And there I found myself, in the clinic office waiting to hear my name called. Doctors and waiting. Two things that I know are a necessity in life, yet the same things that do not like.
First, Some History
I have never liked going to doctor because, let’s just face it, I’m fat. I’m not talking those last five stubborn pounds that just won’t leave even with Hot Yoga or P7600x or whatever, but actually what the PC police call obese. And I have always been fat. From a child in the late Seventies and Eighties when we were weren’t sure what was healthy and what wasn’t. Should we eat three meals a day or snack? Is bacon bad for us? What are all these preservatives in our food? It was a tumultuous time to be a child. I know that I established terrible habits, but my Achilles heal was always that I didn’t seem to be active enough. Even in my slimmest time, in high school, where I was extremely active with after school activities and church league sports, I steadily increased weight from around 150 in 9th grade to probably 200+ my senior year. And then from there college, even though I enjoyed biking, walking, occasional racquetball, softball, etc. I was up to over 250 and then on and on until I broke that terrible 300 mark sometime after the turn of the century. And I have never seen below that line in how long, I don’t know. I used to joke that with each of my wife’s pregnancies, I gained more weight than her. For a stretch there I was doing a majority of manual, heavy, labor, and still only dropped about 30 pounds (not a lot when you are talking less than 10% of your body weight).
Now, for you healthy people, part of this blog is to give you a viewpoint into my world. Some might see it as excuses – I cannot help that. Some might see it as a “cry for help”; I can’t help that perception either. All I can say is that isn’t my intention. I have “tried” most of the diet changes – Atkins, low calories, the “7 fuelings” variants, etc. I have also started several exercise regimens just to have something happen that kills the momentum. Some of these lifestyle changes have lasted a while – up to six months or so, where I have lost a clothing size, but nothing that is substantial.
So, we have fallen back to just trying to eat as clean and local as we can – locally raised fruits and vegetables (oftentimes in the summer as local as our backyard), locally sourced lean meats, very limited processed foods, organic dairy, minimal ingredient meals, no or very occasional carbonated beverages, etc. And then we have tried to just be active. I won a Fitbit Charge earlier in the year and it has helped me try to stay, at least, conscious of my activity. I love to work outside, to garden, to just work in the yard. I don’t use elevators. Those kinds of things that some people will say, “good for you,” and others will say, “that’s the losers way of exercising.” Factor in three kids in school and a two-hour commute one way each day, and there is barely enough time to spend with the kiddos and wife, much less “hit the gym” – 30 minutes away – for 90 minutes.
Factor this in with my northern European roots and what you have is a fairly healthy but fat guy. Just so you know, I have taken advantage of the wellness programs at work with the yearly physicals, etc. so I am very aware of my current health. I have good cholesterol numbers (although my HDL’s could be a bit higher), blood glucose is well within limits, blood pressure is good (has been known to spike occasionally), and I do not have any diseases or ailments.
Josh vs. the Doctor Nurse Practitioner, Part 1
Anyway, back to the original story. I was finally called back from the waiting room and immediately faced my nemesis – the digital scale. This wasn’t just any scale, but the kind with big numbers at eye level that flashes your weight for the whole staff to see. I was just waiting for Dennis Nedry from Jurassic Park to hop up from a cafe table and say, “Fat Boy! Fat Boy! We’ve got a Fat Boy here!” But a crack of the joke later and I was on my way to sit on the butcher paper. After politely telling the nurse taking my vitals that she was sweet to think the normal blood pressure cuff would work, I got to have the first “I know I’m fat, but you don’t have to assume” talk. This happened when I was watching the nurse slowly descend through the “high” numbers twice before re-inflating the cuff again. I politely let her know that my blood pressure is generally between 100/70 and 115/80 and so she would have to go a bit lower before trying to cut the circulation off in my arm again. After that it was just a few basic questions and review of my vitals and now I could finally see the doctor for what I came in for. . . or so I thought.
This visit I would see the NP (nurse practitioner). She was a soft-spoken, older black woman (or African-American, or person of color – take your pick), who came over to help backfill from a similar clinic in Alabama. After she introduced herself, her first words were, “so what are you in for today.” I kindly explained my symptoms and she said that she would like to get a full medical history from me. As she walked through all of the questions about my past diagnoses and my family history to the 10th generation, I picked up a few interesting tidbits:
- She wasn’t asking me questions the whole time, but rather would throw a statement in that I would have to dispute. For example, she said, “so you have limited activity each week” and I would have to explain my activity level.
- She would ask leading questions followed by, “are you sure?” such as, “do you find it difficult to stay away from fast foods?”
This question and answer game went on for about 15-20 minutes before she asked about my symptoms. Once again, I explained what was going on and how this felt different from the past. She listened briefly asked a few more questions about my symptoms and the told me that I had nothing to worry about. After a brief outline of what over the counter medications I should take, she stated that was extremely concerned about my weight. She started a lecture about how I should eat fruits and vegetables and stay away from high cholesterol foods such as “fast food burgers and sodas” every day. She told me my [false] BMI (Medical News Today – “a number of studies have demonstrated that some obese individuals have lower cardiovascular risk and an improved metabolic profile, while a subset of “normal-BMI” people are metabolically unhealthy and have increased mortality risk.”) and then jumped into how I needed to be active. For the next 5 minutes she continued to look over her reading glasses, like a middle school librarian, and schooled me in whole grains, low-fat, no deep-fried, food choices that I should make as well as my obvious need to change my sedentary ways.
I, being a polite person, thanked her and started to stand up. She then asked if I would like any patient education on weight loss, diabetes, hypertension, and heart disease. I thanked her, but stated I thought I had been given enough education over the past hour. It might have been the lack of sleep from the previous night that broke down just that part of the brain-to-mouth filter that I reserve, and I truly meant no disrespect, but the harm was done. Another round of “are you sure” questions came from her obviously quivering lips and again, I thanked her and told her I remembered which medications to purchase from the pharmacy out front.
Leaving with my diagnosis of “common cold” in one hand, I wandered through the pharmacy until I found the Cold and Flu section only to realize she had suggested a decongestant for people with High Blood Pressure, which I have never been diagnosed with – even at that time. But, I felt shamed into getting it. “Maybe fat normal blood pressure is different from skinny regular blood pressure” I thought to myself. Once more, I had gone to one of the altars of health just to be reminded of my inadequacies. No understanding, no thinking of what I have tried to do, just a general “seeming” disdain for me because of my size.
The Next Doctor
Fast forward three weeks. My “cold” symptoms not getting any better, I decided [read: my wife decided] that I might need to go to the doctor’s office. I gave in – under duress – and, after a day of research and recommendations, made an appointment with a local internal medicine practice. Needless to say, I was more that apprehensive; I was scared. Why? I just wanted to be well – correction – I just wanted everyone else to not think my symptoms were because I was fat. I was tired of the looks and the comments from well-meaning acquaintances that reminded me of a Kevin James standup line – “You know what you need to do is – chew sugarless gum!”
And I found myself in another waiting room. And I found myself waiting on another doctor. But things went a different way that day. Still had to get weighed; still had to get all the vitals. But this time, the doctor listened. Was it because I threatened to walk out (in a very nice way)? Maybe. Or, as I want to believe, it was because he took his oath seriously – not just from the physical standpoint, but from a mental and emotional one as well. The need to “do no harm” sometimes means dealing with issues in succession instead of parallel. He was intentionally listening to my symptoms. He was intentionally listening to my chest and lungs. He was simply intentional. After 30 minutes or so, he gave me a bit more serious diagnosis – Bronchitis and possible Pneumonia which had set in over the past month to six weeks. A visit to the hospital lab and radiology would be in order.
What Am I Trying to Say?
Here I sit several weeks after that “good” doctor’s visit. I am well, but still fat. I no longer need the inhaler, narcotics-laced cough suppressant, expectorant, or the rest between flights of stairs. I still have a follow-up with the good doctor on my “other diagnosis [of obesity].” I’ve actually been writing this blog for almost two months. When I started it was about letting people know that there is a normal person inside most fat people; that every health challenge we face isn’t a result of our weight, and that we didn’t just gorge ourselves to this point. However, I think there is more to it. There is an aspect of this that can be applied across many issues that people face. It isn’t always as simple as “just go and do/don’t do that again.” When we are told commanded to “Love one another. In the same way I loved you, you love one another. This is how everyone will recognize that you are my (Jesus’) disciples—when they see the love you have for each other,” it means that we love and honor each other with even the problems, failures, and brokenness. Of course we want to see change! Of course we want to see each other achieve freedom! It all starts, however, with loving – even where each other is in their journey and “doing no harm.” Anyway, I think I have rambled enough. I hope someone finds something helpful in this!
Joshua Thinks 