Worthy

At the December 15 appointment where the surgeon qualified me for the hip replacement surgery I desperately need, I was instructed that I could expect surgery in 6 weeks and that the scheduler would be in touch within 10 days.  When 10 days without a call passed, I called the scheduler.  She was polite but had no date - or even a prospective date - and indicated that I’d have a four week lead when she finally got me on the calendar.  It’s been three weeks since that first appointment; and more than one week since I called the scheduler.  I still don’t have a surgery date. 

The joy and relief I felt on December 15 has begun to wane.  As each day without a surgery date comes to a close, I make the struggle upstairs to bed where in the quiet darkness, I fend off the waves of despair that I feel.  With the help of my amazing pain management doctor, I can get some rest, but I haven’t had a full night of sleep since August.   January 16 will mark the start of my 6th month of living with crippling hip pain.  Over the last 5 months - 5 months - I’ve learned some tools to manage the disability.  But my world is small.  I go to work and then I come home.  Once home, I mete out the last of my energy to cook supper or run a load of laundry.  Groceries must be picked up as I can no longer walk through the store.  JT is indispensable; he does the bulk of our household chores while also trying to keep my spirits up.  He is my daily source of gratitude and grace and he never complains about helping me. Walks outside, a trip to the movies or a bookstore or to a cultural event are simply not an option.  Food restriction remains in place so even if I could go to a restaurant (I can’t), what would be the point?  My life now is small and getting smaller. Everyone reassures me that once I get a hip, a life rich with prospects will re-emerge.  I hope so, but I fear otherwise.  I recognize the dangers of that fear. It’s incredibly easy for me to slip into despair and to wonder if any of these doctors who swore an oath to do no harm actually give a damn about me.  In this case, actions speak louder than words, so I know the answer.  

Still, I try to choose hope.  For my Christmas stocking, I bought myself a mystery box from my favorite jewelry shop.  Inside the box was a tiny silver ring engraved with the words “I Am Worthy.”  It feels like the universe delivered this timely reminder just when I needed it.  Being required to lose weight to qualify for necessary medical care is demeaning and demoralizing; a daily reminder that my needs matter less and that I am not worthy in the eyes of some doctors.  I play a waiting game for medical care denied me because I am fat; it’s a game that makes me feel that I am not worthy at all. So I slip my silver talisman on my finger and struggle onward.

In Which the Indignities Pile Up, part 2

The first time I ever liked my body was when I was pregnant with JT.  The pregnancy and delivery of a baby I had grown inside me were life-changing in so many ways, especially in terms of my relationship with my body.  I could make human life and my attitude toward myself slowly began to shift.  I wasn’t skinny - and never will be - but I felt strong and able.  I began to work out in earnest - not to lose weight but because I liked the way it made me feel strong.  In the years since JT’s birth, I’ve gained and lost weight but never deliberately.  Once I learned that dieting was a one-way ticket to formidable and overwhelming self-loathing, I rejected the practice.  My dysmorphia never went away but could be avoided by not looking in the mirror or joining pictures.  I learned to wear the clothes I wanted to wear because they felt good and because the fat-girl rule of “choosing something flattering” seemed stupid and constricting.  Since pregnancy, I haven’t weighed myself because that number on the scale would destabilize the whole house of cards that was my sense of self.  My outward confidence was unshakable.  Internally, I was sometimes less confident.  So I avoided triggers that brought on self-loathing: dieting and a scale were out; intuitive eating was in.  Deliberate and specific food restriction were out; eating what I craved and what tasted good was in.  Seeing any doctor was risky because weight would inevitably come up and no setting was safe.  I once had a dermatologist tell me that my skin cancer risk was higher because of my weight.  She said it in a disgusted tone that caused the resident to come back in and apologize to me after the doctor left.  By then, I was a sobbing mess and the resident handed me a tissue, patted me awkwardly on the shoulder and recommended a different dermatologist, one who understood the science (being overweight does not cause skin cancer!).  I found a decent gynecologist and got regular pap smears and used a convenient clinic for the occasional sinus infection.  When arthritis in my knees required gel shots, I sought an orthopedist.  Treatment came only after a stern lecture about my excessive weight.  But the treatment was successful and enabled me to return to a busy life of movement, so fuck that doctor became my attitude.  

Then my hip failed me in spectacular fashion.  I *knew* that no orthopedist would help and, true to form, the first three I saw told me I needed a new hip and then refused me surgery.  One refused until I could meet a BMI target; one refused until I lost weight but promised surgery in 1-10 years if I lost an unspecified amount of weight.  One rejected me with no expectation of surgery or explanation but weight was of course the reason.  That there is loads of research reporting on successful hip replacement for high BMI folks doesn't seem to matter.  All of this feels like my fat self and the life I've built don’t matter.  So it is that my confident self has landed squarely in territory that I know to be dangerous for me: I must restrict food to lose weight in order to receive the medical treatment that I desperately need.  Each day that I am denied what will be life-saving and life-altering surgery is a day I live in pain with a side-serving of self-loathing.  At work, many people have offered commentary - mostly along the lines of “I hear that when folks get a new hip they are so sorry they waited “ - as if to urge me to take action.  At first, I smiled and nodded.  But as the commentary continued, I’ve found that honest talk shuts that shit down.  So I tell people who make that comment,“I’m too fat to get a new hip and I’m working on fixing that so I can have a hip.  But thank you for caring.”  It shuts people up - and embarrasses at least some of them.  But it is both galling and humiliating to be in the position; an open acknowledgement that I matter less because I am fat.  I’m hopeful this story has an eventual happy ending.  Thanks to a ridiculous amount of food restriction, I am on-target to meet the BMI requirement one orthopedist set.  I will see that doctor in January and part of me is hopeful; most of me is convinced that he’ll refuse the surgery and set another BMI goal.  But I am doing everything I possible can to get a hip and to prove that I matter.  When this is all over I hope I can laugh about it.  Right now, I just feel incredibly angry and humiliated, like the 5th grader who was once told she was too pretty to be fat.  Now I know that I can be as pretty as I like while I am too fat to matter.  It’s not much comfort.

In Which the Indignities Pile Up, part 1

I’ve been fat for most of my life, at least since the third grade.  For the same amount of time, I would avoid that word: fat.  It felt pejorative and mean.  Knowing how society feels about fat people, I steered clear of it.  Chubby, curvy, chunky….I could live with those words.  But fat - and any discussion of weight or words like overweight and obese - were off-limits. My aversion started in the 5th grade, when the pediatrician explained to me that I was “too pretty to be fat.”  At the time, I was just over 5 feet tall and 110 pounds - taller and more solid than most of my classmates - and I was already horribly aware of how my bigger body was received in the world.  I was a quirky kid who l loved to read and swim and ride her bike.  I struggled to make school friends….girls in fifth and sixth grade did not like the same things I did and so I was an outsider.  I liked food and probably ate too much of it.  I can say with confidence that school lunches were not helpful; neither was my time spent as a latch key kid.  My mother had some weird food limitations habits - she was forever dieting - and that didn’t help my sense of self worth or teach me to eat only when I was hungry.  In  my family, food was restricted in all sorts of ways and so those arbitrary rules governed eating for as long as I can remember.  But it was the way my body was received by others that was most alarming and from 5th grade onward I quietly embraced the message that I was fat and therefore deserved the second class status that fatness demanded.  In Junior High and High School, I secretly restricted food.  For a good long time, I was 5’3” and weighed 125 pounds.  I still felt fat, ungainly, and unworthy.  

My inner shame was often stifled by my outer confidence.  I was - and am - well-spoken and confident of my smarts.  I rode that ability into high school Forensics championships and admission to UCLA.  

In college, I learned to embrace myself while cloaking my feelings about my weight.  I did gain some weight and worked mighty hard to get rid of it by throwing up, a trick I learned in 7th grade and really embraced in college.  I was never slender —— that was just not in the cards —— but I did learn to live in my large body and side-step the dysmorphia I experience toward it.  I worked with counselors on and off in college and grad school and I found my coping tools.  I never liked my body and I often cloaked myself in clothing to hide my appearance.  I also made damn sure that *no one* knew how I really felt about myself, adopting a “fake it ’til you make it” approach to fat self-esteem while never, ever using the word fat or acknowledging my feelings about my weight to anyone but myself.  That’s been one of the hardest parts of the challenge with my hip - the fact that I am suffering because I am fat cannot be denied or hidden away.  But that’s a story for another day.