I am Une Femme d'Un Certain Age (woman of a certain age, it just sounds better in French, everything does). What does this mean? Well, it means I can walk down Michigan Avenue in Chicago in November in shirtsleeves and be really happy. It means that I carry a fan AND a spritz bottle in my purse (much to the dismay of my daughters). It means that every calorie I consume likes to stay with me and every calorie I burn (and dammit, with this 'internal summer' I have there should be SOME burning) doesn't seem to have any impact.
Such a joy, let me tell you.
So, recently the lovely spousal unit and I went to Washington D.C. (yeah, cuz that's where a woman who runs hot belongs in July). We walked 8-9 miles/day, ate really healthfully (they have some great and healthy restaurants in D.C. like Sweetgreen sweetgreen.com/ and Protein Bar http://www.theproteinbar.com/ with very few snacks or unhealthy food (okay, there were a couple of iced mochas consumed, but it was frigging DC in frigging July!)
ANYWAY, I thought, "Well, even though weight loss is not the reason for the trip and I never want to obsess about it (I have two daughters, I try to be sane about that kind of thing) there's NO WAY I won't have lost weight from this trip." Apparently, "NO WAY" does not mean what I think it means, because not one pound had left me (I guess it's so faithful to me that it will never leave, but honestly, my feelings would not be hurt if some poundage and I parted ways).
Before my trip I had seen my doctor and talked to her about the extreme fatigue I had been feeling, probably due to perimenopause, but I wanted to check. She also said that I'd feel better if I dropped about 20 pounds, which I agreed with in theory, at the rate of about 1 pound a week.
So, when we got back, I e-mailed my doctor and said, "Oh lovely, young slender Dr. X, here's what happened on my trip. How the heck am I going to lose weight?" She said she could give me a referral to a nutritionist, but that she and I could also discuss surgical options. SURGICAL OPTIONS!??!?!?!? Are we talking lap band surgery? What the Heck?!?!?! Even discounting my lovely lying friends aside who say, "Oh you look fine." my DOCTOR friends all said, "Um, you are not badly overweight. You would NEVER be a candidate for that kind of surgery. It's shocking she would even suggest it."
So, am I being punished, mistreated (not as in 'beaten' but as in getting bad medical treatment) because my doctor is in her 30's and seems to be naturally slender?
If this were an isolated incident, I wouldn't be writing this blog (venting, yes, venting is also an apt word) but it's not. So let me tell you about the other incidents (interestingly enough, these are all at the same large medical entity).
About two years ago I went in because my knee hurt a LOT and it made what I call 'crunchy granola' noises when I squatted down and then stood up again. I went to the orthopedist and he did his thing (x-rays, manipulation, etc.) and said that I should exercise 1. 5 hours 2-3 times a week. I said, "Low impact? Swimming?" "Nope", he said, "anything" REALLY? Cuz you know, my knee really hurts (I didn't say that, hence the lack of quote marks). His assistant asked why I didn't exercise and I said, "Because I'm a slug." and she said, "Well, at least you admit it." Wow, nice bedside manner. I did go on to inform her that I am LITERALLY (and I ALWAYS use that word correctly) allergic to exercise, having exercise-induced anaphylaxis, and no, you DON'T want it, believe me, it is not nice having an 'excuse' not to exercise.
I did take the Rx for Physical Therapy, I did NOT take the advice to do aerobic, high impact exercise 2-3 times a week. When I talked to my PT, he said that was HORRIBLE advice and would definitely do more harm than good.
So, was it because my doctor was very fit? Was I running (well walking) into fat bias? Probably. I was being treated based on who HE was and his judgement, not MY reality.
But the most invasive (and I mean INVASIVE) episode happened a few years ago. While leaving out details, my urologist felt there was some irregularity in my urine. He said given my age, I should get images of my bladder interior. When Ismayil (lovely spousal unit) and I showed up at Stanford (which was NOT the entity that had made the initial diagnosis) the doctor who was to do the imaging said, "Why in the world did they send you in for this?" and I said, "My doctor said given my age, I should get checked." THIS doctor (who was probably about 60) looked at 45 year old me and said, "You're a baby, you're not at higher risk for this cancer at all." But, of course, since the 'C' word had been dropped and I was already there, we went ahead with the imaging. Given the 'path' that needed to be taken, not only was it uncomfortable, I told the doctor that after that he owed me flowers and dinner! :-)
Yes, everything was all clear (and the images once he got in the bladder were REALLY cool, the ultrasound engineer husband was fascinated) and the test was unnecessary. So, my medical treatment was based on the fact that my mid-30's doctor saw mid-40's me as old.
Am I venting just to vent? No (although venting is fun). The medical industry needs to realize that this is going on and address it, because it adds up to bad medicine. Do I think that MY posting about it and my 39 regular subscribers reading about it will make a difference? Well, as one of my heroes, Pete Seeger said, “The world will be solved by millions of small things." So, if nothing else, it's a start (and hey, maybe by next week I'll have *40* subscribers!)
September 16, 2014
Who knew the age and fitness of my DOCTOR determines MY care?
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On the other end of the spectrum, I see doctors just giving up on my parents because, well, they're old. Which indeed they are, but when my mother complained of pain, the doctor gave her morphine! When her daughters complained, he chose another heavy-duty, highly addictive painkiller. What she really needed was a hip replacement, i.e. to treat the CAUSE of the pain. Which eventually happened. But morphine? Really? So doctors seem to see things through their own age-biased lenses. Which means when you're in your late seventies, go away and take your painkillers because you're teetering on the edge of death anyway.ReplyDelete
That is truly frightening. What I've seen with friends and family is that everyone needs at least one well informed, determined advocate in their lives. Luckily your mother had you and your sister(s) on her side, but it sounds like it was an uphill battle.Delete
Funny but also so true! And by the way, your 39 followers is 33 more than I have. (That said, I do get a ton of traffic from people who want to know what to see and where to eat in Portugal.)ReplyDelete
I am going to say up front that I love the National Health Service (yes I'm British, guess who I am Sharon!) and that it is amazing and everyone should have one. However, I do have a strong reaction against doctors. Especially the one who when I went to see her regarding a rash, asked me if I had thought about losing weight. The rash was on my lower leg.ReplyDelete
I know EXACTLY who you are, JR! :-) Sounds like you ran into weight bias (and bad medicine) with your doc. Let me guess, she was young and thin.Delete
Found out again! She wasn't that young actually though she was too slim for her own good and mine. I have to say my experience is that on average male doctors have been more understanding of obs/gynie issues than their female equivalents. My personal theory is that if female doctors don't have the issues they feel that other women are exaggerating whilst male doctors can't have the issue so tend to be more sympathetic. There are of course exceptions.Delete
Oh, that's an interesting thought, I haven't had a male doctor since I had Elise and that's been 20 years, so I have no experience with that, but you have a good point. (Sometimes women are less supportive of their own gender than men and that breaks my heart.)Delete
Really unfortunate experiences, Sharon. So the "take-away" seems to be, find drs your own age. I have no doubt that there's a lot of age bias out there. But I think the key is just to find really good drs who know their stuff and think about you as a whole person. And are willing to consider a variety of causes for a particular health complaint rather than jump at the first thing that occurs to her/him.ReplyDelete
I completely agree with you. I had just switched to this doctor because her on-line profile said she wanted to partner with her patients for the best possible health care. Unless those patients are older and out of shape I guess, then she just recommends surgery. SighDelete
Sheri, I forgot to thank you for getting me to 40 subscribers! Thanks!! :-)Delete
This is why my PCP and my gynecologist are both 50-ish women, like me. At least when they tell me to exercise, they're realistic about it.ReplyDelete
Yes, sadly I think I am switching GPs again. The 'surgical option' suggestion makes me question any future treatment. I also think a 50 ish female doctor would better understand the effects of menopause on metabolism, although really, any medical professional treating middle aged women should know that. SighDelete
Medicine is supposed to be evidence based and data driven, but since the "right" approach is often not known, humans fall back to what they do know. Unfortunately bias, anecdote and past experience can all play a roleReplyDelete
I completely agree and understand, we all have our filters. One of the reasons I wrote this (besides the fact that kvetching, besides being a great word, is kind of fun), is to somehow spread the word that doctors, especially doctors, need to be aware of their filters in order to practice truly good medicine.Delete
Bad experiences, great writing. The key for all of us is to ditch doctors who don't treat us like the wonderful, unique, individuals that we are.ReplyDelete
We had a wonderful OB/GYN doctor in the shop yesterday, on a quest to get her fellow doctors, nurses, and other medical professionals to eat less meat. She was so much fun to have in the shop and to talk with, I think if I needed an OB/GYN she'd be my pick! Works in Pacifica though.....
I have friends who stick with doctors even though they have bad experiences with them. You have to keep trying new doctors until you find a good fit. I did that, and am now SO happy with my primary care doctor, a woman in her 30s-40s. Thanks for sharing this, Sharon.ReplyDelete
Funny and sad at the same time.ReplyDelete
I like Linda's advice about trying new doctors until you get a good fit, but I also think this problem may be systemic - so thank you for shining a spotlight on it.
(In your funny and charming way!)
My gosh, Sharon -- you are a superb writer! Where's your book? You are so right that it's time to shine a light on this. SO much unnecessary grief in our Western medical world. Which is too bad -- because there are truly some thoughtful doctors and practitioners. I want to be able to be open to what medical folk have to say to me -- not automatically feel like I have to put on armor and listen to what they say with deep suspicion and assume that we are existing in two completely separate dimensions until they prove otherwise (with thoughtfulness and respect to who I am).ReplyDelete
I do not know which of my lovely friends named Jane this is, so I don't know where to send the check. :-)Delete
I go to my medical professionals with an open mind, I think, but my experiences are not helping with that openness. sigh
I experience a similar type of judgment on the other-OTHER end of the spectrum as a youngin', as well! Thanks for shining light on this-something else to look forward to!ReplyDelete
Lordy Fran, other OTHER end of the spectrum? I'm only 31 years older than you young lady! Other, OTHER? Sheesh (no more CARE packages for you Missy!) :)ReplyDelete
thank you for sharing your experience. The more people that are informed about the age/weight bias, the better.ReplyDelete
My two cents: acupuncture is the way to go on verifying if your system is healthy. Western docs get so hung up on the wrong things sometimes. But I value them in the proper place. Acupuncture/eastern medicine made me healthier in the last year than quite awhile!ReplyDelete
It appears that acupuncture treatment is very useful as an individual treatment for several health conditions, but streetsville acupuncture also even more used in combination with other traditional Western medical treatments.ReplyDelete
Another excellent post. What is a doctor who barely made it through medical school? A doctor. We have to advocate for ourselves just as confidently and assertively as we advocate for our children. We're worth it....and age - is all relative.ReplyDelete
Thanks! Sometimes it takes that stepping back to realize that our care is affected by the doctor's attitudes more than our actual symptoms. I recently changed doctors and I gave my new internist a copy of this blog. :-)Delete
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