So today was my three-month followup with the Rheumatologist. Since I’ve had to reschedule it twice (kidney stone, driver conflict) it’s actually four months running into five. I’ve got to keep a close eye on my liver panels so it couldn’t be put off any longer.
That’s how I ended up with the Nurse Practitioner instead of my regular doctor.
I’ve got a great rapport with all of my regular physicians. That’s why they’re still employed by me. If we’re going to have this long, intimate partnership I figure we’d best get along. If we don’t get along you’ll be replaced.
The Nurse Practitioner is going to be replaced.
She did give me my refills and order my labs and that was, after all, the main reason I was there. So that part was successful.
What was less successful was when she started approaching me like Generic Fat Woman Patient. I knew I was in trouble when she checked my blood pressure and said–in a tone of utter astonishment–“wow! You have great blood pressure! 98 over 60.” I haven’t yet gotten the memo, apparently, that all Fat Women Have High Blood Pressure.
Next came the standard Lifestyle Interview. They do this with Rheumatological patients because so much of our illness is reflected by lifestyle. And so many of us (thankfully not me at the moment) are clinically depressed. For some reason not being able to open tubes of toothpaste and shower without pain make some people kind of sad. Anyway, she asked me to “think of one good thing that happened to me last week.” The honest answer–that I’d had so many good things happen I couldn’t narrow it down–didn’t make her happy. When I finally tossed out that I “was happy with how much I’d accomplished on my rough draft” she let it go. Had I realised how fat-adverse she was I would have perversely said something like “I ate a whole chocolate cake and it felt YUMMY.” I don’t like to lie, but it would’ve been funny to see the look on her facelift.
Anyway, I started to get more of an inkling of her fat-adversity when she asked me about “my exercise routine” in the same way that prosecutors ask you where you were the night of the murder. I was pleased to tell her–honestly–that I have a long-standing regimen of Pilates and Gentle Stretching. She seemed as astonished by the fact that I exercised regularly as she was about my healthy blood pressure. (“This can’t be right! This fat person can’t have healthy habits!”)
But here’s the part that really got me enough to write about “on the internet for everybody to see” (as my mother will chasten me). EVERY visit to the Rheumatologist starts out with a review of your medications and procedures. They ALWAYS go over everything you’re taking and everything you’ve had done to you. Since part of my treatment involves studying a couple of the rarer–undisclosed–diseases I have, they are sticklers about this. They are always looking for causality, and I’m a sort of lab monkey. Anyway, we’d already had the part where we talked about my kidney stone surgeries and endometrial surgeries and childhood pneumonia. Everything I’ve ever had done to me by the well-meaning medical profession. And we were reviewing my labs with my chronic malnutrition. I said “yeah, those are always low. We suspect that I have a malabsorption problem.” Because we–my doctors and I–do.
“Have you had a gastric bypass or a lap band surgery?”
::pause for internal scream of rage, eyerolling and mental pimp-slap::
A) You have had a detailed review, both oral and written, of all my medical procedures not =THREE MINUTES= ago.
B) Yes. All heavy people can trace all of their medical problems to weight or weight-related procedures. If I’m not sick because I’m fat then I must be sick because of surgery to make me not fat.
C) Could you act like I’m less of a practice doll in a seminar?
There were a lot more irritating parts of conversation after that, but she lost me. Her whole “you need to set goals” speech washed over my now-emotionally-tuned-out self. The assumption that illness robbed me of both my IQ and goal-setting ability would have ordinarily caused a rage in and of itself. But after the whole “have you had a lap-band surgery” thing…
ARGH. Like I said…this is why people don’t like the doctor. Which is sad because, ironically, I wasn’t even seeing a DOCTOR.
It’s such a Monday.