Self presentation and medical care

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nogutsnoglory

nogutsnoglory

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I'm curious to start a discussion on people's thoughts on our presentation and it's potential impact on the care we receive by doctors and nurses?

Do you think a healthier looking person may get better care because the staff feels they have a fighting chance and sympathize more or is it the very sickly person who will get better care because they need it more in the eyes of medical staff?

Obviously we all should be treated fairly but humans are flawed. Maybe we need to go to a tanning salon and get a nice haircut before our next hospital visit lol.
 
In my personal experience, the sicker you look, the more seriously doctors (at least my doctor) takes you. Case in point - my husband had kidney stones a couple years ago. They were impacted and horrifically painful and he had to have a surgical procedure where they stick a tiny scope up there and blast the stones out with a laser. Hubby was not doing well at all after the procedure in the recovery area. He was peeing pure blood, he was crying in pain, his face was pale, he just looked terrible.

The recovery area for the kidney stone people was lumped together with the recovery area for the colonoscopy people - as a result, my GI walked past and saw us. One glance at my hubby, and my GI was like, "Is he okay?" in a very concerned way. Hubby ended up being fine, but to this day my GI still asks about hubby and how he's doing, just because my GI saw hubby look so terrible that one time several years ago. Based on stuff that, I think if you look really sick and you have a compassionate doctor, you're likely to get better treatment than if you show up looking healthy with weight on your bones and color in your cheeks.

And on that subject, I've maintained my weight and my face hasn't gone super pale lately, even though for the past year or so I've been in a mild flare. Because I still look okay, my GI was very hesitant to put me back on Entocort (I had to basically cry and beg for it) - he essentially suggested that maybe my recent symptoms were due to IBS and not IBD because I still appeared on the outside to be fine. Well, I got my Entocort after much pleading and I'm doing better now - back when I was quite pale and skinny, he was much more keen to give me corticosteroids. So again, I think that looking fine translates into many people's understanding as being that you are in fact fine on the inside too, and that's not always the case.
 
That makes sense and in many ways I think that's true. Just because we look fine doesn't mean we feel fine but it can be misinterpreted that way. I guess I'm just thinking along the lines of how one could think someone is so sick they stand no chance and would rather invest more time into a younger, healthier person based on the fact that they can put them back together.

Maybe it depends on the staff too in how they see us.
 
I hear what you're saying. I think most doctors seem to like a challenge, though - the sicker you are, the more prestige they get when they get you to be (relatively) well again. My primary care doc told me that, in my fight for a diagnosis, I have to remain interesting to my other doctors so that they'll continue to care about my case. He kept using that word, "interesting." If you're not very sickly then you're not interesting, I presume. The sicker you are, the weirder symptoms that you have, the more puzzling of a case you are, the more interesting of a patient you are and the more attention you attract from your doctors? Therefore, I would assume that if you look sickly then that makes you more interesting to doctors than if you waltz into the ER looking fit and fab? I'm not a doctor so I'm just trying to guess at what my primary care doc means by "interesting."
 
I like to credit this mostly to my age (19 when diagnosed; 21 when I landed myself back in the hospital last summer) but I remember always having the loveliest nurses when I was hospitalized. They were always so incredibly kind to me, and I think they babied me a bit because at the time, I was the youngest person in the ward. At the time it was really... nice, very comforting.

I can't say I've exactly dressed up to see my doctors ever, but maybe I should to try and see if I'm treated a bit differently.

I can say that looking incredibly sick did get me to somehow skip the waiting room when I thought I'd be waiting there for hours in emerg, though. :p
 
I can relate to points you both made as I have had my case called "interesting" buy it was in relation to disease manifestation and aggressiveness and not the way I looked. In some ways I think you are right that they like"interesting" Cases because they look at us like lab rats and they want to learn more and possibly write about us in a study for prestige.

I have also bypassed waiting or got my doctor on the phone quickly when staff knew how bad things were for me. I guess so far your points make sense and looking crappy is more likely to get us better care. Of course when you really feel like crap you can't fake it anyway but I sometimes think I look better than I feel and they don't know how bad things are.
 
In my experience, my age has caused me to be on the receiving end of bad care. Because I am young, and a healthy-appearing female, I have gotten the "you're just a drug seeker" card A LOT. It's sad that once I had to leave the pediatric specialists, all of the sudden I was treated like a drug seeking, crazy young person--even though I have clinical diagnoses on my medical chart. I think that age has a lot to do with treatment. I actually had a really hard time getting an initial diagnoses for Crohn's because I was a teenager. And I guess teenagers can't possibly be sick, they are really just looking for attention??!!!

During my last hospitalization about a month ago, I actually had a NP tell me that I "did not want to have fibromyalgia" as if I could chose whether I had it or not. She also told me that they wouldn't give me any extra zofran refills because I "could not possibly need to take them everyday". Apparently that's not humanly possible. Thankfully, my mom was with me to help support me, but that was a really unpleasant experience.

I guess what I'm trying to say is that because I am young, doctors don't always give me the care that I should get. I often get turned away because I must be making my symptoms up, there's no way I could really be sick at my age (20).
 
I find that my being young is more problematic when I encounter people outside of the medical field. I've always had my problems dismissed by people because I'm "too young to have that", and even after diagnosis my own mother still had difficulty understanding I wasn't just faking illness to get out of things.

Even now she still gets upset I take as much medication as I do, even though it's necessary. But it's because she's never had to take medication for something in her life, and doesn't understand what it's like to be sick.
 
Yeah I get dismissed a lot by friends who think because I'm a young guy I am probably just making stuff up or looking for attention. I wish it was true haha, 90% of the time I try not to disclose my health stuff. Medical staff doesn't treat me different due to my age. If anything i think care is better for young ppl.
 
Yep. I think the worst, though, is being told that you just "don't want to get better" by people who don't understand it. I'd gladly get better if I could!
 
Yeah, I also think patients who look sicker get better care or at least are taken more seriously!

When I was first getting tested for celiac, I was 15 and there were no ped GIs in the area, so I saw a regular adult GI. He told me I didn't want to have it because I wouldn't be able to eat anything. And that I just had heartburn. Apparently daily diarrhea, weight loss, b12 deficiency, stunted growth, and anemia are all symptoms of heart burn. :p

Mostly though the nurses are very sympathetic and nice. I had to get a colonoscopy on my 18th birthday, and they were super nice about it.

In high school a bunch of people thought I was anorexic. This was before gluten free became trendy and no one knew what it was. I think they thought I made it up.
 
I think the sicker you look the more doctors pay attention to your complaints. That said, I try not to let my husband know how bad I feel because he is a worrier. Then when I do complain he doesn't take it as serious because I " haven't been complaining!" Go figure.

This is such an aweful disease. It's all on the inside and not until people see you run to the bathroom or lay around in pain do they take notice.

I have been hearing " IBS" for 20 years. Only now it " might be Crohn's". I really hate this disease.
 
I've had a mixture of both good and bad care due to my age.. I've had a lot of GPs fob me off with 'its just hormones ' or 'you'll grow out of it ' because I'm young and they think I don't know anything about health care.

Alternatively, I've had nurses (and other patients) be very sympathetic to me when I get admitted to hospital, I'm usually the youngest there and hospital beds make me look tiny ( I apparently have a very young face) . Last time I was in I had to have nebulizers, and that attracted a lot of sympathy from other patients too.

I've also had some GPs want to push the extra mile because I'm young and want to go off to uni. Some of the not so good ones soon change their attitude when they find out I did health care at college and will be doing nursing in university . So your profession also has an impact.
 
Nurses have always treated me better because I am young. Doctors...not so much. Except for my Colorectal Surgeon. She believed me since day one, diagnosed me, saved my life, and always trusts me when I tell her that something is wrong. Thank God for her.
 
I will say that unfortunately, if you have a disease that is not visible from the outside, doctors are not apt to take you too seriously. Most chronic illnesses are not readily accepted, even by doctors due to them not knowing much about them. When I was at my sickest, I remember having a doctor tell me, you look great so you cant be too sick! I have seen well over 50 doctors since getting chronically ill 10 years ago with many things. I can say out of all of them, maybe 5 ended up being what I would classify as "good doctors". To me the definition of a good doctor is one that A) has an open mind B) listens to you C) is willing to work with you D) has a good bed side manner E) is willing to admit when they just don't know and have the sense to refer you to someone who may be able to help. Not many of them out there though unfortunately..
 
I find this does happen. On the day I was diagnosed via colonoscopy I came in looking horrid from all the prep and constant pain. There was lots of sympathy going on. After a couple months on pred I looked better and was told so, at the time I did feel better. After 2 months of Imuran I went to an appt wearing makeup as it was after school, my doc said I was looking much better even though I felt the same as 2 months prior. Even docs falls prey to the looks= feels equation sometimes.
 
When I was 16, the surgeon who had taken out my appendixthe week before (nothing wrong with it, no diagnosis, no explanation for months of weight loss, sleeping 14 hours a day, constant abdominal pain, abdominal mass etc) told me that he wouldn't admit me to hospital at 10am because I didn't look sick and it was in my mind. My parents persisted and I was admitted. Then he didn't want to order bloods because they were a waste of time and I was fine. The nurses persisted, and bloods were done around 3pm. By 7pm my temperature was 40 deg C, but he didn't want to come into the hospital because he didn't think it was serious (dinner party I believe).

The bloods came back in at 9pm, and he finally looked at them at the head nurses insistence (a lot of these conversations were happening on the phone in my room, so I knew what was going on), and at 9.30 he was in my room apologizing that he was sorry he hadn't believed I was sick, I "looked" far too well to have septicemia.

The guy almost killed me because he thought I looked well (despite my parents who know me best being incredibly concerned). Sometimes I wonder if I should put pale, green tinged makeup on when I'm seriously ill.

Ironically I had a totally unrelated "but you don't look sick enough" moment earlier this week with my suspicion I had something out of the ordinary - bit my doc ran the tests anyway with that "I'm sure you are fine, you don't look sick enough, but lets check anyway" to be rather surprised with a positive for dengue fever!
 
When I first got diagnosed I would actually get dressed up (nothing fancy but put on a bit of makeup and non-wrinkled clothes). I wanted my doctor to think that I was functional and not a crazy person!
 
I have definitely felt mistreated for being young. I find it hard to go to the ER or to fill prescriptions without my parents because anyone that doesn't know what I'm going through too well (like my specialist does) tends to fob me off thinking I'm too healthy looking to be visiting the ER or to be filling a prescription for painkillers.

Again, that young drug-user image comes to mind.
 
Well all of this is making me very nervous. My current GI is sending me to another Crohn's specialist for evaluation and treatment. How sick should I look?
 
I don't think you purposely need to look sick. Just be honest about things, and maybe don't bother with makeup if you normally do if you are worried about it. It's up to you.
 

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