Tag Archives: doctor

Why liking your doctor makes a huge difference.

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When I think about the past two years in terms of doctors, I have a veritable cast of characters that come to mind. Getting married, becoming unemployed, going on my husband’s insurance meant switching from Kaiser, where all of everything was neatly contained in one HMO system, to the wild west (but totally awesome) land of PPO. I didn’t need referrals to see specialists for all that ailed me; and for once, my histamine-hating body rejoiced at the fact that I could pick my allergist based on reviews, proximity, and office hours of convenience. Granted, there were some trials as I adjusted to the PPO plan, like the fact that I needed several different docs — an allergist, a primary care doc, a dermatologist, a lady doc, and an endocrinologist (apparently I’m high maintenance). I hit gold with my allergist, but didn’t so much love my primary care doc. Instead of a doctor who actually listened to my complaints about my weight, I got the old “You’re not trying hard enough. Exercise more, eat less.” Now. Surely there’s some truth to that. But had this doctor taken the time to *really* investigate my claims, they’d find that blood tests don’t lie, and neither was I. So I dumped him, and moved on to the next. I bumbled around with a few different doctors, and now, a year later, I feel that I finally have my medical dream team assembled.

Curvaceous and Stunning Vaudeville Star Lillian Russel

Yesterday I had a two month follow up with my endocrinologist. I like this guy, because not only does he have a great sense of humor (reminding me that I was born in the wrong era, because my weight back then would have been highly desired — even mentioning the curvy old film star Lillian Russel, see below!), he TAKES TIME TO EXPLAIN THINGS. As in, he actually busts out his doctor pen, and starts to draw diagrams on the paper sheet on the exam table. Yesterday, he drew a diagram of the kidney’s role in weight loss, and why a long-term low carb diet can be challenging on the kidneys. (We’re trying a 1,300 calorie  day diet now, with moderate “good” carbs.) I had some very pointed questions about some of the hormone issues I’ve been having, and he gave me very direct, yet polite, responses. There’s a bedside manner that’s needed anytime you’re working with the public, especially when it’s sensitive stuff. I don’t need to be coddled, but if I ask a direct question, I want a direct answer, but delivered softly. This guy has it mastered — even making jokes about Dexter while taking blood. Schwing! I have what’s called “white coat hypertension”. I’m usually nervous at doctor’s appointments, so yesterday, my first blood pressure reading was sky high (156/92. YIKES!). I now know to ask the doctors to re-check mid-way through the appointment. I’ve known this for years, yet Kaiser wouldn’t retest me, and I ended up having to visit a hypertension clinic where, no surprise, my repeat blood pressure readings were great. The doc yesterday got me laughing, took my blood pressure a second time while cracking jokes about my Metformin induced nausea, and lo and behold, my blood pressure was a relatively healthy 126/79. That? Is a good doctor. One who listens, takes note, suggests helpful modifications, and cares.

So who cares if I like my doctor, right? I care. You have to decide to take action after leaving your doctor’s office, to try and manage the things YOU can control. Some things you can’t control, but some you can. I left my appointment feeling encouraged, positive, and motivated to keep working on my weight loss. And that’s why I realize it’s important to like the person who’s helping to take care of and treat YOU. Because YOU matter at the end of the day, and to keep yourself in tip-top shape, “liking” the person who’s giving you the orders is super important. Have you found a doctor you like?

 

 

 

 

 

Medically speaking, attitude is everything.

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On Tuesday I had my long awaited follow up appointment about “Weight management” after starting my thyroid medications. I was nervous, not knowing what to expect, as while I’d been on my best behavior food and exercise wise, my body likes to go rogue. We don’t have a scale in the house anymore either, and after several crushing weigh ins, I was expecting to hop on the scale and be met with a gain, because that’s always what happened before. Why should doing everything right matter? I got on the scale. Down three more pounds. WHEW!!!!! Now, 3 more pounds in a month and a half is devastatingly slow progress. However? It’s progress. Three pounds in a month, after ten months, is 30 pounds. I was relieved, and to make it even better, my blood pressure was fantastic – 110 over 79. As I celebrated my small but valiant victory, the new doctor came in and said, “Aw, too bad you haven’t had much progress, have you?”

My happy mindset deflated like a cheap balloon. I recognize that medically three pounds in a month and a half sucks – – but for a patient who gained NINE POUNDS after a 12 day detox eating nothing but cauliflower and medical shakes, it’s nice to see my body actually reacting in the way it should. As I explained to the doctor that I was actually relieved and happy with the weigh in, I realized how important attitude is. No, it’s not ideal, but a solid, “hey, we’re on the right track” at least, is invaluable to someone who needs a little bit of cheerleading. Most people refer to their doctor’s demeanor as “Bedside Manner”, and while I don’t need information to be sugarcoated, I would like a little bit of optimism.  This applies to all things medically related; a lazy liver, ridiculous allergies to feathers, even scary-looking but benign ovarian cysts. When shit’s gone wrong, some positive encouragement from people who know what they’re talking about is hugely helpful. Otherwise, Dr. Google and I spend lots of late night hours together, my anxiety growing as I comb through horror stories of the very conditions that ail me.

There’s part of me that thinks I need to just “man up” and look past a need for rainbows and sunshine in a medical environment. After all, medically, obesity sucks. It’s dangerous, it’s a huge risk factor, and for most people, it should be simple to treat. However, I’m not most people, and I’m also not the type of person who can easily man up. I’m sensitive. I’m artistic. Sometimes I wish I wasn’t. But; attitude is everything — and a positive one can make a big difference.

Have you had trouble with doctors having a more direct bedside manner? Does it bother you or not? Why or why not?

Portable Sunshine: Perking up my Vitamin D

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When I first found out I had a vitamin D deficiency, I was kind of surprised. Although I’d heard it’s very, very common, I live in Los Angeles, city of perpetual sun and beaches. Even as a child, I spent summers speckled and brown, prancing around the Florida beaches without sunscreen, going back to school in September all tan and bronzed. While I try to wear sunscreen now, some days I forget, and I’m out in my garden for hours, training tomato vines, clipping cucumbers, not realizing till later that “Oops! I’m pink!” So long story short, I spend a lot of time outside — always have, always will. My husband and I even eat our dinners outside now that we’re in the sweet summer months, especially on days when it’s a bearable 85. I’ve always been a sun worshipper, and one of my favorite things is curling up on a beach towel with a good book and a glass of iced tea. So really, not enough sunshine for me?! Granted, I do wear sunscreen on my face every day and sunscreen can slow the absorption of Vitamin D, but I guess thought my So-Cal Sunny Bunny personality would keep me D-lightful.

Basking in the sun in San Luis Obispo, CA.

Turns out, you can’t actually get all your Vitamin D from sunshine. A lot of it comes from our food, and webMD says “It also occurs naturally in a few foods — including some fish, fish liver oils, and egg yolks — and in fortified dairy and grain products.” Well, that explains a lot, because I don’t eat fish, and when I have eggs, I always go yolkless, preferring the taste and low calories of whites. I also in general tend to usually order vegetarian at restaurants as I’m a picky meat eater, and people who don’t consume a lot of meat can have problems in this area.

In addition, obesity also screws things up, because “Vitamin D is extracted from the blood by fat cells, altering its release into the circulation. People with a body mass index of 30 or greater often have low blood levels of vitamin D.” However, the fantastic news is that Vitamin D has a large part in maintaining a healthy body weight because Vitamin D sends receptors to the brain to signal fullness and increase the balance of serotonin, the “happy” chemical that promotes well-being and stomps out depression and anxiety.  Here’s a stat that I especially like: “In a 2009 study published in the British Journal of Nutrition, obese women who were put on a 15-week diet and took 1,200 milligrams of calcium/D a day lost six times more weight than women who followed the diet alone.” (from Women’s Health Mag)

Here are some other reasons you might have a vitamin D deficiency (from WebMD):

  • Your exposure to sunlight is limited. Because the body makes vitamin D when your skin is exposed to sunlight, you may be at risk of deficiency if you are homebound, live in northern latitudes, wear long robes or head coverings for religious reasons, or have an occupation that prevents sun exposure.
  • You have dark skin. The pigment melanin reduces the skin’s ability to make vitamin D in response to sunlight exposure. Some studies show that older adults with darker skin are at high risk of vitamin D deficiency.
  • Your kidneys cannot convert vitamin D to its active form. As people age their kidneys are less able to convert vitamin D to its active form, thus increasing their risk of vitamin D deficiency.
  • Your digestive tract cannot adequately absorb vitamin D. Certain medical problems, including Crohn’s disease, cystic fibrosis, and celiac disease, can affect your intestine’s ability to absorb vitamin D from the food you eat.
Accidental sunshine overdose!!!

Accidental sunshine overdose!!!

So there ya have it – my body gets an A for effort, but my sunshine and calcium levels need more D! My doctor recommended a 5,000 mg supplement of D3 daily, and a friend of mine who is D-deficient said after about two weeks of her supplements, she was bouncing off the walls with her renewed energy levels. While I don’t feel particularly sluggish, I know that I do enjoy being a lazy bum, so hopefully this will perk me up a bit and encourage me to spend even more time outside!

Are you curious about your D levels, or any other minerals/vitamin levels? I know many people who have some kind of deficiency, so I’m not too shocked that I’ve joined the ranks, especially as one website I read said an estimated 77% of all Americans suffer a D-ficiency. (Har, har). I don’t want to be a broken record, but if you suspect something’s up, get thee to the doctor, stat! Till next time… I’m off to catch some rays!

 

 

Medical Mysteries: Solved!

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I’m sure you’ve all been waiting with bated breath for my medical test results to come back… so without further ado… I am diabetes and thyroid-problem free! I kinda knew in my heart that I’d probably be okay – and with that, my diagnosis is: obesity, slow metabolism, overactive imagination.

Because it was my lucky day, the doc also threw in a cholesterol test. My cholesterol is still in the good healthy level, but my triglycerides are creeping up a bit. With my steady diet of butter, bacon and cheese, I haven’t the slightest idea why! I jest, I jest. Kind of.

So! What’s the moral from this? The moral is – as always – that worrying gives small things big shadows. I need to learn to stop morphing these small things into giant, colossal boulders that I try to roll around in my head. However, I also need to stay focused on getting healthy, which means shedding these 40 extra pounds.

This weekend my sister is visiting me, and we’re going to start our day with a trip to exercise with Richard Simmons at Slimmons. It’s a good reminder that exercise CAN be fun if I’m doing the right kind – and it’s a perfect reminder for next week’s goal, which is to exercise at least three times. You keep me accountable, readers. Thank you <3

What’s your goal for next week?

Medical Mysteries – A peek into my “What If?” life

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Hello Friends:

At this time tomorrow, I will not be enjoying air-popped popcorn as I am now…rather, I will be bitchy and wanting to smack someone savoring the feeling of hunger as I fast in preparation for an early morning blood test. You see, I have a host of small but benign medical issues – environmental allergies, occasional stupid anxiety, weird skin sensitivities that flare up at random times, toe nail issues. I was at the doctor this week for a physical, and when questioning my diet and exercise plans, he started to ask me some small, seemingly non-threatning questions.

“Do you smoke?”

“No.”

“Do you ever get cold hands or feet?”

“Yep, why?”

“Do you get shaky if you don’t eat?”

“Yeah, why?”

“How about tension headaches?”

“Yes, why?”

Pause.

“I don’t want to worry you, but we’re going to order a thryoid, diabetes and lipids test. You never know what’s going on, and sometimes all of these small symptoms can be the cause of something easily treatable,” said Doctor.

LYSSA BRAIN – GO!!!! *Image of me lying on a hospital gurney, gaunt, bags under my eyes, holding hands with my loved ones, saying something hopefully poetic and meaningful in my last moments of life.*

“Either condition wouldn’t be a big deal, and it could be totally treatable. We’re going to check just to be safe and rule out any underlying triggers,” said Doctor.

At this point in my mind I’ve already been diagnosed with diabetes, high cholesterol, hyperthyroidism , and, apparently, some form of cancer that just cropped up from hearing about possibly having an easily treatable, un-fatal ailment. Yup. That’s how my brain works. It aint ideal, but it’s kinda funny. I’m the Queen of “What If” – a position I hope to step down from soon, thanks to clever books with weird titles like “Things might go terribly, horribly wrong”.

So this is all strange, because of course I don’t want either thyroid issues or diabetes, but it brought up an interesting question. WHAT IF all of these (see? there I go) random little ailments were part of one larger issue? Would that be better than having all these medical ankle-biters?  It’d be cool to be liberated from random headaches and grass-induced hives and the occasional storms of anxiety that sweep through me like electricity – but it wouldn’t be cool to know I had a jacked-up thyroid or an inability to process insulin and sugar. (He’s less concerned about diabetes as I recently had a test for that and was fine – and yes, I spazzed out before that test, too.)

I’m trying not to get all worked up, because as talented as I am at spazzing, I need to learn to let that hobby go. I’ll head in Friday morning and probably have results on Monday, so in the meantime, I’ll cross my fingers that my blood is balanced and happy and red. As Dexter says, “Blood says so much”.

Have you ever been faced with a medical mystery? Are you the type of person who goes immediately to a doctor at the first sign of something wrong, or do you wait it out and see? If facing a potentially alarming diagnosis, do you suffer from “What If”-itis?

Taking a Stand

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Last week I did something I normally have trouble doing. I took a stand. I suffer from horrible, year-round allergies – so bad, that for a year I had to get four weekly shots. I now get shots about every three weeks and have been getting them for a total of 2.5 years. I am most allergic to Kentucky Blue Grass and Meadow Fescue, which are the most common grasses. I have a bi-annual check up with my allergist that I dread – not because he tells me I’ll still be getting stabbed with things that my make body wheeze and itch for another year, but because he ALWAYS, ALWAYS, ALWAYS brings up my weight. Doesn’t matter that he brings up my weight. What matters is that he dwells on it.

Leo loves the grass... but if I did this I would break out in hives!

It’s a normal thing when you’re obese. Your health is in danger. It seems appropriate to mention it once or twice, but to bring it up and dwell on it? Not necessary. The last time I saw this particular doctor, he grilled me about my fitness routine and my eating plan. When I exclaimed that I was struggling with it he instructed me to “try harder”.  When I said I exercised at least three times a week, he said I needed to do it every day. He then went on to say that maybe after I lose the weight, my allergies will go away. The appointment, which was supposed to be about my allergies, turned into a critique of my lifestyle, and I left with a prescription for Flonase and a deflated self-esteem.

So how did I take a stand? I received an appointment card in the mail for this allergist, and I while I was getting this week’s shots, I asked for a new doctor. It felt good. The nurse asked why and I no problem saying that I felt like he was a bully about my weight. She remarked that he “meant well” and I said, “he may mean well but there’s a right way to bring it up.”

The new doctor might bring up my weight, but hopefully he’ll do it in a kind, “this is a reminder” type of way, and not as in “THE REASON YOUR SKIN ITCHES AND YOU HAVE HORRIBLE ALLERGIES IS BECAUSE YOU’RE FAT”. Because I’m sorry – I’m no MD, but fat does not equal allergies.

My penchant for popcorn isn’t the direct cause of grass-induced hives. If it was, I’d have quit that popcorn a long time ago – and kissed my fat, and my allergies, goodbye.

Don't worry - we didn't even make it through half of this bowl!