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BMI > 29 = Gov't Mandates via Doctors = Condescending Rudeness

Apr 12, 2016 2:50 PM

According to the new government mandated guidelines all patients with a BMI (body mass index) equal to or greater than 30 must be given a handout informing the patient of suggestions, hints & reminders, which the doctor is now required to counsel the patient on: weight loss, healthy eating, & exercising.

I had my 6 month follow up with my rheumy doc today. I've gained 10 pounds since my last visit, and lost another half-inch in height. She asked how I'd been since the last visit and if I'd had any health changes. I updated her on it all, which she responded on each in between...

1) I've been unable to do any exercises due to sickness (Dec-Feb) & my SOB & exhaustion with activity over 10 minutes. But by tracking my steps I averaged between 1200-3000 on a bad day and 4000-6000 on a good day; ... Her ["Are you sick now? If not you need to move more. Do not sit around all day, only walking to your bathroom or kitchen. I take 1600 steps before I ever leave my house every day. Then I'm averaging 12-16000 steps a day. Taking anything less than 10000 steps a day is going to make you gain weight and get deconditioned. It's unacceptable & unhealthy to move less" ]

2) My cardiologist had cleared sob as not related to my heart and he'd referred me for a lung workup next week; Her ["I'm betting your lung doctor will clear you too. Your heart doctor found nothing wrong. You have nothing wrong more than being deconditioned. "]

3) I now have growths on my skin the dermatology doc says are partly autoimmune related; Her response [Well that comes with age." & laughs]

4) I can't take Aleve or anything like it due to the Barrett's Esophagus dx; Her response ["Really? Hmmm."]

5) My Ortho doc did some labs and wanted me to let you know my CRP level was an 8.2 rate;
Her response ["I'm not interested in that. I don't treat OA and the CRP levels doesn't matter to me. "]

6) I'm cutting back my sugar, fat, & portion sizes, because that's what my GYN suggested while I can't exercise; Her response [" That's a good start, but you must get moving. You are deconditioned and must exercise and take at least 10000 steps a day. "]

7) I'm not resting well due to bladder issues and waking to change positions from pain; Her response [" That's to be expected. "]

At this point my hubby tried to speak up and said, "Is it possible she has chronic fatigue syndrome, maybe instead of fibromyalgia? She has all the symptoms and our primary doc has mentioned it before. She can't hold out walking through the grocery store without getting short of breath." (Keep in mind my hubby researched this on his own and has really been concerned over my lower energy levels and SOB with activity.) She immediately cut him off and said," Why would you possibly want to give her another diagnosis with more meds? " He was speechless, and it took me a few seconds to respond that neither one of us wanted more diagnoses or meds. He was just wondering if it was possible, since our PCP has already suggested it.

She cut me off stating that CFS has the same symptoms of fibro and sjogrens, among other illnesses. Then she continued by commenting "You're on way too much medication, & every doctor you have is going to say the same thing, including me that you need to come off some meds, but you can't come off mine; You can justify every single medication you're on but two-thirds of your meds is likely the cause of many of your problems/illnesses."

At hat point the tirade - counseling - or whatever you call it ended, as she told me to put my shoes on and report to lab for some tests. Let's just say my hubby left there po'd 😀, and I want happily with her rudeness either. 😑

I hope everyone else's day has gone much better! πŸ™‚πŸ’•πŸ™πŸŒΌ

Apr 12, 2016 3:00 PM

Wow Flappys my doctor told me years ago I have CFS & Fybromyalgia, lucky me. The two are similar however there are slight differences. There is a test now for CFS but only one hospital in California except payment from certain insurance companies to pay for it, otherwise it costs approximately $700.00 for this test.

Apr 12, 2016 3:44 PM

TidleyWinks, thank you for letting me know that. Do you take anything for the CFS? How do you cope with it, the fatigue? Do you know which hospital tests for it? I seriously doubt my insurance would cover it, but I'd like to know just in case. My PCP has hinted at CFS for two years, just like he did about the fibro before officially dx that one. He's planning to retire soon at some unknown date, but I see him soon for a follow up. I may ask him to check.

Apr 12, 2016 3:57 PM

I don't believe in toxin medications Flappy, I take a large number of vitamins and minerals, with CFS our mitochondria at the cell level does not work properly, it needs vitamin B12 to do so (I read this somewhere ) so I take 2500 mcg of sublingual B12 every day, injections probably would be better but Idk what other toxins might be in that injection. I also believe in vitamin B100 so I take one each day, also a friend of mine who also has CFS takes 4000 units of vitamin D/day so I increased mine to 3000 units/day. Idk which hospitals do this CFS test other than that one in California, sorry πŸ˜• I posted the article on that in the M.E. (CFS) community I belong to on gplus. If you have a gplus profile I can add you and invite you to this community if you'D like.

Apr 12, 2016 4:08 PM

I have a genetic defect of the MTHFR gene, causing a B9-folate deficiency. It also affects the absorption & metabolization of other B Vitamins. I take a multivitamin, B12, L-Methylfolate, Magnesium, & D3. My GYN doc did a test and it showed me at half the level of vitamins needed. He wanted me to purchase the ones they recommend, special compound, but I don't have $200 for vitamins.

What's gplus? I've never heard of it?

Apr 12, 2016 4:11 PM

Have you tried the B12 injections instead?πŸ˜•
Gplus is a social media site,you can download the gplus app at the Google Playstore.

Apr 12, 2016 5:50 PM

I'll check out the Gplus, thanks. My current PCP doesn't believe the B12, nor shingles, nor pneumonia shots work. Lol All my other docs say I should get them, but defer to my PCP to do it. Typical! 😱

You know there funny part about the rheumy doc saying my meds were causing my problems? I had the diagnosed problems first, which caused the doctors to put me on the meds. And I've been on all those meds since before I started seeing her, except the Plaquenil she put me on for sjogrens.

I'm not sure if she was just having a bad day, if she got ticked at my hubby's question, or if she's just trying to follow new Gov't Mandates. But it sure felt like I caught the brunt of it all. I would love nothing better than to come off my meds, but I'm not sure there's alternatives for asthma, hypothyroidism, sjogrens, migraines, nerve damage, damage to my intestines function, and other dx. I rarely take the Tramadol for pain, because I don't want to get dependent on it, as I have too many narcotics allergies. I tolerate a lot of pain before I do take it. Thanks for listening & your support! πŸ™‚πŸ’•πŸ™πŸŒΌ

Apr 12, 2016 8:02 PM

Sounds like it is time for that doctor to retire. Sometimes we see doctors and end up wondering why the hell they went into medicine. I am with your husband on thus one I would have been more than PO'd . I think I would be hoping that physician got to experience the daily challenges that we live with. Karma you missed someone here, please Karma come back...

Apr 12, 2016 8:12 PM

Oh believe me, he got angrier as the day went. I've been considering leaving her anyway. Since I have to find a new PCP, I may as well find a new rheumy too, closer to home. She's no longer the only rheumy docs office in our address. If she treats other patients like that she may lose a lot. And yeah, Karma would be niceπŸ˜‰ Lol

Apr 12, 2016 11:29 PM

Wow. Yeah, you need a new doctor Flappys, one that takes you seriously πŸ’œ

Apr 13, 2016 5:09 AM

I wonder Flappys if your bad attitude doctor would refer you to a fybromyalgia /CFS specialist , I'don't at least ask because I don't think your doctor knows anything about it and her/his attitude stinks.

Apr 13, 2016 10:52 AM

Oh geeze Flappys, so sorry to hear about your experience with the Rheumatologist. It definitely makes me want to not go to my appointment with my Rheumatologist in June. I already got the you need to lose some weight business from my PCP but at least he was nice about it. I told him I already started by counting calories and lost 5 lbs by his scales and 7 by mine lol. I just pray the Rheumatologist isn't rude, it will be my first visit. I would definitely be finding a new one for sure, there is no doctor worth any of that stress!

Apr 14, 2016 8:45 PM

Well guess what? I had my 3 month follow up with my PCP today. He said the exact same things the rheumy doc said, exact! Omg...Lol!! She sent him the labs she ran and apparently told him what she'd told me, so he just repeated it. πŸ€”

Apr 14, 2016 9:31 PM

Grrr rrrrr!!! No one, NO ONE should treat you that way! What the heck. What will you do? Let us know your thoughts on this. I'm sure many of us experience similar issues. Blecthhh...

Apr 15, 2016 1:31 PM

I'm so sorry to hear that you were treated so badly! I seems like your doctors are using the scale number to cover up the fact that they don't know how to help you (and don't know crap about your condition(s)).

Apr 15, 2016 1:32 PM

I'm in agreement Flown, I'll bet that you're right.

Apr 15, 2016 5:28 PM

Flappys I'm so sorry you got treated like that AGAIN! No one should be treated like that! It's ridiculous! Time to find a new team of doctors!

Apr 15, 2016 9:08 PM

You need some real doctors and they are so hard to come by.

Apr 15, 2016 11:42 PM

FlappysLady81, I'm sorry you got that crap not once, but twice from two different so-called professionals. I feel as if some doctors dismiss a heavier person the moment they walk through the door. It doesn't matter if the pt goes in with a stubbed toe or a serious illness, it doesn't matter because the pt needs to lose weight. I'm sorry he had to, but cheers to your husband for standing up for you! It may not feel like it, but every time they hear the message that we can't be dismissed they'll think a tiny bit more about the right thing to say, at the right time, and to whom.

Apr 15, 2016 11:46 PM

We should all stand up for ourselves & each other. The person with a walker is different, someone with a cane, anyone of color . . . you get my drift. Educated or not, people can be Ugly. Stand (figuratively) tall my friends.

Apr 16, 2016 8:32 AM

Thank you all for your support! I'm researching new, younger docs closer to home. It seems older docs think they know it all and aren't willing to learn new things. The younger ones are just getting started and are so eager to learn, they're willing to research the unknown. Sure, I'm on a lot of meds but it's for diagnosed problems. What I'm not on is a lot of pain meds, because my system reacts to a large majority of them. So I tolerate pain until it reaches a 7-8, then I may take my Tramadol. I am changing docs for sure, but I'm trying to be careful too, because I don't want to doc-hop, especially still awaiting my disability hearing. I don't know if that will affect it or not. If anyone has knowledge or experience on that aspect please share! I need to talk with others who use local docs. Hugs & prayers for a blessed low pain weekend to all! πŸ™‚πŸ’•πŸ™πŸŒΌ

Apr 16, 2016 9:17 AM

Flappsy, it seems everywhere I go these days to see a doctor, they all are a lot younger than me. When I went to pain management and they brought in other docs, the first time I saw them I came home and Mom asked how it was. I said it was ok and she asked about the doc. I said he was nice and she asked his age and I said 15!! LMAO!! I hope you find the doc you're looking for and that they are able to help you. {{{Hugs}}} πŸ’•πŸ™πŸ»πŸŒ»πŸ˜Š

Apr 18, 2016 7:22 AM

AlwayZ, you're too funny! I'm not yet 200 lb but that rheumy doc put me as an obese patient, which shows she was only focused on my weight. I guess it came from the 1.5" shrinkage in height! Lol

At PT last Friday the therapist had me and 2 very much younger & healthier guys doing the knee-ball squeezes side by side. He told the guys they weren't squeezing hard enough because he couldn't see their thighs trembling. I'm thinking, "yay, look at me" because my thighs were trembling like an earthquake. Then he instructed us to do a bridge, lifting our waist to knees into the air, without using our arms (only the feet). The guy's were like the San Francisco bride, but I couldn't even lift my bottom high enough to get my hands under! 😨. I pled age differences as the cause. He laughed and said my hamstrings need work! ***sigh*** πŸ™‚πŸ’•πŸ™πŸŒΌ

Apr 18, 2016 12:09 PM

Flappsy, you slay me!!! Always taking things in stride. I remember going to one doctor for my neck and the office notes read that I was a morbidly obese female complaining of neck pain. Now, what happens if a stick figure walked in?? Would they say an extremely skinny female complaining of neck pain?? I think not.. LOL!! πŸ’•πŸ™πŸ»πŸŒ»πŸ˜Š

Apr 18, 2016 7:56 PM

Flappy they did test on me for my vitamin and mineral levels. Found my vitamin D was too low. On prescription D2 and helped with FMS pain levels.

First explain to your doctor that you need to be able to talk to them and be heard as well as for them to comprehend what you just told them! Show you respect or you will move on. Read your office patient rights.

Good luck

Apr 18, 2016 11:52 PM

Omg AlwayZ, I nearly burst out laughing at your post! My hubby would not have appreciated that at this time of night... Having an insomniac night I guess.

Kamel, my PCP told me to stop my b12 & D last Fall and I did. He ran those labs and my B12 is fine, but my D is low again. I didn't tell him I'm on a multivitamin. I'm going back on my D3 too. Thanks for the suggestion! I've always had a very hard time speaking up for myself, ever since childhood. My siblings always picked on me and I've never outgrown it. That and my grandmother teaching me the golden rule, and not to be rude. Lol I will try your suggestion. I think someone else said something similar.

Hugs & prayers to all! πŸ™‚πŸ’•πŸ™πŸŒΌ

Apr 25, 2016 11:14 AM

I found the following article on a fitness page of all things. So don't let your doctor's get you down about weight since it isn't the cause of health problems. Trying to lose the weight is. The goal is to be as strong as you can be in your body and I know that there are a lot of people here that have made tremendous progress in that respect. Remember 'slow and steady wins the race'. Enjoy.

People seek weight loss as a means to improve health and reduce their risk of chronic disease. But, does looking skinny really equate to better health? An emerging body of research is actually suggesting quite the opposite. Glenn Gaesser, PhD, an exercise physiologist and author of β€œBig Fat Lies: The Truth about Your Weight and Your Health,” says β€œthe number on the scale may be a poor predictor of health as it fails to consider cardiovascular fitness, physical activity and diet.” That is: Being fit and fat can be healthier than being skinny and out of shape, aka β€œskinny fat.”
The Link Between Weight & Health As they say, you can’t judge a book by its cover. Just because someone is overweight doesn’t mean their health is at risk. In fact, according a review by Linda Bacon, PhD, author of β€œHealth at Every Size,” except in extreme cases, body mass index β€œonly weakly predicts longevity.” Her review discovered that most studies following large groups of participants over many years β€œfind that people who are overweight or moderately obese live at least as long as normal weight people, and often longer” with the greatest longevity in the overweight category.

New research has revealed yo-yo dieting or weight cycling to be associated with increased markers of inflammation, high blood pressure, low HDL (the β€œgood” cholesterol) and premature death from heart disease. Obesity may not be the underlying cause of disease, as traditional medicine and health policy suggest. Diet quality, exercise and sleep habits have more impact on health than weight. Instead of fighting the war on fat, focus your efforts on eating healthy, being active and forming good sleep habits.

β€œDiet quality, exercise and sleep habits have more impact on health than weight.”

The Alternative to Weight-Centric Goals The alternative approach to weight-centric health goals looks at health holistically and through a different, body-positive lens, which can be very motivating for many people. The Health at Every Size movement promotes weight acceptance and addresses the stigma and cultural obsession with weight that makes it challenging for many people to be healthy. Some experts even believe that the focus on fat and obesity is making the population more obese. How? Research has shown a potential relationship among weight stigma, emotional eating and poor self-esteem.

Shifting the paradigm in how we view weight can be an effective way to encourage small tweaks to lifestyle that makes health even more achievable. This doesn’t mean that you can throw in the towel, sit on the sofa and eat potato chips all day long. The Health at Every Size approach is about being the best person you can be no matter what you weigh. It’s about seizing the day and working toward health β€” physically and emotionally. Instead of making weight loss the goal, allow it to be a side effect of a healthier lifestyle.

If you want to challenge the status quo and face these weighty issues head on, find further reading about the Health at Every Size movement at LindaBacon.org, or check out Gaesser’s book, β€œBig Fat Lies.”

Apr 25, 2016 6:29 PM

Gotobef, thank you for sharing this! πŸ™‚πŸ’•πŸ™πŸŒΌ

Apr 26, 2016 12:17 AM

I agree, someone at a "healthy bmi" can be terribly de-conditioned. I am one of those.
I know larger women who could run circles around me in any race.
You're right. Focusing on feeling comfortable in your own skin, on eating & sleeping well and whatever exercise your DX allows, is much healthier.
So far, it's a life altering improvement for me, to get outside for 15min a day and help around the house.

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