If you’ve been reading this blog and paying attention (and given my sporadic nature in posting, you probably haven’t), you may have noticed that there is a category called “Medical Care”. Generally, whenever the things I’m writing about involve a Doctor (except, sometimes, in the case of Dr. Eeks, who is a Doctor, but works with me as a health coach) or a medical facility.
There is another category, sort of a companion category, called “Medical Don’t Care”. This has offered a few giggles, but also a few questions, namely – “What’s that?” Medical Don’t Care is essentially the opposite of medical care. When I go to see a Doctor or some medical professional who seems to have forgotten about that “professional” part, we use “Medical Don’t Care”.
Recently I was talking to a close friend who has long had weight issues. At one point, as a teenager, he was over 300 pounds. I don’t believe he’s been that heavy since, but he’s about 5’8-5’9 and his weight is currently around 250 lbs. He was also diagnosed with Crohn’s Disease as a child. From the sound of things, that diagnosis should have been debunked years ago, but it’s only been within this past year that his current Doctor took a look at an old colonoscopy and realized that none of the signs for Crohn’s were there.
He had been diagnosed strictly on his symptoms, which happens, though I do wonder why he managed to go all of these years with this diagnosis, and none of his Doctors noticed that he shouldn’t be overweight if he has Crohn’s. Still, that particular matter has been resolved now, but there are newer issues. Over the past few years, when he brought them up, he was told “Oh, you have pain when you eat? That’s just the Crohn’s, what do you expect?”
Since learning that he never had this disease, he’s sought the reasons for this phenomena but has been having difficulty finding anything. He recently saw a specialist who informed him that all of his problems are because he is overweight (that’s putting it nicely – he said “You know what your problem is, don’t you? Your problem is, you’re FAT. And the only thing that will make it go away is if you stop being fat) And of course, the reason he’s overweight is because he eats too much! He runs his father’s business, while taking care of his father, who is dying, has a son from an ended marriage and sees his every other weekend and makes sure that he is looked after and taken care of – quite a juggling act!
Some days he only eats once a day (which, in it’s own way does contribute to weight gain), mostly because no matter what he eats, whether it’s a lot or a little, he has excruciating pain in his gut. But the Doctor doesn’t believe him. He’s fat, so of course he’s lying! One thing you can ALWAYS guarantee, when a fat person says he isn’t eating, he’s lying!
I can’t COMPLETELY blame these “professionals” for saying these kinds of things – especially when they work with a lot of people that are morbidly obese. They just don’t know how to be effective for these people. They’re doing what they’ve been told to do, and it isn’t working, so who else is left for them to blame? People with God complexes tend to not blame themselves, it just doesn’t turn out well when they do that.
Blame or no blame, the burnout is reciprocal. Health care is essentially a two person operation (really there’s more to it than that, but we’re simplifying) – health care professional and patient. If a lot of the health care professionals in one area tend to be burned out, sooner or later, the patients in that area will be burned out as all.
I know this because I was similarly burned out. I’d been burned out by doctors, nutritionists, trainers and still more. They burned me out, not simply because they didn’t know how to help me, in fact, the problem lay in the fact that they did believe that they knew how to help me, and it was simply my refusal to do what they told me to that held me back. And they’d had this problem with pretty much every person that they’ve worked with who had more than a few hundred pounds to lose.
An example of what I’m talking about – 2 years ago, shortly before I started working with Eeks, I was working on getting the Bariatric surgery done. I’d found a surgeon that wanted to do the full gastric bypass and I was going through all the prerequisites, one of which required me to seek out the nutritionist road again. The first one was dreadful, I refused to see her again. I’ve mentioned this before – halfway through our meeting, I asked her if she could give me a list of foods to incorporate into the things I typically eat; a short list of foods that I would eat every day. I was talking to a nutritionist and I felt like I was giving her a golden opportunity to help me. I could gradually add foods onto that list and get rid of foods that were unhelpful. These first foods could be foods that will promote weight loss and good nutrition.
The nutritionist didn’t understand what I wanted. I explained. Apparently she still didn’t understand why I wanted her to do that. She (not so) politely referred me to the food pyramid. Great, thanks for nothing!
I made another appointment but called and canceled it later, informing them that I would not meet with that woman again. As disgusted as I was, I must say now how grateful I am to this woman. She was a big part of the reason Eeks offered to work with me.
I’d made an appointment with the new nutritionist around the time I commenced my efforts with Dr. Eeks. The meeting went well enough, save a few issues: she wanted to know why I refused to meet with the previous nutritionist, though she did point out that if I didn’t want to talk about it, that would be alright. I explained, and she agreed that the other nutritionist had been tactless, but somehow couldn’t seem to figure out how he could help me either, and pointed out that it really did sound like what I needed was “Choose My Plate”, which, she explained, is the governments replacement concept for the food pyramid.
That wasn’t so bad – unhelpful, but at least she wasn’t rude about it. The part that really bothered me was at the end. She informed me that I would need to begin adhering to a 1500 calorie a day diet. What!? Kidding?! I hope!!
No, this was rather serious – I was a bariatric patient, and my surgeon expects all of his patients to be on something like an 800 calorie diet before they go under the knife. I had suggested that we take a more gradual approach to 1500 calories than say, starting that week, but it was pointed out to me that starting at 1500 is a gradual approach. First we’d do 1500, then we’d drop 100 calories, then 100 more, until we were down to eight.
Here’s the problem – another character in my story, the gym owner/trainer that had fallen so short in other areas actually did manage to teach me some useful things. For one thing, he taught me how many calories someone my weight has to eat in order to maintain that weight. In the mid 500s, at my height, I had to consume around 4000 calories a day.
Dropping from “around 4000” to 1500 is a pretty radical change. However, I agreed to it, with trepidation. The nutritionist assured me that this was quite doable and that people do it all the time. I had just started working with Eeks and mentioned my concerns to her. She shared them. She didn’t feel that it was safe for me to drop down to 1500 calories like that, and felt confident that than attempt to just make it happen like that was destined for failure.
She left the choice up to me, but said that she’d feel better about this if I chose to abandon the assignment from the nutritionist and stuck with the plan we agreed on. I’d worked with nutritionists before, to almost no avail, and I had only just started working with Eeks. I felt a lot stronger in my commitment to the work that we were doing than I did with the nutritionist.
I contacted the nutritionist via e-mail explaining the conversation with my health coach, who is also an MD, and my decision to postpone dropping down to 1500 calories. The nutritionist replied stating that she can’t make me do anything, but if I don’t do what we agreed to, that I wasn’t going to succeed in weight loss and the surgeon wasn’t going to work on me.
So, I quit that nutritionist as well, stopped going to the bariatric support group meetings and quit seeing the surgeon as well, finding the whole matter very distracting from all the promise I was finding with Eeks. I decided that if 6 months went by and it didn’t work with Eeks, then I would resume my efforts. What’s 6 months?
Of course, 6 months later I was below 500 pounds and more than willing to give Eeks another 6 months. If the weight loss stopped happening and I just plateaued out, I could always go back to the surgeon. Mind, the surgeon was the best of the bunch, on the bariatric side – out of all the people I had to deal with, I liked him the best. When I talked to him about the matter, he was happy to hear I was putting effort into weight loss and told me to do what I felt would work. He was a funny Indian guy that looked and even sounded a little like he ought to be Scottish. He was something of a maverick, who wasn’t shy about it, either.
The surgeon was a shining example, in my book, of Medical Care; the nutritionists, as well as my friend’s Doctor, a polished model of Medical Don’t Care.