The Thin Line of Fat: A New Series

Those of us who have been fat our whole lives recognize the discrimination and prejudices associated with being larger than "normal." In fact, many of us have even used the terminology ("overweight," "obese," "thick," "big-boned," "large," "Ruben-esque," "full-figured," etc.) ourselves to conform to the outside world. It's a vicious cycle that often starts when we are young and usually never ends--a cycle of self-hate, bad habits, bad choices and lack of confidence that is more enveloping than a black hole.

When you have a chronic illness, there's even more to add to the fold.

For years I struggled with what I knew in my heart to be weight that I didn't earn. And by that I mean in no way to suggest that anyone earns the weight they have (though I'm sure some do), but only that my body was doing things that I knew I couldn't control. It was only years after I was diagnosed with PCOS and someone taught me about Insulin Resistance that I was vindicated.

In those intervening years, however, instead of questioning my body, myself and my sanity I decided to embrace who I was. This was in large part due to meeting one woman in particular who taught me to start loving who I was, regardless of how much I weighed. (Unfortunately and sadly for the younger versions of Me in this world, Heather MacAllister passed after a bout of cervical cancer.) Ever since then I have been on a path of self-discovery and self-appreciation. I am no longer fat-phobic (and yes, you can be fat-phobic even if you're fat) and I appreciate and patronize the online fat-o-sphere daily. (See sites like Big Fat Blog, Big Fat Deal, Angry Fat Girlz, Fatshionista, the Rotund, Babble, and more like those listed here courtesy of Big Fat Blog.)

Then I was confronted with the confirmation that my fat had a cause that could (and probably should) be worked on. I am insulin resistant. That has caused my body to improperly turn sugar into fat and store it indefinitely. Thus, there is a way to start to control it.

For a year I went on a low carb diet, worked out regularly and lost 60+ pounds. By the world's standards I was still big, but for my standards I was svelte.

Then IC hit (or at least what I believe to be IC, PFD and vulvodynia now after further investigation). I was put on medicine that derailed my progress indefinitely by forcing me to gain weight. For the first time in over eighteen months I craved sugar and carbs. And being that it came at the time where my emotional wellbeing was at the eye of the perfect storm (getting engaged, deaths of family and friends including both grandmothers, preparing for and taking the bar exam) I was lost.

Now I struggle again. Not because I don't know what needs to be done...that part has been figured out. But it's more because I'm torn about what it means to love myself. I've agreed for a long time that it doesn't mean I have to be thin, but somehow have I convinced myself that it means that I have to be fat? And is that right? It wasn't until I lost any weight (for the first time in my life successfully) that I recognized it as a burden when I put it back on. I never felt overweight until the past year and a half. I've been fat, big, rotund, large, etc. but never overweight.

I'm at a crossroads where I've begun to get some of my intervening chronic illnesses on some sort of path to recover. Do I get back on the train that derailed a year and a half ago? Or does that train have some drawbacks of its own?

My dilemma continues to be that while I think I'll never be thin, I'm afraid of losing my identity as a fat chick. It sounds bizarre, but true. And at the same time, it's easier for me to rest where I am because, let me tell you, the first month of a healthier lifestyle is a hard road to follow. I know that it'll help the PFD and will definitely help the PCOS and IR, but is that some sort of conformity to the "man" that I don't want to associate with? And I know I felt better 60 pounds ago, so what am I thinking about?

When one has a chronic illness, these are the identity traps we fall into. This is even more true when we are given meds for problems that cause us to gain more weight than the "extra" weight we've been carrying all along. I want to confront my health, but I've spent so long advocating the fact that being fat isn't a health problem. If I lose weight, do I lose credibility now too? But if I gain it, or stay where I'm at, don't I somehow mask the underlying problem?

So the next few months are going to be dedicated, personally, to that issue. I need to get healthier, but I also need to learn to confront my demons about fat and thin and about health and illness...about mental pain and physical pain and how to balance the two.

Maybe it comes down to the fact that I need to have some sort of agreement with myself that it's okay to lose or gain weight on my own, but if its the effect of an illness or its cure, it's not me and it's okay to work against that. Maybe I need to stop identifying myself entirely. Or maybe I need to realize that everyone has that perfect spot and though I'll never be a size 8, a size 20 would be nice.

I'm a big girl. I am beautiful. And I'm beleaguered with chronic illness. Where is my balance?

Only time will tell...

1 in 3

Recent research indicates that 1 in every 3 American women is affected by a pelvic floor disorder of one type or another. Age is not a factor in this 1 in 3 statistic.

The study of 4,000 women (80 percent had given birth) found that 25 percent suffered from anal incontinence, 15 percent from stress urinary incontinence, 13 percent from overactive bladder, and 6 percent from dropped pelvic organs (pelvic organ prolapse). The women in the study were aged 25 to 84. The findings were published in the March issue of Obstetrics & Gynecology.

Don't get me wrong, I'm glad they've done this research but it seems to me that they need to do more broad based research and perhaps have a control group of women who have never given birth. 80% is a big group.

Nevertheless, the study did produce some good, mostly in that it brings up the topic at all.

"One of the myths surrounding pelvic floor disorder is that it affects only older women, but the truth is these conditions are extremely prevalent and extremely debilitating. But because the subject matter isn't cocktail conversation, women feel isolated and don't seek support and treatment," study co-author Dr. Karl Luber, a urogynecologist in the department of obstetrics and gynecology at Kaiser Permanente San Diego Medial Center, said in a prepared statement.

Women with symptoms of pelvic floor disorders should consult with a doctor trained in female pelvic medicine and reconstructive surgery, he advised.

"Among the available options for treatment for these common disorders are physical therapy to strengthen your pelvic floor muscles, devices that can be fit to support your vaginal walls, and surgery. Many of today's surgeries are very noninvasive and can be done as an outpatient," Luber said.

This statistic should be rather interesting in and of itself:

In the United States, more than 15 million women have stress urinary incontinence, 16 million have an overactive bladder, and one in 10 suffers from anal incontinence, according to information in a news release about the study.

I wonder how many of those 15 million that have stress urinary incontinence also has anal incontinence...they are so often linked. Just a thought.

Feels Like the First Time

I finally realized yesterday and today that I've done something I haven't done in quite awhile.

Ladies and gentlemen....I've made progress.

Progress. PROGRESS!!!!

In my struggles with IC/PFD and vulvodynia I have found very little to be helpful other than just not doing anything...and even that is not helpful. This weekend, though I had bouts of pain and fatigue, I finally realized that I'm not in the same ballpark of pain that I was before. I was able to have sex and not be completely debilitated afterwards. And while that may be personal and not a big issue to some, it's a HUGE issue for me.

I think the combination of everything I've been doing is FINALLY helping. Here's what I've been doing that I feel contributes to my progress:
1. Physical therapy. Without it, this progress would be nonexistent.
2. Switch from Lyrica to Neurotonin. I've had relief much quicker.
3. TENS Unit. I actually decided to get a home unit and I'm using it quite a bit--every other day or so. It helps a lot.

I'm nowhere near done with this and there will be setbacks along the way, but it's so nice for ONCE to be moving forward instead of backwards. It's a small step for some, but a giant leap for Mekind.

Now if I could only move forward in other health-related areas. This is inspiration though.

A new resource--shoutout

I wanted to give my readers more than just a link to a resource that I found online. FightingFatigue.org is a site that is dedicated to Chronic Fatigue Syndrome, Fibromyalgia and Interstitial Cystitis. Because these things are all connected and that is the theme of my blog, I found this site very inspiring.

Recently, they posted "104 Great Resources for CFS, Fibromyalgia and Interstitial Cystitis". Another great entry was the one about Conditions Similar to IC.

I have bookmarked the site and check it about daily. It's great that we're building such a community of support.

Tense about TENS

I am testing out a TENS unit "at home" (I'm at work really) today. TENS=Transcutaneous Electrical Nerve Stimulator.

Basically, what it looks like is a generic white box the size of an older palm pilot that can clip somewhere on your clothing attached to some wires which then hook onto some electrodes, mine are placed on the lower back. The little electrodes send out this wave of stimulation which feels neat, and is supposed to relieve pain.

If that wikipedia entry I cited above is true, it may not, though. This BBC article also sheds some light on the subject.

Like I said, it feels nice and we've been using it in PT, but I haven't noticed any long lasting effects from using it. So I'm going to test it out more today (since I already have the electrodes on) and see where that goes. This seems to be the common theme:

Please keep in mind that TENS is not effective in curing pain; it can only to treat it and make the pain more tolerable.

Well, I guess that's good too. We shall see. The above picture appears to be the exact model I'm testing out.

Weekend Torture

As I mentioned in Weekend Inspiration yesterday I had a touch of the flu (or the plague or something) this weekend. It was horrible. I couldn't tell where my PFD/IC pain stopped and my flu pain began. It was one of those times where I really needed some pain meds and none were to be found.

Yesterday I had some noodles and half a sandwich. The sandwich didn't go down easy, but eventually went down.

It was like a 48 hour reminder that I couldn't even get sick like a normal person.

Is Lyrica doing anything but adding pounds?

I've been taking Lyrica fairly regularly for a few weeks now. I can't say it's done anything. I've read a lot about this on the internet--that it may just be a placebo effect. I guess, but I have gained weight on it and it can make you woozy until you're used to it. So it's doing something.

I'm thinking about stopping it.

Maybe I'll give it one more week, making sure I take it regularly, and see if I can see ANY benefit. If not, it's out of here.

A new fight to fight...Pelvic Floor Dysfunction

So, as I mentioned in my first post, I went to see a urologist that specializes in IC this morning. I went out a little less of an IC patient and a lot more of a pelvic floor dysfunction (PFD) patient. To be honest, I have mixed feelings about it as I've been working on this IC thing for a year and a half now, but I'm also calmed by the fact that it explains some of my symptoms that have been ignored until now.

Next steps:
Visit with a nurse practitioner to coordinate PFD care, review other options, etc. (tomorrow)
Start physical therapy for PFD (when my turn on the waiting list comes up)
Research the heck out of this (now until forever)

The PFD diagnosis also begs the question--is this connected with my PCOS/IR? I have a feeling that it is at least in one way. The Body Chronic moves very subtly, but if you look closely you can find the path it took. Sometimes you run into a chicken and egg problem, though and I fear that's where this will lead me.

So with that cat officially out of the bag, I feel as if I can actually focus on the PCOS/IR more than if IC were the main cause of my pain (note: IC may still be a diagnosis for me, but the PFD appears to be primary, the treatment of which could lead to much alleviated IC symptoms). I don't know why I feel somehow that I had to tackle one or the other if it were IC and PCOS/IR but with the PFD and PCOS/IR I can tackle the problem more holistically. Maybe that's something to explore in and of itself.

For now, here are some helpful PFD links that I have found thus far:
Transcript of a presentation by Dr. Moldwin from the Albert Einstein College of Medicine about PFD
IC and PFD from the Interstitial Cystitis Association
A very techinical analysis of PFD from Raul Ordorica, MD
A more narrative description from IC Advice

First Post--What is this all about?

Part of my New Year's Resolution is to keep better tabs on my health. As someone with a few major syndromes, I figured this would be not only a way to keep tabs on it, but a way to share my experiences with the greater community so that others may learn from it.

I have Poly Cystic Ovarian Syndrome (PCOS) and Insulin Resistance.
I have Interstitial Cystitis.

Nowhere else on the internet have I heard those two subjects and their interconnectedness discussed on the internet. I have an inkling that YEARS from now they might find a connection, but nothing is going so far. So for my own sanity, and possibly the sanity of others in my position, I'm going to create a space for learning, investigating and expressing.

And hopefully in documenting my journey and bringing others into the fold, we can unveil some solutions that help us all.