This post can be found at my new website, www.thefatmidwife.com
Lets do some good old fashioned soul-baring, inspired by The Militant Baker.
I have Polycystic Ovary Syndrome. It can mean a lot of different things to different people. To me it means I keep a closer eye on my heart health and blood sugar, both of which are currently normal. It may have contributed to my current size. PCOS correlates to the depression that I have dealt with off and on since I was a teen. I was told I may be infertile when I was diagnosed at 15. I was diagnosed when my mom and I realized my periods weren’t becoming regular as a teenager.
With a little care, I’m lucky that I am as healthy as a horse. The jury is out as to whether fatness is a cause or effect things with PCOS, and frankly I only care about it academically. That same big horse is already out of the barn, and a fancy chestnut mare is she. Turns out, I’m probably not infertile. However, I’m all over the jump-straight-to-spoiling role of auntie, so I won’t be testing that theory.
Other people may see actual cystic ovaries (although this is not guaranteed), heavy or absent periods, thyroid issues, thinning hair and acne and other skin issues. Symptoms vary from person to person. Symptoms may show up at puberty, like mine did, or may show up later in life.
The biggest part of my PCOS that I deal with daily is the beard… I started growing facial hair at about 17. I’ve been super self-conscious of it since then, but turns out people generally don’t notice. Or they’re too polite to say so. Even so, I’ve tried almost everything to get rid of it. Most things I’ve tried have caused more skin irritation and acne than hair removal. I now reap the benefits of a laser hair removal groupon I used few years ago, and a constant supply of tweezers stashed strategically in the bathroom and in my purse. I’ve also made more peace with it and don’t worry about it as much anymore.
Female facial hair can be a sign of hormonal imbalance, but it can also be normal human variation. I don’t discount the fact that the men in my family are impressively hairy. There are women who embrace their facial hair. I think that is awesome. While I like my face smooth, I don’t pretend that the preference is not a cultural thing. Mariam and Balpreet both look great.
I love riding my scooter. My dad rides a motorcycle and I always loved riding with him. A few years ago, I gave up my car (by “give up”, I mean totaled, and refused to replace). I’m not a terribly good driver, and it is much harder to get distracted on my scooter. I chose a scooter partially because I have a tendency to wear skirts every day; I’m not much of a lady most of the time, but straddling a motorcycle in a skirt is a bit beyond my comfort level. This leads to an interesting world in which some motorcycle riders acknowledge me as two-wheeled kin, and some don’t. I love seeing motorcyclists and scooterists on the road. To me, its a party where we all try not to get killed by drivers. And I always give a head nod or wave, either way. It isn’t always returned. I’m sure there is an argument to be made that a scooter can’t always go as fast, is a cop-out, and other reasons that motor cyclists might not openly recognize me. And that’s fine. While it is nice to see a head nod, wave, or two fingers flashed over a handlebar, the absence of recognition doesn’t make me go home and cry at night.
As I rode along a few miles from home, I was thinking about how this correlates to the birth community. Some see it as an adversarial system, where OB-GYNs just want money for c-sections and their evenings free, and labor and delivery nurses are either overworked and surly or saints, midwives are angels, but home-birth midwives might be irresponsible, and doulas take over the roles that friends and families should fill and just annoy the nurses. And of course, they all have trouble working together.
I remember when I first chose to start down the path to become a midwife, I chatted with a labor and delivery nurse one night at a friend’s house. I told her I was really glad to hear what she did, and asked her some questions about her experiences. Eventually, she asked me what my plans were. When I told her I wanted to be a midwife, she laid into me saying that any time a woman had a midwife they always ended up in her care with interventions. My decision was foolish, and harmful. I was shocked at the vehemence. I never ran into her after that night, so I never had the chance to understand the experiences that lead to her frustration with midwives and home births.
Her line of reasoning didn’t make sense, from multiple angles. There are many midwives who work in hospitals, and there is plenty of evidence showing that home births and birth center births are effective for many women.
I don’t think either view has much merit. In birth, no one has a direct ride to the front of the class. Each position has strengths and weaknesses. Every care provider picked their occupation to help pregnant and laboring mothers. OB-GYNs have a level of skill that is required for more complicated cases. Midwives have skills to lead uncomplicated cases safely through pregnancy and birth. Nurses provide care and valuable monitoring and liaising with a hospital. Home birth midwives fulfill a community need for supervision and guidance, even in the simplest of cases. Doulas provide one-on-one support, hands-on assistance, and useful education. They can all work together, within their own scope of practice, to create a community that supports parents at every level.
And maybe we can all go for a ride afterwards.
I am pursuing personal training for a bunch of reasons. In order of importance, these reasons are:
- I really, really like moving things around and being freaky strong
- I like being able to walk, scurry, sprint, ride my bike, swim, and play on swing sets without getting winded
- I like being flexible and bendy
- The apocolypse
- It will likely improve my cardiovascular fitness and overall health
Keep in mind I, personally, find all these things important. You may enjoy (or tolerate) physical activity because of all, some, or none of these reasons. Or you may not. I love a Health at Every Size mentality and will continue to talk about it (a lot), but health is not a moral imperative. Health is not a ticket to basic dignity and respect. I’m at a place where I’m doing things that I enjoy, that improve my health. This does not make me better or worse than anyone else.
It does, however, make me do ridiculous things like meet with a personal trainer. Rob and I introduced ourselves yesterday, and we sat down at my local hamster wheel to fill out the appropriate paperwork. We talked about goals, what I’ve been doing for fitness lately, why I’m coming to this gym (online coupon for a month’s membership and 4 personal training sessions). And then we get to the fun part. I’m far enough removed from my dieting days that my weight and such are more of a passing curiosity than a cause for panic, so we measured my weight and body fat percentage. He wrote down the numbers and said, “Of course, we’d like to see your body fat percentage around [number redacted] percent.”
“Well, that’s a relative “we”. See, I’m here to work on these goals, regardless of any changes in weight or body composition.”
“But diabetes, cardiovascular disease, mortality….”
We went a couple rounds, with me citing these studies, and him citing his book of clients. I’m thrilled for his clients. They have achieved something that they wanted. But only one client he showed me had maintained the weight loss past five years, which seems to correlate with the statistics I cited in our conversation. Her goals are not my goals, and those odds are not odds I’m interested in.
We stopped debating when I said, “Here’s the deal. If I lose weight, you get a giant gold star and a letter from me for your book. If I don’t lose weight, but I do gain strength and reach my other goals, then we still both win.” We came to a truce and he sent me out for a warm-up of my choice. I like the elliptical machine.
We then did barbell squats, leg presses, leg extensions, and wall sits. And by we, I mean I. He pushed me to do reps, and we laughed as my legs shook. We gossiped and talked a little smack. It was glorious. I’m sore today, but I can’t wait to go back next week, after doula training. While Rob and I don’t see eye to eye about weight, I have an ally in my corner because I was able to advocate for myself and put down boundaries about what I wanted out of my personal training.
I know that many large women have trouble finding workout clothes in their size. They either can’t find it or can’t afford it.
I remember wanting to start working out a few year ago, having nothing appropriate to wear, and going to Target, where the only pants and shirts I could find were just a smidge too small, but what else was I going to do?
Well, I’m older, wiser, and love online shopping. Of course, I’d love it more if I could shop in stores, but I’ll take what I can get for the moment.
In stores, Old Navy carries workout gear through an XXL. Their regular sizing is generous, and an XXL will likely fit through a 22/24, even though they’re marked as 20. They have capris, yoga pants, sports bras, tanks, and t-shirts, and carry compression gear. Online, they carry sizes 18W-30W in their plus section. While the selection is a bit smaller and the fat-tax is pretty generous, they carry all styles of gear at decent prices. I went on a spree a few years ago, so Old Navy is what I wear, and I find it pretty darn comfortable!
You’d never know it by their pathetic in-store offerings, but Target carries some decent women’s workout clothes online. Unfortunately, their search function is difficult to use. Some good sleuthing will find you good deals, though.
Woman Within has cemented a place in the online shopping experience. It is great for basics, has excellent prices, and they consistently offer up to a size 40W. Workout pants, skirts, shirts, comfortable swimsuits, and sports bras are available.
Junonia is synonymous with classic plus size activewear. They’re a little pricier, but they’re known for quality and a variety of clothing to cover every activity from skiing to golfing to swimming to tennis to running. Their sizing goes up to a 6x/40W in some pieces.
I’ve heard great reviews of Sparkle Skirts from the fitness group I’m a part of. With pockets, compression shorts, and as finely obnoxious of a print as I could ask for, I’m excited to order one in the future. Sparkle Skirts offers sizing up to a 3x.
Share your favorites, too.
Last week, I was invited to go to an archery range with a new friend while I was in Seattle. I didn’t know what to expect. I was nervous; arrows are rumored to be pointy, and I’m not always known for my physical grace. I shoot handguns a few times a year, but this is completely different.
I ended up having a great time! We shot for about two hours. It was calming to focus on exactly how to hold my body for the next shot. When I got a good shot it was exciting, and every few minutes someone yells “Clear!” and I’d walk down to the end of the lane and pull my arrows out of my target (or from near my target). I loved focusing on where my arms were, my posture, my footing, and exactly what level of strength balance were required. I had a pretty righteous crick in my neck from sleeping in hostel beds, and it felt great every time I pulled the bowstring back and brought my shoulder blades together. It may not have been awfully strenuous, but I was moving for the whole two hours. I’ve looked up an archery range close to me, and I look forward to visiting it soon.
Movement and activity are important for health. Traditionally, we look at movement and activity as exercise- often a punishment for the outrageous sin of eating. When we remove the goal of weight loss, movement and activity are important for other reasons. Regular physical activity improves mood, blood lipid levels, sleep, blood pressure, blood sugar levels, and energy levels. We breathe better and our cardiovascular system responds quicker and recovers faster. When you find something you enjoy, it is a great stress reliever, too.
I haven’t always loved going out and doing physical things, because exercise felt like a chore for so long. A few years ago, I removed the ‘should’ from activity. It took a while, but I started wanting to fit some activity into my life. I feel better when I move. I have less pain, breathe better, and recover faster when I have to hustle somewhere. Also, I’m having a lot of fun!
Joyful movement is all about finding something you love. I love swimming, elliptical machines, biking short distances, weight lifting, chasing my friends’ kids, and I just may love archery now, too. I have a game on my phone, Ingress, that means I walk around for hours stopping near public art and landmarks looking suspicious (It is a sort of highly technical multi-player, never-ending version of capture the flag that uses Google’s maps and your GPS).
I’m still discovering things I like to do, and how to fit them into my schedule, especially as my schedule is so variable. I like working out at a gym; not everyone does. I got a deal online for a month’s membership and some personal training sessions at a local gym. I’m looking forward to getting to know their machines and find out how I can improve my ability to “throw things around.” I love my strength. While you can almost always find me in a dress, and often find me in heels and makeup, I still love the opportunity to help carry a couch, or climb a tree, or move some boxes.
I have friends who love to dance, love to run, love yoga, love to garden… When you remove the temptation to judge activity solely by its calorie-burning attributes, it really is all about what you like.
Movement has also been an opportunity to pay attention to how I feel. For a looong time, I assumed that I got winded before my muscles ever even noticed what was going on, and my feet hurt, because I was ‘out of shape.’ Turns out, I have asthma (I thought I got rid of it as a kid), a pretty impressive heel spur, and a decent case of plantar fasciitis (Those translate roughly to “perpetually walking on spikes”). I got an inhaler, and it works like magic! I have orthotics coming in next week, and I can’t wait to be able to step up my game, physically. I’ll have to figure out how to fit them in my dressier shoes, but I expect to feel quite a bit better on my feet. That means I can do more walking with less pain, which is so great when I like to play Ingress and wander around on foot for hours. Paying attention to yourself as you become more active means you can understand your own needs better.
What do you like to do?
photo via: http://www.flickr.com/photos/lolitserica
You don’t have to read this post. Just go talk to a fat person. Ok, fine, read this post for a more concise version. Then go talk to a fat person in your life.
Doctors, nurses, midwives and other health professionals can make taking care of myself a real pain in the butt. People of size have to worry about two things when they see a health professional- will they be able to treat me appropriately and will they be willing to treat me appropriately?
Depending on a person’s weight and size, a health professional may not be able to accommodate them. Offices may not have chairs large enough. If your chair is uncomfortable or impossible to sit down in, where should I wait? Their blood pressure cuffs may not be large enough. A too-small cuff will read incorrectly- readings will be higher than that person’s actual blood pressure. I also know from experience that it is also painful. Exam or treatment tables are designed to hold a certain amount of weight- that weight can be 250, 300, 400 pounds or more, but a large person can’t always be certain that the equipment they’re told to sit on will support their weight. For me, this is something I particularly worry about when getting a massage. Exam gowns are uncomfortable for everyone, but I promise they’re more uncomfortable if you can’t fit your arms though, or when the little sheet you’re supposed to cover your legs with doesn’t even cover across your hips. Scales often top out at 350 pounds- how is a larger patient supposed to even know their size? How am I supposed to trust a care provider to care for me, when they can’t acknowledge and care for the physical realities of my body?
After physical concerns, I have to worry about how a care provider will treat me. There are so many personal stories about mistreatment. First, Do No Harm talks about the realities of patients seeking help and how they are treated. But maybe you’re not persuaded by personal stories- let’s talk facts for a moment. How care providers feel about my body impacts how they treat me. Doctors spend less time with fat patients, offer them less options, and offer less education. Doctors assume they are lazy, dishonest, and won’t be compliant with treatment. When asked to rate all patients, doctors acknowledge they just don’t like fat patients! Don’t take my word for it, go read this article published in the American Journal of Public Medicine.
Fat patients sense this distrust and distaste. They remember their mistreatment years afterwards. It means that as a group we seek preventative care less often, including pap smears and mammograms. When we do have health issues, we may wait until they reach emergency status, because as bad as it is feeling poorly, it is worse when you’re treated awfully about it.
This behavior makes it harder for fat patients to access even basic health care needs. Care providers, including doctors, nurses, midwives, massage therapists, psychologists and counselors, nutritionists, physical therapists, social workers as well as others need to embrace some compassion and empathy for their fat patients, and treat us with the human dignity and respect we deserve.