Insensitive Drs at Childrens (overweight child)

[Anonymous]

I know this may not be a "special needs" issue exactly but I need to share.
My DD is 16 and she was admitted to children's hospital in DC. she has no special needs per se. She is overweight, but in the 4 months prior to being admitted she lost 35 lbs. At the hospital it was a constant struggle. she weighs 230, and she is 5'4. The doctors were the most insensitvie people i have ever encountered. she was in the hospital for a head injury but they made no hesistation to send in the nutrtionist and some other doctors to tell her that she was overweight. meanwhile we are waiting 2 days to get seen by the actual neurologist. DD has great eating skills and makes sure to exercise at least 4 times a week, which is how she lost the weight. But i feel like the way she was treated at childrens was obnoxious. they even went as far as to but on the discharge form under how her stomach felt (when they do the physical exam) "soft obese belly". really? WTF. before she had an MRI they came in at 4 am to "measure her to make sure she could fit in the machine". again really? she is a size 14, 38-36-45 so yes while she is plus sized, she is not HUGE. she is in high school and does not get treated even half as rudely by other teenagers. She has a wonderful personality and actually has a nice body "shape" and is beautiful (not just me as her mother, but everyone tells her that even school friends). what makes this whole thing worse is that she is 16 years old and understands that she is "fat" and is working on that. Have any other kids been treated insensitively at children's?

please do not flame me for this, i guess i just felt the need to vent.

[Anonymous]

That really sucks.

Regarding the MRI machine, since it was a Childrens, is the problem perhaps that they have a child sized machine? I know that some medical equipment is sized differently in childrens hospitals, and since your daughter is clearly an adult size, the machines might not have worked for her.

What made me think of this is because when my mom had heart surgery, they had to borrow some equipment like needles from the children's equipment (she was a very petite asian with tiny veins). Perhaps someone with a medical background can chime in?

Regardless, they should have handled it with more sensitivity. I am sorry

[Anonymous]

OP - I'm an emergency room RN so let me try to give my professional opinion on this, before I give my personal.

The nutritionist could be part of the hospital's protocol. I worked very briefly at a childrens' hospital and it was their protocol that any child who was admitted and was over a certain BMI had an automatic consult with a nutritionist. It was just their standard protocol and was always out of my hands, but was their way of trying to deal with childhood obesity and risks for diabetes. I would have gotten in trouble if I did not alert the nutritionist. **PERSONAL OPINION** I understand the point of it in theory. But honestly, it created more issues than helped. Now, if I had a patient with abnormal lab results that indicated their weight was causing a problem, I understand. But for something like a broken arm, it seemed a bit ridiculous. The kid and family already have enough going on.


"soft obese belly". As part of my physical assessment, I have to note if a stomach is hard, soft, distended, etc. Soft doesn't necessarily mean fat, it just means it isn't hard to the touch. I've had skin and bones patients who I document as having a soft belly. Having said that, I have NO idea why they would document obese. Some doctors and nurses document patients as obese in their write ups, I usually just include height, weight, and BMI. I can't recall ever seeing a documentation of "soft, obese, belly". Sorry about that OP, some doctors/nurses are a little more callous with their labeling.

As for the measurements, I have to agree with 21:06. They likely had different machines and wanted to make sure they right one was used for your daughter's measurements. It would have been nice if they explained this to you, especially since it was 4am and no one enjoys being woken up for something they think is unnecessary.

OP, it sounds like you might have gotten a group of very clinical nurses and doctors. Some of this stuff may have been necessary (the nutritionist consult, documentation of soft belly, and measurements). That said, I really do think that the nurse or someone should have explained WHY this stuff was being done and the fact that they didn't makes your frustrations totally valid. Sorry you had that experience OP. I was about your daughter's size as a teen and can remember being treated like crap by one doctor at my ped's office. He actually left me in tears. Some doctor's have really shitty bedside manner!!

But thank you for your post OP. It reminds me that even though I know why I do everything, I have to always remember to explain to my patients what I'm doing and why.

[Anonymous]

Yes, she was in there for a head injury. But she also presented with a weight problem. It's not okay for a 16 year old to be 5'4" and weigh 230 (or 265) lbs. That is unhealthy. Her Body Mass Index is almost 40. Anything over 30 is obesity. Medical staff addressing this issue aren't being rude. They're doing their job.

You sound super defensive. Yes, your daughter has done a great job losing the 35 pounds. She still has work to do. Hopefully there's been some thought given as to what might have contributed to her being so overweight, ie stress, lonliness, poor self-image. Addressing the underlying emotions around overeating are just as important as eating healthy and exercising. Continue to focus your energy on supporting your daughter and her good eating habits.

[Anonymous]

Anonymous wrote:Yes, she was in there for a head injury. But she also presented with a weight problem. It's not okay for a 16 year old to be 5'4" and weigh 230 (or 265) lbs. That is unhealthy. Her Body Mass Index is almost 40. Anything over 30 is obesity. Medical staff addressing this issue aren't being rude. They're doing their job.

You sound super defensive. Yes, your daughter has done a great job losing the 35 pounds. She still has work to do. Hopefully there's been some thought given as to what might have contributed to her being so overweight, ie stress, lonliness, poor self-image. Addressing the underlying emotions around overeating are just as important as eating healthy and exercising. Continue to focus your energy on supporting your daughter and her good eating habits.

RN who posted above you here. Yes, it is a weight issue and I'm sure OP and her daughter know that her weight is unhealthy. That said, she was hospitalized for a head injury. I don't think any type of consult done with a nutritionist is really going to stick, as I'm sure OP and her daughter were thinking about more serious issues at the time. I think it would have been fine to write in their discharge summary that she should see a nutritionist. Or even provided them with the information of a nutritionist at the hospital.

I am no longer overweight, but keeping my weight in the normal range is something I will always struggle with. I have an extremely low metabolism and it takes a lot of work to stay within a normal weight range. While I do think that obesity, especially in children and teens, is a problem in our country, I think some medical professionals take it to extreme levels. I have a friend who was having some health issues and was told by 2 different doctors it was caused by her weight. She felt fairly humiliated and did not seek another opinion. She lost weight and began a pretty aggressive exercise routine, yet her problems persisted. She finally saw a 3rd doctor who diagnosed her with a problem that had ZERO to do with her weight, and was not even exacerbated by her weight. While she was able to treat the issue, she has long lasting effects because it took so long to treat.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Yes, she was in there for a head injury. But she also presented with a weight problem. It's not okay for a 16 year old to be 5'4" and weigh 230 (or 265) lbs. That is unhealthy. Her Body Mass Index is almost 40. Anything over 30 is obesity. Medical staff addressing this issue aren't being rude. They're doing their job.

You sound super defensive. Yes, your daughter has done a great job losing the 35 pounds. She still has work to do. Hopefully there's been some thought given as to what might have contributed to her being so overweight, ie stress, lonliness, poor self-image. Addressing the underlying emotions around overeating are just as important as eating healthy and exercising. Continue to focus your energy on supporting your daughter and her good eating habits.

RN who posted above you here. Yes, it is a weight issue and I'm sure OP and her daughter know that her weight is unhealthy. That said, she was hospitalized for a head injury. I don't think any type of consult done with a nutritionist is really going to stick, as I'm sure OP and her daughter were thinking about more serious issues at the time. I think it would have been fine to write in their discharge summary that she should see a nutritionist. Or even provided them with the information of a nutritionist at the hospital.

I am no longer overweight, but keeping my weight in the normal range is something I will always struggle with. I have an extremely low metabolism and it takes a lot of work to stay within a normal weight range. While I do think that obesity, especially in children and teens, is a problem in our country, I think some medical professionals take it to extreme levels. I have a friend who was having some health issues and was told by 2 different doctors it was caused by her weight. She felt fairly humiliated and did not seek another opinion. She lost weight and began a pretty aggressive exercise routine, yet her problems persisted. She finally saw a 3rd doctor who diagnosed her with a problem that had ZERO to do with her weight, and was not even exacerbated by her weight. While she was able to treat the issue, she has long lasting effects because it took so long to treat.

thanks so much nurse anonymous!! (not being snarky... i just dont know your name)
im the OP btw. but my DD does not like going to the Dr's because of other doctors who have flat out said that she was fat. this was at kaiser. and i think that it is bullying. in fact it is more than not liking to go to the dr, but she had to go to the dr for a throat infection and the dr (also at kaiser p) was telling her how this could have been caused as a result of her being overweight. she had strep. i am worried that once she goes out into the world (college!!) she will be so worried about getting treated like shit that she will avoid all doctors. even though she wants to be a nurse. (which isnt too far from what i have seen lol because i have friends who are nurses, who havent had a check up in 13 years)

[Anonymous]

Anonymous wrote:, your daughter has done a great job losing the 35 pounds. She still has work to do.

you sound like a complete asshole. (im not op)

[Anonymous]

OP, anonymous nurse here! You have a totally valid reason to be concerned. I hated going to the doctor while I was struggling with my weight because I always left feeling worse about myself. Go in because I twisted my ankle at practice? Get told if I lost weight I wouldn't be putting so much stress on my body. Yes, because when I fell in a ditch and jerked my ankle around, that was totally caused by the extra 20 pounds I'm carrying. Even in college I hated the Dr. Because I felt like I'd be judged the second I stepped on the scale. It definitely impacted my seeing a doctor when I needed to.

Is your daughter close to 17? If she is more adult than child,I'd recommend getting her out of pediatrics. I had a much easier time when I made the switch at 21, although at that point I was only borderline overweight.

And yes, nurses can be the worst patients. I drive DH insane when I self diagnosis instead of going to a doctor!

[Anonymous]

Anonymous wrote:OP, anonymous nurse here! You have a totally valid reason to be concerned. I hated going to the doctor while I was struggling with my weight because I always left feeling worse about myself. Go in because I twisted my ankle at practice? Get told if I lost weight I wouldn't be putting so much stress on my body. Yes, because when I fell in a ditch and jerked my ankle around, that was totally caused by the extra 20 pounds I'm carrying. Even in college I hated the Dr. Because I felt like I'd be judged the second I stepped on the scale. It definitely impacted my seeing a doctor when I needed to.

Is your daughter close to 17? If she is more adult than child,I'd recommend getting her out of pediatrics. I had a much easier time when I made the switch at 21, although at that point I was only borderline overweight.

And yes, nurses can be the worst patients. I drive DH insane when I self diagnosis instead of going to a doctor!

you are the best! im so happy that there is someone on this board who is not crazy/judgmental/ otherwise obnoxious she is going to be 17 in march? how do i get her out of peds?

[Anonymous]

When I was 8, I had a sick visit with a ped at my office who was not my normal one. My mother stepped out of the room to grab something, and the doctor called me tubby. I didn't tell my mom for about a year until they had me see him at another sick visit and I started crying and told my mom what had happened before. Asshole , calling an 8 year old tubby.

[Anonymous]

Anonymous wrote:When I was 8, I had a sick visit with a ped at my office who was not my normal one. My mother stepped out of the room to grab something, and the doctor called me tubby. I didn't tell my mom for about a year until they had me see him at another sick visit and I started crying and told my mom what had happened before. Asshole , calling an 8 year old tubby.

doctors need to learn some fing manners

[Anonymous]

Anonymous wrote:Yes, she was in there for a head injury. But she also presented with a weight problem. It's not okay for a 16 year old to be 5'4" and weigh 230 (or 265) lbs. That is unhealthy. Her Body Mass Index is almost 40. Anything over 30 is obesity. Medical staff addressing this issue aren't being rude. They're doing their job.

You sound super defensive. Yes, your daughter has done a great job losing the 35 pounds. She still has work to do. Hopefully there's been some thought given as to what might have contributed to her being so overweight, ie stress, lonliness, poor self-image. Addressing the underlying emotions around overeating are just as important as eating healthy and exercising. Continue to focus your energy on supporting your daughter and her good eating habits.

Way out of line. OP's DD is clearly doing what she should be doing, she's lost 35 pounds. The last thing this family needs is a lecture from you. She did not present with a weight problem. Nice to dress up your point with the lingo, but you are just wrong. If I was hospitalized for a head injury, would I also present as nearsighted? Totally irrelevant. Show some compassion.

[Anonymous]

Anonymous wrote:OP, anonymous nurse here! You have a totally valid reason to be concerned. I hated going to the doctor while I was struggling with my weight because I always left feeling worse about myself. Go in because I twisted my ankle at practice? Get told if I lost weight I wouldn't be putting so much stress on my body. Yes, because when I fell in a ditch and jerked my ankle around, that was totally caused by the extra 20 pounds I'm carrying. Even in college I hated the Dr. Because I felt like I'd be judged the second I stepped on the scale. It definitely impacted my seeing a doctor when I needed to.

Is your daughter close to 17? If she is more adult than child,I'd recommend getting her out of pediatrics. I had a much easier time when I made the switch at 21, although at that point I was only borderline overweight.

And yes, nurses can be the worst patients. I drive DH insane when I self diagnosis instead of going to a doctor!

OP - you are in denial of how bad the situation is.

Your DD is fat. The doctors aren't lying and can't make her feel "fat" because she just is. It's a fact not an emotional or value judgement.

You said she isn't huge. Compared to someone who might be 400 lbs you are right she would look fine but compared to someone of normal size she is huge. The top weight to be in the normal range for someone 5'4 is 145. I once weighed more than your DD. I feel for her but one way I kept getting bigger was not facing the reality of how truly big I had become. Also a size 14??? Come on I did that too. You have one item of clothing in that size that is all stretched out and fits so you convince yourself that is still your size making it easier to avoid reality.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP, anonymous nurse here! You have a totally valid reason to be concerned. I hated going to the doctor while I was struggling with my weight because I always left feeling worse about myself. Go in because I twisted my ankle at practice? Get told if I lost weight I wouldn't be putting so much stress on my body. Yes, because when I fell in a ditch and jerked my ankle around, that was totally caused by the extra 20 pounds I'm carrying. Even in college I hated the Dr. Because I felt like I'd be judged the second I stepped on the scale. It definitely impacted my seeing a doctor when I needed to.

Is your daughter close to 17? If she is more adult than child,I'd recommend getting her out of pediatrics. I had a much easier time when I made the switch at 21, although at that point I was only borderline overweight.

And yes, nurses can be the worst patients. I drive DH insane when I self diagnosis instead of going to a doctor!

OP - you are in denial of how bad the situation is.

Your DD is fat. The doctors aren't lying and can't make her feel "fat" because she just is. It's a fact not an emotional or value judgement.

You said she isn't huge. Compared to someone who might be 400 lbs you are right she would look fine but compared to someone of normal size she is huge. The top weight to be in the normal range for someone 5'4 is 145. I once weighed more than your DD. I feel for her but one way I kept getting bigger was not facing the reality of how truly big I had become. Also a size 14??? Come on I did that too. You have one item of clothing in that size that is all stretched out and fits so you convince yourself that is still your size making it easier to avoid reality.

so since she is already doing all things necessary to fix herself... why is it needed to pull her down? what is wrong with you?

[Anonymous]

Nurse again! I don't live in the DC area so can't help with practices. Do you have a PCP? I would start there and find out what age they start taking new patients. Some will say 16, others will be 17 or 18. If they start taking patients at 16, see if you can set up her yearly physical there and then get her medical records. I'd say that is your best bet or, if your nurse friends are in your area, see if they know of any good places.

To be honest (and don't tell my patients this!) I have not been to my PCP in years. I go to my OB regularly, but for vaccines and other small issues, I use the minute clinic. If I think I have an issue that might require a scan or invasive test of some sort, I go to urgent care. The whole song and dance with a PCP just wasn't worth it.

Btw...congrats to your daughter on her weight loss so far. That's fantastic! And I hope her head injury was nothing serious.