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 this is within a hospital, not a private practice, they likely have. Patient Representative - I would look to connect with the patient rep to tell them what happened. They can work with the surgeon and his staff to re-educate them and reinforce how important matters like this are.

It is a private practice. Not part of hospital.

This totally sucks. You know HIPPA Law more than the average patient. Maybe reporting them will save you again from being hurt and other patients. I am glad you had a place to vent. Stay the course.

I am so sorry this happened to you. Please don’t let them get away with that. I worked in health care for many years and for the most part worked with some of the most caring people I know. That was completely inappropriate and unprofessional. You need to speak with the office manager and you surgeon. When you have to see someone in that office refuse to see that PA, You are not the only patient they have done this to I am sure.

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....

Edited August 18, 20187 yr by Missouri-Lee's Summit

19 hours ago, Bootscraper said:

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.

That worst part of this is that you have to keep reliving the impact of their comments and kicking yourself for not saying anything.

The lesson everyone on this forum should be hearing is SPEAK UP. Don't let the comments slide. Report, confront... but "do" something. When we do nothing, we essentially are telling ourselves that we don't matter. That our feelings don't matter. And that others are free to speak about us as they please. I am looking forward to future posts here in which someone was so moved by the stories and advice here that they spoke up. Everyone: be a self-advocate. You matter.

Edited August 18, 20187 yr by Missouri-Lee's Summit

I hope you have to take a survey? I do. If you do, fill it all out!!! With names, times, dates, and details. Also, this type of situation demands you take it to either the practice manager or clinic manager and file an incident report. You can then demand to never be seen again by that particular PA. It's a serious, serious infraction and everyone involved needs to have that in their records.

I'm so sorry this happened!!

Edited August 18, 20187 yr by FluffyChix

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.

No, no. Have been going there 2 years and never was asked to fill out a survey. As I wrote in a previous comment, I have already written a letter to the surgeon & practice manager. Thanks

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

That worst part of this is that you have to keep reliving the impact of their comments and kicking yourself for not saying anything.

The lesson everyone on this forum should be hearing is SPEAK UP. Don't let the comments slide. Report, confront... but "do" something. When we do nothing, we essentially are telling ourselves that we don't matter. That our feelings don't matter. And that others are free to speak about us as they please. I am looking forward to future posts here in which someone was so moved by the stories and advice here that they spoke up. Everyone: be a self-advocate. You matter.

I empathize with Bootscraper's feelings that feels she should have spoken up, but personally I don't have one lick of regret. I know that had I done so, no justice would have been served. The real justice is reporting her higher up the food chain, which is what I am doing. That would have been squashed, and ended there. I am playing the long game, not a quick adrenaline hit. I kept my cool and showed restraint, which now will give me much more credibility in the retelling of the story to the surgeon and the office manager (which I have done). Further, had I said something, that would then be fodder for the PA and her minions to twist in a game of telephone. I will not have my words twisted. I gave her *nothing* to twist around. I walked away or "turned the other cheek." But I am making sure that the right people are aware of her actions.

While current circumstances may not reflect it, the culture around the DC area is not one in which you can just have confrontations and say whatever you want. So, I cannot think of a word I could have said or anything I could have done differently that would change anything. Had the office manager or surgeon been there, I could have told them. But they weren't in the office. Anyway, to each his own.

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.

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.

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?

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

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!