Reflect & Refute

A week ago, the plastic surgeon that did my abdominoplasty consult said a few things that rubbed me the wrong way.  Some of those things were just hard truths ("It's going to be harder to lose weight at 37 than it was at 30."  UGH!!), some were things based on his experience and not just me ("I find it's better to do the surgery after the weight loss because people are more inclined to keep the weight off when they are pleased with what they see in the mirror."), and two things in particular just annoyed me and I want to address.

Does this mean that I don't like the doctor?  Hardly.  I like him and his staff but these are things near and dear to my heart and register as pet peeves. 

1.  Fat People Must Have Shitty Self Esteems

I have my moments of looking at myself and being frustrated with what I see in the mirror.  Not because what I see looks bad, but because I know that's not me 100% of the time from every angle. I close my eyes and envision some sexy minx in an ornate floor length mirror who then slinks her way across the room draped in a Catherine D'Lish gown. I envision stepping over the torn letters of desperate suitors that have been rejected from consideration. At the door is a delivery man with champagne, roses, and a kitten with a very large bow.

The only time I realize the error of my fantasy is when someone tries to shake me out of it by pointing out that I'm not that person.  If no one points it out, then I'm happily oblivious that I might not be every man's fantasy, that women want to be me and be my bff, and that I can speak to all the tiny creatures of the world.

Okay, all kidding aside -- I know what he meant.  Most people don't seek out plastic surgery because they're in love with their body as is.  BUT I'd like to think the only reason why I fight so hard for my health and my body (all 5 orthopedic surgeries, all my "day one" start overs), is because I'm delusionally in love with my body as it is now and as I know it can be.  The only way I know how to do this is through love.  I can't heal my injuries, I can't lose the weight, I can't even consider surgery from a place of shame or hatred.  It's just not me. 

When I see the bits and pieces that I don't like, I am reminded of how I got them.  It's like after each trauma, someone gave me the physical weight as a way to display to the world my actual emotional weight.  I don't carry the emotional baggage anymore (just a few postcards), and I'd rather not carry the physical weight either. 

But please trust that I'm pleased with what I see in the mirror. 
Maybe a little too much.

2.  "People Usually Lose Weight After a Celiac Diagnosis"

(Disclaimer:  I'm not a doctor or scientist, just a nerd)

Let's cover some basics first: 
Gluten Intolerance/Sensitivity: inflammatory reaction
Celiac Disease:  auto-immune reaction
Wheat Allergy:  not the same as Celiac Disease, and can sometimes present as an anaphylactic reaction.
Gluten Free Diet:  dietary choice OR dietary necessity
Gluten Free Item:  reliance on manufacturer labeling and testing; no international standard (but many place it at under 20 parts per million)
Celiac Safe Item:  ideally 0 parts per million (and for many this means cross-contamination is still an issue)

There are two types of people with Celiac Disease:  people that have had the disease since birth (and presented as "failure to thrive" -- abdominal distention, bloating, not growing or gaining weight) and people who have been diagnosed later in life (on average it takes 6-10 years to get a diagnosis, but I hope with awareness that it's getting better -- diarrhea, abdominal pain, vitamin malabsorption, skin issues, etc.). 

When you are diagnosed with Celiac Disease, you CANNOT eat any glutenin or gliadin.  No amount of wheat/barley/rye is safe.  And for some people who are cross-reactive, no dairy or oats either (the proteins are similar, body makes an identification error and floods body with antibodies). There are no "cheat meals," for someone that has Celiac Disease

Once upon a time, there were no gluten free or Celiac safe analogs for things like bread, pasta, cookies, pizza dough, etc.  So you just had to avoid eating those things.  By nature of excluding whole food groups, people would lose weight.  And it wasn't always cause they wanted to -- remember, they've been sick for a long time and just want to eat and not feel gross.  And believe me, you cannot easily eat that many fruit and vegetables to replace the calories delicious fluffy croissants could give you.

But now.... there are analogs.  And quite often they are not nearly as delicious as what they're trying to mimic. Quite often, the solution is to add fat and sugar to gluten free items to make them taste better. Instead of wheat pasta, you're now eating corn/rice pasta.  You're not bypassing all of those calories in your diet. 

And because you're not sick (though it can take a long time for some people to get past the symptoms, and years for your body to repair the physical damage), newly diagnosed people with Celiac Disease are often really excited (but cautious) to eat, now that they know not everything will end up with them white-knuckling their knees while they use the loo.

So that's why people with Celiac Disease do not automatically lose weight after their diagnosis.  Because they know what they can eat without getting sick AND there are options!  At some point the euphoria wears off, and you stop wanting to try all the new analogs, and your weight may or may not be an issue.

Re-Grouping

As promised in my last blog entry -- a few lists in relation to my experience between 2009 and 2010 ("the first time around" "the second time around") (and I am sure that I'll be adding to these lists the more I think about it):



What I was good at
  • procrastinating
  • not hyper-focusing on the daily ups and downs
  • celebrating my small victories
  • self-awareness 
  • rebounding after a setback (sometimes?)
  • chutzpah and willingness to at least try
  • making awesome playlists
What I was bad at
  • meal planning
  • workout planning
  • consistency in regards to just about everything
  • waking up early to get to the gym before work
  • drinking enough water
What worked 
  • playing (making exercise fun, choosing fun exercises)
  • food logging
  • wearing the BodyMedia armband/FitBit
  • being supported by friends that understood both being overweight and having a serious injury to contend with
What didn't work
  • getting injured kinda sucked
  • Celiac Disease
  • drinking alcohol
  • "cheat days" versus planning in the things I wanted
What resources I had and used
Weird new creature
at the office gym
  • free office gym
  • walkable city
  • expertise and support from friends
What resources I had but didn't use
  • free exercise classes offered at the office
  • free exercise classes offered near where I live
  • supportive friends that wanted to take classes with me
What resources I need this time around

  • foam roller (with bumps? no bumps?)
  • more FODMAP recipes (that I will eat)/shopping lists (that are manageable) 

. . . And for some kicks, let's throw in Doug Newburg's five questions: 

1. How do you want to feel everyday or about your life in general?

  • I want to feel unrestrained by past mistakes.  I want to feel emboldened to take on new adventures without fear of failure or injury. 

2. When, where, and around whom do those feelings happen?

  • I feel confident in myself when I am confident in the net that I've made for myself -- supportive friends, good doctors/physical therapists, but also when I trust myself to survive setbacks. 

3. What gets in the way of those feelings or takes them away?

  • When I am injured, I tend to doubt my whole self -- my past, my present, my future.  I know it's not a fatal injury, but it shakes me to my core. When that happens, I shut down and wall myself off from the things I know that work out of a bit of shame, but also because I'm cautious.

4. How do you get those feelings back?

  • Keep asking myself if I am seeing things for what they truly are or if I'm projecting my fear and caution too far.  Trust friends' appraisals and borrow some of their confidence. 

5. What are you willing to work for? 

  • My long-term spine health
  • The possibility of an abdominoplasty


Re-Introduction and Re-Focus

Hi.

My name is Robby.  I'm 37.  I've been overweight since I was 8 years old (first trauma: witnessing my Nana die at 8; second trauma: losing my Mom at 13 -- the story is here).

My highest adult weight was 240(ish) pounds (109kg) from the age of 16 until 21 or 22.  My lowest adult weight was 188 (November 2010 -- to fit in a bridesmaids dress) (photos here)

In the 8+ years since then, I've had 5 ortho surgeries (neck artificial disc in 2012, lower spine fusion in 2016, plantar fasciotomies and heel spur removals in 2017 and 2018, and ankle stabilization/modified Brostrom procedure in 2018).  I was also diagnosed with Celiac Disease in April/May of 2016.

For those who have been with me a long time, you already know all/many of these details.  Sometimes it's really hard to package up my life time in a quick blurb of "how did I arrive at this moment" to people that need to understand all/a little of that to understand who I am, how I am, and why I am certain ways. I know I'm not unique in this. We are all the sum of our stories -- the current and past drafts -- as well as what is still to be written.

And yet, standing in front of him with a paper gown on, I felt like I needed him to understand something:  I wasn't looking to take the easy way out.  I felt even terrible for thinking it.  This isn't easy for anyone. I needed him to see past the fat suit and to see me.  I needed him to see the fighter underneath it all, not a person conceding defeat of any sort.

Yes.
Vague.
I know. 

This Friday, I had an appointment with a plastic surgeon to discuss my body -- the things I want to address surgically and what I need to do to be a good candidate for surgery (mainly abdominoplasty with a little liposuction contouring).

I've been wrestling with myself about whether I wanted to talk about this or not, or if I was somehow betraying my core philosophies on some level.  It's really hard to  kinda be known for (here, here) as someone who is unabashedly (and sometimes delusionally) going to love herself and defend herself/her body against all attacks from the outside world to then walk into a plastic surgery center.

In the end I realized a few things:  (1) I'm human and am allowed to be curious; (2) body positivity and plastic surgery need not be polar opposites, but I need to know my motivation; and (3) I've always tried to be honest here.

(1) I wanted to know a few things:  When I got down to 188, my lower abdomen didn't change that much and was that just resistant/skin/a lost cause?  Could we address the L5-S1 scar on my lower abdomen that's very visible? Could they help give me stronger abs (correcting diastasis from obesity and surgery), which in turn will help me get more stable years out of my back?  Is the fatty deposit between my boobs a morphological issue or just a weird place to store some bodyfat?

(2) Motivation:  Now that I've been cleared by my physical therapist to work out more on my foot, I needed some concrete goal (like needing to fit into a bridesmaid dress) that made me want to invest in myself.  I might get to the end of my "homework" process and realize I don't need/want surgery.  But ultimately, I see my lower abdomen as a "scar" from the trauma of losing Nana/Mom. And I hate the idea of living a life always carrying that scar/trauma -- that I can do the hard emotional work, but still not lose the physical reminder.

(3) Honesty:  I might not talk about everything right as it's happening, but I know how important it is to normalize the thoughts and feelings of what it's like to be an obese person in this body, in this world.

I have my work cut out for me (there's some other stuff that he said that I will address in another entry):

— He wants me to go balls-to-the-wall and try
to get down to that 188 again... and then try for another 5lbs (he did comment that it's going to be much harder to do this the second time around, almost as if doubting my commitment -- pfffffft!).
—He says my skin makes me a good candidate and that he's encouraged by the way my skin has healed after other surgeries (Lord Squigglesworth is a shadow of his former self).
—He was also kinda surprised at how awesome my legs/butt are (see? proof that I'm an athlete!)





My intention for my next blog post is to write a few lists in relation to my experience between 2009 and 2010 ("the first time around"):

  • What I was good at
  • What I was bad at
  • What worked 
  • What didn't work
  • What resources I had and used
  • What resources I had but didn't use
  • What resources I need this time around
Current Weight:  210 lbs (yay, period bloating!)
Goal Weight:  183 
Pounds to Lose:  27

Mini-Goal -- 15lbs in 3 months (seems doable?)