the HAES® files: I Trust in Second Opinions

by Health At Every Size® Blog

by Jeanette DePatie, MA, ACE

I hate going to the doctor.  I mean, a lot of people dislike seeing their doctor, but I truly loathe it.  This is especially true when I’m seeing a new doctor for the first time.  For days ahead of time I feel anxious.  By the time I’m driving to my appointment I have sweaty palms and feel sick to my stomach.  Usually by time I get to my appointment, my pulse is racing and my blood pressure has risen many points above my daily average.  It’s a big deal.

I think this stems from my childhood.  I was sick a lot.  And by a lot, I mean a lot.  It was not unusual to miss four or five days of school per month being painfully, desperately ill.  The doctors didn’t have an easy answer for what was wrong with me.  So they convinced my parents that I was “making it up” in order to “get attention.”  I lived like this for nearly a decade.  They sent me home year after year, sick and in pain and telling me it was all in my head.

As it turns out the problem was not in my head.  The problem was in my neck.  I had several severe tumors that left untreated could have ultimately led to brain damage or even death.  At one point, my parents finally put their foot down.  They said they would not rest until we figured out what was wrong with me.  If that meant a lot of tests, it simply meant a lot of tests.  And there were many.  Once we finally got a diagnosis, we were able to schedule surgery and remove the tumors.  I have not suffered with that particular illness since.

What I have suffered since is some serious trust issues around doctors.  When I was younger, my doctors accused me of making up an illness in order to get more attention from Mom and Dad.  As I grew older, and we knew that I had suffered from a real and dangerous medical issue, I’ve simply had to deal with doctors diagnosing me as fat.

Going in for knee pain?  Told to lose weight.  Got a sore throat?  Told to lose weight.  Feeling fatigue?  Yup, you guessed it: it was time to lose some weight.  Once again, I was discounted and disbelieved about the state of my health and told that if I undertook this one simple fix (to lose weight) everything would be just fine.  Of course, outside of the usual mimeographed diet (one egg, one piece of dry toast, 1 cup of coffee for breakfast, one salad and scoop of cottage cheese for lunch, broiled chicken breast and steamed vegetables—no carrots or peas—for dinner) the doctor didn’t really have any reliable method for me to lose weight and keep it off.  That was apparently up to me.

A few years back, on the advice of a friend I saw a new doctor.  This guy was supposed to be really good and not fat phobic at all.  I saw him a couple of times and things seemed to be going pretty well.  I explained to him that I believed in a Health At Every Size® approach to wellness and preferred not to focus on fat as a diagnosis.  I agreed to work carefully on healthy behaviors and follow his directions for such.  The last time I went in to see him we sat and went over the results of my recent health screenings.  He agreed that all my numbers looked very good and were well within normal ranges.  He complimented me on my healthy diet and regular exercise.  He agreed with me that eating well and exercising don’t necessarily lead to significant weight loss.  And then, he proceeded to ask me when I was planning on having weight loss surgery.

I stared at him in disbelief.  Did he not just say all my numbers looked good?  Why aren’t we celebrating the fact that by all reasonable measures, I’m quite healthy?  He responded by saying, “We should consider weight loss surgery as a preventive measure.  Although you’re well now, you’re bound to get sick and die unless you lose weight.”

I responded, “Well, I’m not a doctor or anything.  But I’m pretty sure I will get sick and die regardless of whether or not I lose any weight.  I’m pretty sure that happens to humans of all shapes and sizes.  And what are you 65 years old or so?   Don’t men your age often have prostate problems and problems with testicular cancer?  Maybe we should start cutting some stuff off, you know, just for ‘prevention’.”

I couldn’t believe that the doctor was recommending risky, sometimes irreversible, surgery based on some vague idea that I might get sick someday.  As a kid, I couldn’t get anybody to run tests to see what was wrong with me.  As a fat adult, I had a doctor ready to significantly alter a perfectly normal human organ because I might get sick someday.  I became very, very angry.

And of course as I’m standing there, red faced and trembling, the doctor felt this was a good time to check my blood pressure.  And lo and behold it was a little high.  The doctor pointed to this as proof that it was time to get in for surgery and get cutting.  I didn’t feel I had the sanity points left to explain that those points of elevated blood pressure was the direct result of me trying not to strangle him.  I left the appointment and didn’t see that doctor again.  In fact I didn’t see any doctor again for another two years.  Somehow I don’t think this is the kind of preventive medicine that doctor had in mind.

But all too often that is the result when we are shamed and belittled and stigmatized and not believed about our own experiences and symptoms in the doctor’s office.  We are angry and hurt and frustrated, and we just stop going.  There are a number of studies being conducted which look at this very issue.  Are fat people no longer going to the doctor because the experience is so traumatic and deeply troubling?  And what are the long-term effects of delaying medical treatments and routine care?

Eventually, I shopped around until I found a good doctor.  I have a great deal of respect for my current doctor and I believe he respects me as well.  But honestly, I always wonder if this is the visit where it all changes—if this is the visit where he turns on me and shames me and stops respecting me and my experience.  And as a person of size, this is something that I will always wonder.  Because the experience of being shamed in the doctor’s office is not unique to me.  In fact, fat people experiencing shame at the doctor’s office is probably more common than not.  For now, I have a good doctor and am seeing him regularly.  For now.

But I fear deeply for those who don’t have the energy or the resources to keep trying to find a doctor who will respect them.  What about those who are too sick to wait?  What about those who simply assume they deserve to be shamed and believe every shameful thing a doctor says to them?  What about those who have wives or husbands or parents or children or siblings that are only too happy to reinforce those messages of shame?

That is why I speak out about this emotional, frightening and sometimes embarrassing subject.  That is why I speak out about fitness and wellness as Jeanette DePatie (AKA The Fat Chick).  That is why I teach fitness classes to people of all ages, shapes, sizes and abilities.  Because I want people to know that they don’t have to be shamed at the doctor’s office.  And that it’s always a good idea to get a second opinion—whether it be about a particular treatment or medication or an exercise plan or the general attractiveness of your thighs.  Never let a single voice other than yours be the final voice in terms of your rights, your wellness, your experience or your life.

11 Comments to “the HAES® files: I Trust in Second Opinions”

  1. I responded, “Well, I’m not a doctor or anything. But I’m pretty sure I will get sick and die regardless of whether or not I lose any weight. I’m pretty sure that happens to humans of all shapes and sizes. And what are you 65 years old or so? Don’t men your age often have prostate problems and problems with testicular cancer? Maybe we should start cutting some stuff off, you know, just for ‘prevention’.”

    I ADORE YOU! I am very sorry for your experience, but it is great to know that someone talks back. I am trying to think of a creative way to get through to doctors en masse, but haven’t been able to think of anything. When my husband started working as a nurse’s aide he asked one of the nurses — who had worked at many hospitals in various regions because she liked to travel — if the doctors at that hospital were particularly stupid, and her reply was no, they were pretty typical.

    Anyone who wants to mess with a healthy gut, the foundation of wellness, should be put in the stocks, in my opinion.

    • Thanks so much for your comment. I am sad that your experience of doctors is similar to mine. I did speak back. But that doesn’t mean I didn’t have a complete rage/fear/anxiety sobbing meltdown in the car after. It’s just so hard…

      • I am going to have a business card printed which reads:

        I am NOT cognitively impaired, delusional, irrational, personality disordered, or STUPID. If you suffer from any of these conditions, please do not inflict them on me.

        And hand one any time I see a new “health” care provider.

  2. YES…yes…YES…need I say more? We are what we are for different reasons. Some are fat due to actual medications…some, if not most, are fat because of all the garbage hormones and perservs…in the foods….
    Whatever the reason for being of different size is irrelevant. Last winter I went to a walk-in clinic as I’d been coughing, trouble breathing and exhausted. The idiot told me I’d feel better if I ate right and did more exercise. First, that is the most bigoted ignorant and presumptions comment ever (I am very health focused and into complimentary medicine).. Second, I walked out of her office and went to another clinic who ran some tests to confirm a major infection/etc…SO really …
    Personally, I want ALL WOMAN, skinny, fat, average, whatever to speak up and talk back. We should all be offended. Think about it, do skinny women not get sick? Is putting on weight a cure for them?
    Sarcasm …humour…said it all …sometimes I say nothing and then I go home pissed as heck …sometimes I’ll write a bitch letter….most often I will ask “so doctor, is that what you would recommend to a slender women if she came in with the same symptoms?”
    More often than not, it’s a waste of energy and time to deal with ignorant bigots. Let’s remember that doctors are human and as we know, there are good humans, great humans, stupid humans and humans who choose to remain ignorant.

  3. Thank you. I’ve been avoiding doctors for quite a while for the very reasons you cite. Problem is, as I get closer to Medicare age I know that my good fortune won’t last forever. Sooner or later I will need some expert help, if for no other reason than to get access to treatments that I couldn’t obtain or couldn’t afford without a dr’s presecription.

    I already have longstanding asthma and (particularly since OTC inhalers are no longer sold in the US) going without ANY asthma medications or inhalers or any way whatsoever to deal with occasional asthma episodes other than “relax and wait it out” is actually dangerous. I do know that. I got scared away from asthma docs when (at my last semi-crisis, when I had to go to urgent care for a breathing treatment) the Urgent Care doctor told me that (you guessed it….) I ought to lose weight because my asthma was either caused by or made worse by the fact that Im fat. I decided, FINE, I’ll have to get along on my own for that too now.

    In all honesty, I really do believe that whenever and however I die, chances are extremely high that the reason for it will be bias and neglect on the part of health care providers — and the fear of dealing with them at all that such bias and neglect (and sometimes abuse) has caused me to develop.

    • RG. I am so sorry that you have had so many bad experiences. But I would encourage you to find a care provider before you have a health crisis if possible. I know it can be an agonizing experience, but there are some doctors out there who are quite awesome. Mara has some advice for finding a fat friendly doctor as well as a link to her fat friendly doctor list here: http://cat-and-dragon.com/stef/fat/nesbitt.html And Ragen Chastain has some wonderful tools here: https://danceswithfat.wordpress.com/2013/04/01/what-to-say-at-the-doctors-office/ Maybe you could have a trusted friend go to the doctor with you as an advocate to help support you. As you know asthma can be very serious (even life threatening). I hope you can find the support you need to find a doctor you can work with. Sending healing thoughts…

  4. Thank you. I have read all that advice on how to find a fat friendly doctor. And its great advice. Assuming that you don’t have the smallest, lowest bidding HMO that your employer could find. It assumes that you have a lot more choices than we actually have here. For example, with my HMO, in my relatively rural area, I only have a choice between three primary care providers (my so-called “medical home”) in the town where I live. Of course it isn’t the same three, because not a single one of them has been there more than 2 years. And every time a new one leaves, I just get a letter telling me to “find a new primary care provider.” I guess I could look at providers in other small town clinics owned by my HMO east of here. The problem is, I work 65 miles west of where I live, so have a 130 mile commute each day even without having to wander 40 or 50 miles to the east to try to by some miraculous chance find a fat friendly health care provider in one of those towns with an HMO clinic to the east of here. And the idea of “interviewing” health care providers prior to the first visit? Nice idea, but my HMO doesn’t allow it. The only way to get to talk to a primary care dr you haven’t seen before is to schedule a “New Patient Visit.” Those lists and ideas are great for people who live in large populated metropolitan areas, but in rural parts of the country where you have far fewer choices and employer provided “managed care” of some sort rather than indemnity-type health insurance — not so much.

    • I’m so sorry RG. Sounds like your situation is extremely challenging. Ragen’s page offers some advice about how to talk to the doc in front of you, but limited choice makes this an extremely tough situation. I have spent around 100 hours this year on the phone negotiating to get switched to a PPO so I can keep my current doctor under Covered California. But that’s in a major metropolitan area. It’s maddening. I’m so sorry. I sincerely hope you can somehow someway find a way to get the help you need. You are so worth it.

    • I totally understand your dilemma, rg. I, too, live in rural America and go to a rural health clinic. I did find a practice filled with female DOs who each specialize in various organs — thyroid, adrenals, etc — and also do cranial-sacral work (which I really need, having an injured spine), but they don’t even keep a waiting list. All decent doctors have full practices, and I have to just count myself lucky that I have a male nurse practitioner who is sane and reasonable and prescribes my desiccated thyroid as I ask. I have to care for myself, diagnose myself, treat myself, and I avoid doctors like the plague that they are.

  5. I’d like to have a biz card that reads something like:
    Professionally educated post-graduate woman with original marbles available to work with like-minded non-patronizing caring individuals.

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