Tag Archive | Health

I Have a Luscious Beard

My facial hair does not reach this level of awesome.  That is both a relief, and tragic.

Madame Clementine Delait (1865-1939)
My facial hair does not reach this level of awesome. That is both a relief, and tragic.

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.

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Scooters and Birthwork

Me, on my scooter in February.

Me, on my scooter in February.

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.

Adventures in Personal Training

Young Tough Girls
From flickr user: sixmilesoflocalhistory

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….”

I told him I understood his concerns, but that long term weight loss is not statistically likely.  And that my health can improve significantly from improved diet and activity that I enjoy.

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.

Amy, What About That Ted Talk?

I’ve had a bunch of people ask me about this video.  Peter Attia talks about fat stigma, diabetes, and alternate theories of why people are fat.

There is pretty good science about the idea that there are reasons that lead to obesity other than the “two whole cakes” theory, which states (approximately) that all fat people are somehow sneaking two whole cakes daily. He talked about one of those suggested reasons. The idea is that insulin resistance causes obesity, not the other way around. This is promising. I love that people are looking at their preconceived notions about fat people and talking about them publicly.

I also support the fact that he pointed out that there are a good number of obese people that are metabolically healthy, and thin people with metabolic syndrome. These are often tied to diet and exercise, hence why I follow a HAES® mentality for those that WANT to improve their health. 
Those messages I support.

However, for those people who are fat and metabolically healthy- that means that they aren’t showing signs of insulin resistance. I think that needed to be more than a passing note in his lecture, because if they aren’t showing symptoms of insulin resistance, then why are they fat? I fall into this category. 

I have trouble with his messages of “I eat like this, and I lost a bunch of weight,” and the idea thinner is tacitly better, and realistically achievable. Not everyone loses weight with improved diet and/or activity. I also think that health is multi-dimensional, and sometimes the best thing for someones overall well-being isn’t improving their physical health at the expense of their social, emotional, and/or spiritual health.  This approach does not so much fix the stigma fat people face, but changing the bar by which we judge fat people-  if they’re insulin-resistant, and doctors say it is ok, then they’re not terrible people?  But those other fat people…

I don’t agree with a moving target for stigma.

I Want to Move It, Move It?

Maybe someday I'll be this awesome.

Maybe someday I’ll be this awesome.

retrieved from flicker use banafsh

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). 

Jimbo Pelligrene found something he loves!

Jimbo Pelligrene found something he loves!

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?

Back from the HAES® Training

Lucy Aphramor, Amy, and Linda Bacon

The training was amazing.  Linda Bacon and Lucy Aphramor were brilliant.   There were over 50 people at the training, and about half of them were dietitians.  There were people from as far away as Australia.  Everyone in the room believe that fat people have the same health goals as thin people. We covered a few things I have thought about before in conjunction with Health at Every Size®, but never quite connected in the same way.

We talked about how health is multi-dimensional- there is physical health, emotional health, spiritual health, social health- you can’t hold one above the others and expect to feel well.

I mentioned First, Do No Harm in my previous post.  I’ve talked in classes before about the futility of prescribing weight loss to patients, as it almost inevitably results in weight rebounding and worse health than just being fat.  I’ve talked about how our current medical model creates a barrier to treatment.  However, Linda and Lucy clarified and condensed these issues.  These are all issues of medical ethics.  Providers, by and by large, get into the business to help people.  But when providers are taught to prescribe weight loss, and that weight is a result of laziness and a lack of willpower, they are harming the vast majority of their patients.  That is simply unethical. If providers knew and shared the facts about long term weight loss attempt results, we wouldn’t recommend it anymore, and more and more, people wouldn’t consent to trying it.

In the next few months, I’m setting up a forum to create a conversation between fat patients in Denver and Denver care providers.  Hopefully we can address some of these barriers to quality care.

We talked about the fact that being fat can exacerbate some conditions.  Being fat can impact joint pain, diabetes, and heart disease.  However, is weight loss necessary? Experiencing one of these conditions doesn’t make weight loss any more reasonable of a goal.  Also, there are things that you can do for any condition that doesn’t include such drastic measures with such poor results.  While it is clear that eating a varied, enjoyable, quality diet and physical activity can improve diabetes and heart disease regardless of weight loss, joint pain is harder to assess.  Eating low-inflammatory foods and getting enough sleep can improve joint pain, and sometimes physical therapy can improve symptoms, without weight loss.   Thin people with diabetes, heart disease, and joint pain are given suggestions to improve their health that don’t include weight loss.

The last thing that I took away from this training a reminder of the community available to me.  I was reminded of the HAES Community, where you can find researches, authors, activists, care providers, and more in your community.  I heard more about ASDAH, who actually owns the HAES trademark.  They have another listing of health professionals that work within a HAES mentality.   They hold annual conferences, do lots of work in the community, and have excellent educational resources on their site. I heard of local HAES activists, and left having met many many awesome people.

Fat Discrimination, Part II

Tools of the Trade

 

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.

Chub Rub II

If you’re wearing shorts or working out, inner thigh protection is a little harder than putting on protective clothing.  I see this type of chub rub as a triage system.

First, try using something you already have at home:

Lotion/Oil – Your favorite body lotion or favorite oil (coconut is a hit) can create enough of a barrier to reduce friction between your thighs (or other body parts).  This method may not last very long if the lotion or oil absorbs quickly.

Powder – Baby powder or cornstarch can stop your skin from rubbing.  This method can be messy, so you can use a washcloth or powder puff to apply.

Deodorant– Your deodorant can also work to ease the friction.  Just  apply the same way you normally do.

Silicone Lubricant – sounds silly, but the same silicone lubricant you may* keep bedside will reduce friction and is long-lasting.

If any of those don’t work, time to bring out the big guns.

Powder–  There are powders designed exclusively to prevent chafing, the most well-known being Anti-Monkey Butt Powder.

Monkey Butt Powder

Bar– These look like deodorant, but serve the express purpose of reducing friction.  BodyGlide is a prime example that I have used.

BodyGlide

Secret Shield is a smaller brand that I have heard recommended more than once.  It is available on etsy.

Secret Shield

Cream – Monistat Anti-chafing gel comes in a small tube.  It goes on clear and provides a slight barrier between the legs.

Monistat Anti-Chafing Gel

*(nay, probably should, but that’s another post)

Leave your recommendations in the comments!