Except if you’re fat

So since the overturn of Roe v. Wade last year, this list has been passed around. It is a list of gynecologists who will perform tubals and such, no questions asked. Great!

However, here is the catch. If you’re fat? You’re out of luck. I know this because my former Austin doctor is on the list. And she told me when I saw her last year (before the overturn) that I needed to lose 50 pounds before she’d even consider it.

This is bullshit for several reasons. But for me, personally, losing weight is nearly impossible. I have hypothyroidism, I’m multiply physically disabled. Exercise is hard for me. Currently, I am homeless and have very little access to good and healthy foods. I’m also currently dealing with heart problems that may be some form of heart disease.

Losing weight for me is not as easy as just joining a gym and eating “right”. And while I was not homeless when I saw the Austin doctor, I was living below the poverty line and as we know (or should know by now), eating healthily on food stamps is a struggle.

So, I do appreciate that this list exists but I wish people would remember that fat people also exist. Seeing this list with no disclaimer for fat people is hurtful. It feels like I and my fellow fat people are being ignored. Which is what society does to us, if they’re not ridiculing us, that is.

Except if you’re fat
{advertisement}

Understanding the Vulva: Part 2 – What the heck is an ectopic pregnancy?

Let’s Talk Ovulation.

For ovulation to occur, which is when the follicle releases the ready ovum or egg into the fallopian tubes, a series of conditions need to be met – including hormonal level, overall health of the individual person, and so on. If the conditions aren’t met, then ovulation will not happen.

This is why things like stress, nutrition, weight level, can all interfere and impact your menstruation, because they can change the conditions inside your body in such a way as to prevent ovulation or delay it.

At the start of each menstrual period, a group of follicles will become potential candidates for ovulation, since they are in the right stage of growth. After the first several days, one will emerge as the dominant follicle and the other candidates will die off. The dominant follicle will continue to develop until the time comes for it to release the egg into the fallopian tube. The release of the egg is what is called Ovulation, and is necessary for reproduction to occur.  After the egg is released, there is a period of up to 72 hours during which it needs to be fertilized by sperm, or it begins to break down.

While there are averages regarding how many days from the first day of your period to when you ovulate, the exact number of days it takes is both individual, meaning it is different for everyone, and can change as a result of various internal and external factors such as stress levels, hormone levels, overall health, medications, and so on. This is why just judging based on a calendar whether or not you’ve ovulated can be imprecise and inconsistent. It can be better to track other changes such as basal body temperature, as well as changes to your cervical fluid in order to get a clearer picture regarding at what point you are in your cycle.

So, what exactly happens when you get pregnant?

Continue reading “Understanding the Vulva: Part 2 – What the heck is an ectopic pregnancy?”

Understanding the Vulva: Part 2 – What the heck is an ectopic pregnancy?

Understanding the Vulva: Part 1 – Anatomy

The news over several months has been abuzz with the absolutely horrible disgusting and harmful bills being passed and proposed with regards to reproductive rights including access to abortions. The bills which will harm all uterus havers as well as women, has sparked discussions surrounding reproduction which have revealed a distressing lack of knowledge on the subject.

This should be less surprising than it is, given that the organs and parts that make up a uterine reproductive system are not even fully understood by many in the medical field, so it’s not unrealistic that those who grow up as part of the restrictive culture surrounding the whole area of reproduction would be pretty ignorant on the subject, but it is telling that even the basic anatomy and biology of what happens is so poorly understood. Additionally, with the tradition of separating children according to gender during sex ed classes, means that men in particular seem to ignorant of what goes on in Uterus haver’s bodies.

As someone who has studied this area from both a medical and sexology perspective, as well as a personal one, I thought it might be helpful to clear up some misconceptions. Since this post ended up being a lot longer than I expected at first, it’s divided into two parts.

Let’s start with just a basic anatomy.

What IS a Vulva?

Continue reading “Understanding the Vulva: Part 1 – Anatomy”

Understanding the Vulva: Part 1 – Anatomy

Let’s Talk About “Unnecessary” Tests

Ford’s government recently proposed a series of cuts to what is covered by OHIP in the provincial budget. As justification for him depriving the population of Ontario of adequate healthcare, in particular those who happen to be poor, on social assistance including disability, or underage, were the claims that a significant portion of tests are unnecessary. He went on to claim that less than 4% of family doctors are responsible for ordering over 40% said tests, in a demonstration of how statistics and a lack of understanding can be used to obfuscate the truth.

Let’s start with the latter claim. While it may seem strange that such a small percentage of family doctors may be responsible for so many tests, it’s less surprising to those of us who deal with chronic illnesses.

Not All Family Doctors

Continue reading “Let’s Talk About “Unnecessary” Tests”

Let’s Talk About “Unnecessary” Tests

Dear Doctors: Even if you Disapprove, You Need to Educate Yourself

Dear Doctors,

I understand. Marijuana, for all that it has been legalized, is still a controversial topic when it comes to its uses in medicine. It wasn’t that long ago that medical professionals feared reprisal for prescribing it, either from government bodies, law enforcement, or insurance companies. Despite all the mounting evidence suggesting its benefit in treating various conditions and its relative safety, it’s hard to overcome the conditioning of several years that viewed it as an illicit substance.

Even if you disagree with the use of marijuana, however, it is important that you educate yourself about it from reliable sources, and not just about the negatives either.

Why?

Because regardless of how you feel about it, I guarantee that you have patients who either use it or are exposed to it regularly. Ignoring for the moment the problems surrounding making your disapproval obvious making it more difficult for your patients to discuss their health, use, symptoms of concern, and so on; not being educated about marijuana on a medical level puts your patients at risk. Continue reading “Dear Doctors: Even if you Disapprove, You Need to Educate Yourself”

Dear Doctors: Even if you Disapprove, You Need to Educate Yourself

Medical Records, Digital Technology, and Empowering Patients

One of the interesting side effects of living with a first-year university student in what is essentially pre-med, is that occasionally I get asked input on issues related to the medical system. One such topic that came up was digital technology in medicine and it’s impacts on patient health and care.

Hey, wait, I’ve got something for this.

Immediately my mind went to the MyChart system that the Ottawa Hospital used back when I lived there.

The MyChart system is basically an online portal that allows patients who register for it to access their chart online. It’s not complete, but it contains notes on any tests run in the hospital network. The part that was most useful for me however, was the fact that it let me access up-to-date blood test results when I was in the hospital.

One of the realities of being a neurodivergent woman with a chronic illness, is that I have to navigate a prejudiced medical system. It’s not uncommon for certain symptoms to be taken less seriously when they present in women, a part of the medical systems pathologizing of either having a uterus or being a woman. These symptoms can include among them, abdominal pain and iron deficiency, two major aspects of Crohn’s Disease.

In addition, frequent hospitalizations that result in being given pain medication means there is always a risk of being mistakenly perceived as a drug seeker.

All these things put together make hospital visits not only very stressful but inconsistent with regards to quality of care and treatment. The worry of course is for something serious like a blockage, fistula, or abscess being missed because the doctor assumes you have a low pain tolerance or thinks you’re trying to score. Not to mention being in severe pain is both unpleasant and also not good for your health. Continue reading “Medical Records, Digital Technology, and Empowering Patients”

Medical Records, Digital Technology, and Empowering Patients

How Can Pain Cause Weight Gain?  

For years the assumption has been that “obesity” leads to pain. Many patients have had the experience of looking for explanations of pain issues, only to have the problem never investigated and told to lose weight instead. Then years later, find out that their pain was actually the result of an underlying issue, made worse through a lack of early treatment. You might have seen a comic or visual joke involving a visibly injured patient and the doctor saying “have you tried losing weight?”

In my book, Young, Sick, and Invisible, I discuss how this same trope was directly responsible for my own autoimmune conditions being ignored long enough to cause long term and severe disability and damage.

In a recent post, I had responded to an intentionally insulting comment with a long explanation of how their assumptions about my use of a mobility aid and my weight was influenced by a series of misunderstanding about obesity, pain, and disability. Included among this explanation was the statement that “obesity” or rather weight gain, can often be a symptom of chronic pain rather than it’s cause.

In response to this statement I received a question, and while the phrasing made it clear the comment wasn’t actually a legitimate inquiry but another chance for the commentor to engage in fat shaming, the underlying question sparked my interest.

Heavily edited, the question was this:  

“I understand how obesity can contribute to pain by putting stress on joints, but I don’t understand how the opposite can happen. Can you Please explain it to me and help me understand? How does Pain cause Weight Gain?”  

To begin, the concept of “obesity” is widely misunderstood and is oppressive in and of itself. As a knowledgeable friend recently explained it –  The word is based on the Body Mass Index scale (BMI) where the ratio of height and weight was determined and everyone who scored within certain parameters was considered as having a healthy BMI while anyone whose BMI was above this range was deemed obese. A person who had very little body fat, but was very muscled, especially in relation to their height, would be classified as obese. In fact, since muscle tends to weigh more than fat, a body builder is more likely to be classified as obese than what most people consider to be representative of an “obese” person.

The concept that obesity is synonymous with fatness is a misunderstanding that has become accepted as a standard, and is used by doctors to excuse their own medical negligence when it’s the result of internalized biases regarding fatness.

What’s more, more and more evidence suggests that body fat percentage is not actually a reliable indicator of an individuals health, nor is there actually a reliable standard as to what fat percentage can be considered healthy and which is unhealthy. That rather fat distribution and percentage is really just a variation in body type much the same way that shape, height, etc. are.

The attempt to pathologize fatness ultimately makes as much sense as claiming that a certain eye colour is an indicator of overall health. Contrary to popular belief, just being fat is not in itself unhealthy.  A fat person can be just as healthy as someone who is considered slender. What is unhealthy is when there is a sudden significant increase or decrease of body fat percentage outside of regular growth and development. In the specific case of an increase in body fat levels, what is unhealthy is when it is spurred by malnutrition, stress, and immobility which in addition to spurring weight gain also have a measurable negative impact on blood pressure, blood sugar, and arterial plaque. Even in this case, it’s not the weight gain in particular that is of actual medical concern, but rather the specific effects on those measured stats.

The medically accepted myth that fatness all by itself is unhealthy is another example of the fallacy that correlation signifies causation. Additionally, this accepted fallacy has had significant impacts on our social understanding of body size and health. 

A more accurate way to look at the connection between a high body percentage and pain would be that it can contribute to pain when an underlying problem exists, and when the specific individuals natural body fat percentage is significantly lower than what it is now. There are many people out there who are fat, who not only experience no pain whatsoever, but also have perfectly healthy stats.

In fact, the social convention of proper weight is so distorted, that the little abdominal bulge many women spend years trying to eliminate, is actually not the result of fat but is actually their internal organs pressing up against their abdominal wall.

Weight on it’s own, doesn’t cause pain. Rather, in an event that someone has an underlying condition that may cause pain, carrying more weight than their body naturally would under optimal conditions, can put additional stress on the injury site and make pain more intense. The impetus for the pain however, is still the initial underlying injury or condition.

What many ignore is that pain and its related symptoms can actually be the cause of accelerated weight gain and that the best way to address both is to treat the underlying cause of pain and to treat the pain itself.

How can this be?

Continue reading “How Can Pain Cause Weight Gain?  “

How Can Pain Cause Weight Gain?  

Stolen Freedom

Last year, I received one of the best gifts I’ve ever received. A kind family donated their departed matriarch’s wheelchair to me, after I had previously been told that my pain and inability to stand or walk far distances was not valid criteria to qualify for the accessibility device program.

Having access to the chair opened up worlds to me that I had long been unable to experience. I was able to go back into nature again, to explore my neighbourhood, my city, more thoroughly and comfortably. I was able to enjoy the outdoors more thoroughly than I had in years. I could even play Pokémon Go, without having to be the passenger in a slow-moving vehicle.

I met many of my neighbours and became an actual part of my community.

Although I was facing the fact that my marriage was falling apart, that I was facing even more financial vulnerability and hardship than I had already dealt with for the past seven years, I felt better about myself than I had in a long time.

I felt more a part of the world than I had before.

Continue reading “Stolen Freedom”

Stolen Freedom