The Last Thing You'd Expect To Hear At The Doctor's Office....

[REP]

I've had a rather serious new symptom for the last six months - severe, unexplained weightloss. My doctor is quite worried; I'm a kidney patient and weight loss of this magnitude with no change in diet or exercise is a serious sign of something being wrong. The obvious has been ruled out: my diabetes is still very well controlled and I don't have parasites or a c. dificile infection; he believes I may have become hyperthyroid.

When I went in for my follow-up, the MA taking my vitals noticed that I had dropped another 10 pounds in three weeks and said, "Oh, I wish I could do that, especially over the holidays!" When I explained that that was what I there for - unexplained weight loss - she said she wished she could 'catch' it. Another nurse said that she wished that she had the same problem. Really?

My doctor doesn't know what's causing it and he doesn't say stupid things - and he does correct others when they go on about how 'wonderful' it is that there's something else wrong with me.

[WestHoustonDem]

1. I had the same thing happen to me before my Crohn's was

diagnosed. People can really say stupid things. I actually had my doctor speak with the nurse after a similar incident.

I hope you and your doctor get the weight loss under control soon. :hug:

[REP]

5. I'm Hoping My Usually Super-Mild Crohn's Is Acting Up

Without getting specific, I am symptomatic for that. If it is "just" the Crohn's, well that's okay then, since I'm not malnourished or anything (my CBC was normal, except for elevated ESR).

[WestHoustonDem]

7. I hope that's it REP.and that it's a short lived flare

:hug:

[siligut]

2. This is worrisome.

I know your MD has taken a good history of your physical/bladder/bowel activity and food and water intake. Even someone trying to lose weight wouldn’t have such drastic results, scary. Hyperthyroidism sounds like something to hope for in a case like this, as it can usually be treated successfully.

It is pretty disturbing to hear a medical professional seem to be pleased or envious of your difficulty. They are desirous of your weight loss, not illness. Still, one would hope for more sensitivity. Unintentional weight loss is very serious, hope you and your doc figure it out soon.

[REP]

6. Mild Hyperthyroidism Without Cardiac Involvement Would be Okay...!

Aside from the unexplained weightloss, I don't have any other 'classic' hyperthyroidism signs, such as warm, moist skin; in fact, mine is drier and itchier than usual (but it is colder here than usual), so perhaps it's very mild hyperthryoidism which won't give me a heart attack! If it is, then I'll join with the nurse and not mind having it ... but still, it was an odd thing for a medical professional to say. The more I think about it, the more I wonder if she didn't realize I wasn't there for a follow-up for the unexplained weight loss.

[mopinko]

3. smack them

or complain to the doc. what stupidity.
this is the kind of shit that you get when you replace r.n.s with barely trained assistants. (assuming this is the case. i never see r.n.s in the office anymore.)

[nashville_brook]

4. mopinko's right -- assistants are not the professionals they used to be

that's why it's all the more important that verbal assaults like this don't go unreported. it's the responsibility of the office to make sure the staff is adequetely trained and this is a clear example of the absence of that.

i used to teach social skills for womens' physical exams -- think, one step above standardized patient. this was for second year med students mainly going into family practice. the first thing we worked on -- and the overriding theme of the program -- was professional dialogue.

first rule: a patient comes to you with a complaint or a dianosed disease that is the main focus of their life at the moment. you don't minimize it. that's the first refuge of a person uncomfortable with human suffering. "oh, i WISH i could lose that much weight!" that bascially tells the patient that their illness isn't of any concern. "sheesh, if ONLY i could lose 10 pounds without trying! MY life would be peachy." well guess what. "I (the patient) didn't come in today to discuss your weight problem. I'm here because MY weight loss indicates a serious illness and i'm terrified." the assistant's cavalier attitude suggests that your problem isn't a problem in their eyes -- so, effectively they are denying your concern, illness and terror.

in "civilian" life, if this were a friend or colleague saying this, you'd STILL feel reduced, but at least you'd have the benefit of a relationship which comes with the opportunity to correct them. you don't have that option in the professional setting. the assistant takes your weight, BP and pulse and is gone. you're left feeling alienated, terrified and (at best) questioning the professionalism of the office.

it's up to you to convey your dismay to the office. i would do this in a letter that spells out exactly what happened, why it was wrong and what you expect to be done about it (higher standards of interpersonal skills). give them action items that require follow-up, so you can determine if your concern is being taken seriously.

if there's no follow-up, then it's time to find another office, because if they are this sloppy in social professionalism, then you might wonder how your records are being handled. your labs. your billing.

i'm sorry this happened. i've been treated like a piece of meat and much worse, and even with my background i have had trouble standing up for myself. it's not easy -- especially when you are sick! :hug:

[Warpy]

8. They're also human beings in a weight obsessed culture

so cut them a little slack. I've said a whole lot of tactless things, especially at the end of a nightmarish 12 hours night shift when I was seriously dragging booty.

[REP]

9. This Was 2 PM, In a Regular Office, Not the ER

And it's not my thyroid, after all. So it's either the Crohn's, cancer or nothing (I'm betting on 1 and hoping for 3).

Yanno, I know what it's like to be overworked and tired - but I've never taken it out on someone else, especially someone sick and in pain. The MA in question has always behaved not only professionally but is a really nice person, so her dumbshit comment was unexpected. Having had to explain what "nephrotic" means to RNs more than once, I'm not unused to medical personnel who should really be elsewhere, but not at this office, where I always receive excellent care and the staff is friendly, polite and knowledgable.

[mopinko]

10. i thought you were going to say

"oops! i made a terrible mistake! i am so incredibly sorry for the pain and suffering i have caused you! here is a check."