It only matters what works for you.

Archive for the ‘doctors’ Category

More from the cardiologist

My husband had his two year follow up from the cardiologist the other day. The good news is, he looks great. She’s very pleased. The better news is, he also had a stress test (which he utterly failed 2 years ago before his quadrupal bypass) and he passed with flying colors.

The best news is, he’s finally off the beta blocker, which slows down his heart rate and is known to cause weight gain. The doctor is sure that isn’t his weight loss problem. Really, she’s sure. I think she just doesn’t like that as an answer. Because the last time she cut his dose his slow weight creep stopped, and it has been slowly, painfully inching down, even though his meals (which I procure, so I am certain) haven’t changed a bit.

The bad news is, he got another lecture on being fat and what a risk factor it is for future problems. I am very, very glad he takes his health seriously, but I don’t really love to hear doctors pushing weight loss surgery. There was a conversation about whether or not our insurance really will cover it, despite categorically stating that it doesn’t, but we’ve put that aside for the moment.

Because as a fat woman, you can be certain that 1) I have looked into the surgery and 2) I have friends who have had it. More research will be done, but one thing that seems to be standard is, in order to have the surgery, you must have been in a standardized weight loss program of some sort for 6 months before you  can be approved. And if that is the case, we might as well start there and see if he ever even needs to consider surgery. Which, off beta blockers, I think he won’t need.

And that is how we joined Weight Watchers.

 

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Which way is care?

I wrote this some months ago and held it back because it felt too raw, but now it is January and the season of dieting, so it’s time to post it.

On a private forum with women I care dearly for, there have recently been a number of posts about how they are once again getting back on the strict diet wagon in the endless pursuit of a size they like better.

My next thought was that I, too, should get back on the diet bandwagon because there is no question that my life would be easier if I were lighter.

And right after that thought, my stomach clenched. And I was overcome with a very visceral feeling of fear. And it was all I could do not to cry.

This is crazy.

I have spent over half my life depriving myself of food. Punishing myself for being fat. Eating what I ‘should’ even when I really, sincerely, would rather never eat again than have another bite of kale.

Just the passing thought of another strict diet was panic inducing. I can’t. I feel frantic, and sick about the idea. My body is enacting a flight response. It is clear to me that my body and mind find the idea traumatizing.

Even worse than that are the voices ringing through my mind as I type this. The kind ones say I shouldn’t give up on myself. The firm ones tell me no pain no gain and if I just try <insert preferred method> that it will be easy and I’m sure to see results.

The last results I got were burnt out adrenals and a thyroid crisis.

There are even uglier voices in my head too. Quitter. Loser. Fat lazy slob.

At what point does something you do for yourself become something you do to yourself?

Why is cutting bad, but starving yourself good? Why are recreational drugs bad, but damaging your brain chemistry via food is encouraged?

I think about the best eating plan to follow and I feel despair. Another long procession of food that I don’t want. Forcing myself to eat, and yet still so hungry.

Does saying no make me weak? or Strong? Is it self love, or self hate?

If it were a job I hated that much, people who love me would tell me to do everything possible to find another job.

If it were a relationship with a person that caused me such fear and anguish, people who love me would tell me that it’s a bad relationship and that I should remove myself.

Somehow because it is food and fat, the rules are different.

But after a lifetime of self torture, I’m ready to try living a new way, where I might treat myself with love and respect and ignore the voices that tell me I must fit into a mold that is too small for me.

So no more kale for me.

Is it really hate?

I recently read this viral post on Facebook about one woman’s journey to Thin, and how it wasn’t as great as she’d always been told it would be. (It was such a big hit that Cosmo did an article on the post.)

A life long fat person, she finally decided that society was right, and everything that was wrong with her life was because she was fat.

I felt deep inside that as long as I was fat, I wasn’t going to be able to stop hating myself enough to ask for more. So much cultural messaging says that if you are fat, you should be grateful for whatever love you can get – even if that love isn’t love at all.

So she went on a program of extreme weight loss. She doesn’t detail her method, because that’s not what this is about. I’m sure it was calorie restrictive and exercise abusive, because that’s what she says, and she got down to a place called Thin.

And you know what? Every horrible voice in my head, every bit of horrible anti-fat messaging from society was validated when I lost weight.

Attention from the opposite sex and better jobs and everyone was nicer and more thoughtful. The heartfelt dream of every fat person in America.

For five years, I got to be treated like a human being.

And it pissed me the fuck off.

I think that quote, right there, is one of the most important things she says in the whole piece. We the fat are told that all our problems will go away if we can just get to Thin. So she did. And sure enough everything was fixed and everyone was nice, even though she was exactly the same as she’d always been.

I understand completely. Glennon Doyle Melton talks in some of her interviews about how women are taught to be smaller and smaller and take up less space until we’re barely even there. Being fat flies in the face of this cultural imperative. Not only that, we do it on purpose. It’s a different kind of prejudice than racism, because your skin color is luck of the draw. If you’re fat, It’s Your Fault. So we deserve every molecule of heaped scorn and derision. No accomplishment can ever balance out the size of your behind. It boils us down to one, single aspect of ourselves and balances the entire universe of our experience on that soft, jiggly fact.

Statistics prove that We the Fat make less money, get less comprehensive medical care, have fewer opportunities, and miss out on more social niceties than those of normal weight. Put a normal weight person in a fat suit and they are horrified and astonished every time. It’s not codified. There is no law that allows it. But it is unending and universal.

Then life happened, and she didn’t have time to obsess about every bite of food she put in her mouth, and she didn’t have time to exercise every day. And she had a baby. And over time, she put all the weight back on. And now she doesn’t care, and she’s going to fight a society that says she has to.

My allegiance lies with fat me who missed out on half of her life because society said that she didn’t have the right to live it. …My allegiance lies with every kind and wonderful person out there who is told that they have nothing to offer the world because their body takes up too much space.

The second line that really, really stuck in my head is this.

I will not give the abusive assholes who say that they matter more because they weigh less the satisfaction of watching me hate myself into a small enough body to be loved by them.

Is the obsessive dieting and the endless determination to be thin at all cost a form of self hate, rather than the self love that society and medical professionals tell us it should be?

Frankly, I haven’t decided what I think yet. They tell us to diet to be healthier, but it hasn’t actually done me any good in the long run. Extreme dieting isn’t sustainable, every bit of data and research proves that. Yo-yo dieting is worse than no dieting at all. The research shows us that too. Did I diet all those years because I loved myself and wanted to be healthier? Or because I hated myself and wanted to be the ‘good girl’ that society wanted to see?

I think I know the answer, and I think I don’t like it.

More sleep

As I mentioned, I’m getting more sleep now that my husband has an autopap for his severe sleep apnea.

I also had a sleep study done. Because we were pretty sure I have restless leg, they sent me to an actual sleep lab. I’d had a sleep study done once before, probably fifteen years ago. Back then I was diagnosed with ‘hypopnea’ which just means I didn’t breath hard enough when I was asleep. They tested my lungs six ways from Sunday and determined they weren’t the problem. I had night time oxygen for a while. Then the problem went away.

Sleep studies start about two hours after my normal bed time. I got the very first appointment, but I think that just led to me sitting around longer. I had plenty of time to change, set up my travel fan, my white noise maker, fill out the required paperwork, and read a chapter of my book before the attendant came to wire me up.

If you have an in-center study done, I’d like you to know that when you get home, if you rub lotion into your hair where that nasty adhesive paste is, it will come right out. I know, it seems counter-intuitive to rub more goop into your hair to get other goop out, but it works brilliantly. My mother in law had to wash her very short hair three times to get it all out, where as mine was clean first try.

I suppose some people actually sleep in sleep centers. But I’m not sure how. The temperature was wrong. The bed was wrong. And I was wired like a lab rat. I could barely turn over. Fortunately, I was tired and it was well past my usual bed time so they got some data. Not much. I had a very unfortunate experience in that the attendant didn’t respond to my bell, even though I rang it as instructed every 10 minutes over an hour. By the time he showed up, I was furious. When I woke at 2am I just wanted to run to the bathroom and take some advil for my knees, which I couldn’t reach because of the wires. By 3 am when he finally came in, I was up, mad, and never going to get back to sleep.

The next morning you  can bet that I was on the phone to the people in the main sleep center offices. I filed a complaint. Partly because I wanted the incident on record in case I had to do it again. I didn’t want to be charged for it. But mostly because I was mad. And I’m the sort that is willing to raise a fuss. But a lot of older people do these studies, and they don’t raise a fuss. They aren’t comfortable doing so. Which may or may not be why the attendant was sub par during my experience.

They did get enough data. Fortunately. And I do have restless leg. Well, actually I have restless leg and Periodic Limb Movement Disorder. If you’re awake, it’s restless leg, when you’re asleep, it’s PLMD. I have both. Sometimes.

Me, being me, I got on Google and looked into all the non-drug options. Blood sugar is fine, had my iron tested, dramatically upped my magnesium, took the proper amount of the Bs. None of that made any difference. Then I tried some things like valerian and GABA as natural sleep aids. They didn’t help either. I never have trouble getting to sleep, I just can’t stay asleep because I’m twitching.

I now have an appointment scheduled with a sleep specialist to see what he has to say about things.

Although I must say, getting my husband on his machine has made a very unexpected positive difference in my own sleep. I wonder if bad sleep is just a habit I can train myself out of?

Wouldn’t that be something?

Dear young self

If I could go back in time and tell my young self one thing, it would be to not diet, no matter how many people told me “If you just…” and other annoying untruths. Because the science is clear now. While short term a diet can and often does improve some health markers like cholesterol and blood sugar, over the long term what repeat dieting is mostly likely to do is make sure you stay fat.

And if you think about it, really, would dieting be a multi-gazillion dollar industry if it actually worked long term? Of course not. If it worked, you’d do it once, the weight would stay off, and that would be it. They make all that money because you have to keep going back and doing it again longer and harder.

I found this article written by a neuroscientist to have some interesting things to say.

The root of the problem is not willpower but neuroscience. Metabolic suppression is one of several powerful tools that the brain uses to keep the body within a certain weight range, called the set point. The range, which varies from person to person, is determined by genes and life experience. When dieters’ weight drops below it, they not only burn fewer calories but also produce more hunger-inducing hormones and find eating more rewarding.

Evolution designed us around periodic famine. If too many died too quickly, then we’re a failed experiment. So those who had some way to slow their metabolism when necessary are the ones who didn’t starve to death. Fat is important for survival, if you don’t live in a world with a McDonald’s and a Starbucks on every corner. Your basic functions do not believe that a size 2 is more desirable than a size 22, and every time you ‘starve’ (ie Diet) it is more convinced that you need all the help you can get to survive.

On my most serious diet, in my late 20s, I got down to 125 pounds, 30 pounds below my normal weight. I wanted (unwisely) to lose more, but I got stuck. After several months of eating fewer than 800 calories a day and spending an hour at the gym every morning, I hadn’t lost another ounce. When I gave up on losing and switched my goal to maintaining that weight, I started gaining instead.

The author’s own story mirrors mine. There was a joyful time when I quickly and fairly easily (if you consider involuntary vomiting easy) lost 100 lbs in just a few months. I was on a strict low carb diet, and I was being introduced to my soy allergy. Soy is in everything, so every salad with soybean oil dressing, every handful of snack nuts roasted in soy bean oil…a huge list of common every day foods caused me to be violently sick almost every day. It took me quite a while to figure out why. It wasn’t intentional, but I took the weight loss gratefully. But then I got down to a certain point and that was it. Nothing else I did over a several years following ever took me down below that point. No matter how dramatic.

The causal relationship between diets and weight gain can also be tested by studying people with an external motivation to lose weight. Boxers and wrestlers who diet to qualify for their weight classes presumably have no particular genetic predisposition toward obesity. Yet a 2006 study found that elite athletes who competed for Finland in such weight-conscious sports were three times more likely to be obese by age 60 than their peers who competed in other sports.

I find this particularly interesting. Devoted athletes, no genetic predispositions, and yet repeated dieting seems to cause overall weight gain over time.

But our culture’s view of obesity as uniquely deadly is mistaken. Low fitness, smoking, high blood pressure, low income and loneliness are all better predictors of early death than obesity. Exercise is especially important: Data from a 2009 studyshowed that low fitness is responsible for 16 percent to 17 percent of deaths in the United States, while obesity accounts for only 2 percent to 3 percent, once fitness is factored out. Exercise reduces abdominal fat and improves health, even without weight loss. This suggests that overweight people should focus more on exercising than on calorie restriction.

And here’s the real winner. Despite the media telling us what a horrible drain on the system fat people are, the data actually shows that it’s being sedentary and out of shape that is the issue. Sure, those often go together, but our sedentary life style is the real problem.

So if I could go back an talk to my young self, I’d ask her to take another dance class. To ride her bike every day. To ignore how she thought she looked in sweats and go to the gym anyway.

So this January, don’t start another diet. Find something physical that you enjoy, and put your time and attention to that instead.

 

 

 

Good news and bad news.

The good news is, I reacted beautifully to the cortisone shot. I’m moving better than I have in probably 3 years. I genuinely had no idea how much my knee hurt. Being pain free on one side is amazing.

The bad news is, it doesn’t actually fix anything. And they wear off. And there is a limit to how many you can get in a year. And it doesn’t fix anything.

At my next appointment I’m having a shot in the other knee. I want to see what that feels like. I also have a long list of questions about which OTC pain relievers are recommended for long term. There is a joint lubricant they can inject and I want to get that set up and try it. I need to know when and how they can overlap.

I’m going to ask if they know an actually China trained doctor of Chinese medicine. Acupuncture is supposed to do really well for arthritis and I’ve had good results from it before.

I saw a podiatrist. Unfortunately my insurance doesn’t cover custom orthotics  Pity, because even just the commercial ones he gave me have helped some.

Plans are building. Things are happening. We shall see.

 

Irreverence for the win!

Last week I went to see yet another new doctor. This one was a pain specialist.

This summer, before things went crazy, I went to the Orthopedist and said “my left fibula won’t stay put.” So he took some xrays and turns out I have severe osteoarthritis in both knees. Not terribly unexpected at my weight and with my other issues. My question was “Why does only the left one hurt.” He didn’t have a good answer for that, and sent me off to physical therapy.

Looking back, I seem to have failed to mention physical therapy. Oh well. It went ok. I did it in between moving. It helped me get back some basic mobility, but nothing major. I expect it would have helped more if I hadn’t had to do it around moving when I was already exhausted all the time. Anyway, it got me to the point where I could manage the pool, and that’s what I’m doing now.

Back to the orthopedist. I went back this week to ask about a brace. Someone is supposed to call me, but at my weight, and with the shape of my leg, he’s not sure what a brace can do for me. And he once again referred me to the pain specialists. Because they are in charge of non-surgical management of severe arthritis.

She is fantastic. We chatted and I gave her my history so we were building a rapport while someone tracked down the files I’d had sent over from the orthopedist. And when she finally saw my pictures she said “Holy crap, your knees look like shit.” Which made me laugh and laugh. And I knew then that we’d have a long and healthy relationship. Because they are really terrible.

And then we talked briefly about options and I got a cortisone shot in my left knee. Right now it’s sort of numb. We’ll see how it goes.