Diagnosis: Fat. Prescription: Lose weight but don’t exercise!
I get so tired of ranting about how I’m treated at the doctor’s office, or how scared I am whenever I meet a new doctor.
So, today, I’ll rant about how my husband was recently treated at the doctor’s office.
A week ago, Conall had a … well, we’re not sure. He had symptoms of a heart attack: extreme chest pain, shoulder pain, shortness of breath. I took him to the urgent care that is right across the street from our apartment. They were great, took care of him as best they could, then had him transferred to the emergency room via ambulance.
They ran all sorts of tests on him and determined that he didn’t have, and wasn’t having, a heart attack, so they released him with instructions to follow up with a primary care physician. They didn’t do anything for his pain, but that’s a different issue. The pain went away on it’s own by Saturday.
So, of course, on Sunday he decided to participate in archery for two hours. Of course.
But I digress.
On Monday, he had an appointment with a new doctor. As much as I didn’t want to have him see a new doctor for whatever this is, he needed a “you may return to work” note, and he hasn’t been to a doctor for three years. This was a doctor that was a “preferred provider” from our insurance. Maybe that should have warned me. She was able to get him in fast though, and so I made the appointment.
When we arrived at the office, we weren’t in the waiting room five minutes when we were called into the office. We didn’t even have a chance to finish all the paperwork. The nurse came into the examination room and asked all the usual questions, including questions like “how active are you?”
Now, I’ve written previously about the “health initiative” his work is engaged in. We know for a fact that Conall walks 35 miles a week because he wears a pedometer, and some weeks he walks even more than that. That’s only the walking part of his job. He also does a lot of lifting, pulling and pushing heavy items, bending, stretching, and so on. In fact, he has a very active job.
Besides that, he is active in his hobbies. I mentioned the archery he did on Sunday because he wasn’t hurting any longer. He shoots both cross bow and long bow (the cross bow has a 75 pound pull, which means it takes 75 pounds to pull the string to full extension, cock the bow and put the arrow in; the long bow has a 35 pound pull). For about two and a half hours, he shot arrows on a range that had staggered targets from twenty yards to forty yards. After he shot six arrows, he’d walk down to the target to retrieve them and do it again.
He also fences regularly. Every Thursday night that he’s not working, he fences for three or more hours.
So, he’s very active.
Oh, did I mention he’s fat? Y’all kind of guessed that, right?
Up until last year, he was “only” overweight (at a BMI of 29). But then, he broke his knee at work near the beginning of the year, and our karate dojo imploded. The lack of activity for three months from not being allowed to work or doing any of his hobbies, as well as not being able to get back into karate since then has meant he has really packed on the pounds — all 20 of them.
Those 20 pounds were enough to bring his BMI up three points and put him into “OMG YOU’RE GOING TO DIE TOMORROW!” range.
The doctor came in and, right off the bat, told him that he was “obese,” and needed to lose weight, first and foremost. If he didn’t, dire things would happen, like more events that put him into the ER last Thursday. Then she started talking about the tests that were done on him at the urgent care and hospital. Everything looked okay, except his blood sugar — but she wasn’t too concerned about that, because he had an IV in, and that could cause a false high reading.
His “high reading”? 109 for a NON-fasting test. He’d had milk, a protein shake, and some raisin bran in the four hours preceding the test. According to ABC News, the normal range for a non-fasting blood sugar test is between 100 and 130. But this doctor wasn’t too concerned about how “high” his result was because having an IV is known to mess with the values.
The only reason I didn’t say anything to her was because we needed that all-important piece of paper saying he could go back to work.
And Conall, even though he has read the studies about losing weight, heard my commentary on the UCLA meta-analysis of diets (and how they don’t work for anybody), and even sent me links to studies that were either completely ludicrous (study shows you can catch obesity from your fat friends!) or showed how the obesity epipanic is so overblown …
Even after all that, he told the doctor, “Yes. You’re right and I’ll work harder to lose weight.”
Up until then, losing weight had NEVER been a priority for him. He knew he was healthy because of normal blood pressure, normal readings on all tests (granted, that was three years ago), not eating much fast food or restaurant food, and living a very active life. But now, because this doctor told him to lose weight, it became a priority.
I had to bite my tongue to keep from telling her off. When we got out of the office, I went off about her. She either didn’t read the notes the nurse took about how active his life was, or she took one look at him (and even though he’s tall, big boned, and has a LOT of muscle, he also has some fat on him) and decided he was lying. Either way, she made a decision about his health — that he was in her office after a very terrifying and painful episode that we still don’t know the cause of — because he is fat.
At the end of the visit, she gave him a paper that stated his next steps (as well as the work release). The paper told him that because a heart incident hasn’t been completely ruled out, he needs to not exercise or do anything strenuous until after he gets a stress test. The very next bullet point pointed out that he has a BMI of 32 and therefore needs to change his eating habits, increase his exercise, and lose weight.
Did I mention she never asked what his eating habits are?
This is the first time Conall’s been diagnosed “fat.” Because of his height and muscles, and because his BMI has never officially been “OMG YOU’RE GOING TO DIE!” he’s been able to bypass that part of an examination. At the most, a doctor would tell him, “You might want to think about losing weight at some point, or at least not gaining any more.” But he was never told “if you don’t lose weight you will die.”
It took him a day and a half before common sense kicked in. Until he realized that she just treated him like I’ve usually been treated. Until he realized that he was allowing her to do the same things to him that he’s seen me do to myself after doctor’s visits (before I found Size Acceptance/Fat Acceptance and Health at Every Size®). I also helped by making fun of all the stupid things she said (the “high” blood sugar level, the “don’t exercise, but eat better and increase activity so you lose weight”). At one point, I also said, “If you are going to die tomorrow because your BMI is 32, then at BMI 44 (close enough, I’ve not been weighed in forever but all my clothes fit the same) I should have died yesterday! Oh, wait! I probably am already dead, my body just hasn’t figured out it’s supposed to lay down yet!”
And he agrees with me. We’re only staying with this doctor until the results of the stress test come back. Once that happens — whatever the results are of it — we will be finding a new doctor for him who won’t fat shame him, who won’t diagnose him as fat and tell him all his issues will be fixed if he just eats better and exercises more so he’ll lose weight.