virginiaRN

So, as noted much earlier in the postings, I did contact the practice manager and the doctor. I got a written apology via email, and them saying they "hoped I would continue my care with them because after care is so important." I left a very short post on Yelp stating, "The surgeon is excellent but I cannot with good conscience advise anyone with weight issues to go to this practice." A few months later, I get an email from the physician. His PA and the rest of the staff fully admitted the whole thing, never denied it. He claims he had individual meetings with them, forced them through various trainings, etc. Apparently, this "shook up" the whole office culture. He requested that I remove my Yelp review. So, this is a violation of Yelp policy for a business owner to ask for a review to be removed. I complained to Yelp. They never responded. I contacted my local Northern Virginia/DC Yelp "coordinator." She did nothing.

I wrote a lengthy email to the physician stating that, in my humble opinion, any problems with business of late is due to the buzz in the area about his practice. EVERY. SINGLE. PERSON. I. KNOW. WHO. HAS. GONE. TO. THIS. PRACTICE. has issues with it, similar to these. In fact, the woman who I go to who waxes my eyebrows (I know, random), told me--without prompting--that the physician ragged on his own wife's body (apparently she had been one of his patients.) His wife is his current practice manager. My waxing lady ended up going to another practice, had the procedure, and has lost 50 pounds, thus far (I think she is like 6 months out.)

I work in healthcare in the area, and any time the name of this practice comes up, numerous persons will speak up and tell their horror stories--not with the actual surgery, but how they were treated. So, this is not an isolated incident. I knew SOME of this going into it, but not to this extent.

In any event, Yelp removed my review. And then, out of spit toward Yelp--I had been a "Yelp Elite" for 4 years, was about to be "Gold Yelp Elite"--I deleted all 500 of my reviews. This is not the first time an owner has tried to get me to change my review, which I will if the situation grants it, but typically I will not. But I am also very fact-based and don't get into great detail. In this case, I only wrote two sentences, because I didn't want to get sued for slander, but I wanted to be crystal clear. (I also quit being a Yelp reviewer due to their lack of support.)

The surgeon was of course, thrilled to hear Yelp removed my review, and now thinks his business will thrive. He overestimates the impact of my one Yelp review. His practice has a very bad rep in the area. As a newly graduated and board-certified Family Nurse Practitioner, I will not be referring patients to him. There are plenty of great practices to refer to.

Quote

On 11/28/2018 at 3:40 PM, mylighthouse said:

Hello,

I'm sorry that you're dealing with chronic pain. People have responded to your post with some good information... it's always good to hear other people's experiences.... especially when you are in a position like yours. When you are dealing with long-term chronic pain, it can be depressing... you get to where you feel like NO ONE understands what you are going through. A lot of people do not understand, because they haven't had to deal with chronic pain before. Speaking from my own personal experience, it is easy after years of chronic pain to feel hopeless because you have tried so many medications, etc, etc, and nothing helps. Not to mention all of the side effects that may occur from taking these medications, drug interactions, etc etc.

My story.... I'll keep it short (haha... I'll try). Had a colon resection in 2015 that kept me in the hospital for 2 months! It was my first "open" abdominal surgery. Over the last 6 years, I have had 7 abdominal surgeries, 3 "open". I have terrible scar tissue/abdominal pain. I know my surgeon cut away some adhesions when he repaired my incisional hernia. Several months after my colon resection, my surgeon told me that I may need to stay on Tramdol the rest of my life. Here I am 4 years later and I'm still taking 300 mg of Tramadol a day.

My current med combo for pain only is Tramadol, ES Tylenol and Gabapentin. The Gabapentin worked for awhile, but one time when I was in the hospital a few months ago, they thought I had a bad reaction to it. It turned out that my sodium level had just dropped like crazy and it was causing probs. So I temporarily weaned off Gabapentin before they pinpointed low sodium being the problem. Now I am back up to 1800 mg of Gabapentin a day, and it does not help much. When I saw my surgeon yesterday, he said to talk to my GP about increasing the Gabapentin or trying something else, like Lyrica.

Ideally, I would love to be med free as far as pain meds go. I spend most of my time in bed. Exercise makes my pain worse. Fluffy had some really good insight.... I think exercise is great, but I guess in some chronic pain cases, it may actually make pain worse. I definitely think you need to give exercise a shot and see if it helps. I also can attest to the fact that carrying around extra weight can make pain worse.

I also use some salves/rubs for my scar tissue/nerve pain in my abdomen. They help ease pain temporarily. The other thing that I've been trying for 3 months now is CBD (no THC). I take a CBD tincture under my tongue twice a day. I also have a CBD vape. You see what I'm saying? When you are dealing with chronic pain, you are willing to try different things... I'm not gonna lie, sometimes I feel desperate. BUT, it can be dangerous too.... there are things out there that may be "natural" products, herbal supplements, etc, that can be harmful. I try to research things before I buy them.

I hope that you can find something that will help you get through the pain issue. In the meantime, remember that you're not alone, as you can see from the response of others here. It is nice to know that others can understand or somewhat understand what you're going through, isn't it? Afterall, we are human and knowing that others can identify in some way with us actually helps "lift" our spirits a bit. At least I know it's helped me. Good luck and keep your chin up!

You have REALLY been through it! I totally get where you are coming from about feeling desperate. I live in an adjoining state to 2 states where medical cannabis is legal. Alas, it is not where I live. Absolutely agree with you on the "herbal supplements" and danger. When I am getting a history, and medication list from my patients, typically they leave out the herbals. So I have to ask, sometimes multiple times before they tell me. Sometimes they wait until the end of the appointment. And I'm like, "ahhhh, you are taking gingko biloba. That's why your warfarin isn't working correctly! AHA! Let's talk about this."

I appreciate your post and hope you get some relief in the meantime. I'm so sorry you are feeling so bad. I really hope you find some solutions soon. I'm not your provider and wouldn't want to offer medical advice over the internet (illegal for me!) but I reallllllllyyyy hope you find some help that assist in living your life. That just really blows to be in that much pain.

1 minute ago, virginiaRN said:

Thanks for such a long post! You are too kind to take you time to post this.

Actually, I am familiar with many of these points. I am an RN and am graduating in 13 days with my Master's in Nursing and will sit for boards in less than a month to be a Family Nurse Practitioner. In my clinical rotations (Internal Medicine, Family Medicine, Ob/gyn, even Peds), I give my patients talks about eliminating simple sugars out of their diet.

In fact, I did my capstone project on the Medical Management of Bariatric Patients, and in addition to the inflammatory processes that simple sugars inflame, we are at high risk for dumping syndrome. I experience extreme dumping syndrome--both early and late dumping syndrome. Early--from the simple sugars (for example, if I would ever eat like a cookie or half a cupcake) and late (from high fat, like bacon or fast food.) I have had my gall bladder removed so it exacerbates the late dumping syndrome more than someone who has their gall bladder.

I'm a stage 2b breast cancer survivor and couldn't tolerate Tamoxifen for a variety of reasons. So, against my doctor's wishes, I had to d/c that med a few years ago. They wanted me to take it for 10 years. I couldn't even tolerate 18 months. I ended up on 13 other meds to ameliorate the s/e caused by the Tamoxifen. Then I had to have a salpingoopherectomy (hysterectomy but left the ovaries so I wouldn't go into premature menopause.) I am quite familiar with the troubles of Femara--my mom took for a while and was MISERABLE.

I have the same experience with wine--it causes me pain too. I don't even bother anymore. It's unfortunate but it's just the way it is.

I don't know about the actual percentages of for every x y z pounds you lose, your pain is reduced by x percent. I'd love to read the research on that. If you happen to ever get the citation, please post or msg me. That is a powerful statistic that I would love to use with my patients I see in clinic. It would motivate them to get moving on weight loss.

Nonetheless, I am continuing to work on my weight loss, having lost 100 pounds so far. Exercising is more sporadic now, especially in the last days of my MSN wherein I'm having to submit so many papers, assignments, take finals, etc. Terrible excuse, but it's my reality nonetheless. I do what I tell my patients to do and get up and march around the house for 10 mins multiple times a day, when I'm not at clinic. And/or walk outside when it's not 29 degrees here! My husband is runner who runs at 7 mins/mile (old guy now who used to run 4min/mile) so when he walks we me especially, he keeps me on a good pace.

As you probably know, weight loss and eschewing alcohol are the two major actions you can take as a breast cancer survivor to prevent a recurrence. There are numerous studies on this and I can post if you would like. (I'm in the last few days of coursework and working like a dog to submit assignments, study for finals and boards! So this moment is kinda bad, but soon!)

It sounds like you have been through the ringer and I appreciate your post. I'm off all pain meds. I have muscle relaxants that I can use for spasms but I don't use them that much b/c of s/e. The one muscle relaxant that doesn't cause sleepiness is Lorzone, but it's not that effective. I have never had a prednisone shot, although it's sounding mighty enticing. My concern about that is the same as with my patients. It raise blood sugar, puts you at risk for fungal infections, etc. I'm not a big advocate of prednisone injections in general.

Thanks again for your post and I will continue my Quest to continue to lose weight and very SOON be able to up my exercise even more that my paltry amount. The rebound pain is real with NSAIDs (which I cannot take anyway, as all of us with GBS) and the endorphins released by exercise (and sex, btw!) are inimitable!

Keep up all your great work!

Oh yes, and I forgot, I, too, have that horrible tight and painful feeling around my chest from my b/l mastectomy. Very little has been researched to manage this except for massage and dry needling (and stretching!) Ugh. I know the feeling though!

On 11/28/2018 at 2:17 PM, FluffyChix said:

Ok, so sorry you are going through this and have to live with it. The worst thing in my opinion is always being on a level of pain where you can't sleep, move, etc.

But here's where I probably won't be popular, and I can only give you my story. And everyone is SO different and lives a different pain history.

In short, I have osteoarthritis, degenerative disc disease, cervical stenosis and sacral stenosis, bone spurs on my spine, hips, joints. etc, etc, chronic bursitis in both hips, a 50% ACL tear, and neuralgia 360 around my chest extending 8 inches + neuralgia in my hands/feet from hand/foot syndrome during chemo. And in addition I'm a stage 3c BC survivor on Femara (a drug that causes even more bone and joint pain). I've been on opiod pills, neurontin, tramadol, flexeril, nsaids, tylenol, pain Patches, pain gels, cortisone shots to the joints. Oh and now I have a Parkinsonian trimmer in my head and hands from the radiation/chemo--so it causes constant muscle tension cuz I trie to keep my head/hands/shoulders from shaking deep inside my body.

I used to not be able to sleep longer than 1-2 hours at a time before waking from pain and unintentional movement. I still sleep in a recliner. And every day I woke, I'd wake in at least a 6-7 pain level. I would not medicate until it was an 8+ to 10 cuz I hated the side effects of the drugs. And now that I had surgery, most of that or a lot of that is off the table.

Here is what finally helped me.

1. Adjusting my diet to be as clean as possible. (Every time I eat beef or pork, I wake the next morning 20 years older... Every time I have carby carbs like grains--pain so bad I feel 80 years old. Every time I drink any kind of alcohol other than a little red wine--pain like cray. cheese and dairy is the same way unless it's very very small amounts of reduced fat or fat free dairy.)

2. Started doing severe calorie restriction, then IF and that reduced the pain ENORMOUSLY! Like...magically.

3. Lose weight. I think my doc gave me some number like: for every 15% of body weight you lose, you reduce your pain level by 20-30%?

4. Get PT and then do the frickin core strengthening exercises religiously. (I'm slacking on this! But I can tell when I do them and when I don't. The difference in pain level is a magnitude of 10 with v. without.)

5. Walk daily. Daily. Even when I don't feel like it. Even when it hurts. By the time I'm done, it always hurts less.

The best thing I've done is lose the weight. I can do things now without pain meds that I never thought I could or would be able to do. My goal is to get to 125-130lbs to take off as much extra stress as possible and improve my pain level as much as I can. I think the pain meds caused a continual cycle of spring-back pain (forget the name of it). So it was like a self-fulfilling prophecy. Because I medicated, I would have more pain at the end of the cycle and need to take more meds. And because I medicated, I'd built up a tolerance and needed more and more meds to help. Now if I absolutely must have one, it takes maybe 1/4 of the amount it used to take. I now wake only in a 2-3 and end of day is usually only a 4 which is entirely manageable for me.

Some meds that play well together and amplify their effects:

1. Gabapentin + Tramadol together

2. Tramadol + Tylenol together (this one is especially good)

3. Norco 10/325 + Flexoril (last resort med)

Lastly, this is the killer part. (Sorry in advance...and you can only do what you can do--and only you know how clean your diet is and if you are eating low cals.) If you are 5'5" and 178lbs and female, you still have some fluffy slush to get rid of that absolutely would help reduce the pain level. I wouldn't say that if I didn't feel the difference in myself. It was night and day relief.

I'm no longer on any pain drugs. And the only scripts I take are my Femara, thyroid, and omeprazole. I walk daily. I try to do strength training 2-3 days per week as much as I'm able. And I can actually "fast walk"/jog which I never thought possible. It's now been 1+ year since one of my cortisone shots and about 6+months since the other and I'm holding up really well.

I hope my story helps you. I'm sorry for going on about myself. But I just think, if it was possible for me, how many others would/could benefit from it. The freedom from drugs is really just a great gift of this surgery and lifestyle.

Thanks for such a long post! You are too kind to take you time to post this.

Actually, I am familiar with many of these points. I am an RN and am graduating in 13 days with my Master's in Nursing and will sit for boards in less than a month to be a Family Nurse Practitioner. In my clinical rotations (Internal Medicine, Family Medicine, Ob/gyn, even Peds), I give my patients talks about eliminating simple sugars out of their diet.

In fact, I did my capstone project on the Medical Management of Bariatric Patients, and in addition to the inflammatory processes that simple sugars inflame, you are at high risk for dumping syndrome. I experience extreme dumping syndrome--bother early and late dumping syndrome. Early--from the simple sugars (for example, if I would ever eat like a cookie or half a cupcake) and late (from high fat, like bacon or fast food.) I have had my gall bladder removed so it exacerbates the late dumping syndrome more than someone who has their gall bladder.

I'm a stage 2b breast cancer survivor and couldn't tolerate Tamoxifen for a variety of reasons. So, against my doctor's wishes, I had to d/c that med a few years ago. They wanted me to take it for 10 years. I couldn't even tolerate 18 months. I ended up on 13 other meds to ameliorate the s/e caused by the Tamoxifen. Then I had to have a salpingoopherectomy (hysterectomy but left the ovaries so I wouldn't go into premature menopause.) I am quite familiar with the troubles of Femara--my mom took for a while and was MISERABLE.

I have the same experience with wine--it causes me pain too. I don't even bother anymore. It's unfortunate but it's just the way it is.

I don't know about the actual percentages of for every x y z pounds you lose, your pain is reduced by x percent. I'd love to read the research on that. If you happen to ever get the citation, please post or msg me. That is a powerful statistic that I would love to use with my patients I see in clinic. It would motivate them to get moving on weight loss.

Nonetheless, I am continuing to work on my weight loss, having lost 100 pounds so far. Exercising is more sporadic now, especially in the last days of my MSN wherein I'm having to submit so many papers, assignments, take finals, etc. Terrible excuse, but it's my reality nonetheless. I do what I tell my patients to do and get up and march around the house for 10 mins multiple times a day, when I'm not at clinic. And/or walk outside when it's not 29 degrees here! My husband is runner who runs at 7 mins/mile (old guy now who used to run 4min/mile) so when he walks we me especially, he keeps me on a good pace.

As you probably know, weight loss and eschewing alcohol are the two major actions you can take as a breast cancer survivor to prevent a recurrence. There are numerous studies on this and I can post if you would like. (I'm in the last few days of coursework and working like a dog to submit assignments, study for finals and boards! So this moment is kinda bad, but soon!)

It sounds like you have been through the ringer and I appreciate your post. I'm off all pain meds. I have muscle relaxants that I can use for spasms but I don't use them that much b/c of s/e. The one muscle relaxant that doesn't cause sleepiness is Lorzone, but it's not that effective. I have never had a prednisone shot, although it's sounding mighty enticing. My concern about that is the same as with my patients. It raise blood sugar, puts you at risk for fungal infections, etc. I'm not a big advocate of prednisone injections in general.

Thanks again for your post and I will continue my Quest to continue to lose weight and very SOON be able to up my exercise even more that my paltry amount. The rebound pain is real with NSAIDs (which I cannot take anyway, as all of us with GBS) and the endorphins released by exercise (and sex, btw!) are inimitable!

Keep up all your great work!

On 11/27/2018 at 9:17 PM, 2Bsmaller18 said:

Have you looked into going to physical therapy? There are other modalities like ultrasound as well as exercises and stretches that could help. I would recommend having an eval done by a PT and see if you can get some relief. The PT could also give you some advise for body mechanics, posture etc. to prevent further issues.

Can't remember if I replied. Yes I looove PT. I have gone to about >20 full cycles of PT as an adult. And I'm 45. LOL So that tells you how much I have gone to PT. Specifically, I have been helped by dry needling. I'm actually going to a PT (who does dry needling) today, to see if I can get any relief. I think I have some benes left this year, but may have to pay out of pocket if not. It's worth it.

5 hours ago, 2Bsmaller18 said:

Have you looked into going to physical therapy? There are other modalities like ultrasound as well as exercises and stretches that could help. I would recommend having an eval done by a PT and see if you can get some relief. The PT could also give you some advise for body mechanics, posture etc. to prevent further issues.

I love PT. I failed to mention that in my OP. Yes, I have been in PT for my neck or low back over a dozen times in the last 10 years. Dry needling is amazing too. I'm going to a special PT who does dry needling on Friday. I really hope my insurance covers! It was literally a godsend, but I maxed out my PT visits in previous years. I don't think I have this year. Thanks.

1 hour ago, LaraK said:

Hi, I have a similar history of lower back pain and have recently had 2 major knee operations for injuries. So I’ve been on a lot of pain meds over the last 6 months and just had a facet joint block L4/L5. So I can relate and sympathise with your pain. I’m not so familiar with your meds as I’m in the Southern Hemisphere and we have slightly different names here. But what I’ve found that seems to work for my lower back pain is a combination of paracetamol and a muscle relaxant.( Besides the heat/cold etc). Both are non addictive and ok for the tummy. But discuss with your dr first. I may take something with it to protect my stomach, if I’m worried. (here it’s called nectizole/nexium/altosec). I also try and not overdo things, which is easier said than done and I use breathing meditations for pain relief. There are some wonderful apps that you can download. Try Insight Timer. Has such a huge variety of meditations for different ailments. I’ve also been doing hydrotherapy for my knee rehab. The Water is nice for my back too, but you have to be careful not to overdo it. The Water is deceptive. I believe that the the bottom line is self kindness and self love and listening to your body. Again easier said than done...when you are in agony. Good luck.

I did fail to mention the barrage of muscle relaxants that I have tried. They do help. And tylenol (paracetamol, same drug, different name). I've not familiar with the triple med you mentioned, although I was on celebrex (a COX-2 inhibitor, similar to NSAID, but less ulcer risk) with nexium--and that's when I got the peptic ulcer.

I love water exercise. I should get back to that! Thanks.

5 hours ago, Missouri-Lee's Summit said:

I tried EVERYTHING before finally settling on opioids. My daughter is a PharmD and two of my three sons are medical doctors. Anyone who tries to treat me as an attention-seeking, drug-seeking hypochondriac... WATCH OUT! My pain is my pain. 360mg morphine daily with oxycodone 10mg for breakthru. The CDC has made it hell for many chronic pain patients because of the opioid-crisis hysteria.

https://twitter.com/ThomasKlineMD

Indeed. I actually just wrote a paper on this for my master's program. So much misinformation out there about opioids. Thanks for your response.

http://dontpunishpainrally.com

7 minutes ago, toodlerue said:

Wow. You just wrote my pain story! You have tried everything that I would suggest except lidocaine Patches. They are expensive but I can't live without them.

I also wear an neoprene exercise belt around the house when I need heat & ThemoPac when I need heat when I’m not at home. I also take Norco. Some days I take 2 & somedays I don't take any, just depends on the day. So I know I’m not addicted to them.

Best of luck finding out something that works for you!

Yes! I have Lidocaine Patches. I've tried so many things, it just slipped my mind. They are okay. Not the best, but better than nothing! Thanks.

Hi Folks. Question that you all may or may not have run into. I had roux-en-y GBS 1.5 years ago. Lost almost 100 pounds. That is going well. I have some chronic back issues (degenerative disc dz in lumbar and cervical region) and have done all the injections, radiofrequency ablations, epidural blocks, etc., that I can manage. Pain persists, but ortho has stated it is not appropriate for surgery. To be fair, I wasn't really going around hunting down someone to operate b/c the idea of back surgery is not exactly thrilling to me, having taken care of the post-op back surgery patients in home health and with the back surgery success rate of 50%.

Prior to surgery, I was able to take NSAIDs and certainly took my share. My surgeon stated no way on the NSAIDs. After me badgering him, he allowed me to take Celebrex 100mg twice a day along with Nexium 40mg once a day. I did this for 3 weeks. I ended up with a peptic ulcer which had to be treated for a month with a multiple medication cocktail. It was not fun. The ulcer was way more painful that the neck and back pain I originally had. For a while, I managed on regular or arthritis-strength OTC tylenol. Then, my pain management doctor rx'd Vicodin, which is never a good long term solution. So, I took it, with the knowledge that I shouldn't take this long term. I've dc'd this myself and I am still in pain. Also prohibited by my GBS surgeon are oral steroids (prednisone, prednisolone, etc.)

FWIW, I have unsuccessfully taken Cymbalta, Neurontin, and a few other neuro-type drugs. I take Lexapro for moderate depression. I can't take a number of meds also because of my epilepsy history from the age of 9. Oh, and I maxed out my chiro benefit this year (20 visits.) Out of pocket, chiro is $70/visit and the chiro wants me there twice a week. I have expressed that I really loved his services but I can't afford $140/week. I used to get 90 minute deep tissue massages about every 10 days, but my therapist moved far, far away and I've struggled to find someone even half as good. Currently doing epsom salt baths, Tylenol, and heat and or cool packs. Normally, I'm good but unusual activity types usually throw me over the edge. (This weekend had a house flood which entails me and my family moving lots and lots of things from one area of the house to another.) I've even done acupuncture, but the cost was prohibitive ($900 for 3 treatments.) I even have my own TENS unit and foam rollers. I do some strengthening and stretching exercises on my own, which helps too.

I need to find a better solution for pain management. Anyone find solutions and/or good providers who have a handle on this? I will travel to see someone good. Thanks in advance!

5 hours ago, RhondaRob said:

That is awful sorry that you had that experience congratulations on your 5 year cancer free Journey and don't allow anyone to make you feel ashamed about your body I would have reported them good luck

Yes ma'am. Scroll up. Reported. Thanks!

6 hours ago, Saddy said:

I’ve been through hell and back. What would I do? Let their boss know, get over and move on. You don’t want to spend all your good energy hitting over someone who is not really all that important in your life. It’s already happened, you can’t change a thing. What you can change is your way of thinking. Place your energy onto something you enjoy rather than these idiots.

Personally, I am over it. I was pretty much over it the next day. Having been heavy most of my life, I've been called much worse, in much more public circumstances, and cried real tears over it. My skin is old leather at this point. As a card-carrying member of the medical profession, I do feel an implicit and explicit duty to protect other patients from this type of behavior. Ironically, as a Family Nurse Practitioner, I will be giving referrals to practices of various specialties. This will not be one of them. Just last spring, in my first Family Nurse Practitioner rotation, I referred all my patients who were interested in learning about bariatric surgery to a different practice because there have been a few other incidents with this practice (that I experienced and some of my co-workers experienced.) I must have referred 20 people to a different practice is 4 months. So, about 5 per month. I graduate in December. If I practice for 20 years (at least), that's 20 x 5 x 12= 1200 potential customers/patients. The surgeon is about my age, so he'll likely be practicing at least that long. I'm sure they'll get along just fine without my referrals, but I'm sure they would have liked them just the same. Just saying... Anyway, thanks for your support. #longgame

12 hours ago, superthin said:

In my mind I’m picturing a Julia Roberts in Pretty Woman scene, where she tells the nasty lady in the store, “big mistake”. Lol, my mind just goes there. Seriously though, I’m really pissed off on your behalf, definitely file a report. Just know that you are an amazing warrior, fighting cancer and losing all that weight!! We all have your back!

That would have been completely dope to say. I will keep that in mind for (god forbid) future episodes. Thanks!

13 hours ago, GreenTealael said:

I'm sure they are the type of people that have been doing this all their lives... Bad behaviors don't start at 32

Oh and I forgot they violated a clause in the Hippocratic oath

"Into whatsoever houses I enter, I will enter to help the sick, and I will abstain from all intentional wrong-doing and harm, especially from abusing the bodies of man or woman, bond or free. And whatsoever I shall see or hear in the course of my profession, as well as outside my profession in my intercourse with men, if it be what should not be published abroad, I will never divulge, holding such things to be holy secrets."

Word. Definitely violated this.

34 minutes ago, jess9395 said:

My misunderstanding. I thought they were in the office and both involved in the care. I stand corrected.

Yes. I do.

No worries.

Nope. Walking in the hallway & talking abt patient details is the kind of stuff covered in first semester of clinicals, in any part of the medical profession, as you know. No worries. My post was more of a stream of consciousness, a vent. Certainly not organized very well. ✌🏽

50 minutes ago, 2shea said:

I know nothing of HIPPA as I am in Australia, so can't have an opinion whether they did or didn't violate the regulation.

What did they violate? In my opinion, good old plain human decency. Laughing about a patient's arms or other body part is not letting off steam or venting in a black humour way, they were being downright nasty and mean spirited towards a patient/client. It doesn't make it any less so that they were among themselves behind a closed door thinking they couldn't be heard.

Oh, and sorry about not being clear in my OP. They were laughing about my SIDE BOOB coming out of my dress. This only hit me as I replayed the scene in my mind going down on the elevator. I was so stunned, initially I wasn't clear what I heard. But my son confirmed what I heard. I can't update the OP, I don't think or else I would! Thanks.

53 minutes ago, jess9395 said:

I’m gonna be the odd duck here; but while I am truly sorry you had to hear what they were saying.... what is the HIPPA violation here? They were in a closed office with the door locked, taking amongst themselves. It was not meant for anyone else to hear, they believed they were in a private, secure, locked, closed office. They did not mention a name or any confidential medical information. They were letting off steam and venting in the black humor those who deal with life or death medical and mental health scenarios do.

I may get stoned for this, but what did they violate?

Oh, and they do NOT deal with "life or death scenarios." As I wrote in earlier posts, their office closes at 4pm, opens at 9am. They see people in the office. The one time I actually came in with blood pressure of 70/50 and dizziness, they left me in the waiting room for 1 hour. They know NOTHING of dealing with real emergencies. In the 14 years this physician has been in practice, never has there been a patient death. I was an ER nurse. I know from "life or death medical and mental health scenarios." Further, even in the ER, if we EVER did joke about a patient--typically never about the body but about a bogus story about how a man got a Shampoo bottle stuck up his anus ("I fell in the shower), we did it in the BREAK ROOM, which is located strategically far from patient rooms. Just curious, do you work in healthcare/medicine?

48 minutes ago, jess9395 said:

I’m gonna be the odd duck here; but while I am truly sorry you had to hear what they were saying.... what is the HIPPA violation here? They were in a closed office with the door locked, taking amongst themselves. It was not meant for anyone else to hear, they believed they were in a private, secure, locked, closed office. They did not mention a name or any confidential medical information. They were letting off steam and venting in the black humor those who deal with life or death medical and mental health scenarios do.

I may get stoned for this, but what did they violate?

Happy to enlighten you. I teach nursing students of all levels at university, so this is something I am up to speed on. HIPAA specifically states a few things that are of issue here. 1) A member of the care team should not discuss patient information with anyone (in the office, out of the office, or whatever) who is not DIRECTLY involved with the care of the patient. That would include the receptionist and the billing employee. The particulars of the PAs discussion were not need-to-know for the receptionist to check me in or out, nor for billing to submit my bill to my insurance. 2) They were EXITING the office. Even prior to the them exiting (about half of their statements came out as they exited the office--literally walked into the hallway), their words were audible from the hallway. The onus of privacy is on the office. That is why many offices have "white noise machines," to obliterate the private patient information being discussed within the office space. 3) Even within the office, staff is required to use a low tone, and to only talk about information that is relevant to care. Hope that helps.

Part of me would also like to start sending postcards to the office of me in bathing suit with lots of SIDE BOOB showing. But... that'd be super-ornery. LOL

On 8/16/2018 at 7:35 PM, virginiaRN said:

Hi, folks. I have not been on this board for a long time. Today, I had a visit to my bariatric surgeon's physician assistant (PA). I am 16 months out from roux en y surgery and have lost a total of 101 pounds. I went there today because I have been experiencing severe abdominal pain, bloating and flatulence at night, every night x 2-3 weeks. I should add that I am an RN and am one semester away from completing my Family Nurse Practitioner Master's degree. The PA gave me some advice, ordered some meds and labs and I checked out--it was about 4:10pm.

She had told me to do the labs today, due to the severity of the symptoms I was having. Their office was closing. I went to my PCP's office--which has a lab tech--and they were closing and the lab tech had left. I went downstairs to the outpatient lab and it was closed. The only lab open was the STAT lab on the 2nd floor. Since I was still in the building, I thought I'd just double check that the PA did not want these labs to be drawn STAT. I went back to the office.

It was locked. I knocked on the door. I had already heard the cackling and loud voices from 10 ft away. As I got closer, I heard the PA saying "I know, and every time she moved her arms! I couldn't believe it! And she had her teenage son with her!" Needless to say both me and my teenaged son (almost 17) heard this. He drove me today because I wasn't feeling well and he also needs to rack up his driving hours to complete his driver's permit and get his regular license. Just then, the PA, the receptionist and someone from the billing dept emerged from the door. They turned white as ghosts. Their jaws almost hit the floor. Being the classy person that I am, I didn't reference that I overheard them talking about something on my body just then. Their reaction confirmed what I thought I overheard. I asked the PA if she wanted the labs STAT, she said no, and my son and I walked to the elevator. The women huddled back by the door, somehow frozen. The only way to either the stairs or the elevator was toward the direction my son and I walked. Clearly, the women felt ashamed (?)/shook by being overheard body-shaming a patient, violating HIPAA, and being overall terrible people.

As we drove home, I was pretty hurt. Most patients at a bariatric surgeon's office are going to have body image issues. Whether they are pre-op or post-op, they have likely experienced some type of negativity about their bodies (either from within or without, or both.) Also, I should add, I am a breast cancer survivor. December 2018 is my five-year anniversary of having stage 2 invasive breast cancer and having a b/l radical mastectomy and subsequent reconstruction, followed by a hysterectomy. One year after my b/l mastectomy, the reality hit me that my GG breasts were now AAs, mutilated and scarred. I felt unattractive, repulsive and beyond depressed. I was thrilled to be alive and that it was caught in time to prevent spreading to my lymph nodes and that by doing a b/l mastectomy, I didn't have to do chemo or radiation. I failed to be able to tolerate Tamoxifen, and had to be put on a cocktail of other meds that resulted in me gaining about 50 pounds to my already Rubenesque 225 lb body. It was a low time.

Then, I got my reconstruction. My breast did not, do not, and will not look like "porn star" boobs, or "stripper boobs," although many people have suggested that was the "up side" of breast cancer. See, when you get a radical mastectomy, they hollow you out like a cantaloupe. Then, either at the same time, or at a later surgery, they insert implants (or, in some cases, spacers). Because I was 220 pounds when I got my reconstruction, they put the biggest implants the FDA allows--800 cc. The reconstruction surgeon repaired a lot of the scarring caused by a severe post-op infection from the initial surgery, during which both of my breast turned black and I had to debride the dead tissue myself at home. I was and am thrilled that I had a good reconstruction surgeon and, after recovering, felt a little bit more whole.

While I had no breast tissue before, but now, any extra cushion vanished as I lost over 100 pounds. My breasts are skin and implant. It's definitely not a "hot" look. Well, all this cancer talk comes into play because what the women were talking about was my breasts. You see, when you get a breast reconstruction, your breasts don't look like regular breasts. Again, they are hard, stiff, and look like "robot boobs," as I call them. Today, at the office, I was wearing a bamboo material sundress, that was mostly dark teal, but also had other colors tie-dyed into the design. In the front is a "peekaboo" hole. The rest of the dress is just an A-line dress with a full skirt. It is not particularly "sexy." (Including my flabby/flappy wing-like arms!) But because my breasts don't move, there is a tiny bit of "side boob" seen protruding into my armpits. Not regular side boob--because remember, nothing is "soft" anymore. No, it's part of the round, button shape (just imagine an implant covered with skin, literally.)

As I reconstructed what the women were saying, I recalled more and more of the beginning. I guess in the moment, in shock, my brain kind of protected me and I somewhat blanked out. Look, we are all human, I get it. We all make mistakes. But for God's sakes, you would think that the staff--including a provider--would be a little more sensitive about yucking it up about patient's bodies while anywhere near the doors/exit.

I am posting here in general for support because it just feels yucky. I know I've never done anything like that as an RN, but one never knows how one's words may affect another person. Also, the HIPAA violation bothers me. I work very hard to whisper, even when I am behind closed office doors, because I know how much sound carries in offices. I often tell my patients "I'm sorry I'm kind of talking softly, but these room walls are paper-thin and I want to protect your privacy." I know I won't have the b*lls to tell the office. I feel like somehow they would turn it around on me, even though 3 of them were there and me *AND* my son heard that. And as a mother of a 16 year old son, a 19 year old son, and a 21 year old daughter--it's creepy.

The implication that my son--who has seen me go through hell and high Water with cancer and this gastric bypass--would even think about looking at my breasts is disgusting. This can only come from a woman with no children. The PA is probably like 35 (I am 44), no wedding ring. Normally, I wouldn't even mention any of that because I fully believe in living my own life and others live theirs but for f*cks sake, please don't foist your sick thoughts on me.

I would like some thoughts on how I might handle this. I feel like I won't have the courage to say anything, for fear of being "gaslighted." But, I also feel like there is a lesson for their staff to learn. It occurred to me to write an anonymous letter to the surgeon/head of practice and give a little vague summary of what happened and advise that his staff might want to not be so catty, mean, and to stop violating HIPAA. I don't know. I just know it hurt. I'm hurt. Thanks in advance for any words of wisdom.

I can't seem to edit the OP, but I wanted to make sure you all knew the update which is that yesterday morning, I wrote a letter to the practice manager & to the surgeon. Love all the comments and they are great. Just wanted to let you know the "reporting" has been done, at least at "level 1." There are more levels to go and I am contemplating my next moves. Thank you!

1 hour ago, Plucky said:

I think you should document the behavior, and report it to the practice. If you don’t it will just happen again.

The PA should not be working in healthcare with this type off attitude.

Most importantly you do not deserve this treatment. Think of it this way if you were at work and witnessed someone treating a patient in this manner, would you “let it go”? You would likely speak out for the patient. Don’t you deserve the same care?

Yup. Scroll up. Documented. Letters sent. Thanks 4 ur support!

Hi scroll up. I already sent letters! thank 4 ur support

3 hours ago, Missouri-Lee's Summit said:

You are a classy lady. I have not been moved by another story on this board as much as this one. You have a gift of speaking from your heart, which gave everybody here a front-row seat to your pain. I applaud you for that courage. It's not easy to put your hurt on display.

Your son learned more that day about you and your strength than you realize. Your restraint in reverse-shaming your PA/and staff was not a weakness in my view. You are a consummate professional. You behave as a professional with your patients and in your everyday life. Lucky are the patients who have you as their care-guide. It's easy to admire people who do "great things", but it's people that go through everyday struggles, survive them, and keep moving in a positive direction that I look to for inspiration. Being big (and former big) people, we've all tasted some of the pain that was unceremoniously dished out to you that day. We've all had to figure out how to process that pain. By sharing your story, I believe you gave those (here) who are not as gifted at expressing their inner feelings, a voice.

You mentioned the idea of writing a letter to the head of practice. I would start drafting a letter now while your thoughts are still fresh in your mind. Composing such a letter in itself would be therapeutic for you. Whether you decide to send it is another matter for you to consider. If you do send the letter, however, I would NOT send it anonymously. As a self-advocate and a role model for your children, it is important for you to stand behind your words. It would be too easy for the head of practice to dismiss a letter written anonymously. The PA/staff would not be able to deny the words that came from an actual person as easily as words coming from a ghost. By signing your name, you also leave the door open for a response. If one receives a letter like this from an actual person, there is an obligation to follow up. If you send it anonymously, you will always wonder whether it was intercepted and destroyed before reaching the head of practice, whether it was read and acted on, etc. Just as you were placed in the position of having to process the hurt they caused, let them now defend their unprofessional patient-shaming.

By writing this letter, you are not only helping to correct a wrong done to you, but to future patients who would be at their mercy. This PA is young. She obviously still has some important lessons to learn about being a compassionate caregiver. While it might have felt good to lambaste that PA/staff directly (in front of your son), I think being shamed professionally by her superior is a far better lesson.

Just my two jellybeans....

Thanks for your kind words. Letter was written yesterday morning and sent to the surgeon and the practice manager. It was a much shorter and direct version of what I posted here. I also amended my positive Yelp review--kept that general but was very specific about the PA who made body shaming comments. Again, thank you for your support. The responses I got helped me write that letter yesterday morning.

11 minutes ago, Brassapple said:

They’re a**holes and while the right thing to do is to let it go, it won’t work because people like them will do it again and again. I suggest you go straight to the surgeon and ask for them to be in the room and give them a long lesson in body shaming.

If this were just a bunch of sorority girls, yeah, maybe (?) let it go--or have the confrontation there. But this PA--a provider with a lot of power over the lives of others--needs to have her card pulled. Trust that I am on this. After sleeping on it, and waking up a little fresher, I wrote a letter to the surgeon and the practice manager. But I may not be done there. Taking stock and deciding about next steps.