Young? Chest pain? Fat? It’s your weight, it can’t be your gallbladder (even if tests say otherwise).

Tod writes:

I think it would be relevant to note that although I am a guy, I am FtM transgender and at the time the doctor in question considered me a young woman. I don’t think she would have treated me this way if I had been a cis man; the stigma against overweight women seem much worse than overweight men.

Anyways, this happened about a year ago, when I was 19. I had a terrible relationship with my doctor, primarily because she spent most of every checkup questioning me on my eating habits, and clearly did not believe what I told her (I live a pretty healthy lifestyle, and still manage to be 5’5″ and weigh 220lbs). She was convinced I needed to lose weight to help my asthma (still not sure how that one was supposed to work) and my somewhat high blood pressure that I couldn’t seem to mitigate regardless of changes in lifestyle.

I started having fairly severe pain in my upper chest, especially at night. Being as I lived at school at the time, I went to see the campus health center, which is staffed by extremely nice and competent nurses. The woman I saw there told me it sounded like a very bad case of gallstones. She suggested I change my eating habits, come back the next day and see if that helped. It did indeed help; no fats or oils, no pain. I also talked with my mom around this time and found out women in our family have a history of developing pretty severe gallstones around this age. So I called up my doctor and scheduled an appointment for that weekend, when I could get home.

She seemed very skeptical of the nurse’s conclusion when I told her, and insisted I get her notes from when she met with me. The people at the campus health center were also somewhat bewildered by this, but happy to comply after working out what forms I needed to sign.

So I go home, then to the doctor with these notes; she barely glances at them before stuffing them into her file and asking me to describe what was going on. I do so; she cuts me off as I start talking about how eliminating fats from my diet had done a lot to help with the pain (although at this point it was starting to come back if I so much as twisted too suddenly). She asks me if these ‘fatty foods’ were pizza and nachos that I was eating in the middle of the night.

I was rather stunned and told her no, I was talking about salad dressing, some fatty red meats, and the occasional side of french fries. And I don’t eat in the middle of the night.

She insisted, though, basically telling me she thought I was sneaking junk food in the middle of the night and that it was just causing me heartburn. She also insisted I was too young to get gallstones, even though I told her my family has a history of it.

I argued with her about it and finally she consented to schedule me for an ultrasound to have a look, as well as several blood tests to ‘cover all the bases’. I happily complied with the blood tests, went for the ultrasound the next weekend. By this point I am restricted to eating things that contain absolutely no fat or oil, and am in a constant, although somewhat low level of pain; I’m having attacks every night after dinner regardless of what I eat.

The ultrasound tech was very nice, and when I described my symptoms also immediately concluded it was gallstones. It didn’t take him very long to locate them; I could see them on the screen before he even started to point them out to me – there were a lot; my gallbladder was (quite literally) about half full of gallstones. Afterward we discussed the standard treatment (removing the gallbladder) which he said would be the best option in my case, and should be done soon. He sent the results along to my doctor and said she would help me get a surgeon.

So I go back to school, wait for the call from my doctor to schedule an appointment. A week goes by; no call. The technician said she should have gotten the ultrasound results the day after the procedure. I decide to call and find out what’s up.

Turns out yes, she did get them! No, she hadn’t been intending to schedule an appointment with me. Why? She doesn’t think the gallstones are the problem. It’s my weight, she insists.

Apparently at this point she wasn’t even bothering with the sneaking junk food idea any more; I was just in pain because of my weight.

At this point I decided enough was enough. I stopped seeing her and immediately found a new doctor (the one my dad went to, so she was somewhat familiar with our family). She was able to fit me in that weekend when she found out what was going on; she then immediately scheduled me for an appointment with a surgeon, who scheduled me for surgery within the week; he was somewhat alarmed by the fact that I was in constant pain now, implying that the gallbladder was probably becoming infected.

After the surgery, he informed me that if they had waited much longer (as in a matter of days) there was a high likelihood I would have died or, at the very least, had a much longer recovery; my gallbladder had been so swollen it had started to fuse with other neighboring organs. Much more vital ones.

At the next appointment I had with my new doctor (my first proper appointment really, since at the first one she had been mostly concerned with getting me to the surgeon) we started going over medication I was taking and she was shocked to find that old doctor had instructed me to take Albuterol (an inhaler for asthma symptom relief) preventatively, twice a day, every day. Apparently this is not how Albuterol is meant to be taken, and is in fact fairly detrimental, since it causes – wait for it – high blood pressure!

As soon as I started taking my inhalers the way they were meant to be taken, my blood pressure dropped right down into a very healthy range. What a surprise.

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Period after menopause is NOT normal – get a 2nd opinion if necessary

Qultluvr writes:

I’d like to tell my story so that women in menopause know that having a period (after not having one for at least 6 months) is NOT normal.

My tale really involves 2 women – myself and a friend who is about my age and about the same size as I am.

We both had what seemed and felt like a menstrual period after having been told we were in full menopause. Since I had a reliable doctor, off I went to be checked out. My doctor said it is definitely not normal and sent me for a D&C. The tissue from the D&C came back as “pre-cancerous” and my doctor said the standard prescription for that is a hysterectomy. I did a little research and found the same thing. So my doctor sent me to a surgeon, who though grumpy and mean (to everybody), scheduled the surgery. The surgery was decidedly not fun, but all went well. The pathology report came back with the info that there had indeed been a tumor (cancer) in the cavity of the uterus. Now it is 6 years later and I am able to dance/work/chase-my-grandkids to my heart’s delight.

My friend’s story is very different. She had what seemed like a period and thought it was normal and ignored it for several years. She mentioned it to another friend, who urged her to talk to me and I urged her to go see a doctor. So she did and got the usual “you’re too fat” run-around. She insisted that something must be done and did get a referral to a local surgeon – who said she was too fat, that nobody could do a hysterectomy on her and refused to do the surgery. I’m not clear how many doctors she went through, but she did eventually find one competent enough to do a hysterectomy on a 300ish pound woman. My recovery was 6 weeks; hers has been over 6 months. My total time from first visit to totally recovered was 5 months; hers was about 3 full years, some of it listening in misery to some jerk tell her she’s too fat and refusing to treat something she clearly knows is not okay. Her outcome now is pretty good, so this story has a reasonably happy ending for both of us.

I think it does have two clear points.
1) If you think something is wrong, get to a doctor and keep going until you find one who will treat you respectfully and actually listen to what is going on.
2) It does really help to have found a doctor you can trust before you really need one. I know how hard that is and yes, it is hard. I had to drive an hour and a half from my home to the doctor’s office (same distance to the hospital) and it was absolutely worth it at the time I needed a reliable doctor most.

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).

A cosmetic surgeon’s prescription: Lose weight

Cindy writes:

A cosmetic surgeon’s prescription: If you want to ‘enjoy your youth,’ lose weight.

I’m one of those lucky women whose body image problems were passed down through the women in her family.

I’ll skip the details, and get to the meat of my story.

At 23, I had breast reduction surgery. I never had problems exercising, never had back pain. I just had large breasts. My mother — who is heavy and large-breasted — finally convinced me that I should have a reduction surgery. I guess she thought it was the only thing that might make me look slimmer.

I’ve been heavy since adolescence. (The heaviest I’ve ever been is 164, but to my family, that means you’re “a cow.” I am under five feet tall, I should say.) Anyway, I expected the doctor to tell me he wouldn’t do the surgery until I lost X amount of pounds. He didn’t. He cleared me. He told me the reduction would improve my mobility and keep me free of back pain. Basically, the surgery would be good for my health.

At a post surgery check up, the surgeon ended my appointment with a stern moral lecture about my weight. He didn’t feed me any crap about my health. I have low cholesterol, low blood pressure and a robust immune system. I’d come through the surgery great and only needed pain medication for one day after surgery.

His concern? He didn’t say it outright, but his concern is that no man would ever want to sleep with me. He actually told me how great his life was because he was trim (Yeah, dude, your life isn’t great because you are filthy rich, have a yacht and a medical degree. Yeah, your weight is responsible for that endless supply of sex-ready vixens you have on speed dial!) He took my parents money, did the boob job and told me I was too ugly to screw. Nice. (I have to say my once beautiful breasts were disfigured permanently from the reduction. They are oddly shaped, I have keloid scars and have lost feeling is portions of my breasts.) If I could go back, I’d cancel the surgery.

Even though I was enjoying my youth plenty (as in having regular, rather exuberant sex with another girl — I had the broken coffee table to prove it) this made me feel like a leper. I sat in my car and bawled, and never went back.

Fast forward 14 years. I now have a family doctor who isn’t fat-phobic and doesn’t prescribe weight loss for every little thing. I refer all my friends to him.

I’m still “enjoying” my relative youth.

Miss my large breasts, though.

Fat discrimination in kidney transplants

In related news, the New York Times reports today on a study showing the higher a person’s body mass index, the less likely they are to receive a kidney transplant.

The study in question – posted online on Dec. 19 in The Journal of the American Society of Nephrology – included more than 130,000 patients registered for kidney transplantation from 1995 to 2006, and followed each as they waited for available organs. Led by lead author Dr. Dorry L. Segev, an assistant professor of medicine at Johns Hopkins assistant professor of medicine at Johns Hopkins, the team of researchers found:

After controlling for sex, ethnicity, insurance status and other variables, they found that compared with those of normal weight, the obese people were 8 percent less likely to receive a transplant, the severely obese 28 percent less likely and the morbidly obese — those with a B.M.I. over 40 — 44 percent less likely.

Article author Nicholas Bakalar suggests financial disincentives might be a play, citing that it is “known that obese patients are likely to have more complications and a worse outcome” (although he doesn’t offer up any statistics or numbers to justify this). He goes on to point out, however, “the practice is to assign organs only on the basis of how long a patient has been waiting, so such considerations should not enter into the decision.”

“There is a major organ shortage, and deciding how to allocate kidneys is difficult,” said Segev. “If the transplant community decides that patients with higher risks should have lower priority, this is something that should be formalized as public policy.”

Our commentary:

If you feel you have been denied placement on an organ transplant list or have been denied an available organ because of your weight, here are a few recourses available to you:

Get another opinion: If you feel your doctor is in error or is dispensing medical advice under bias, see another specialist.

Put on the pressure: Send written requests to your doctor, the hospital, the hospital’s administrators, its Board of Directors, the state medical board, your state and national representatives. In your letter, include detail on what was said to you, by whom and on what date. If you have written materials, include a copy. Ask the facility to provide their procedures and requirements on organ donation.

Find allies: Ask your doctor or your legislator to write a letter on your behalf. Contact your local patients rights association. Marshal your friends and family on a letter-writing campaign. You are not alone and the doctor or hospital needs to see this.

Research your condition and all known treatments for it: Not only will you understand the medical talk, but you will be more armed to recognize and combat bias in treatment plans offered.

Use the law – discrimination is illegal: Hire an attorney, or if you cannot afford one, many legal referral services offer information on how to secure free legal services or can give a referral for a non-profit association offering free legal services. Your local bar association may also provide information on free lawyer services. Don’t stop there: Contact your state medical board and even the National Department of Justice.

A degenerative spine is no excuse not to diet and exercise!

Amber writes…

I injured my back in 2004 while at work in a call center. It was during the holidays, so I was working long hours sitting at a computer. One day I went to adjust my position in the computer chair and I felt an unbelievably strong pain course through my back and down my left leg.

Since then I have been on a nightmare journey to not only try to stop any more damage to my spine, but also to hopefully try to heal the damage done and one day become pain-free.

The first spinal surgeon I saw actually asked me “How I’d gotten myself to this point.” Then he proceeded to lecture me while I cried out of pain and shame. He basically told me I had no one to blame for my bad back but myself, and more specifically my bad eating habits and lack of exercise.

I swore that I would never see a doctor about my back again. Then in April of this year fate had other plans.

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You’re too fat to have surgery

This isn’t an emailed submission, but it’s definitely relevant to the scope of this site. An article, “Where Fat Rules Out Surgery,” reported today in the Monterey Herald reveals a growing trend in the numbers of patients being denied nonessential surgeries by British health authorities because of their weight.

For two years, Frances Kinley-Manton says she lived with arthritis pain in her hips, a condition that kept her in a wheelchair. She wanted hip replacement surgery. But doctors at Britain’s National Health Service said she was too fat for the operation

Read more…

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