You need new doctors. The rest is awful too.

mrsconn23

Dear Prudence,

I had a really hard pregnancy and went from slightly overweight pre-pregnancy to slightly underweight postpartum. Breastfeeding carved even more out of my body. Our son is two now, and I’m still fighting to get up to a healthy weight. Everyone has an opinion about this, and everyone has worries about weight gain, so there’s no one I can talk to. My doctors were unworried about weight loss and they missed recognizing how risky my pregnancy was until the third trimester. Afterwards, I had to search out a new practice to find someone who would take my postpartum concerns seriously. My mom was congratulating me about avoiding mommy tummy, my sisters are acting jealous and my husband once told me he missed my old boobs and ass. He apologized but it stings. My in-laws send me snake oil supplement articles, but at least they understand that it is a problem I want to solve even if I’m not going to do it that way.

I’m the last in my friend group to have a baby so I feel like my friends are blasé about pregnancy issues. So many women in my mom groups say things like “you’re lucky” or “I wish that was my problem.” Forget pretty privilege, strangers on the light rail offer me a seat when I’m traveling alone because I look sickly. I don’t feel lucky—I feel exhausted and I hate my new body. Also, we want a second child but no amount of chugging Ensure seems to be getting me close to healthy for that. How do I get people to realize this topic hurts, and I either need empathy or silence?

—Not Lucky

banana468

Well, for those you're close to I think you can be clear "Actually this is a health problem because we can't figure out why I can't put the weight on and I'm chronically fatigued."   If people continue to be blase then ask pointed questions, "Are you of the belief that it's OK to be constantly low on energy as long as I'm thin?" 

short+sassy

I am seething with so much anger for the LW.  It hits very close to home for me, though for totally different medical issues.

Though I did laugh when she talked about her ILs.  God bless'em, at least they are taking her concerns seriously.

A problem we have in this country is we treat doctors like they are all-knowing Gods.  They aren't.  A LOT of them SUCK...the dozen I've had, except for two sure did...some even to the point of gross incompetence (that was one guy).  The MINUTE a doctor starts blowing you off about a medical problem, is when it's time to start researching and see someone else.

The LW should Google her issue.  Check forums.  Find some possibilities for what might be wrong.  That could help her narrow down the type of specialist she needs to see.  Because her OB/GYN or GP might not have any knowledge about what is wrong with her.  And then see the new doctor armed for bear.  Like, "Do you think it could be X or Y or Z?"  It will make the doctor at least think about what you are saying and evaluate the options you presented.  Or maybe it jogs their mind and they think it might be A.

As for people's comments, I'm giving her permission to be a blunt bitch.  And be dramatic with the worst case scenario.  That's what I do, though I'm nice the first few times I explain it to people.  Like (for her), "I am not lucky. I am sick. I am wasting away and doctors have no idea why."  If she's comfortable telling people about her desire for a second child, especially with family, make sure to throw that in, "Seriously, mom?  You know H and I want another baby but there is no way we can try until we know what is wrong.  It would be incredibly dangerous for me and the baby."  

levioosa

short+sassy said:

I am seething with so much anger for the LW.  It hits very close to home for me, though for totally different medical issues.

Though I did laugh when she talked about her ILs.  God bless'em, at least they are taking her concerns seriously.

A problem we have in this country is we treat doctors like they are all-knowing Gods.  They aren't.  A LOT of them SUCK...the dozen I've had, except for two sure did...some even to the point of gross incompetence (that was one guy).  The MINUTE a doctor starts blowing you off about a medical problem, is when it's time to start researching and see someone else.

The LW should Google her issue.  Check forums.  Find some possibilities for what might be wrong.  That could help her narrow down the type of specialist she needs to see.  Because her OB/GYN or GP might not have any knowledge about what is wrong with her.  And then see the new doctor armed for bear.  Like, "Do you think it could be X or Y or Z?"  It will make the doctor at least think about what you are saying and evaluate the options you presented.  Or maybe it jogs their mind and they think it might be A.

As for people's comments, I'm giving her permission to be a blunt bitch.  And be dramatic with the worst case scenario.  That's what I do, though I'm nice the first few times I explain it to people.  Like (for her), "I am not lucky. I am sick. I am wasting away and doctors have no idea why."  If she's comfortable telling people about her desire for a second child, especially with family, make sure to throw that in, "Seriously, mom?  You know H and I want another baby but there is no way we can try until we know what is wrong.  It would be incredibly dangerous for me and the baby."  

Obviously I'm in the field, so I'm biased, but it goes both ways. I see a lot of shitty providers. I'm trying my best and I know I can't possibly know everything, and it would be pure hubris to claim I know everything and I'm always trying to learn more. I have no issue with trying to refer to a higher level of knowledge if I don't know what's going on or if I've tried the workup and nothing is coming out of it. But patients also have to take responsibility sometimes and also not everything is pathologic, Tik Tok. Like the other day I had a young 20s something arguing with me about needing a colonoscopy for their constipation. No other symptoms. Zero family history. They didn't drink any water, just one coffee a day. No exercise. Only processed foods and no fiber. I was like "yo, it's not cancer, it's just your lifestyle and the great news is you can change that. If you do the things and are still having issues in a month come back." But then they got mad I was "brushing them off." They demanded I send to a specialist and threatened to complain. 

Then you have bff who called into her primary doctor with sudden joint pain, fatigue, and fever of 104.7 F only to be told it's "because she's a mom and works too hard and is just exhausted." Meanwhile I'm over here panicking for her because if it isn't some kind of Tick borne illness we can find on testing next up on the differential list is a vicious leukemia or autoimmune disease. And obviously something is wrong with LW too. So no, providers can suck too, and for women in particular the healthcare landscape is a hellish dystopia with super limited research and care. Because if a man called in with BFFs symptoms, or if a man gave birth and continued to have weight loss and extreme fatigue, the workup would be vast. 

Overall yes, there are shitty doctors (which yes, is not great) and there are good doctors. There are good patients and bad patients. I do think the landscape is changing as the climate has become more patient centered with shared decision making. The problem is people in healthcare are so burned out that even as the older (traditionally more egotistical doctors) retire, there are even bigger holes in communities as people leave healthcare and the rest of us keep getting burned out. I am worried that people are also going too far in the other direction and there's too much hate and anger towards providers, most of whom are just trying their best and who are overwhelmed with insane schedules and the onslaught of tasks. People yell at me all day long about what their insurance is providing them. One of our MAs and then her doctor got yelled at and told that "karma was coming for them" because of where we work, then the patient told them they hoped the doctor would pay. And he's an excellent provider who does fantastic care. This field is exhausting, every one is mad, hell, we're mad that care is based on insurance companies running our medical decision making, and the US is a dumpster fire. And no, we don't know everything, but damn is it exhausting to fight literally everyone, all day long, especially when many times there is an explanation, but you don't want to hear it or do other things to manage it. Again, I'm not saying that providers are perfect, or patients are all awful, but it's complex and it all fucking sucks.  I get it. I get it as a provider. I get it as a patient with an autoimmune illness which took years to diagnose, with another autoimmune illness I heavily suspect and which other providers mention and hint at but no one will fucking actually diagnose. It's people's lives and their quality of life, and it bleeds out to their families and their communities. 

I dunno. I'm just ranting at this point.

charlotte989875

levioosa said:

short+sassy said:

I am seething with so much anger for the LW.  It hits very close to home for me, though for totally different medical issues.

Though I did laugh when she talked about her ILs.  God bless'em, at least they are taking her concerns seriously.

A problem we have in this country is we treat doctors like they are all-knowing Gods.  They aren't.  A LOT of them SUCK...the dozen I've had, except for two sure did...some even to the point of gross incompetence (that was one guy).  The MINUTE a doctor starts blowing you off about a medical problem, is when it's time to start researching and see someone else.

The LW should Google her issue.  Check forums.  Find some possibilities for what might be wrong.  That could help her narrow down the type of specialist she needs to see.  Because her OB/GYN or GP might not have any knowledge about what is wrong with her.  And then see the new doctor armed for bear.  Like, "Do you think it could be X or Y or Z?"  It will make the doctor at least think about what you are saying and evaluate the options you presented.  Or maybe it jogs their mind and they think it might be A.

As for people's comments, I'm giving her permission to be a blunt bitch.  And be dramatic with the worst case scenario.  That's what I do, though I'm nice the first few times I explain it to people.  Like (for her), "I am not lucky. I am sick. I am wasting away and doctors have no idea why."  If she's comfortable telling people about her desire for a second child, especially with family, make sure to throw that in, "Seriously, mom?  You know H and I want another baby but there is no way we can try until we know what is wrong.  It would be incredibly dangerous for me and the baby."  

Obviously I'm in the field, so I'm biased, but it goes both ways. I see a lot of shitty providers. I'm trying my best and I know I can't possibly know everything, and it would be pure hubris to claim I know everything and I'm always trying to learn more. I have no issue with trying to refer to a higher level of knowledge if I don't know what's going on or if I've tried the workup and nothing is coming out of it. But patients also have to take responsibility sometimes and also not everything is pathologic, Tik Tok. Like the other day I had a young 20s something arguing with me about needing a colonoscopy for their constipation. No other symptoms. Zero family history. They didn't drink any water, just one coffee a day. No exercise. Only processed foods and no fiber. I was like "yo, it's not cancer, it's just your lifestyle and the great news is you can change that. If you do the things and are still having issues in a month come back." But then they got mad I was "brushing them off." They demanded I send to a specialist and threatened to complain. 

Then you have bff who called into her primary doctor with sudden joint pain, fatigue, and fever of 104.7 F only to be told it's "because she's a mom and works too hard and is just exhausted." Meanwhile I'm over here panicking for her because if it isn't some kind of Tick borne illness we can find on testing next up on the differential list is a vicious leukemia or autoimmune disease. And obviously something is wrong with LW too. So no, providers can suck too, and for women in particular the healthcare landscape is a hellish dystopia with super limited research and care. Because if a man called in with BFFs symptoms, or if a man gave birth and continued to have weight loss and extreme fatigue, the workup would be vast. 

Overall yes, there are shitty doctors (which yes, is not great) and there are good doctors. There are good patients and bad patients. I do think the landscape is changing as the climate has become more patient centered with shared decision making. The problem is people in healthcare are so burned out that even as the older (traditionally more egotistical doctors) retire, there are even bigger holes in communities as people leave healthcare and the rest of us keep getting burned out. I am worried that people are also going too far in the other direction and there's too much hate and anger towards providers, most of whom are just trying their best and who are overwhelmed with insane schedules and the onslaught of tasks. People yell at me all day long about what their insurance is providing them. One of our MAs and then her doctor got yelled at and told that "karma was coming for them" because of where we work, then the patient told them they hoped the doctor would pay. And he's an excellent provider who does fantastic care. This field is exhausting, every one is mad, hell, we're mad that care is based on insurance companies running our medical decision making, and the US is a dumpster fire. And no, we don't know everything, but damn is it exhausting to fight literally everyone, all day long, especially when many times there is an explanation, but you don't want to hear it or do other things to manage it. Again, I'm not saying that providers are perfect, or patients are all awful, but it's complex and it all fucking sucks.  I get it. I get it as a provider. I get it as a patient with an autoimmune illness which took years to diagnose, with another autoimmune illness I heavily suspect and which other providers mention and hint at but no one will fucking actually diagnose. It's people's lives and their quality of life, and it bleeds out to their families and their communities. 

I dunno. I'm just ranting at this point.

It’s got to be so hard. I’m so thankful when I had J that my doctor’s office (my actual doctor wasn’t working that day) took my weird symptom of extreme itchiness with no rash seriously, got me in, diagnosed me quickly, and delivered J relatively healthy. I don’t let myself think too hard about what could have happened if we had a doctor who didn’t know what it was or told me to take a Benadryl and see if it gets better. 

short+sassy

We all have our own POVs and I acknowledge mine is very skewed by the atrocities that my medical care has been.  It's been a year and I thought my anger would subside by now.  But it hasn't.  It includes a lot of anger at myself that I was way too complacent for way too long.  Trusting that my doctors knew best and they didn't.

My health has been so much worse for the last 20 years because of it.  I can't get that back.

I should have done my own research years ago and that's what this LW needs to do also, since her concerns are being ignored and no one is giving her answers anyway.

Of course, no one should be yelling at healthcare workers and I'm sorry that happens to @levioosa.  It's not right, especially when most healthcare workers are just trying to help.

But the same time, patients absolutely need to do their own research and advocate for themselves.  Sometimes that might lead to ignorance.  But then there is also ignorance too often within the medical field.  I have had some bad experiences where a doctor or nurse tried to steamroll me, even when I KNEW they were wrong.  But I was too timid and unsure of myself to do anything but roll over.  That is actually one of the perks of being middle-aged and having more experience.  Now I have the confidence to stand up for myself and question things if they don't seem right.  

charlotte989875

I think one of the hardest things is that you have no idea what type of doctor/ provider you’re going to get. I’m also a white woman with a PhD which gives me a lot of privilege in a medical setting that many women, especially women of color, don’t get. And there is so much medical sexism and racism in this country that quite literally kills people. 

At the same time I’ve seen what some close friends in the medical field have gone through, especially in the last few years and it’s horrid. The abuses, the unbelievable hours, inadequate pay. It’s all too much. 

short+sassy

charlotte989875 said:

I think one of the hardest things is that you have no idea what type of doctor/ provider you’re going to get. I’m also a white woman with a PhD which gives me a lot of privilege in a medical setting that many women, especially women of color, don’t get. And there is so much medical sexism and racism in this country that quite literally kills people. 

At the same time I’ve seen what some close friends in the medical field have gone through, especially in the last few years and it’s horrid. The abuses, the unbelievable hours, inadequate pay. It’s all too much. 

So true!  I know I tend to focus on sexism because that is what I've experienced.  I'm sure that is part of why the LW isn't being taken seriously either.

But I realize there is racism within the medical industry also.  Just like other industries where women get the short end of the stick, it's always even worse for women of color.