# A rant about fat phobia in the medical community.



## Tracyarts (Mar 26, 2021)

I just need to be heard by my "tribe" so to speak. 

I'm dealing with a medical problem. It's complicated and potentially very serious. I'm starting the process of diagnostic procedures and meeting with multiple specialists to figure out what's wrong, how to best address it, and what my prognosis might be. 

So far my weight is being made the main focus although the more likely factor behind this is my autoimmune disease and a medication I take to manage it. 

The physician in charge of my care is my primary care physician, an internist. And she is convinced that everything wrong with me is a direct result of my weight and associated comorbidities. And is completely ignoring the fact that my autoimmune disease can cause everything I'm currently dealing with as well. And I have been fat for decades but only developed these problems since the autoimmune disease started. So which is the most likely cause? 

And when I went for the first round of diagnostic procedures, the physician I saw at that clinic started pushing weight loss surgery on me as "the last chance to prolong my life". 

Why can't doctors just let me go through this ordeal in peace and find out what's wrong with me, what can be done about it, and how it's ultimately going to affect me before laying into me about how my weight is killing me and I need to surgically rearrange my digestive system to prolong my life. 

For all I know this problem might be terminal. It could also be no huge deal. But I won't know anything until the tests are done and results analyzed. 

And telling me my weight is killing me and I need weight loss surgery before they even know what is wrong with me is not helping anything.


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## AuntHen (Mar 26, 2021)

@Tracyarts Are you able to switch to a HAES or fat friendly doctor at this point (if there is one in your area)?


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## Tracyarts (Mar 26, 2021)

I would like to, but it's taken me 3 months just to get in with this doctor. I live within an hour of Houston, TX so there are plenty of doctors here, and certainly fat friendly ones. But I don't know how to go about finding one. 



AuntHen said:


> @Tracyarts Are you able to switch to a HAES or fat friendly doctor at this point (if there is one in your area)?


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## loopytheone (Mar 27, 2021)

I'm sorry you are having to go through this, what a bunch of asshats. I wish I could offer advice on how to change doctors but it is obviously completely different in america compared to where I live. I hope that they manage to find the source of your issues, fix it, and then you can go tell them to swivel on a cactus.


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## Dr. Feelgood (Mar 28, 2021)

Tracy, I'm sorry you had to go through this. How can a doctor help you if he won't even listen to you? Even scarier is the thought that if he blew you off, he probably does the same thing to his other patients. Have you considered writing to your county's medical licensing board and telling them just what you have told us? They might get him to clean up his act.


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## Tracyarts (Mar 29, 2021)

I think this might be an ongoing problem with this doctor, she had the worst rating of the 4 internal medicine doctors at the practice, but she was the only one currently accepting new patients and I couldn't wait another 6 weeks for my 1st appointment, when one of the more highly rated doctors had an opening. I will be switching to a different doctor in the practice when I'm able. I'm not sure how much good it would do writing the licensing board, but I'm going to speak up in some way once I get more answers about my condition. I just want to get through the upcoming diagnostic procedures right now. 

I've been having respiratory problems for years. At first it was explained as living in a heavily industrial environment and the emissions from the plants and refineries along with toxic spills and releases were causing constant irritation and inflammation of my respiratory system. All the really bad medical stuff was ruled out once before in 2019, and I was told that I needed to move away in order to get better. 

It got better after we moved away from the city and to a place with better air quality. But then it got worse again. Since late fall I've been getting out of breath more easily and in the past couple of months I started getting out of breath just walking across my house and having chest tightness. So I finally found the new primary care physician and she immediately went to it all being weight related. Until my chest x ray showed multiple tiny spots all over my lungs. That explains the breathing problems but what are the spots? 

Anything from metastasized cancer to scar tissue from previous respiratory infections. Quite possibly a complication of my autoimmune disease or the medication I've been taking for it. Methotrexate has caused this exact problem before in other patients. Maybe pulmonary hypertension or blood clots. Won't know until tests are done. 

So my initial cardiology and pulmonary evaluation was fine, echograms of heart and legs were fine. My pulmonary function test was fine. Pulse oxygen at rest and at exercise are normal. Next step is pq lung scans I think? Then trans esophageal echogram, pulmonary pressure check, a cardiac angiogram (maybe). Cancer screenings. More lab tests. Possibly a lung nodule biopsy. 

I really don't appreciate the primary care physician making my weight and related comorbidities the main focus though. How it's limiting what diagnostic procedures can be done and will interfere with my getting an accurate diagnosis. How my treatment options are limited and my prognosis will be much worse because of my weight. So instead of fixating on that why not focus on what can be done? 







Dr. Feelgood said:


> Tracy, I'm sorry you had to go through this. How can a doctor help you if he won't even listen to you? Even scarier is the thought that if he blew you off, he probably does the same thing to his other patients. Have you considered writing to your county's medical licensing board and telling them just what you have told us? They might get him to clean up his act.


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## FatAdmirerEric (Mar 29, 2021)

I think you should file a formal grievance against this doctor who obviously is overlooking a number of issues.


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## Tracyarts (Mar 29, 2021)

At this point she's not overlooking anything in practice. I've been referred to be scheduled for the lung scans and cardiac tests. Been referred back to my rheumatologist to start investigating whether it's autoimmune or methotrexate related, been referred to start cancer screenings, and even referred to a kidney specialist to make sure my kidneys can handle contrast agents for the angiogram and a possible contrast CT scan. So while she's running her mouth in appointments about it all being a fat issue and how much my weight will hamper the diagnosis and treatment process, she's not actually denying me any care. As of now the only tests not being scheduled are the two involving contrast agents, because methotrexate has reduced my kidney function. But I'm already scheduled for an appointment with my rheumatologist and waiting to find out when I see the kidney specialist. So she's doing her job. Just being really toxic regarding my weight while doing it. 



FatAdmirerEric said:


> I think you should file a formal grievance against this doctor who obviously is overlooking a number of issues.


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## mathfa (Mar 29, 2021)

I'm sorry you've had to deal with this Tracy, it's scary how common these stories are (although in this case it seems like this doctor is just overall not good). Hopefully you are able to get the medical care you need regardless.


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## Tracyarts (Mar 29, 2021)

And the tragedy of it, this is how fat people die from ailments that don't kill thin people. Either their doctors blow it off as fat related, like mine initially did and it's found too late. Diagnostic equipment isn't accessible to or can't give accurate results on fat bodies, I have to travel 2 hours to have an angiogram at a hospital that can accommodate my body on the cath lab table, and the CT scan won't be as detailed as possible due to my body size and the machine's inability to image through thick chest walls. Or the patient gives up due to frustration or shame or reaching the limit of their ability to take all the stress and conflict. 



mathfa said:


> I'm sorry you've had to deal with this Tracy, it's scary how common these stories are (although in this case it seems like this doctor is just overall not good). Hopefully you are able to get the medical care you need regardless.


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## Orchid (Mar 30, 2021)

You might try www.reddit.com/r/AskDocs/ and ask some specific medical questions there


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## Tracyarts (Apr 1, 2021)

I had more tests today at a nearby hospital and everyone I dealt with there was perfectly gracious and accepting. But still need to deal with the fatphobic internist until I get some answers or a different doctor in the practice has an opening.


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## Tracyarts (Apr 3, 2021)

Well it looks like I probably had a pulmonary embolism at some point in the not too distant past and never had symptoms serious enough to go to the ER. Apparently that happens. It's not a serious enough clot to kill you but the symptoms are vague and easy to dismiss, so it takes time to figure out the problem. Sometimes months. Which fits in my case.

I'm going for more tests in the next couple of weeks to see if it did any permanent damage to my cardiopulmonary system. But nothing in any of the tests I've had so far show anything concerning enough to justify a hospital admission, so I'm being treated at home with a stronger blood thinner than I was already taking. 

Still don't know what the many tiny diffuse spots in my lungs are. Could be anything still, but it's not the top priority. 

I'm not dealing with the fatphobic internist anymore, she's dealing with my husband and my cardiologist. I'm dealing with him and the cardiologist's assistant. After this is resolved, I'm transferring to a different primary care physician.


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## Tracyarts (Apr 13, 2021)

Well, it just doesn't get easier. All progress is on hold with my diagnosis and treatment until my doctor can either locate a facility that can accommodate my body (very problematic during the pandemic) for a specific test or I lose enough weight to have access to the procedure table designated for that test at the hospital I was initially scheduled at. Of course this is being framed in the context that my body is the problem here and the most realistic solution is fasting to lose enough weight to be allowed access to the diagnostic procedure I need.


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