Wednesday, March 1, 2017

The Cheese Grates It: How To Shut Out Your Patient

I'm thinking about talking to the doctor about the lovely conversation I had with the nurse. He's better than a lot of doctors I've had as far as not telling me I need to lose weight, but things like this let me know that he still has that old mindset that big person = lazy person.
All of my life I've worked very hard to counter the belief that I'm lazy. Once I got into my teens, I was constantly tired. I was always more alert and awake later in the day. Hence why I work nights. I was always being told by family members that I needed to get outside and do something. Then at night, I couldn't sleep. I'm a bit discouraged that things have changed so little where doctors don't bother to try and tie factors together, they just tell the patient that healthy patients do X, y, and Z, and therefore, all patients need to do X, Y and Z, or they are not compliant and are bad patients (and bad people.)
I realized many years later that during my teens, my thyroid gland was dying, and that was sapping my energy. My bipolar disorder onset when I hit puberty, but I didn't know it until I was close to 40, because I have type 2 bipolar, which isn't as obvious. I also developed fibromyalgia, but that wouldn't be diagnosed until after I had my son.
At this point, hardcore exercise is out of the question for me. My knees, ankles and back are shot from all the years of doing physical work. This is why I liked working out in the therapy pool. There is a rec center near my son's place with a therapy pool, but there are weeks (like this one) when I have so little time that I'd probably never get there. Maybe now that the temperatures are warmer I could try to walk around the damn mobile home park a lap or two. I don't know.
Trouble is, doctors want to turn every patient into the Perfect Patient. Well, the Perfect Patient probably doesn't go to the doctor very often, because everything's perfect. I know I wouldn't go to the doctor very often if I didn't have to take these damn medications and have my damn blood levels monitored for my damn stupid thyroid and worthless ass pancreas.
A good doctor doesn't assume, they ask, and then they listen, and they don't lecture. Lecturing pushes the patient away. The likelihood is, the patient knows they aren't being entirely compliant. Maybe they can't, maybe they won't. You have to treat each person like an individual, not like a number.
When working 50 and 60 hours a week, I'm not going to be counting every single carbohydrate gram that goes in my mouth. I'm going to eat something to stop me from being hungry. I'm compliant about taking the Metformin. I'm not compliant about getting X amount of exercise every day outside of work, and I would wager a guess that Bitch, if you were working four, five, and sometimes six twelve hours a week, plus having to drive 40 miles one way at least one of those days, plus having to help out a key person in your life who really needs the help at this point, and most of the time getting less than 5 hours of sleep (often more like 3), yo ass would not be that great about getting extra exercise either.
I know I could do better about watching the amount of carbohydrates I ingest. I've also been drinking a lot more caffeine during the last couple of years, which also has a tendency to raise blood sugar. Under optimal circumstances, I would be doing "better" with this. Maybe if I were a better, stronger, happier person I would also be doing better.
However, when the so called treatment leaves you feeling bad about yourself, like nothing you do is any good, then the medical personnel are doing something wrong.
Say to me "hey, Cie, do you know of a reason why your A1C levels might be higher than last year?"
I would say to you "Yeah, Doc, there's this," and I would tell you what I just said above. I would also say that I'm trying to be more mindful about it again, because I am.
Then the doctor would say "we'll increase your metformin levels. Let's recheck your blood in six months. By the way, how much do you exercise?" (Rather than assuming that I don't based on my body type.)
I would tell the doctor what I said above. Then maybe the doctor would say "well, try to increase your activity level where you can. I can see that you're extremely busy."
See how much better that conversation would be?
I still haven't 100% decided whether I'm going to say something. I go back and forth about changing doctors, because this doctor is far from the worst I've encountered. Finding a doctor that treats a patient rather than a chart, particularly when you are a horrible, horrible fatty like me, is difficult to impossible.

~The Cheese Hath Grated It~

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