Wednesday, April 20, 2011

Doctor's Appointment, and an Eating Plan (A Long, Rambling Post)

Yesterday's ultrasound appointment was routine. It took a half hour or so and they imaged and measured my ovaries and uterus (I did not get to see the screen or get any information during the ultrasound). Then, as directed, I went up to see the doctor who would give me the results. It was a new young doctor I hadn't seen before... one of some dozen doctors in an OBGYN practice. I was nervous but ready for answers.

It went like this.
Dr: Oh hi! Hmmm, we don't have the radiology report yet!
me: Right, they said it would take a couple days but that they made the u/s available on the network for you to look at.
Dr: Oh, yes. Well, hmmm. You haven't had any bleeding or pain though right?
me: right...
Dr, grinning: so you wouldn't need any treatment anyway! Let's just wait til they send me the report.

(this is a contradiction of what I was told earlier, that if there was an indication of cancer I'd need a biopsy at the very least. And that there would probably not be bleeding or pain in such a case. Or it could be fibroids.)

me: Well, I'd appreciate if you could just look at the u/s and give me some feedback. My mother died from ovarian cancer and I had a LEEP surgery a couple years ago for pre-cancerous cervical cells, so I am a bit on edge.
Dr: Well really it's *their* ultrasound so I should let THEM read it. (Looks at clock) Hey! Tell you what! I will have a nurse call you in a couple of days with some results. Hey, I won't even charge you for this visit! No copay! Deal?
me: uhhhh...
Dr, stands up grinning, opens the door and says to the lady in the hall: Hey! No charge for this visit, okay? Make sure she doesn't get charged!

And then he walked away.

So I might get some results on the cervical screening before the weekend but I will probably have to wait til next week for the ultrasound results. I admit I was emotional when I left. I had been told the doctor would give me the RESULTS of the u/s at that visit. Now I had to wait. I had a slight breakdown in the car, shed a couple of tears, then got myself together and decided it wouldn't do any good to worry. So I am just going to go on doing my thing, assuming all is well, and will get the results when I get them.

(And yes I do usually stand up for myself better and would have insisted they call a different doctor or someone who'd take the time to look at my results, but I was taken off guard by his whole demeanor, and had fully expected to get some results, and I guess I was sort of stunned into just sitting there thinking, "what the heck??")

So on to my eating plan.

I've decided there are certain things I want to cut out of my intake, if not 100% then at least to a large degree. But there are a *lot* of changes I want to make, and I don't want to overwhelm myself trying to do it all at once. Baby steps.

Eventually, I want to:

Cut out artificial sweeteners (with a switch to Stevia along the way. Still deciding if I want to use that on occasion but the Splenda has to go) which would include cutting out diet sodas.
Include healthy portions of fruit, low fat dairy, and even some starchier/carbier veggies like peas and sweet potatoes, which I have not had in a year.
Increase my exercise including my PT exercises
Increase my sleep quantity and quality
Drink more green tea, plain, unsweetened
Drink less coffee or learn to drink it without sweetener
Eat only unrefined types of soy, like tofu, and not very often
More beans, legumes
Less fatty meat, cured meat, processed meat
More local grass fed beef and free range chicken and eggs
Figure out how to do this in a more convenient manner. Maybe more raw veggies is a good start... less cooking!

I have decided to go ahead and do the Medifast Transition program now. Usually they recommend doing that once you reach your weight goal, but I have been on Medifast for over a year now and I am ready for a change. I don't want to just *quit* Medifast but want to give Transition a chance to help me find a healthy way to eat. I am also cutting way back on soy just because I think moderation is a good idea since I am dealing with reproductive system issues. I have eaten a ton of soy over the past year and just to err on the side of caution I am cutting out most soy from my diet. That means I am switching to whey-based Medifast meals as I do Transition.

Transition, in a nutshell, looks like this:

Stage 1: add 1 cup of any vegetables per day (this means adding back in carbier options like green peas, carrots, and sweet potatoes). This is in addition to the 5 Medifast meals and the Lean & Green meal (5-7 oz protein + 3 veggie servings + healthy fat) eaten each day.
Stage 2:  Cut back to 4 Medifast meals, continue eating the above plus add 2 medium pieces of fruit or 1 cup cut fruit/berries.
Stage 3: Same as above, but add 1 cup of low fat or fat free dairy (like yogurt).
Stage 4: Cut back to 3 Medifast meals, continue eating as above, plus add 4-6 more ounces of lean meat or an appropriate serving of beans/legumes and 1 whole grain serving.

Then you can go from there to either continue with some Medifast meals or cut them out in favor of other foods with equivalent nutrition. This ends up at about 1500 calories max.

I think at least for awhile I will count calories while I do this so I don't go overboard. I think this is just the change I need to get excited about making my *health* a priority. Honestly, I have been a bit resistant to anymore weight loss lately. I know that sounds insane. Of course if I could snap my fingers and weigh 150 pounds I'd do it, but I think I'd regret it and regain some weight. I have changed SO MUCH over the past 3 years. It is a lot to get used to. I still am honestly shocked when I am out and about, and someone I haven't seen in ages says, "wow! You look GREAT!" or "I didn't even recognize you!" I am just stunned. I think, "what??? I look great???" And yesterday I went without sleeves for the first time this season and I was SO uncomfortable it was insane. When I took off my jacket and went in to the doctor's office with bare arms I felt completely naked and FAT. I felt like taking off that jacket was like taking off my "thin person costume" and now everyone could see that I was morbidly obese (because my arms look really bad to me right now, very saggy and, well, like they used to be obese!) It's like everyone can see my secret when I don't have sleeves on. So yeah, I am still working through a few things.

This post probably seems long and rambling. I started it early this morning, and have been getting up and doing stuff like feeding kids and dogs, getting dressed, helping with art projects and making coffee. So every time I come back and sit down I write something else :) So forgive the writing style today, and I hope the content makes sense!

And for those who have emailed me lately, I apologize for not responding. I do read and appreciate every email, and have been answering about 25% of them since February when I was sick. I will probably answer them all at some point, but if not, please know it's just me being overwhelmed and not anything you said.

Enjoy your day.


Mirtika said...

From what I've read--and bear in mind I really LIKE tofu, grilled, yakitori style or steamed and added to a thai stir-fry, etc--that the soy products that ARE generally recommended are the fermented ones: natto, tempeh, miso... It is a refined product, tofu. :) And it's easy to eat a lot (due to low calories), I know, I ate tons once.

And as you transition, don't freak IF you get some water weight back. If you're gonna add some starchy stuff back into diet and increase the healthy carbs (more veggies, fruit), then it may happen. It's just part of the process if it does.

Hope they have some mercy on you and call you by tomorrow with results...

gracies tough journey said...

Lyn, the way the doctor treated you was totally unacceptable. I have worked in the medical field for 30 years. First you shouldnt have even been scheduled for the appointment if the results were not ready,this is a waste of your time and money(gas). Second, he should have made every effort to get those results since you were there. He could have called the lab to get a prelim right then and there. Of just look on the dang computer for the prelim himself. What a SOB. For some reason this really burns my bootie for you to be treated that way. Ugh.Sorry for the rant.

Mirtika said...

Um, that was me, Princess Dieter. That's my other google account. :)

Ex Yo-Yo Dieter Debbie said...

That doctor sounds like an ass...even if he comes back with the diagnosis, it may be best to get a second opinion. There's WAY too many risk factors to treat you so nonchalantly (and even if you had no risk factors, I still wouldn't trust him). It all sounds like a big red flag to me - you deserve better treatment than that.

Take care...and great planning for your transition phase.

Bonnie said...

Lynn, I agree this is totally unacceptable. STAND UP FOR YOURSELF and call the office and tell them you were treated poorly and want results NOW. At the very least, he won't treat someone else the same way. You are paying for their service, don't be intimidated!

Leslie said...

I aqree with other commenters about the doctor - very sketchy and evasive behavior, and unprofessional.
I'd call every day, at least once, and say that I wanted to know something before the weekend.

Your food transition sounds sane and sensible. You'll feel your way through as you go. I have no doubt that you'll be successful!

Claire said...

Agave nectar is an even healthier sweetener alternative than Stevia, and tastes fantastic! Agave doesn't elevate blood sugar like other sweeteners, which is a concern for me. Even better, it's usually sold as an organic product.

I think it's a great idea to limit (or better yet, eliminate) soy in your diet, especially with your female cancer risk. My dd has endometriosis, and soy is a big no-no for her, as well. The only kind of soy I eat is edamame, which doesn't have the same estrogenic properties.

I hope you get a chance to read "Eat for Health," by Joel Fuhrman. He talks about diet and its effect on cancer and other diseases.

That doctor just ticks me off. What a jerk. Would it be possible for you to call and get another appointment before Friday so you don't have to think about this anymore?

Anonymous said...

First, the food. Your plan and the transistion plan to get there souinds perfect.

Second, the MD. :O I know what you mean about being taken so off gurard that you just left. You DID protest and ask for appropriate treatment, but he was so flippant, I'd have been sitting there with my mouth open and watching him waltz out, too.

I hope you've read the commednts--DO CALL THE OFFICE NOW and ask for a verbal report. Explain what happened, use words like "negligent". It seems negligent to me, considering myhistory, that he would not even look at the computer or call the lab..." They HATE the word negligent.

If the receptionist gives you blah, blah, blah, ask to talk with one of the more senior MDs that you've seen or his nurse.

Tell them you'll hold.



Diana said...

Oh man, I just want to smack that doctor upside the head. What a total jerk! Seriously, I think you need to call the clinic and tell them exactly how that appointment went. Just tell it like you told it here. He definitely needs to be talked to by his superiors. Geez, I'm still boiling just reading about it.

Stevia - it's the only sweetener I use now. I've tried several brands but my favorite is NuNaturals NuStevia. It doesn't have all the additives that some of the other Stevia brands (Truvia is the worst). NuNaturals offered to send me free samples to test and review on my blog, but I don't like doing that (I'm too lazy). I bet if you contacted NuNaturals they'd send you some of it to try. Here's the guy's email address - His letter asking me to review their products was a hoot. They're a little company in Eugene, OR. Anyway, let me know what you think about the product.

I'm still mad at that stupid doctor. :)

Ashley said...

So, I don't know if this makes you feel better or not, but a lot of doctors (myself included) aren't actually very good at reading ultrasounds. It's not trivial and if you don't do it every day (which most general practitioners like obs, family docs, pediatricians, etc. don't), then the chance of them pulling up an ultrasound on a computer screen and telling you anything useful are very low. They shouldn't have led you to believe your results would have been ready today, unless have an ob on staff who is good at looking at ultrasounds. (If I order an ultrasound I always tell the person that the radiologist will have to look at it and I'll call them in a few days with results. I don't even pretend I could do otherwise.) I suspect if the guy had told you anything today, it wouldn't have been the same thing that the radiologist report said next week and that the doctor knew this and that's why he didn't want to look. He knew he probably wouldn't be able to see anything. I am, in fact, always suspicious of anything a doc (who isn't a radiologist) tells me he read off an ultrasound. I'm not excusing him if for treating you badly, but in the same situation, I wouldn't have tried to read the ultrasound either. I would have actually told you the truth about it though.

katie said...

Sorry to hear about that dissapointing MD visit..he did not handle it well. Where was the nurse or practice manager? I would call and speak to someone you have a relationship with there and someone who has the power to make things happen..your reg MD or the above. Waiting is hard. If you need a result to be sane then you may have to march back in there and demand what's possible. The squeaky wheel thing is sadly true. One must be a consumer of medical services just as one does with any other service. Good luck all around!

katie said...

Reading ultrasounds is a specialty and so the office MD probably couldn't (and you would not want him to) read it. That said he should have framed his response to you in that language. he was clearly very uncomfortable and di not know how to handle your distress.

hopefulandfree said...

Gosh, I'm sorry you had a frightening experience, and that it went nothing like you had been led to believe...

Makes me sad that the doctor didn't show you more caring when you mentioned your mother.

Take care of yourself. Be very gentle and kind to YOU, especially loving, because that sounds like it was traumatic for you. I hope you have some loved ones near by to talk with and hold close.

Anonymous said...

You know, I rarely come back and post a second time, but this time I'm just too annoyed to let it go.

Re: the excusing of the jerk who passed himself off as a doctor. While it is true that most MDs are not skilled at reading ultrasounds, it is also true that HE COULD HAVE CALLED U/S and gotten a preliminary impression.

Yes. He could have.

I am not an MD. I'm just a social worker who worked in a little community hospital for 7 years. And maaybe little community hospitals work differently, but I have had u/s and xrays and other kinds of imaging done and EVERY TIME I was told before I left that room info about the test. Either everything looked good and no cause for concern is apparent or "hmmm. There's a little something here that Dr. Whosit will want to talk to you about."

Once when I had a suspicious lump on my breast, the MD over the ultrasound lab came in and asked to be shown where the lump was because what he wanted to make sure it was the film had the right spot. It was a very odd lump and he did a manual exam--and right then, with his hands on my boob, he said--"This is okay. It's nothing to worry about."

You know, now that I think of it that exact thing happened twice once with two different doctors on the same lump at different times.

Now granted, the people doing the ultrasouds, etc are probably not supposed to be giving the patients info, but I worked there and they knew me

My point is that if a SMALL town hospital has someone right there who can do a quick read, so does yours. That MD could have called down and gotten a prelim. He could have. He decided to blow you off instead.

I would not let it go. No matter how many excuses are made for this guy, the truth is that he chose not to extend himself.


Karin said...

Doc = first class douchebag and should be written up (or whatever you do to complain about a doctor's visit). I'm sorry you had to go through that. I've gone through that sort of experience before as well and I remember leaving the office feeling like I was in some sort of dreamland..just didn't seem real and it didn't really hit me until it was basically too late to do anything about it.
My thoughts are with you, you're going to do great!

Anonymous said...

You sound like you're really considering your options and making good choices for yourself. I've lost about 70 pounds in the last 9 months and I'm at a stall position. However, I'm also very conscious about not wanting to regain my weight, which I've done a few times in my past. So, even though I still want to lose, more importantly, I don't want to regain. I spend a lot of time considering what my eating options are and what do my future eating options look like. I think I'd rather hold steady for awhile than charge ahead, make drastic cuts that leave me feeling deprived and looking for a fix. I applaud your insight and willingness to think about what's going to work for you.

Anonymous said...

PS - The doctor treated you with disrespect and is a total ass.

timothy said...

you need to contact the main dr and let him know how absolutely unacceptable this guys behavior was, but don't dwell on it, you're going to be fine! bravo for the transition and good luck with it. you're dietary changes protect you from cancer since cancer cells feed on sugar. wow i'm rambling aren't i? lol just pay attention to your body and adjust accordingly, you of course are a GODDESS and can do anything!!!!

Theresa said...

total support! Bring on maintenance!

Lea said...

What a jerk doctor. Honestly, it sounds like he was uncomfortable with reading the ultrasound, and, instead of just being honest and saying something like, "the ultrasound people specialize in this and, honestly, they will do a better job and I would feel more comfortable letting them do the reading," and answering your questions as best as possible, he just blew you off. At least, I'm hoping that's what this is and not just a case of him trying to shoo you out so he could do something else. But, if this IS the case, then you are better off in the long run, having somebody well-trained in reading the images take a look. It sure does stink in the meantime, though. Jerk doctor.