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Medical Assertiveness Part I

“Two roads diverged in a wood, and I – I took the one less traveled by, and that has made all the difference.” Robert Frost

My recent shoulder and knee issues have me thinking about the side benefits of weight loss. As you all know, I started losing weight in 2005 because I’d spent the good part of 2004 figuring out what I wanted for myself. Two roads had diverged: Did I want to lose weight or stay where I was? Either way, I was going to commit to my decision because I was tired of the guilt trips and the hemming and hawing. After journaling it out, I realized that I loved myself and wanted to change, and so I took the road less traveled.

130 pounds later, roads diverged again, but the decision about which path to choose was easier to make because the self love that got me to lose weight got me to my doctor to start unraveling the mystery of my joints. At 300-pounds, I was afraid to seek help; afraid of being told to simply “lose weight.” But at 160 pounds, I’d gained the confidence I needed to not only find answers, but to work proactively for solutions.

In my last blog, Lori commented: “Can you imagine how you would be feeling today if you had not lost the weight? It's mind boggling, isn't it?”

Yikes! I’d probably be in total agony, still refusing to see a doctor, of if I'd seen a doc, I’d probably be taking pain killers like candy. Instead, I chose the road less traveled.

After reading Lori’s comment, I searched my files and found two essays I’d written regarding finding my voice in the medical world - a voice I’d not have found without the confidence that came with losing weight. I truly admire people who can be advocates for themselves no matter what their weight, but what I’ve learned through years of writing about weight loss is that most folks who are obese and overweight struggle, as I did, to find respect in the medical community. That’s why these essays are so important to me. (I’ll post part two next week.) They remind me just how much self-esteem and self-respect play into how we deal with our health.

From April 2008:

Hyaluronic acid has been a godsend to my dilapidated knees. Every six to eight months, I have a series of three injections in each knee over a three-week period (six injections in all). The medication replaces the synovial fluid I lack, providing a cushion for my kneecaps.

The injections can be painful when not administered properly because the needle must go between two joints and deep into damaged tissue. When done right and slowly, it’s not too bad. I go to my happy place and relax and it’s over in less than two minutes. Most of the time, my favorite orthopedic assistant/specialist, Steve, gives me the injections. He calls me things like “Scooter” and “Buddy” and makes me feel relaxed and safe.

During one of the series of injections eight months ago, “Doogie Howser” walked in the room with Steve and I immediately tensed. “Doogie” was a med student, Steve explained. I asked the young pup skeptically, “How many of these have you done?” He answered enthusiastically, “I’ve been doing this for two weeks!”

“Um, son?” I said, rolling my eyes. “I have underwear older than you.”

He laughed nervously, but thankfully, he listened to Steve’s advice and the injections went smoothly.

Last week, however, Miss Barbie Med Student walked in with my doctor, not Steve, and took control of the needles. She jabbed each one in – two inches deep – without saying a word to me or a breath of a warning. I was pissed. But did I say anything? Heck no. I went home, limping, and wondered how I’d tell my doctor next week that I didn’t want Barbie within 10 feet of me.

Why is it so hard for me to be assertive with doctors? Probably because most of my life I've been so passive. All week before my next injections I played a scenario in my head of me in which I was kind yet firm if another Newbie walked in the room ready to stab my knees like they were porterhouse steaks.

On appointment day, my doctor walked in the room followed by a tall lanky young newbie who nervously stuttered, “Nice to meet you” and shook my hand. His hand was sweaty. Great. My doctor said Newbie had been taking ribbing all day and was feeling a little “off.” Off? OFF? Some kid who couldn’t handle some teasing was going to put needles in my knees?

I didn’t think so. That’s when something that felt like courage bubbled up inside me.

“How many of these have you done?” I asked Newbie.

“A few,” he said, smiling.

“Doc, I gotta tell you,” I said. “Last week, that girl really hurt me. I didn’t walk right for 24 hours.”

In response, my doctor actually apologized. He asked me if I’d feel better if he did the injections. I said yes, but if he’d talk Newbie through one, I’d be OK with that.

I looked at Newbie and said, “Here’s my advice. Go S – L – O – W. Don’t attack my knee like it’s dinner.”

He turned 20 shades of red and I’m sure he was close to wetting himself, but god love him, he found the joint, injected the needle slowly, and it didn’t hurt much at all. My doctor did the other knee and all was well. Tonight, I’m walking without holding on to the furniture throughout my house.

Walking out of the doctor’s office, my stomach wasn’t hurting from the stress, my shoulders were relaxed, and I sang a Peter Frampton song all the way home. I was assertive. I told my doctor what I needed.

I took the road less traveled…and it made all the difference.

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