Thursday, March 30, 2006

Diversity: Make it Work for You!

One of the things I love about living in a diverse area is that said diversity is taken into account. I think I get better treatment in a number of ways because of it.

Case in point: I’ve been having painful menstrual cycles since day one. I couldn’t go to the ticker tape (actually office paper) parade the first time the Twins won the World Series because I was curled up around a pillow on my living room floor attempting to figure out how many acetaminophen I could take at once without pissing out my liver. As it turned out, quite a few.

Now, I had told my various doctors about this, and they basically paraphrased the Bible at me. “Almost all women have some sort of pain with their periods/childbirth/existence. Take some aspirin. There’s nothing wrong with you.” Of course, they never bothered to check if there was anything actually wrong with me.

I’ve spent years thinking I’m fat, because even though I’ve managed to get my weight down as far as 118, the dimensions of my stomach never changed. I believed I had no will power, that my “fatness” was my fault.

So when my nurse practitioner said I was just “fat,” I didn’t even react very much (Luckily for me, other people reacted quite strenuously. Thank you, Baby!). I was used to being called fat, and had pretty much given up on all pretenses toward American-style attractiveness anyway. I couldn’t change the brown or the short or the gay, and damn it, I couldn’t even be thin! However, I knew enough medical terminology to weasel a single test out of her.

When I went into a dark room with the ultrasound tech, I had no idea how much my change in community makeup was going to change my life. Because I now live in a place where 30% of the population is black, the diseases that affect black people are now on the radar. In Minnesota, where about 12% of the population is black, that’s too small a proportion (as far as I could tell) to pay attention to, so everyone gets treated according to the Caucasian model and assumptions. Unfortunately, if you’re one of the 12% it means sub-standard care.

The tech showed me my kidneys, which she imaged and measured because the black population has a higher incidence of kidney disease/failure, etc. Kidneys themselves really do resemble the beans, or vice versa. Mine looked exactly like the images of normal kidneys I’d seen in various medical journals.

She had to do some digging to find my ovaries. I wasn’t sure whether we were prospecting for organs or petroleum for a minute there. It wasn’t particularly painful, however, just pressure in odd directions bordering on “really uncomfortable”. I’d been worried about cysts, so getting a chance to look at them and confirm that they looked fine was reassuring.

When my uterus swam onto the screen, it was not so fine. The tech had to tell me what I was looking at. I’ve known what the female reproductive system should look like since I was four, so not recognizing my own was a little alarming.

The tech said, “Oh look, you’ve got fibroids. A lot of black women have fibroids. I see it all the time. This one is seven centimeters. That’s fairly good sized, you know.” In fact, there was one on each side, obscuring my ovaries from the sound waves, as well as my Nurse Practitioner.’s ham hands.

The tech was musing to herself, “Yeah that’s about the equivalent of a five month pregnancy.”

Say WHAT!?! You mean the reason I need to rebuild the front of my bike because I can’t breathe and lean over far enough to reach the handlebars isn’t because I lack self-control? My beer gut is not the result of beer? (Not for lack of trying.) I realized this winter that I’m even avoiding snowboarding because I can’t reach the binding latches behind my ankles and breathe at the same time (While naked I can reach just fine, but it’s just a little too… “invigorating” to snowboard naked). I’ve been preoccupied with losing weight for about three years now, and finding out I’ve been wasting my time gauging by my stomach size is both wonderful and infuriating.

My head nearly exploded with all the restructuring I have to do around my self esteem. I’m still overweight, but I’m not THAT overweight. The fact that my waist measurement and my inseam are the same is a ratio I now may be able to change, for the better. I haven’t believed that for at least fifteen years.

Change. Now, that’s a conundrum isn’t it. I am generally not in favor of having someone rummaging ‘round my innards with sharp steel objects. It just seems like not such a great idea. I’ll watch it on the Discovery Channel. I’ll even study to do it myself, but I have never wanted to be the subject. Then I saw those fibroids.

In about five minutes, I went from “I don’t want to have surgery” to “wheel me into the OR now. I’ll inflate my abdomen myself! Gimme that trocar! Somebody bring me a sterile bicycle pump, stat!”

Things don’t happen quite that quickly, unfortunately. I have an appointment with yet another nurse practitioner in two weeks, and I’ll probably have to say “all the right things” again in order to get anything further done. However, I finally believe something can be done. That’s no small victory.

So, thank you to last week’s NP for reminding me how the lack of diversity can adversely affect care, and a huge thank you to the tech who did my ultrasound for treating me like an intelligent human being with an actual medical problem. It is unfortunate that it took fifteen years to get me to her, but at least I finally got there.


Anonymous Buzz said...

Nekkid snowboarding! Now, that's a sight that just might be worth abandoning my cocoa and book by the warm fire and stepping outside to go watch! *eg* Heck, toss my cocoa in a to-go mug and boxer-shorted snowboarding might get me outta the lodge. I wonder if I can pimp my walker with snowtires?

- buzz
(too late to look up my blogger id)

12:45 AM  

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