Weaponing Healthcare

Today, my primary care doctor opened my appointment by telling me that he believes I’m a hypochondriac. I’ve survived and/or live with multiple illnesses, including cancer. I live with more than one rare disease, including common variable immunodeficiency, which is serious and life-threatening. I have autoimmune diseases, renal insufficiency, postural orthostatic tachycardia, and arrhythmias. I’ve been treated for atrial fibrillation. I have aortic root and ascending aortic dilations. And I have PTSD and serious, life-threatening, bipolar.

All of this is documented in my medical record at Intermountain, where my primary care doctor works. It’s not in my head. It’s not me imagining health issues that don’t exist. They exist, and I’m attempting to address them. I worked as a medical writer and editor at some of the best institutions in the country for years. When I get a diagnosis or face a health challenge, I do research and have the determination to address the situation however I can.

Today, I was asking about my fasting blood glucose being over 100 for the past two years. That’s diagnostic for prediabetes, but none of my doctors brought the high results to my attention. High blood sugar seems like something I should be able to discuss without being called a hypochondriac. It’s especially important given that my chances of developing diabetes are 3 to 4 times higher because I have bipolar disorder.

I was also at the appointment to discuss my BUN level and (BUN/creatinine ratio). My BUN has doubled in the past 5 months and is above the normal range. Perhaps that’s not an issue, but given my history of renal insufficiency and the fact that lithium, which I started taking at a higher dose 5 months ago, causes kidney disease in about 26 percent of patients, the higher BUN level seems like a valid issue to raise.

Healthcare systems don’t seem to welcome the type of patient I am—one who’s female, has chronic health issues, and has a mental health diagnosis. We wait years or decades before our issues are taken seriously and addressed. By that time, we often have medical trauma because of how the healthcare system has treated us or our conditions have progressed, often irreversibly, because we were gaslit into thinking it must all be in our heads, a point our doctors belabor.

If I can’t approach my doctor for routine care, explanation of test results, or to discuss a health concern—the very things primary care providers are supposed to do with their patients—without the entire encounter being dismissed as evidence of a mental health problem, then why am I even trying so hard.

This isn’t the first time this has happened here in Southern Utah. Another doctor at Intermountain denied the fact that I had atrial fibrillation despite a preponderance of evidence that I had the condition. I was denied the medication I needed because of his insistence that I didn’t have afib. Yet another doctor at Intermountain tried to tell me my diagnosis of common variable immunodeficiency was unfounded despite the fact that I have extensive documentation of that disease from accomplished immunologists who know how to diagnose and treat immune system dysregulation.

I’m tired. I’m tired of this treatment. I’m tired of this sexism, this ableism, this dehumanization. I’m just tired. These attitudes and behaviors on the part of doctors cause unnecessary and severe iatrogenic illness for those of us who are subjected to them. I can’t carry that burden on top of my actual health and mental health issues. I’m tired.