Hysterical White Female

I signed up for a weight management clinic because the high blood pressure really lit a fire under my butt. Otherwise I would've soldiered on alone because the last thing I want is to go to the doctor even more. That is NOT my dream.

The deal with PCOS is I need to follow a low carb diet which sometimes messes up magnesium and potassium levels (per past personal experience). So I wanted to work with a doctor on losing weight again (pregnancy and early motherhood was not kind to my BMI) who would order the blood work and track those levels. I also wanted to see if there were any good alternatives to metformin now that I'm not trying to get pregnant. I can haz real drugz now! Woot!

Okey dokey. Off I go to see the weight loss doc.

Well, unfortunately, while the doctor is nice enough, I have pushed his 'hysterical white female' button. I am an intense person, a creative thinker, insatiably curious, a fast talker, am well read and I know that sometimes I 'hit' people wrong. It's a consistent issue.

In a corporate setting, with time, people realize I am really good at what I do, I don't play games, I am reliable and helpful but with a quirky kooky flavor. Eventually they come around and I gain credibility. It's hard to achieve similar credibility in a 20 minute doctor visit that makes me talk even faster because I know time is short.

So I had a follow up appointment yesterday with the weight loss guy. I wasn't sure if I was going to make it because my breathing has been dodgy. I'm better in that I don't need to go to the ER, but I'm not stable either. I feel great sitting on my ass, but attempt anything more than that and I hit the wall.

The problem is, a lot of things sound like a great idea while I'm sitting on my ass feeling pretty good. Then I do them and they don't go well. Such as moving some heavy furniture up stairs a couple days ago.

I decided to try the appointment anyway because being on prednisone for a month is not going to help weight loss, I need all the help I can get.

So I got there and couldn't feel my knees. Just was really weak. Then I couldn't breathe well. Then I realized, I hadn't been breathing so hot all day, but had been ignoring it.

Living in 'I'll be fiiiine land'. Agh. Stupid me. I have to get better about this fiiiine shit.

So I sit in the waiting room and enter 'the zone' where I'm just working on finding where I'm going to get my next breath. It's a delicate process. Breathe too deep and I make it worse. Breathe too shallow and I make it worse. I have to find the sweet spot between the constraints so that I don't completely lose control of my breathing. It's a very zen thing, except it hurts.

I finally take my rescue inhaler which brings some minor relief, but by now it's too late. I'm getting tighter. Suddenly my chest and shoulder muscles are heavy and I can't lift my shoulders to breathe--the muscles are fatigued. I truly had no idea I was this far gone. At this point, I'm in the exam room waiting for the doctor and I realize I am in trouble. So I start to panic.

Panicking is never good. Don't ever panic. It makes things so much worse. I am usually so good about not panicking, but I had hit my limit.

I lost control of my breathing rate and basically had an enormous charley horse throughout my lungs--especially on the right side where the scarring and growth are located.

I was really upset about it.

In tears.

I was embarrassed because everyone was watching.

Mortified really.

Afraid I was going to end up back in the ER.

Angry that I had let this happen to me.

Frustrated that I still hadn't vanquished this latest episode.

Wondering if the asthma had damaged my lungs to the point where the coarse 'wheeze' torturing my airways was ever going to go away.

All of this was going through my mind and it made it very hard for me to focus on gaining control. I have not lost control like that in over 10 years--I am the calm, cool, collected asthmatic.

Apparently, however, I looked like a big faker????

Because once I finished the nebulizer treatment they gave me, the weight loss doctor started to play mind games with me. "Do you want to have asthma? What if you could have something else?"

Apparently, I wasn't wheezing enough for him? Or something? I had been wheezing all day but was clearing the 'coarse' rattling gunk that was the root cause with coughing, which is why I ignored the tightness. I cleared my lungs, felt better until the gunk came back. Wash and repeat.

So yeah, I agree with him. When he had his stethoscope on my back, I doubt there was a lot of noise. The gunk that had been rattling around in there irritating my airways went quiet, underground (but it came back out and tortured me at 1 am that night). Of course I was also intermittently holding my breath because it was the only way I could clamp down on the spasms and try to regain control. So I don't know how much wheezing there was to hear.

Regardless of how much I was or wasn't wheezing, who the fuck asks someone to answer that kind of question without disclosing the something else? Because how do I know the something else isn't cancer, you know? Are we playing 'Make a Medical Diagnosis Deal' and I have to decide which door to open? Really? Is he serious?

Play power games much?

Paternalistic dick much?

So I say, "Well I am not qualified to make that kind of decision. I'm not a doctor. I know in my medical records there is a pulmonary function test where my FEV1 is 70% of predicted." I knew this because my pulmonologist showed it to me, explaining she had sent it to the asshole allergist.

"But you also have normal pulmonary function tests."

I just looked at him as I couldn't figure out what to say. I should've clarified that yes, I have had pulmonary function tests when I'm healthy so, of course, there are normal ones. I mean, duh! I was not symptomatic when those were performed so they would not have shown much. They should be taken as a sign of successful asthma control. For some reason, he goes the opposite direction with it.

I suspect he's thinking I had those tests because I complained of being sick when, in fact, they were administered at every pulmonary visit for years regardless of how I felt. (And I hated them and actually their existence caused problems with the asshole allergist--I want to burn the damn things so no one ever sees them. Wait...is that even possible?)

I also should've pointed out he had access to my medical records and could have viewed my recent hospitalization records himself had he thought to do so. I had documented drops in oxygen. I have scarring and now a growth in my lung. The x rays also showed airway constriction. I had visits from three pulmonologists while in the hospital and everyone agrees I have asthma.

What does this guy know that they don't? Particularly given that I have a 6+ year long relationship with my pulmonologist. What is she missing that he is catching in just 2 visits?

Basically, he has decided I have a vocal cord problem which can mimic asthma and tends to have a psychological component. So, you know, I'm making it up and his asking me if I wanted to have asthma or not was a psychological hoop for me to jump through to see if I was emotionally invested in being sick.

You know, there is a power gradient in medicine that favors the doctor and it is ripe for abuse, even among the well intentioned. I am at the mercy of their education, intelligence and character --which all too often I have found lacking. To me, what happened yesterday was abusive. I felt manipulated and discounted. I hate feeling like I have no credibility or power and I feel threatened because this kind of stuff is when they start taking away medications and refusing to listen to me. It's the asshole allergist all over again, only with a slightly more palatable facade of faux sincerity.

I am also frustrated with myself. Obviously I am totally screwing up something as a patient and am too stoopid to figure out how to prevent these kinds of interactions. The other thing that angers me, is I let these nuts convince me there is something wrong with me. Why do I give them that credibility when their logic is so obviously flawed?

Now I don't know if I want to go back. I mean, I do want to go back and confront him on this, but do I want to continually subject myself to someone who thinks I'm a hysterical white female who just needs therapy????

No. Not really.

I am not hypochondriac, but apparently I play one in the doctor's office.

As far as standing up for myself, the doc in question sent me a follow up email inquiring about my food diary. I replied adding the following:

"I have some further thoughts on our conversation with respect to asthma that I will bring up at our next appointment. After that, I would like to confine our work together within the scope of weight loss."

And I've been working on what I'm going to say. His response to the boundaries I set will determine if I ever see him again. Now I just have to convince myself to make the appointment, which is proving harder than anticipated.

Note: This post references 'yesterday' but that's not right. This was all a few days ago, but I wrote it the next day hence the use of 'yesterday'. I'm not going back to change it, but I realized when I published the prednisone post that it made for a weird timeline so I wanted to clarify it in case anyone got confused. Timelines referenced don't actually coincide with a post's publication date.