Weight, what now?

[mizarchivist]

Ring ring!
Hello?
Hi, this is [person] from [your PCP's] office.
Hi. 
I'm here to help you schedule an appointment with our nutritionist.
Why?
Because your test results came back and you're pre-diabetic.
...
...
...
WHAT?
expurgated version: Oh, this was a surprise? - why yes it is. This is the first I've heard of it. Would you like to speak to Dr. G? Hell yes.

So the deal is that with no indication of what my base-line is, just on the chart on the wall and one glucose test, my BMI/weight/age, I have a "25% chance of getting diabetes within 5-ish years, if I do nothing with my weight." 
Despite the fact that I weigh 10 lbs less than I did last year
That he doesn't know my medical history as it has been written from a hole in the wall, as they have not yet been transferred. 
That my overweight family members have to date not gotten Diabetes
And WTF- I'm not that heavy. I would be curious to know what resource he's using to determine this outcome. 

My answer to Dr. G was that it's the most stressful year of my life. I am not remotely concerned about this outcome at this time. I do not have the luxury of doing a lot of the things I'd like to do right now, but that this will change really and for true when some factors out of my control are different. But for now, it's just not going to happen. It is what it is and I think I'm doing quite well under the circumstances. Next year. We'll see. After he knows me and my charts better.

(but really... what does he think I should weigh? If it's the fucking BMI.... well, we need to have words. )

ETA: From the Doctor since I wrote last...

"In regards to BMI, I completely agree that it is not a very accurate determination of healthy weight but a rough tool that should prompt us to take a more comprehensive look into health/fitness. I look forward to getting toknow you more as a patient and a person. Regards, Dr. G"  

So, he still hasn't addressed the issue of what caused him to make this deduction. I've emailed back with the request he elaborate. If it's weight, what does he feel would be a safer weight. If something else, what. If a combination, what. We shall see. I'm feeling somewhat mollified after he agreed about BMI, but his first impression is radically marred. I will not be blindly following his suggestions, but then again it's not a good idea to do so anyway.

ETA 2: " Hemoglobin A1C is slightly elevated. A level between 5.7-6.4%" ... OK. So it's that. 

Comments

[hammercock.livejournal.com]

Oh, HELLS no. SMASH!!!

[mizarchivist]

A bit, yeah. Turns out that I was supposed to have gotten an email with an explanation, which is not in the patient portal inbox at all- so.. that. Surprise! Diabetes (maybe).

Seriously, if he's basing off BMI, I may well get a new doctor. Maybe just in the practice, but... No. All the no.

There's been an email sent to him requesting more information.

[catness.livejournal.com]

Seriously, because otherwise, it's just THE WAR ON OBESITY, and that makes me seethe.

[mizarchivist]

Seething barely covers how I feel, yeah.

[dani-namaste.livejournal.com]

Speaking of the war on obesity, my nephew's doctor just gave my sister a lecture about how fat the nephew is. Literally told her, in front of my four-year-old nephew, that he's too fat and he's going to get diabetes and die if she doesn't do something about it.

I discovered this when I saw him on July 4th and he said, "I got a secret," then leaned in and whispered "I'M FAT."

I was ready to drive down to that doctor's office and slap her in the face.

[mizarchivist]

That's criminal. And cruel.

[dani-namaste.livejournal.com]

I was mortified. I've already been counseling my sister in how to get JJ to eat healthier; the doctor was trying to do the "just feed him boiled chicken and rice" nonsense. But to start that talk in front of a four year old—who's already super-rambunctious and doesn't understand why the grownups keep snapping at him for being FOUR YEARS OLD—was too much for me to deal with.

[surrealestate.livejournal.com]

Bleah. I feel like there must be some sort of mistake, like they called the wrong patient (which is why there was no message in your portal) or there were some weird results of some blood test. Because otherwise, I mean, it's not even that it's just angry-making, it *makes no sense*.

[mizarchivist]

I know, right?!
This is a good point. Thank you. It's possible there was a mix-up on this and someone who's actually a more likely risk is the one who should have been called.
So, they can be wrong because of their weights (hah) and measures, or because they are not very precise in their record keeping this one time....

[woodwardiocom.livejournal.com]

..Quod the f*ck?

[mizarchivist]

Pretty much.

[tikibar]

Christ, don't go see them if you've cut your finger. "Based on the amount of blood you're losing now, in a year you'll die from blood loss!11!one" Or... "Doc! I walked in on her and she was asleep! It must be narcolepsy!"

From one data point I, too, can extrapolate ALL THE THINGS!

[tigira.livejournal.com]

Really? One blood test and they can be certain you're pre-diabetic? No. no no no no no.

Multiple tests. I can see, "We'd like to do random glucose tests every couple of weeks for the next few months," or even, "Let's do a full fasting blood glucose."

But. No.

And applying BMI? Absolutely not.

[first-clark.livejournal.com]

Calmly, calmly. Perhaps error, perhaps thoughtless evaluation, but resolution you are pleased with will more likely be found through frank discussion directly with the practitioner. If you're still unhappy, yes, finding a new PCP is on your to do list. As for the rationale, provided, agree it's insufficient. I recently went through this, but motivated but blood chemistry values that crept into the red last year. I still challenge my PCP, his students, and my nutritionist every time they slip up and presume BMI or weight loss are my motivators. Yes, that happened, but it was a side effect of my successful blood chemistry experiment. Best wishes.

[veek.livejournal.com]

NO PART OF THAT IS OK.

Seriously???

[taura-g.livejournal.com]

*blink*
*blink*
*blink*
SERIOUSLY???

Wow. I'd be pissed too.

[mzkero.livejournal.com]

So.... Being prediabetic myself, I can say that they determine this from an A1C test. It only needs to be administered once. It is not necessarily weight dependent. You can also have this condition due to other medical issues. And they are not wrong about the simple fact that if you do nothing the likelihood of developing diabetes is great. Now, it is not stress worthy. And they obviously handled it F-wrong.

IF, they based this on anything other than your A1C blood test, I would run, not walk out of there.

Give a call if you want to talk about it.

Did they write a prescription

[drwex]

for Rude, with a side order of Inadequate Patient Communication?

I mean, really. OK, there's a blood test and it's an indicator and it might be worth a conversation. But seriously, the medical equivalent of hollering YOUSAGONNADIE is not terribly... well, anything good.

Re: Did they write a prescription

[mizarchivist]

Also, "you're fat."
Nice way to introduce yourself to a new patient.

Re: Did they write a prescription

[drwex]

I didn't see this in the other comments, so sorry if I missed it, but did they not notice the part about you being a nursing mom? And, you know, maybe the (already dubious) metrics associated with body size might be just a wee bit INAPPLICABLE for nursing moms.

We have a lovely coat-rack by the door; please hang your assumptions there on the way in...

[weegoddess.livejournal.com]

WTFF?

Unbelievable.

I wonder if you can find a nurse practitioner in that practice. They seem to be so much more Clueful.

[mizarchivist]

+1

[dani-namaste.livejournal.com]

UMMMM... For the record, I'm a hell of a lot heavier than you, and I'm nowhere NEAR diabetic. I can't stand when doctors pull that kind of crap. Another doctor told Nick he should "try to lose weight" because of his cholesterol levels. My husband. Lose weight. My first thought: "FROM WHERE????"

The way that medical professionals have been flipping out over body fat is out of control lately.

The plan

[mizarchivist]

I really showed him! I went and had a carb-rich dinner with a sweet, alcoholic drink, then had a sundae. HAH. ... Or something. I'm pretty sure I won't keel over tomorrow from this. I'm waiting to see if the doctor actually can manage to answer my questions that I asked in a clear and unambiguous way. If not, I will see if someone else in the practice can fit me in. ... If not that shut_it_already has recommended her doctor in Central Sq.

Re: The plan

[dani-namaste.livejournal.com]

Good for you! They tried to tell me I had gestational diabetes because I had a cinnamon bun for breakfast the morning I took the test, but the horrid 3-hour test came back normal. Stoopid doctors.