Too fat to get pregnant – need WLS, ob-gyn doesn’t believe patient

Mel writes from Australia:

Hi
I found your blog and thought my story would fit right in.
I don’t have a good relationship with doctors. Frankly they terrify me, and I avoid them at all costs. Before we started trying to conceive I only went once a year for my annual pill prescription and pap smear if needed. My gp is good though, a really lovely person who never tries to tell me it’s all about how fat I am. Unfortunately not all doctors are as helpful.
I have been trying to conceive for more than a year now. In that time I have been to my gp for preliminary tests, taken vitamins every day, cut out the caffeine, watched what I eat and have recently taken up exercise at the gym. Unfortunately I have still not managed to get pregnant and have been having long long cycles with irregular temperatures and heavy bleeding. Off to my gp in January-she was very helpful, sent me off for an ultrasound and some blood tests, mainly general stuff since I hadn’t had any tests for around a decade, but also a GTT. It came back fine-no diabetes, nothing wrong with my girly bits on the ultrasound. She told us to keep trying and come back in a couple of months.
I returned to her in April, still with some crazy issues relating to long long cycles, long periods and no pregnancy. She told me it was fine to keep trying but would like me to see a gynaecologist. She wrote on the referral “Mel has been trying to conceive for more than 12 months but has been unsuccessful. She has a family history of PCOS and is overweight. Please help her with her fertility issue”. Okay I have no problem with what she wrote, it’s all accurate.
Off I trudged to the gynaecologist, test results in hand. In the time between January and May when I saw the gynaecologist I had been exercising and had lost around 15kg, which I thought was a stellar effort and showed I was trying to address the inevitable “you need to lose weight”. My gp had told me to lose 5% of my bodyweight and if my weight was the problem then my cycles would miraculously sort themselves out-after losing the weight there has been no improvement so I thought I had pre-empted their comment.
The first thing out of the gynaecologists mouth was “How much do you weigh”. 135kg. “Do you realise how obese you are?” I then told her I have been working hard to lose weight through diet and exercise, thinking to cut her off before she got into her fatbashing rant. As i explained that I had lost 15kg since January, was doing 90 minutes of cardio at the gym 5 times a week, and eating a low GI low fat low carb diet she rolled her eyes at me in disbelief. Her reply was “You are too fat for a baby. You need to get down to 65kg before I will help you”.
At that point I should have stood up, told her to go f*** herself and walked out but I was stunned. I guess she took the stunned silence as agreement because then she whipped out the lapbanding pamphlet and told me I had to have weight loss surgery. I told her no, not under any circumstances would I do that, it doesn’t work (my aunt had it done and is bigger than she was before), and she then continued to patronise me. She told me I was infertile because I had been on the pill for 15 years, that taking basal body temperatures was a waste of time as they don’t show ovulation, and that I would need ivf to conceive. She could tell all this apparently from looking at me and reading my full blood count, my GTT results and looking at my completely normal ultrasound results. I just sat there as she lectured me about how I had to take pre-natal vitamins (because of course, being fat, I must be stupid and incapable of reading). She told me I must be very lazy because she only had to walk for 30 minutes a day to lose 1/2 a kilogram.
Not once did she ask me about my symptoms, and when I pointed out that I didn’t have the crazy cycles and issues before I went on the pill and I was fat then, she ignored me and kept bringing up the weight loss surgery as the only option available to me. As I left she handed me the weight loss surgery pamphlet and told me to think about it for next time I came. No hope was given, no suggestions on how she was going to investigate or manage the issues I am having in terms of cycles and some pretty severe bleeding, just “you are fat. you are fat. you are fat”.
By the time I left her surgery I was in tears, and as I walked away I had never felt so depressed in my life. All I wanted was a baby, just one, I had walked into her office so full of hope and had been in a really good place before she opened her mouth. I rang my husband and could barely speak, I was so upset. As I told him what had happened he got more and more angry till finally he said “How can you let someone speak to you like that. You are worth so much more than that”. At that point I realised that the strong assertive Me had been turned into the compliant humiliated voiceless Me by someone who didn’t know me, didn’t care about me, and didn’t even behave in a professional manner towards me.
I don’t know what box of cornflakes she got her medical degree off the back of, but if she actually genuinely wanted to help me (even if in her opinion the only possible option was helping me lose weight) then did she really think she was going to get very far by just humiliating me? As for me I am now needing to go off to my gp again for another referral, but I have put it off for the last few weeks because I am not sure if I can face going through that again with another specialist. I thought the Hippocratic oath said “first do no harm” but I guess that emotional damage to a fat person doesn’t count as she didn’t see me as a person, just a big pile of lard.

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Miscarriage, D & C scheduled, doctor suggests WLS

A reader writes:

First I want to say thank you so much for this blog. It makes me angry, but it also helps me feel understood.

I have always been fat. I was a fat child, a fat teenager, and now am a fat adult.

When my husband and I decided to try to have a baby, we discovered that I had a fertility issue (unrelated to my weight) that would prevent any sort of natural conception. Fast forward six years to our second IVF try and we were ecstatic that it worked. Until week 10 when I went in for my first scan and they found that the baby did not have a heartbeat. We were crushed. We decided that I would go off all medication that was supporting the pregnancy and wait for my body to spontaneously abort.

Unfortunately a week later, I ended up in the emergency room, bleeding heavily and in a significant amount of pain. I will say that I in all of these situations, my fertility doctor, the OB who did the first scan, and the ER staff & doctors, all of them treated me with respect and compassion. After receiving some pain medication, I opted to come back the next day for a D&C, considered a same-day surgery.

Here is where my story turns so awful. Because of my husband’s work duties, he was unable to accompany me to the surgery wing the next morning, although he was able to be there before I actually went into surgery and for my recovery. I waited alone for my file to get processed, for the nurse to take my blood pressure and temperature and finally I sat and waited for the anesthesiologist.

I got called back by Dr. H and walked back to sit at his desk. He ignored my medical history (which showed no prior problems with anesthesia at my weight) and began to detail all of the complications that can happen under anesthesia at my weight. Fine. Whatever. I was in a haze and pretty much ignored him unless I was asked a direct question.

But then he looked me in the eye and said, “You know, we have a really excellent bariatric surgery program here. You should think about doing it. You can always get pregnant again later. Your knees will thank you if you do it. I know you’re fine now, but that much extra weight will have a lot of repercussions later on.”

I sat there, stunned. And shamed. And to this day, thinking about it makes me cry. I said nothing in my own defense.

Later as I was laying in pre-op, a chaplain came by and prayed with me. Then he just stood and talked to me for awhile. Out of nowhere, Dr. H comes up to my bedside to check in before surgery. He looks across the bed at the chaplain and says, “I’ve been trying to talk her into doing our bariatric surgery program.”

Did I mention that pre-op is just a bunch of curtained off areas?

Thank God for the chaplain who glared at Dr. H until he left and then just stood with me and held my hand. The shame I felt was indescribable. I was already blaming myself and my body and my weight for being the reason that my baby was gone.

I didn’t tell anyone about what Dr. H said. I didn’t write an angry letter to the hospital. I tried to forget it, but even though that was almost 3 years ago, I remember every second of the horror that I felt. The way that my shame almost choked me.

You don’t have to post my story on your blog, but I felt that this was the time and place to share what happened. Maybe I will go ahead and write that letter telling the hospital how I was treated. I’m fairly new to the Fat Acceptance blog world and it’s going to take me some time to change the way my mind works. I’m hopeful that I can work to put that shame behind me and stop blaming myself for what happened.

Thanks for the venue and for reading this far.

“It Would Be Unethical to Help a Fat Woman Get Pregnant”

Janet writes…

Hi, I saw your call for emails re: bad experiences with doctors. Boy, have I had a ton of them. But this is the most recent, and most painful to date.

To bring you up to speed rather quickly, my husband, “Chuck,” and I have been trying to have a child for the past 4 years. We have had two miscarriages. Finally, we were referred to our friendly neighbourhood fertility specialist. We first met him and he was very nice, and incredibly professional. He saw us, we filled in a 14 page questionnaire, and we talked about the situation. He first thought I had PCOS, which turned out to be not the case. Then he did other tests, and failing all that, he concluded that if I lost a bit of weight it might be helpful. He figured that, hearing that advice from him would be the push I would need in the right direction, I guess. So anyway, he sends me away for three months to work on my weight, which I do. I watch what I eat, I exercise, I enjoy life… I am careful. And we try like hell to have a child naturally.

After the three months are up, and we aren’t pregnant, we head back to his office.

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