no really, WEIGHT REFUSED!!!

Early this morning, a comment on yesterday’s post came in and, as I typed up my response over my morning coffee, I realized that it really required its own post. KB said:

I’m not 100% sure it always is “too much preoccupation with this BMI shit”  You point out above that they need to measure dosage for kids -that doesn’t change when you’re an adult.  depending on what you’re there for, the ER wouldn’t necessarily be able to call your dr or anyone else in time.  weight doesn’t make you sick, no, but it can change how much medication you need.  I respect not wanting to know your weigh, or hear lectures about it, but sometimes they do need to measure it.

How about a little back story? A couple of years ago, back when I was still doing WW and was very well acquainted with how much I weighed, I was really struggling with a flare-up of my asthma. My allergist had me on a few medications, Flovent for one, and I was taking a few others under the supervision of another physician elsewhere. When he handed me the inhaler, he told me that I should get some relief from the asthma in a couple of weeks. Only, I didn’t. My asthma persisted and when I went back to him for a med adjustment he told me that clearly it wasn’t my asthma that was causing the shortness of breath and that I should perhaps take up my difficulty breathing with my primary care physician. When I asked what else it could be if not asthma, he, an extremely thin man, made a sort of sweeping gesture with his arm toward me and said, “Well, conditioning for one.” When I raised my eyebrows at him, he back pedaled somewhat and said, “although you do appear to be sitting there comfortably.” He ended the visit then, and I went out to my car to cry. My allergist just tried to tell me that I was SO VERY FAT that I couldn’t breathe. (And he wasn’t the first doctor to fail me so miserably. I actually had one physician tell me I was faking the asthma.)

So, that day I made an appointment to see my primary care doctor, only the doctor wasn’t there that week. Everyone was being seen by the Nurse Practitioner. I went ahead and made the appointment anyway. When I went in the next day, I dutifully got on the scale as I was told. The nursing tech recorded my height and weight, then she took me back into the little room, took my blood pressure and then left me to wait for the RPN. Now, the RPN at this practice looks like she could be a supermodel. She’s probably a size 0, if she’s even that big. She’s got this long, blond, thick, wavy hair and an elegantly made up face and she’s always wearing the most stylish outfit I have ever seen. Here I am, all schlobby in my mom jeans and a tee-shirt with my still-wet-from-the-shower hair clipped back with a hair clip. In fat, was lucky to have gotten a shower before leaving the house. (And, to top it off, I couldn’t get a breath. Imagine someone hands you a drinking straw (and not even a big fat one from McD’s, a regular sized drinking straw) and tells you that you can only breathe through that. That’s what it was like.)

So, I give her a brief history of my this asthma flare up, and explain to her about the Flovent not working, and as I’m talking, I’m watching her look at my chart, where my height (62 inches), weight (190!!) and my blood pressure (140/90!!!) are recorded side by side. And she’s got a pencil in one hand and it starts to hover over the numbers alternately, back and forth, while I’m trying to explain that I can’t fucking get a breath. When I’m done talking, she puts the pencil down and looks at me. “I don’t know why the Flovent isn’t working,” she says. “But your BMI is way too high and so is your blood pressure.” I explain that I’m doing the WW thing and she nods curtly, then gets up to hand me a brochure about the effects of weight on blood pressure with some “tips” on getting your blood pressure down. Then, before I knew it, I was bundled out of the office with strict instructions to exercise more or I was going to end up on blood pressure medication. Never mind the fact that I was struggling for air or that I was on no less than three separate medications that are known to cause elevated blood pressure (Flovent included!). Never mind that I was already keyed up about my weight, which could also cause a rise in blood pressure. Rather than doing something as simple as referring me to a pulmonologist, she looked at my weight and threatened me with blood pressure medication.

I remained short of air for about a month before I was finally able to find my own pulmonologist and get an appointment with him. He tweaked my meds and guess what! Now I can breathe!! And I’m even fatter than before!!

So yes, I do agree that sometimes a physician or other health care worker might need to know what my weight is. But I disagree with the conventional wisdom that they should check every. single. time I set foot in a doctor’s office, or that the BMI is even a useful indication of health at all. Having surgery? Yes, I get it. You need to weigh me to ensure I get the correct amount of medication to remain properly anesthetized without killing me. Sign me the fuck up. Where’s the scale? Do they need to know my weight in the ER? Well, that depends on the situation. But the vast majority of office visits I’ve had, especially recently? No, they don’t need to know my weight in order to excise a cyst (sorry, more TMI) or to do a pap smear (again, with the TMI!), or to shove a catheter into my bladder (I can’t stop!), or to do a follow-up visit on my asthma meds. Especially when, at best, that information earns me a lecture on the DANGERS OF OBESITY, or at worst, prevents the health care worker from even bothering with a correct diagnosis because s/he’s too focused on the sheer and horrifying enormity of my fatness.

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