Disabling

My hip has grown worse in the past month and now I mostly get around with the aid of a cane.  Pain is my daily companion and pain relief is not effective.  Sleeping continues to be a significant challenge.  Though I am physically and mentally exhausted, I can rarely rest.  At night, I require narcotics to have shot at two hour windows of sleep, mostly managed when I sit up.  Being in constant pain has a way of fraying neatly all of my patience for myself and dimming my coping skills to a mere shadow of their former self. I’ve struggled mightily to be in good temper about the situation.  I cry on a daily basis.  

The only solution is a total hip replacement.  I’ve read volumes of medical research and by all accounts, a new hip will work and find me right as rain.  I’ve seen several surgeons but none are willing to operate until I lose weight.  Some are murky about the target; others use the discredited BMI standard.  Ultimately, I lack the emotional bandwidth to keep trying to find a surgeon who will operate now.  And so I’ve yielded to deliberate weight loss - dieting - as the avenue to relief.  It’s a dangerous road for me.  I am eating a daily calorie diet of 800-1200 calories; once a week I mix it up and approach 1800 calories.  A combination of self-loathing and pain seems to dim my appetite, so I’m not as hungry as I feared.  Food restriction has been made weirdly easier because of my long-standing body dysmorphia, a condition that fills me with self-loathing.   For many years, I have managed the worst side effects of dysmorphia by using body positivity and intuitive eating.  Neither of those tools are available to me while I restrict food to reach an arbitrary BMI standard.  Most doctors know that BMI is bullshit and, rather than defend it, they use the insurance companies as their excuse.  In some ways, that’s neither here nor there as I am now stuck: forced to restrict food and contend with a dysmorphia that is in full command.  I assume that everyone who sees me is filled with loathing for my body, as I am.  Though I do my best to compartmentalize that sentiment, it’s still in command more than I would like, as I knew would be the case once I started restricting food.  I put on a brave face for everyone but my son and my sister; both have been incredibly good to me.  My sister is both a kind and patient advocate as I lose weight while gripping tightly to the shards of my sanity. She’ll come East to help when I have the surgery and is basically a candidate for sainthood for dealing with my bullshit.  The only good news in this fucked up situation is that food restriction is working. I am close to the BMI goal for surgery set by one of the surgeons.  I hope like hell he'll stick to that proposal because in this strange race to exchange one crippling disability for another, I'm at risk for losing it all together.