It's not what you are eating, it's what's eating you…

Posts tagged ‘#MDPTSD’

What is actually going to take, for others to stop judging and shaming people based upon their appearance???

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Important Disclaimers: I’m NOT a clinically trained medical or mental health professional, nor am I trained in law enforcement or public safety.

IF you or someone you know is in danger of hurting themselves or others, please contact emergency services, immediately.

This blog is being written to both serious personal and professional activism, so there may be some profanity in it, it’s definitely NOT meant to appearance shame anyone whether they work hard to look their best or they are more like me and don’t, anymore.

As my blogs in the last 3 months have touched upon bias I get for my appearance not just in the real world but when seeking emergent medical attention.

As well as my life in the last 50 years of being appearance shamed about weight and looks.

Bullying by peers  and medical bias can have both dire psychological and physical consequences acutely and long term, if a patient can actually live through some of the things we should never be put through ONCE, let alone over and over again.

IF any above topics or profanity is a trigger to anyone, please don’t read, thanks.

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“I swear to GOD, they both  looked and reacted to me like myself and myself ALONE,  was FUCKING soley responsible for the Obesity and Opiate epidemics!!!!”

Above comment made by myself when discussing my ER visits and a recent medical admission when having a followup appointment with my long term primary care physician, yesterday and catching her up on that, as she knows I hate going to the doctor, so for me to go to the ER three times in a 5 week period, as Thanksgiving and the weekend after I couldn’t stop projectile vomiting, so I went into the ER 3 days later, 2 days after my 50th birthday.

As well as for Hanukkah/Christmas, I got a potentially life threatening cellulitis infection in my face, which caused ER visit #2 and the ER visit #3 a week later was due to the “gift” of the c-diff infection I got from all the intraveneous antibiotics they gave me for the cellulitis infection.

This is the thing, NO ONE at this point can cause me emotional duress, because they don’t like that I’m still fat despite quite the gastric bypass history and that I don’t even try to be anything resembling an attractive human being.

I can’t care anymore, that’s my perogative, I feel like a really old person who feels like shit most of the time, having a lot of severe chronic pain head to toe,  if I take a shower and put clean clothes on, well, you’re welcome.

Doesn’t mean I am going to judge those who want to look and feel their best, as I’ve said before, there’s nothing wrong with that.

However there’s something terribly FUCKING wrong, when people look at another just because it offends on some level their desired aesthetic for others when someone doesn’t meet them.

You don’t like the way someone looks where other than that, their behavior and looks doesn’t effect you, in any other way???

Don’t fucking look at them, it’s that easy.

Slightly, a little more harder but worth the work, is to try and get past that your bias that is causing you to judge someone negatively when their existence has NO effect on how you live your life.

And if you’re an actual physician  and have a patient who may be of excess weight and ONLY that, even without a bariatric surgical history, and never has had a comorbidity due to Obesity in their life, if a patient tells you they can’t stop throwing up and they are having trouble eating and keeping liquids down, telling them to completely stop eating is never the answer or such as if a patient is admitted during a different emergent encounter and a line of offensive questioning that has NOTHING to do due with the admitting diagnosis and being cavalier as such as discharging them because they get offended when you ask them if they are abusing cocaine or heroin, which is in direct contradiction of the comments you made about their Obesity moments prior, realize that you’re not the first physician or first person to be so unnecessarily critical as well as absolutely WRONG in your judgement of a patient.

This blog isn’t about me, though.

Honestly, normally when a physican treats me like crap, I can give it back appropriately where I’ll call them out on their bias, either to their faces or by filing a grievance, I don’t and no one else has a right to do more than that.

But I can’t stop thinking that human beings who are vulnerable, whether or not in a patient role,  don’t have a voice and constantly are being told by their peers and clinical professionals there is something wrong with them because of their particular aesthetic.

I have no problem saying this has and will continue to kill people, unnecessarily until others realize they could be so harmful, even if it’s not intentional or with malice.

Whether it’s patients who will not seek professional help due to bias and being labeled and not believed or it being assumed a patient has medical or mental health issues they don’t, just based upon what they look like and/or they are a one in a million patient in their physical responses that differ than most the population of humans to treatments.

Or human beings who’s depression or behavior is at risk of being  of fatal to themselves and or innocent others, because they can no longer bear hearing how either ugly and fat they are or how ugly and too thin they are.

Just be kind and if you can’t be kind, just ignore someone versus going out of one’s way to bully and/or shame someone and do it like someone’s life fucking depends on it.

Because it actually does…

Important Note: Anything that could be hurtful to myself or another reader will NOT be published.

Physicians with biases ARE physicians who HARM, even if it’s unintentional…

 

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Disclaimers: I am NOT a clinically trained or credentialed medical or mental health professional. NOTHING I say should EVER be taken in lieu of professional medical and/or mental health evaluation or treatment of ANY condition.

I can ONLY put my opinions, where I hope to help people, where I have in guiding them, at the very best, simultaneously,  at the same time to get the best medical or mental health treatment, from trained clinical professionals, in an appropriate setting , such as what I do with gastric bypass patients in various scenarios with gastric bypass reversals, among other things.

BUT,  what I have to say about how various biases carried by physicians and the potential for physical and emotional harm, still needs further civil, respectful and responsible but sometimes when appropriate, critical discussion, not ONLY by patients but the actual medical and mental health professionals within their own  communities.

I ONLY believe though, when dealing with a provider who one might feel is showing bias that effects one’s care,  of discussion of potential  misbehavior, if  one feels that they’re being treated unfairly or unreasonably, because of that bias (I’m talking about appointments, not to the point where blatant physical or emotional malpractices have occurred) of filing a grievance, if a discussion doesn’t resolve the issue and/or finding another physician.

It is NEVER okay to threaten the emotional or physical wellbeing of anyone, including a physician or any provider, for biases and if depending on the degree of physical and/or emotional harm has occurred, if that’s an actual issue, there’s legal remedies one can look into and/or take.

That’s it, making or threatening a physician’s physical and emotional safety and wellbeing is NEVER okay (more will be elaborated about that, in the content of this blog).

Also note, I have people I associate with where they may find my communication style at best, offensive, because I’m kind of open with my various disabilities and with those disabilities, it’s difficult for me to be concise or write well, even if this topic definitely needs discussion and resolutions.

***

All I wanted to do last weekend,  was to  have an okay weekend.

Let me explain, as most people know, that due to my disabilities, that I don’t have anything normal in responsibilities, like people my age do.

But in my case, I kind of dread weekends, while my blogs have been both personally and as an activist, VERY serious as of late, it’s kind of scary where I live, because on weekends, when staff isn’t here, people are more likely to act out.

Even with cameras, unannounced drug sniffing K9s and security during nights and weekends.

While I explain to those few about explaining where I live,  that 1/2 the building where I live are good to have as neighbors, the other half is people who have issues with drug addiction and what it takes to support an illegal drug addiction (dealing and/or other illegal and unsafe behaviors to support an addiction of themselves and who they associate with) , if one’s on their way or headed to rock bottom, especially for poor people, it’s not a fun thing to live amongst, even if I have some empathy for non violent addicts.

The best way I can describe where I live is my building is like a stupid drug cartel that’s badly managed and a church had a baby.

Seriously and it’s NOT funny or fun to live in, even though I’m grateful for my housing.

Also as a serious activist, if I’m going to point out where doctors fail patients in under medicating patients or being afraid to use opiates as a last resort, I also have a responsibility as an activist, to do no harm, myself.

To either patients or providers or to anyone.

The last thing I’d want to give the impression, as an activist,  is that people can be complacent nor would I want to enable, when it comes to the potential of drug addiction or feed into a denial pattern, if they actually are in the midst of drug addiction or heading into drug addiction with either prescription or  illegal opiates.

I know it sounds like I’m digressing, please be patient, I will make my point when it comes to physicians and their biases and how it harms.

Because of all the clinical data I have to read, both as a patient and as an activist, who’s trying to find answers both to opiate addictions and obesity surgery complications, is by using Google.

So when last Saturday night,  it was in my suggestions on Google,  to check out a physician driven site to support and educate medical providers, especially as it applies to interventional pain management or obesity related issues (among many other medical topics but those were the 2 most talked about ones, as well as ones I’ve discussed ad nauseum in this blog in the past) , I didn’t need that site, to know that bias among physicians was horrifyingly pervasive and permanenting who apparently were WAY unaware that they had a few of these awful biases that I’m going to discuss in this blog.

I just didn’t need to see it on Saturday night, when my building was a hotbed of not life threatening criminal behavior due to drugs, but it still was scary because you don’t ever know when that’s going to escalate.

I happen on that physician site to read an article a blog that  a pain management specialist wrote,  who was trying to make a point on how tricky it is to do pain management using a popular stereotype that’s perpetuated not only with non physicians, but within the medical community.

Patient #1:  was a morbidly obese patient who misused opiates claiming she was under medicated, that she was treating who had  needed a double knee replacement and severe  back pain  due to a disc issue (and apparently her inability to stop eating for more than a minute)  and had mental health issues and when the physician pulled her meds due to her non compliance and her quite clearly expressing the patient having NO willpower whatsoever, that patient trashed her online, so she thought, as right after that happened, she received a bunch of negative reviews on a bunch of medical websites.

Patient #2: Very friendly thin patient perfectly compliant dying of cancer, who used a moderate amount of opiates sparingly, despite her severe intractable pain due to terminal cancer with mets and in this instance, the pain management doctor had a nauseating borderline reverence, for.

I will admit, that I’ve had that kind of prejudice similar to patient #1 even though I’m not known for compliance with most meds, other than narcs due to high tolerance (and how I’m resolving that, will be in another blog, soon).

But that blog by that pain management doctor, hit me way harder as an ACTIVIST.

This is what I know to be true, due to the  activism that I do.

Bias can kill patients not only from physicians even if it’s not intentional, due to stigma, as well as by,  non physician peers.

I get that all the time, when I have to talk to a gastric bypass patient with catastrophic complications, into what may be right for them, such as a a gastric bypass reversal, who’s going to die, has a BMI of 19, even with weight loss of 200 lbs and NO surgery to correct extra skin, so their BMI is actually even lower, when that’s taken into consideration, but they’re afraid of and what’s worse, is their current bariatric surgeon is afraid of doing a reversal, in case they become morbidly obese, again.

Where they are more likely to DIE from their catastrophic complications, before Obesity again could put them in mortal danger.

Or in the case because I’m a body diversity activist and find thin shaming repugnant, if I say that someone who’s thin, they’ll usually share their skinny shaming stories and if they’ve had a past or current history with bulimia and/or anorexia.

Or when I see within the weight loss surgery community, patients who get very thin because they’re terrified they’ll be fat again, not realizing that it’s not ideal, it’s actually unhealthy,  to be exercising intensely like an athlete, on 400-1000 calories a day, not only does that make them more at risk for exercise related injuries, it kills their metabolisms, in the long run, if not creates other health risks.

So doing behaving that way is no insurance policy that a bariatric patient won’t gain weight again or have any other severe health problems.

Or if they have bariatric surgical complications, quite a few bariatric patients actually think they deserved them, because they were fat in the first place and had to resort to bariatric surgery.

Or when patients who are morbidly obese to medical and mental health issues and want bariatric surgery or to lose weight, they sometimes become obese due to inactivity due to their health issues and their medications, they can’t have their total knees without losing weight or their bariatric surgeries and they can’t lose weight without either surgeries and are absolutely in a no win situation.

With weight stigma, especially when it comes to Obesity, it hurts both fat and thin patients.

With fat patients, they hate getting medical care, because if they go the doctor for strep, it’s going to be blamed on their weight.

And it shouldn’t be any surprise but it will be to providers, if they have fat bias, the patients who they are treating are FULLY aware of that and that’s why people of weight loathe to seek medical treatment which can sometimes kill a patient, but even at unfortunately, at best,  unnecessarily makes getting any kind of medical treatment, a lot harder than it should be.

It also hurts and potentially harm  thin patients, because they may less likely to think they could have health issues, and their physicians feel the same way, because if they’re a “healthy” weight, it’s presumed, that they’re actually healthy,  when they may not be.

With opiates due to stigma, if a physician has a patient who’s in intractable severe pain, there is a risk they will self medicate and possibly harm if not accidently kill themselves,  they engage in unsafe and unhealthy behaviors to treat their pain and/or they kill themselves, if they aren’t appropriately medicated and/or suddenly taken off their medication.

Especially now, with the opiate epidemic, patients who are compliant, but have been on opiates for a long time are now starting to die, because they find a dealer and/or patients are actually commiting suicide, becoming collateral damage because of the opiate epidemic,  due to unbearable physical pain, because they don’t feel they have any other options and they have no quality of life and they have no options as a last resort for pain.

Absolutely NO physician should be congratulating themselves or encouraging as a positive behavior,  that a terminal patient has great “willpower” by not using opiates for severe intractable pain, if medications are working properly, when the risk of addiction in that patient is next to nothing and the patient is ONLY afraid to take opioids, because of stigma due to drugs, and would rather die a horrifyingly  painful death than be considered a drug addict due to stigma , even if the patient is going to DIE.

NONE OF THIS IS OKAY!!!

I’ve said this before, as a medical activist.

HOW and WHY, in this evolved technological era, why are people becoming MORE backwards in our society, has to be discussed openly, without stigma.

BUT medical and mental health professionals take an oath to try and not do harm.

IF they have personal biases, regarding fat patients, challenging patients to treat or mental health patients and/or any other kind of  biases, who are coming to them for any kind of treatment, they OWE it to their patients, to give them the best possible care.

And they can’t do that, if they have ANY kind of  preconceived particular bias towards ANY population of people.

In the defense of physicians or any medical or mental health provider, while I’m not excusing bias that limits their ability to care for their patients, they shouldn’t have to worry about physical or emotional harm, either.

Also patients LIE, like all the time or don’t even realize the dangers if they are aren’t lying a lot, but about things that may seem trivial to them but it’s not and it makes them a liability to both themselves and possibly their providers, especially one who is prescribing narcotics to them.

But even if 9,999 out of 10,000 patients are lying, especially about what they’re actually ingesting, all of them deserve to be given the benefit of the doubt, especially if the 10,000th patient may be, if not, is actually telling the truth

Every patient deserves an individual patient tailored approach to their unique physical makeup being able to feel safe with their medical and mental health providers.

Every provider should feel that they don’t have to worry about being physically or emotionally harmed, because they say something or take a course of an action that a patient doesn’t agree with.

Patients should just stop seeing that provider in that case, in case of negligence or harm, consider a legal remedy, that’s it, if a reasonable (as patients can be respectful, responsible and critical at the same time) discussion or resolution is NOT possible with a provider and/or seek a different provider, if possible

But pretending that bias doesn’t exist, that it can harm patients in their ability to get appropriate (and sometimes lifesaving) treatment of their health conditions,  that resolving one addiction and not addressing the nature of addiction, can lead to another, is harming people, both patients and providers, alike.

Because we aren’t having the responsible and respectful dialogues we need to, as as society,  because of STIGMA.

So while I will hold a physician to the hippocratic oath, it couldn’t hurt anyone, if we actually all took it.

Note: Constructive feedback, only.

Also note: Again, I believe in both any of the obesity surgeries AND opiates, as an absolute last resort. I’m not against any weight loss surgery, I just have a unique situation in being one of the more long term gastric bypass reversal patients out there, of being asked about that, a lot.

As it applies to opiates, I have lost people I’ve cared about due opioid addiction as well as see it in other case, such as described above, ruin people’s lives, so again, it bears repeating, I’m not trying to feed into or enable the opioid epidemic, as an activist.

Although, I’m also not going to apologize for being supportive of invasive medical treatments for different health issues, i.e. both obesity surgeries and opiates, but I will always strongly urge people when you take drastic action, make sure you have a long term plan, are well educated and are well supervised, medically (and mentally), life long.

Nor am I going to apologize for the length of this blog, due to the sensitive nature of what I addressed in this blog,  that I had to so  comprehensively and fairly, to do  justice both to patients and providers, alike.

And if you saw at times, what frightening words or phrases sometimes end up in search engines for my blog, well you’d understand better, why I have to have such a lengthy in depth disclaimer.

Thanks!!!

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