this stage, I had gained 35kg – over a third of my body weight again – in less than a year. According to the doctors, this was because I ate too much and didn’t exercise.

They referred me to a dietician, but I couldn’t take her advice because I was too tired to shop or cook. By now, I had to put my government postgraduate scholarship on hold and go onto sickness benefits, as I could no longer read more than a few pages at a time without sleeping – previously I had been reading between 2 and 4 books a day. As 1999 went on, I found an antidepressant that helped me not have bouts of suicidal thoughts, though I was still exhausted and hopeless. I had now developed severe dizziness on top of the weight gain and lethargy and was spending most days in bed.

I would emphasise that at no time did I disagree with the doctor’s assessment that the weight gain was my own fault – I thought that I was being lazy and obviously eating too much.

My parents and friends (with the exception of my girlfriend) were also concerned about my weight and thought that I should exercise more. With the dizziness and extreme fatigue, this was impossible, and by early September 1999 I weighed 135kg (a BMI of 47.5). The doctor thought I might have Chronic Fatigue Syndrome, but at this point, she became concerned with my dizziness and sent me to an audiologist to have my middle and inner ears checked. The audiologist checked my hearing and performed a few basic tests, then was so concerned about my dizziness that he sent me for a test to see if I had a brain tumour. This test was negative, and the audiologist performed more balance tests – in the process, he put his hand under my ear, his thumb touching my throat, and noticed that I had a swelling on my thyroid.

The audiologist – the only health professional not focused on my weight – was the only one to notice that I had a 4cm palpable growth on my thyroid.

Back to the doctor for a thyroid hormone test – the results came back as abnormally low. Low thyroid hormone produces fatigue and weight gain. She then sent me to have an ultrasound, which revealed the growth, and I was referred to a thyroid specialist. This specialist did not focus on my weight, but was very professional and helpful – I had further tests, including a nuclear medicine scan and several biopsies, all of which were inconclusive. On December 30th, 1999, now weighing 145kg, the left half of my thyroid was removed. It turned out to be a malignancy, which had grown a full centimetre in the 12 weeks since the first scan. Fortunately, further scans and biopsies showed that the malignancy had not spread beyond the left half of my thyroid, so I did not have to have radiation therapy.

The specialist told me that if my treatment had been delayed another five weeks, the tumour would have expanded past the thyroid, and from there it is a lot more difficult to treat.

It’s taken me a long time to recover from the anger and suspicion of this treatment, and I moved to a new town with my girlfriend and saw new doctors who had no problems with my weight – they were focused on my health, instead, which was a pleasant surprise. I still have to have blood tests, thyroid palpation, X-rays and ultrasounds at regular intervals to make sure that the cancer hasn’t returned, and it’s taken years to get my thyroid medication right, but I am again in good health. I’m still on anti-depressants, though, and now have no contact with the friends that were pleased to find out that I wasn’t just fat, I had a “real disease”, and am still angry at my parents for thinking that my weight gain was a fault of mine, rather than supporting and helping me when I was seriously ill.