Tag Archives: doctors

communication, condescending twatbags, healthcare, safety, social media, YouTube

Sometimes it’s necessary to turn off the seatbelt warning chimes…

This morning, I woke up to more negativity on Facebook. I sighed and blocked yet another rando who decided to chime in on my flippant comment on Carolyn Hax’s advice column. I wrote about that situation yesterday, but for those who don’t want to read my rant, here’s a brief synopsis.

A woman in her mid 50s, describing herself as obese, was complaining about her gynecologist’s insistence on harping about her weight at every appointment. The woman wrote that she discusses her weight with her internist, and had engaged the services of a professional personal trainer. The letter writer was annoyed by her gyno’s fixation on her weight, especially since the doctor’s suggestions were not workable for her. She was seeking advice on what she should do about the doctor’s unwanted warnings about her weight issues.

Carolyn’s advice was to find another doctor, or be more assertive about asking the doctor to stop fixating on her weight. She wrote that if the letter writer was too nervous about confronting the doctor verbally, she should write a letter. I agreed with Carolyn’s advice, and yesterday’s long winded rant spelled out the reasons why I agree. A lot of other readers did not agree, and felt that the woman should simply follow the gyno’s orders, annoying as they might be to her.

I was one of the first people to comment on the Facebook post about this column. I wrote “Get another doctor, or be like me and don’t go.” It was kind of a flippant remark, but I was being serious on one level. As I mentioned in yesterday’s post, I don’t go to doctors very often at all. I realize that many people would say that’s unwise, especially since I can afford to go. But medical situations– at least when they involve me, personally– make me a bit crazy.

In yesterday’s post, I wrote about a woman named Winnie Jay who blasted me and someone who responded to me, then called me “girl”. Winnie Jay doesn’t know me, and doesn’t know the origin of my comment. Like it or not, avoiding doctors is one very effective way to avoid being lectured about weight loss. It may not be the wisest thing to do, if you want to maintain your health. But it truly is an effective way to silence the shaming, at least from a doctor.

I wasn’t offering advice, though, when I wrote “don’t go.” I don’t expect that the letter writer was reading comments from randos on Facebook to find out what she should do. She wrote to Carolyn Hax, not the Overeducated Housewife. 😉 I was just responding in a flippant way to the column… that is, in a way in which I’m sure a whole lot of people can relate. Who wants to spend money to hear a doctor tell them they’re fat? Duh… most fat people already know they’re fat, and a lot of people have already considered the obvious solutions to that problem.

If I wanted serious advice on losing weight, I certainly wouldn’t consult a gynecologist. The vast majority of physicians don’t actually get that much training on that topic in medical school and can’t offer advice that works. Most of them can only offer drugs and surgeries. If I wanted to lose weight, I’d probably visit a nutritionist and a personal trainer. If that didn’t work and I was still determined, I might go to a doctor who specializes in bariatric surgery.

Why waste time discussing weight loss at a 15 minute routine gyno appointment, when you could be talking about more specialized topics that a gynecologist would be better able to address, like coping with menopause or enjoying sex during middle age? Especially when the letter writer– obviously someone who values maintaining her good health– is already addressing her weight issues with her general practitioner? Or, at least she claims to be doing that… but why would she lie about seeing a GP?

After yesterday, I thought maybe that pithy comment would be part of my history, but then I woke up to a tag from another young woman who is now on my block list. She wrote something along the lines of, “Sure, don’t go to the doctor, get a disease that goes unchecked, and die. Stupid advice.” That this person called my “advice” (which my comment wasn’t meant to be) “stupid” is what prompted me to block her. I figure if it’s her first inclination to insult strangers online, she’s not someone I want to know, or need to engage with further. Life is short. Especially when you don’t visit the doctor on a regular basis. 😉

At first I was pretty annoyed about the second person’s comment. It stings to be insulted by another person, even when it’s a stranger. But then, after talking to Bill over our breakfast of blueberry pancakes, bacon, and coffee, I came to a conclusion about the weight obsessed gynecologist. And it was all due to the obnoxious comment from that stranger. Perhaps the rude rando did me a solid, after all.

And now… about today’s blog post title.

A few days ago, I was watching random YouTube videos and I came across one by a content creator called “Fixin it”. The channel is about how to do minor household and car repairs. The video that attracted my attention was titled “How to TURN OFF the Annoying SEATBELT ALARM BEEPS CHIMES”. See below:

This COULD actually be very useful information to some people.
Here’s one he did for Nissan cars.

The guy who runs the “Fixin It” channel explained that sometimes the seatbelt alarms go off when they aren’t necessary. In today’s nannyish world, where we have warning chimes and flashing lights for every hazard, the warnings can be overkill. Or, maybe there’s some kind of malfunction in the software or hardware that make those alarms go off when they aren’t needed.

I used to drive a Toyota Corolla and the alarm would go off whenever I put something in the passenger seat. In my car, the alarm would turn off after about fifteen seconds, but sometimes they’d keep sounding. That’s pretty annoying and potentially dangerous, especially if you’re the only one in the car, you’re wearing the seatbelt, and you just want to rock out to the Doobie Brothers while you’re “rockin’ down the highway”. The warning chimes can be distracting and cause unnecessary stress.

I was curious about the comments. Most people were delighted by the guy’s practical advice. They had all consulted YouTube to find out what to do about the annoying nanny chimes in their cars, and the “Fixin It” channel had really helped them. A few people wrote to say that the advice hadn’t worked for them, which is bound to happen sometimes. And I wasn’t surprised to see comments chastising Fixin’ It for offering advice on how to disarm an important safety feature in a car. Below is a small sampling of those reactions…

Or.. and follow me close on this one, buckle your seat belt.

could also make a video on how you dont survive an accident for not wearing seatbelt. because the only reason you want the beep off is you dont wear it and it keeps beeping

dude really? it’s there to save your life.

Not a good act to show

I wouldn’t recommend doing this

I like beeps because it warn me I am not wearing seat belt

You “fix” it by wearing your seatbelt lmao

Here’s a brainwave! If you wore your seat belt as the law dictates, you wouldn’t have any warning noise.

y’all can just buckle up bro.

It seems so simple, right? Just buckle your seatbelt and you won’t hear the beeping. Except sometimes you don’t want to put stuff on the floor of your car, and you don’t want to have to buckle all of the belts to prevent the chimes from going off while you drive. And some of us don’t need a warning chime to do the right thing. Some of us are married to a man who turns into Pat Boone if they don’t buckle up. 😉

There I was, talking about Carolyn Hax’s advice column with Bill, thinking about the two insulting comments those two women– neither of whom know a fucking thing about me– decided to leave for me like sprays from shitstorms, as opposed to rays of sunshine. And then it dawned on me. They weren’t unlike the incessant seatbelt alarms. Then I realized that the obnoxious OB-GYN was even MORE like the seatbelt alarm that won’t turn off.

I stopped to think about that letter again and realized these things:

  • The letter writer self identified as obese. She knows she’s fat.
  • It’s not possible for a person to lose weight immediately, as the doctor suggests it. It takes time and effort.
  • The letter writer has written that she is taking steps to lose weight and get fit. She says she’s hired a personal trainer and works out with them three times a week. It’s true that exercise alone usually doesn’t help people lose weight as much as eating fewer calories does. But it is an important, health promoting step to take, and it is a sign that she’s doing something to be healthier.
  • The letter writer clearly cares about her health. She not only sees a gynecologist regularly, but she also sees a general practitioner. That’s more than a whole lot of people do.
  • Although a lot of people think fat people are liars (and I’ve blogged about that phenomenon, too), I see no reason to assume the letter writer is lying about what she’s been doing to improve her health.
  • Even if she is lying, she’s mainly only hurting herself by doing so. Continuing to nag her about her weight isn’t helpful, and might even be harmful, if she decides she no longer wants to visit the gyno.

I’ve mentioned that I very seldom go to doctors. I probably should go to one, especially now that I’ve hit menopause (or so I assume– it’ll be official in January if I don’t have a period). But I don’t go to doctors because I was harmed by a couple of them. Both were overly concerned and very critical about my weight when I had come to them for help with other issues. One of them actually physically hurt me and left me with some pretty awful trauma issues.

My decision to not see a doctor could be disastrous if I placed a high value on living for a long time (which I don’t). Or, my decision to see a doctor could be disastrous if I see one that gives me bad advice or just blows me off (see this post for an example of a situation like that), blaming all of my issues solely on my weight. It sure is annoying to have to PAY for that experience, especially when it turns out there actually was a pretty serious issue going on that had nothing to do with weight. Or, I could do everything right and still die in my 50s because I was in the wrong place at the wrong time (see here for an example of that scenario).

Life is a crapshoot. The one thing that is certain, for every single one of us, is that someday, we WILL all die. There is no escaping it. And while most people want to live for as long as possible, some folks would just as soon leave the party early. And then there are people who wouldn’t mind staying longer, but don’t have a date, have no transportation home, and/or can’t afford the bar bill. 😉

If you are an especially risk averse person, you might choose to go see every kind of doctor there is, listen to everything they say, and follow their advice religiously. Maybe, if you can afford to do that, and you still have time to do anything else, you might enjoy a long, healthy, pain free life. But most of us can’t do that, nor would we WANT to do it. Moreover, if you ever venture outside of your bed, you’re going to be at risk of freak accidents that could kill you faster than cancer and diabetes ever could. And hearing the same annoying warning chimes from one doctor, when we’ve already been “buckled up” by another, isn’t effective or useful. Sometimes, it’s necessary to turn off the seatbelt warning chimes to stay safe, and get from point A to point B without having a wreck.

So, I stand by my flippant “non-advice” for the letter writer to find another doctor or, if she doesn’t want to hear the incessant fat shaming warnings, simply stop seeing her (or any other) gyno. Like it or not, she’s going to die someday, anyway. It might even happen when she’s rockin’ down the highway, listening to the Doobie Brothers, while grimacing in annoyance at the sounds of the malfunctioning seatbelt warning chimes.

Standard
controversies, healthcare, law, Police

Repost: Hey, all you druggie pregnant folks! We’re warning you!

Since I don’t really feel like typing any significant fresh content today, I’m going to repost this blog entry from the original Blogspot OH. This post appeared April 19, 2015. It’s been retitled and edited somewhat, because there was dated and irrelevant content in the original post.

Last night, I shared this photo, which randomly popped up on my Facebook feed.  A woman I knew in school had posted it with the comment “You’ve been warned.  No excuses.” I knew the photo would generate discussion, and it did. Most of my friends were horrified by the photo, although “Papa Smurf” was a notable and predictable outlier. [Papa Smurf is a former friend now… he was a mansplaining pain in my ass one too many times, and I finally advised him to fuck off. I call him Papa Smurf because he was very sanctimonious and enjoyed trying to act like everybody’s daddy.]

I understand the idea behind this sign and I comprehend why a lot of people are behind its sentiment.  However, while I get why people agree with it, I think it’s counterproductive to threaten patients before they’ve even been seen.  All a sign like this does is tell the pregnant mom who might be using drugs that the doctor would prefer them to go somewhere else for their prenatal care.  Indeed, that could be why the sign was posted.  OB-GYNs typically pay a lot in malpractice insurance, and a pregnant person with drug issues could potentially have a riskier pregnancy.  Of course, a drug abusing mom who is really bad off probably wouldn’t bother with prenatal care anyway. 

Those who use drugs recreationally might see a doctor, but if the doctor flat out tells them they will call the law on them, they will very likely avoid medical care.  That may be fine and dandy for the doctor who doesn’t have to deal with them, but what about the unborn child?  The sign seems to be advocating for the welfare of the unborn baby, but if the doctor scares off the mother, what good does that do?  And doesn’t that sort of conflict with what doctors are supposed to be doing, which is providing healthcare to people who need it?

I happen to be pro-choice, but I couldn’t help but notice.  As long as abortion is legal in the United States [remember, this was written in 2015], it seems kind of ridiculous to take this sort of attitude, anyway.  I mean, the mother to be can terminate her pregnancy if she chooses.  Using illegal drugs is against the law, anyway.  Why turn it into a crime against the unborn?  Why does the fact that the mom to be is pregnant even come into it?  She’s breaking the law, so deal with her. 

At this point, we don’t force people to see their doctors.  People have a hard enough time accessing appropriate medical care for reasons other than being threatened and alienated.  This attitude of needing to police private citizens is creepy to me [I really had no idea what was coming, eight years ago, did I?], and in the long run, I don’t think it makes things better for anybody.  Of course a pregnant woman shouldn’t be using drugs, and something should be done if she comes up positive on a drug screen.  I think the attitude toward her should be more supportive and helpful, not threatening.    

Besides…  a woman whose newborn baby comes up positive on a drug screen at the hospital is going to be referred to CPS anyway.  All that sign does is encourage the mother to avoid seeing doctors and give birth outside of a medical setting.

Here’s another thought.  For most medical procedures, physicians must get informed consent before they go ahead with it.  I suppose a sign like this informs patients that the doctor(s) at this practice will do random drug screens, and gives them the option of going elsewhere for their prenatal care.  But what about health care professionals that do screenings without the patient’s knowledge or consent?  Isn’t that a violation of their rights?

I know there have been cases in which mothers have been arrested for having positive drug screens and have gone to court.  In South Carolina, there was a big case involving pregnant women, Ferguson v. City of Charleston, who were tested for drugs without their knowledge or consent.  It went all the way to the Supreme Court, which ruled that the search in question was unreasonable, especially since the searches had the potential to land someone in jail.

In any case, while I certainly wouldn’t condone a pregnant woman using drugs, and I agree something should be done to help or dissuade drug abuse in pregnant women, I don’t think taking an adversarial, threatening attitude is in the best interest of patients.  The goal shouldn’t be to sell mom down the river; it should be to get her appropriate help so she can successfully raise her child.  I think it would be hard to do that by threatening patients with getting the police and child protective services involved before they’ve even been seen.  

Edited to add in 2023: I don’t know if the photo is real or fake. I just thought the discussion it generated was interesting. You can see the original post here.

Standard
healthcare, mental health, psychology

“Please, Doc, don’t weigh me unless it’s really necessary!”

Yesterday marked the first day of National Eating Disorders Week 2022. Fittingly, a few days ago, I read an interesting article in the Washington Post about a new trend in U.S. healthcare. It involves special cards that one can hand to a physician. See below:

I like this idea.
From the More-Love.org Web site.

I haven’t seen a doctor since 2010. One of the main reasons I don’t visit doctors is because I once had a very traumatic and unnecessarily physically painful and humiliating experience with one. I did see doctors a few times after the traumatic experience, but as I’ve gotten older, it’s gotten even harder to make the phone call for an appointment. I know very well that this isn’t the greatest policy for promoting my personal longevity. I could definitely use a check up. However, for many reasons, visiting medical people causes me a great deal of stress. One of the main reasons it’s stressful is because of that goddamned scale, and my long history with eating disorders. No, I don’t mean the obvious ones that might put a person in the hospital. There are actually a lot of eating disorders out there, and most don’t get diagnosed. But they do exist, and I’ve struggled with them for years. I have less of a problem with them now, mainly because I have a very loving and understanding husband who doesn’t body shame me. I would be lying, though, if I said those problems have gone away entirely. There isn’t a day that goes by that I don’t think about it.

I know I usually have less of a problem going to see a doctor if I know I won’t have to be weighed. For instance, in 1999, I had facial cellulitis that almost put me in the hospital. I had to see an ear, nose, and throat doctor for treatment. He was a great doctor, but one thing that I especially liked about him was that he didn’t force me to get on a scale. He simply looked at the mess on my face and prescribed antibiotics. The family practice doctor who sent me to the ENT guy was kind of an all knower, but he actually reassured me that my weight wasn’t that bad. At that time, it wasn’t that bad, since I was waiting tables and lost a lot of pounds because of that. However, I was never so sick, so often, as I was in those days.

Although I know weight is an important measure for some health issues, I think it’s pretty cool that someone has realized how absolutely mortifying getting on the scale is for some people. The above cards were offered at Element Primary Care in Omaha, Nebraska. A 30 year old woman named Dani Donovan, who is an attention deficit/hyperactivity advocate and suffers from binge eating disorder, happened to see the cards at the office. Donovan reportedly avoids going to see physicians because of the stress of being weighed. She happened to find a practice where, apparently, the staff recognizes this issue, and how it prevents people from seeking care. According to the WaPo article:

“I didn’t even know that saying ‘no’ to being weighed was a thing you could do,” said Donovan, 30, an attention-deficit/hyperactivity disorder advocate who has a binge-eating disorder and often avoided doctor’s appointments because being weighed was so stressful. The card led to a good conversation with her doctor, Donovan said, that helped build trust and make her feel empowered.

Donovan took a photo of one of the cards and posted it on Twitter. It’s caused quite a stir.

These cards were developed in 2019 by a Los Angeles area eating disorder coach named Ginny Jones. Jones is a survivor of several eating disorders, including anorexia and bulimia. Jones came up with the cards after many experiences she had when visiting physicians. A lot of them would praise her for losing weight, even when it was noted in her records that she has had eating disorders. She now offers the cards for sale on her Web site. When Jones was contacted for a statement about her cards, she said:

“I wish I could say I was surprised by the ‘controversy’ around the cards. I created them to address weight stigma, and it’s basically fatphobia to jump to conclusions and say blanketly that asking not to be weighed is unhealthy.”

Personally, I think these cards are great, although I can’t imagine presenting one to any of the military doctors I’ve seen in my lifetime. But then, again, I haven’t been to see a doctor in about 12 years. My blood pressure shoots up whenever I’m in a military healthcare facility, and they usually take one look at me and assume I have any number of health issues just by my appearance. I have found that a lot of doctors aren’t good listeners, either. That is especially true with military providers, in my experience.

In 2007, before we moved to Germany the first time, I actually wore an ambulatory blood pressure monitor for 24 hours to prove that I didn’t have hypertension, because my blood pressure readings were so high in the office. As soon as I stepped out of the military hospital, my blood pressure was completely normal and stayed that way. I came back to the office the next day with a bruised arm and documentation in my file that I have white coat hypertension. That may no longer be true today, given my family history, but the way the providers acted during that last visit put me off of going back, even though the person I saw was actually very kind to me when I told her what had happened to me at the hands of an Air Force gynecologist back in the 1990s.

The Air Force gyno I saw back then gave me my very first (of two in my entire lifetime) gynecological exams. It was so painful and distressing that I left her office traumatized and horrified, and actually felt violated on the level of sexual assault. Besides really hurting me with her instruments and not apologizing for the pain she caused me, this doctor also fat shamed me and predicted that when I went to Armenia, I would gain tons of weight. In the 90s, I was dealing with eating disorders more acutely than I do today. Today, I seem to have replaced eating issues with drinking issues. Again… not healthy, and I probably should see a doctor, but I just can’t bring myself to do it. Even having these cards probably wouldn’t get me into the office, although I do think they would help, if I found a kind and understanding physician who was sensitive to these issues.

According to the Washington Post article, as well as my own anecdotal experience, there are a lot of physicians who have a bias against obesity. They seem to take obese patients less seriously, especially if they’re women. The article reports, “one piece published in the British Medical Journal found that weight stigma actually led to increased mortality and other chronic diseases and ‘most ironically, (weight stigma) actually begets heightened risk of obesity.'” There have been a number of articles about how the medical community tends to focus on weight, even when a medical issue is clearly not related to the patient’s weight. Like, for instance, someone comes in with a broken arm and gets told that weight loss would benefit them. There’s no doubt, weight loss would be beneficial, but that’s not why the person came in to see the doctor. In that sense, I can see how these cards could be useful. If you’re going to see the doctor for a specific issue that has nothing to do with obesity, perhaps it wouldn’t be a bad thing to skip the scale, at least for that visit.

Of course, some physicians will never be onboard with avoiding weigh-ins. In the WaPo article, a physician named “Umbereen S. Nehal, a former chief medical officer for Community Healthcare Network in New York and a board-certified pediatrician,” reported that she strongly believes patients must “be weighed every time, regardless of when they were last weighed or why they are in the doctor’s office.” The doctor claims to be have sympathy for patients like Donovan, but she’s not convinced that avoiding the scale will improve healthcare outcomes. She says, “Is the hypothesis that somebody who is obese, let’s say, if we don’t weigh them, fatphobia will go away? Those visual cues will not go away. So my beef with this is that it disrupts processes in the system for efficient data collection and that data are used for a variety of things.”

My answer to Dr. Nehal is that a lot of people avoid the doctor entirely because of this issue. She may be getting more data when she weighs patients at every visit, but a lot of people won’t even come see her because of the mortifying prospect of being weighed, the psychological stresses that come from that experience, as well as the potential humiliation that comes from a fat shaming doctor. Seriously… if you’re feeling fine, and you don’t want to deal with the discomfort of being weighed, how likely are you to schedule screenings? Is that the outcome Dr. Nehal wants? For people not to come in to see her at all? Then she won’t get ANY data, and the person will show up in the emergency room instead. And that will not only lead to poorer healthcare outcomes, but it will also lead to much higher medical bills.

Another doctor who was quoted in the article, Fatima Cody Stanford, an internist who specializes in obesity medicine, also insists that weight is an important measure. She notes that U.S. medical schools do a terrible job teaching students about weight, and that many people don’t visit their doctors very often. Stanford says she would tweak the card to something that says:

“I’m happy to get weighed but please do not provide any negative or derogatory comments associated with my weight.”

That way, the doctor gets their data, and the patient doesn’t have to deal with fat shaming. I would add, though, that in my case, it would not be true that I am “happy to get weighed”. I hate being weighed every time. It causes me a lot of distress, and that’s why I avoid doctors unless I’m about to croak. So I think Dr. Stanford might want to rethink that wording, although I appreciate that she recognizes how upsetting being weighed is for some patients.

I looked at Element Primary Care’s Web site, and it appears that their approach to care is different on many levels. For instance, I notice they offer telemedicine appointments, focus on keeping their practice small, and it appears that instead of using a traditional insurance model, they provide care for a monthly fee. This eliminates co-pays and insurance deductibles, and allows patients to access care when they need it. The direct primary care membership plan can be combined with a high deductible/less expensive insurance plan which would cover hospital care or other unforeseen care needs that still use the traditional insurance model. I have heard of a growing number physicians’ practices eschewing traditional insurance coverage, which allows them to be able to make medical decisions that don’t have to go through third parties at insurance companies. I think it’s a great idea, although it will probably take some time for it to catch on nationwide. Change can be slow, but I do think overhauling our health insurance model could be a game changer for a lot of people.

At Element Primary Care, about half of the patients decline to be weighed, but some will weigh themselves at home and report their weight that way. Or, if they have a condition that requires their weight to be monitored, the patient can turn backwards on the scale, which is how many eating disorder patients get treated. That way, they don’t have to know that number, and it won’t affect their psyche. The cards allow the patients to advocate for themselves and be more of team member in their healthcare. It may also make them feel “safer” from judgment and humiliation. Personally, I don’t weigh myself at all anymore, and when I have gone to see the doctor, I don’t let them tell me how much I weigh. I know from personal experience that knowing the number can lead to distress.

I think the pandemic has caused a lot of issues with weight and mental health. I recently read that a number of young people have developed eating disorders during the pandemic. Even President Biden is addressing it, which is very fitting, since National Eating Disorders Awareness Week begins today. Kudos to Mr. Biden for bringing this up, since I know Trump doesn’t care about helping people with eating disorders. I recently read that doctors are seeing a lot of adolescents in emergency rooms, dealing with eating disorders. There’s also a lot of depression and anxiety being reported, due to the pandemic. I think any measure that makes seeking help easier is commendable.

While it may not always be medically appropriate to skip stepping on the scale, I like the fact that some healthcare professionals are noticing and addressing this issue. And I think it’s amazing that some people are empowering themselves by presenting these cards, although I would not be surprised if some people get lectured by their doctors for not being weighed. I would like to see less lectures from doctors as a general rule. People need to take ownership for their own health, and physicians need to stop seeing patients as people who need to be given orders or lectures about taking care of themselves. Especially if they are competent adults.

Anyway… I probably won’t be going to see a doctor anytime soon, and in fact, I hope I don’t live to be super old. I think it’s overrated. But I definitely think the cards are kind of cool, even if I’m sure they don’t always go over too well with more traditional physicians. I know that if I had given one to my ex psychiatrist, for instance, he probably would have laughed me out of his office. And he never weighed me once– but he did fat shame me quite a few times before I told him to stop. He also gave me a prescription for Topamax off label, hoping it would slim me down. Is it any wonder why I hate seeing doctors?

Standard