Thursday, May 17, 2012
Did You Call Me 'Fat,' or 'Phat'?
A couple of weeks ago, my doctor's office called my home and left a message on my answering machine: "Dr. B— would like you to come in and discuss the results of your recent tests. There's nothing serious, but he'd like you to come in as soon as possible. Could you please give us a call..."
My mind went immediately to the tests I had been sent to earlier this year at the neurologist. For a long time, I have been experiencing severe circulation problems. My fingers, hands, and arms, as well as my feet and legs, go numb easily. Like, when I'm sitting with my legs crossed or lying in bed with my feet interlocked at the ankles. Like, when my arms are folded, or when I'm lying in bed, on my back with my hands gently resting on my stomach—my arms are the first thing to go to sleep, from the elbows to my fingertips. If, in my sleep, I roll onto my stomach (I should really say when, not if; it happens every night), my arms extend above my head and I lose feeling from my shoulders to my fingers.
It really sucks.
At the beginning of this year, after I suffered what seemed like an anxiety attack—shortness of breath, extreme fatigue, and chest pains—my doctor suggested that I was under a great deal of stress, but that I should have tests with a specialist to ensure I wasn't suffering nerve damage. We even thought there might be carpal tunnel syndrome, because my wrists were sore and I almost always experience a numbness in my fingers, especially in my pinkies.
At my appointment, electrodes were stuck to my extremities and a current was shot through wires. A computer displayed graphs that spiked during these jolts. Each time the specialist recorded the reading, he told me that the readings were normal. Nothing out of the ordinary. Nothing to worry about. No nerve damage. No carpal tunnel.
I was relieved for about a second, but the obvious question popped up: "So, what is wrong with me?" The neurologist had no answers.
And so I went home, not feeling any better.
That brings us to the phone message. When I heard about the test results, I thought that perhaps the specialist had found something in the readings after I had left. Perhaps, there was a problem after all.
Being a worrier, I assumed the worst. I would need surgery. I would be placed on more meds—I already take for pills a day to combat cholesterol and migraines. I don't even like taking multivitimins.
Last week, my doctor and I met. I should take a moment to discuss my relationship with my GP. Doctor B is a bit of an asshole. A tolerable asshole. As a doctor, I feel he takes my welfare seriously. It's his attitude I can largely live without.
I don't tolerate tardiness. If I book an appointment at 8:00, I generally expect to be seen at 8:00. I am willing to wait an extra 15 minutes to be shown to an examination room and another 15 minutes to be seen, though if I'm made to wait that long, I complain. If 20 minutes expires before I'm seen to the examination room, I leave. If I wait in the examination room more than 20 minutes, I leave. If 30 minutes passes since my appointment is scheduled, I leave.
I understand that emergencies arise. I acknowledge the fact that sicker people take priority over my scheduled appointments. But I work as hard as my doctor does: most people do. Though I probably don't pull down as much income as Dr. B, my time, I would argue, is just as valuable. And so I'll walk out the door if the time that I've alloted my physician has expired.
Thirty minutes, or I walk.
I've walked out on my doctor twice. Once, I knew he had an emergency arise. He was busy and I never saw him. No problem. But I had a meeting to get to, and so I left.
Another time, I don't know what he was up to. I had scheduled the first time slot, at 7:30. When I arrived, he was already with another patient. No problem, I thought. Emergencies arise.
At 7:40, I was shown into an examination room, where his receptionist took my blood pressure (generally at about 128 over 60, heart rate at around 70 BPM). "The doctor will be with you shortly," she said, and I was left alone.
My doctor has only two examination rooms, which are side by side. The walls are thick enough to suppress words but thin enough to hear tones, especially when the doctor and his patient are speaking light-heartedly. A woman was in the next room, and she was laughing. The cadence of the voice told me she was chatting, possibly telling Dr. B. a funny story. His tone revealled that he was teasing her; her laughs proved it.
At 8:00, I got up and headed to the reception area and declared my departure. There were patients waiting to be seen and I told the receptionist that I was sure someone there had an 8:00 appointment and I was letting the doctor get caught up. I had the rest of my day to get to. As I discussed this, Dr. B. came out with his patient and he saw my exchange with the receptionist.
I wasn't angry. I didn't make a scene. I simply said I had a job to get to. I had used up the time I had allocated to my physician. I had no more time to spare. If my doctor wished to see me, he'd have to call and make an appointment.
I did remind my doctor that if I were to miss an appointment, he would expect me to pay him.
He has never made me wait more than five or ten minutes since.
When I do wait, I often check e-mail, Twitter, Facebook, and so on on my iPhone. Whenever my doctor enters the examination room and sees me on my device, he says the same thing: "Geek."
He then proceeds to pull out his smartphone, which is always the latest piece of high tech.
Last week, he went through my file to tell me why he had called me in. It had nothing to do with my nerves. It was my cholesterol. Through genetics, my cholesterol levels are naturally high, and so we manage them with medication. I take Crestor, if you must know.
Over the years, my cholesterol levels have gone from a natural 8.8 to a 4.2, sometimes as high as 4.7. My latest blood tests, which I have twice a year, showed a level of 7.2.
"I see one possible reason," said Dr. B, pointing to the floor. "Get on the scale."
I weigh 175 pounds. That's 10 pounds more than the last time he weighed me, when he said I should lose 10 to 15 pounds. He measured me around my belly (not around my waist, which has fit into size 32 pants for decades): it measured 37.5 inches.
(By comparison, in February of 1998, at the end of my first year of living in South Korea, I weighed 140 pounds. That's the lightest I've been in my adult life.)
"You're not a geek," he said. "You're a fat geek."
"Fuck you," was my reply. We have that kind of relationship.
"Look," he said, turning serious. "You're not fat. I wish I looked the way you do. But with your cholesterol, you can't afford to screw around. Are you taking your meds every day?"
"Fuck you," I repeated. "I might miss a day every month or so, but they sit next to my bed and I tend to take them before I crawl under the covers."
"You know, most patients aren't honest with their doctors," he said. "We'll see." He wrote out a requisition for a blood test and gave it to me. "Maybe they messed up the test. Promise me that you'll take your meds every day for four weeks, not missing a single night, and then get this test done. And then come back."
He paused, holding onto the form. "Promise me."
"And exercise. Lose 20 to 25 pounds. I can see it in your neck and jowls; you also have man boobs."
He handed me the form. "Okay. You're not fat, but you are a geek."
"Is that fat, or phat?"
"I don't give a shit. Just take your meds and lose the weight."
My diet—the first diet I've ever been on—started last Thursday.
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