Body Health

Sex & the Doctor/Patient Relationship

 

I’ve been working on my “new patient” paperwork for evaluating a new doctor. I never assume that the doctor I am seeing will work as a primary physician until after I have an initial appointment with them. Unless they can treat me as a partner and equal in my own health, I won’t have anything to do with them.

Now, I haven’t had any real issues filling these out, but I’m glad that when the paperwork is more than 2 pages long they chose to mail it out early to give me a chance to fill it out (whereas it would not be filled out completely if I had had it at the time of my appointment — it’s 4 pages, plus pages to explain my issues).

But I came across a question that I have never seen on a new patient intake form before.  They want to know if I’ve had more than 4 sexual partners.

I understand that sexuality is an important part of one’s health. Letting your doctor know about your sexual activity (and its relative health or ill health, as well as how careful or how ignorant you are about protecting yourself from STDs) is important. It is also important for them to know your sexual orientation and where you are on the whole gender spectrum.

But, it is a subject difficult for many people. Women who have had over 4 sexual interactions in their lives are told by our society that we are “dirty sluts” or “skanks.” It doesn’t bug me, but I could see some female patients avoiding the question for fear of being judged by the doctor. And that’s even BEFORE considering whether one should confide their sexual orientation, thoughts on polyamory/open relationships, transsexualism or any of thousands other issues that people fear to confide to anyone — let alone a medical professional who is supposed to have strict ethics.

It’s the specific number that bugs me. Who chooses that line in the sand? I know that “on an average” most heterosexual women have 4-5 sexual partners in their lives and most heterosexual men have maybe 6-8. I’ve never lied about the fact that my numbers are more than 10x the average for a heterosexual woman (which may be a surprise to one of my old boyfriends who found me on Facebook some months ago………I think I was still somewhere in the single digits when I was with him). But I can see some heterosexual woman (or even bisexual, not so sure about lesbians) looking at that and saying to themselves: “Oh, I’ve had 6. I must be a slut!!”

We are so very quick to judge ourselves worse than anyone else.

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Cravings & You

This should be short and sweet (OK, maybe I do pun sometimes. What’s the pun? I craved picked beets, and not all sugar is made from cane. Some of it comes from beets).

Every once in a while, I’ll get a craving. Sometimes it’s real, and sometimes it isn’t.

So why are there real and unreal cravings?

Well, the answer to that involves a story from my life (really? Like I NEVER tell stories about me here – for those humor-challenged, yes, that was sarcasm).

During much of my childhood, adolescence, and young adult years my parents often blamed my weight on “sneaking food” or when I hit teen years, that I must have an eating disorder. (Yes, fat people can have eating disorders. And yes, even anorexia and bulimia).

At one point my father insisted I join an eating disorder support group. Well, less of a support group and more like group therapy.

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The Difficulties of the Dead of Winter

No, I’m not going to start moaning and crying about the weather.  Nor about SAD.

However, they do have their place in this post.  I have not been able to keep up with regular posting since Thanksgiving. What I finally sat down and recognized is that I have become more easily overwhelmed.

You have to understand, my family (like myself) can be quite boisterous.  Even my elder sister, who is the least boisterous of us all, has what people have called an “overwhelming personality.” Though, I have to admit, there’s a bit of a tie whether my personality or my Dad’s is the more overwhelming in the family.

When we get together as a family, as does happen during the holidays, too much togetherness can be very overwhelming.  As I work through my issues, I am relearning to actually recognize the first warning signs, which I have in the past learned to ignore or suppress.  It doesn’t mean that I stand up and have a hissy fit about being overwhelmed, it means that I need to recognize the first signs so that I can take a few minutes away to recenter myself.  And if I need more than a few minutes, I need to learn to not feel guilty that I need that space.

But my family is not the only people in the world who can be overwhelming. Sadly, I’m just not quite sure how to communicate that need for space, for breathing room, without the person(s) I’m talking to either going into their own guilt spiral or worse, stressing their resentment about the fact that I need that breathing room.

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The Struggles: Mental & Physical

 

I hear every day that I am just not working hard enough; that other people have overcome worse issues; that I’m just being lazy or unwilling to do the “hard things.”

It doesn’t matter if they are talking about my mental issues or my physical ones.  In fact, with both sets of problems, I am simply considered to be malingeringor worse, I am a hypochondriac.” The nicest way to say it is to say that I have a somatic symptom disorder.” (SSD)

In speaking with my sister, I do realize that the way that the Diagnostic and Statistical Manual of Mental Disorders (latest version DSM-5) describes it, that it is not a diagnosis that is a polite way of saying that I am a hypochondriac or that I am malingering.

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Living the Fucked Up Life

 

Via How Late Divorce Seriously Messes Up Retirement For Older Women

Why is this a surprise to anyone?

Women born in the late 50s, the 60s and the early 70s got stuck with the “Superwoman” concept (meaning we’re between the ages of 40 to 70). We were taught that yes, we could be absolutely ANYTHING we want to be. However, in the process of “being who we want to be” we also needed to excel in the so-called “traditional roles” of women.

We could be a CEO, but we also had to be a perfect wife, a perfect mother, a perfect housekeeper and a number of other time-consuming roles that meant we did absolutely NONE of them well. So, we spent a good portion of our lives feeling we were failures.

It wasn’t until the latter 80s and some of the 90s that we even had a GLIMMER of support in being the person we wanted to be, whether or not that had anything to do with the “traditional female gender roles.”

And, we are STILL fighting that same damned fight.

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Special Diets

 

via Family: Mom Had Extreme Views On Nutrition, Only Fed Malnourished Boy Fruit & Nuts

I don’t give a flying fuck what kind of diet you choose for yourself, whether it be vegan or like Gandhi (a fruitarian – similar to the diet this woman gave her child) or any other special diet.  In fact, in cases of allergy, I do support you choosing for yourself the healthiest diet that you can.

HOWEVER if you plan to feed your child(ren) the same diet, you had damned well better learn how to read a lab report, and get used to discussing the lab results with your pediatrician.  (the link goes to a website that explains what the results of assorted lab tests mean)

I know many people in my life who have to eat special diets.  I know people with celiac disease, serious cases of irritable bowel syndrome (IBS), allergies to common foods or herbs (garlic and onion are both foods and herbs – and yes, I know someone deathly allergic to both), serious insulin resistance, and other diseases/allergies/mutations that require a change in diet.

But, even the parents with these diseases/allergies/mutations keep an extremely close eye on their child’s/children’s health. They are actively working as a partner to the pediatrician, and any symptoms of malabsorption or malnutrition are dealt with IMMEDIATELY.

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The New Scarlet Letters

 

For those of you whose high school experience did not include the required reading of The Scarlet Letter by Nathanial Hawthorne, I would encourage you to read at least the plot synopsis linked in this paragraph.

I’m truly sick and tired of the hypocritical, judgemental and pseudo-righteous attitude of a portion of humanity.  And sadly, it is most often perpetrated by the female of the species — just as it was primarily the female Puritans who encouraged the public shame of “fornicators and adulteresses.”

It is the phony, saccharine-sweet, “concerned” commentary given to total strangers as if that person has a right to tell someone else how to live their life.

Now, you all know that I am what the medical establishment calls “morbidly obese.” Additionally, I have also been very clear about the work I am doing to get more healthy, not only psychologically but also physically.

You also know that I have chronic pain in both my lower back (from ruptured discs and arthritis) and arthritis in my ankles and feet.  Walking any distance further than half a football field is painful for me.  So, when I shop at our local Walmart (which is, sadly, the most economical choice local to me), I inevitably use what is called a “mart cart.” (essentially a little scooter).  I have to pick and choose where I spend my energy (or spoons), and even with using the scooter and having a stock person help me load my vehicle, I am often exhausted by the time I’m home (20 minutes away from home).

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Being In Control

I don’t like not having a plan.  Yes, I admit, I am a control freak in a hell of  a lot of ways.  And yes, I do tend to vacillate between wanting to control those around me, followed fairly quickly by trying to take a far more hands’ off attitude, putting all my control in controlling myself.

And I have gotten far too good at trying to make sure I am always in control of myself.

It’s one of the reasons that as a young 20-something, I chose to lock away all of those chaotic feelings.  Highest on my list was passion.  I locked that away actually far earlier than 20.  I locked it up my sophomore year of high school (1983/1984).  I put passion deep down in an oubliette, and bricked up the hole. The way I was thinking, passion did nothing for me except cause more pain.  Without it, I was able to be more rational, more able to deal with the fairly normal ups-and-downs of teenage angst.

Aggression was next.  Note, not assertiveness.  Pure aggression, with all of the violence that it entailed.  I had spent far too much time dealing with keeping myself as safe as possible without having to join a gang, and wanted to end that willingness to physically destroy someone else to keep myself safe.  I forced myself into the mold of a pacifist (not that I could even honestly call myself one).

Shame was on that list too, but I was never very good at keeping it or guilt under control.  In fact, far too often both shame and guilt were fairly easily used for someone else to control me, or at least manipulate me into allowing them to control me.  A fairly strong lack of body modesty helped me to turn body shame (except in relation to romantic interactions) into my bitch, but instead of turning it onto myself, I externalized it quite a bit.  That left that huge hole open for my ex-husband to use against me.

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Chronic Pain Sucks Your Life Away

This week has been exceedingly difficult.  Frankly, I’ve spent most of it flat on my back.  No, get your minds out of the gutter, it wasn’t for that.

Sadly, I’ve been either trying to survive until today (being written at o’bloody-dark-30) when I will be traveling down to Eau Claire for a pain injection.  I did attempt to get in earlier (and had been told if all I needed was the injection, I would be fit in), but the reality is I have to discuss a few things with the doctor, so I had to wait for the first available time.

An injection doesn’t just stop working one day.  It kind of fades away.  And given that my body (as usual) doesn’t always work the way that the doctor thinks it should, it gets injected in a place he thinks shouldn’t actually work for my  pain.

You see, I have two ruptured discs in my lower back.  This basically means that there’s a hole in the outer layer of the disc, letting the fluid inside leak into the spinal canal.  Enough of that fluid has leaked from my L4/L5 disc (see photo above) that it is in essence completely gone, and the nerve associated with it is pinched between the bones.  The fluid is still leaking from the L5/S1, but is not yet completely gone – but it is still pinching the associated nerve.

It took us a while to find the right spot to inject.  The first injection I ever got was just above the L4/L5, and lasted maybe a month.  They moved down to the L5/S1 for the second attempt, and sadly that only lasted a week.  Finally, they moved down to the sacroiliac joint (target shapes above), and we found our spot to keep the pain muted some.  It doesn’t go completely away, but it — along with other therapies — keeps it from being at a level where I can function somewhat.

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Struggling With Executive Function Issues

I have been searching online quite a bit for general “tips and tricks” for supporting my day-to-day functioning with diagnosed cognitive issues in executive functioning. In my case, the primary issues are time tracking issues including poor deadline matching and poor planning assessment; deficits primarily in short-term memory, with some conceptual issues; issues with multitasking; and poor analytical processes.

On one hand, many of the attentional issues can be temporarily overcome with intense concentration (such as when I take tests).  These attentional issues include word finding, word deafness (a mild form, not a full aphasia – yet consistently, the word I hear as opposed to the word spoken by someone is heard as either simple profanity, or as a more obscene concept than intended), compromised motor skills (clumsy to the point of tripping over air sometimes), and issues with phonemes as a articulation disorder (more than simple spoonerisms, which also happen quite often, this is more of a verbal dyslexia).

While temporarily overcoming this issue is helpful, it has also caused some issues with discussing my cognitive issues with assorted medical professionals.  I have what is amusingly called White Coat SyndromeIn my case, again, this is not a pure phobia.  Yes, my blood pressure will often rise when dealing with a new doctor, and sometimes with specific specialty professionals.  But, it is almost better described as a “chip on my shoulder.” I routinely have this discussion with my therapist, because it is a very strong emotional response when dealing with medical professionals, psychiatric professionals and even worse with dental professionals. Continue reading

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