Body Mass Index

Dear Ellen,

You know with a title like that, this is going to be a good one! So, I was just at the sleep doctor for a follow up appointment with my CPAP (pressurized air) machine that I use at night. He walks in the door joking about Old MacDonald EIEIO.

The doctor plugs in the memory card from my breathing machine into his computer. I got the equivalent of A+, which we know is important to you and me for some reason. Then my doc looked down at my chart and said, "I see you've gained ten pounds."

"Yeah," I responded. "I'm working on it. I have this thing where I gain weight in the summer and lose it in the winter. I'm backwards from most people. I think I eat more when I'm happy. I'm happier in the summer."

No response; he's charting. Then my 3.5 year old makes crazy noises and acts a little rambunctious.

"You silly boy," Doc says. You better be good or Mommy's not going to cook you any lunch. Or, she's going to cook it and eat it all herself. So she can be happy."

"Whoa...that was mean!" I say.

(Parenting moment where I have to respond or redirect my 3.5 year old).

"You know, Doc, you ought to know not to say mean things about women and their weight. I'm surprised you don't know that by now."

Smiling and charting, he says, "I just speak the truth. I have no filter."

Then we move on into more productive territory like BMI and healthy weight and that if I want to redo my sleep study to see if I still need the breathing machine, I should lose some weight so that I don't skew the studies. In my mind, 'lose some weight' means get back down to the weight the sleep study was done at so we can isolate and eliminate the variable of the sleeping aid I took for the sleep study and see if I really do have 'hypopnea' or if it was drug-induced.

Doctor charts out loud. I wonder aloud "Does it make a difference how you write this up? I mean, I'm not asking you to lie, but if you make it sound like the re-study is my idea then insurance might not cover it."

I agree to talk to insurance and see what they will cover. I'm still nervous about this because a doctor stamp of approval with minimal details strikes me as sometimes a better option than all the minutae, because insurance companies will pounce on any detail and harp it to death to try to prove why something doesn't need to be covered. Anyway. At some point in here I tell him I signed up for Zumba.

"I don't know what that is."

"It's a Latin dance cardio class."

More charting.

As I'm leaving, the doctor says, "I'll reschedule you for a revisit within one year and you can call if you lose weight. We're talking significantly lower than the weight you were at when you started the study."

"Wait, what? What does that mean?"

"I mean like my weight."

"Um, what is that?"

123.

"Why do I have to weigh what you weigh?"

"Because if you're not significantly lower than when you started, the insurance won't pay and you're wasting your money."

"I'm not trying to change that variable. I'm talking about the sleeping aid."

Apparently he missed that part.

"So I will call you," I continue, when I weigh (previous weight minus 1) and I've talked to my insurance about what they will cover.

We're out in the common area by this point. Actually I think the door was open and we were heading out right around the time the doctor told me I need to weigh what he weighs. Bear in mind I'm taller than he is. All the staff behind their computers know how much I weigh now, if they were listening.

As I'm walking away, he calls, "Okay, but until then I've got you scheduled for one year."

Tonight, I'm going to tear it up at Zumba. When I got home, I went for a run. I made myself eat lunch. Then I googled a BMI calculator, just for fun. It's weird, if I lose three pounds I will no longer be considered overweight. I know there is such a thing as ideal weight, and I should lose more than three pounds to be in the MIDDLE of the ideal weight for my height. But it made me wonder...if I gained twenty pounds and then went in, what would Doctor 123 say?

Love you,
Hannah