Wednesday, January 09, 2008

Health care hassles

Jim came down with pneumonia on Christmas day. He had a fever and chills and so he spent most of the day on the couch under a blanket. He just thought it was a seasonal virus until he called his doctor's office two days later, at my urging, because he wasn't showing any signs of improvement. The triage nurse believed that Jim was not suffering from "what is going around" and that it sounded like he was dehydrated, so she recommended he go to the emergency room. I left work a little early to get him, and his parents took care of the girls for us.
We had a truly dismal experience in the ER, complete with a phlebotomist telling him that "when you have the flu you need to let the heat out" while Jim's entire body shook under two coats and a blanket. Oh, and even though they took a chest xray, they never mentioned that he might have pneumonia. They hydrated him, gave some IV antibiotics, and sent him home with a recommendation to "follow up with your doctor as needed". He called the next morning and got in to see a doctor in our doc's practice. (Side note, what is the point of having a Primary Care Provider when you never get to see him? Jim was told he is completely booked until April. WTH?) The doctor had his records from the ER and told him right away that he had pneumonia and could be hospitalized unless he wanted to be treated as an outpatient. Jim chose outpatient so that I wouldn't be dealing with the kids alone. I was glad because while I expected to take care of them by myself, since after all, he would be too sick to deal with them, at least at home he could get better rest. And so he did; for several days he slept for 10-12 hours at night and napped during the day. He's doing fine now but it was pretty scary to see him that sick.
Through this experience Jim had two "fat patient" episodes that really annoyed me. When we were at the ER, a physician assistant was checking him over. He asked if Jim or anyone in his family is diabetic, and Jim answered "no". The PA asked this at least twice more, with a tone in his voice that sounded like, 'come on buddy, you're too fat not to be diabetic, so let's just fess up.'
Jim kept insisting that he was not diabetic. He's never had high blood sugar levels; in fact neither have I. Yes, it is possible to be fat and NOT be diabetic. My obstetrician didn't want to believe this either; when I was pregnant with Caroline he had me take the glucose tolerance test twice because he was sure I would develop gestational diabetes. He actually seemed somewhat disappointed to see my blood glucose numbers both times.
OK, I've digressed... back to Jim. He saw the doctor at our office the next day. This was a doctor he hadn't met before, an associate of our doctor. While he was there, the doctor asked him if Jim was interested in having bariatric surgery. Jim said he didn't know. After all, he was feeling lousy and just wanted to know what was wrong and how to get better. The doctor repeatedly encouraged bariatric surgery, telling him he really should look into it. In fact, he said, if his brother needed it, the doctor would kidnap him and take him to have it done. ??? Is this really an appropriate topic for discussion when treating someone with pneumonia? Obesity is not a risk factor for pneumonia. It just wasn't the time to be discussing weight loss surgery.
Some of you reading this may think I'm overreacting, that these health care providers were just concerned for Jim's well-being. I certainly hope they were concerned, since taking care of people is their career, and I would assume they chose that career at least partly because they care about people. Unfortunately the health care profession has a long history of not looking past the fat when treating people. I was recently re-acquainted with a really interesting blog, Junkfood Science. When I read this article, I was amazed; it described so eloquently what I've been feeling for a long time. I've had experiences like Jim's all my life. Going to the doctor makes me anxious enough that my blood pressure goes up even though it is normal when I take it at home. I am hypertensive and medicated for it, but the only time I get a high reading is at my doctor's office.
Anyhow, I think Sandy Szwarc is telling a truth that people don't want to hear, that in her words, "Science is being misused for marketing and political purposes." I've realized for a while that the media takes information out of context, so I now generally ignore most stories I read or hear in the media that start with "according to a new study". I'm not just talking about studies about weight, weight loss, or the correlation of fat to disease, but studies on most any subject.
Of course, being a fat woman, I am more in tune to the deluge of information we get telling us that fat is bad. That's a whole bigger rant though, so I'll save that for another post.


Bec said...

How's Jim feeling now? It seems like it took me forever to recover from my last round of pneumonia.

Thane tagged your kids a couple of days ago, but I am just getting around to posting to you about it.

These are the rules . . .

Make a list of eight random facts/habits about yourself.

At the end of the list, choose eight people to tag and list their names.

Leave them a comment on each of their websites to let them know that they have been tagged.

The people tagged will write a post on their own website about their eight things, post these rules, and tag eight others.

sherri said...

I don't think you're overreacting at all. I think the Dr's comments were insensitive at best, unethical at worst. Jim's presenting symptoms and concerns should have been not only the primary focus of the visit but, if we are to believe physicians, the only topic given how busy and pressed for time they are. I sincerely hope Jim is feeling better and hate it that you both had to go through all that to get a proper dx and healing.

pollyanna said...

Wow Silly Mama. I'm sorry #1 that Jim was so sick.

I think it is inappropriate to be treated the way you and Jim were. I'm sorry about that.

Hugs to you guys and I hope Jim is better now.