RheasOfHope

one girl's thoughts on life, mental illness, eating disorder recovery, and hope.

When you stand up for your health June 6, 2017

To say I have difficulties with doctors would be comparable to saying the Titanic had difficulties with an ice burg.

As early as I can remember, doctors have been expressing “concern” about my weight. When I first began gaining significant amount of weight—from what I now know to be binge eating disorder—my pediatrician informed my mother that I needed to lose weight–suggesting she lock her eight-year-old daughter out of the pantry (an act my parents took into consideration and often used as a threat against me). The same doctor later noticed that, around age twelve, I was developing scoliosis from that ever-present elementary school trend of carrying your backpack on one shoulder. She informed my mother that losing weight would alleviate some of the pressure on my spine; which would mitigate some of the pain I was experiencing. The binging continued.

In my teens, my pediatrician would frequently inform me that we should “probably start looking into how to lower your weight given your family history of heart disease, high cholesterol, and diabetes.” While it is true that heart disease, high cholesterol, and diabetes are as ubiquitous in my family as black hair or short stature, these scare tactics only turned an already overweight, binging teen towards increased binging in an effort to make the embarrassment of being called fat and fear of these “inescapable” diagnoses “disappear.” This, of course, only trended my weight even higher.

Near the end of high school, I began to experience some unusual feminine concerns—the solution to which was, again, suggested weight loss. It wasn’t until I had an ultrasound in college, that it was determined that these feminine concerns were actually ovarian cysts. I was told the cysts would have been easier to see had the ultrasound waves not traveled through the extra layers of adipose tissue—despite the fact that that was my first ultrasound and no one had postulated cysts in my numerous visits, as the concern was on weight loss. Once again, losing weight was suggested as a solution to my medical concerns. Unbeknownst to my doctors, during those first semesters of college I was in the beginning years of a restrictive eating disorder that thrived on being told I was overweight, and used those words to intensify the eating disordered behaviors.

In college, when I first sought counseling at my college counseling center for what I believed was an eating disorder, I was again rebuffed secondary to my weight, and informed that I was merely feigning an eating disorder because I did not know who I really was. Because, as we all know, no overweight person could possibly have a restrictive eating disorder or be engaging in purging behaviors. Her response to my eating disorder, combined with years of pediatrician shaming past, continued to fuel my ED-NOS. My general practitioner at the time, the infamous Dr. Khaki Crocs, also felt that an overweight individual could not have a restrictive/purging eating disorder. He diagnosed me with an adjustment disorder. His explanation, “an adjustment disorder is like, well, I could diagnose my nurse with one now. She turned 50 this month and has been having difficulty coping with it. You’re experiencing life changes, and you’ve likely lost your appetite because of it.” It was only after I produced papers from Lindner Center of Hope with a diagnosis of ED-NOS, that he added the eating disorder diagnosis to my chart—without removing his initial diagnosis of adjustment disorder.

After college, I began to notice my knee sounded like bubble wrap when I walked and that it would throb for hours after I exercised. This pain was likely intensified by the strict exercise regimen of my eating disorder that never took a day off or let me take it lightly. Dr. Khaki Crocs was dismissive of my concerns, but my pleading that my knee felt wrong was met with a sympathy MRI. The MRI showed osteoarthritis of my knee behind the patella—where the tibia and femur meet—crepitus, worn away cartilage/bone, and edema. Dr. Khaki Crocs and my physical therapist suggested weight loss. To this day, my knee remains the same. A co-worker even joked she knew I was coming because she could hear my knee cracking as I walked.The most endearing  moment with dear ol’ Dr. Khaki Crocs, however, was when I voiced my concerns about my weight trending upwards, and he wrote the following words on his prescription pad before handing it to me, “Welcome to adulthood.” Thanks pal, way to take my health seriously. You’re a gem.

A few months ago, Dr. Khaki Croc’s replacement—whose partner I got by virtue of his retirement—decided to address my weight. My blood pressure was slightly elevated (we’re talking 128/75, so not even high), likely due to my dislike of this woman and my fear of doctors. She took that as a cue to remind me of my family history of high cholesterol, heart disease, and diabetes—all of which are further complicated by obesity. I informed her that just the week before my blood pressure was too low at the dentist’s (because dentists apparently take blood pressures now), and the elevated pressure was likely a manifestation of my anxiety. She then suggested weight loss again as a means to lower that “too high” blood pressure.

Later in the visit, I expressed to her that I had noticed my weight trending upwards as of late that seemed out of context of my following my meal plan, reincorporating meat into my meal plan, and no longer purging. My dietitian had suggested that that weight increase could be secondary to a thyroid condition, my Effexor, or PCOS. When I relayed this to my doctor, she informed me that my two-year-old blood work showed no indication of thyroid abnormalities, that she’s been “prescribing Effexor and drugs like it for over 20 years and no one has ever lost weight when they went off of it,” and that “even if you had PCOS, it wouldn’t cause you to gain weight.” Her suggested treatment for my concerns was to “remove a couple hundred calories from your diet.” I explained that I’m recovering from a restrictive eating disorder, and that my dietitian uses the diabetic exchange system instead of calories—to which she rolled her eyes and replied, “Well, that has its own issues.” I left with her suggestion to restrict a few hundred calories and instructions to work out more–despite her knowledge of my history with disordered eating and overexercise. I, of course, shared this idiocy with my dietitian, and—after a laugh and mini-vent session–we continued on the same meal plan I already have.

Knowing that I deserved better than Dr. Khaki Crocs’ replacement, I sought out a new doctor last month. This doctor spent 45 minutes with me discussing my eating disorder concerns, my medical issues, my medical history, and what I want out of a doctor. Based on her conversation with me, my medical abnormalities, and past medical experience, she asked if I would be willing to do a blood test–as she felt I likely had PCOS. Forty-eight hours later, I got a message in mychart, “Your labs all look normal. These were done to see if things other than PCOS could be leading to your symptoms. No other signs of issues [were] seen, which does support a diagnosis of PCOS Your sugar is normal. Your cholesterol is good.” She was able to provide me with an accurate diagnosis and explanation for my weight gain in two days compared to the eight or so years I spent with Dr. Khaki Crocs and his croc-less replacement. She truly listened to me, addressed my concerns, and asked how we can worth to better my health without reigniting the eating disorder.

 

There is a powerful hashtag circulating right now–#TheySaid. The purpose behind this hashtag is for women to share their body shaming stories, how they overcame them (or didn’t), and to remind us of our shared humanity as women while empowering us to rise above body shaming. This is my #TheySaid, and my #SheReplied. Never forget your voice is powerful and necessary when it comes to your health. I don’t tell these stories to expose the inadequacies of my former doctors (though they are glaringly obvious) or in an effort to seek sympathy. I relay these stories to show that when you are fat, doctors only see fat. Your arm could be falling off or you could have lost all your blood, but when you are fat, the solution won’t be to reattach the arm or begin a blood transfusion. No. When you are fat, the first solution would be for you to lose weight. After you’ve lost weight, then they’ll see about the arm reattachment or giving you some blood. I relay these stories to remind people that they deserve appropriate medical attention at ANY weight. People deserve love and affection at any weight. People deserve life at any weight. Advocate for what you deserve–you are worthy.

 

Zephaniah 3:17

“The Lord your God is with you, the Mighty Warrior who saves. He will take great delight in you; in his love he will no longer rebuke you, but will rejoice over you with singing.”

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The road to health is not paved with bricks of shame August 10, 2012

Recent columns in the Cincinnati Enquirer and Columbus Dispatch sparked this post. These particular columns were on the topic of Ohio Senator Eric Kearney’s recent report on the findings compiled as a result of the passing of Senate Bill 210 (the Healthy Choices for Healthy Children Act) in September of 2010. This bill requires all school districts in the state of Ohio to report the BMI findings of students in kindergarten, third, fifth and ninth grades.

To understand my viewpoint on this recent publication, I must first take you back to the year 2002– my ninth grade year. I had just finished the agonizing ritual of dressing out in the locker room for my gym class, and was sitting in the middle of our enormous yet aging gym while the overhead florescent lights flickered ominously. It’s not that we didn’t have money to replace the lights either; I’m convinced the whole thing was a sick experiment in the psychology of gym class on teenagers. Anyway, as our gym teachers walked out of the locker rooms and announced that we were dividing the class into boys and girls, I knew something unpleasant was imminent. While the guys were shepherded into a remote corner of the gym, we girls were lead down the hallway to the wrestling room like sacrificial lambs to slaughter.

As we were lead into the room the first thing I notice is the red padded walls emblazed with our school logo, followed closely by what was set up by each of those walls. Along the first wall was a scale; the kind where you have to move the weights over the bar, get it to balance, and wait anxiously for it all to be over. Affixed to the second padded wall was a measuring tape. Along the third wall was a table containing a caliper and what appeared to be a steering wheel for a Fischer-Price-sized car. We were lined up along the fourth wall. That’s when I was dealt a devastating blow; today was BMI day. Glorious. At this time I already knew I was medically obese, I knew I was the largest girl in my class, I knew I was teased relentlessly for my weight, and I knew today would be no exception. What I did not know was that I was already in the thick of an eating disorder. First up, the scale. We went up one by one in alphabetical order. We were weighed, the numbers announced aloud to a class of silent girls each eagerly waiting to hear the weight of their classmates, and were expected to do this without complaint. I don’t remember my name being called, walking up there, hearing the number or her writing it on the clipboard. What I do remember is the feeling of complete degradation and shame during the entire process. Next, we were all lead to the tape measure on the wall. This portion of the humiliation was fine; as most girls in my class were of similar height to myself. Apparently 5’2” is a popular height among Midwestern adolescents. Again, one by one, we were measured, the number called aloud and written on the clip board.

Third came the caliper and steering wheel (which turned out to be an instrument that somehow measures BMI through electrodes you touch on the wheel) tests. As before, we approached the table one by one, did the test, and had the numbers announced to the class before being recorded on the clipboard. Again, the feeling of indignity returned as she grabbed my arm and placed it between the caliper points. The number placed me off the chart she had created. Anything I had felt about myself that was positive melted away as the girls in my class laughed at the fact that a new category was created solely for me. Somehow I made it through the class, through high school, through college and after. However, this day in class ten years ago is never far from my subconscious. I feel that it, along with a variety of other factors, was a major trigger in my later development of anorexia/bulimia, depression, self-mutilating behaviors, and a general sense of feeling lesser than those around me.

I write this story not as a “feel sorry for me” story, but as a cautionary and all-too-true account of what is happening to children around the state every day. Each time these tests are conducted, children face unnecessary shame and humiliation based upon what the state perceives they should weigh. They are told by trusted teachers, administrators, counselors, whomever, that they don’t fit what society thinks a child of their age and height should be. They compare their numbers to those in their class; whether to brag or to bring embarrassment to those around them. They wear their BMI numbers like Hawthorne’s scarlet letter; whether they intend to or not, whether the testing was conducted privately or in front of the class, whether they’re proud of it or not. Every day children are subjected to the message that they don’t fit in or that they are not good enough; recording and reporting their BMI only strengthens these negative messages.

Now, back to Senator Kearney and his wonderful (read: ANY antonym for wonderful) report. Under the HCHC Act, EVERY school district in Ohio is required to report annually on the BMIs for kindergarten, third, fifth and ninth graders. However, only 244 districts actually reported; with 686 others either applying for a waiver or opting not to conduct the screenings altogether. Only 75% of counties in Ohio reported results; even if it was only one district in the whole county, it was recorded as part of the 75%. Almost 92,000 students were screened. The results concluded that in every grade level, between 59 and 67% of students were at a healthy weight; with the remaining percentages split between underweight, overweight and obese. Because of how the categories are arranged, approximately 33% of students in each grade fell into the latter two categories; results that shocked and appalled Senator Kearney. He is calling for the Ohio Department of Health to become further involved in the BMI screening process as a means to decrease the skyrocketing incidences of childhood obesity by reforming cafeteria food, increasing the amount of physical activity in school, and making BMI screening MANDATORY. While I agree that students need healthier food in the cafeteria and more time spent engaging in physical activity, I do not agree that children need to take part in the shaming BMI screenings as part of a mandatory school curriculum. In fact, BMI is not even the most accurate measure of health or obesity. According to BMI measuring techniques there are some current Olympic athletes that fall into the “obese” category despite their peak physical health; as BMI fails to take into account a person’s muscle mass. Children and parents do not need to take part in BMI screenings at school to determine their student’s level of health. Parents and doctors can  screen a child’s health in a protected, private and non-judgmental environment—not a school.  I know that I am just one person, and that I cannot overturn this senate bill myself, but I do know that I can do everything in my power to ensure that my future students do not face the same fate that I did as a result of these discouraging BMI screenings. I wish, for once, the state would consider a student’s mental health when making decisions related to their physical health.