Stop Assuming a Person's Weight Correlates to Their Health

Every single article or photo in which it is suggested that we embrace all body types, love them with abandon, and accept those with a little--even a lot--of extra meat around the middle, there's the inevitable top comment by an average-sized person: "We need to stop glorifying obese body types, because it's clearly not healthy. We're creating an environment in which it's acceptable to be morbidly obese, and that isn't going to lead to a healthy and prosperous life for those people."

All right, a couple of things to address here.

One, I saw this great post the other day that said, "Don't exercise because you hate your body. Exercise because you love it." The more you love something, the more likely you are to care for it--can we acknowledge that that's generally true? So no, we don't need to tell these people to get healthy and THEN love their body. Once they grow to love and accept it, they will be further motivated to put the effort, time, and mental stamina required to make it healthier.

Furthermore, CAN WE PLEASE STOP PRETENDING WE CAN REMOTELY GUESS A PERSON'S HEALTH BY THEIR WEIGHT.

Exhibit A:

Here's me at the start of college. Please excuse the goofy expression--it's shockingly hard to find normal pictures of myself at this age. Probably the least I've weighed in my adult life, around 130 pounds, if I recall correctly. And I was LOVING IT. I think I bought a pair of size 6 pants once, around that time. I was blown away--I was elated. I thought I was ALL that. As you may have guessed, this was when I was diagnosed with diabetes, so my body was depleting all my fat stores in order to survive, because it wasn't able to get the proper energy from food. But dang, I looked hot.

Exhibit B:

Still college. Still thought I was hot stuff. I was gorging myself on all the regular high-fat, high-carb foods that a college student loves, but I was terrified of needles and refused to take much of my insulin. My blood sugars were quite high all the time. If I were to attempt at this age what I was doing back then, I'd land in the hospital within a few days. I think it was largely my young age that saved me--I should have developed diabetic neuropathy, vision problems, etc. You're getting my point. Super unhealthy, but I look fine.

Exhibit C:

As I began to, you know, ACTUALLY take my insulin somewhat properly, the weight piled on. I still wasn't eating healthily, and so I ballooned up. After the birth of Q, I developed hypothyroidism, which also caused me to gain weight. But guess what? I was still healthier than the pictures you saw above, because above, I was quite literally killing myself. Now, for the first time since my diagnosis, my blood sugars were acceptable.

My rollercoaster of weight loss and weight gain has continued, and I acknowledge that it might not ever end. I developed severe anxiety in the winter of 2015 and had to force myself to eat--on bad days, I could barely manage 500 calories. My weight plummeted quickly, but of course it came back just as quickly once my mental health improved. I probably looked "healthy," yet I could not eat, could not leave my house, and was in constant physical pain.

So now, I'm somewhere in the middle. I have a mental and physical history that complicate my relationship with food, but I think I am coming closer and closer to self-acceptance. I don't look at the pictures of me at my heaviest (over 200 pounds, not counting my pregnancy with Q, at which point I was about 250) and hate them. I like that woman. She is me. She is raising her daughter and doing daily battle with a very difficult disease. I. Am. Her.

I'm eating much healthier these days than I was several years ago, and my blood sugars are in better control than they've ever been. I still have some weight to lose, but I don't feel so obsessive about it. I'm more interested in my mental health (which admittedly needs some work right now), and in striving to promote body positivity not only for myself but for women in general (so yeah, you'll see me at the pool with hairy legs and an insulin pod slapped prominently on my arm, because one of the beautiful things about getting older is that sometimes you get less self-conscious).

So, unless you plan to stop every single person you see to request a lifelong medical record, do not assume that their weight is correlated to their health. I understand that there are significant medical problems that can arise from being overweight, but no one is trying to downplay that. But you can never assume those normal-sized people walking around aren't dying. And the more you give overweight people your unconditional love and acceptance, the better it will be for everyone.

Miscarriage

This is not a happy Mother's Day post.




It started, as it almost always does, with a positive pregnancy test. I believe my exact words were, "Oh no." I must have repeated those words two dozen times in the next hour, showing the faint line on the test to my husband and pacing the room, sitting on the bed beside him, getting back up again, and saying, "Oh no," over and over. I had wanted this baby. For a year I had begged him for it. I had made plans, gone to the doctor, gotten my eyes and teeth checked, and even gotten skin tags removed in preparation for this event. And when it finally happened, all I felt was terror.

The next few days were spent looking forward to bedtime each night, when I could sleep and forget that I was pregnant. Doctors appointments were hurriedly made, and I began making insulin adjustments with my diabetic nurse, checking my blood sugar 15 times a day (twice as much as my normal), and measuring every tiny bit of food that I ate. I bought packages of almonds and string cheese because they settled the gnawing hunger without disturbing my blood sugars. I was sick at the time, so my blood sugars were difficult to control. I set a +20% background insulin, and moved it up gradually each day until I was at +50%. I had lost my voice, as well, which Q took as a sign that she should demand to be read to, constantly. I ate as purposefully as I could, but I began to lose weight from the stress.

I aimed for meals that did not exceed 30g of carbs. Even the ketchup was carefully measured.

Sometimes, during the morning, especially, I felt optimism. I felt that I could do this. I felt happy that I was finally getting my very last pregnancy over with. I felt proud that I was giving Q the sibling that I had so long desired to give her. But during the evening, I struggled. I knew that this pregnancy, by its nature, would either end in miscarriage, death, or major surgery. I didn't know if I could handle it. I fought off wave after wave of panic attack by myself, because I was no longer able to take my anxiety medication (a category D).

My "baseline" pregnant picture, at 4 weeks and handful of days

I was not at all prepared for the onslaught of emotions that happened when I experienced a miscarriage at about 6 weeks, 2 weeks after I had found out. I had already gotten my prenatal blood work, had my first appointment with my endocrinologist (who said all looked good), and booked my first ultrasound for the end of May. That night, I dreamed I was miscarrying, and the next morning, there was a little bit of blood. The morning after, there was more, and I knew it was over. It came to me that my sense of smell had been returning to normal, and my breast tenderness had decreased over the past week. I went to the ER to have it confirmed, and I calmly ready my Calvin and Hobbes comic book, but when the nurse walked into the room, I cried and told her I just wanted to go home and be with my daughter.

It was equal parts sadness and relief. Both were deep, intricate feelings. I recognized that the timing had been all wrong, and that my mental health was not at the place it needed to be to cope with a diabetic pregnancy. And I found that will all motherhood comes incredible risk--of bodily pain and of heartbreak. I read other stories of miscarriage on the internet as I tried to prepare myself for whatever physical symptoms might come. Would it hurt? Would I be able to see the baby? If so, what should I do with it?

But I was also limp with relief at having my body back, and especially at being able to take my anxiety medication when I needed it. I no longer had 6 long months of throwing up ahead of me, or doctor's appointments every week, blood work every month or two, and many long, long days of obsessively checking blood sugars and beating myself up the few times I inevitably miscalculated carbs (perhaps a sliver of cake at a birthday party that was 30 grams, while I estimated 20 grams) and found myself with elevated sugars. Wondering, "If I eat this half a homemade muffin and go high, will it hurt the baby?"

I can see that this is one of those things that changes you forever. My miscarriage was, I think, very mild in terms of the many stories I've seen, but I know it has etched something in my heart. I know many miscarriages are much, much worse. I'm sure they're worse when you have no previous children. I'm sure they're worse the further you are along. I'm sure they're worse when you desperately, desperately wanted this pregnancy. I'm sure they're worse when you felt a bond to the life inside you immediately.

I don't like the stigma and discomfort I feel around the subject. My heart feels just the tiniest bit lighter, though, when I tell someone about it, like the grief gets spread just a little thinner. And I understand, now, the inherent pain and risk of motherhood, and of the great sorrow many must feel at Mother's Day. I am miscarrying through it, but I still get to cradle my beautiful, incredible, 4-year-old daughter in my arms and enjoy her drawings, her jokes that made no sense, and her holding my face in her hands and telling me she loves me, so it is still a precious day.

I have given the name "Coriander" to the tiny baby who is now gone, because that is the approximate size he or she was, so I had placed a tiny ball of coriander on S's desk so we could look at it and try to get ourselves excited about the difficult journey ahead of us. I don't feel guilty for my mixed feelings. But I would want Coriander to know that I fought very hard for 2 weeks for you. I wasn't at all sure that it was the future I wanted, but I lived by my measuring cups, food scale, and glucose monitor. I  made many appointments for you. I worked harder than anything to breathe through my panic attacks and not take that medication--though I asked several health professionals if I could please, please just take it to get me through the beginning--hoping one of them would say, "Yes, it's fine." I was so afraid, but I was willing to do almost anything for you. You would have adored Q, and I hope we all get to see you in heaven one day. Thank you for the gift you gave me for Mother's Day, and how you have changed me as a mother and as a woman. I know that even your tiniest, shortest life had an important purpose.

The "Today-I'm-Randomly-Depressed-About-My-Autoimmune-Disease" Post

I can barely remember not being diabetic, which is funny, because I've only had it since I was 18. It's not something about which I grit my teeth together and mutter, "Oh how I long for the good old days" as I blissfully bask in memories of sodas that WEREN'T diet and trips to the corner gas station with my best friend to buy packets on candy. I don't remember what it's like to not read nutrition labels and count carbs for all my meals. Or squeeze tiny drops of blood out of my fingers several (okay, 8-10) times per day (it doesn't hurt anymore, but it used to).

I'm not sure what I could tell a non-diabetic who has a loved one with this disease--what are some things that I could explain that you wouldn't necessarily find in a medically-based synopsis?
First, it always comes with fear. You have to learn to live with the fact that you're always one bad mistake away from dying. Rarely do I have a night where I don't have the thought flicker through my head, "What if I have a low blood sugar in my sleep and never wake up?" Of course, I've always woken up, so far. But to be taken like that, unprepared, haunts me.

Then there's the hassle when you get sick. When all you want to do is curl up on the couch and do nothing, you have to stay on top of your disease, because your body produces more sugar when you're sick to give you energy to help fight off the illness--which, I imagine, is super helpful to non-diabetics. For diabetics, it means higher blood sugars, which means feeling ill from the bad sugars on top of feeling ill from just feeling ill. It also means that that extra sugar is not being utilized to help our bodies heal faster, so we tend to stay sick longer. Of course, we try to adjust our insulin as needed to account for the spikes, but by the time you've gotten the hang of how much you need, you'll probably start getting better again.

And when you catch a stomach virus? You're watching your levels like crazy, because all that not-eating can lead to a low blood sugar, and a low blood sugar when you can't eat or drink anything is kind of bad news. If you don't want to pass out and have a seizure, you should probably have someone on call to take you to the hospital if your sugar drops. S was taken there last year after a bad low during a stomach virus and was promptly given an IV with a squishy bag full of pure sugar (dextrose, he thinks). The veins in his arm were hardened for a month. The memory of seeing him lying on the floor, dazed, is something I try to push out of my mind. I have never had it that bad, though I did have a low while being extremely nauseous a few months back, but I sat on the couch and took tiny sips of apple juice, closed my mouth tight to make sure they didn't come out, and rocked back and forth on the couch until the feeling passed and my sugars came up to acceptable levels.

There are also small inconveniences that you get used to. Sometimes I'm late taking my daughter places because I check my blood sugar right before I drive, and it's low--so I drink some juice and wait 15 minutes to check again. I have little, itchy red bumps and sometimes bigger, angry red rashes on various places of my body because my skin is not a fan of the adhesive part of my pump--but it gives me better control of my numbers and allows to bypass the 6 or so injections every day (however, you area also at a greater risk for DKA, a condition during which your blood becomes so acidic--often due to prolonged high sugars during a pump malfunction that you are unaware of--that your organs are in danger of failing). I always wear black pants so I can wipe my fingers on them if they have a little extra blood and there's no tissue available (I know this probably sounds gross, but I think most type 1 diabetics do this--after a number of years, the "gross" factor goes away). Going outside can be inconvenient because I worry about my insulin going bad--if I leave my pump in the car during this brief walk, will the insulin vial be okay, or will it get too hot? What if I go in a hot tub (I have to change my pump after that)? I get tired of carrying so much STUFF all the time. I wish I could have one of those small purses, but I need to pack my pump, a back-up pod, an insulin vial, a couple of needles, glucose tabs, a granola bar, and sometimes an extra tester.

And you know the suckiest part? Even with all of that, I know the worst is yet to come. I know that autoimmune diseases tend to stack--I've already gotten hypothyroidism on top of my diabetes diagnosis, back when I gave birth to Q. And there's a good chance there will be more. Sicknesses hit my body harder, complications seem inevitable, and type 1 diabetics are at greater risk for, well, pretty much everything. Even with good control. Sometimes it makes me feel tired and angry. Sometimes I have trouble articulating that I want so badly for Q to have a sibling because I can't picture her parents being healthy at 60 or 70, if we're there at all. But I have to weigh that against the heavy, heavy fear that another pregnancy would do irreversible damage to my body and my mental health--and that I can picture myself dying during delivery, calling out her name and telling her I'm so sorry to leave her when I know I'm her whole world.

This turned darker than I meant, but the point is, give some special love to those you know with "hidden" diseases, whose lives may well be harder than you've imagined, and who know it will be a lifelong struggle to keep up their mental and physical health. And God help me not to burst into a million pieces if my child or children ever got this horrible disease. I know how to treat it, yes, but I also have a deep, intimate knowledge of every impossible facet and life-altering implication.