TLDR: I (30F) went for my annual physical and saw a PA at the practice and she repeatedly called me obese and I felt that she treated me not as an individual but as an obese person. How do I bring this up?

A little context: I am not, nor have I ever been thin. Nobody in my family, on both sides, are thin. The only time I have been a size 6 was when I was in the deep end of an eating disorder as a teen. I also do work in healthcare so I'm fairly well versed in a lot of health stuff, medical jargon, assessments and their validity etc. I am also aware that the subject pool for BMI was originally 19th century white European men, and the 1970's revamp of it also completely excluded women from the subject pool, so it is ultimately one of the most inaccurate tools to measure someone's health.

That being said- my BMI is in the obese category. I am very short and I would call myself plump but not necessarily obese, and to be honest I truly don't even care about the label because I know it's based off BMI which doesn't account for ~women~. I am active, at least 5 days a week with several different types of exercise and I focus on healthy whole food options. I literally did a 22 mile solo backpacking trip in the Rockies this summer and am an avid skier, hiker, and yogi, I really am not limited in my physical capabilities at all and have active healthy hobbies. My labs were perfect. I generally have little physical health concerns and have been addressing my mental health with appropriate providers, but recently (~3wks) have been having an episode of insomnia in the form of early waking. Again- this is only in the last month. The PA told me my BMI was in the obese category, fine, then used the large BP cuff because of my BMI despite my arm measurement falling nearly 3 inches under the lowest recommended arm circumference for the large cuff, told me that my obesity is likely causing my sleep problems, even though I've lost some weight and the sleep issues are very new, and then further told me that I need to pay attention to my obesity because in 30 years it'll cause "problems" without expanding on any actual concerns about my health and weight other than it being in the obese category. She included in her after visit summary, "30 year old well appearing female, obese and in no distress" as well as "order home sleep study, given obesity, per pt request" so not only did I have to request the sleep study, but she justified it with my weight rather than with my sleep issues.

My biggest concern is the lack of trauma informed care. Up to 20% of women have struggled with disordered eating. That is a LOT. Up to 1 in 5 women have had disordered eating and she never asked me about it prior to mentioning my weight 4 times. But to go in and repeatedly call me obese and label me as an obese person on my medical record solely based on my BMI feels like I am being boiled down to "obese person with obese people problems cause by obesity" when there is actually no real reason to suggest that my fairly steady weight is causing acute sleep problems; nor am I experiencing any weight related issues. When I saw the MD last month he did not comment on my weight at all. In a dramatic sense it very much felt like "well you're a big fat fatty so you have fatty problems and you should be careful because you might be fat forever" and just felt very ~mean girl~ especially because she didn't actually tell me any concerns tied to my weight.

I would like to address this with my PA. I don’t necessarily plan on seeing her again after that experience, but I also feel like it would be beneficial for her to hear how the way she offers care and impact people. I want to be kind and informative with genuine feedback. What do I say in a message to her to provide this feedback?

Thanks in advance 🩷🩷🩷

Hi everyone, doing just like the title says.

Possible TW for talk of dental procedures and detailed descriptions of events. Sorry if this is a bit long.

I (20M) had a series of cysts growing in my mouth when I was really young. They first came up when I was 11, and had to go to surgery to get them removed. The hospital's environment was at first really inviting for me. I've had various dental surgeries in the past before this event, and while I was understandably nervous as a young kid, the staff were doing a great job at keeping me feeling calm. The surgery happened, everything was fine and I had to do an overnight stay the hospital with no issues.

Then when it came to discharging me from the hospital, where one of my surgeons (I think?) had to remove the gauze that was buried deep in my mouth. I let them do it, and the first piece hurt quite a bit, but nothing concerning.
The second piece was where it started. The staff managed to pull it out quickly, but it put me in a brief moment of excruciating pain. I remember asking them if we could take a break and let me breathe, but they said it would be better to keep going and they went on before I could think about it.
The final part was the hardest. The excruciating pain was back, and the gauze had trouble getting out, being stuck halfway through. The surgeon was trying to yank it out of my mouth, and I distinctly remember it felt like my nose was on fire, and it was getting difficult to breathe between that feeling and some shortness of breath after I started to panic. I was in tears somewhere in the middle of this, once again asking the surgeon if we could stop. Same answer; it would be better if we just kept going. At one point during this, I tried to signal the surgeon to stop with my arm as my mouth was "blocked" by the burning feeling, and one of the staff nearby held it down instead. There was the sound of the stitches/gauze ripping too, which terrified me.

Nonetheless, I had to see the same team a few months later for a check-up. The same staff tried to joke that they were the "evil ones" and laughed it off, which put me in a bad mood whenever I saw them again.
After that all happened I noticed that I got a fear of any kind of procedures with doctors in general. Including needles, bloodwork, or anything resembling a sharp object in general sent me into heavy panic attacks. I've even once had that same sort of reaction to a neurologist taking out a paperclip to test my sense of touch.

Two years later, when I was 13, I had the same surgery. Thankfully it wasn't as serious as the case prior, but when it came time to remove the gauze again and the nurses wheeled in their stitching equipment, I began to have a panic attack. That wasn't the rough part for me. I was incredibly embarrassed about how they both stood frozen by the door with completely blank expressions, before excusing themselves and saying they'll help someone else while I calm down. When they came back, I was begging for a local anesthetic, and we had a minute of back-and-forth with me begging and them saying "It's not the usual for this" before they eventually agreed.

That was the final nail in the coffin when it came to me trusting any medical professionals. I've become extremely picky on who to trust, and a single bad impression just tells me to never contact them again.
For example, the dental clinic I go to has 3 working dentists, and I was scheduled with one of them to do some fillings in my molars back in 2025. When I asked her how the anaesthetic is supposed to feel in my mouth, twice, all she said was "I'll just leave the room for 10 minutes the come back." then when I started to feel pain and asked her to pause, she began to grow irritated and snarky with me by the tone of her voice. I've avoided her from then on.
I now have some new cavities I need to fill, and I was at first booked with her again. I changed the appointment to be with the only one dentist I trust at the clinic, despite the receptionist warning me I'd have to wait 2 months for his availability. It's up to a point where I'd rather have a painful tooth for those 2 months than get treated with anyone I'm unfamiliar with. This appointment is in 6 days from the time of posting this, and while the pain has progressed quite a bit in my tooth, I'm feeling somewhat better knowing who'll be doing the procedure on me.

I will also need a bone graft and an implant for a missing tooth sometime in a few years. I'm terrified, but I try to not think about it. My only other option would be to wear braces for who knows how long...

I've been slowly progressing on my fear of doctors over the years, and while I do have panic spikes before any kind of injections today, they thankfully aren't as serious as almost a decade ago; I'm able to compose myself within 5 minutes or so.

There’s a category of extreme surgical errors called serious reportable events or, more colloquially, “never events.” Wrong procedure. Wrong patient. Wrong site. Unintentionally retained object. 

But Texas hospitals and surgery centers report about 200 of these surgical errors every year. That’s the reported number. The real number, patient safety advocates say, is likely higher.

For patients, the challenges don't always end after the mistake. Texas medical malpractice laws cap damages, and the caps are significantly lower for county hospitals. Attorneys say those limits can make it difficult for some patients to find legal representation, even after catastrophic surgical errors.

Patient safety experts and advocates say there is work to be done to prevent these errors. 

It seems unlikely, though, the error rate would ever reach never. Advocates, attorneys and patients say that, when these errors do happen, there should be accountability for at least the most egregious ones.

The Dallas Morning News investigation ‘Under the Knife’ examines why these errors happen and how patients fare after the fact.

READ HERE.

TW medical trauma, detailed description of injury

Two car collision. My C5C6 vertebrae fractured and penetrated my spinal cord. I couldn’t move or feel anything. I couldn’t even breathe right. Smth heavy was on my chest. My body was seizing. They refused to do a scan and said it was FND. Because I have cPTSD and ptsd diagnoses. Gave me a neck collar. Sent me home.

I developed fatal complications. The fractured bones were shifting. Excruciating pain. Intracranial hypertension. CSF leak. Intrathecal hemorrhage and pressure. Seizures with me conscious or not. Pneumonia on the second day home. An UTI that lead to sepsis because of complete urinary retention. I felt like I was dying an infinite amount of times every hour.

Went back to the ER. They did a CT scan and immediately did emergency surgery. It didn’t really help with symptoms. Spent three weeks in ICU, one month in general ward, and one year in rehab. A C4 complete quadriplegic. I was 21.

I keep thinking that if they had taken me seriously the first time, maybe the spinal shock wouldn’t turn into spinal injury. Maybe the bones wouldn’t shift and further damage what little I had left. Maybe without complications i wouldn’t have my bladder removed, rely on TPN, and dream of death every other night. Maybe I would be walking.