BP is borderline. Not perfect but it's always higher sitting in the office after the 15 minute drive in morning traffic, navigating the parking lot that's often clogged with people waiting for the spot nearest the door to open up because God forbid they should have to walk 10 feet. They're usually still sitting there with the engine running after I find a spot and walk the 50 yards to the door.
Next comes check-in, paper work (all the legal mumbo jumbo no one ever reads) and the dreaded weigh in - always fun, especially with a full bladder.
The assistant comes in to take my BP reading, collect my updated paper work and says the doctor will be right in and she is. She's usually prompt and always smiling.
Not surprisingly, my BP is a tad high but nothing to be alarmed about. White Coat Syndrome, I think they call it.
She asks about my winter in Florida, how the wrist I broke in September was healing, exercise goals, blah, blah, blah.
We discuss my lack of exercise. She asks if I walk when I play golf.
"Not in the 98 degree heat", I reply. She laughs.
She asks if I've thought about swimming. Great exercise, non-impact. Won't hurt the knees.
I say, "Sure, but you have to get into a bathing suit to do that, right?"
At this point, I'm convinced she has absolutely no idea who I am or what a self-depracating sense of humor is because she immediately and quite sincerely asks if I have "Body Image Issues" and if I would like to see a counselor to deal with them.
"Oh hell no!" I replied. "I don't know many 63 year old post menopausal mothers of three who actually like squeezing into a bathing suit and flaunting their cellulite riddled bodies around a public pool."
Now in all fairness, this small boned woman, late thirties I'm guessing, about 5'3", 100 lbs. max, zero body fat, probably can't relate to the issues I'm dealing with at 63. She's obviously swimming in a different gene pool.
As a family practitioner, her practice includes prenatal care and delivery, infants, children, adolescents (Aha! Body Image Issues) and adults.
I divulge I'm often tired and try to catch a 15 minute power nap in the afternoon if I can.
I tell her about my aching knees (a problem for years) ankles, left shoulder. All things my peers, even the skinny ones, complain of too.
She suggests a metabolic panel to check my thyroid, hormone and vitamin B and D levels.
She asks me to fast before the blood draw and return in two weeks with BP readings taken at home.
Now, for the duration of this appointment, she's also typing like madwoman on her computer, explicit details of our conversation.
This, in the medical profession is called, CYA. (Cover Your Ass for those reading who were born yesterday)
As we say our goodbyes and I walk to the elevator (No, I didn't walk up or down four flights of stairs!)
I start reading her printed report, detailing our visit, diagnoses and patient plan.
It's thorough and details everything we discussed although she paraphrased my comments about getting into a bathing suit. She was sure to include that I chose to wait on increasing my BP meds and nixed the suggestion of counseling for my Body Image Issues.
And then I noticed that in her Assessment/Plan, item #1 was a Diagnosis of "Obesity," followed by a code number.
During my physical last fall she said she wasn't worried so much about weight as long as all my other vitals and tests (Triglycerides) were good, and they were. Overall, I'm extraordinarily healthy and always have been.
I've never been in denial that I'm overweight but I've also never eaten more healthy than I do now.
I've also never been skinny, lean or small boned.
At 63 I've accepted the fact that I'll never look 25 again.
But obese?
By whose standards? Eileen Ford?
Some standardized chart, put out there by medical professionals who do not take into account age, body type, injuries, pregnancies, family history and numerous other factors says I'm obese? I guess it's based on a height to weight ratio.
I joke with the sweet medical assistant who happens to be built like a defensive lineman, that something like that may be enough to put another person on suicide watch but not me, I just bought a lot of new clothes!
I make sure she understands I really am joking, lest she inform the doctor she should try again to push counseling for body image issues.
I like my doctor. I do. I think she's competent and sincere.
But I think it may be time to search for one with a better understanding of age related issues; one who is less concerned with documenting every word exchanged lest a claim of medical malpractice be filed down the road. To be sure, I do understand the need for accurate records should something arise in the future but I've decided this CYA mentality gets in the way of a doctor-patient relationship.
And I blame the insurance companies and legal profession for ruining American healthcare.
