Monday, October 31, 2011

A Medical Professional. Really.

Warning: there's a big rant coming (though not, for a change, a big fat rant), and I'm in pain and cranky, so it might not be fun to read.

A couple posts ago I wrote about the incompetent staff of Miya Day Spa in south Sacramento, which should be avoided at all costs. Oh, oops, I didn't write about it here. I Yelped about it here. Anyway, they were lame and they hurt my sore back even more by dropping my legs on the table. Hurt for a day or so, got a bit better, then over the weekend, of course, it got really sore. Last night I found that turning over in bed was about a 15 step process.

Called the wonderful Dr. Chu at Elite Spinal and Sports Care, got a 4 pm appointment. But before he could even start working on me, my back seized up so bad from lying face down on the table that I couldn't move. It took a good 15 minutes of sweating and cursing (on my part), and tilting the table so I could slide backwards off it onto my knees, and then a lot of buttock-clenching, core-engaging, and deep breathing before I was on my feet again. "You really need to call Kaiser," said Dr. Chu. I nodded. "It's really quite inflamed in there," he said. I nodded.

I called Kaiser before I even left Dr. Chu's office, and a very nice advice nurse set me up with an appointment with my regular doc tomorrow morning, and a phone appt. with a phone doc this evening so we could talk about getting some useful medication into my system. I had already taken all the ibuprofen my stomach could handle.

Unfortunately, over the last 10 years, I've had this back thing flare up badly about five times. I know exactly what works. Ice at first, followed by heat/ice alternation. A combination of anti-inflammatories, muscle relaxants, and strong painkillers. When it's just tweaky, anti-inflammatories alone can help me out. If things are pretty bad, I have to add the muscle relaxant. I don't go asking for the pain pills until the pain makes me cry out involuntarily and break a sweat.

Unfortunately Dr. Frooze, or Fruze or Froos, or whatever his name was on the phone, didn't accept that I am a competent witness of my own experience. He prescribed me prednisone - good call, possibly, given that I have a finicky stomach when it comes to ibuprofen - and some muscle relaxant. I said, "Oh, and when this has happened to me before, I've been prescribed Vicodin for the pain, which seems to help stop the vicious cycle of pain and spasm." Dr. F. smiled condescendingly (I could actually hear this on the phone) and said, "Well, Tylenol will work just fine."

"I'm sorry, but Tylenol does nothing whatsoever for this pain."

"Yes, two extra-strength Tylenol will work very well."

"Doctor, I have had this condition several times and I know from experience that Tylenol will not work at all."

"Well," said Dr. Frooze, "You see, the pain in your back is your body telling you not to move in certain ways. When we prescribe painkillers, we interrupt the signal that your body is giving you. And, don't forget, don't just lie there! You have to move around to keep from stiffening up."

"I--- I... I don't think you understand the situation I am in. I am in a lot of pain."

"Well, put some ice on it for 20 minutes twice a day."

Tears came to my eyes.

"Right. I've been doing that."

"OK then," said Dr. Frooze, "Do you still want the prednisone and Relaxafil [or whatever]?" Like if I didn't get my narcotics I wouldn't want anything else that might help me. Really? Really? Dick.

"Yes, of course. My husband can go pick them up for me."

"So if these don't work for you, you can bring it up with your regular doctor."

"Sure." I was just too worn out to argue anymore. We ended the phone call.

I fumed. What a freakin' jerk! To tell me what was going to work on my pain, and how I didn't know that pain is a signal telling my body not to move in certain ways. ARGH! Grrr!!! MMMMFFFFF! And other expressions of frustrated rage.

The thing is, I just need to be a lot more assertive about what works for me, even if what works is an opioid. I just get self-conscious about it. Like they're gonna think I'm Dr. House or something. I fumed some more. I called Kaiser back and told the advice nurse about my experience. She was actually really sympathetic about it and sounded kind of mad at the doctor. But she couldn't take my complaint. She gave me a number to call.

The number, of course, put me through voicemail hell, put me on hold for 15 minutes and finally hung up on me. It's well after regular hours now so I'm just gonna hunker down with what Tim brings back until my appointment tomorrow.

And Dr. Chu and I are going to find me a trainer who works Tuesday or Thursday so I can work the heck through whatever imbalances and weaknesses are making this back thing act up so bad this year. I want to move again.

Thursday, October 27, 2011

So, That's Offensive. Pass It On.

I've been reading a lot of blog posts by the funny, prolific, and smart Ragen Chastain lately, and she's really been drawing my attention to the prevalence of anti-fatty messages in the media. Not just the weight loss companies with their ever-present ads about belly fat or toning up for summer, but the "journalism" that goes around citing "studies" and "reports" and "evidence." I was on my way home from the supermarket today (with kale, onions, whole grain cereal, chicken broth, organic yogurt, cereal, and yes, Halloween candy for the kiddies and Tim and me), when NPR absolutely blew my mind with "Workplaces Feel the Impact of Obesity." Yeah we get this sort of thing all the time, but I guess I just expected better from All Things Considered. Here was the quote that made me swear out loud in the car:
"Studies estimate that nearly 10 percent of U.S. corporate health care costs are due to obesity and its complications. For a large company like Dow, that means tens of millions of dollars a year. On top of that is lost productivity, not just from doctor's appointments and sick days but also, research suggests, because obese workers are simply less efficient on the job."
Wow. OK. First off, there's "obesity and its complications." There is a small but highly qualified group of researchers, including Dr. Peter Muennig of Columbia med school, who are beginning to suggest that the much-vaunted "complications" of obesity (heart disease, diabetes, hypertension) may in fact be more complications of stress associated with the social and psychological stigma surrounding obesity for certain social groups. This is a guy who used to write about the "obesity epidemic" and wring his hands about DeathFatIsComingToGetYou, and now he writes this. In any event, it's far from proven that obesity causes these health issues.

And then there's the "research suggests" that "obese workers are simply less efficient." Are you freakin' kidding me? This is simply deplorable. Really. Here's what I wrote on NPR's website.

This is probably the most offensive and worst-informed story I have ever heard at NPR. The casual "research suggests" that "obese people are simply less efficient on the job" is just jaw-dropping. I dug up one of the studies that "suggests" this, and found the research's premises highly questionable at best. One quote: "Ricci and Chee (2005) estimate that on an annual basis, incremental costs associated with reduced productivity are $358 per obese worker." In other words, less than $1/day. As a highly educated, highly professional, and highly efficient fat worker, I am appalled that you would produce a story perpetuating the "fat people are lazy" stereotype on such flimsy evidence. What about parents' efficiency in the workplace? What about people with migraines? What about lost work productivity from the smokers who sneak out of the building every 90 minutes to feed their habit? Or those annoying Crohn's disease patients, always rushing to the restroom? I am going to devote the rest of my week (outside of my productive work time) to publicizing and denouncing this story. For shame, NPR.
Hey, at least the smokers and IBS patients might be thin. Or they might not. It doesn't matter. IT DOESN'T MATTER. Your size has nothing to do with your productivity, unless your productivity is measured by how many times you can squeeze through a 14" squre hole in the course of a day (see Pooh, not being productive) or by how many annoying reporters you can asphyxiate by sitting on them. So, as promised, I'm devoting my spare time to letting the world know that NPR's story deserves a great big bogus-slap.

You're welcome.