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Wednesday 2 March 2022

Who The Health?!

We’ve all seen similar stories covered in our local news or even in our news feeds online, “So and so was a nurse who loved snowboarding with their spouse and doing things in their community until one day they injured their back lifting a patient and later found they couldn’t move without excruciating pain.” and then they get into all of the care they were offered, therapies tried or meds prescribed. They get into how their life was taken away from them by the pain. Now house or couch bound, hope seemed all but lost. Then one day something they were offered works and “now they’re running 5k’s again! Isn’t life full of miracles!” BARF! Look, I’m not a full on hater here, but we’ve all seen these stories of otherwise socially acceptable-bodied individuals getting everything offered and thrown at them so they can “get back to living!” and all of that. The reality for anyone outside of what is deemed to be a socially acceptable-body is far more grim.

I know so many people, myself included, who have lived with chronic pain for over a decade. We have had to bear witness to our own limitations increasing along with the pain. Because we live in bodies deemed “other” we don’t get offered anything but enforced suffering or outright denial of our personhood. It is so appalling and degrading and wrong and yet this feels more common than those feel good stories will ever be (at least in the USA). I’ve had well meaning friends insist I get my right knee “checked out” and all I can offer back as a response is a slight smile because I can’t do the emotional labor of having to explain the failings of our healthcare for profit system and how it seeks to do anything but care for us. It seems an easy thing to say, hey go see a doctor, but the reality is so fucked up I can’t go to a doctor’s appointment or even the ER without first fasting because they will see my fat body and immediately pathologize it/me as diabetic (I’m not, but that is beside the point).

The way hospitals and doctors treat those in pain is absolutely horrific to me. I was accused of being both a drug seeker and not in pain at all when my gallbladder failed and I had to drive myself to the ER and refused morphine or any other pain meds. I explained to the team caring for me that I wanted to be clear headed so I could make informed medical decisions for myself and their reactions were akin to seeing an extraterrestrial. At one point the doctor looked right at me and said, “I’m not even sure you’re in any pain.” and smiled at me. I looked them dead in the eye and said, “I came in here at a 9/10 and you’re saying I’m not in pain? I’ve been vomiting from the pain alone!” It would take another 3 months to get the correct diagnosis (after 3 wrong ones) and another 9 months after that before I could get on the schedule to have my gallbladder removed. And mine was a common and relatively straight forward procedure. Imagine if it was rare or involved far more complicated issues?!

If you are white, able bodied, and below a size 14, you get treated with care, urgency, and kindness. If you are anyone else it is an absolute crap shoot! If you are Black, fat, queer, non-binary or trans, you will be forced to prove yourself and your humanity at every step if you’re lucky enough to get past the initial “Oh maybe there is something medically going on with this person” and that is a tough one to get past. I know some pretty incredible, talented, brilliant and the most caring of people and the level of pain they live with day to day absolutely boggles the mind. I say this as I am coming to terms with my own chronic pain. Realizing all of these years later the damage past jobs have caused to my body and how those 11 months of excruciating pain changed me as a person but also took a lot of my mobility away.

To seek any kind of treatment is like gearing up for battle. One must steel themselves before opening up to medical professionals these days. We must advocate for ourselves and ask ridiculous questions like, “What would you offer as treatment to someone in a smaller body with this same issue?” because we know the only “treatment” we are ever offered is to shrink our bodies and suffer in pain regardless of scientifically known outcomes. Many physicians won’t even physically examine our fat or Black or disabled (or all of the above) bodies. To them we are a nuisance at best and repulsive at worst. It is at the hands and words of these so-called care providers that we get the worst of the abuse and trauma thrown at our bodies and minds. What about the lives we were meant to be living? What about our contributions to community or the world? Just because I have no desire to run any k’s ever, doesn’t mean I should have to suffer and lose mobility or be denied treatment. And the shit thing is, even when we are offered treatment for pain relief (often meds), it doesn’t even mean it will work or be sustainable. I have friends who get regular cortisone shots in their spines and knees and hips and things just to barely get by. They are not thriving, they are functioning at a very low level, but not because of anything they have done or deserve at all. As if being a good or bad person should have anything to do with getting the medical care and attention one needs. 

Living in a body deemed as “other” means having to ask again and again for accommodation. Will the waiting room have a seat I can use comfortably? Will the hospital gown fit? Will I be able to get up on the exam table? Will I be able to get up onto the x-ray table (that thing is tall!)? Will I fit in the MRI machine? Will they have a back/knee/arm brace that fits me? Will I be denied surgery due to my size? And all of this is before we get into insurance coverages, co-pays, or final billing amounts. UGH!

There needs to be a massive overhaul of our entire healthcare system, but failing that (because it has always failed us), a paradigm shift so that simply seeking relief from horrible pain isn’t seen as “drug seeking” or simply being a “big ole baby” (the way nurses talk about patients when they don’t realize we can hear them! Whew!). I think there have been some recent attempts here for better and more accessible tele-health options. I think I read about one specifically aimed to help fat folks get better medical care too, forgive me for not knowing the name (please comment if you know it!). I think it’s a great idea and good first step in the right direction. I wonder to this day if I would have gotten the same correct diagnosis from a surgeon I never met because they had a hunch on over the phone. If they saw my fat face would they have still ordered that one last test? Would I still be suffering from a zombified gallbladder? I can’t know, but I have a hunch. 😉

Because I’ve had such physical jobs in the past I have also been injured on the job and had to go through worker’s compensation processes in order to get care. In case you didn’t know, you cannot just go to your regular doctor if you get hurt at work. Nope! You have to go to an occupational clinic and lemme tell ya, both times I had to do this they treat you like a scammer the second you walk through the door, no matter your actual injuries. It is utterly dehumanizing and I hated it so much. Having said that, they did have a back brace that fit me and it has been a life saver for me over the years since I’ve had it. But there was zero care, zero compassion, zero empathy in these clinics. 

I don’t really have a big point here other than just UGH FUCK THIS SHIT! I am currently in need of an eye exam (I’m way overdue), a dental cleaning (and like many thousands of dollars in dental work that I likely won’t ever actually afford to get and thus have a tooth rotting out of my head), and either physical therapy or chiropractic adjustments/treatment for my knee (I feel like it’s misaligned at my hip maybe). Only the eye exam and teeth cleaning would be covered by my insurance and I have pretty damn great coverage, all things considered. Yet it is somehow on me to “BE HEALTHY” and all of that bullshit thrown at us in marketing campaigns every fucking day of our lives. Health in this way is not accessible or even attainable for everyone. We all need to let go of that notion. 

No matter your life or lifestyle, being able bodied or healthy is temporary at best. There will come a time when you will need medical care/attention/treatment. This is simply how bodies work, they break down over time. Just because my car guy says that my little Toyota will “run forever” doesn’t mean that I will. My running days are long gone. I wish I could just go in for a tune up like I can my car! Ha-ha! I really hope I can find a chiropractor who will treat me humanely and with compassion because I have some childhood trauma from chiropractors that I’d rather not revisit but also unafraid to, ya know, because I think it’s my best option for my knee knowing what I do about going to the doctor for such things. And I think it’s perfectly “healthy” to be pissed off about all of this! Because it’s fucking maddening and we all know better, dammit!

I saw a post in a group I’m in on FB yesterday asking if everyone is always denied knee replacement and must suffer many years of pain and mobility degradation or if smaller bodies get approved for these procedures right away. What I thought is what I saw in comments, that yes smaller folks get more approvals, but more often than not it isn’t the patient that is the issue but the “success rate” of the procedure as far as longevity. One person said they knew someone young and thin who was denied and forced to suffer for decades because it wouldn’t be viable to do it again at age 60 if they did it in this person’s twenties. That person died in their early thirties because they also had seizures, and living with the pain, decreased mobility and a myriad of meds, lead to their quality of life degrading. Had they had the knee replacement they could have survived the seizure that took their life away because the other issues that came after would have been prevented. But it is doctor’s who insist on these “success rates” and such because to them it’s about “the work” and never the human receiving the procedures.

To be told to lose weight in order to get necessary medical procedures/surgeries is inhumane, cruel, and dangerous. You are telling someone that their pain and their life mean nothing if they are not such and such a size. You are telling us all that we do not matter to the world in any capacity unless we accomplish what no scientific study to date has proven to even be possible! What the hell is the point of that?! You might as well ask me to jump over the Empire State Building as it is just as likely to be possible! Even if it was possible to lose weight (insert the biggest eye roll emoji here), how could anyone expect to accomplish this while suffering in excruciating pain? To look someone in the eye and insist that their life is in their own hands in that most vulnerable of moments?! Are you fucking kidding me?! We should all be glad that I am not in a position of power and punishment doling because I would have a special sort of place juuuuust for such “care givers”.

The stigma our healthcare system has custom built-in for itself to deny care to as many people as possible is also claiming it is all our own faults for being fat in the first place, regardless of what our medical needs actually are. Not to mention the fact they no one truly knows for certain why populations of humans, and many other species, have increased in size at the same rates globally. I’m no scientist, but I read a lot of articles written by them. I know that no scientific study has ever found a way to lose weight in a safe, meaningful (as in more than 10 lbs), and permanent way, ever. So when a doctor gets on their high horse about this stuff or reached for the stomach amputation pamphlet (they always do), I ask them very pointedly if they consider themselves a believer in science. Not that I think belief has anything to do with science, but you know what I mean. Someone who studies science and uses its principles in their work should not be offering suggestions of health organ amputation to anyone! Nor any other ridiculous method of weight loss getting hyped up today. They should know better, they are paid and educated to know better, and yet they and the insurance companies refuse and we are left to suffer at their hands and willful ignorance.

May the force be with us all.

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