The doctor stopped treatment with COVID-19 so that the patient did not gain weight: why so

Turning to the doctor, patients expect a professional approach and maximum return. But there are situations when standards imposed by society can lead to a doctor’s wrong decision about treatment. This situation faced the author of the blog for publication Huff Post.

Photo: Shutterstock

Next - from the first person.

A package of methylprednisolone is just a foil box of 21 small, acidic, white tablets. If someone asked me a few weeks ago what recipe would be the key to defeating pneumonia, I would not point out these steroids.

I became ill on March 10, on Tuesday. It wasn’t the kind of illness anyone was serious about - a disgusting dry cough at the end of winter. Yes, I saw several articles about some distant virus, but this happened on the West Coast, far abroad.

By Wednesday, I was almost sure that my temperature rose and my cough became more painful and noisy. I almost completely lost my sense of taste and was choking.

My husband went and bought the only flu medicine available at our local pharmacy, where there were no thermometers left on the shelves. While I was relaxing at home, I looked through emails and made decisions to cancel meetings, classes, and other plans.

By Thursday, I couldn't take more than a shallow breath. By Friday morning, it was difficult to eat without getting tired—without losing too much air to cope with the chewing. I finally got in line in a three-hour virtual waiting room to speak with a doctor through a telemedicine app. She diagnosed me with viral bronchitis in less than five minutes. I was quickly prescribed several medications to combat my worsening respiratory symptoms.

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I recently turned 29 without any diagnoses for a high risk of serious symptoms, but even with medications, pneumonia developed in less than two days. I decided on an x-ray and additional testing, which was sent to a remote doctor. She decided that I should monitor more regularly during self-isolation, and continued treatment as presumably positive for COVID-19, a disease caused by coronavirus.

By the last day of taking steroids, improvements were obvious, but progress was short-lived. The steroid course ended on the morning of the 18th, and after 24 hours the symptoms began to regress. The mucus in my chest became darker and thicker again, and the inflammation made me suffocate again and again. My chest rattled on each exhale, and my breathing was almost the same as before I applied for treatment.

Since I did not have time for a scheduled registration with the same doctor, I had to wait in another virtual line to talk with someone who was available if I wanted to avoid the emergency service.

After a few hours, I finally contacted the doctor who checked my medical history. She told me that she had looked through notes and records of previous visits, and then asked about my vital organs (they can be tracked using the app) before finding out the reason for my visit. I explained that the symptoms began to deteriorate rapidly, but she did not pay attention to my complaints.

Then I decided to ask directly: “Can you extend my steroid prescription for another week? I think that was the key to helping heal to the end. ” She immediately shook her head and said: "I do not recommend it, because this medicine can lead to weight gain."

I asked again. She refused, moving the conversation to the steps that I could take to limit the spread: hand washing rituals, daily disinfection procedures, social distance.

When the reception was over, I felt abandoned, furious and confused. While my mother and husband decided whether I should find another doctor, I began to investigate the relationship of viral pneumonia, steroids and weight.

I didn’t even find concerns about weight gain with short-term steroid use, but I would not care if I did. I knew that this drug treats inflammation, that this steroid helps some patients with COVID-19 pneumonia recover faster. I posted on Facebook about my disappointment.

The comments were mostly supportive, with shocked and evil emoticons, words of solidarity. One mentioned malpractice; some noted that they now abandoned weighing for checks; some people told their stories about how healthcare providers and psychiatrists overweight when it was irrelevant and inappropriate. Another shared his fear that heavier people might not get access to ventilation devices during times of shortage because they would be misunderstood.

A few more friends joined in to play the devil's advocate, believing that there should be a reason for the doctor's comment. A relative explained that although this seems like a bad deed, the doctor may have worried about gaining weight, which in the future will affect health. For example, it provokes type 2 diabetes. The nurse mentioned that people with a body mass index (BMI) over 25 have worse outcomes and higher mortality rates, but a recent study claims that people who are overweight (with a BMI of 27) have the lowest risk of death .

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In addition, obese patients have better results in treating various diseases, including significantly lower mortality rates in the treatment of pneumonia, the disease that this doctor should have focused on.

Higher weight people receive lower quality care from their providers, including delays in access to treatment due to bias. This could be the cause of the worse results and concomitant illnesses that my friends worry about. During this pandemic, when healthcare providers decide whose symptoms are most urgent and serious, lack of access and reduced quality of care will cost lives.

Comments in defense of the doctor indicate an inner belief that being fat is bad, being fat is leading to other bad things. They point to subconscious patterns of thinking that identify erroneous decisions, such as excessive attention to future weight, and not recovery from a tangible virus. We need to stop justifying the obsession with the healthcare industry by weight — and that starts with fighting our own tendencies towards the same beliefs.

I did not include my weight in the vital organs associated with the application, so this doctor did not really know either this number or my BMI. She could see only my face on the screen. I suppose that perhaps she concluded about my weight based on the poor camera angle. But her statement was more like a reflex, without taking into account my own body or experience.

Since she could not really appreciate me with her own eyes or number, she made the assumption that any kilograms received would not suit anyone's benefit - regardless of their weight. At that moment, she projected a cultural ideal on my treatment - inspired confidence that it was better to keep my figure than to defeat life-threatening pneumonia.

If you are a patient whose treatment is stifled by a biased doctor, you should seek help elsewhere. But this is easier said than done. My call cost $ 50. And the second opinion will cost another $ 50, or a much more expensive trip to the emergency room. What will happen to those who do not have that kind of money? Or time?

Fatphobia (control over the lives of a certain group of people) will continue to negatively affect the quality of care that all people receive if doctors are distracted by weight standards or cultural ideals. During a global pandemic, when actual or virtual lines for medical care are wasting time and doctors are much more overworked than usual, we cannot postpone treatment due to bias.

This doctor did not allow me to protect my needs, although I was an informed patient. Her reluctance to expand on essential drugs during a pandemic demonstrates how widespread our cultural obsession with thinness has become.

It took me a few more hours to find a new doctor who was glad I contacted him and helped me find the right dosage to extend steroids for a few more days. My worst symptoms have disappeared, and I know that everything will be alright with me. I believe that these doctors will help me make a decision about my health based on saving my life, not my waist.

But this experience made it possible: if we want to overcome this pandemic, we must become fierce defenders of ourselves and not be afraid to challenge the existing state of things.

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