Saturday, January 15, 2011
Below is my response to another Spark Blog about fat-shaming doctors:
For any "tough love" doctors who may be listening, here's a story about what happens when "fatties" leave your office.
I need a hip replacement. No question about it, xrays prove the joint is gone and I'm months if not weeks away from a wheelchair.
Doctor #1 was my husband's surgeon, has met me, has my records (I go to the same practice), knows I'm fat, and told my husband to have me come on in when I was ready. Apparently so he could work out some aggression.
He walked in and, without looking at my xrays or file, pronounced that I can't consider operating on you, you are too fat. Don't I know what a hardship it would be for him and the nurses who would be forced to take care of me after? THEN he looked at my xrays, looked shocked, and said he would consider "helping me" if I manage to lose 100-150 lbs. But he didn't think I would. Excuse me doc, get out of the way unless you want my fat ass to contaminate you on my way out the door!
I went home and ate an entire Marie Calendar Key Lime Pie while crying and muttering, "Frack you, Dr. #1." I mean, why the hell not? The experience was humiliating and anti-motivational. It made my normal-weight friends mad, but I'm used to it from doctors. Then I did more research and discovered that while the risk of infection is higher, improvement in quality of life and pain relief are absolutely equal between morbidly obese patients and those of normal weight.
Dr. #2 gently examined my range of motion and found it non-existent. He looked me in the eye and asked about my level of function. We discussed the research. He explained that because it's 1 hip & not both, and I have siblings with same problem, I probably have genetic hip dysplasia and while the weight doesn't help, this is NOT MY FAULT. He explained that in his experience he's had bad results in patients over 300 lbs. My choices were to try to loose weight, acknowledging this would require a very difficult reduction in calories, or to refer to another surgeon (in another state) who works with super-morbidly obese patients. I needed to lose 30 lbs to meet his pre-op criteria. He proposed that I come back in 3 months & if I had lost 15 lbs, he would put me on the surgical schedule & trust me to lose the rest.
I went home, joined SparkPeople and ordered a swimsuit so I can try water-walking. I've lost 10 lbs. so far because I can see light at the end of the tunnel and have a reasonable doctor who is treating me with respect.
P.S. If I come to see you about a problem, say an ear infection, it does not build a therapeutic relationship to refuse to treat an acute problem unless I acquiese to your demand that I submit to your preferred weight loss method first. I'm pretty sure diet pills won't make the bacteria in my ear go away, nor will weight loss surgery. Oh, and I will be happy to have weight loss surgery if you pay for it, my insurance won't. Really, I ask every year.
Friday, January 14, 2011
Today I googled, called and emailed looking for a pool to water-walk in with my brand new, stylish black and gray swimsuit (thank you, eBay!).
Budget is tight because we spend about 25% of our single-earner gross income on medical expenses. Just today husband was told he needs surgery on his wrist, oy vey! Partly, though, I just can't see spending tons on a membership when literally all I can do is walk across the pool for maybe 1/2 hour, hopefully get out unassisted, then go home. (I would love to try a seated Yoga class, too, but those are all during the day when I'm at work.)
The least expensive option ($3-4 per session) is the high school pool. My kids and I (at age 34! a million years ago!) all learned to swim there, but the facilities are...not posh. If I wanted to hang out in a stinky locker room with teenagers I did not give birth to, I'd be a gym teacher.
A private club near work is $125 to join then $45/mo. More if hubby wants to come with, which he says he does. They did agree to give me 1 free pass to check the place out but won't budge on fees.
The Y is my first choice, with a 4' pool, hot tub to loosen up in, nice locker room. They even have 1/2 off joining fees this month, but a family membership is $90/mo; definitely not in the budget. Less if I leave off hubby or daughter, but that's no fun. I emailed to ask if they'd give me a break until my surgery even though I don't qualify for a scholarship (their website said something about partial memberships but no details). Maybe they've missed me since I went back to work (12 years ago), got divorced, started grad school and had neither time nor money for my Y habit?
The Y also is giving 5 free passes through the end of the month, so that's definitely where I'm water walking the next 5 times. Beyond that it depends on what response I get. One way or another, it's time to get wet!
Wednesday, January 12, 2011
I've lost about 10 lbs. in the last couple of weeks. And I'm feeling the urge to sabotage myself. Guess I still have some issues to work through!
I'm staying on track but there is an annoying voice in the back of my head saying, "You can't lose weight. You know you can't, you never have. If you do you won't be able to keep it off. Oh, and you've been losing weight fast--you're ahead of schedule so it won't matter if you take a break from eating healthier."
I don't know who "she" thinks she is, but she's pissing me off. She gives really bad advice. Plus, there is absolutely no better way to get me to do something than to tell me I can't! My husband is totally supportive (just one of the many reasons #2 is better than #1 was). More importantly: I WANT A NEW HIP. I WANT A NEW HIP AND I WANT IT NOW! I don't have time to screw around with annoying voices (or Marie Callender key lime pies) trying to lead me astray.
At some point I need to do some naval gazing and figure out exactly why I feel the need to get myself off track. But for now, the important thing is that my BEHAVIOR is being directed by my rational self. Did I mention I really, really want a new hip and I can't have one unless I lose weight?
Now if you'll excuse me, I'm going to go purge my urge to chew with some lovely Celery Radish and Olive salad.
Saturday, January 08, 2011
It is interesting living with someone who has had lap band. My husband had his put in a few years ago and rapidly lost 85 lbs. He's mostly kept it off, but stalled before reaching his goal weight.
He regained some by cheating the band, mostly by drinking with meals to flush food past the band to have room for more. At one time we had the band deflated due to other medical issues. He's now back on the program, back to his previous level and working really hard to get to his goal weight.
Anyway, meals together are interesting. The pouch formed by the band is about the size of a golf ball. A normal stomach holds 3 pints! He has to eat protein first, then veggies if he has room. Carbs are last, partly because they tend to get "stuck" and that isn't pretty. He's also sodium deficient for some weird reason, so salts everything liberally!
My challenge is to keep my fat and sodium down, while keeping protein, calcium, iron and complex carbs up. He occasionally packs a lunch for me if I'm too busy and I have to really specify what I need. I can have all the lettuce I want in my salad. No, really, honey, I WANT 3 cups of lettuce! (He doesn't eat any due to the low nutrient content and other band issues.) Please don't chop my meat, egg, cheese and veggies into dust, I like CHUNKINESS! (He chops everything fine, again to make his band happy.)
We are using salad plates at dinner. Not so much to help with my portion control, although that's a nice added benefit, but to assuage my guilt. He measures his servings with a shot glass. I know there's no reason for me to feel guilty, but I do anyway.
Many of our needs are the same: Low fat. High nutrient. Quit eating crap! Exercise more! The differences do make cooking a challenge, though. I still make a mostly veggie stir-fry, but we serve his first and pick out meat and carefully selected veggies. He skips the rice and crunches on a couple of chow mein noodles instead. He loves Splenda and I can't stand it, so as a compromise I use 1/2 sugar and substitute the rest with 1/4 of amount called for in Splenda when I bake. I'm learning to love left overs. I try to get enough fiber in my diet to overcome the side effects of my pain killers. He has to take fiber supplements & that's all there is to that.
I'm surprised and grateful that so far I've been able to lose a few pounds. I really didn't think I could do it without weight loss surgery. When hubby had his done, he had different insurance but our current plan won't have anything to do with ANY type of obesity treatment. This is despite my having at least 5 co-morbidities! So on we go with this mix & match food plan.
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