Saturday, June 6, 2009

Assumptions

After a week of sore, red, scratchy eyes and no relief, this morning I decided I'd better go to the walk-in clinic and try to get some eye drops. I walked in, waited an hour, and got shuffled to a room.

"What are you here for?" asked the nurse, and then the doctor. "Eye infection," I said, because my daughter had already been diagnosed and cured by antibiotic drops. They looked at my eyes, told me not to wear contacts for a week, and said I should use the eye drops four times a day. Then I had to sit and wait for the printed "doctor's orders."

When I got the sheet, the diagnosis was conjunctivitis (eye infection). The instructions were there telling me how often to use the drops and not to wear contacts, but there were two more curious, handwritten notes as well:

"Increase water consumption to 8 glasses per day."

"Start walking 30 minutes per day."

Interesting. There had been no discussion about my weight, my activity level, or even my general health (except when asked if I felt I was healthy in general, I said yes.) Neither the doctor nor the nurse asked me how much water I drink or whether I am active. I have to wonder if the recommendations were a way of giving a fat chick some "tips" to get into better shape. Maybe...

I am not dehydrated, that's for sure. I already drink about 12 glasses of water per day. So it's interesting that they assumed I am drinking less than 8.

I already bike 30 minutes most days. And on top of the biking I often walk a mile, too. Granted, it was sporadic last month. But how would they know that without asking? How do they know I am not already walking 3 miles a day or doing step aerobics or lifting weights (which I also do)? They don't. They didn't ask. I guess they assumed because of my weight that I am sedentary and need to start doing SOMETHING.

Now, don't get me wrong. I am not upset whatsoever. I liked the nurse and the doctor. I think it is great to make health suggestions to the obese. Maybe they were trying to avoid making me feel uncomfortable by addressing my weight. After all, when the automatic blood pressure cuff barely fit around my arm, and the machine refused to give a reading, the nurse just said, "oh, that machine doesn't do so well with certain.... (cue nervous glance at my thigh-sized upper arm)... situations."

I know they mean well. I just find it interesting that *because* I am fat, it was assumed that I am not drinking enough water and not walking or doing other activity for 30 minutes a day. Why not ask? I know women who are my size and bigger who are far, far more active than women half our size. Being fat doesn't necessarily mean we aren't doing ANYTHING.

And since they never asked about my weight, they didn't know that I have *lost* a significant amount of weight, and that I probably eat more vegetables in a day than they do in a week. How would they know if I used to be 350 pounds and got down to 238 by working out for 2 hours a day? Eh, people look at a woman weighing 238 pounds and they just see fat. Maybe even lazy. They don't stop to think that maybe that person has a lot of healthy habits and is proud of how much weight they've lost. People just assume.

So I came home and put in my eyes drops, drank my 10th glass of water so far today, and biked for 30 minutes. I walked my daughter to the park and will probably walk a mile later this evening. I feel great about what I am doing and who I am. People might see me walking down the street and think "wow she is huge" or they might think "wow she is out walking a lot!" But what they think doesn't change who I am and what I am doing. The fit girl is out, and soon when people look at me that is who they will see. Not the fat chick, not the chick who needs to drink more water, not the sedentary chick. The fit, strong, healthy chick!

**For a really great post about this topic, read this one on one of my very favorite blogs:
Marshmallow's Doctor Appointment

32 comments:

Vickie said...

it might not be something that they 'put' in the notes - the computer might do it automatically . . .I am discovering more and more automatic things with all kinds of computer systems.

glad it didn't offend you. and you are so right about not being able to tell if someone is on the way UP, the way DOWN, or staying just where they are. I have stopped assuming anything based on appearance - it is just impossible to know. And I wish it were easier to know - because then it might be possible to find people in real life to talk to about all the things we talk about in blog land.

Megan said...

I actually think about that quite a bit. Often times I find myself looking for opportunities to drop how much I exercise or how healthy I eat just to make sure people don't think I'm lazy or eat poorly. Way to go, it sounds like you're really getting back in your groove!
Megan

Anonymous said...

I second Vickie's suggestion about the message being automatically printed. I saw this as well when I worked in this type of healthcare environment. It's unlikely it's a personal message to a fat patient with conjunctivitis. If so, that doctor and nurse have way too much time on their hands!

Anonymous said...

I know that you have had a tough year. I also KNOW you are on your way to losing the weight you gained back. Even more important that losing the weight is the strength you are showing by not letting anything discourage you.

I am behind you all the way!

Thanks for the encouragment. I check your blog daily...hoping to get a new tidbit.

PW

Lyn said...

Vickie~

the note was actually added by hand... sorry I didnt clarify that in the post. I went back and fixed that.

mythreemonthokinawadiet said...

I am glad it dit not offend you as well. There are too many "offended" people these days. It is almost like it is a human right Not to be offended.

I have come to the conclusion I am only a patient file in the doctors office.

I had a check up before I dieted. Supposedly I had a thyroid condition which I wanted to believe. Then she told me I should weight 72kg (160lbs). I weighed more than that in grade 7.

No pre questions nothing. I knew I was not a human just a number on a file and another 240 dollars for her.

Chubby Chick said...

You should have asked them how CUTTING BACK on your water and activity level was going to help with your eye infection. hehe

Coley said...

Ahh yes, this is such an intriguing post. I completely agree. When people see me with a friend of mine, we are very often together - no doubt they look at her as the vastly healthier of the two. Little do they know, I have pushed that girl up three flights of stairs because she was winded after the first half of the first flight...
Her being a size 8 and my a size 22 has nothing to do with that. Only to do with how we've coped with our stress in the past.
And just because she chose drugs and promiscuity over eating.....
it's hard to have a story that tells itself to anyone you pass, and they draw their conclusions before you have a chance to open your mouth.
Alas it's how it is, and I suppose was something instilled in us in some way to protect us as some time in some form. Who knows.

Glad it didn't upset you. It's nice to see those words and say "I already do all that." INstead of thinking "Sigh... I know..."
Proud of ya :)

Katie said...

If I were you, I would call the clinic and speak to a nurse or the Dr, as you have "questions about the diagnosis and instuctions". I would let them know that the instructions to drink water and walk seemed more related to your weight than to your eye infection, but that the subject of your weight never came up. Then, I would ask why those instructions were listed, because if the Dr was concerned about your weight, you wanted to know -- for example, was there a problem with your blood pressure, pulse, general appearance/health that was of concern for him to have written those instructions?

If the answer is no, then you can point out that you have lost weight, regularly exercise, & drink lots of water. Maybe that will be enlightening for them, and you will be helping many other women out there with some extra weight that are actively trying to get healthier!

:)

justjuliebean said...

I second Chubby Chick's suggestion. That would be great, just look at them all puzzled and ask that question. I would be irritated myself, mostly because 8 glasses of water and a 30 minute daily walk likely isn't enough to have much impact.

cmoursler said...

ugh. people. When I miscarried in 2005 I was 229 lbs. The doctor didn't check my hormone levels or anything. He looked at me and said "Maybe if you lost some weight it would be easier to carry a baby'. That was alot of assumption in one little sentence. I unfortunatley took bait- hook line and sinker. It's only recently that I started to question that premise. Sometimes I think doctors are working with a shorthand mentality in a long hand profession. Keep up the good work.

South Beach Steve said...

Assumptions are so dangerous. While you liked the doctor and the nurse, I find it somewhat troubling that they did not discuss either issue with you, and make a recommendation on assumptions. There is no doubt, the advice they gave was true, but it isn't applicable as you are already doing it. You are doing good my not letting it bother you. Make it a great week!

Hilly said...

It just amazes me that they not only assumed that but also gave you that advice when you went in there for pink eye. Pink eye, for God's sake!

I'm glad you were not offended. I might have been more miffed than you. :)

MondayIsHere said...

Your post makes me laugh and it makes me sad. I've been overweight since I was 18 and I've only once ever had a doctor even mention my weight to me. Doctors get very little education in nutrition while in medical school. I think they're uncomfortable broaching the subject. Perhaps they fear being asked a question they won't know the answer to; who knows?!
In my opinion I think it was completely inappropriate for them to write that on your instructions. Had it come from your family physician who knows you, that would be a completely different story. I think the doc-in-a-box better stick to the facts at hand if he isn't going to assess the complete situation.
I agree with your other point about people not knowing where you started. I had a friend who lost a good bit of weight and started dating online. She got completely bummed when guys would be turned off by her weight because she was feeling GREAT about herself. I had to remind her that she was meeting these men where she is "right now". They didn't see you at 280 or where ever she started so to them she's just a big girl. It's a painful fact of reality that all fat people have to deal with at some point in time.
I'm glad you decided to take their "good advice" in stride. Sometimes I'm embarrassed to be a nurse. Keep up your great work!

Andra said...

I actually changed doctors because once, years ago, I had the audacity to ask my PCP advice on healthy, sensible weight loss. She told me with a straight face, "Stop eating so much fried food and cake." I was so upset that I couldn't formulate a reply. This was of no use to me whatsoever. Sure, I've eaten my fair share of fried foods and cake but to make the assumption that that's all I was eating was so frustrating. Needless to say, I have a wonderful and supportive MD now who told me that I was an inspiration because I'm putting my health first.

GRAMEE said...

at my dr. the print out often says something about my blood pressure.. i don't have high blood pressure..
but often is a little high from the anxiety of going to the dr. i asked the dr about it..
he said when they put in your blood pressure...or weight in to the computer the program adds in its little recommendations..

Ria said...

Great observation. I remember very well how miserable I felt at 230 lbs on the way up the scale . . . and now, on the way down, I feel great.

Go, fit strong healthy chick, go!

Pam said...

I am glad that didn't offend you too. It would have me. I changed doctors years ago because after going to the same Dr for 5 years, one day she arbitrarily tells me I should be thinking about watching my weight. I made her hand me my chart where I went through and showed her my weights for the last 2 years, which had been as much as 75 more pounds than what I was at that time. She said "Oh I guess you are already."
I am actually about to change again because I have asked my current PA on countless occasions for advice on what to do to help me with losing weight and she tells me that I just have to do it, that once I come in and have lost 30 or so pounds and she sees I'm serious, then she'll prescribe something. Huh? If I can start losing on my own, why would I want the pills? Now that I am on my way, I plan on finding someone to be in my corner with me!
Hope your eye is doing better (and I agree with Chubby Chick, too!)

clickmom said...

I got the same attitude when I was trying to buy a kayak yesterday. I didn't say a thing either, just smiled and went about my business. But inside I reminded myself that underneath this pudgy exterior I imagine I am ripped along the lines of Gillian Michaels by now.

Hanlie said...

Wow, that story by Marshmallow is something else!

Great post again! I think about this often, since I am also working hard, but still very fat. I was telling my husband about an incident where some youths were totally uncouth and arrogant the other day and how it incensed me. My husband said that he hoped I'd told them off, and I said no, these were the kind of people who would publicly ridicule me for being fat. They don't know that I'm going to gym every day and eating super healthy...

I love Chubby Chick's comment!

Mama Bear June said...

I'd have been ticked off. And I would have done what Chubby Chick suggested and asked if they wanted me to cut BACK on my healthy habits. I don't think they should have written that without discussing it with you. You have an awesome attitude and you totally ROCK!

I had an idiot, senile regular doctor at the military base and am thrilled that he finally retired.
Path to Health

Jessica said...

I'm am so proud of you. You are doing amazing work.

My first thought (as a future health care worker) is, shoot, that is the kind of think I might do... stupid.

Then I thought, it is nice of the office to at least try... many people aren't ready for change...

Now I wonder if you sweetly informing the doc (yes after you got the rx) about your background might have changed that doc and nurse for future encounters? I hope people will help me be better at my job.

I'm just human, and I am entering health care because I want to serve.

Terri said...

I think it's great that you reacted the way you did...just let it fly by. Me, I actually felt my blood pressure rise! I'd had to call them and explain to them that 1. you are drinking water and 2. you are exercising.

But this is something that I must work on. Not letting things get to me!

Mike579 said...

I understand your frustration. Hang in there and just enjoy the process. And as my Sifu says, "don't think so much!" You are right to not have been offended. I am 290 lbs and 5'10". Getting healthy is a process and it takes time. Find the place of peace and love. Bless you for writing your wonderful blog and inspiring others (including ME!) :)

Lynn Haraldson-Bering said...

This makes me wonder all over again (and this is a good thing) what I assume about people when I first see them. I'm going to be more mindful of that, to remember your post and experience. Thanks, babe. Can I hire you to be my conscience for a few weeks?

kb said...

Why weren't you offended? I mean, of all the people who should have been trained that you ASK health history instead of assuming, doctors and nurses should know better. and while those instructions were pretty harmless, those same assumptions have led to fat people being dangerously undermedicated, or have their true, sometimes life threatening issues ignored in favor of weight.

Winderdoodle said...

100 pounds ago I avoided all doctors like the plague. I didn't want them to ask me about my weight or health and I was so annoyed when they blamed my health issues on my weight. I just wasn't ready to hear it and thought that blaming any health issue on my weight was a cop out for finding the real issue.

I see things a lot differently now. I think it must be hard for them to approach people that aren't willing to hear the truth about weight and how weight impacts their lives. Perhaps the doctor knew that the weight wasn't impacting your eye situation but that weight would or could cause other issues. By putting it into the prescription he was trying to be helpful without being "in your face" about it.

Regardless, it probably wasn't a good assumption on his part to think that you weren't already doing those things. You have formed some very healthy habits that that's awesome!

~Wendy

Lucrecia said...

You handled that better than I would have. I think I would have had to call them out on it. I appreciate they were trying to help, but to many that could have been a set back. Congrats to you on seeing the positive in it!

Lady Downsize! said...

I'm going to play devil's advocate for a second, and maybe someone else thought the way I am already, but maybe it wasn't about you or your weight. Maybe the comments were written on the wrong paper. Maybe they were comments intended for another patient.

I don't do this often Lyn, so don't take offense, but if I had of been in your shoes I may have asked why those handwritten comments were there. If it was for the reason that you said then I would have questioned why there were no question/discussion, then maybe proceed into your successes! For me, any assumption when I feel I am doing well or leaps and bounds from where I might have been before I get offended at generalized assumptions. Those comments could be just the triggor to throw me in the wrong direction emotionally and mentally. However, I am glad you were able let it slide and carry on. Great for you!!!

Heather said...

that is quite interesting. hopefully it is just a coincidence, but even still, you are right - for people to judge without even knowing what your lifestyle is like or how you have worked hard to lose weight is kind of sad actually. I have had similar experiences and it really is too bad.

happyfunpants said...

In order to be sure that you're not assuming things, I second Katie's advice.

What if something did come up in your charts, etc. where you should be alerted? You bringing it up in this fashion may help them know that you are serious about what you are doing.

I don't know where you live, but I do know that if your assumption is correct, you don't have to go there anymore. To be treated in a passive agressive situation by your doctor/PA is absolutely uncalled for.

Even if you're not upset, you might consider calling them and telling them what happened to help out the countless women (some of which already commented) that would have been offended. What if it was just one person who added it without the consent of the doctor/PA? That person may be going against policies at that clinic/hospital and should be told that that isn't acceptable.

Actual Scale said...

Since it was handwritten, it was obviously added by the Dr or nurse.
While I wouldn't be offended by the suggestions, I would be less than thrilled that while they took the time to make assumptions, they did not take the time to ask any questions.
Doctors & assumptions are a really bad mix!

I like Chubby Chick's suggestion - that would puzzle the heck out of them. lol