A Tale of Two Doctors

(A digression of the normal Friday Series.)

Thursday I went to two doctor appointments; my GP and my OB/GYN.  I went for entirely different reasons.  I went to the GP because I needed a “get out of jury duty” pass (because my migraines have gotten to the point of having them two or three times a month, and I have to be in bed until they finally go away), a new order for lab work, and some medicine for a rash.  The OB/GYN visit was my normal “well woman” visit.

I had the GP appointment first.  My regular doctor (which I loved so much in October last year) wasn’t able to see me, and since the letter documenting my migraines was time sensitive, I took a chance with another doctor at the practice.  She was just as great as my regular doctor.  I was weighed in a separate room away from everybody, then went into the examining room.  My blood pressure was taken (120/88), and the reason for my visit ascertained again.  I waited a few minutes for the Doctor to come in, and when she did, she introduced herself.  We talked about my need for a script for my skin problem, my need for the doctor’s note excusing me from jury duty, and how if I’d fasted before coming in today, she could have done the blood draw right then for my labs.  (I’d had a banana for breakfast, so no blood draw.)

It was a very laid back appointment.  She took the time to listen to me, figure out what I needed, and we proceeded from there.  I was not chastised for my weight, nor for my blood pressure.  I left there feeling good about this other doctor, and feeling like I wouldn’t have a problem with seeing her for something major should my doctor not be available.

After that, I had my visit with my OB/GYN.  This was not my first visit with her.  We’ve had at least 6 visits in the past (when I had a cancer scare, when we were trying to figure out exactly what was wrong with me, and last year’s well woman exam). 

I was called in, and weighed on the scale in the room (also away from everybody else).  The nurse asked how tall I was, and I answered (5’2″).  Then my blood pressure was taken (122/84).  Then I was left to get ready for the doctor.  As soon as she came in, she started in on my weight, and my BMI.  See, I had gained 30 pounds in a year and 4 months (since I’d last been in to see her).  My BMI is now 47. 

She wrote that down on a paper printed with the fields Height, Weight, BMI, <18.5 underweight/18.5-24.9 normal/25-29.9 overweight/>=30 obese, Blood Pressure, and circled >=30 obese.  (Like I don’t know I’m obese?)

Then I got a lecture on how I need to lose weight because of my “high” blood pressure.  Yes, at 122/84, she considers me to have high blood pressure, and in fact, so high that my migraines may be caused by it.  In talking to me about my “high” blood pressure, she didn’t ask me if I’ve been stressed lately (I have), if I’ve been sleeping well (I haven’t), if I’ve changed my diet at all (I haven’t, except for eating more crock pot foods when the oven was dead).  In lecturing me about my fat, she didn’t ask what changed in the past year, if there has been any major changes in my activity levels (there has) and why (knee surgery and subsequent relearning how to walk through PT, being on low exercise allowance by my surgeon, went from walking 2+ miles a day with my job to not walking at all due to surgery and recovery for approximately 8 months).

Other than scolding me about my weight and informing me about how bad for my health my weight is (with no other information but the weight, BMI, and blood pressure reading), she spent more time talking to me about the book I was reading (Neil Gaiman’s Neverwhere) than talking about my health.

I left there feeling quite a bit demoralized, and more than a little bit angry.

I didn’t say anything to her at the time.  I was shocked at this new behavior from her.  Like I said, I’ve seen her at least 6 times in the past two years, and this is the first time she’s ever done this.  She never even so much as mentioned BMI before, much less write out what mine is and circle obese.  I honestly don’t know if she’s drunk the cool-aid or if she was always like this, but there was so much going on in the first few months she was concentrating on my real problems, so that left things like BMI on the back burner.

I will not be going back to her again.  My GP office does yearly well woman exams, and I think keeping all of my healthcare (or as much as I can, the GP can’t do nuerological exams for my migraines) with one practice is a good idea.  Because then, when they look at me and say, “Your x is elevated, what is changed in your life?” I know they are really looking at actual health indicators.

Not, you know, using short cuts to decide if I’m healthy or not.  Because you can tell from a BMI number and a “high” blood pressure of 122/84.

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18 Responses

  1. Yes, at 122/84, she considers me to have high blood pressure, and in fact, so high that my migraines may be caused by it.

    Oh, come ON. That is ridiculous. A systolic of 122 is not hypertensive, and it’s especially not hypertensive in a doctor’s office, where it’s bound to be higher because of the stress of being there. And any lowering of BP from weight loss in and of itself is usually temporary, a side effect of the diuretic (water loss) effect of dieting. (Diuretic medications are often prescribed for hypertension.)

    Maybe she didn’t so much drink the Kool-Aid as she had someone inspect her and demand that she “crack down” on her patients for being fat? Insurance companies in the States do that kind of thing a lot.

    • Having somebody crack down on her is possible, UHC is notorious for being more invasive than most patients know or would like (if they did know).

      My blood pressure usually sits around 115/75. When I worked for UHC in a very stressed filled position, it was bouncing between 140/100. That last is definately hypertension and something to be watched. When I quit the extremely stress filled job, my blood pressure went back to my normal within a week.

      I’m not concerned at all about a couple points off “ideal”.

  2. 120/80 is completely awesome blood pressure. It is even very good on the new-fangled scales where anything less than totally awesome is a harbinger of doom. That doctor has no judgment. Or is completely making stuff up in order to pressure you to diet. I would never trust her with sharp instruments.

  3. I went to the doctor Tuesday and my blood pressure was 137/75. The doctor I saw (who doesn’t like my weight either, but told her I would absolutely not be dieting) said this number was fine. My grandfather, who visits the same office but sees a different doctor, had a reading of 160/80 and was told that number was fine for him!

    But 122/80? That is perfect! Unless she’s thinking it’s too high for your height, like they do with that stupid BMI.

  4. Wow. Have you thought about writing this up in the form of a letter to her, so maybe she’ll reconsider her practices in future?

    In particular, I’m thinking about the sentences that start, “In talking to me about my “high” blood pressure, she didn’t ask me …” and “In lecturing me about my fat, she didn’t ask…”. The points in these sentences could be a very useful guide for her, if she could read them in a non-defensive way. Perhaps rephrased to, “It might have been helpful if you had…”?

    Sorry to hear about your rotten experience.

  5. I think you should not only fire her, but write her a letter telling her exactly why she is fired.

  6. I second Fantine. That’s just ignorant.

    (Though, Neverwhere is a great book.)

  7. I’m so sorry your ob/gyn was such an ass. Even under the newly-lowered blood pressure standards, 122/84 would be considered borderline blood pressure by the most strict interpretation, not high by any standard. And I don’t think anybody would argue that it’s high enough to cause migraines.

    I’d be willing to bet a whole lot of money that if your BMI was 22, she would have told you your blood pressure was fine, and would have looked for another cause for your migraines.

    • As my husband said last night when I told him about what had happened, as my gynocologist it’s not her specialty to look for the cause of my migraines. That’s what I have a nuerologist for. (And yes, I had made her aware of the fact that I am seeing a nuerologist for my migraines.)

  8. Fire her, and write her a letter laying out the reasons why.

  9. That’s annoying. That’s exactly the sort of behavior that makes someone who is already insecure about their weight too embarrassed to go back, to ANY doctor. A lot of people who trust doctors internalize that kind of “What are you DOING!? You’re KILLING yourself!” message that many of them give off.

    Years ago, If I had the visit you had, I’d have taken it to heart and been fully humiliated. Nowadays, if a doctor started to write down the BMI chart and circle where I am on the scale, I’d have calmly informed her that BMI is horse shit, and that she has no business condescending to me so much as to think I couldn’t figure out where I am on the BMI scale.

    ARGH. 120/80 (approximately) isn’t bad at all, and getting on your case over that is inappropriate and belittling. As others have suggested, write to her and let her know why you’ll no longer be seeing her.

    • Nowadays, if a doctor started to write down the BMI chart and circle where I am on the scale, I’d have calmly informed her that BMI is horse shit, and that she has no business condescending to me so much as to think I couldn’t figure out where I am on the BMI scale

      I’m at the point where I would very much do this now, if I wasn’t so shocked at the 180 degree turnabout she was showing. Like I said, I’ve visited her at least 6 times before, and never once did she do any of this. Yesterday was the first time, and the behavior shocked me into silence.

      • I can understand that, honestly. I’d have been shocked, too. I HAVE been shocked like that; there was one time when a nurse was trying to check my breathing, when I had seriously clogged lungs and difficulty breathing without wheezing loudly. She told me she “couldn’t tell”, because she “couldn’t hear through the fat”. I was so humiliated, because this was YEARS before I’d heard anything about FA, and honestly believed there was something wrong with me if the medical professionals couldn’t hear obvious wheezing!

        Of course, I was shocked into not thinking about how horrible it was of her, until much later. I wish I could go back and have told her, “Then you’re an incompetent nurse who should go back to medical school until you can figure out how to do your job right.” I have zero patience with that bullshit, when I’ve had years of doctors making me feel horrible. I’ve learned, the hard way, how to overcome that shock.

        (Basically, I’ve learned how to trade rudeness with rudeness. 😄 Not always right, but certainly fair.)

  10. Holy hell. This woman sounds like a complete moron. Fire her, fire her now, and fire her thoroughly (via letter as suggested by other commenters).

    • That’s my plan.

      I’m just really glad the doctors at my GP’s office are really good, and that they do gynological well woman visits, so I don’t have to try and interveiw another new doctor.

  11. The doctor I work for, while not exactly fat-friendly, will always take the time to test blood pressure at least twice for a patient. Many outside factors can effect the number.

    Of course, he doesn’t mind giving “diet” pills to women with a BMI range slightly in the “overweight” range either.

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