For Fat Patients and Their Doctors

A very well researched article … love the phrase ” we must be CEOs of our own health”.

Dances With Fat

If you are here for the evidence list, it’s at the end of the post!

Two patients have high blood pressure.  One is thin, one is fat.

The thin person goes to the doctor and receives recommendations for interventions that, evidence shows, are likely to lower blood pressure.  When that person goes back for a check-up, the doctor will test their blood pressure to determine if the interventions are working.

The fat person goes to the doctor, and research tells them that there is a greater than 50% chance that the doctor will view them as awkward, unattractive, ugly, and noncompliant, and a nearly 30% chance that the nurse will be “repulsed” by them.  (All of the evidence is linked at the bottom of this post)

The doctor recommends weight loss to “cure” the high blood pressure, but does not tell the person that the vast majority of the time people gain…

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I started this blog because I am a big believer in taking charge of your own health and exotic evemaking sure you know and understand what your doctor is prescribing and why.  I have come across many doctors who are more than happy to sit down and explain everything.  I have also come across a select few who are of a mindset of ‘I’m the doctor, I know best, ‘just do as I say’’.  They do not like their decisions being questioned and it’s like pulling teeth to get answers.  Now really, it’s 2013 not 1950’s, or 1850’s for that matter. The healthcare system today is moving towards a more pro-active approach to patient care.  Yet there still are some doctors who, for lack of a better word, are condescending to their patients.  I say this because I have one of these doctors.  A gynecologist as a matter of fact.

I will say upfront that he is a very good doctor.  He doesn’t believe that surgery is the answer to all problems like some other doctors.  I had another gynecologist that just wanted to do a hysterectomy.  This doctor said no.  I asked why, he said you don’t want surgery. I asked why again, he said you don’t want surgery.  This is where his lack of communication or explanations comes in.  I had to do my own research to figure out why he was saying I didn’t want surgery.   I don’t want surgery.

Not having the surgery means having another plan of action.  That also means other complications can come into play. In 2012 I started on a hormone therapy for a few months. It was a progesterone only hormone called Prometrium. It caused swelling in my legs. A little while afterwards I also suffered from multiple pulmonary emboli that came from blood clots from my leg.  Over the past year I have been getting tests to find out why I had the blood clots and to check for cancer in my body.  My pharmacist approached me about the hormone I was taking saying in rare cases it has caused blood clots to form.  When I brought this to my doctor’s attention recently when he wanted me to go back on the same hormone he was very adamant that it wasn’t the hormone.  “It’s impossible” he said.  He brought out his big book to read up on it.  I had the printout from the pharmacist with me to show him. His response was “well if you don’t need it then don’t take it”.   I didn’t take it.

Now having just seen him again this past week because my issues are not resolved, he said “I am putting you on Depo-Provera just for 3 months. It should clear everything up”.  After our last talk about Prometrium and I wouldn’t go on it I didn’t think he would prescribe another progesterone hormone treatment for me.  So when I went to fill the prescription it was the same hormone and with a clear warning that it can cause blood clots!!  He just prescribed another type as if I wouldn’t know better!  I found that very condescending.

My bleeding issues have been going on for 3 years now.  It doesn’t help that I am on blood thinners now because of the Pulmonary Embolism.  Because of my age I should be in menopause.  I do get a monthly shot to try to force the menopause.  At what point does the body say enough and you have to give in to the surgery?

My first plan of action is to talk with my thrombosis doctor about the hormone and blood clots.  I won’t be taking the new prescription until I speak with him.  I will get him to talk with my gynecologist.  Then take it from there.

Being pro-active in your own health care is your right.  It can also save your life.

Have a Great Day!



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Fibromyalgia is a complex illness to diagnose and to treat. There is not yet a diagnostic test to establish that someone has it, there is no cure and many fibromyalgia symptoms — pain, fatigue, problems sleeping and memory and mood issues — can overlap with or get mistaken for other conditions. A new Mayo Clinic study suggests that many people who have fibromyalgia, especially men, are going undiagnosed.

The findings appear in the online edition of the journal Arthritis Care & Research.

More research is needed, particularly on why men who reported fibromyalgia symptoms were less likely than women to receive a fibromyalgia diagnosis, says lead author Ann Vincent, M.D., medical director of Mayo Clinic’s Fibromyalgia and Chronic Fatigue Clinic.

“Health care providers may not think of this diagnosis when face to face with a male patient with musculoskeletal pain and fatigue,” Dr. Vincent says. “These findings need to be explored further.”

Researchers focused on Olmsted County, Minn., home to a comprehensive medical records pool known as the Rochester Epidemiology Project, and used multiple methods to try to get at the number of people over age 21 with fibromyalgia.

They used the epidemiology project to identify just over 3,000 patients who looked like they might have fibromyalgia: Roughly a third had a documented fibromyalgia diagnosis. That amounted to 1.1 percent of the county’s population 21 and older.

In the second method, researchers randomly surveyed Olmsted County adults using the American College of Rheumatology’s fibromyalgia research survey criteria. The criteria include the hallmarks of fibromyalgia: widespread pain and tenderness, fatigue, feeling unrested after waking, problems with memory or thinking clearly and depression or anxiety, among other symptoms. Of the 830 who responded to the survey, 44, or 5.3 percent, met those criteria, but only a dozen had been diagnosed with fibromyalgia.

Based on the study’s findings, the researchers estimate that 6.4 percent of people 21 and older in Olmsted County have fibromyalgia — far more than have been officially diagnosed with it.

Fibromyalgia is more common in women, but men can get it too. The discrepancy between the number of people reporting fibromyalgia symptoms and the number actually diagnosed with the condition was greatest among men, the study found. Twenty times more men appeared to have fibromyalgia based on their survey response than had been diagnosed, while three times more women reported fibromyalgia symptoms than were diagnosed.

“It is important to diagnose fibromyalgia because we have effective treatments for the disorder,” says co-author Daniel Clauw, M.D., director of the University of Michigan Health System Chronic Pain & Fatigue Research Center.

Studies also show that properly diagnosing people with fibromyalgia reduces health care costs, because they often need far less diagnostic testing and fewer referrals looking for the cause of their pain, Dr. Clauw says.


Is it because women are explaining their symptoms differently or doctors think this is a woman’s syndrome?  It’s bad enough that there are still doctors out there who don’t believe in fibromyalgia for women.  It must be harder for men with the fibro-fog.

Have a Great Day!



Note:  The above story was retrieved May 20,2013, from : Mayo Clinic (2012, December 19). Men with fibromyalgia often go undiagnosed. ScienceDaily.


Posted in FIBROMYALGIA | Tagged , , , , , , , | 3 Comments

Study Hints of Links Between HPV and Lung Cancer

This study just came out.  What else is this HPV virus going to cause?  Now Lung Cancer?

Study Hints of Links Between HPV and Lung Cancer.

Have a Great Day!




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The following was posted in the Los Angeles Times on April 7th, 2013 by Susan Silk and Barry Goldman:

It works in all kinds of crises – medical, legal, even existential. It’s the ‘Ring Theory’ of kvetching. The first rule is comfort in, dump out.

When Susan had breast cancer, we heard a lot of lame remarks, but our favorite came from one of Susan’s colleagues. She wanted, she needed, to visit Susan after the surgery, but Susan didn’t feel like having visitors, and she said so. Her colleague’s response? “This isn’t just about you.”

“It’s not?” Susan wondered. “My breast cancer is not about me? It’s about you?”

The same theme came up again when our friend Katie had a brain aneurysm. She was in intensive care for a long time and finally got out and into a step-down unit. She was no longer covered with tubes and lines and monitors, but she was still in rough shape. A friend came and saw her and then stepped into the hall with Katie’s husband, Pat. “I wasn’t prepared for this,” she told him. “I don’t know if I can handle it.”

la-oe-0407-silk-ring-theory-20130407-001This woman loves Katie, and she said what she did because the sight of Katie in this condition moved her so deeply. But it was the wrong thing to say. And it was wrong in the same way Susan’s colleague’s remark was wrong.

Susan has since developed a simple technique to help people avoid this mistake. It works for all kinds of crises: medical, legal, financial, romantic, even existential. She calls it the Ring Theory.

Draw a circle. This is the center ring. In it, put the name of the person at the center of the current trauma. For Katie’s aneurysm, that’s Katie. Now draw a larger circle around the first one. In that ring put the name of the person next closest to the trauma. In the case of Katie’s aneurysm, that was Katie’s husband, Pat. Repeat the process as many times as you need to. In each larger ring put the next closest people. Parents and children before more distant relatives. Intimate friends in smaller rings, less intimate friends in larger ones. When you are done you have a Kvetching Order. One of Susan’s patients found it useful to tape it to her refrigerator.

Here are the rules. The person in the center ring can say anything she wants to anyone, anywhere. She can kvetch and complain and whine and moan and curse the heavens and say, “Life is unfair” and “Why me?” That’s the one payoff for being in the center ring.

Everyone else can say those things too, but only to people in larger rings.

When you are talking to a person in a ring smaller than yours, someone closer to the center of the crisis, the goal is to help. Listening is often more helpful than talking. But if you’re going to open your mouth, ask yourself if what you are about to say is likely to provide comfort and support. If it isn’t, don’t say it. Don’t, for example, give advice. People who are suffering from trauma don’t need advice. They need comfort and support. So say, “I’m sorry” or “This must really be hard for you” or “Can I bring you a pot roast?” Don’t say, “You should hear what happened to me” or “Here’s what I would do if I were you.” And don’t say, “This is really bringing me down.”

If you want to scream or cry or complain, if you want to tell someone how shocked you are or how icky you feel, or whine about how it reminds you of all the terrible things that have happened to you lately, that’s fine. It’s a perfectly normal response. Just do it to someone in a bigger ring.

Comfort IN, dump OUT.

There was nothing wrong with Katie’s friend saying she was not prepared for how horrible Katie looked, or even that she didn’t think she could handle it. The mistake was that she said those things to Pat. She dumped IN.

Complaining to someone in a smaller ring than yours doesn’t do either of you any good. On the other hand, being supportive to her principal caregiver may be the best thing you can do for the patient.

Most of us know this. Almost nobody would complain to the patient about how rotten she looks. Almost no one would say that looking at her makes them think of the fragility of life and their own closeness to death. In other words, we know enough not to dump into the center ring. Ring Theory merely expands that intuition and makes it more concrete: Don’t just avoid dumping into the center ring, avoid dumping into any ring smaller than your own.

Remember, you can say whatever you want if you just wait until you’re talking to someone in a larger ring than yours.

And don’t worry. You’ll get your turn in the center ring. You can count on that.

Susan Silk is a clinical psychologist. Barry Goldman is an arbitrator and mediator and the author of “The Science of Settlement: Ideas for Negotiators.”

I have been in situations where people have said the wrong thing to me, and I just shrugged it off.  This is a great way to educate people when they hear of bad news concerning family, friends or colleagues.

Have a Great Day!



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