Welcome to my first post in Laughable Furies & Petty Qualms

The ‘healthcare system’ in the US is really really awful. It’s so bad you have to ask yourself at times, are they intentionally messing with me??? This has been my experience as a relatively privileged person – I know it is unbelievably worse for a LOT of people.

I’ve recently had ‘elective cosmetic surgery’ (tummy tuck) to repair my severely separated core muscles and excise the 5lb fanny pack of fat/skin that my stomach had become. Few things:

• Insurance doesn’t pay for your muscles to be repaired until AFTER you’ve got intestine poking through (hernia).
• These issues had built over the course of my life from many factors – being chubby, hormonal imbalance (more on that later), pregnancy, etc.
• I did what I could to resolve them through diet and exercise, but my pre-surgery status was the best I could reasonably hope for without going under the knife.

It’s been expensive, stressful, inconvenient and highly uncomfortable. Also, 10000% worth it and I wish I’d been able to do it a decade ago – would do it again, knowing all this, in a heartbeat.

My point is, I wanted this – I actively pursed it and was thrilled to be able to have it done. And yet, I’ve been in for two follow-ups and left crying both times from the way I was treated.

Some background for context:

• I started puberty young, first period at age 11. Had a couple cycles – started putting on weight, especially in my abdomen. Sprouted a lovely lady-stache and started having stomach issues. My periods soon stopped entirely for two years until my mom made me go to our small-town doc.
• The doc talked to me for a few minutes, told me to lose weight, and prescribed birth control to regulate my cycles. No bloodwork, no tests – no efforts to figure out why any of this was happening. Cool. Cool cool cool.
• I was not enjoying my high-school years as a fat hairy troll person and it turned out the birth control was like magic. I didn’t change any habits and the weight just fell off and my stache chilled out. OK, yay! One of my male teachers took me aside after a class and told me I looked really good but not to go ‘too far’ with the weight loss. K.
• I started experiencing what I can now recognize as anxiety, but at the time I just knew I couldn’t do anything stressful or eat a meal without IBS flaring up. Shitting oneself is not a good look. I eventually (16ish) got referred for an imaging test to see what was going on internally. The doc told me to drink this nasty contrast stuff and then ‘roll like a log’ while on the table. I awkwardly complied and the test showed….GERD. I was told to take an antacid and lose more weight. That didn’t help.
• I’m off to college – relatively thin, severe undiagnosed anxiety, stomach issues – but I was having a good time so wasn’t all that bothered. This is when I had my first panic attack – which essentially feels like you are dying. My boyfriend took me to the ER, where my hand was shaking so much I couldn’t even sign my name. The doc talked to me for a few minutes and sent me out the door with a couple Xanax – no explanation of what was wrong with me.
• Keep in mind this is early internet days, but I started reading what I could find on my own to help understand my symptoms and how to navigate life as best I could as it was becoming increasingly clear that nobody else was going to bother.
• I moved to the South with my boyfriend after graduation and during those years I saw various disengaged doctors and eventually asked to try some antidepressants. They didn’t work and the side effects were awful. My weight had crept up despite my efforts to control it via Weight Watchers and Curves and a million other things – so many of my concerns were dismissed as being weight related and I was told to lose pounds.
• I’d taken a trip to my hometown to look at wedding venues and somehow developed an infection in my thumb. Having learned by now that doctors aren’t that helpful, I tried an alternative treatment recommended by a friend’s mom where I put a piece of raw potato on the spot and covered it with a band aid to sleep. I have a reasonably high pain tolerance but by 3am I was at the desk in the ER saying ‘Listen, I know how this sounds, but my thumb hurts SO bad.’ The doc I saw didn’t even look at my hand, he just started asking if I did a lot of laundry??? Told me I was fine and sent me off with hydrocodone. I took enough to be able to sleep, and later that morning I had to pull off the road to throw up several times while touring venues because the meds and continued pain made me nauseated. Once back at my mother’s house I heated up a sewing needle and lanced my own thumb. Ah, sweet relief.
• I was a depressed anxious mess by the time I moved back to the Midwest, with my now husband, and we started thinking about having a baby. I was still on birth control and didn’t have periods without it. After several doc visits where I was told to lose weight, I was finally referred to an OBGYN. She did a bunch of bloodwork and sent me for an ultrasound. Turns out I have PCOS, with hormone imbalances and cysts in my ovaries. She put me on metformin as an off-label PCOS treatment and told me to try and lose weight to get my cycles going. After a year with no success she brought up Clomid as a possible option but I decided to focus on losing weight first. I started Atkins and severely limited my carb intake – no more than 20g daily for about a year. I was thinner but I was not healthy, and this diet was very difficult to maintain – but I lost a bunch of weight and got my periods to occur naturally, albeit irregularly. I started doing all the fertility stuff – charting my basal temp, checking my cervical mucus, scheduling sexy times, testing and testing and testing. I bought pregnancy tests in bulk from Amazon, I got a little nuts.
• I finally got that positive pregnancy test, after two years of working toward it. Then I miscarried. It was early, a chemical pregnancy – it just didn’t take. I was devastated – feeling like a failure at the one thing my body was designed to do. A few months later I was pregnant again and went on to deliver a healthy boy. We moved again, North this time, and the stress of being a new mother with a new job in a new town with zero support systems took a toll. I started putting on weight, got Shingles thrice, and self-medicated my mental issues with alcohol. I was super depressed and anxious but I’d accepted that as my ‘normal’ by this point.
• I stopped birth control to try for another baby, and I developed a bunch of ovarian cysts. These things HURT – so I went back to the doc and eventually got sent to a neighboring town for an ultrasound. The tech started acting strange during my test and she left the room to call a radiologist in. He didn’t acknowledge me or speak to me directly, just looked at the screen, said something to the tech and left the room. She told me to get dressed so we could walk to the ER as I had an ectopic pregnancy. I’d been tracking my cycles again and really didn’t see how I could be pregnant given my timeline, but was dismissed. The ER folks said I would be sent for surgery immediately to have an ovary removed – and that I was lucky to have the surgeon on-call as he used laparoscopy vs. the other guy who would have sliced me open. So lucky y’all. I called my people with this news and was trying to coordinate a ride home, my parents were en route for a visit anyway, when the ER nurse came back in and told me my Hcg level was ZERO and there was no possible way I had an ectopic pregnancy so they were discharging me and I should follow-up with my doctor. Buh-byeee.
• Following that, I decided I was done breeding. I’d wanted to get a breast reduction forever and now that I was done having kids I started the long and stupid process of getting the procedure approved by insurance. I was rocking E/F/G cups by this point. One thing insurance wants you to do is lose weight – shocking right? My doc recommended phentermine to help me along. Ok sure – so I started taking my prescribed speed, adopted a rigorous workout schedule and got down to my lowest weight since high school. Got my procedure approved, scheduled with a surgeon and did everything I was told to do as prep. My parents drove up to stay and help following my procedure and my mom drove me to the appointment an hour away. During pre-op check in, my blood pressure was up a bit – normal white coat syndrome stuff for me. The surgeon came in to tell me he was cancelling the procedure due to my bp. I asked for a little time to take deep breaths and calm down and he said I could try but ‘the bottom number does not change.’ I could not relax and he came back in to tell me it was still a no-go. He was clearly annoyed by this point and informed me that he was losing money not being able to do the procedure and that basically I was being a problem. I found a new surgeon.
• I went back home, and my dad hadn’t been feeling great so they cut their trip short. A few weeks later he was diagnosed with leukemia. This was a huge shock as my dad was one of the healthiest people I knew, and he was also the rock I could depend on in this life. It was a very rough three years while he underwent treatments while living several states away. I didn’t have energy for anything non-critical. I stopped exercising and taking my medical speed, and soon gained weight back.
• My dad died after doing everything possible, it was an awful experience for everyone involved. It took a lot out of me and as I was trying to pick up the pieces of my life I started looking in to getting my breast reduction again. I scheduled with surgeon #2, went and had the procedure done and it turned out great. The hospital called me to ask if anything unusual happened while I was under anesthesia – no idea what that was about but super sus. My mom said the surgeon came out to tell her I’d made it through but that she wouldn’t have done the surgery if she had known I’d gained the weight back. At my 3 week follow up she said “SOME women ask me when they can get back to exercising…”.
• I wanted to move closer to ‘home’ so I could be with my family and try to shore up my support systems and get my mental health under control. I started seeing a new doctor and she is truly wonderful. She took time to speak with me and understand my issues, gave me excellent recommendations and referrals and I was able to make some good progress.
• PCOS can lead to diabetes pretty easily because it made me insulin resistant, which also means my body thinks its starving so it packs on the pounds. I have a lot of family with Type 2 and I did not want to develop that particular issue. I talked to my doctor about starting Victoza (similar to Ozempic) because it was shown to have off-label effects on insulin resistance and could lead to weight loss. My insurance approved it, shockingly because I did not have a diabetes diagnosis. I started taking it and did lose a significant amount of weight, along with gaining a bunch of crappy side effects, but I was happy. I switched to Ozempic after a while and had continued weight loss – my insulin resistance was resolving and my A1C was improving. Then the whole world stated taking Ozempic and insurance automatically denied coverage for anyone without a diabetes diagnosis. Now granted, I was taking it off label and it did help me lose weight, so my doc recommended trying to get approved for Rybelsus, which is the same medication at a higher dose that is intended for weight loss. That was approved for me in the Spring and all was fine until July when they changed their formularies and my coverage was denied, no notice or communication other than my refill wasn’t processed.
• Just to be clear – I was prescribed a med by my doctor to help address issues that made me high risk for developing diabetes. This med was effective, but it was prescribed willy-nilly to anybody wanting to drop a few pounds and that ruined it for the people who actually needed it. I was then prescribed the SAME MED under a different brand name which is intended to treat weight loss (on-label), and that was also effective until insurance decided not to cover it anymore. This med is $1200 a month out of pocket. I had been told my entire life to lose weight and had finally found something that worked that wasn’t dangerous, only to be told ‘no, get diabetes first and then you can have this med.’ Frustrating does not begin to cover it.

Bringing us back to now:

If that was exhausting to read, imagine living it. Anyway, all this hormone weight gain/loss, stress and pregnancy was hard on my body. I was now at a weight I felt good about, eating very healthy and getting decent activity. I’d quit my full-time job during covid and had been working from home since, which has greatly reduced my stress and improved my overall health.

Even so, my stomach ain’t cute. I looked about 7 months pregnant unless I was sucking in my stomach. I had to stuff all this extra fat and skin inside my clothes. It was uncomfortable, unattractive, and causing a host of other health problems.

I went through the undignified process of surgical consultation, figured out how to come up with the cash (thanks mom! and selling feet pics) and tried to organize my whole life so I could take a 6-week hiatus to recover. Surgery went great, I’m feeling better than I probably should, trying to take it easy and making sure I can heal well.

At my one week follow up the surgeon asked how I was doing and I said, pretty good except this one drain is painful. It had leaked and the bandage was gross and my skin is very sensitive. People are difficult about these drains apparently – wanting them out asap. It isn’t fun having them but I also am prepared to be uncomfortable for a bit through this process. I know I’m not the expert, have told her I trust her opinions and that I will be highly complaint to any instructions.

But she was acting like I was being a difficult child. She didn’t want to pull the painful drain because it had more volume. I didn’t ask her to pull either specifically, it is supposed to be guided by the log of output I’d been keeping. I told her ‘I am not trying to tell you your business about what to do, you asked how I was and I’m just reporting that there is some pain.’ She decided to pull the painful one, and also chastised me gently and repeatedly to ‘just call if there is anything going on, we can change your dressing anytime.’ I said, yes I know but it wasn’t bothering me and I knew I’d be seeing you today.

Now, I was a little upset from the way she was treating me, but I also know I am sensitive and emotional right now and it wasn’t a big deal. I didn’t say anything negative and made it all the way home before having a little cry meltdown.

The remaining drain started to leak after a few days. As directed, I sent a message in the health portal, along with pictures and my output log. The message said ‘This is what is happening, I am fine, it doesn’t hurt but you advised me to check. Please let me know what to do, if anything.’

The nurse called me the next morning and asked what was going on, I repeated this and said that I was doing fine and didn’t want to arrange a ride over to just get the dressing changed unless I really needed to. She looked at my output log and made me an appointment to come in the next day. She said, ‘another day of this low output and she will probably be fine to pull the drain.’

This place is a 30 minute drive from my house and I can’t operate a car yet. I was able to get a ride arranged but it was an imposition. The nurse who checked me in looked at my output chart and said, ‘yeah that is probably ready to come out, I’ll get the supplies laid out for the doctor.’

I had my drain bulb sitting on my lap and the doc comes in and immediately says, oh wow that’s a lot in there when did you last empty it? I said last night. She said, what time? I said, its written on that output log I gave to your nurse. She doesn’t even look at the paper her nurse is holding and she says ‘yeah I’m not pulling that today’ and starts acting like I’m arguing with her. I said – that’s fine, I am fine with it, I was not pushing for you to take it out today.

She smirked at me and said ‘Are you sure about that?’

Mmkay now I’m pissed.

I said, ‘yes I’m sure – I am just trying to follow the instructions you gave me last time so I don’t get fussed at again.’

She told her nurse to change my dressing, informed me that it didn’t need a dressing anyway (news to me!) and left the room. I was upset but trying to hold it together. The nurse changed my dressing and was asking me some questions when I started crying, as I do when I have to be confrontational, especially when I am already worn out.

The nurse was instantly reassuring and I’m trying to gasp out an explanation between sobs. I put my sunglasses on and quickly walked out of there to go cry in the car on my chauffeured ride home.

Now, was this one thing a big issue? Absolutely not. But I’ve experienced years of dismissive and disdainful medical care and it is exhausting. I understand that the general public can be non-compliant, pushy and dumb when it comes to medical stuff, but I know that I am not that way and have done nothing to indicate otherwise. It would be nice to be treated like an intelligent individual who is happy to follow medical guidance.

I’ve been annoyed about it all day so here I am writing this all down in the middle of the night because I’m so worked up I can’t sleep and get the rest I need to recover.

Thanks for reading, rant over.

But yeah – don’t forget that self-care ladies. (rolls eyes)