Arthur and Kevin's Nellorat (nellorat) wrote,
Arthur and Kevin's Nellorat
nellorat

Fat & Doctors I

Once again, I seem to have successfully negotiated fatphobia with a new physician, but I'm not sure it's over, and the whole experience was very stressful.

As you know, Bob</a>, yesterday morning I finally went to a gyno after a number of years just not doing so. On an amusing side-note, from the reaction of the physician's assistance who did the new-patient intake and of the doctor, it's apparently very unusual for someone without a specific complaint to go to a new doctor after not going anywhere for years. (And yes, I usually get in to the dentist because of a specific problem.) My main reason for the appointment was to be checked for various cancers; he took a pap smear & I have appointments later this month for a mammogram and a pelvic sonogram. The sonogram is not for any symptoms or issues but because it's hard to do a good physical pelvic exam on someone of my weight. I've had them before & am happy for the referral. I also asked about menopausal narrowing of the vagina and the estrogen cream I'd heard of that might help.

When we talked, though, he just had to tell me all about the real threat to my health: my BMI. It was the first major thing out of his mouth: the menopausal changes are an issue to you, but they're nothing compared to this threat to your life. Yes, he did! He started out carefully explaining what BMI is, with a little calculating wheel and everything. He may even have used the word "ridiculous" for my BMI number.

When I was seeking help for my extreme menstrual pain, I had a set speech, but now I found myself almost caught flat-footed. And the whole thing--talking to a doctor like this about weight has to be done so carefully, and because he was very terse and businesslike in his exam, I had almost no sense of him as a person. Some doctors are impressed by medical terms, while others are actually offended. (One doctor said accusingly to a friend, "Where did you learn those words?") You have to be firm, but if you come off as adversarial, that can spoil the whole relationship. And unless you feel like sitting through the opening talk, you have to interrupt, maybe repeatedly, which is not polite with anyone and which doctors are often totally unused to.

This time I think it went about as well as can be expected, although I cried afterwards to supergee in the car & still felt significantly upset as late as last night.

Because of the lack of practice, I even almost forgot to mention that I have lost between fifty and seventy-five pounds three times in my life. When I did,

Dr.: That's very difficult.
Me: No, it's very easy--for me it was very easy. It's keeping it off that's hard, and I won't do anything that isn't sustainable.

In another exchange, I could identify with and appreciate his verbal pickiness:

Me: The only way to lose that much weight is surgery--
Dr.: No, it isn't.
Me: For me. For me it is. (Dr. nods.) And I've really considered it very thoroughly and decided against it.

At least, unlike the neurologist I saw a long time ago, he didn't push me to WLS.

One thing I think helped was that I did admit that I am aware of risks to my health because of the weight. This is only realistic, and I think if I had tried a doctrinaire fat-acceptance approach, he would have just argued with me. As it is, I said I had read extensively, even in bariatric journals, and I feel I am doing almost all I can--although I should exercise more than once per week & I do always keep working on my eating for diabetic control and other aspects of health.

He ended up saying that I was pleasant to talk to (whew, relief) and had an interesting, "academic" way of talking (also relief). At least he listened to me.

Well, so he's not horrible. Unless something awful happens, I'll only have to see him once per year for a check-up and referrals, and if something awful does happen, I'd be seeing a different specialist in the same medical complex anyway: they have a huge, state-of-the-art gynecological oncology department, which I hope to never use but am glad to have access to.

But--shit! And I was so happy that the paper gowns were nice and roomy even on me!

Btw, apparently the vaginal cream is less like Viagra and more like Cialis, in that you take it regularly, and so it does raise systemic estrogen, though not nearly as much as HRT. I'm waiting to make sure my boobies are totally healthy: if not, of course I just use KY Jelly, and if so, I'll then research & consider the risks vs. benefits.

Mood: still cranky about this
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