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.

Edited August 17, 20187 yr by virginiaRN
added detail and typo

If I wasn't an RN, I might not report it. But I feel just like I am a mandatory reporter of abuse for the elderly and children, I am a mandatory "feedback giver." Unfortunately, they crossed someone who knows all too well exactly what ethical codes they have violated, not to mention HIPAA. I will let them know in writing, likely the PA, the MD, and the office manager. And I will be discontinuing care with them.

I didn't want to add fuel the fire, but the PA's plan of care was completely inappropriate for my case. She wanted me to get allergy tested (right, b/c after 44 years of living, a brand new food allergy developed 2 weeks ago--yes, it can happen but it's unlikely.) And she recommended I take a medication with aspirin in it, which the MD expressly told all patients never to take. In fact, I have his printed packet stating not to take it. So odd. Having just gotten over a peptic ulcer d/t taking celebrex with nexium (also rx'd by a different PA)--which is not optimal to take as a bariatric patient, but is indicated sometimes, I am extremely leery of taking any NSAIDs or aspirin.

I can say that I did personally grow from this and will be even more on guard to protect my patients. But it is just sad that people who are trusted with the care of others are so blase about it. Anyway, thanks folks for your help! I feel better just being able to vent! I will let you know how it goes.

You're a more mature person than me...

I still think all of her future children will be wholely cloven foot...

Report them ASAP

There is no excuse for this. I have been a primary care pediatric nurse practitioner for 28 years. Sure, there are situations that come up that I talk about with other providers in my office but not in that way. Just because a door is closed does not mean someone is not eavesdropping. I had a shared office with a pediatrician for several years and if we needed to discuss anything sensitive about a patient, parent or staff member we actually texted each other back and forth while sitting at our desks because the walls have ears.

I urge you to make what happened known to the doctor and practice administrator. The people involved need to be counseled and warned that further behavior like that will not be tolerated.

I am very sorry this happened to you, especially with your son there.

Something similar happened to me when I was at a new Dr's office. This was a couple of years ago and I was being seen for weight loss medication management (I was being put on a appetite suppressant). I was in the patient room waiting for the doctor to come in and I could hear the nurses in the main area (open work station, all patient room doors faced the nurse station). I could hear them talking about me and laughing about what I was coming in for and saying that I was about the same size as someone else they must have all mutually known. I was mortified that they were discussing why I was in the office and my body with each other and within earshot of other patients that were in their own rooms. I did not say anything, I wish I would have, just to hopefully prevent other patients from feeling as awful as I did in that moment. They are not ignorant of their behavior, they are apathetic of how it affects other people and should be called out on it.

Horrible you had to go through that. You are obviously a very strong person for biting your lip and not going apesh*t on them when they walked out the door. Glad you decided to do something about it. They shouldn't get away with it and be able to hurt others they way they hurt you. Granted they didn't know you were in earshot but regardless It's not something they should be so comfortable doing. Whatever the outcome Congrats on your success in all you have been through.

So sorry this happened to you, and unfortunately it happens too much among professionals that damn well know better.

Write that letter and spare the next patient that doesn't have your strength to bear this. If they talked about you like this, it is very likely a part of this office's culture and needs to end. The letter needs to go to the office manager and the surgeon, not the offending parties. I would stress that since the conversation was so blatantly mutual among the parties that this cannot possibly be an isolated occurrence. Ask for discipline to be brought against them, nothing less than discipline will put an end to it, suggest transfers even, add that you are copying your state regulators. I know this sounds extreme but it happens too often. (Someone in my surgeon's office doesn't want to work with the bariatric patients because she 'can't stand them' - well guess what? She sure as hell isn't working with them because she is gone)

And never think if you speak another language it is excusable! A story to illustrate my point- My very good friend Martha. Her father was Amish, fell in love and married outside the faith. He was extremely lucky his family didn't totally" shun" him, because they almost always do. At any rate Eli remembered and still honored many of the basic tenets of his former faith. He taught all children respectful actions and the German-Swiss language of his ancestors. Martha worked with me at the local Wal-Mart, a place many of our local Amish patronize.
Martha is waiting on 2 Amish women who proceeded to make snide remarks about" the stupid ugly English( Amish term for people outside their faith) girl who was trying to serve them!"
Martha had just enough to make her ? angry! She said in perfectly spoken German " Thank you very much for your observation, ladies. Shall I give Bishop Yoder, my grandfather, your fine regards?. 2 very embarrased, bright-red faced Amish ladies headed for the front of the store where they could pay for their purchases and leave. Final score Martha 1 Amish Women with loose tongue 0

Dear Virginia,

I am seething at how cruel and unprofessional these medical professionals (I use the term, professionals, very loosely here)! If I knew where you were seen, I’d be in the Clinic or Hospital Administration Office in five minutes to report them. How dare they treat you or anyone else in such a hateful manner. Their terrible attitudes and lack of compassion have no place in the medical field.

When they go low, you went high! Good for you! All be best to you, Dear Virginia!!!

As I read all the posts, I thought that the PA and her partners in crime really don’t deserve the benefit of the doubt by confronting only them. I would certainly give a copy of your post to the PA and her partners, but I would also set up a meeting with Administration or Quality Control for the Hospital or Clinic and also inform the surgeon. No one else should experience what you did, and it truly sounds like these people have a field day discussing all their patients in a disrespectful and hateful manner.

I had a terrible PA that I saw during an Urgent Care visit. The next day, I called the general clinic number and said I wanted to talk to somebody about quality of care. When you do this, you get immediate responses!!!

 

17 minutes ago, GamePlan18 said:

I hope it wasn’t your intention to classify a whole group of people just because it isn’t something you are interested in

Seems to me maybe she was referring to the way hers look in comparison to the "perfect" image of them usually associated with those of a stripper or porn actress. Rather than classifying a type of person that gets this type of surgery done.

Out of her whole story that's what you decided to focus on. hmmmmmmmmmm

08/17/2018 04:03 PM, J San said:

Seems to me maybe she was referring to the way hers look in comparison to the "perfect" image of them usually associated with those of a stripper or porn actress. Rather than classifying a type of person that gets this type of surgery done.

Out of her whole story that's what you decided to focus on. hmmmmmmmmmm

Lol, I guess you didn’t read my whole comment where I agreed that she was mistreated and that their behavior was childish and insensitive, but it’s ok that you chose to focus on only part on my reply, I’m damn sure not here to argue with some random, about something I was saying directly to the OP. You have a nice day now dear. ?

Read it perfectly fine but that was not the focus of your statement. I guess you didn't notice but this is a public forum, one where others read and respond to posts of others. And I damn sure will have a nice day. and hopefully you damn sure will as well. DEAR

On 08/17/2018 at 09:10, J San said:

Read it perfectly fine but that was not the focus of your statement. I guess you didn't notice but this is a public forum, one where others read and respond to posts of others. And I damn sure will have a nice day. and hopefully you damn sure will as well. DEAR

I never disputed the fact that any random can respond, I stated I wouldn’t be arguing with said random, when I was replying to the OP. Again have a great day, sweetie. ??‍♀️