Fatties and Healthcare

I was recently fortunate enough to be a guest blogger on Sociological Images.  I blogged about the Fit/ Fat debate.  One of the commenters is a health care  provider who mentioned the issues that fat people create for health care workers. He/she was very respectful and kept the discussion to the facts.  Specifically mentioning that we are more difficult to turn/lift/carry, people who have more skin folds are harder to keep clean, it can be difficult to adequately feed us in a tube feeding situation because our bodies can require more calories and be Insulin resistant.

I’m not disputing these issues, but I am asking some questions:

1.  If the numbers are true and 30% of the population is actually obese, that means that the health care system is unable to provide adequate care to a full third of the population.  How is that ok?  Why are people not working on solutions? It’s not like this is a new issue – how did the people responsible for our health care not see this coming and get ahead of the issue?

2. How do they provide healthcare for NFL Linebackers? Those guys get hurt all the time and they are huge. Who takes care of Shaquille O’Neal – that dude is 7’1 and 325 pounds and he was injured a lot.

3. Fat bodies aren’t the only ones that cause issues for health care providers.  Elderly bodies, those frail from disease or malnutrition, people with certain disabilities, people with alzheimers/dementia, young children, people who lack sufficient muscle mass, people with severe osteoporosis etc. all pose difficulties for health care providers.  I work with people who are dealing with under-eating disorders and their bodies create tons of difficulties for their health care providers – they are frail, their stats are all over the place, their bodies won’t tolerate food, etc.

The difference between these other situations and obese people seems to me to be that obese people are told that we should “do something about it” or, more correctly, that we should have “done something about it” before we got sick and so we “deserve” our sub-par health care, or at any rate we don’t deserve to have people working on solutions that would allow us to get the best possible care and allow health care workers to provide care for us without putting themselves at risk.

However, the idea that the solution is just for all of us to become thin is problematic at best. Scientifically no study of intentional weight loss has ever shown a long term success rate above 5% so there is some question as to whether long-term weight loss is possible for the majority of people. Even if it is, that doesn’t help people care for the person who comes in right now with a health problem and a large body.

What I am suggesting is that the problem is neither large people nor health care providers.  The actual problem is that the health care providers don’t have what they need to give large people adequate care without putting themselves and/or us at risk for injury/health issues, and that’s not a good situation for anyone.

So I think that instead of pointing the finger at each other, fat people and health care providers should form a team against the problem. For example in some large people turning them face down causes breathing problems because their fat compresses against their diaphragm. They have massage tables with cutouts so that pregnant bellies don’t get squished, why can’t they do the same thing for fat people?  It seems like these problems are solvable if we just put some effort into solving them.

Published in: on July 17, 2011 at 11:13 am  Comments (33)  

33 CommentsLeave a comment

  1. You bring up some relevant points here dwf. Not everyone is a perfect height or weight to make life “easier” on healthcare practitioners. People come in every shape and size, including obese, we have health issues, why can’t we be welcome at the table as well? Or is it simply the same old “money talks” BS that runs everything in this country?

    Thanks for posting this.

    Jules

  2. Wow, those are really good points. Although some more ridiculous docs might tell a person with osteoporosis they should’ve drunk more milk or stayed more active and on some level, deserve their weakened bone structure, no doc in his right mind would ever say to an old person, “You don’t deserve treatment because you’re old.”

    ALTHOUGH…not to rant here…after nine years in the UK and seeing just how broken the NHS is, I can say that sort of thinking does indeed exist in the NHS. My neighbour, who was about 78 when she got ill with what later turned out to be a stroke which resulted in the paralysis of one side of her body. They refused to run tests on her or treat her as they would someone my age because of how old she was, and this was a woman who’d paid into the system her whole life, served in the war and its reconstruction, and never was sick a day in her life. If you’re over 65 in England, you won’t have the money spent on you because you’re not considered worth it.

    The NHS also classifies any pregnant woman with a BMI over 30 as high risk and make it clear that they will deliver her baby no other way but through c-section for the sake of health for babe and mum because after all, fat women have fat vaginas and fat babies. And they most assuredly get pregnancy-induced hypertension and gestational diabetes which will run up costs even more, dammit. As an “obese” woman, I delivered my first son on the NHS vaginally after having had a completely uneventful pregnancy, and my son was a mere 6 pounds, 2 ounces.

    When I was pregnant for the third time after a miscarriage with my second son, there were complications with my baby, and he turned out to have a severe case of spina biffida, too ill to live, and I had to make that heartbreaking choice all mothers fear. As I was having a scan to determine how severe the damage was, my stomach was bruised and punched painfully by the ultrasound scanner as they muttered over and over again, “She’s too fat to see anything clearly…this is ridiculous, a waste of time”, even laughing as my pregnant abdomen jiggled around… and the result was that they wrote “because of maternal size, results were unclear”. And on the day I had my procedure to do something I never, ever though I would have to do, the doctor informed me that this had happened to my baby because I was too fat…which of course I believed because I was distraught and looking for a reason. It wasn’t until I moved to Germany and had genetic testing done that I learned I have a weird chromosomal tic responsible for what happened, but that doctor telling me my son died because I was fat has never left my head.

    It goes deeper than docs saying fat people are hard to clean. It goes right down to the basic fact that being fat is a moral failing and the reason every bad thing happens to you. And that mentality will never die…it’s as ingrained as those who think genocide is justifiable in certain cases, a deep human need to strain the imperfect from our race and just leave behind beauty..

    • I’m really sorry you went through this. Being pregnant and obese can be really hard and it’s sad, as bad as the US is with it, other countries can be worse. I became pregnant in South Korea. I returned to the US at about 30 weeks. Being pregnant in a country with a 3% obesity rate was, simply put, a nightmare. My OB didn’t have a large blood pressure cuff and by the time I left, my blood pressure started to look high but once I returned home, it was normal. Very likely, it was the fact that they were using not only a too-small cuff on me but that they were using one of those electronic blood pressure machines you normally see at your pharmacy.

      Anyway, Yorkie, there’s a website and blog for you to check out, I love them both. The same woman keeps both and she has tons of information on obesity and pregnancy and talks about stuff women go through from providers during their pregnancies. I read a lot of her stuff when I was pregnant in Korea and really needed something to keep me from crying from all the stuff I was reading online. Anyway, check them out (especially if you ever want to post your story, she’s always looking for stuff on the mistreatment of obese pregnant women.

      http://wellroundedmama.blogspot.com/ Is her blog and then her website is: http://www.plus-size-pregnancy.org/

    • The story of your baby was heartbreaking. I’m so sorry this had to happen to you.

      Your last paragraph is very interesting. I’m sure we agree on the substance of the issue, but instead of talking about “straining the imperfect from our race”, I would say that people seek to eliminate that which does not look/seem/act like they do. We tend to attribute negative characteristics to people whose size, race, physical features etc. are different from what society has dictated to be the norm. And as we have sadly seen so often in history, our hatred of the “other” has led to many horrors.

    • Yorkie, I’m so sorry this happened to you. The way those people treated you was downright evil. It’s sad that they can judge but behave in such a reprehensible manner. Sick.

      So sorry for your loss. Glad to know you found the truth.
      ~ManDee

    • I am so sorry for what happened to you.

      I disagree with you about the BMI/NHS thing though – I was pregnant and fat in the NE of England, with twins. No one ever said to me that I *must* have a c-section. (Ended up having one anyway but not because of my fat, rather because of my twins thin, if that makes sense – one was suffering IUGR and losing weight in the womb) I can quite imagine some doctors saying such things but it does not appear to be policy or a universal opinion.

  3. As a (fat) health care worker, I have worked with all sorts of people, most of them elderly but some who were just in the LTC facility for rehab. One of the patients at one point was a very big and tall woman who weighed 400 pounds. She had broken her tibia. She could help us to turn and position her and she was alert, awake, and oriented to person, place, and time. She was cooperative. I had no trouble at all taking care of her.
    On the opposite end of the spectrum, while doing my clinicals for nursing, there was a patient not much over five feet tall who weighed approximately the same. She was catatonic. She couldn’t help at all. Yes, she was extremely difficult to turn and clean. I have to say that I was pleased that everyone who helped care for her always spoke to her in a gentle tone and no-one berated her for her size. It did take four of us to take care of her.
    On the other hand, I cared for a man who had both legs amputated and was in kidney failure. He was a small man but very hard to move because his skin was so fragile. He developed bed sores constantly no matter what we did. It took two of us to manage with him and he was very difficult to deal with because of the fact that the pain made him scream whenever we touched him.
    I tell you this: people aren’t in the hospital because they’re healthy and while size can make it difficult to care for a patient, smaller patients can be difficult to care for too, and sometimes more so. Everyone deserves to be treated with kindness in this vulnerable situation.

  4. Thank you! Some time ago my gyn referred me to a particular suburban facility for a bone scan. The weight limit on the machine was 300 pounds. When I called back my gyn and asked for an alternative, I was told there were none. End of bone scan. She didn’t like fat people and wasn’t going to waste her time on my fattie problem.

    Years later, after Cushing’s Disease had made me even fatter, the endocrinologist who saved my life sent me for a bone scan in NYC. The issue of weight never even came up.

  5. I saw that comment over on Soc Images — thank you for addressing it directly! I have a couple of friends who are nurses, one who entered the field recently and one who has been nursing for 20 years. Both of them tell me often that they struggle to move patients for a variety of reasons, some of them outlined in the comments above. One major problem, however, is understaffing — and that gets to your “resources to do the work” issue. It might take more people to move an obese person or a person with fragile skin, but there simply aren’t always enough staff to accomplish that safely.

    A close friend spent 40 days in hospital because he had spinal surgery that went awry (physician error). He was a former football player and still quite active, so laying still was incredibly painful for him (and it would be for anybody after that long a time period!!) However, at 6′ 3″ and roughly 275 pounds, he was difficult to move. His family and I ended up regularly assisting nurses in turning and positioning him because there simply wasn’t adequate staff to do it.

    I did want to offer one hopeful counterexample. At age 34 and without children, I have severe menstrual bleeding and cramping. I’ve had a heap of diagnostic tests, but no one can find any reason for the bleeding. I went into a doctor’s office and saw on her whiteboard a list of reasons for heavy bleeding. I’d been tested for all of them except — obesity. At 5′ 8″ and 215 pounds, I fall squarely in the “obese” category.

    When the doc arrived, I took a deep breath and said “Listen. Is this happening to me because I’m fat?” She told me that the association was not well-established, and that it was “like a lot of health conditions — we just tell people to lose weight because it’s going to be good for them anyway.” Because of my high level of activity (health at every size!) she suggested that I wasn’t bleeding because of my fat, I was just…bleeding.

    I was really grateful that she addressed my question realistically and kindly.

  6. I had to have spinal surgery 2 years ago. I had degenerative disc disease and needed the L4 S1 disc removed and a small rod put in my spine. I literally could not walk to get my son from the bus stop without crying because my spine hurt that much. To my amazement my neuro-surgeon said nothing about my weight before the surgery. I kept waiting and waiting for him to berate me, but he did. My surgery took 3 hours longer than it was supposed to. Then the berating started. When he came out to talk to my mom and my husband, the first words, FIRST words, out of his mouth were not how I was doing, but to tell them, and I quote, “She’s just too fat.” My mom and husband were shocked beyond being able to talk. Unfortunately this was before I had begun my look into HAES and the science behind all the studies that say that fat is bad, blah blah blah, so my loved ones weren’t armed with information to help against this doctor. When I found this out, all I could do was sit there wide-eyed and mutter about the fact that even if it were as simple a matter of CI/CO then it wouldn’t have made one fig of difference because I couldn’t MOVE without pain. Literally, I slept in a recliner because I couldn’t lay in a bed. I was in worlds of pain. After the staples were removed (several days late, but I can’t blame anyone there because Hurricane Ike swept through and there was no way to get to the surgeon’s office to have them out), I walked out of that office and swore I would never go in there again, and I never have. I refuse to be treated as a sup-par person simply because I have excess adipose.

    I get that anything but an ideal body size has the potential to make medical treatment difficult. The issue I have with this though, is that according to those “in the know” if you have the ideal body size then you shouldn’t need medical treatment in the first place because “everyone” knows that thin = healthy.

    You’re right, we don’t need to play the blame game, or point fingers at who should be solving the problem, we should be doing it together.

  7. I am one of the “bad fatties.” I weigh around 400 pounds. I’m 5’3″ tall. I am 55 years old. I have assorted health issues of the sort that get fat people as a class demonized. But even before I started to have health problems, I had trouble with health care providers.

    I could write a book about the ways I’ve been marginalized for my weight by health care professionals. It isn’t pretty and it shows a side of human nature that isn’t nice. Such ill treatment has made dealing with health challenges thousands of times harder than need be.

    I have been silent about what has happened to me because it has been hard to disentangle the moral ambiguities foisted on me by society from the reality of my own self worth. I think it is time that we who have had to deal with the health care industry are more vocal about what has happened to us.

  8. This is SUCH a hot button topic for me!

    I once had a doctor who blamed EVERYTHING I was ill with on my weight (BTW, I’m not ill very often). A turning point came for me when I came in for some large red bumps on my legs. My day job is working with elderly patients in assisted living and nursing home settings so my immediate concern was that I might have contracted an infection from my job. Long story short, after several visits, I was diagnosed with some kind of skin condition (name I can’t remember) and told that it was because I was too fat and “you know what you need to be doing”.

    I was furious, ashamed, and sad. I’ve had this body for thirty-mumble years. I know how it works. It doesn’t lose weight, no matter how much I diet or workout (which is fodder for another post). My anger won out. I realized that this doctor was dangerous. If she blames everything on her patient’s weight, then she could very likely miss a real problem and not treat it correctly.

    I went to a new doctor and told him my story. He kind of gawked at me for a moment and then said, ” I have no idea why you would have been told that. We don’t know why people under 70 get the condition you have. We think it’s because of stress, so you just want to be sure to manage your stress.” Hallelujah!!! And he’s been my doctor ever since because I can TRUST him!

    BTW, I followed his advice and started exercising more frequently (because I ‘d noticed that this helped). I actually weigh a little more then when I saw the first doctor but haven’t had an outbreak since I stopped seeing her.

    ~ManDee
    http://www.chubbygirlcomics.com

  9. What an interesting array of responses…! It wasn’t my intention to post seeking sympathy. I’ve thought about telling my story on the sites like Well Rounded Mama et al, but it feels like turning a buck from the misfortune of my poor baby boy who didn’t make it.

    It’s only that I’ve JUST moved back to the US after 12 years overseas (like two days ago), and I’ve had the ‘advantage’ of having been in an HMO, BC/BS, the NHS, and the German medical system, and I can tell you…the topic of my weight came up the least with the German system. My Frauenarzt (whom I nicknamed WunderGyne) actually berated me the first time I sat in her office and asked if my weight was an issue with trying to get pregnant again. If you know anything about Germans, they are very direct and say exactly what they mean, good or bad, and she was no exception. The only time she said anything to me about my BMI was when I was heavily pregnant and getting whiney about the pain in my back. She merely pointed out that the pregnancy was putting me in a higher BMI category which meant that yes, I’d probably have more pain than other women because of the heaviness. The fact that I gained 20 pounds with that pregnancy and lost nearly twice that shortly after was rather startling to my docs, tbh!

    Newme, I probably should have put the word “imperfect” in quotes. It was early when I typed that, and I’m still jet-lagged!

    • I’m in love with the treatment I get in Germany.

      My doctor did raise the question of weight with me, and then he sighed and said, “though I don’t know how we’re going to do it. I haven’t managed to lose weight. Even though I’ve given up Cognac!” And he sighed some more.

      Then we had a good laugh about how impossible losing weight is, and discussed whether it’s worth giving up Cognac for some elusive ideal.

    • I knew we agreed, Yorkie. Hope your jet lag goes away ASAP!

  10. It seems to me there are a two issues here. One is the way fat people are treated by health providers and have everything blamed on adipose tissue. That’s something that (hopefully) can be overcome – sooner rather than later – by education, activism and so on.

    The second, which hasn’t specifically been raised, but which is going to become an increasingly urgent issue, is the question of medical equipment itself. That, to me, is the nightmare issue, because the reality is that CT scanners, MRIs, beds, ambulances, the whole works, have to be reconfigured if the full spectrum of body types are to receive proper medical care. But that’s easier said than done, at a time when health costs across the first world are spiralling.

    My partner works in aviation and I’ve asked him about the issue of getting bigger seats onto planes, so that bigger passengers don’t have to face the humiliation of being turned away or being forced to buy two seats and his view (and he’s clinically obese himself) is that it presents so many problems in terms of reconfiguring cabins and airline profitability that it’s unlikely ever to happen.

    I’m not saying any of this for any other reason than to throw it out there. What’s the solution? I don’t know.

    • Yes, appropriate medical equipment is already an issue. When I was trying to get a diagnosis of what turned out to be ovarian cancer, I needed to get a CT scan done. I was over the limit of the machine. The tech came out and looked me over. She said she thought I would be ok. Her letting me take the scan instead of turning me away literally SAVED my life. What if she’d been fat phobic? Would I be here today? Chilling thought.

    • This reminds me of something I saw on the CBS news page. It was a slide show of all of the things that are available for fat people. Some of the items I think are a great idea but the tone of the slideshow was horrific. It came across as being very shaming in tone.

    • Alexie, on the matter of airplane seats, I spoke to a co-worker today who told me that Airbus is looking into having seats which adapt to your body-shape pop out of the floor. I do not know if he’s pulling my leg, or if they actually consider that something like this might be feasible in ten or fifteen years. But there *are* possible solutions, and people are thinking about them.

      And CTs and MRs, you can produce them with larger bores, just like you can manufacture bigger blood pressure cuffs. There are already 78cm-bore CT scanners on the market, designed for patients weighing up to 500 lbs, and MRIs with 70 cm bores for up to 550lbs (and with the magnets not being any bigger nor the image taking any slower than on a smaller device). Nothing in the technology precludes us from making them bigger.

  11. You with horror stories of healthcare – please submit them to the First Do No Harm website. http://fathealth.wordpress.com/ . Vesta44, who is a frequent poster in the Fatosphere and has her own health horror stories, collects stories such as the ones you tell. It is useful to have them all in one spot and is an invaluable reference to anyone researching such outrageous treatment.

    • I need to do that one of these days, not just for the outrageous way I was treated by the first OB I saw after returning here from Korea (was told I could not have a trial of labor at all due to my BMI because I was destined to fail and if I needed an emergency cesarean, they might not get through all the fat in time to save my baby–YES, she really told me this) but for the way I was treated by the second OB at my six week post partum check up (who, apparently ticked because he didn’t get to collect on that fat repeat cesarean check, told me I needed all of these various medical things done and that if I couldn’t lose the weight with diet and exercise, then I needed to look into bariatric surgery and that doesn’t even include what he said about my breasts while he was doing the breast exam). Just still have a lot of anger about those things though I did do a bit of venting in the ICAN group.

  12. Sometimes I think it’s not Fat Acceptance we need so much as a society wide campaign: Don’t Be An Arsehole. I mean, where do people get off with so much rudeness? If they’re shaming and talking about fat people, you can bet those same people are feeling free to open their mouth and let the bile pour out over some other issue.

    • meiningerswbi, you are absolutely correct. When did do many people decide that they could be so rude about everything? And tactless. And wrong! Out loud, and in public! I support your Don’t Be An Arsehole campaign!

  13. My boyfriend is an X-ray technician and one thing he has repeated to me several times is “Humans don’t have handles.”

    It doesn’t matter how heavy a person is. Once they get to be adult size, you’re looking at having difficulty moving them solo. Yes, it’s harder when the person is heavier, but even a 100 pound person can be difficult to turn.

    Open MRIs are a blessing, and not just for the fat. My dad has wide shoulders that scrape the inside of the tube on a standard MRI machine, and that has nothing to do with his weight. He’s just built like his Dutch (think viking) ancestors.

    As for tube feeding, if it’s just CI/CO then they should be able to monitor the patient to help them lose weight on the tube feeding right?
    >:)

    On the “fat friendly products,” I finally found a step stool that’s rated at 300 lbs. I weigh 250 and I want to be able to lift something as well as myself. So much is made as cheaply as possible, I really want to have a weight rating listed on most things.

    (Sorry for rambling, lots of topics I wanted to touch on.)

    • Lol, “Humans don’t have handles.” Love it!

      I just wanted to briefly comment on the tube feeding question. I think it’s important to remember that even if someone loses weight because their TF cals are restricted, there’s still a 5% chance the weight will stay off. Plus, up go the negative health impacts of weight cycling. Additionally, in many medical circumstances, we don’t want to restrict calories because we want patients to be anabolic for healing, recovery from surgery, etc. Finally, the amount of weight a person would lose by having their tube feeding restricted would be minimal in the typical “temporary” hospitalization situation anyway.

      I agree with you on the open MRI… it’s also great for those of us who practically have a coronary being closed into that little one… shudder! :)

  14. I agree that medical care is not set up for the fat or very fat. What I would like to see is not only more equipment designed for fat people but more of an emphasis in med schools to learn to treat fat bodies. I’d love to see specialists in bariatric medicine just as there are specialists in every other aspect of the body. I’d go to such a doctor, knowing that my needs would be met there.

    And while I’m on the topic of specialists, why aren’t there more gerentologists seeing patients? Our population has a huge baby boomer contingency and there are very few doctors who specialize in helping older people. As you said in your blog, (I’m paraphrasing) it’s not as if the need has suddenly emerged – people born in the late 40s to the early 60s are needing specialized care.

    Good job on the blog!

    • I’m in naturopathic med school, which is full of mostly thin students. I am working on how to encourage and teach size diversity, though it is a huge challenge, especially when just being in school consumes so much time and energy.

      I find that I am often the only, or one of the only, fat models in our various lab classes. Some days, I am grateful to be able to provide diversity, whereas other days I want to cry because I feel so exposed and judged (though I think I am judged less than I feel). Abdominal exams are particularly anxiety producing. When working with patients, I have seen students and doctors make assumptions about weight and health, which I do my best to counter.

      We are just taught that fat is bad and most don’t question it. However, as I have started bringing in people to talk about weight and health and HAES, I am pleased to see many peope respond positively. I constantly encourage people to consider HAES when working with all of our patients. It will take time, but the movement is there.

  15. The bit I never get is why people bang on about fatties costing the health care system so much money. If fat really truly is so bad, that’s great for the health care system (and the pension system), because it means less people living to a ripe old age. Getting old is the most costly thing you can do – there are hip replacements, medications, specialist visits, podiatrists, bone fractures and a whole host of things to look forward to. And if you’re unlucky enough to get dementia, the costs explode. Smokers, on the other hand, are the cheapest citizens around, because they pay high taxes on their ciggies and then conveniently die much earlier than everybody else!

    • That’s right. And don’t forget social security costs. if you live long past retirement, you rack up a huge ss bill. Plus what people forget is that most people don’t just die suddenly in their sleep; if you get old, you will likely get SOME kind of fatal health problem that will cause you to deteriorate before you die. Old age is our biggest risk factor by far, and the older you get the greater the risk. It’s funny how often people forget that.

  16. When I’m not dancing I work with disabled children so I have to provide personal care on a fairly regular basis, often to people considerably bigger than I am. From the standard mobility aid training I know there are plenty of options available to lift and manipulate someone who is heavier than you – by any amount – more or less mobile or more or less capable of giving assistance. Whether these options are provided or not is the issue, and some people simply do not think about it.
    When someone is at their most vunerable and needs care, it is not the time to start beating them with the size-ist stick, and we should never make assumptions about people’s health or care for their health.

  17. Correct me if I’m wrong, but don’t people know what they’re getting into when they decide to work in health… CARE? That means they have to care for people. CARE for them. All of them. The old, the mentally ill, the homeless, the fat, the people of colour, the gay, the trans*… all of them.

    That’s why it’s called health CARE.

  18. sleepydumpling-
    I work in health care. Many doctors find out they don’t want to be doctors once they start doing it, but it is too late to change careers by that point. These doctors are usually pushed by their families into the profession.

    Then there are weirdos who want to be in charge of everyone and become doctors to justify their massive egos. I think this actually makes for the majority of medical students. I trained classes of second year med students in phlebotomy. We told them all repeatedly WAIT FOR AN INSTRUCTOR BEFORE BEGINNING THE PROCEDURE (because they were practicing on each other), there weren’t enough of us to personally supervise everyone at once so they had to take turns. But hey, we were just actual phlebotomists with years of experience, and they were Medical Students sooo every year, without fail, they all start poking each other with needles without a clue as to what they are doing because they assume they know better than people who do it for a living. Physicians would try to cut in line in clinics to get their blood drawn, “I’m a doctor” as their only justification. One of my co-workers used to make fun of them and talked about how they probably pull this crap at the grocery store, too. I don’t know how nurses deal with them all the time, its like having bossy children but then having to do what they say.

    This isn’t to say all doctors are crappy, just that good ones are really really rare. I wish patients felt empowered to argue with their doctors more, the authority they wield is so important that it shouldn’t go unchallenged.

    I worked in the lab and for awhile I did problem resolution with physicians and nurses. It wasn’t until I talked to my sister about her job (H.R.) that I remembered getting yelled at and belittled by people wasn’t a normal part of employment.

    Other people (CNA, Phlebotomists, etc) are just people who took a technical course because they wanted a job that couldn’t be outsourced. I started that way and was fortunate enough to run across feminist/fat positive literature. I try to be a positive force for fat patients at the hospital by challenging the attitudes of others, but this post is 100% correct in saying that people feel that it is okay to complain about a fat person because they “should” lose weight. Its ridiculous. The treatment of people with substance abuse issues and transgendered people is something else that bothered me. I wrote a letter to one of the directors of the medical student program about the kind of crap I witnessed but I don’t know if they did anything about it (once again, lowly lab worker probably doesn’t count a lot to them).

  19. The first thing I thought when I read everyone’s posts is “How can the medical community expect people to care and be proactive about their health if they judge them and treat them badly?” If a doctor is mean to someone they may find another doctor – or they may stop going to the doctor! What ever happened to *helping* people??

    Several mentions of blood pressure cuffs gave me bad flashbacks to my own hospital visits. I have felt like someone under Gitmo torture with that thing on my arm – the nurse will say (when they finally get it because my arm was apparently too fat to read the first time) ‘ gee your blood pressure is a little high’ and I’m thinking ‘yeah yours would be too if someone was using a pressure cuff to cut your bleepin arm off!!!’ Once I had a nurse do my pressure with the stethoscope under the cuff for my pulse, and he couldn’t get it and he said it was because “there was too much tissue” – I had never heard “you’re too fat” put so…scientifically. Another time I came home and I had red marks around my arm that lasted for days – they tried to take my blood pressure and broke my blood vessels! And this is for my own good, for my health?!?!

    Logic dictates that in order to save lives and uphold the physician’s oath, every piece of medical equipment made should be adjustable or have a variation to accomidate every conceivable body shape or size. The bottom line and politics etc. obviously dictate otherwise. Not having the right size equipment is unacceptable. It is especially aggrivating on things like bp cuffs and seatbelts – would adding a few measley inches really be that hard? A few inches…and lives could be saved. What kind of doctor would object to that?


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