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.

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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.

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.

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.

PCOS isn’t a real disease, it’s made up by fat women.

Susanne writes:

From 1999-2001 I was suddenly health insured again and although I was living about 150 mi away from the specialists I eventually needed to see, I decided to have a thorough checkup. I am significantly overweight and qualify as morbidly obese; strangely, most doctors observe, I don’t seem to have the expected health problems from it, but for various reasons I wouldn’t mind losing about half of my body weight, which would still make me overweight, but not as much. I’d like to be able to buy clothing in a local clothing store, and I guess I admit I’d like people not to stare at me on the street. Three different diets didn’t help much (20 pounds off), and the exercise typically recommended for people in my situation didn’t seem to impact me much, either. The results of that push to get treated were, after many trips back and forth, a doctor supervised diet and exercise plan, a lot of tests, a few procedures, a preliminary diagnosis of PCOS. Just as I was ready to start treatment for that, I had to change jobs and move about 1,000 miles away to a different city. When I changed jobs, I had a six month exclusion of treatment on my new policy for anything that was a pre-existing condition. After the six months were over, I went to a gynecological practice that was recommended univocally by a number of my new female colleagues. I was lucky enough to have doctors in the first city who gave me a copy of all the test results and treatment attempts, and I took this file of paper along with me expecting to pick up where I had left off. I have never been so humiliated. A robe that covered a third of my body, a nurse who addressed me by my first name in a town and culture where the usual form of address is Ms or Mrs., insulted me by telling me straight out that my stomach is disgusting, and then read my blood pressure four times because she didn’t believe anyone at my weight could have a bp of 120/90, and a gynecologist who took one look at me, and even before doing the basic gynecological check, started a checklist of new procedures she wished to perform on me because something was wrong (as I stated that I had irregular, weird periods). “I am going to give a prescription to start your period immediately, you should probably go on birth control, you will have to have an immediate biopsy, and let’s see, we’ll start with thyroid”…and my reply was “actually, I have been through a lot of this already, my most recent result for thyroid problems was negative” and she said “how do you know that?” and I pulled out my folder of two years of testing. I said, “you may want to look at these. My last doctor had just arrived at a diagnosis of PCOS when I had to move.” The reply? “PCOS isn’t a real disease, it’s been made up by fat women.” I said, “I just had a biopsy about eight months ago,” and she said, “we can’t trust the results of those tests. If they told you you have PCOS they are quacks and are not interpreting the results correctly. You need to do what I say.” I said, “you know, I am not three years old. I have been reading medical materials since this diagnosis showed up on the horizon, and I think PCOS is a pretty well accepted phenomenon, you can question whether I have it, but I don’t think you can question whether there is such a thing as PCOS” and she said, “why are you reading medical materials? You can’t possible understand them,” and I said, “I have a Ph.D. I may not understand everything, but I am capable of understanding a lot” and she said, “well, you are NOT a doctor.” Realizing we weren’t going anywhere, I said, “can we complete the physical exam?” There was some issue with how the speculum was angled (she didn’t seem very experienced in performing the procedure) and she said, “stop bearing down!” and I said, “I am not bearing down” and she said, “well, who would have thought your vaginal muscles would be so strong. You can’t be having much sex.” (Note: I had indicated on the form that I am sexually active with my partner. I guess she didn’t believe anyone as disgusting as me could be telling the truth.) I thought this wasbeyond the pale and I said, “would you please complete the exam?” I left the office shaking.

Two days later the practice nurse called back to schedule all of the tests that this doctor had ordered. I said, “I will not be scheduling tests with your practice, after my insulting experiences in your practice, I am not sure that you or the doctor is competent” and she said, “you just can’t stand it that someone is finally telling you the truth about your weight.” And I said, “no one knows the truth about my weight better than me. I am the one who lives in my body, thank you very much.”

Thank you to the doctors in the first city who didn’t assume I was just a lazy pig. I stood up for myself with this new practice, but I doubt it had any effect on them. And I haven’t been to a doctor since then. I wish I could get the courage to find another gynecologist, but I can’t risk this kind of treatment again. It made me feel suicidal for weeks. I am pretty sure I had cyst rupture last week. I know I should find a new doctor. But I am at a crucial point in my work and I can’t risk the emotional disequilibrium. I am shaking just writing this.

“It’s only been in the last year I’ve found a doctor that looks at me as a person”

Branwyn writes…

I have so many stories, years and years of being treated as just “fat” instead of a person with real, physical problems.

My first time with the prejudice doctors have against overweight people was when I was 16.  I’d had amenorrhea for a year at that point.  My grandmother (who I was living with) took me to the doctor, who, after doing a pregnancy test and a cursory pelvic exam, told my grandmother that I was just fat, and that if I lost weight, I’d get my menses back.  Oh, I weighed 165lbs on a 5’2″ body.  I was in a size 16, which yes, is overweight, but not what is usually considered normal to interfere with menses.

That started my hate of doctors and my utter loathing of my body.

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