(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.