Weight, temperature, pulse, and blood pressure are baseline diagnostics that go on your chart every time you visit a doctor.
People fixate on weight, because they’re sensitive to it. But if you kept showing up at the doctor with a 100⁰ fever and the doctor kept saying “We need to get that fever down. Liquids, Tylenol, and bed rest are what you need”, what else do you want the doctor to tell you?
“Hey, there’s a secret panacea that will fix all your problems, but we just won’t give it to you, because it’s too cool to prescribe”?
Like, for a gunshot wound, they’re going to stabilize you as best they can and then it’s going to be a bunch of bandages and bed rest. “Hey, have you lost a much of blood due to a recent period?” isn’t even an unreasonable question to ask.
Some of us had much heavier periods than that. I went to the doc once complaining of heavy periods that were making me anemic. She decided to do an exam, so I stripped off, took off my pad, and laid down. She was a little delayed coming back, and when she stuck in the speculum and opened it up I dumped 200ml of blood in her lap.
Wouldn’t that make the docs question reasonable? Like aren’t they just asking if you’ve had an abnormal period to cover all the bases? From my admittedly ignorant perspective, all women have periods, they happen every month, it’s a major part of your lives and health, seems a normal thing for doctors to ask about, no?
Like if a random dude is asking you how much you bleed on your period that’s fuckin creepy, but that seems like a basic health question for a doctor to ask to me.
Ya but that wasn’t asked in the comic, it was asked in the comment I’m referring to. I’m aware it wouldn’t be relevant to a wound, but during a normal physical it would seem a routine question.
Like, for a gunshot wound, they’re going to stabilize you as best they can and then it’s going to be a bunch of bandages and bed rest. “Hey, have you lost a much of blood due to a recent period?” isn’t even an unreasonable question to ask.
Did you not read the conversation that preceded your comment?
Yes outliers exist and no it would not be a reasonable question for a doctor to ask how much you bled during your last period while they’re treating you for a gunshot wound lol
Not to mention weight is 100% required for accurate medication dosing.
Its also valuable to understand trends. I got real sick once, and kept going back to the dr. Had they not taken my weight every visit, we wouldn’t have been able to track that i lost almost 30 pounds in a month
If it was just put in the chart, it’s not a problem.
The biggest problem is when weight is considered as the first and only medical explanation for symptoms that would prompt further inquiry in a person who isn’t overweight.
The second problem is people are tired of hearing advice about how to lose weight, like, wow, thanks, never heard that before.
The first problem contributes to poorer outcomes because diagnosis and treatment is delayed or missed. And they both contribute to overweight people being more reluctant to go to the doctor, which, again, contributes to poorer outcomes.
IMHO, and not being a doctor or even in the medical field, I think obesity is America’s #1 health problem. Every time I’m in the doctor’s office, every time, I’m the only non-fat person. Now imagine the doctor’s experience. “Fat people keep coming in with problems and I can’t figure it out!” I can see how they get blinded after awhile.
Another thing I’ve noted, next time you see someone in a leg cast, they won’t be skinny unless they’re obviously a teenage athlete. You won’t be able to unsee it.
So I can’t blame docs for wanting to eliminate the issue before them. I feel ya though. I’m a functioning alcoholic. Try getting treated for anything once you admit that.
“Doc, I’ve been drinking a 12-pack of light beer a day for 20-years, this symptom is completely new.”
“Have you thought about cutting down?”
🙄
I’ll leave you with this thought: Installing satellite for a little old preacher man in South Chicago,
“Shalafi, you ever hear the term ‘little old man’ or ‘little old lady’?”
“Of course.”
“Why you think that is?”
Funny enough for a preacher, his take was that we didn’t evolve to be tall or fat and our bodies can’t handle it into old age. 25-years later, that’s still a compelling take.
We little old ladies are little because we shrink, honey. I don’t even have osteoporosis (yay) and I have excellent posture, but I’ve already lost an inch.
I’ve discovered that when you’re old they start measuring again, like when you were a kid. And they replace “When was your last period?” with “Have you had any falls?”
(From now on, my reply to that one is going to be “I refuse to answer on the grounds it will jinx me,” because I said No and then tripped in the middle of crossing the street the next day.)
I brought spinal compression up in that interesting conversation! But as we both agreed, it’s more than that. How many truly tall or truly large people you know in their 70s or 80s?
Anecdotally, the only large elderly person I ever knew was great-grandpa. I suspect he looked like the barrel-chested gangster in “Last Man Standing”. :) He could barely walk in his 70s, BUT, made it to his mid-90s in bed. (Weirdly enough, I cannot find a pic of that actor!)
Obesity has a lot of social factors to it, too. The only cheap food is junk food, you have to drive everywhere, and your job is sedentary, and you don’t have money to play hockey… I mean, there’s a lot that goes into it. Making everything an individual medical issue is bad policy.
Have a little (or a lot of meat) on your bones is protective for bone breaks for people with osteoporosis, so you might see some leg casts on old skinny people.
But the main thing is, yes, to do a thorough workup and not stop at the first and most obvious possible cause of a symptom. The second thing to do is recognize that the person probably is a) aware of the problem and b) has all the same information you have. I’ve never been surprised by what a doctor told me, neither that I was overweight, or that I change change my diet, or that I should get more exercise. So why waste that time and also endanger the relationship with that?
I think nowadays at least we have GLP-1, which I’ve got some doubts on, but at least it’s something that’s more likely to work than Another Diet.
The problem is the doctor is a doctor. It’s the same with psychologists, the patients are depressed because their life is depressing, but the only thing the shrink can do about it is try and get them to feel better.
The psychologist isn’t making the patient the problem, simply, changing the material conditions is beyond the scope. If the patient is suicidal because they’re broke, you, as a doctor, can’t prescribe them more money. The best you can do is get them to cope with being broke, and try and put them into a mindset that will enable them to try and stop being broke. The alternative is to tell the patient “well, you’re fucked” and leave.
Likewise, if a patient has a weight problem because they live in a food desert, you, can’t follow them around and control what they eat. All you can do is give them meds for the immediate symptoms, and try and get them to make an effort to lose weight.
Unless you have a stubborn parent, most people around you don’t tell you to lose weight because it is a sensitive topic.
The truth is it’s in the best interest of your health to lose weight and the doctors office should be the one place where you hear that regularly and hopefully any judgment is just perceived. The more consistent this is the less it should seem targeted or judged.
A lot of doctors don’t do it anymore and you can probably find one. I get told this and it’s a conversation starter for me to talk about obstacles and progress. I also get told by the dentist to floss more every damn time, but being so sensitive about this as to not see a Dr or dentist seems like an issue in and of itself. Talking about the sensitivity with someone might be the first step in being able to deal with the weight issue.
It’s also pertinent to certain medication dosing regimens which are weight based, but I’m sure most people just get triggered with their self-esteem issues when they step on the scale so they assume it’s for the doctor to poke fun at them for being fat.
Ah young one, you see the reason you have no motivation, feel exhausted and sad all the time, and no longer feel any joy from activities is due to a lack of exercise.
Look kid, I’ll do some jumping jacks. Now I’m Smiling! See! You try, and you’ll see. Exercise releases dopamine so that’ll fix you up.
I see the exhaustion with my wife, because she doesn’t move around. It feeds on itself. “I’m too tired to walk a mile.” Then you will always be too tired to walk a mile.
So few of us get exercise that my doc is happy when I answer “several” to, “How many times a week do you get your heart rate up?” And I’m not talking about “real” exercise, just simple shit like dragging my kayak in and out the swamp, or paddling like mad to get out the sun, or lifting heavy stuff working around the yard.
My little kids screamed while hiking when I told them the creek was 1.2 miles. “A MILE!?” When I was their age we started gym class with a mile jog and then did other stuff. (Two months later they could make that trip with no pain or fatigue.)
As with my comment above on obesity, I can’t blame docs for wanting to eliminate obvious issues. If my windshield is filthy and I’m complaining to the mechanic about my dim headlights, he’s going to start with the obvious. Cleaning the windshield won’t fix the headlights, but it will help and allow him to focus on troubleshooting further. (OK, that’s kinda sloppy but you get the idea.)
Good idea! She eats loads of rice, not much if any iron. Going to ask her. I have iron pills we can try as well. One other thing, we cook in cast iron almost exclusively, so that should cover iron intake?
But anyway, I’ve been so low on blood (bleeding hemeroids) that they damned near did a transfusion on me, still had plenty of energy.
Fellow h-bleeder here, they had to give me iron infusions. I was exhausted and noticed hearing my pulse in my ears because my heart was working overtime trying to oxygenate me
It varies, between people and in my case over time. I got mine injected and was “cured” for a few years but it eventually flared up again. I should go again but my situation doesn’t allow for it right now. Metamucil helps more than anything else.
“And before we begin, please step on the scale so we can give you diet advice you have definitely not heard a million times before.”
Weight, temperature, pulse, and blood pressure are baseline diagnostics that go on your chart every time you visit a doctor.
People fixate on weight, because they’re sensitive to it. But if you kept showing up at the doctor with a 100⁰ fever and the doctor kept saying “We need to get that fever down. Liquids, Tylenol, and bed rest are what you need”, what else do you want the doctor to tell you?
“Hey, there’s a secret panacea that will fix all your problems, but we just won’t give it to you, because it’s too cool to prescribe”?
Like, for a gunshot wound, they’re going to stabilize you as best they can and then it’s going to be a bunch of bandages and bed rest. “Hey, have you lost a much of blood due to a recent period?” isn’t even an unreasonable question to ask.
People only lose about 2-3 tablespoons of blood during a period.
Some of us had much heavier periods than that. I went to the doc once complaining of heavy periods that were making me anemic. She decided to do an exam, so I stripped off, took off my pad, and laid down. She was a little delayed coming back, and when she stuck in the speculum and opened it up I dumped 200ml of blood in her lap.
Yeah the “about” is doing a lot of heavy lifting in that sentence in my comment.
Eh, you’re velma, I’ll let it slide cuz you do a lot of heavy lifting yourself around here.
Wouldn’t that make the docs question reasonable? Like aren’t they just asking if you’ve had an abnormal period to cover all the bases? From my admittedly ignorant perspective, all women have periods, they happen every month, it’s a major part of your lives and health, seems a normal thing for doctors to ask about, no?
Like if a random dude is asking you how much you bleed on your period that’s fuckin creepy, but that seems like a basic health question for a doctor to ask to me.
It’s not pertinent when treating a wound like in the comic.
A pregnancy isn’t more important than saving the life of the person with the wound.
Doctors already know how much blood people (it’s not just women that have periods by the way) tend to lose during menstrual cycles.
Ya but that wasn’t asked in the comic, it was asked in the comment I’m referring to. I’m aware it wouldn’t be relevant to a wound, but during a normal physical it would seem a routine question.
Did you not read the conversation that preceded your comment?
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My first gf would easily lose that much a day, every day for 5-6 days. Never knew a woman like that before or since, but outliers exist.
Yes outliers exist and no it would not be a reasonable question for a doctor to ask how much you bled during your last period while they’re treating you for a gunshot wound lol
Not to mention weight is 100% required for accurate medication dosing.
Its also valuable to understand trends. I got real sick once, and kept going back to the dr. Had they not taken my weight every visit, we wouldn’t have been able to track that i lost almost 30 pounds in a month
If it was just put in the chart, it’s not a problem.
The biggest problem is when weight is considered as the first and only medical explanation for symptoms that would prompt further inquiry in a person who isn’t overweight.
The second problem is people are tired of hearing advice about how to lose weight, like, wow, thanks, never heard that before.
The first problem contributes to poorer outcomes because diagnosis and treatment is delayed or missed. And they both contribute to overweight people being more reluctant to go to the doctor, which, again, contributes to poorer outcomes.
IMHO, and not being a doctor or even in the medical field, I think obesity is America’s #1 health problem. Every time I’m in the doctor’s office, every time, I’m the only non-fat person. Now imagine the doctor’s experience. “Fat people keep coming in with problems and I can’t figure it out!” I can see how they get blinded after awhile.
Another thing I’ve noted, next time you see someone in a leg cast, they won’t be skinny unless they’re obviously a teenage athlete. You won’t be able to unsee it.
So I can’t blame docs for wanting to eliminate the issue before them. I feel ya though. I’m a functioning alcoholic. Try getting treated for anything once you admit that.
“Doc, I’ve been drinking a 12-pack of light beer a day for 20-years, this symptom is completely new.”
“Have you thought about cutting down?”
🙄
I’ll leave you with this thought: Installing satellite for a little old preacher man in South Chicago,
“Shalafi, you ever hear the term ‘little old man’ or ‘little old lady’?”
“Of course.”
“Why you think that is?”
Funny enough for a preacher, his take was that we didn’t evolve to be tall or fat and our bodies can’t handle it into old age. 25-years later, that’s still a compelling take.
We little old ladies are little because we shrink, honey. I don’t even have osteoporosis (yay) and I have excellent posture, but I’ve already lost an inch.
I’ve discovered that when you’re old they start measuring again, like when you were a kid. And they replace “When was your last period?” with “Have you had any falls?”
(From now on, my reply to that one is going to be “I refuse to answer on the grounds it will jinx me,” because I said No and then tripped in the middle of crossing the street the next day.)
I brought spinal compression up in that interesting conversation! But as we both agreed, it’s more than that. How many truly tall or truly large people you know in their 70s or 80s?
Anecdotally, the only large elderly person I ever knew was great-grandpa. I suspect he looked like the barrel-chested gangster in “Last Man Standing”. :) He could barely walk in his 70s, BUT, made it to his mid-90s in bed. (Weirdly enough, I cannot find a pic of that actor!)
Most of my dad’s brothers. Anecdotally, that’s about 10 men right there.
Obesity has a lot of social factors to it, too. The only cheap food is junk food, you have to drive everywhere, and your job is sedentary, and you don’t have money to play hockey… I mean, there’s a lot that goes into it. Making everything an individual medical issue is bad policy.
Have a little (or a lot of meat) on your bones is protective for bone breaks for people with osteoporosis, so you might see some leg casts on old skinny people.
But the main thing is, yes, to do a thorough workup and not stop at the first and most obvious possible cause of a symptom. The second thing to do is recognize that the person probably is a) aware of the problem and b) has all the same information you have. I’ve never been surprised by what a doctor told me, neither that I was overweight, or that I change change my diet, or that I should get more exercise. So why waste that time and also endanger the relationship with that?
I think nowadays at least we have GLP-1, which I’ve got some doubts on, but at least it’s something that’s more likely to work than Another Diet.
The problem is the doctor is a doctor. It’s the same with psychologists, the patients are depressed because their life is depressing, but the only thing the shrink can do about it is try and get them to feel better.
By making the problem the patient and not their life, the psychologist is actively doing harm.
But the result is that the psychologists has clients, so the psychologist gets paid, and from that comes a whole host of emotional justifications.
The psychologist isn’t making the patient the problem, simply, changing the material conditions is beyond the scope. If the patient is suicidal because they’re broke, you, as a doctor, can’t prescribe them more money. The best you can do is get them to cope with being broke, and try and put them into a mindset that will enable them to try and stop being broke. The alternative is to tell the patient “well, you’re fucked” and leave.
Likewise, if a patient has a weight problem because they live in a food desert, you, can’t follow them around and control what they eat. All you can do is give them meds for the immediate symptoms, and try and get them to make an effort to lose weight.
Unless you have a stubborn parent, most people around you don’t tell you to lose weight because it is a sensitive topic.
The truth is it’s in the best interest of your health to lose weight and the doctors office should be the one place where you hear that regularly and hopefully any judgment is just perceived. The more consistent this is the less it should seem targeted or judged. A lot of doctors don’t do it anymore and you can probably find one. I get told this and it’s a conversation starter for me to talk about obstacles and progress. I also get told by the dentist to floss more every damn time, but being so sensitive about this as to not see a Dr or dentist seems like an issue in and of itself. Talking about the sensitivity with someone might be the first step in being able to deal with the weight issue.
Hilarious.
With a 100° fever, you’re not going to the doctor, because you are just dead.
100F I’m assuming
Bro, what?
Wow you are very clever.
It’s also pertinent to certain medication dosing regimens which are weight based, but I’m sure most people just get triggered with their self-esteem issues when they step on the scale so they assume it’s for the doctor to poke fun at them for being fat.
Yes, there are medical reasons to step on a scale.
And if someone has had an eating disorder, stepping on a scale and being told to lose weight is the opposite of good medical practice.
Thanks doc
Science has finally discovered what people have known forever: exercise doesn’t release dopamine in all people.
Trouble swallowing? Just take these pills every four hours for two weeks and you’ll be cured!
That’s Parkinson’s for ya. Except the pills are forever.
I see the exhaustion with my wife, because she doesn’t move around. It feeds on itself. “I’m too tired to walk a mile.” Then you will always be too tired to walk a mile.
So few of us get exercise that my doc is happy when I answer “several” to, “How many times a week do you get your heart rate up?” And I’m not talking about “real” exercise, just simple shit like dragging my kayak in and out the swamp, or paddling like mad to get out the sun, or lifting heavy stuff working around the yard.
My little kids screamed while hiking when I told them the creek was 1.2 miles. “A MILE!?” When I was their age we started gym class with a mile jog and then did other stuff. (Two months later they could make that trip with no pain or fatigue.)
As with my comment above on obesity, I can’t blame docs for wanting to eliminate obvious issues. If my windshield is filthy and I’m complaining to the mechanic about my dim headlights, he’s going to start with the obvious. Cleaning the windshield won’t fix the headlights, but it will help and allow him to focus on troubleshooting further. (OK, that’s kinda sloppy but you get the idea.)
Your wife might be anemic, it often goes undiagnosed in women.
Good idea! She eats loads of rice, not much if any iron. Going to ask her. I have iron pills we can try as well. One other thing, we cook in cast iron almost exclusively, so that should cover iron intake?
But anyway, I’ve been so low on blood (bleeding hemeroids) that they damned near did a transfusion on me, still had plenty of energy.
Fellow h-bleeder here, they had to give me iron infusions. I was exhausted and noticed hearing my pulse in my ears because my heart was working overtime trying to oxygenate me
They can bleed that much‽ Mine just ache sometimes and bleed a tiny bit if I don’t use a bidet or eat enough fiber
It varies, between people and in my case over time. I got mine injected and was “cured” for a few years but it eventually flared up again. I should go again but my situation doesn’t allow for it right now. Metamucil helps more than anything else.
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Well, not every condition, but see my comment above as to what I’ve observed in life.