Thursday, January 31, 2008

Red Pill Blue Pill Old Pill New Pill

Earlier this week, I left my office with a tremendous sigh and a drag in my step, commencing the stroll two blocks over to meet my new therapist. I am somewhat begrudgingly undertaking this repeated step of couch-lying in an effort to improve those things that I haven't managed to deal well enough with on my own. I am cynical of my prior history with LCSW's, MSW's, PsyD's, and LPRN's, but not so cynical as to deny that I may need a little help in my quest for self-improvement, particularly with my urges to binge. I know where they come from. I know why I do it, and what the triggers are, but I am still obtusely confused as to how to effectively stop them, despite the unbeknownst efforts of several internet article authors and yearly humorous calendars.

It is with that cautious optimism that I feel obliged to pose a question on a very serious, much maligned, and equally praised tool for self-growth and healing. Why the FUCK does every emotional wellness practictioner cling to the idea of psychotropic drugs with the earnest of a crackwhore to her fix????

I can ramble on about my considerably fucked up family and past, and it raises nary an eyebrow...it didn't from this one either. But upon the first mention of the words Zoloft, Xanax, Cymbalta or Prozac, the pen scribbles furiously, the "uh huh's" change to questions on dosage, assumptions of efficacy, and immediate thoughts of trying a new something. It leaves tremendous suspicion that these people are little more than highly paid advocates of Pfizer and Lily.

I left the last shrink (a real one, not an LCSW, etc..) I had because every time I saw him he wanted nothing more than for me to remind him of my current dosage and immediately write a script increasing it. If I had stayed with him, I would be a zombie- comfortably numb, and imperviously sending hundreds of dollars to the pharmaceutical companies who sponsored him.

Yet I've returned again. What the fuck is wrong with me, you might ask? My first experience with "therapy" was when I was 8 or 9. Several attempts from then until late college left me with one seemingly undeniable truth- "therapy" did not work for me. In fact, it seemed such a waste of time, energy, and money I resented even the word.

Yet, here I am. Several months post-op and my eating compulsions have not faded, disappeared, or otherwise left me alone. In fact, in some ways they are stronger because of my inability to partake in them as much as I used to. The other stuff that puts me back on the couch, talking about uncomfortable, painful shit that does much better repressed deep inside some unused brain synapsis covered in cobwebs...well, we'll just have to see.

When I mentioned to the new shrink that I didn't want to be on the SSRI's for more than a few months, she asked why, with this look as if I had two heads, or just made a shocking statement akin to wanting a sex-change operation.

It felt like a lobbyist for the tobacco industry asking a 2 pack-a-day'er why in the world they'd want to quit smoking.

I'll keep you posted, but so far things do not look great for the soft-spoken shrink and her taupe-shaded couch.

Monday, January 28, 2008

Lipo at 13? WTF?!

There are 13 year olds out there vying for liposuction, tummy tucks, and gastric bypass. If I think back hard enough, I probably would have enjoyed the idea of a little liposuction on my thighs, possibly the hips at that age. Hell, I also would have taped my breasts down if I had thought of it. I'm sure based on peer pressure, poor self-image and the litany of other teenage emotional maladies that plagues american girls that plastics would be a welcome device. However; the trouble that draws my focus today is that I am reading that these things are actually happening. There are actually doctors perfectly willing to comply if the money is there.

As for breast implants, nose jobs, and the like, those are for another day; but TLC had a special on especially young obese people, and articles I've read regarding a very young teenager in Texas who had lipo, and then followed it with banding when she re-gained the weight. Don't even get me started on the Mexican doctors who don't care if you have a 30 BMI to start out and will carve you up anyway.

I remember the exact moment in time when food became a problem for me. I was a skinny kid- a tomboy...a girl climbing trees and the only girl at my catholic school welcome to play kickball with the boys (which worked well for me because my crush was always the pitcher). When I was 12 my Mom came out to us as a lesbian, we moved away from my hometown and friends, and my sister departed for adventure in multiple scenic homes for problem children all in the span of three months. Jesus, what a cocktail for kiddy suicide.

When we got to our new home, I weighed 83 pounds at a height not too different from what I am now. Puberty hit, and I have no doubt that attributed to a little weight gain...hips and breasts will do that, but by the end of eighth grade I was up to 115 lbs. Still a size 2, but not making any friends in the human form at our new digs, I found them in the shape of Elio's pizza and macaroni and cheese. I remember learning to hear the exact motor sound of my mom's partner's truck, so that I knew when I'd have to run to the kitchen and toss away whatever food was left in front of me. How fucked up is that? Another move, and the awkwardness of high school at my feet, I put on more weight, upping it to somewhere in the 150 range until I was the perfect size 14 (so sayeth the Caldor pants Mom bought for the new school year round about junior year).

I also continued to make friends, not at school, but in the kitchen. I learned how to hide exactly how much I was eating and the fine art of binging. Mom was decidedly no help in this department. I don't blame her, but verging on 300 lbs herself and more in tune with other things than dieting (or denial- take your pick), it never occurred to her to figure out why I was getting so big. I finished high school near 160, managed to take it all back off in the first year college; and then played the roller coaster of gain and loss, loss and gain, and mostly gain for the next ten years.

It took me years to come to the decision of putting a band around my stomach. I'm hitting 30 in less than a month, and I still have vast concerns about the idea of plastic surgery. I was a mature kid. I had more adult friends as a teenager than any my own age. I read Shakespeare and Plato with intense earnest while others my age were more likely to hit the arcade after school. STILL, I can't imagine on my best day I would have had the emotional maturity to make such a decision. Even if I had, my mother would have nixed me at the gate. NO WAY in hell, she would have said; and I would have tromped back to my room slamming the door for good measure. (Adolescent obnoxiousness did not pass me by entirely)

These kids are asking for, and getting advanced medical procedures at 13, 14, and 16. Still very young, and naive, they feel impenetrable and have no concept of informed consent. Worst of all, perhaps, many seem to see surgery as a quick fix (I speak of course to bands and bypass- not lipo, which in some ways is a quick fix).

On the one hand, I can see the optimistic side...save a kid who is pre-genetically disposed to obesity a lifetime of self-hate, loathing, social isoation and misery. On the other hand; it appears the ones to take the most advantage of this are the permissive parents who let their kids eat anything, sit on the asses all day eating twinkies and playing XBox and then trot them off to the surgeon to take care of the problem they helped create.

This is an altogether frightening proposition.

Friday, January 25, 2008

Republicanized?

If I can put aside the weight commentary for just a bit, I have a venting coming due of an entirely different variety.

I was raised a liberal. My mom had me marching in demonstrations against nuclear weapons wearing anti-Reagan t-shirts when I was still in diapers. I grew up as part of the working poor, standing in line for the state subsidized powdered milk and block of cheddar cheese they gave the welfare families. I played with other children in our little corner of the low-income housing where roach traps were common, and we were told to stay clear of the older kids who ran with gangs. We shopped at thrift stores and fabric stores for clothes, and toys were things like bins of cornmeal and kidney beans with funnels and empty sour cream containers. We didn't go to Disneyworld, and even Riverside, the local amusement park was a once a year treat.

I still think of myself as a social liberal. I believe in abortion rights, and help for the "working" poor. I think immigration is a good thing without complete amnesty, and don't believe in the death penalty.

I do however, carry a more cynical view of the lazy welfare-ites who find they profit more from remaining on federal and state welfare programs for years and years than putting in an 8 hour day at McDonald's. I carried myself up to my current Manhattan apartment and lifestyle by working my ass of for twenty years, so I resent those that would rather stay home and watch the next season of Ally McBeal on their huge flatscreen TV's (though they live in a trailer and for some strange reason can't afford groceries this week) while I get up every day and go to work. I have a limited view of "classism," as it purports itself, because I managed to crawl the hell out of it all on my own.

My mother would likely roll over in her grave to hear this, but she didn't live long enough to see my own sister subsist on government handouts for the entirety of her adult life!

Unless you live under a rock, you know that this week the government announced a tax rebate program that would give $600 to single tax payers and $1200+ to families with children. Even those that did not pay tax last year (thank you, EIC) but earned more than a flat amount ($5000?) will benefit from $300 each. Those however, who earn more than $87K as a single or $174K as a couple will get nothing. Zero, zilch, NADA. You are "phased out" and deemed to be part of the wealthy who doesn't need such a windfall.

That may be true if you're single and live in Bumfuck, Oklahoma; but if you live in Manhattan, $87K a year means you probably live with a roommate, you have trouble making ends meet just like everyone else, and you could definitely use a little break from good ole' Dubya and Nancy P. If you're a family and only pull in $174K a year and you have kids and private school, and nannies, and medical bills to pay for just like the rest of America, you're equally strapped.

I don't know about you, but I am personally PISSED and offended that my thousands and thousands of dollars I paid in taxes last year (Oh yeah, and I had to do a payment plan to get it to them) will benefit those that will use it to pay down their gambling debt or run out to Wal-Mart and put a few more kitschy things on layaway. I'm outraged that I'm subsidizing the jeebs that couldn't afford their rents in the first place who ran out and got sub-prime mortgages and SURPRISE! can't afford those either. Oh, and their friend the govt. is going to bail out the lenders too.

My colleagues had a response to my outrage and despair, "Welcome to the Republican Party."

How sad, how irretrievably broken is our system. My boyfriend is a Republican (it used to be that I wouldn't even date them), and we've had some interesting political debates of our own. I don't qualify for any of the IRS' "benefits" because I don't conform to the American norm of married, mortgage holding, child-bearing normalcy the IRS deems deserving. Then again, talking to my Manhattanite colleagues and friends, the only thing that gets them is a boost up to the AMT (alternative minimum tax- to those of you who don't have to bear it) basis, more evil than what I have to endure.

When it comes to economics, I am moving ever closer to the dark side, with what seems something akin to Darth Vadar breathing down my neck. If things continue down this route, I may even sway my side to the true dark emperor, Mikey Bloomberg.

I feel like screaming!

Thursday, January 24, 2008

PC Philosophical Debate

Let's talk about the "F" word for a moment or two. I do not refer to that wonderful catch-all noun, verb, and sometimes adjective that isn't welcome on television or radio lest the FCC stamp you unsuitable and slap you with an enormous fine. I'm talking about FAT. I've used it here before, and plenty, but an article about its acceptance and the increase of obesity-hugging blogs read yesterday had me rethinking.

It's pretty taboo (even in this country) to point at someone and call them fat. Perhaps you whisper to your friends, or make pointed looks in their direction, but if you're going to refer to someone, the polite way to phrase it is "overweight," "heavy," "obese," "thick," or if you're 5'3", 200 lbs, and living in a fantasy world, "chubby." We've even made up pleasant acronyms (BBW) so that the fat women of the world can date without having to describe themselves as anything of the above, or lie and call themselves simply "curvy." But we who are (or were) fat seem to deem ourselves allowed to use the word. A difficult comparison, but not unlike African Americans and the N word, or Lesbians and the D word (incidentally I felt myself grandfathered in on that one because of my Mom), we feel entitled to call that F word our own and berate or compliment ourselves with its affectation.

There's a whole "FATOSPHERE" of fat acceptance websites, articles, and blogs out there of people who are tired of dieting, tired of people expecting them to conform to a size 4, or even 12, and just want to be loved and accepted the way they are. I used to be a pseudo-member myself. After all, what self-respecting person with decent self-esteem wants to go around feeling like shit about themselves all the time? Nobody.

But when you're verging on taking up the space of two people, can't fit properly into the rides at amusement parks, can't sit in a theatre without encroaching on the people on either side of you, can't ride in an airplane without a seat belt extender, or visit a buffet without all eyes on your choices, or even go up a flight of stairs without sweating like a buffalo, where do you draw the line between empowerment and denial?

My mother, at her heaviest (perhaps 280 or 290 and 5'1") would tell me when I asked her about losing weight that it took her 30+ years to accept herself as she was and she wasn't going to let anyone else make her feel badly about herself. A noble thought at first glance, but it also inhibited her from ever trying to do anything about it. She loved her food, her butter and salt on everything and would manage to find her size 24/26 pants somewhere. My entire childhood I was both deeply embarrassed and incredibly saddened by my mother's weight. I felt like in some way her weight problem was partly mine and my sister's fault because of our burden on her as a single mother. She only managed to lose weight when hit with the disease that would eventually kill her.

At my heaviest (which I won't divulge here in numbers, but suffice it to say was FAT), I wrote a brief commentary that was published in the Best of Salon Table Talk section. It was an enumerated treatise of sorts in support of those who were fat- that diets and exercise did not work for everyone- and the portion of the population that were genetically "blessed" with the extra weight should not be ostracized like a Calcutta leper colony. It also contained a list of things which made being fat intolerable, unhealthy, and not something to be celebrated.

When I read the words of Kate Harding in the Fatosphere, I know she has some good points. Not everyone with a BMI of 35 is unhealthy, no matter what the articles may indicate. There are a lot of factors at play.

But I also know that it wasn't until I could give myself an honest look in the mirror that change was possible.

Tuesday, January 22, 2008

Plateau: The Cold Arctic Tundra of Frustration

I can say with sincere elation that over the last month of winter-induced digestion of comfort foods that I haven't put back any additional poundage that I've worked so hard to attain.

People who have been no more than minor acquaintances in the office and out have made commentary on my weight loss, and it has felt good. Fitting into clothes that I couldn't squeeze into before has been a marvelous undertaking, and throwing to Dress for Sucess those size 18 suits was a triumph.

All that said, I feel I've hit a rock of sorts. I haven't seen my weight drop more than a pound in either direction in this last month. My surgeon would likely smile at that and be pleased with the slow loss, the evening out of things, so to speak; but it's difficult to go from 14 pounds of loss one month to nary 5 or 10 the next. It's tough, when there's a goal in mind, and the numbers represent far more than they should.

If I'm honest with myself, I know I can attibute the frustration only to one place..and that is me; to the two chocolate milkshakes I had in the last week and a half; to the grilled cheese and sodium-laced chicken soups I've had at work, to the lack of exercise.

I'm not sure where I'm going with this, except that I needed to type, and get it out of my head and onto page. I suppose that's where I always work best. I think my goal for the next couple of weeks is to focus on re-attaining my focus to where it should be; and figuring out the next step of this band, where it will take me.

I'm halfway there, and the rest is decidedly an uphill battle...somewhere akin to the Himalayas. I'll get there.

Wednesday, January 16, 2008

In Defense of the Band

Yesterday, in a rare (these last few months at least) lull at the office I found myself scanning the message boards on MSN, and bumped into a post from someone looking for input on the lapband. She was the usual sort just seeking general advice.

In my enthusiasm for the product which has changed my life, I made the tragic, naive mistake of responding in earnest to her query, and the result was a two hour debate with uneducated, anti-bariatrics, likely-slender jeebs which left my blood pressure on high alert.

I despise debating, arguing, and to some lengths even discussing the band with those who don't have it, haven't done the hours and hours of research that I have, and yet remain staunchly opposed to bariatric surgery in general, and more particularly label the band the "easy" way out. I am not foolish enough to believe that I will change anyone's convictions on the subject and moreso find it an exercise in futility engaging in raucous debate with those who will never know what it's like to be in the situation of needing this particular tool.

Yesterday though, I took the bait, and lashed away at myself for it in the end- closing the window after a final post and promising not to return to engage myself further.

"ARGGGGHHHHHHHHH," I screamed at myself (quietly and inside my head).

In some manner of speaking, I feel this should go without saying, but since I have devoted an entire post to the subject, I am going to say my peace once more- both for those that are interested in getting the band, and for those that may read this blog thinking it is the worst thing in the world (other than RnY).

The band is NOT easy. Nothing about it is easy. The simplest part is the two hours in surgery, and you are not even the one doing that part. For months leading up to the surgery, you will face a mountain of psychological self-doubt, feelings of failure, acceptance, defeat, fear....you name it. You will put your body through the rigors of countless exams by strange and probing fingers, echo-cardiograms, blood draws, lung capacity machines, sleep apnea procedures, and the worst- manometry- a thick tube down your nose and into your esophagus for the better part of a half hour while forced to sip water at various intervals. You may fight tooth and nail with an insurance company with the supreme power to issue you one devastating word- DENIED. You will work with a dietician- just as you SHOULD if you were doing it the "hard" way, learning about proper portions and calories, fat, and carbs. You will learn to read labels if you can't already. You will have to start exercising and maintain it...just as you would if you were doing it the "hard" way. You will undertake the most grueling "diet" of your life pre-op, taking in only clear liquids and protein shakes leading up to surgery to make your liver optimal. You will be expected to lose some weight before they will put you under the knife.

Post-op, if you are unfortunate like me, you will face some of the worst physical pain you have ever felt in your life. You will not be able to wipe your own ass for a day or two and you will feel like crying every time you try to bend over to pick up something you dropped. You will invariably develop "dropsies" syndrome during this time and drop EVERYTHING. You will STILL feel hungry. For three weeks, or a month, you will not be able to eat normal food. You will continue subsisting on protein shakes, and chicken broth, and mashed potatos. You will have incredible gas pains. You may be terribly constipated. You could develop infections, or other post-op complications.

Once that's over- the real fun begins. You will have to go back to the gym. You will grit your teeth and get back to work. You will re-learn how to eat normal food while your stomach heals. You will have scars where there were none before. If you are wise- you will consider them badges of courage. You will continue to be hungry until you are blessed with your fills.

After your fills- you will kiss goodbye FOREVER some of your favorite foods, the things that brought you comfort when you were lonely, sick, feeling miserable. You will not be able to get that wonderful "stuff your face" feeling as before. You will struggle internally for months until you find a way to work around your brain's desire to eat, and eat, and eat and eat. You will throw up if you try to eat to fast, or try to eat things that your band will not accept.

You may feel a lack of energy, or downright faint on days that you just aren't able to get that caloric quantity that your body needs. Your hair will fall out. Maybe just a little...maybe a lot. You may have to buy a wig and develop a tough exterior. Your skin will start to sag in areas that the fat held it up before. You may have fill after fill after fill and still not feel "tight." You may feel worse when you look in the mirror than you did when you were a size 18, 20, 22, etc...etc...etc..

You will have to continue going to the gym, making proper choices with your food when you eat out, and you may have to hide it all from the people you care most about in the world because they WILL judge you, no matter what.

YOU WILL HAVE TO BE STRONG.

NOTHING about the band is easy.

If you get through all of this, and don't defeat the band, you will also lose weight. You will gain a confidence you may have never had before. You will see your clothes start to fall off of you. You will cry the first time you step into a regular clothing store and not only are treated well, but the clothes fit you in the dressing room. You will feel energized. You will watch the numbers on your scale drop to those you may not have seen in years. People will treat you differently. Sex will be better. You won't shirk from mirrors or cameras anymore. You will be proud of yourself, and the work you have done.

The rewards are too numerous to recount, and they are different for everyone.

So please- to everyone and anyone out there- do not try tell me that the band is the easy way. You have no idea what you're talking about.

Tuesday, January 15, 2008

Queen Size

Cable TV, in its 1000 channel plethora of vivid color, HDTV, fibre optic glory has no shortage, especially today, of after-school special variety "feel good about yourself"/improve yourself programming- in both the reality and non-reality based forums. The past week I noticed a few weight-focused things that caught my attention.

Yesterday, whilst putzing around the boards there was a post about a new Lifetime/WE variety made for TV movie with Nikki Blonsky (the plus-size chick from the new Hairspray). Titled the same as my post, it was about an obese high school girl who is nominated for Homecoming Queen as cruel prank, and then (I think) goes on to win and change the minds and hearts of her fellow students and administrators. Say it with me people....AWWWW. In some cruel twist of fate, this movie was on late last night when I couldn't sleep...on Lifetime or WE, I can't remember which, and basically they're the same channel, and I watched it for the better part of two hours until I couldn't stand it anymore. The fat girl, her socially acceptable slender best friend, her non-understanding, and in fact berating mother, her plight through the torturous gauntlet of high school, the boy that secretly likes her, and the requisite binging scenes of Blonsky downing Haagen Dazs and cupcakes.

Here's the thing. I get it. It's nice to have a message of "love yourself, and others will love you." It's nice to see something that shows teens a positive message. It's nice to see someone Blonsky's size (at 4'10" and clearly around an 18/20 [I'm guessing, but tried to find something on Google]- not so different from where I was 50 pounds ago) on TV; but good GOD this was so over the top unrealistic it does nothing to really help the younger generation with similar problems. I couldn't watch, except to think.. "jesus, was my ass that big when I was her size?"

At the other end of the spectrum, there's a new show called "How to Look Good Naked," (another fine product from the Lifetime/WE set) that I absolutely love. Hosted by an over the top queen-like guy who's not afraid to put your headless mostly naked body in full color on the side of a building for comments from passerby's; this is something far different from Biggest Loser, The Swan, or Extreme Makeover. It gives the same message about self-acceptance that the Blonsky movie does, but it manages to do it without making me cringe.

When I started down the surgical weight-loss road of life, I became obsessed with shows like the latter, thinking in my lawyerly black and white way that I was going to either be everything I wanted, or unhappy.

Watching this show in particular reminds me how far I have come; and frankly, I just flat out love the format. For me, Blonsky can go back to Hyde Park, or continue making cheesy movies for girls that won't help them in the end except to join her in a cupcake and say, "see, she gets it"...

Monday, January 14, 2008

"No Longer Qualify"

Just for kicks I went back to the lapband site today; not the message boards I frequent every few days to see what's new, but the official Inamed site. I plugged in my height and new weight, a number that before now, I hadn't seen in many, many years...eight or so, if you're counting. Wonder of wonders- I no longer qualify for the band surgery at my new weight!!! I've come down 9 BMI points, several sizes on top and bottom, and I'm really only half way there- unless you're reading this Dr. J; I've accomplished your goal as of this week.

Everything has changed. The way I look at myself, the way I feel about myself...it's all intertwined.

The holidays proved to be challenging. Dinner with the SO's family (who doesn't know), where it was easier to make a visit to the bathroom after eating than to refuse some or most of the meal in front of me. I became the poster-child for the band with family and friends at home in Connecticut who hadn't seen me since before the surgery, and a MAJOR nsv- I can now cross my legs, both ways..and without yanking on my pant cuff.

It's such a simple thing and something I'm sure most women who can do it take for granted every day, but I haven't been able to cross my legs since college. Every day it seems, there is something new I feel or can do that I couldn't before.

At one of the support groups at the end of last month, there was a lot of discussion about confidence and self-esteem; something I thought I had even when I was fat. A comment a friend made about me probably two or three years ago at this point has always stuck with me. She, for point of reference, is a size 4, and stunning. She remarked that she envied my confidence, my ability to walk into a room with a certain poise, an assertiveness. I always thought that was remarkable, given her natural gifts. I always knew I was pretty, that is not the comparison; but it was clouded for so long (literally, your face loses so many of its features when it's inundated with fat) by insecurity.

I felt before that I had confidence. I was shy growing up, to the point where I would hide behind my mother's skirts, but somewhere in college and prior to that I developed this ability to become assertive; primarily through forced extrovertion in social situations- where I was most uncomfortable.

When I was fat...well, fatter than I am now (technically I am still "obese"), I walked with an assuredness, I dressed well; but what was on the inside was ugly and shameful. I sincerely felt inwardly that I didn't deserve a lot of things...good relationships, a family, a better job, etc...because I overate, because I was this fat creature. It's a strange dichotomy, this false confidence.

I feel a change in that too. I no longer feel like that ugly person. I don't carry shame with me everywhere I go; and I am deserving of so many things, not just because my body is smaller.

For regaining that feeling, I will always be indebted to Dr. J., and to this band. It is nothing short of miraculous.