Turning to the doctor, patients expect a professional approach and maximum impact. But there are situations where the standards imposed by society, unable to lie down for a wrong decision doctor about treatment. This situation faced the author of the blog for publication Huff Post.
Hereinafter in the first person.
The methylprednisolone pack is just a foil box of 21 small, sour, white tablets. If someone asked me a few weeks ago which recipe will be the key to victory over pneumonia, I would not point to these steroids.
I became ill on 10 March, Tuesday. This was not the kind of disease to which anyone seriously. It was a disgusting dry cough in late winter. Yes, there were a few articles on some obscure virus, but it was on the West coast. It was abroad.
By Wednesday I was almost sure I had a fever, and my cough became more painful and noisy. I almost completely lost my sense of taste and choking.
My husband went out and bought the only cure for the flu, available at our local drugstore, where the shelves had no thermometers. While I was resting at home, I was reviewing emails and took the decision to cancel the meetings, activities and other plans.
By Thursday I couldn’t do more than a shallow breath. By Friday morning it was difficult to eat, not tired — without losing too much air to cope with the chewing. I finally got in line three hours in the virtual waiting room to speak with the doctor through the application of telemedicine. She diagnosed me with viral bronchitis in less than five minutes. I was quickly prescribed some drugs to combat worsening respiratory symptoms.
I just turned 29 years without any diagnosis for high risk of serious symptoms, but even with medications pneumonia developed in less than two days. I decided on x-rays and additional testing, which was sent to the remote doctor. She decided that I should conduct more regular monitoring during the isolation, and continued treatment as presumptively positive on the COVID-19, the disease caused by a coronavirus.
By the last day of the steroids improvement was evident, but the progress was short-lived. A course of steroids ended on the morning of the 18th, and after 24 hours the symptoms began to regress. The mucus in my chest again became darker and thicker, and the inflammation made me gasp again and again. My chest rattled at every breath, and breathing became almost the same as before I sought treatment.
Because I didn’t have time for a routine check with the same doctor I had to wait in another virtual queue to speak with someone who was available if I wanted to avoid of emergency services.
In a few hours I finally got in touch with the doctor who checked my medical history. She told me that you’ve reviewed the notes and looked up the records of my previous visits, and then asked about my vital organs — which can be monitored using the application to find out the reason for my visit. I explained that the symptoms began to deteriorate rapidly, but she paid no attention to my complaints.
I decided to ask directly: “Can you renew my prescription of steroids for another week? I think that was the key to how to help heal to the end.” She immediately shook her head and said, “I don’t recommend it. This medication can lead to weight gain”.
I asked again. She refused, moving the conversation away steps which I could take to limit the spread: the rituals of hand washing, daily disinfection procedures, social distancing.
When it ended, I felt abandoned, angry and confused. While my mom and husband have decided if I should find another doctor, I began to explore the relationship of viral pneumonia, steroids and weight.
I did not find concerns about weight gain with short-term steroids, but I wouldn’t care if I found. I knew that the drug treats an inflammation, that this steroid helps some patients with caused by COVID-19 pneumonia to get well soon. I wrote in Facebook about her disappointment.
Comments were mostly supportive, with shocked and angry emoticons, words of solidarity. One mentioned malpractice; some noted that they now refuse weighings for checks; some people told their stories about how medical professionals and psychiatrists overestimate the weight when it was irrelevant and inappropriate. Another shared his fear that heavier people are unable to access the mechanical ventilation devices during the shortage, because they will not be perceived.
A few more friends joined in to play devil’s advocate, believing that to review the doctor must be a reason. A relative explained that although this seems like a bad thing, the doctor could worry about the weight gain that will lead to future health problems such as type 2 diabetes. The nurse mentioned that people with a body mass index (BMI) over 25 years of age have worse outcomes and higher mortality rates, but recent research claims that people categorized as “overweight” (with a BMI of 27), have the lowest risk of death.
In addition, patients with obesity have better results in the treatment of various diseases, including significantly lower mortality rates in the treatment of pneumonia — diseases which were supposed to focus the doctor.
People with higher weight have a lower quality of medical care from its suppliers, including delays in access to treatment due to bias. This may be the cause of those worse outcomes and comorbidities, which worried my friends. During the pandemic, when health care workers decide whose symptoms most urgent and serious, lack of access and declining quality of medical care will cost lives.
Comments in defense of the doctors point to the inner conviction that being fat is bad, that being fat leads to other bad things. They point to the subconscious thought patterns that define erroneous decisions, such as excessive attention to the future weight, not the tangible recovery of the virus. We should stop trying to justify the obsession of health industry the weight — and it begins with the struggle against our own tendencies to those same beliefs.
I did not include your weight in vital organs, associated with the application, so this doctor really knew neither that number nor my BMI. She could only see my face on the screen. I guess it’s possible that she concluded that my weight, based on bad camera angle, but her statement was more like a reflex, without regard to my own body or experience.
Since she couldn’t actually judge me with your eyes or a number, she made the assumption that any received kilos will not work for the benefit of anyone — regardless of their weight. At that moment, she projected the cultural ideal for my treatment — instilling confidence that it is better to keep my figure, than to win life-threatening pneumonia.
If you are a patient whose treatment strangling a biased doctor, you should seek help in another place, but it’s easier said than done. My call cost $50, and a second opinion will cost you another $50 — or much more expensive trip to the emergency room. What will happen to those who do not have that kind of money? Or time?
Fatphobia will continue to negatively affect the quality of aid, given to all people, if the doctors are distracted by the weight standards or cultural ideals. During a global pandemic when the actual or virtual lines for medical care spend the time, and doctors are even more overworked than we used to, we can’t postpone treatment because of bias.
This doctor did not allow me to protect my needs, although I was informed by the patient. Its reluctance to expand the rate consumption of essential drugs during a pandemic, demonstrates how common was our cultural obsession with thinness.
It took me several hours to find a new doctor, who was glad that I turned to him and helped me find the right dosage to prolong the steroids for a few days. My most severe symptoms have disappeared, and I know I’ll be fine. I believe that these doctors will help me make decisions about my health based on the preservation of my life, not the waist.
But this experience serves as a reminder that if we hope to survive this pandemic, we must become fierce defenders of themselves, not afraid to challenge the status quo.