Tuesday, April 27, 2010

Visiting the Doctor While Fat

It seems like everytime I have something to say, it's because I've read something excellent that Melissa McEwan of Shakesville has written (I do read other blogs, really). This time, it's her post on going to the doctor while fat.

It's very well documented that up to 50% of doctors harbour a widespread bias against fat people. And we also know that men have to be a whole lot fatter than women before they're classed as fat, so this is a problem that disproportionately affects the fairer sex (as if we didn't have enough to deal with). In fact, the folks at Shapely Prose have a whole blog dedicated to collating stories of doctors offering misdiagnoses and all around disastrous advice on account of fat: First, Do No Harm. The stories therein are all from women. Granted that could just be how the blog readers skew, but I find it rather telling nonetheless.

Not one to be left out, here's my story.

I have been on many diets. The first one I embarked on was shortly after I was tagged for the TAF club in primary school and my parents thought they should do something. The last one I was on is the one I want to talk about. Oh, there were many in between, like any good fatty I've gone through periods of "eating well", "lifestyle changes" and even the goddamn Atkins diet (I have never ever wanted a piece of toast quite as badly as I did back then, and I can't even tell about you the mental torture involved in avoiding a lovely hot bowl of chicken porridge when you're sick). But the last one, the last one was the one where I was going to do it right. I wasn't going to be part of the 95% that gain back all the weight and then more. I decided that I would pay for a program that was presided over by healthcare professionals. You may have heard of it - the Dr. Bernstein diet.

Sure, I did the research beforehand. I read the forums where people on "maintenance" talked about gaining back the weight (people I assumed were cheating and just wanted to maintain the veneer of doing well). I read about how some people experienced hair loss and how others stopped getting their period on the diet (but you are monitored throughout the diet by health professionals!). I read all about these things, but I wasn't going to be one of them, it was going to work well for me. Of course it was. I was going on a Diet. This was going to Change My Life.

The diet involved keeping your caloric intake between 400-900 calories a day. Only that's not how it was framed. Rather, there was a list of foods that you were allowed in the quantities they were allowed in. And there were foods on that list you were discouraged from eating too often (to give you some idea, you weren't allowed things like carrots and peas, and if you wanted an apple, it had to be a small one). I did really well on it, then I ran out of money and couldn't continue the program, and I wasn't comfortable restricting my food intake so drastically once I wasn't under the constant care of health professionals (you get to talk to a nurse for 10 minutes a time three times a week) so I went to the "maintenance" phase. I'd already lost 30kg, so I was feeling pretty good about myself. I still read as "fat" but was probably closer to "plump".

The maintenance phase is where you can start "eating sensibly". Which any good dieter knows involves small amounts of carbs and smaller amounts of fat and lean protein portions the size of your palm. Two months in, I started experiencing episodes of chest pain. Not scary heart attack chest pains, more like I was wearing a bra that had been crossed with a boa constrictor. So I went to my doctor about it and was diagnosed with boobs that were too big. *cough* So I was sent away with a prescription for some massage therapy and was told to work out to strengthen the muscles in my back and chest.

So I did. But the episodic pain kept coming and it was worse each time. Twice I went straight to the emergency room because all I wanted was morphine to stop the pain (and also my partner was pretty freaked out that I was having such severe chest pains). Each time a report was generated, sent to my doctor and each time I was told that they were muscle cramps (obviously the first thing the ED did was to rule out a heart attack). I kept working out (which really helped with carrying the groceries home, I can't recommend it enough if you are able to fit it into your life) and I kept going to those massage appointments that are far less pleasant than you imagine. In fact, they hurt like hell. But not as much as those waves of pain that kept hitting me at random moments.

Eventually I worked out that if I chewed over-the-counter painkillers that contained codeine it'd dull the pain enough that I could just sit around and ride it out without having to keep presenting to the harassed emergency department staff. All for having boobs that were too big. What a burden to bear.

Except it had absolutely nothing to do with my impressive knockers. And I assure you that they are quite impressive.

I'd gone to Canada over school break (God bless the universal health care availabe in Canada...) and I got the now familiar pain again. Only this time it didn't go away. I'd made it through an entire bottle of Mersyndol (not recommended) over three days and it was still there, and more insistent with time. I'd lost my appetite and I was impossibly itchy all over despite the absence of any dermal symptoms. Then one night, like a knife through the fogged pain-haze was a bright, white stabbing pain, unlike anything I'd ever experienced in my life. This time, I called an ambulance.

Some laughing gas and some more morphine later, I was discharged and told to visit the GP the next day. Knowing that this could not possibly be big-booby-itis, and knowing that my original doctor was unlikely to reverse a diagnosis she'd held onto for the past three years, I went to my partner's father's doctor (who came highly recommended). That doctor took one look at me and panicked. He quickly scribbled a report, told me that I was severely jaundiced and made me assure him that my next stop after leaving his office was a hospital emergency room. He told me to stay there till I was admitted.

For the past three years, I had been experiencing gall bladder attacks. This time, the gallstone had moved and by the looks of things (i.e. bright yellow) it had lodged itself in my common bile duct. I was in liver failure (also explains why I was so damn itchy, hyperbilirubinemia would do that to you).

I needed my gallbladder out, and to complicate things, the surgeon also had to look for the stone that was stopping up my pipes. I think I was given the choice between being sliced open end-to-end and a laproscopic procedure. I can't remember, at this point I was on a morphine and benedryl drip. There was something about having to wait longer for laproscopy, I think. So I chose to be gutted. A week later and there was still no improvement. That's how long it took the people at the hospital to realise that instead of being a lazy fatty who was not invested in getting better, there was a second stone that was missed.

I will have you know that once the second stone came out, I did all the rehabilitative things they had me do. Twice and with enthusiasm.

So there's my story. I'm fat, I have large boobs, clearly my body couldn't support it despite having supported it all this time. Obviously the diet I was on was an unmitigated good and couldn't have caused anything like episodic pain consistent with a gallbladder attack (P.S. this is actually the #1 reason for gall bladder issues in young women).

I'll leave you here for today, but do remind me to tell you guys about the time where I presented at a doctor's office because I had violent diarrhea for the past three-four days and was given the "you should lose weight" talk. Oh and that time I went to ask a "family health professional" about whether my birth control pill was adequate contraception for someone of my heft and got a long lecture about health and weight loss instead. And and and and and and and there is so much more where this came from. Buy me a drink and I'll tell you all about it.


  1. I can't imagine going three years of that only to realize you COULD HAVE BEEN BETTER if someone had pulled their head out of their ass sooner.

    My mom is always trying diets and it really concerns me. I mean, yes, she could exercise more, but I'm a twig and need to exercise more. I just worry that something like this will happen, where she'll basically unintentionally hurt herself and the doctor will be like, "Hey, at least that blood pressure went down, eh?"

  2. My brother's a doctor. I was in a new job and I was having severe back pain which I could not figure out the cause for. I'm also fat: and have been consistently fat for years, no sudden weight gain, just a general I-like-my-food plumpness.

    I moaned about the back pain to my brother. He told me that I had back pain because I was fat.

    I stared at him, really kind of horrified, which apparently he mistook for eager interest, because he was busily telling me about how my extra weight put strain on my back and means I'm not sitting properly because I was fat, hence the back pain.

    But, finally, I told him that if he were my GP, I would right now be walking out resolved to change doctors.


    Because, I told him: You know I've always been fat. This is no sudden weight gain. But I haven't always had back problems: this is new. So obviously my being fat isn't causing the back pain - something else is causing the back pain.

    "Possibly," my brother interrupted, "but you wouldn't be suffering the back pain if you weren't fat! Being fat makes it all worse!"

    I told him that the back pain was the problem: that if I followed his advice and tried to lose a lot of weight suddenly in order to fix the back pain I would do my health a lot of damage - a lot worse than simple back pain - while the immediate cause of the back pain would be going unsolved: and so his diagnosis of "you're fat and that's why your back hurts" wasn't just wrong, it was actually harmful.

    A week or so later a friend to whom I had also complained about my back pain gave me a copy of her NHS health & safety diagram for setting up your desk and computer correctly, and I checked out my workstation and found that my computer needed to be moved three inches to the right. I did that, and my back pain went away.

    I told my brother the next time we spoke on the phone.

    He told me that while I might have resolved the immediate cause, I would go on getting back problems because I was fat.

    I figured he was probably a lost cause...

  3. Yonmei: It's very difficult in most people's minds not to conflate "fat" with "unhealthy and most probably uncomfortable". I'm sorry that your brother is so stunningly unsupportive. Glad your workspace is now more ergonomic though and good for you for sticking to your guns. It can be very hard to do that in the face of authority (the doctor) and with a family member (who is supposed to be on your side!) agreeing with said authority. You seem to have done quite alright :)

    Anonymous @ May 3rd 5:02pm: So much harm can be done with constant dieting and as you're reporting, you'd be hard pressed to find a doctor that will admit that the risks of yo-yo dieting far outweigh the risks of carrying "extra" weight. I have the same problem with my mother, despite my coming into fat acceptance and making peace with my body, she hasn't. I like to think that my occasional, casual conversations about it are slowly changing her mind, but I'm not really holding my breath. Oh, and she lost her gallbladder a year before I did under similar circumstances (her years-long misdiagnosis was *drumroll please* that her internal organs were all displaced due to the three caesarean sections she underwent...the last one being SIXTEEN YEARS AGO *cough*). Despite sharing the experience, the clue-by-four didn't hit her quite as hard.


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