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Old 09-12-2011, 10:09 PM   #1
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Default Getting the fat lecture after WLS

As some of you may know, I have pulmonary Sarcoidosis, an autoimmune disease that can attack any area of the body but in my case, attacks my lungs, causing fibrotic lesions as well as fatigue and joint pain. Prior to my WLS and subsequent 140 pound loss in 2005, I had a very hard time getting around, had to use an inhaler, and had lots of joint pain and fatigue; however, the weight loss eased my symptoms and, perhaps coincidentally, I've done fine for years.

So fine, in fact, that I haven't had to see my pulmonologist since 2007.

Last year, since starting school again and lots of life and work stress, my Sarcoidosis has started acting up again, and my breathing is difficult. I'm sleeping 16 hours a day when not in school or work, and my little joints in my fingers and feet hurt. In short, I'm a hot mess.

I tried to get in with my lung doc but he couldn't see me for many weeks. I never really liked him a lot so I had my nurse practitioner, my primary care provider, manage me. However, I continued to get worse and worse, despite short burst doses of Prednisone and two inhalers. Time for a specialist.

She recommended a different lung doc and I thought why not, got scheduled and saw him last week. What I expected -- a prescription for low dose prednisone -- didn't happen. In fact he have me NO treatment at all. Instead, he blamed my fatigue on my (very stable, very minimal anemia), and said I needed to 50 pounds. He said it's great that I lost 140 pounds but I'm still a 200 pound woman and am "far too fat". When I asked how I could exercise when I can't climb stairs, when I wake up coughing (one of the primary symptoms of Sarcoid is dry cough) and when am so fatigued I can barely keep my head up, he had no answer. NONE.

I've only had a couple of fat lectures in my life, because mostly my providers have been super cool and understanding; we've discussed how weight loss might help my hypertension and stave off diabetes, but mostly they've been happy to treat me while encouraging lifestyle changes. This guy, however, gave me an inappropriate lecture (it's like telling a MS patient to climb Mt Everest) and refused to treat me. And I especially wasn't expecting it after losing weight, particularly when my symptoms had been gone for such a long time. However, the one thing I have that is unrelated to my weight -- my autoimmune disease -- is being linked by this so called "specialist". Anti-fat bias, much?

I asked for treatment. He denied me. So I won't be seeing him again. And, back to the drawing board to find a lung doctor to treat me, hopefully one that knows his backside from his elbow.
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Old 09-13-2011, 07:31 AM   #2
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Originally Posted by Miss Vickie View Post
Last year, since starting school again and lots of life and work stress, my Sarcoidosis has started acting up again, and my breathing is difficult. I'm sleeping 16 hours a day when not in school or work, and my little joints in my fingers and feet hurt. In short, I'm a hot mess..
The spirit is willing but the flesh is weak.

Sometimes you just have to admit something is beyond you, even if "only" due to the stress issue. Do yourself a favour, recognise your limits and accept them. It's damned hard (and heartbreaking) to give up plans and dreams but it's even worse to live with a broken body. It sounds like you're about to seriously re-break your body. No amount of steroid based meds will fix that and even their efficacy will fade after awhile.

I wish you the best. You have some tough choices to make.
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Old 09-13-2011, 01:54 PM   #3
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Miss Vick, so sorry to hear about that unpleasant experience with the new Dr., but I'm glad to hear you know it was him, and not your medical conditions that was the problem.

Do you have any idea of what you could try or what another pulmonologist might suggest? Or are you at the end of your 'i know what to do here' rope?

Keep us informed and I wouldn't necessarily give up your dream--I know you don't plan on doing that anyway.
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Old 09-13-2011, 01:58 PM   #4
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Originally Posted by Miss Vickie View Post
As some of you may know, I have pulmonary Sarcoidosis, an autoimmune disease that can attack any area of the body but in my case, attacks my lungs, causing fibrotic lesions as well as fatigue and joint pain. Prior to my WLS and subsequent 140 pound loss in 2005, I had a very hard time getting around, had to use an inhaler, and had lots of joint pain and fatigue; however, the weight loss eased my symptoms and, perhaps coincidentally, I've done fine for years.

So fine, in fact, that I haven't had to see my pulmonologist since 2007.

Last year, since starting school again and lots of life and work stress, my Sarcoidosis has started acting up again, and my breathing is difficult. I'm sleeping 16 hours a day when not in school or work, and my little joints in my fingers and feet hurt. In short, I'm a hot mess.

I tried to get in with my lung doc but he couldn't see me for many weeks. I never really liked him a lot so I had my nurse practitioner, my primary care provider, manage me. However, I continued to get worse and worse, despite short burst doses of Prednisone and two inhalers. Time for a specialist.

She recommended a different lung doc and I thought why not, got scheduled and saw him last week. What I expected -- a prescription for low dose prednisone -- didn't happen. In fact he have me NO treatment at all. Instead, he blamed my fatigue on my (very stable, very minimal anemia), and said I needed to 50 pounds. He said it's great that I lost 140 pounds but I'm still a 200 pound woman and am "far too fat". When I asked how I could exercise when I can't climb stairs, when I wake up coughing (one of the primary symptoms of Sarcoid is dry cough) and when am so fatigued I can barely keep my head up, he had no answer. NONE.

I've only had a couple of fat lectures in my life, because mostly my providers have been super cool and understanding; we've discussed how weight loss might help my hypertension and stave off diabetes, but mostly they've been happy to treat me while encouraging lifestyle changes. This guy, however, gave me an inappropriate lecture (it's like telling a MS patient to climb Mt Everest) and refused to treat me. And I especially wasn't expecting it after losing weight, particularly when my symptoms had been gone for such a long time. However, the one thing I have that is unrelated to my weight -- my autoimmune disease -- is being linked by this so called "specialist". Anti-fat bias, much?

I asked for treatment. He denied me. So I won't be seeing him again. And, back to the drawing board to find a lung doctor to treat me, hopefully one that knows his backside from his elbow.
That completely sucks your doctor treated you that way then gave no information or treatment that could help you.

Hope you find a doctor far more informative and useful.
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Old 09-13-2011, 03:13 PM   #5
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Originally Posted by Miss Vickie View Post
As some of you may know, I have pulmonary Sarcoidosis, an autoimmune disease that can attack any area of the body but in my case, attacks my lungs, causing fibrotic lesions as well as fatigue and joint pain. Prior to my WLS and subsequent 140 pound loss in 2005, I had a very hard time getting around, had to use an inhaler, and had lots of joint pain and fatigue; however, the weight loss eased my symptoms and, perhaps coincidentally, I've done fine for years.
Anti-fat bias, much?
I asked for treatment. He denied me. So I won't be seeing him again. And, back to the drawing board to find a lung doctor to treat me, hopefully one that knows his backside from his elbow.

So sorry you had to experience that in the midst of your pain and fatigue. I hope you can find a new doctor asap, because that doctor's bias renders him unethical for treating anyone, to tell the truth. Refusing treatment, and demanding you do something you're not capable of is more than unreasonable. It defies logic.
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Old 09-13-2011, 03:56 PM   #6
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F*** that f******.

How unprofessional. You don't chastise somebody in pain about their weight, and you sure as heck don't do it to somebody who's already lost 140 pounds. Jerk off.
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Old 09-13-2011, 08:18 PM   #7
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Vickie..............honey, I am so sorry that happened to you.............Doctors are supposed to do no harm.............how the heck can he justify the way he treated you...............another health professional! I am so mad right now.

All the love, support and encouragement you have given all of us here at Dimensions..................it just makes my blood boil that he treated you this way.

Find another Doctor right away. Someone who cares about their patuents, listens and trys to find solutions for treatment.............they are out there. just sometimes hard to find. My onocologist has been my personal Godsend...........not just with the cancer but also taking charge and ordering other tests for unrelated medical problems I have had for years...found congenital heart defects, and that I did NOT have asthma which I have been using an inhaler for years and a few other IMPORTANT issues that are now solved thanks to his persistence. I feel healthier and more cared for than any other time in my life. You will find yours!
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Old 09-14-2011, 12:05 AM   #8
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Vickie, I'm so sorry that you had to see this jerk. Sometimes I believe certain Doctors shouldn't ever practice with patients. I don't care how book smart they are, if they don't have proper bedside manners, they shouldn't have the opportunity to cause more harm to the people who are seeking their help.

I know you're a strong, intelligent woman... and can move on to a better professional Doctor, but seeking this idiot was a waste of your time, money... and had no excuse what so ever to act this way.

Hugs. Allie
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Old 09-16-2011, 10:44 AM   #9
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Originally Posted by HereticFA View Post
The spirit is willing but the flesh is weak.

Sometimes you just have to admit something is beyond you, even if "only" due to the stress issue. Do yourself a favour, recognise your limits and accept them. It's damned hard (and heartbreaking) to give up plans and dreams but it's even worse to live with a broken body. It sounds like you're about to seriously re-break your body. No amount of steroid based meds will fix that and even their efficacy will fade after awhile.

I wish you the best. You have some tough choices to make.
Oh, believe me I know my limits, better than anyone else, in fact. I've accepted them and figured out how I can go about getting through this next year without compromising my health. My health care providers are all on board with the plan -- except the aforementioned jerk -- and once I get through the next few months things will improve for me.

Ironically, one reason I'm choosing to become a nurse practitioner is that floor nursing is exceptionally hard on the body. I know that I can't keep up the pace of 12 hour shifts in L&D for much longer and need a back up. I chose to use my pretty smart brain to my advantage.

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Originally Posted by Jes View Post
Do you have any idea of what you could try or what another pulmonologist might suggest? Or are you at the end of your 'i know what to do here' rope?

Keep us informed and I wouldn't necessarily give up your dream--I know you don't plan on doing that anyway.
Thanks, darlin'. The treatments beyond what I'm doing are low dose steroids over long term, or other immune modulators like methotrexate. I was hoping for super low dose pred but my regular NP didn't feel comfortable prescribing that. I know what my options are, but since the meds have side effects, providers are hesitant to prescribe; I understand, I'm a prescriber-in-training, but quality of life is also important.

Oh yeah, no way am I giving up. Giving up is not an option. I've been through too much already, especially when I know that ultimately this will improve my health and stress level.

In the meantime, one of my medical team came through with a treatment for my fatigue so at least I have more energy. I can use NSAIDS to treat the joint pain and inhalers to treat the lungs so if that's what I have to do, that's what I have to do.

But the fat lecture REALLY stung, particularly because it was so unexpected.

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Originally Posted by CastingPearls View Post
So sorry you had to experience that in the midst of your pain and fatigue. I hope you can find a new doctor asap, because that doctor's bias renders him unethical for treating anyone, to tell the truth. Refusing treatment, and demanding you do something you're not capable of is more than unreasonable. It defies logic.
You're right. I'm going back to my old pulmonologist who, even though he wasn't aggressive or communicative, was at least polite and kind. I have an appointment for repeating lung function tests and then an appt to see my old guy the following week. Once we have that info, we can move forward with more meds, if necessary.

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Originally Posted by Diana_Prince245 View Post
F*** that f******.

How unprofessional. You don't chastise somebody in pain about their weight, and you sure as heck don't do it to somebody who's already lost 140 pounds. Jerk off.
Funny how we as nurses know what these doctors, apparently, don't.

Quote:
Originally Posted by Theatrmuse/Kara View Post
Vickie..............honey, I am so sorry that happened to you.............Doctors are supposed to do no harm.............how the heck can he justify the way he treated you...............another health professional! I am so mad right now.

All the love, support and encouragement you have given all of us here at Dimensions..................it just makes my blood boil that he treated you this way.

Find another Doctor right away. Someone who cares about their patuents, listens and trys to find solutions for treatment.............they are out there. just sometimes hard to find. My onocologist has been my personal Godsend...........not just with the cancer but also taking charge and ordering other tests for unrelated medical problems I have had for years...found congenital heart defects, and that I did NOT have asthma which I have been using an inhaler for years and a few other IMPORTANT issues that are now solved thanks to his persistence. I feel healthier and more cared for than any other time in my life. You will find yours!
Thanks, Kara. You're such a sweetheart. I think this happened for a reason, to bring home to me just how bad it is out there for fat folks. I've had two comments made to me recently, about how we need practitioners who are fat friendly, and practitioners who specialize in chronic illness. I'm thinking that once I get my feet wet as a NP I may try to get such a practice going.

It also cements in my mind what kind of practitioner I want to be, and the behavior I wish to avoid. I hope to heaven I never make someone feel like I felt.

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Originally Posted by BBWMoon View Post
Vickie, I'm so sorry that you had to see this jerk. Sometimes I believe certain Doctors shouldn't ever practice with patients. I don't care how book smart they are, if they don't have proper bedside manners, they shouldn't have the opportunity to cause more harm to the people who are seeking their help.

I know you're a strong, intelligent woman... and can move on to a better professional Doctor, but seeking this idiot was a waste of your time, money... and had no excuse what so ever to act this way.

Hugs. Allie
Thanks, Allie. He was pretty awful and obviously had a bias. He mentioned how he never eats lunch (goes out for a run instead, loves to run, runs every day, even though it hurts) and he's stick thin. So I guess I shouldn't have been surprised.

Thanks, all, for the support. I guess I thought I wouldn't be subjected to the whole "you need to lose weight" schtick since I'd lost 140 pounds, but to some people apparently that doesn't count and you can never be too thin.
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Old 09-16-2011, 11:21 AM   #10
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Originally Posted by Miss Vickie View Post
Thanks, all, for the support. I guess I thought I wouldn't be subjected to the whole "you need to lose weight" schtick since I'd lost 140 pounds, but to some people apparently that doesn't count and you can never be too thin.
You ought to write him a note. A thank you note. Tell him that your appt. with him gave you a working example of how not to treat your future patients, and you're very glad for his help!

seriously.

haha. Can you imagine? SCANDALOUS.
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Old 09-16-2011, 11:24 AM   #11
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Sometimes -- and I know it's wrong -- I feel that it should be legal for foul, unprofessional, useless doctors to be flogged. I'm sorry you had to go through that at all, Vickie. I have a condition affecting my eyes that isn't nearly as dire ad yours. It's been under the care of a medical facility that is thoroughly inadequate and I've been put through a keystone caper with them for years.

When I went for a routine checkup to be fitted for glasses at an eye place that came highly recommended by friends, the doctor there who was every bit as impressive as depicted handed me a card for a guy who deals with my particular issue. At the time I was too tired, too overwhelmed to even muster to pursue it. I bring this up because I wonder if the best course of action would be to find out where a DOCTOR would go if s/he had the same issue. The eyedoc woudln't say anything bad about the place I was going but I got this still and quiet vibe from him that he was familiar with their work. He handed me a card and recommend someone even though I hadn't asked for it. Looking back on it I suspect he knew enough that the place I'm going now is Mickey Mouse. I'm sure doctors are familiar with the smell of snake oil when they smell it and won't go to someone they don't trust or respect. I'm thinking of going back to the eye doctor (I have to anyway) and getting that recommendation again. Is there another place where you can go and let them have a look just so they can point you in a better direction?
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Old 09-17-2011, 07:49 AM   #12
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...This guy, however, gave me an inappropriate lecture ....
Truly sorry to hear that. This sort of thing is entirely unnecessary in our modern lives that are stressed enough with a steady daily flow of unavoidable bad and annoying news as it is. And examples of rude, intrusive incompetence such as this tend to stick with us, perpetuating and multiplying the damage. At the very least I'd lodge a composed but detailed and forceful complaint so that the perp faces consequences for his despicable behavior.
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Old 09-21-2011, 04:23 PM   #13
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You ought to write him a note. A thank you note. Tell him that your appt. with him gave you a working example of how not to treat your future patients, and you're very glad for his help!

seriously.

haha. Can you imagine? SCANDALOUS.
Bwah. I love it. If only I didn't live in a small town and will soon be joining the ranks of providers. The last thing I need is to get a rep as a smartass (too late!) Maybe the day I leave for points south.

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Originally Posted by LillyBBBW View Post
Sometimes -- and I know it's wrong -- I feel that it should be legal for foul, unprofessional, useless doctors to be flogged. I'm sorry you had to go through that at all, Vickie. I have a condition affecting my eyes that isn't nearly as dire ad yours. It's been under the care of a medical facility that is thoroughly inadequate and I've been put through a keystone caper with them for years.

When I went for a routine checkup to be fitted for glasses at an eye place that came highly recommended by friends, the doctor there who was every bit as impressive as depicted handed me a card for a guy who deals with my particular issue. At the time I was too tired, too overwhelmed to even muster to pursue it. I bring this up because I wonder if the best course of action would be to find out where a DOCTOR would go if s/he had the same issue. The eyedoc woudln't say anything bad about the place I was going but I got this still and quiet vibe from him that he was familiar with their work. He handed me a card and recommend someone even though I hadn't asked for it. Looking back on it I suspect he knew enough that the place I'm going now is Mickey Mouse. I'm sure doctors are familiar with the smell of snake oil when they smell it and won't go to someone they don't trust or respect. I'm thinking of going back to the eye doctor (I have to anyway) and getting that recommendation again. Is there another place where you can go and let them have a look just so they can point you in a better direction?
Lilly, I'm so glad you were given information which could guide you to a better place for your health issue; I've done the same thing for patients when they've told me they're seeing someone who I KNOW practices unsafely. (Nurses and doctors know, usually, what other providers are doing because they eventually see the patients).

The really sick thing in my case is the guy I went to came HIGHLY recommended from nearly every provider I know. Most people think the guy I was seeing is too laid back (I agree since he's done little for me -- OTOH until recently my disease has been in check) but that this new guy is very aggressive. Aggressive, yes, but not in treating my illness appropriately. There are a couple other docs in town, one of which practices with my other lung doc so I could possibly switch but that would be awkward. And another lung doc who specializes in sleep apnea. So this is supposedly "the" Sarcoid guy. So that's it. That's all we have between here and Seattle in terms of providers who can treat me.

My plan at this point is to get my testing done, see my old pulmonologist next week and talk to him about my concerns about lack of aggressive treatment. I'll see what he thinks about low dose prednisone. If he can't help me, I may have to branch out and go to Seattle (or Portland) where there are more options. In the meantime I'm trying to be gentle to my lungs.

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Truly sorry to hear that. This sort of thing is entirely unnecessary in our modern lives that are stressed enough with a steady daily flow of unavoidable bad and annoying news as it is. And examples of rude, intrusive incompetence such as this tend to stick with us, perpetuating and multiplying the damage. At the very least I'd lodge a composed but detailed and forceful complaint so that the perp faces consequences for his despicable behavior.
Thanks, Conrad. I'm going to write him a letter (email, actually) and talk to my primary care provider about it. We have a medical board here, but I'm not sure he did anything so bad that it would interest them but it's worth a shot. I got a call from my GI doc who received a copy of his visit note and asked, "What gives?" and I told him he thinks my fatigue has to do with the one brief, resolved episode I had of diverticulitis several months ago and the very mild anemia which has been consistent for many years and is related to my autoimmune disease. Despite all evidence to the contrary he thinks I have a GI bleed. He said "Well that's a long shot" and told me to see someone about my lungs. Yeah, thanks.
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Old 10-08-2011, 06:26 AM   #14
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I'm not a health-care professional, nor to I portray one on television, but I've dealt with enough of them over the past 10 years to make personal observations, and comments. . First I'd like to say this. . Just because you've attended Med school, done your internship, and residency. .You still may not be fit to treat human beings!

My wife was a very healthy, vibrant bbw, who over time became a ssbbw. . Now in her early 50's began to have some health issues. She experienced some knee issues, and was actively trying to lose a bit of weight to alleviate that particular issue. . There were a myriad of problems, of course every single one of them was attributed (rightly or wrongly) to her weight. (has anyone here not heard this same story)

Our experience with the "medical community" had been such that I not only would seek a "second opinion" but often a third if possible when it comes to medical treatment, most often at personal expense. . All this due to attitude, and manner of some physicians. I realize we're all humans and therefore have our own set of issues and prejudices, but a human being is still a human being thin or fat!! Please afford each person that ability to feel "human" in your presence. . Good luck with that!

Over the years as a "care-giver" for my mother, a maiden aunt, and my wife, I feel I've had enough experience to make reasonably educated comment, from the side of the "end user" of medical treatments. . if by proxy. I have "fired" more than one doctor. . and have no problem doing it. In fact both times when I did, the end result was far better than had been with the previous physician. .I'm not here to bash doctors, except to say we are all human beings and deserve to be treated with the same dignity regardless of our size, race, sex, or anything else. Most of us realize we don't always make the best "life choices", if I said I did I'd be a liar! The issue is, once we've made that realization, please work with us as a team. . not as an overlord!

I wrote a blog about my wife's battle with ovarian cancer and the horrible way in which the "medical community" treated her. . . and her eventual loss of that battle. . It was one of the most "eye opening" experiences I'd never recommend for anyone. . I don't think our story is so unique, I do however think my attitude on things is much different.

I would never tell anyone not to see a physician, however, if that said physician treats you shabbily. . They should be reported. . period. . I didn't mean for this to become a rant, please forgive me, but I want to see everyone treated with dignity, respect, and civility. . Especially when they are in need of assistance. .
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Old 03-05-2012, 11:59 AM   #15
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No one deserves to be treated like that, sorry you had to hear that.
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