- A doctor stated that a man who suffers from fatigue, joint pain and body aches may have weight-related arthritis.
- Dr. Mike discusses his experiences with Lyme disease diagnosis and seeing the patient after treatment.
- In medicine, weight bias is a common problem that leads to poorer outcomes.
A well-known doctor has spoken out against weight bias in medicine. He shared the story of a young man who believed he had Lyme disease but was not diagnosed and his symptoms were ignored.
The morbidly obese man suffered from fatigue, joint pain, body aches and fatigue for several weeks. Doctor Mikhail Varshavski was the first doctor to diagnose the man’s symptoms as weight-related arthritis. He is better known by his nickname Doctor Mike. Social mediaAfter reviewing the patient’s medical record,
But Varshavski says he suspected the man was too young for that diagnosis. He diagnosed Lyme disease after further investigation.
Varshavski believes that the condition could have advanced to his heart disease and possibly even premature death if it had been left undiagnosed. Visit his YouTube channel.
“A lot of my patients do suffer with their quality of life because they fall into the category of morbid obesity,”Varshavski spoke. “But it’s also not right to blame everything that’s going on without doing a proper history and physical.”
The patient was treated with over-the counter medications and creams
Varshavski states that the patient was sent home for treatment with over-the counter meds after the initial doctor’s diagnosis. However, the pain became worse and the patient developed a rash.
According to his medical records the patient was taken to an urgent care clinic where he received a topical steroids. Varshavski was told that the topical steroid did not relieve the rash. However, it did reduce the pain in the joints and muscles.
The man reported that he was not getting better and went back to his doctor. He ordered X-rays but said the patient’s most likely cause was his weight.
“If you look at the course of illness for this patient — the fact that it was getting worse, there is not only joint pain, but there is also body aches, there is also fatigue setting in, rashes starting to happen — these are multiple systems being involved and that tells me something systemic is going on,”Varshavski spoke.
Varshavaski stated that Lyme disease was that something. He assembled the information using photos of Varshavaski’s rash as well as questions about his life. According to the man, the patient owned a dog that had just gotten a tick. Lyme can be transmitted by ticks.
Varshavaski tested blood for two types of antibodies: ELISA (which tests for antibodies against bacteria that causes Lyme disease) and Western Blot (which tests for antibodies against bacteria that causes Lyme. This is used to confirm a positive ELISA Test.
Varshavaski also gave the man doxycycline (an antibiotic to treat Lyme). Two weeks later, both the tests returned positive and the man’s symptoms disappeared.
“Had he advanced to late-stage Lyme and suffered from neurologic or cardiac complications, he might have required a hospital stay for IV.
Antibiotics
,” Varshavski said. “He might have died as a result a cardiac arrhythmia.
In medicine, weight bias is common and leads to poor outcomes.
A significant majority — nearly three-quarters, according to the The Centers for Disease Control and Prevention has the most recent data — of Americans are overweight or
Obese
. Yet, it is easy for clinicians to fall for long-held but false societal messages that weight is a key indicator and measure of health.
One study of more than 4,700 medical students across the country found that 74% exhibited implicit weight bias — meaning they weren’t aware of their negative attitudes toward bigger-bodied people — and 67% had explicit weight bias, meaning they consciously had more negative feelings when, in this case, presented with photos of obese people.
People with obesity and overweight can be denied care. Doctors may not see beyond their patient’s weight and patients may avoid care if they are scarred by weight bias.
Varshavski advises patients to confront their doctors if they feel that they are over-emphasizing weight.
“That is your right as a patient,”He said. “The relationship between a provider and a patient has to be strong in order for proper health outcomes to occur.”