Went to the GP

July 4, 2013

I don’t go to my GP very often, about once or twice a year, and it’s usually for physical health problems. Some people who have chronic mental illnesses have regular appointments with their GP about their mental health. My CPN has asked me a few times over the years “when are you next seeing your GP?” as if I was going to regular appointments so I wonder if it’s expected. My GP hasn’t suggested it to me and I’ve not asked him.

I’m kind of ambivalent about having regular appointments. I think it could be useful for my GP to know what was going on with me and keep track of things assuming he wants to do that. Also assuming the GP and the psychiatry services aren’t communicating well already. But it’s not like the GP is going to be changing any of my treatment. The whole point of going to a specialist, a psychiatrist for me, is to have them take over the specialised care of more complicated or long-term illnesses even though the GP is still required to keep co-ordinating the different parts of the care or at least make sure co-ordination is happening. I’m happy with the co-ordination that is going on and while I might be missing some of the subtleties that are happening, it makes no difference to what actually happens to me as far as I am concerned. Some people will want to be more involved and know exactly who, what and when. That was me ten years ago but not anymore. I don’t know if it would be useful for me to have regular appointments with my GP just to talk about my mental illness. I’m crap at talking about it so maybe more practice would be a good idea but would ten minutes once a month or whatever actually make any difference? I suppose it would be another excuse to get me out of the house which I could do with. These reasons are the ones I’ve thought about whenever the idea of regular appointments with my GP has come into my head, which isn’t often.

About a week ago, the backs of my thighs started getting sore (bear with me, I have a point… in four paragraph’s time) as if the muscles or something were too tight. It got worse so by Friday I couldn’t sit for more than a couple of minutes without having to get up. Fuck me, I never realised how much I took for granted being able to sit on a toilet seat. The pain was from my ankles right up into my bum in both legs. It wasn’t continuous and it moved up and down over hours. When I was lying down or walking, it felt like cramp or tightness with some throbbing and prickling or spiky feeling. If I walked more than about half an hour it got more and more painful and my legs started to feel weak. When I was standing still or sitting down, it felt as if a pole about an inch thick was being pushed into the backs of my legs. It would throb and get sharp pains so that I felt like I had to move or lie down. It felt painful whenever something even softly pressed into my legs. This was all only at the backs or slightly to the sides of my thighs and calves. When I looked in the mirror, there was a little bit of varicose veining in my right calf but none anywhere else. But I could see the raised, swollen ‘poles’ that were around veins I think. There seemed to be blue-ish lines anyway. The swollen bits were a good bit thicker than the veins and mostly I couldn’t see the actual vein. The swellings felt hot and springy.

So I asked Drs Google and Wikipedia who seemed pretty confident that it was phlebitis (not thrombophlebitis) and not anything dangerous like a DVT or whatever. I was thinking that since it was happening on both legs and from ankle to arse that it might be something systemic rather than a local problem. Meaning I might be able to palm it off on my medication! But to be serious for a split second, a medication side-effect made sense since the symptoms were so wide-spread.

I saw my CPN two days ago and I asked her to look at my legs and she didn’t see varicose veins other than the one little bit and could see the new swelling of whatever the fuck was happening. I said I thought it was phlebitis. She said perhaps I was right but perhaps Drs Google and Wikipedia wouldn’t mind if I saw a real doctor and perhaps I should go to my GP. I’d need a definite diagnosis to find out if it was a medication side-effect for a start. She also got hold of my psychiatrist who said he didn’t think it sounded like any of my medication was to blame but that I should go to the GP as I might need antibiotics. Drs Google and Wikipedia hadn’t mentioned antibiotics.

Of-fucking-course by the time I’d actually got to the GPs yesterday my legs were a lot better and there wasn’t much pain or swelling left by the time I saw the locum. She said it was definitely not anything serious and wasn’t sciatica, thrombophlebitis or DVT but it might be myalgia from the risperidone. It’s going away and as long as it goes away completely then I think that’ll be the end of it.

This is a very long story to say that it was actually really upsetting for me to go to my GP even though I was almost certain she’d say I didn’t have anything serious and that whatever it was would go away by itself. I didn’t want to go and made a lot of excuses to myself when this first started. I got pretty frightened at one point thinking that perhaps whatever it was that was happening might be permanent and that I would be stuck with it. I felt ashamed at the thought that maybe I’d damaged my body permanently. I felt better once I convinced myself it was only phlebitis but I shouldn’t have done that because I’m not a doctor and can’t diagnose myself. I even wondered if perhaps I had a DVT and if I’d been thinking that then I should have phoned the emergency GP or whatever it is you do then. I would have had to ask Dr Google again. This is all because I keep thinking of what will happen if the doctor starts tearing me a new one because I am fat. This isn’t some irrational fear: I’ve had doctors and nurses be horrible to me about being fat. Once I went to the nurse at my GP surgery to get my blood pressure checked (it has been high on and off ever since I had the problems with venlafaxine) and she did that but insisted on weighing me even though I said I didn’t want to be weighed. She was very disapproving and plain fucking horrible and I came out of that appointment wanting to take a machete to my body and cut the fat off it. That lasted for weeks and even made me think that I should let my eating disorder back into my life so that at least I could lose weight. It’s not just the horrible things that doctors and nurses can say that worries me, it is that I will cry. And cry and cry and cry and not be able to stop. Humiliate myself even further. So when I think about all that, going to a doctor seems a big risk and more of a risk than maybe having a DVT or having something seriously wrong.

This locum GP was really nice to me and didn’t once mention my weight or say anything at all about my size. I think if I’d been thin she wouldn’t have said or done anything differently. I probably wouldn’t have been in tears twice because I was so overwhelmed and freaked out about her even looking at me though. Reading fat acceptance blogs, tumblrs, etc, has been great for me in a lot of ways but I think it’s made me even more anxious about what might happen because I’ve heard so many bad things that have happened to people just like me. If I hadn’t read those stories then I’d feel a lot worse about what had happened to me I suppose. So maybe I should try to go and see my GP more often so I don’t get so anxious when I have to see him (or a locum) for something important. Haha, just read that back and realised I’m not counting my mental illness problems as important.

I’ve got an appointment with the crisis team nurse tomorrow and I think she’ll discharge me. It’s the third time I’ve had the crisis team this year. Or the fourth, I can’t remember. The last two times have been really helpful and I’ve felt the difference. But I can also feel myself starting to feel dependant on the nurse visits and worrying that I won’t be okay without them. I’m not attached to any of the nurses in particular, though the last two have been great, but it’s more the idea of “it’s okay that I feel so bad now because I can hold out for another three or four days or whatever until the next appointment”. That seems a bad path to be on. Most of me wants to be fucking free of all this and I can’t be until I’m okay enough on my own, or at least on my own most of the time. I’ve also just acquired a social worker somehow (I thought it was a one-off visit to do an assessment [personalisation?] to see if I ‘officially’ needed more support but she’s saying she’ll see me again, don’t feel like I can say anything about it) who has referred me to another support service. So that’s even more. I’m too proud as well. I don’t want to see myself as some kind of complete loser who has an empty life but I know my life is pretty empty compared to most people and it’s not like I like my life at all. I don’t want all this. I don’t want to be ill. I want to be free.


Today in fat-hating culture

July 17, 2011

Kathy Reichs is a forensic anthropologist and professor anthropology who also writes crime novels about a woman who is a forensic anthropologist. At least according to the source links on Wikipedia, there is a fair amount of autobiography going on in her books.

I was given a copy of ‘Grave Secrets’ as part of a random book sharing thing – I posted off books to people on a list and a couple of months later several books were posted to me. I’d never heard of her and had never gotten into crime novels as a genre either. But I read it and was moderately interested by the introductory explanations of forensic anthropology and of Guatemala, where part of the book was set. There was very little about Guatemala and I found that what description and explanation there was in the book, particularly of the brutal and lengthy civil war,  was frustratingly superficial. Not really off to a great start with this book but not that bad either, hey?

Ha, then the initially subtle body judgement escalated into full fat-hatred. Want some quotes? Page numbers are from the UK edition published by William Heinemann in 2002.

“[…] when a woman appeared in the doorway. She was overweight, with hair the color [sic] of dead leaves.” p.91

“There were two doughnuts left in the box. How many calories would that be? One million or two? By tomorrow they’d be stale.” p.145

“[…] I spotted a woman in surgical scrubs. She had long, curly hair, secured with a barette at the back of her head. Pretty and thirty-something, with a quick smile and 36Ds, Lisa was a perennial favourite with the homicide detective.” p.157

“[…] a man I assumed to be the family lawyer. He was tall, with a girth almost as great as his height. A fringe of gray hair ringed his head and curled up the collar of his two-K suit. His face and crown were high-gloss pink.” p.163

“The man’s face, once muscular, had softened by years of rich food and liquor. […] His meaty grip registered a four.” p.163

“Two girls appeared in a doorway across the hall. Both had fried blonde hair and looked like they ate a lot of potatoes. One wore jeans and a UBC sweatshirt, the other a peasant skirt that hung low on her hips. Given her poundage, it was a bad choice.” p.209

” Ryan looked at Gaudreau. ‘I don’t use e-mail that much.’ ‘And when you do?’ Gaudreau shrugged. ‘Sexychaton.’ ‘Thank you, kitten.’ Gaudreau looked as sexy as a baleen whale.” p.215-216

“A man the size of South Dakota dropped a bag on the floor and flooped into the seat to my right. A tsunami of sweat and hair oil rolled my way. Ryan’s eyes met mine, then shifted towards the windows. Wordlessly, he got up and changed location. I followed a compassionate thirty seconds later.” p.246

Most of these quotes seem innocuous at first. Just a writer trying to do short, punchy descriptions of her characters, right? The judgement of the characters’ bodies, which the reader is invited to go along with, is not simply disapproving and downright shaming of a certain type and size of body but is also mocking in tone as well. Using fat bodies as a source of humour is consistent through the story. Contempt is all fat gets in this book and that also sums up my experience with mainstream culture in my part of the world. It isn’t simply the fat jokes that are hurtful but that the readers who laugh along with them are having their own fat-hatred strengthened and normalized. In the end, that is what this book is to me: another push towards keeping the fatties down.

So, Kathy Reichs, welcome to fat-hating culture. How glad I am that you played your part.

Eating chocolate

July 21, 2009

I’ve been on a diet (even when calling it a lifestyle change instead) for most of my life. My mother first put me on a diet when I was about 7 years old. And while there were months when I abandoned dieting out of sheer hopelessness even when I wasn’t actively counting my daily calories, or some variation of that, then I was actively policing my food intake and trying to restrict it.

A bar of chocolate as a morning snack has been out of the question. Laughable even. I told myself: I’m fat and fat people shouldn’t be eating chocolate. I should be trying to loose weight at all times. Because, duh, the fat. Chocolate and loosing weight is not happening. From the ages of about 12 to 16 years old my mother tried to convince me I was allergic to chocolate. I even paid lip service to the idea myself and told people “I can’t eat that because I’m allergic to chocolate”. It did help to have such a good excuse. To be fair, part of my mother’s chocolate allergy theory was that she believed it gave me acne but it was also certainly not agreeing with me in other ways too (i.e. my weight). So I didn’t eat it at all for a few years. And I mean at all. I avoided chocolate as if it would send me into anaphylaxis.

When I was in my early twenties I started to binge eat and compulsively eat. These are two different things to me but I realise some people see them as equivalent. From then until last summer I couldn’t eat a bar of chocolate by itself and stop there. It was an irresistible trigger to keep eating. Sometimes it would be the start of loosing control and I would end up pushing (literally) the food into my mouth and swallowing as fast and frantically as I could and keep eating and eating and eating whatever I could find until the pain started and then I could stop. The pain from the sheer volume of food was what snapped whatever ‘turn’ in my mind that was the core of the binge. However, sometimes when I ate a bar of chocolate it was the beginning of days of what I call compulsive eating. I wasn’t binging on huge amounts of food at a single time but instead simply nearly continuously eating. I ate at about a normal speed and I ate normal (for me), or roughly normal, things but instead of gaps or breaks between snacks and meals I had more snacks. The pattern my ED therapist recommended me to try and follow was sleep-breakfast-gap-snack-gap-lunch-gap-snack-gap-dinner-gap-snack-gap-sleep. When the continuous/compulsive eating thing appeared, and I use the passive voice intentionally because it felt like I had very little control over it, then every “gap” was replace by”‘snack”. Except I didn’t eat meals when I was alone because, duh, the fat, so it was more like sleep-snack-snack-snack-snack-snack-snack-snack-snack-dinner-snack-snack-snack-sleep. Another description is that it was days of low level, slowed down, continuous mini-binging. The ‘turn’ in my mind was there though not as intensely as the frank binges but the behaviour was different. I sometimes think that the behaviour that I call compulsive eating is what the general public think that all obese people do all the time and that is why they got so damn fat! Well let me tell you, you know pretty early on then something is fucking wrong when you eat like that and it looks even to the most casual and callous glance that the inside of this person’s head is a fucking unpleasant place to be. Also, try opening your eyes … most people who are categorised as obese do not have disorders (see section 2.4 for the UK government funded NICE Guideline on Eating Disorders for a review of the epidemiological research. Or try putting “prevalence eating disorder” into PubMed.)

Did I get distracted by ranting about the perception of obesity. Good god. Anyway …

Today I ate a bar of chocolate as a morning snack. A single bar of chocolate. Because I saw it in the shop and thought it looked nice. I just ate it and didn’t think about whether I was a failure as a human being. I don’t even want to eat more. Which actually feels a bit bizarre. It’s just chocolate. I can eat it whenever I want. And when I genuinely mean that and I’m not trying to con myself, persuade myself or convince myself out of it in any way it really did turn out that I didn’t devour the world. I also had to deal with the other things that drove my binging, restriction, fasting and compulsive eating but dumping the whole idea of “I can’t eat that because, duh, the fat” has been given me huge amount of breathing space from the insistent push of the eating disorder demands. That Shapely Prose article was published almost two years ago and I read it back then and very much agreed with it. It has taken me even longer than two years of thinking and mulling over this stuff , a course of psychotherapy, medication and a fair bit of time talking about it as well to get me to this point. Yep, still fat and still eating chocolate. I bet there are people who would laugh at me so hard for this and say that this is the most convulted way of lying to myself and making it okay to eat chocolate EVERZ. To them I say: it’s just chocolate and it’s my body, don’t worry, it’s not your problem.

Maybe a little step forward

July 20, 2009

After my last rant here, which was a fairly straggly summary of the inside of my head, I think I may have made a little progress on how I feel about my body. I’m still at the stage in fat acceptance of believing that it makes perfect sense for everyone else that there is nothing wrong with being fat – and I do not mean that in a damning-with-faint-praise kind of “nothing wrong” instead that there genuinely isn’t anything bad, lazy, unhealthy or in any way intrinsically negative about being fat – except for me. Yeah, yeah, I know. It’s where self-hatred meets narcissism. And about as rational as thinking that buzzing noise is bees trapped in the wall.

But today I was thinking that if another person never had to see or touch me again then I’m okay with my body the way it is just now. Really, just now. All 17-ish stone (240-ish pounds) of me. There’s been a few times when I’ve changed my mind about things (previously accepted Set In Granite Facts) that have been prompted about thinking about my pets’ bodies. One of my old girls had an operation on Friday and thinking about the changes in her body as she ages made me think about how well I’ve done by my own. My bladder works and I can pee whenever I want. That is damn convenient in the society I live in. Same for bowels. I can walk and get around the ubiquitous steps (seriously, until it was pointed out to me I never noticed, what is with all the fucking steps everywhere?) with relative ease. This isn’t a case of “well I’m fat, but at least I’m not physically disabled!” Putting down a group of people to raise my own status is just frankly stupid because it’s based on untrue assumptions about people who have physical disabilities and therefore undermines me when I am trying to be rational. Also basing your own self-esteem on being ‘one-up’ or ‘better than’ someone else is just going to teach you the hard way that people really are equal. No, what I mean is that my new interest in seeing the things my body has done for me made me feel a little gratitude towards my body. Rather than focusing on its/my defects and weaknesses I suddenly did see that it/me has some good points.

As someone who has the down the cliched eating disorder exercise of “list the things you like about your body” and only come up with “I have okay eyelashes” then I think I’m getting somewhere.

ETA: The clumsy use of pronouns when talking about my body is actually kind of intentional. I have problems in that area and will post about it as soon as I can drag myself out of the existential mud.

Feeling divided and tempted

July 18, 2009

I have an eating disorder. Or at least I have an ‘official’ diagnosis of bulima though currently binge eating disorder fits me better. When I say “I have an eating disorder” I feel like a fake and that, any second now, someone will point out how ridiculous such a claim is and then go on to emphatically point out how much I am insulting and cheapening people’s experience of genuine eating disorders. Then there is more pointing and laughing …This flashes though my mind every single fucking time I say or imply in any way that I have an eating disorder. I know where some of it comes from but I still don’t know what to do about it or even whether I should do anything. I am almost entirely anonymous on this blog but I still don’t want to associate the words bulima and binge with me. If I ever let myself think about having an eating disorder, I feel such intense shame.

I have been told directly by a psychologist that I trusted and had confided in that I shouldn’t diet. I have an obese BMI. Her reasoning was that dieting would be an almost inevitable trigger for my binge eating and restriction/fasting cycle (also called bulima but see above) and that my eating disorder does me more harm than my fat. Not specific to me but the same diet-and-you’ll-binge message  is repeated in eating disorder self-help books and on fat acceptance blogs. Both seem to be reliable sources of information as have evidence to back themselves up including the Minnesota Starvation Experiment.

On the other hand, I have what seems to be everyone telling me that I should diet. From my GP to my family to my friends to the clothes shops to my bank balance to my new ladder. Yes, my new ladder. It has a weight limit and I’m over it. It cost me £44 and it isn’t strong enough to hold me safely. I have done the yo-yo diet thing which I personally find more humilating than being shamed for being fat. I have a lot of triggers just now. And I am so tired of it all. This fight in my head feels very similar to the fight I used to have when trying to resist a binge. In the end, I just wanted the fight to stop and since it seemed the fight wouldn’t stop until I binged so I would binge. Futile in the end because it just prolonged the cycle so I’d have the same thing to deal with in the near future but in the end, I just wanted some peace. This current fight seems to be the same thing: just diet, just do it, the shame and humiliation will stop, the laughing or sneering stares and comments will stop, at least I will be doing something … I can’t get away from the message to be thinner but I can get away from the message that fat is okay. I can abandon that, never visit those sites again and laugh at those sentiments along with everyone else and only I’d know my traitorous thoughts. It would be so easy to slot right back into dieting and weight loss.

And maybe I would find some peace in dieting and feel better about myself with weight loss. Is it really inevitable that I would binge? Would I really regain all the weight again? Perhaps there is a chance that it would all work out beautifully but the other outcomes look pretty grim. I can’t stand this uncertainty and feeling so lost.

Don’t You Realize Fat Is Unhealthy?

June 7, 2009

Don’t You Realize Fat Is Unhealthy on Shapely Prose is fat acceptance in one genius, cutting post. Kate Harding’s ten principles answer not only the trolls on her blog and the intrusive questioning and prejudice (i.e. trolls) that fat people have to deal with in real life but also the little voice in so many fat people’s heads that is internalised fat hatred.

7. Human beings deserve to be treated with dignity and respect. Fat people are human beings.

8. Even fat people who are unhealthy still deserve dignity and respect. Still human beings. See how that works?

Those two points have dragged me out of some pretty nasty beliefs about myself that were masquerading as rational and unassailable facts. This post’s clarity and thorough reasoning is something solid to hold onto.

Totally Awesome – Joy Nash

April 29, 2008