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

Posts tagged ‘#mhealthfairview’

What this #mhealthfairview expert interview on #CNN is missing about #coronavirus preparedness that can help physicians, other healthcare providers and responders, to prepare better for themselves, patients and the public…

https://www.cnn.com/2020/03/10/opinions/osterholm-coronavirus-interview-bergen/index.html

Important Disclaimers: I am NOT a clinically trained medical or mental health professional, nor do I have any training in public safety.

I will always encourage any person in medical or mental health crisis to be evaluated and treated by clinically trained professionals in appropriate care facility.

Full Disclosure: I am a long term patient in the M Health Fairview system, who has been less than thrilled with my care by some physicians both recently and long term where I’ve blogged about it.

I’m also an Obese, cigarette smoking, non violent (but not wonderfully tempered when met with a lot of judgement) mentally and medically disabled patient with intractable widespread and localized physical pain, who gets a fair amount of a trinity of prescription medications known for abuse or addiction from one long term reluctantly prescribing physician.

I also have neuro deficits that also make it difficult to be concise, this blog isn’t being written to talk about myself, although it will come off like that at first.

It’s meant to help and I’m not honestly being flippant when I say like the novel COVID-19, it will get worse, before it gets better/helpful to not myself, but to anyone who commits to reading it in its entirety.

***

Okay.

Actually NOT okay, on multiple accounts not just personally but concerned as a serious medical and mental health blogger.

So about several weeks ago my lower back pain and sciatica got much worse.

About several months ago my long term physician went on medical leave and I even loathe to talk about it, as to protect their identity, even though I’ve made mentioned of that physician in the past.

In that amount of time which I’ve written about, I had more ER visits in the last 4 1/2 months than I have had in the last 5 years.

First it was Gastroparesis related nearly choking and dying in my bathroom due to uncontrollable vomiting 2 days after Thanksgiving 2019 but being really sick with Gastroparesis stuff the entire holiday weekend and being sick as a fat person still, who had trouble eating and getting fluids in, most of 2019.

Well, Gastric Bypass REVERSAL related Gastroparesis, which for those of us who get it vary symptomatically within that population, as well as those who get Gastoparesis, as they vary, too.

Then I got non diabetic Cellulitis infection that required a ton of oral, IV and intramuscular antibiotics and guess what I got from that?

Clostridum difficile.

This blog isn’t about the state of my digestive system where I’ve already addressed as an activist/blogger the need for longer term followup in Gastric Bypass reversal patients whether or not they end up with Gastroparesis or not.

It’s not even about how stupid but worth mentioning that with my regular PCP who does all my medication management out, that I am being made to go next week in clinic, just to get an renewal of my script for an opiate, as I haven’t had an issue with online requesting meds in any other category even though I’m pretty sure even after a course of heavy duty antibiotics (Vanco) that I still have c-diff.

And here’s where my very unique complex medical and mental health history should help hopefully physicians and other clinical professionals, as well as my history as a blogger/activist who has a 6 continent (the good people in Antarctica apparently know better than to attempt to read my blogs, apparently)  reach about Suicidology and the medical and psychological trauma prior to and after serious bariatric surgical complications can hopefully help physicians and other responders, as well as patients and the public when dealing with novel COVID-19, as far as potential medical and mental health ramifications due to the pandemic, especially in this social media era, as it applies to some of the things that was discussed in above linked video/article.

Yeah, almost 700 words in, and I’m about to make my points, now.

Some of the misguided psychological response to COVID19, is it can’t/won’t happen to me and at least that is being discussed to an extent.

Then there is the issues of bringing up the Obese, as far as novel COVID19 hitting the United States.

Okay, does that mean for all people with a higher BMI over 30, or people who have the co-morbidities that are associated?

What about thin never been of excess weight people who have family history and have diabetes, pulmonary hypertension and high cholesterol and are on medication for it, not just because of their medications but their risk?

How to address that a mandatory quarantine in an acute care facility for those who become sick, also present a potential medical and mental health chaotic danger to physicians, other health providers and responders, in addition to patients and the public themselves, some of it we are starting to see, others you won’t know adverse human response to those circumstance experiencing it, such as suggested in above article?

I’m not, no one in that article is suggesting mass or personal hysteria as a response to novel COVID-19.

But topic fatigue and whole encompassing relentless fear isn’t a good response to the pandemic, either.

I can only hope people need to know, that if there was ever a time, if it’s possible to try in unknowns to tap into what’s good and helpful to ourselves and others, even for those of us who don’t have an “A” game, now is that time.

I may not be the right person to be talking about novel COVID-19, but I think I bring up topics that should warrant further exploration, both immediately and the long term about medical and psychological response to and by and for with good intentions.

A few last things people should be thinking about, whether or not  this pandemic will put them in mortal jeopardy, is end of life wishes, something I’ve discussed in the past, hoping to remove stigma, as blogger.

Such as having Advanced Health Directives prior to potentially becoming catastrophically ill.

Because you shouldn’t wait till a medical crisis to decide important life and death decisions, let alone a matter of life and death decisions.

I have a filed and  updated a very specific AHD, DNR/DNI of not wanting any life saving or life extending measures should I experience any kind of medical crisis (they are void if mental health causes a person to be a threat to their own lives or any other)  over 18 months ago and while truthfully, I think I get treated with more bias than I should by University of MN physicians and the very few physicians I’ve seen outside that hospital system, the U of MN is getting my body, for medical education purposes, as my organs aren’t of any use to any other, when I die.

Other day to day life decisions are impacted for me by disability, and that has to be taken in consideration, if one’s own personal barriers when it comes to having to experience adverse circumstances in life, that are beyond their realm of control.

Again, this blog is being written with the best of intentions to help others.

And I understand that my life circumstances and perspectives are unique, if not a little bizarre.

But, as someone who writes and cares about sanctity of life issues, in and outside of crisis situations, in hopes to conduct myself and help others with dignity and constructively, and it’s my hope it helps others figure out a way that helps themselves and others deal with this, in the most medically and mentally safe way as possible and further discussion on how to help those who are going to be so adversely impacted.

Important Note: Anything that is not constructive to any other or myself will not be posted, I can handle a respectful difference in opinion and welcome that but hateful rhetoric or responses will be handled appropriately and responsibly, so please don’t waste my time or yours by even trying, as no one is forcing you to read anything I write.

And yes, I realize what a weirdly wordy specific title this blog is…

Thanks!!!

A few more observations about how flawed #mhealthfairview ‘s ER department is, then I’ll let this go…

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Important Disclaimers: I am NOT a clinically trained medical or mental health professional, this blog is more personal in nature but to make an activism point.

HOWEVER, I will always encourage people in medical and/or mental health crisis to seek immediate evaluation and treatment in acute care facility i.e. hospital.

But as a patient in a bigger body, who’s received inefficient and ineffective care when actually seeking emergent medical treatment, the only thing I can say and the reason why I’m still alive to say it, is I’ve had to fight harder to get treatment in the past, as well as the little I do now, to still be here to talk about this.

***

I can’t go back and try and re-edit my last blog which goes into great detail about a bad ER visit I had at Fairview U of MN’s ER on 12/4/2019, which I highlight more about the attending controlling physician being kind of misogynist and fat phobic but realizing I knew from the start I was going to have problems during that ER visit of not being taken seriously for the reasons why I was there.

It happened to be last Thanksgiving, exactly a week ago and last Saturday, I could eat a couple of bites of cereal or toast, then end up throwing up immediately or hours after, in addition to left quadrant and other mid abdominal pain.

The one thing I also had on Saturday and I have it every few months is a ventricular tachycardia episode.

I didn’t say anything though about my ventricular tachycardia episode because it’s normal for me and other people that I know of that have Gastroparesis after gastric bypass reversal (which is fairly common for us reversed peeps) , as well as those who have Gastroparesis who’ve never been overweight.

I, in 2016, weighed quite a bit less,but was sick of then the problems I had eating so I actually thought about having a total gastrectomy and started seeing GI at the U of MN.

So how I know I have Gastroparesis even though it’s not that I’ve been formally diagnosed with it, is that I actually had a gastric emptying study Summer of 2016 at the same hospital that I was in the ER last Tuesday, that indicated that I had Gastroparesis.

My weight fluctuates wildly for someone who hasn’t been thin for over 11 years, 18 years status post gastric bypass and over 9 years status post gastric bypass reversal.

While it’s not normal even for me, prior to my gastric bypass to every few years be up gaining and losing 40-80 lbs, it’s been that way since my reversal.

This is the issue and while I’m still going to file a grievance with my visit, even though there was no malice on the part of any of the hospital staff  and even I can understand where one of my symptoms I have that could be considered not acute (such as intermittent left quadrant pain for OVER a year) but paired with vomiting and syncope episodes and an honest belief that I had acute pancreatitis if not other issues, as I have every organ in my abdominal region including gallstones in gallbladder and my appendix is that I was treated due to my weight of last year which put be me in almost borderline MO BMI territory, is that I still do NOT have any ACTUAL co-morbidities of Obesity.

Just a big bloated fat body and it’s been way bigger in the last year, while I’m up almost 40 lbs since that stupid gastric emptying test in 2016, I’m down almost 50 lbs since my heaviest a year ago.

I had a great GI nurse practitioner at the U of MN, the reason why I stopped going to her or seeing a GI surgeon is that I refused to have a naso-gastric 24 hour monitoring test. And I was told the chances of my having a total gastrectomy for having a hard time eating and the little that I could eat of it feeling being stuck forever, wasn’t going to happen.

In late Winter of 2017, I actually saw a GI surgeon at HCMC, about a ventral hernia repair and realized I wasn’t even going to do that, because I found the hospital scary even though the surgeon was great and didn’t want an inpatient procedure there.

I do not have the sanity points do keep seeking acute and non acute care, when it seems like most physicians can only see my Obesity or overweight and try to diagnose disease or syndromes based upon having a larger body that doesn’t have ANY of those diseases.

Or they use the fact I have mental health issues and/or the fact I get pain meds to make assumptions about me medically and mentally that are just NOT true and aren’t evident in behavior or tests.

My long term boyfriend who’s never been overweight, eats like crap actually does have high blood pressure, high cholesterol and Diabetes due to family history that is well controlled with medication.

He however NEVER has to put up the with the shit I do, the little I seek medical attention in the last several years by any medical professional or physician.

For someone in my case where I had a great bariatric surgeon and still have a great PCP who are Fairview doctors, the Obesity and Opiate obsession by most of the physicians and medical staff that has existed not just at this hospital and their ER department, but across the board, is appalling.

I get that it was medically evident that I didn’t need to be at the ER on Tuesday.

The problem is, the next time it might be medically evident that I should be in an ER or seek specialty care, I will NOT go and really no one could blame me.

Nothing I’m saying shouldn’t ever prevent any physician from catching what could be in me or another patient an Obesity related medical event.

But I’ll never actually get diagnosed and treated effectively  based upon bias and barriers by even the most qualified physicians if they are going to base my medical care upon what I look like or find that I’m not credible based upon something like BMI, a non violent mental health history and current medication regimen that doesn’t contain medication for ANY Obesity related diseases.

I hope this spares any larger patient from having the same problems I’ve had in getting medical care, but it’s even worse when someone is heavy post bariatric surgery, is heavy and despite best attempts can’t get their body weight down, even though they can’t eat much and quite often, anything to have to keep going through crap.

The health issues are bad enough.

Not being believed and/or taken seriously, is actually worse, though.

So that a cyclical vomiting fat patient NEVER gets treated horribly by an ER doctor, especially the same one, THREE times in the last 9 1/2 years at #FairviewHealth…

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(Above picture taken 2004/2005 when in school to become a NASM CPT after discovering a love of exercise 3 years status post rny, loving the endorphin high first and the results from being fit, 2nd, even though I had duodenal ulcers than, severe nutritional deficiences and severe reactive hypoglycemia )

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(picture of me 11-2016, when I still walked 5-10 miles a day 3 to 4x a week, stopped a year later when pain levels caused falling risks, nothing compared to how much I’ve fallen, thrown up, can’t eat much, in the last year, 6 years status post reversal at the time of picture, 9 years post reversal, 18 post rny, now and I look much worse now and can’t care).

Important Disclaimers: I am not a clinically trained medical or mental health professional. I am considered and recognized favorably in my activism that has saved other people’s lives when in medical and mental health crisis that is rooted in horrific gastric bypass complications.

I also do activism that is centered around physicians, other healthcare workers, first responders and police officers to be safe in their workplaces.

However when  obesity bias and potentially other biases effects the potential medical and psychological wellbeing and could be a threat to a patient’s life, I have a problem and grievance wise, so should the attending physician who I saw earlier today, who didn’t remember me, but will hopefully will NOT forget me and what he did past and present, now.

***

Dr. Klos,

This is about my visit 12-4-2019 and other visits in 2010 where unfortunately for the both of us, I had to deal with you thankfully just once yesterday  around 12:20 pm when you let me know you were discharging me.

You came in after 2 hours of my being at Fairview, after coming in complaining of left quadrant pain, severe abdominal vomiting last weekend, which I wasn’t going to go the ER during a long holiday weekend that had winter weather hazards that caused tons of car accidents and other seasonal related injuries and my birthday  on Monday (which I’ll explain in greater detail, as I go along).

The original resident I saw was kind. I think all the hospital staff was kind except you.

The issues of bouncing back with the vomiting, not being able to eat much for the last year and that left sided abdominal pain that I get whenever I eat and the labs I had being normal, when I kind of copped an attitude of why I was in the ER earlier today, you used my labs being normal, as well as the abdominal x-ray being normal without a lot of patience or kindness.

I said that I waited til today, went NPO after 8pm, which I had to explain several times to your staff, as I know what NPO means, didn’t drink any liquids, take any meds and ate very little yesterday or ingest anything orally.

I knew fairly early like an hour within my getting roomed, I wasn’t believed, as even when I was given an IV and being clear that I was nauseous and couldn’t give a urine sample due to how little I ate and drank yesterday and that I felt I was dehydrated that I wasn’t even given a bag of fluids and I didn’t ask for anything else except a diagnostic, which I did get an x-ray which ruled out acute pancreatitis.

As we were rounding out our conversation with you both and the resident and I made a comment about just quitting eating and drinking as I could do that for a long time, as I have in the past, it just leads me to faint and fall on a regular basis you made the comment “well don’t quit drinking fluids”.

I would’ve been more devastated, except in the last year especially, my weight while I’ve lost over 40 lbs without trying, I’m very bloated and am significantly larger at this weight in size than I have been in the past, while I have a obese bmi, I look closer to being morbidly obese, even though I still haven’t had any co-morbidities due to obesity, ever.

I saw you in the ER in June of 2010, I had horrible labs then, I had duodenal bleeds you did nothing about, even though I had been admitted 2 weeks before that visit, which was either my 2nd or 3rd admission and I was directly admitted a few days later by my bariatric surgeon due to intractable abdominal pain and projectile vomiting dozens of times a day even though I was obese then.

When I ended up seeing you the day before Thanksgiving in 2010, I honestly thought you’d take me more seriously, I was almost 3 months post open rny reversal, still with severe abdominal pain and intractable vomiting, it took you hours after begging to order diagnostics and after they were done, I had been there for so long, I unhooked my IV and quietly left the hospital, not trusting that I’d be helped anymore, as I had to fight too hard and for too long that day to get the help I did.

Then the day after Thanksgiving 2010, received a phone call saying I needed more diagnostics and ended up 12-2-2010 on my 41st birthday still with intractable abdominal pain and projectile vomiting of not being able to go through with a scheduled EGD by my bariatric surgeon who ended up having to order a PICC line, as I still had bad labs and was so dehydrated, as no one could get an IV in me that day, after 3 people trying 5 times.

You Dr. Fat Phobic are a dangerous physician to any female with a bmi over 24. I could understand having some kind of issue with a patient who’s had similar symptoms over the last year that are only getting worse.

I cannot though understand you thinking fat patients should never be able to eat again.

Or not believing even though I have normal labs now and am absorbing the little I can eat and drink, you didn’t take me any more seriously over  NINE years ago.

I did become suicidal and did try once in August of 2008 to intentionally overdose after living with intractable abdominal pain and intractable vomiting for 6 years.

I was also again suicidal in 2010, because of my awful bariatric surgical complications but  I had a parent lose a sibling 6 months prior to reversal and already knowing what trying to commit suicide did to my family, fought much harder than I should’ve had to had to, to stay alive in 2010

I do not make myself get sick on purpose, I don’t go to the ER because I’m bored or lonely or looking to score opiates. I very seldom seek medical attention at this point, filed a DNR 9/2018 with my absolutely amazing long term  Fairview PCP in Princeton and filed a body bequeathment to FUMC, realizing as a long term smoker (not saying I’m perfect, but it’s hard to think of quitting smoking when I can’t really do anything else) earlier this year vs. being an organ donor, so even in hopes after my death I can help physicians.

My life though is dedicated to helping patients in crisis. I have people all over the world who are in bariatric crisis, need a reversal, are terrified about getting fat and I’m really good at helping them get through the reversal process, so that they can remain ALIVE and after reversal navigate through that.

I’m really good at helping bariatric patients who have bariatric surgical regret, mourn using food as a coping mechanism, become suicidal, who want a reversal to explain why it’s not going to be done and can get them with other help, to see the good things about the weight loss process and that they will lose the bariatric surgical regret and enjoy the good things that can come from having a bariatric surgery and weight loss.

I’m good at helping patients who become suicidal due to bias with obesity and chronic pain, to get professional help but not let the bias by physicians realize they aren’t alone, especially for those like me where I’ve had issues with weight gain not being able to eat and having very few doctors believe me, but my bariatric surgeon at U, did believe me.

I hope there is an adminstrative process, as if I have to adapt to not eating anymore, having to give up that a normal weight loss process will follow and having to deal with a life that leaves me homebound, in an enormous amount of pain due to not being able to take in fluids, meds and food, I guess so be it.

But I’ll be damned that I survived what I did and to let you do a THIRD time to me, to another patient who DOES NOT have a voice or any recognition of just despicable your attitude towards fat patients are.

And not only is despicable but it’s potentially deadly should a heavier patient in medical crisis and/or mental health crisis, have to be dependent on your flawed judgement due to your bias for their care and it potentially ruin their life, if not end it.

I really hope that Fairview Health makes this right so that no other patients ever have to go through what I’ve done with this physician, not saying physician should lose their job, but is in dire need of the dangers of their severe fat bias.

Alissa “Lisa” Kasen /”unstapledlisa”  d.o.b. 12/2/1969, my email and phone are correct in mychart, if anyone wants to address this at Fairview and hopefully this WILL be addressed with attending….

Important Editorial Note: After 5 hours of publishing, I know with the attending I saw earlier today, that I did see him 2 other times in 2010. The time and circumstances I haven’t gone back and verified yet on my medical records as far as the June 2010 instance, even though I did see him then and it could’ve been in the first admission I had in June of 2010, but I do remember not being taken seriously being an obese patient who was super sick in an ER and how devastating that was.

I will edit when I have the time and hopefully feel slightly better to clear up dates. As many doctors I saw with 6 admissions and countless ER visits in 2010, I do know how bad that particular ER doctor made me feel and how unlucky I felt that I had to deal with him twice in 2010, how much shame and sadness my encounters made me feel then, only lessened today as far as shame because it’s not mine to bear and I should’ve never had to worry when I having the labs of a starving person in 2010 and prior, to have an ER doctor justify that because my bmi fell in the obese category and I was clearly not aesthetically pleasing as well as credible about how bad my complications were, even though they were in my medical records at that time.

Additional Important Edit/12-5-2019 After seeing past reviews when researching attending physician this morning  and reading about him engaging in unacceptable ways with trauma patients, which I was NOT, while I knew I’d make an inquiry to file a formal grievance with the U of MN, as well as I’m not protecting his clearly misogynist fat phobic tendencies so I’ve actually added his name and hopefully through the right process future patients will not be at risk for further potential medical and psychological harm by this physician, at least in Emergency Medicine.

I also was not able to access my 2010 records electronically, hopefully they will get pulled during the grievance process, or that they exist somewhere if not online.

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