Healthcare For Some

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Yesterday I ran the Five College Realtors 10-Miler, which was my first event since last summer’s surgery and my first road race since September 2013. My time was well off my personal record for this course, which I set the last time I ran it in 2007, but I have been through quite a lot in the last nine years so expecting to pick up where I left off would have been unrealistic. Besides, it was just great to be able to race again regardless of what the clock said.

As I have written before, I owe a debt of gratitude to everybody who has helped me recover over the last two-plus years, but at the same time I think others who do not receive the same level of care from their own support systems, including their medical teams.

When I went to my primary care doctor in late 2013 complaining of back pain, I received orders for x-rays, an MRI, and a CT scan, referrals to see a physical therapist, a physiatrist, and multiple surgeons, and a collaborative discussion about the pros and cons of complementary treatments, such as acupuncture, chiropractics, massage, and neuromuscular therapy. Subsequently, I received a topical medication, oral medicines, injections, and referrals to more surgeons. Ultimately I required an operation, and then another one, more scans, and physical therapy that continues to this day.

When my “overweight” patients go to their doctors complaining of back pain, more often than not they report receiving one intervention and one intervention only, one that research shows is only achievable for a tiny fraction of the people who attempt to attain it and may not improve their condition even if they do: a directive to lose weight.

Are we not all deserving of thorough, collaborative, evidence-based healthcare, or just those of us who are thin?

4 thoughts on “Healthcare For Some

  1. Actually, the first stuff I saw about how to talk to your doctor about your weight predates Regan.

    I’ve been running a mailing list for fat diabetics since the mid-90s. (Our #1 rule is: We change our diet for our blood sugars, not for our weight.) Folks were passing around Hanne Blank’s letter to her doctor back then: http://cat-and-dragon.com/stef/fat/hanne.html

    Speaking of Regan Chastain — I don’t know if you’ve ever seen some of the hate about her. It’s depressing.

    They mock her for claiming she ran a marathon (she never claimed she -ran- it; she registered as a walker) or about taking “too long” to finish (she completed the course long after it was officially closed, but she DID walk the whole course. I bet those who hate her have never walked 26+ miles at once in their lives!)

    Chastain is currently training for a tri-athalon. Instead of cheering on a fat woman who is making great strides at improving her physical fitness, they mock her for “claiming to be an athlete” and for “spreading lies that fat people can be healthy.”

    There is a lot of stupid out there. I have to keep reminding myself that you cannot fix stupid.

    • The hate that she receives is really sad, and I feel bad for people who only know how to cope with issues in their own lives by irrationally taking out their emotions on others. Specifically, I remember how some people eagerly jumped all over her when she barely missed the cutoff of the swimming leg of a triathlon. They accused her of never having even started despite all evidence to the contrary.

  2. Congratulations on racing again!

    There are people who have written excellent advice for how fat people can deal with doctors who refuse to treat patients until they lose weight. One way is to say, “That’s not going to happen overnight, so why don’t we start by treating me as if my weight is not the sole issue. Treat me like you would someone of a ‘normal’ weight.”

    I first hurt my back in the mid-1980s. I was sleeping on a sectional couch. My back went one way, my legs went another, a disc went POP! Until then I was very physically fit. I was fat but probably not yet “obese.” I went to a gym 3-4 times a week. I could run up two flights of stairs without breaking a sweat.

    I still have nightmares from the week I spent literally crawling around my apartment because I could not walk. I had no health insurance. The pain was amazing. One day the disc went POP! and I could walk again, but the pain was still bad.

    Then and in all the years since, no doctor has ever seriously treated it. Even before my leg was damaged (unrelated) I started walking with a quad-pod cane because I can lose feeling in a leg and fall.

    My last and probably final attempt to do something about my back was going to a “back clinic” run by a major hospital, about 5 years ago. The doctor insisted on trying PT first, despite my telling him tales about previous attempts.

    I informed the therapist that although I exercise as much as possible, given my now-damaged leg, anything involving my back should be started slowly. She didn’t quite roll her eyes. As I’m now very fat, I can only guess what she was thinking.

    She tried a few things. Then a few more. Then it started hurting. She insisted on my trying a few more things. And that’s why I brought a change of clothing.

    Probably the most disturbing thing is that every time I point out that incontinence is considered a sign of a serious problem with back pain, I’m told, “It’s normal for people who are morbidly obese to be incontinent.” Which is utter nonsense.

    • Really sorry to hear about your injuries and the way you were treated at that clinic. Almost every single time I have an appointment related to my back, I am asked if I am having any issues with incontinence, as the presence of such a symptom can indicate a serious issue, as you said. To have that symptom brushed off and attributed to one’s weight is irresponsible and disrespectful at best. Regarding your initial point, sounds like you might be referring to Ragen Chastain, who has written some excellent resources for how to deal with practitioners who insist on focusing on weight loss. I know you already know about her; I am just mentioning her name for the sake of readers who might not already be familiar.

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