Let's Get [A] Physical: Anti-fat Bias & Medical Professionals

on my way to the doc

I'm not the first person living in a larger body to leave my doctor's office feeling anxious and icky. Doctors are well known for their lack of understanding and empathy when it comes to matters of size. Diet Culture is so pervasive, so insidious, no one is immune to anti-fat bias -- even health professionals, no matter how good their intentions might be. 

I chose my doctor, nurse practitioner, and office staff because they are women of color working in a racially and socioeconomically diverse community. She was also cited by Noom (more on Noom another time, suffice to say I no longer support or recommend Noom to anyone because 1. They are a diet, no matter what they say and 2. My views on size and shrinking the self have changed drastically since then) -- which I was using at the time of my GP search -- as a fat-friendly doctor (not Noom's term, whatever they said I can no longer remember). This means that the office provides chairs that my ass can fit into and has large blood pressure cuffs in each exam room, things that make people living in larger bodies feel like normal people. 

At first, she and her NP were pretty decent about not overtly harassing me about my weight; however, as I have gained weight the past few years, there have been more suggestions about food restriction, exercise, and so on, including last week when I had my annual physical.

The past two times I have gone to my GP, both times for my annual physical, I have opted out of the weigh-in portion of my visit. Did you even know that was an option? I didn't until my 2020-2021 quest to deprogram myself from Diet Culture. I was so tired of overtly and covertly being told that there was something inherently wrong with me, something broken that needed fixing, because I am living in a bigger body. I learned that BMI is sham science and to question causation versus correlation when weight is blamed for health issues. Okay, so keep in mind that my doctor has no idea what I've weighed the past two years. She has no data, other than last year's bloodwork, upon which to base her conversation with me. And yet, she brought up food choices and intake -- not because of my health, mind you -- but because of my appearance. 

As she talked at me about lean meats and portion sizes, avoiding "junk" foods, and not buying these things so they're not in my house, I gritted my teeth. Has it ever crossed a doctor's mind that people are not necessarily fat because they eat like pigs at a trough (dehumanizing) or keep fun foods in their homes (weight is not about self-control)? I am overweight because of genetics, a history of food restriction since early childhood that messed up my metabolism and the always-accompanying disordered eating that comes along with that, poverty in my youth and access to food, trauma and the resulting influx of cortisol and other hormones, as well as several injuries/surgeries and chronic illness that have made it extremely difficult to engage in physical activity.

I am fat. I don't need to be fixed. I am still an awesome human worthy of love and respect.

So, I took a deep breath and defended myself: I'm a vegetarian (it's been twenty years); I am deprogramming myself from Diet Culture and disordered eating, I do not restrict my food and as a result I am not eating entire packages of cookies when I'm sad or stressed; yes, I have fun foods in my house because I like them, I eat them, and I have children who like and eat them; I will not restrict my eating ever again, I spent years doing that and it's done more harm than good, like disrupting my hunger signals; I am following the Intuitive Eating model and, yes, have met with a dietitian and am currently working through the IE workbook; I am newly diagnosed with RA and we're still figuring out my treatment, so I'm dealing with painful flares and swelling that make it impossible for me to engage in movement and activity with regularity -- especially because I have a history of pushing myself too hard and rendering myself unable to do anything for days after.

I now remember having a similar discussion with her last year after she suggested "weight loss" surgery, not stomach amputation but the gastric sleeve which is maybe a little better but also NO. I explained to her then that my issue was in my head, not in my stomach. That I was working with a therapist to deal with childhood trauma, unhealthy relationship paradigms, and the sudden loss of my mother. Why was I having to revisit all of this, and then some, again now at this visit?

No one should have to defend themselves and their actions to their doctor to prove themselves free of fault when it comes to their appearance and deserving of care when it comes to their health.

I left my physical feeling exhausted. It's exhausting to feel attacked. It's exhausting to feel the need to defend myself. It's exhausting to explain the effects of trauma, food restriction, and chronic illness to a person who has Thin Privilege and doesn't know what it's like to deal with chronic pain and mobility issues.

I think it may be time to find a new doctor. Again.

Levity in Marriage

Husband: I wish I had a personality [beep beep boop]

Me: ...uhhh, you have a personality.

Husband: Does flatulence count as a personality?

Me: Your asshole does have more to say than your mouthhole.

/scene

Progress v. Perfection

How many of you out there came out of this past year thinking to yourselves if I could just stick with X or I did great doing Y until Z happened and then all bets were off or why can't I just get it together and [fill in the blank]?

I've spent most of my adult life raking myself over the coals for these sorts of "failings". Why can't I just put my ass in a seat and write more? If I could just consistently plan my grocery shopping and meals ahead of time each week, I would eat more nutritiously. I was doing a great job attending water aerobics classes until the kids took turns being sick and I was home with them for 2 weeks, now I just can't get back into the swing of things. Why can't I keep my fucking house clean and tidy?

Well, I've got news for you and me: this is life! 

If your life is at all influenced by family, friends, colleagues, etc, it is never, Never, NEVER going to be simple, consistent, or without interruptions and roadblocks. These inner attacks (as my therapist calls them) do us absolutely no good and invalidate any progress we make in the name of imperfection. All we can do is strive towards our ideals and do the best we can.

Ideally, I want to write every day. I restarted this blog in January 2021 to gather an audience of readers to help keep me accountable. On January 1st, I came up with this idea.  On January 2nd I wrote, published, and shared my first entry. On January 3rd, I ran errands and then slept like the dead for the most of the day before dinner and family time and then slept like the dead again for most of the night until 6 woke me up this morning bright-eyed and bushy-tailed and ready for "mama school" (that's what we call it when I teach him and I'm keeping him home this week because omicron AND let me also say here how awesome his teacher is for sending me home scripted instructions for his daily lessons and activities). And here I am, on January 4th, post mama-school, writing this entry. Have I written every day? No. Am I about to publish my second entry of the year? Yes! That's progress and that's awesome!

Ideally, I want to buy groceries weekly in preparation for a well thought-out weekly menu. This probably happens half of the time. The other half of the time, we do not starve. Those weeks, we fly by the seat of our pants and rely more heavily on simple meals and partially prepared foods.

Ideally, I want to hit the pool three times a week: twice for classes and once doing my own thing. Lately, I've been getting to the pool once a week; but hey, once a week is more than no times a week (which is how often I was going last January-May). Progress! And looking on the bright side, classes are now being offered three times a week at a more convenient time for me, so maybe I'll graduate to being a twice a week regular. More progress!

Ideally, I'd like to keep my home clean, tidy, and company ready (don't worry, I have fairly low expectations for what this means) at all times. In the past I've done Apartment Therapy's January Cure, Clean Mama's daily cleaning rhythm, among other things to help me stay consistent. I've got news for you, people. I could be as consistent as the sun and this place would still be in shambles 40% of the time because I have two teenagers who live so far up in their own heads they wouldn't notice if rats ran across their feet let alone that they leave a trail of clothes and other crap in their wake no matter where they are in the house or what they're doing. I've got a designated "landing pad" in my entryway, coat hooks and cubbies for each kid, routines aplenty for putting everything in its place during transitional times after breakfast, after school, after dinner, and before bed. So long as I have a husband with ADHD and enjoyment of my own sanity, I will never have the house in the shape I want it to be and that is okay. I'm a mom, not a maid. It's not worth my wrath and resentment to micromanage every living being in my home to keep my house in tiptop shape. NOT. WORTH. IT.

Instead, I lower my expectations and leverage my power. 

When I began my stay-at-home-mom gig, I learned quickly that a good day consists of keeping my family alive and feeding said family. If I am also able to keep up with the dishes and do a load of laundry, it's a very good day. Now that my kids are older, a good day consists of keeping everyone alive, getting them all to school, and providing them with tasty strength and growth food. If the dishes are washed and put away, the counters are clean, and a load of laundry has been done, it's a very good day. All of this plus doing something for myself (writing or swimming or napping or reading) is my definition of success. These are simple expectations and they are a challenge for me to meet, and I'm okay with that!

As I stated earlier, I am a mom -- not a maid. As we know, moms carry the heavy mental load of care for those we take care of, including our partners. I take the lead on almost everything in our household: food, clothing, childcare, education, play/entertainment, child-related communication with school/parents/friends, behavior expectations and discipline, household management and assigning of domestic tasks, healthcare oversight and appointment scheduling, oversight of petcare/grooming/veterinary, and on and on and on. My partner works many hours and provides for us (we can discuss how squicky this antiquated setup makes me feel at a later time) and makes a real effort to support our household by endeavoring to do anything I ask him to do. I expect my kids to do the same; frequently, 14 and 17 do not feel the same way. Therefore, it is necessary for me to remind them that we all have our parts to play:

Mom, I need clean clothes. When are you doing laundry? Well, I asked you to sort and deliver your dirty clothes and linens to the laundry room three days ago; you did not. You need to do that before I can wash your clothes. And, by the way, your problem is not my emergency, so I will not be ruining my Christmas holiday by doing four loads of 14 and 17's laundry. Thanks, bye!

Mom, what time is my playdate with Best Friend? It's at noon, but we can't leave until your room is cleaned up. Come on, you pick up your toys and I'll vacuum.

Mom, why am I locked out of my phone? Why do you have missing assignments in your classes? OR Why isn't your room picked up yet; I told you to do this two days ago. OR Because you're acting like an idiot and texting with people you don't know in real life and dude is trying to be slick using a shared Spotify playlist to show you a penis pic. OR whatever because the power of the electronics are strong in this generation, grasshopper. Let me also say here that you can similarly leverage hangouts with friends, money requests, and fun non-necessities to which said child feels entitled.

Mom, have you seen my [earbuds, hoodie, book, whatever]? Look in the Box of Doom.  The Box of Doom is a sanity saver. That trail of stuff my teens leave behind them like a snail's trail that I cannot convince them to pick up despite asking a million times? I don't have to pick their things up and put them away, but I also don't have to suffer with their junk all over my house and in my way and harshing my vibe. Any of their crap that's in my way or bothering me, I just throw it in the Box of Doom. They can be inconvenienced -- not me! -- by losing their stuff and having to dig through the box to find it. Then, whenever I feel like it, I demand they clean out the Box of Doom; leftovers will go straight to the Goodwill.

Despite all of my talk about lowering expectations and leveraging power, it is my goal to raise my kids to be -- as Michaeleen Doucleff writes in her book Hunt, Gather, Parent -- "accomodido": I want them to notice the things in their surroundings that need to be done and then help out by doing them without being asked. That is going to require me to approach things a bit differently with my kids. I need to better figure out my boundaries, limits, and higher expectations so that I can narrate and demonstrate noticings of what needs to be done before we are in a crisis situation (i.e. me freaking out or the dogs without water or 14 without clean clothes) and then providing my kids with the opportunity to demonstrate their agency.

I'm still working on this from my own end and, you know what? That's okay.

OHHHHH(micron): Here We Go Again!

I have been looking forward to sending my kids back to school now that the holidays are over. We enjoyed our time together, but I'm ready for us all to get back into a purposeful routine in which I can enjoy a modicum of time to myself and a less-trashed house. 

Oh, Omicron, you sneaky little bitch. You almost ruined our first family holiday since the pandemic began and, due to the teenage stupidity of 14 and 17, gave us a post-Christmas scare. We required 14 and 17 to isolate in their room and mask in the shared kitchen and bathroom space; it was a long-suffered time between Christmas and New Year's. 14 tested negative on Friday morning; 17 went on a trip to Chicago with their exchange program and today -- their last day there -- their host tested positive for covid. Now 17 will quarantine (for a second time) with their chaperone until they're cleared, hopefully by their school's mandatory test on Tuesday. 14 and 17's school is using the test-to-stay model, which I'm satisfied with as the best of both worlds: the safety of avoiding covid and the sanity of my kids staying in school.

6's school is another story, in that they have not yet shared any sort of return-to-school protocol in light of the recent omicron spread. Usually the school holds classes outdoors as much as possible, but with the below-freezing temperatures that will not be possible upon return. Combine that with the small but vocal anti-mask contingency and I am not feeling secure sending 6 back at the moment.

Our entire family is vaxxed and we adults are boosted, but I have two major issues with this Omicron outbreak:

1. Even though this variant is supposedly milder for those of us vaccinated, going about business as usual will only exacerbate the spread and its deleterious effect on:

• those who are high-risk or unvaccinated
• healthcare workers 
• the already-diminished healthcare system, which will be unable to meet general public need during another serious outbreak

We need to be thinking about the greater good here and not just how contracting Omicron will affect ourselves and our immediate families. "I'll only get a mild case of Omicron" is a short-sighted and selfish response.

2. I've been recently diagnosed with a chronic auto-immune disease and am being treated with cancer drugs (immuno-supressants). I struggle with day-to-day caretaking of my kids and household chores as it is, the last thing I need is another chronic illness like long-covid as a result of Omicron or any other variant. I want to be able to show up for my kids and myself without any more roadblocks; I don't want to deal with anymore setbacks when it comes to my ability to parent or eventually go back to work. So, I'm not messing around with omicron.

I'm freaking out a little bit here because -- like you -- the last thing I want is to go into 2022 like we did 2021. Things were just beginning to look up: I could see friends, I went out for drinks once, we even went out to dinner a couple of times, my kids were back in school and relatively safe. I don't want to go back to the way things were, self-isolating and feeling like we're on top of each other day in and day out. I want time! I want space! I want quiet!

But wanting, hoping, wishing, does not make it reality. So please, act accordingly.