ER Visit for Abdominal Pain

10/10/16

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I am a plethora of fucked up shit right now. The Bipolar Mania and my abdominal pain is getting worse. I went to the ER last night where everyone was as loving and respectful as possible. Oddly, two men I complimented on their bow ties, came and hugged me, both saying, “You’re beautiful!” That never happens.

Get Thee to the Hospital Already!

I’ve known I have gallstones for over a year, but the gallbladder wasn’t hurting me so I haven’t had to deal with it. However, I’ve been having increasing right upper abdominal pain for months, thinking it was a hernia (incisional). I also considered the gallbladder, but it didn’t fit the typical gallbladder attack.

Then the Mania hit and all of my body’s pain vanished. I didn’t realize it was gone until I started taking the Risperdal and the dips down from the highs brought back the intense pain I live with every day.

Symptoms

  • Off & on again fever (highest 103.5)
  • Sweating profusely (not related to Blood Glucoses)
  • Diarrhea that 20 Immodiums a day and Pancreatic Enzymes don’t quell (so no bowel obstruction)
  • Upper right abdominal pain that radiates through my back, which then changes to a knitting needle feeling (the pain has no rhyme or reason… independent of food choices… making this Atypical Gallbladder pain
  • When the spasms hit, Pain Level is a 6

I am really good at using Dr. Google and self-diagnosing, but I had run out of ideas for matching my pain to a cause, so trekked off to the hospital.

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Prelim Work

Because I know hospitals are wary of people with pain, thinking they are drug seekers, I am clear with each care provider overseeing me that I am 2.5 years clean from opiates and do not want them. They visibly relax, relieved they don’t have to figure out how to have That Opiate Discussion. I use Mindfulness Meditation for my pain relief and did my best with it the past week.

They took me right in and, during my vitals, we see my Heart Rate is 118… double what it should be. Noted. I was taken right to a room, meeting a lovely nurse who got the IV in my fat, fat arm’s one-vein-I-have on the first try. Then the Nurse-Practitioner came in with two students (she didn’t ask permission to have them in there, but I couldn’t have cared less at the moment… and I always let students watch anyway). I was delighted to see an NP and she thanked me for that, most saying, “Where’s the doctor?!”

Quickly, I was given Toradol, which didn’t do squat, and then Zofran (for nausea), which helped a little more. Then I was wheeled down to get a CT, a fat girl wheelchair that held my body comfortably.

I was in tons (laughing about the word “ton,” seeing it in editing) of pain at that time (the pain coming in waves like contractions). The tech helped me onto the narrow table.

Contrast Pleasure

The scan had contrast, which I have grown to enjoy. I used to cry when they said I needed it, but now…. shudder of pleasure

I teach others how to enjoy it as well.

You see, when the dye goes through the IV and into the body, it makes a searing beeline for the groin. More specifically for me, my clit. (Men say it goes to their testicles.)

You know, when some people get it, they uh- they start to- well, they get an orgasm. Can you believe that?

While I don’t orgasm, I have learned to, quite literally, lie back and enjoy the short ride.

I even overlook the nasty iodine taste in my mouth. Too much of a hot party going on down south.

When the procedure was done, the sweet tech and the wheelchair pusher-guy helped lift me to sitting, grabbing the sheet behind me and pulling. I was zipped up quick as could be!

Missing My Pain Doula

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It was going to take an hour for the results. I was texting with my fawn, then I got really, really sad about not having Zack with me.

Zack had been my medical doula for 2 decades. Longer. Even when he was pregnant (30 years ago), he was with me when I had surgery, loving me through it.

I began having another spasm, told my fawn I had to go for a few minutes, then cried as I did my Lamaze breathing, leaning over the raised head of the bed, my tears falling onto the blue sheet as I huffed and puffed in a sobbing rhythm. Big hot tears of remembering how Zack spoke up for me, protected me, gave me my meds on time, even wiped my ass after surgeries when I couldn’t reach. (That’s love right there.) I didn’t want to bother him with my pointless sadness, so didn’t call, but I could feel the emptiness engulfing me.

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I was NPO, knowing surgery might really be possible, and how alone I was going to be if that happened. How would I get food? How would I remember my meds? How would my ass stay clean?

(An aside: I have been being terribly non-compliant with my Risperdal and Trazodone. I asked my fawn to help remind me/encourage me to take them about 11 or 12 at night, but I over-ride him and just stay up for 24+ hours. Zack was like a Psych warden… handing me my pills and watching while I swallowed them. Alone, I get to be a bad patient because I would rather feel GOOD than sleep. Even though there are bugs and shadows and such. Yeah, I know. STOP IT! One of my sweet friends sent me a picture of herself making a stern face that she said says, “TAKE YOUR MEDS!” Maybe it’ll help.)

The Results

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The NP came in and told me they couldn’t see any hint of a hernia in that area. I was really surprised. However, the gallstones were present, but labs showed no cholecystitis, so surgery was ruled out for the moment. She said I did need to have surgery as soon as possible, though.  I told her I had a GI Doc I would call in the morning (10/10/16… I did… next post).

She then said I had an infection in my intestines. (The paperwork is in the car, I can’t find what it is called at the moment.) She wanted me on Flagyl, but I am allergic to it, so changed it to Cipro. She also was prescribing Bentyl for the colic-like abdominal spasms. She said she would prefer I stay in the hospital for a couple of days, but I said I could take care of things at home. (Sheesh. Lyin’ through my teeth, I am.) She said, fine.

When she went out to do discharge paperwork, the sweet nurse came in and did vitals. My HR was now up to 124. She left, the NP came back in.

“I really want you in the hospital for a couple of days now.”

I asked what would they do. She said meds and pushing fluids. I said I could do that at home. She had me sign out AMA. I was told to return to the ER in 12 hours if I couldn’t see my GI doc, wanting to check my HR again. I said, “Sure, no problem.”

I left with the prescriptions and tried the 2 closest pharmacies, neither of which takes my insurance. I was exhausted, crying in frustration and went home.

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I tried working, but was in so much pain, I laid in bed and boo hoo’d myself to sleep. I slept fitfully for a couple of hours at a time. Up for 2, back down again for 2.

I did not take my Risperdal or Trazodone last night.

I called my GI doc’s office at 7:50am and got an 8:30am appointment.

That’s the next post.

Next: Blindsided: The Fat-Shaming Doc Visit

Checking My White Privilege

My inner-racist/classist/transphobic/homophobic

(etc.)

Disclosure:

Even though I am a fat Latinx who has mental illness, am physically disabled and a sex worker on the LGBTQI spectrum, I have a massive slew of inner (and outer) work still to do. I was raised in the American-Anglo world… the middle-class, English-speaking, able-bodied, white world… with white privilege.check-privilege-gif

I so want to be helpful in the various “causes” going on in our world, around the world.

I do not want to be hurtful.

Not here in my Navelgazing Writer blog.

Not in my Tumblr blog

And most especially, not in my life.

Where I know I still need work (and I acknowledge I surely have blind spots yet to be discovered):

(in no particular order)

#Black Lives Matter

I speak up for #BlackLivesMatter often, as often as I can in as many places as possible. I believe in the Movement with all my heart. I follow along, watching the debates between #AllLivesMatter, #BlueLivesMatter and even the dissention between the ranks about the Movement itself. I write about #BLM where I can, use the hashtags, engage family and friends and am seriously considering a #BLM tattoo. Yet it still isn’t remotely enough. I know that. I want to do something. Do something more. I keep looking for where I could be of more use. I will explore that here.

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Islamophobia

My boyfriend/lover/submissive (my fawn) is Muslim. I am struggling with Islam in ways that make me cringe and hold my head in utter confusion. As an atheist, all religions are confounding to me, but at the moment, Islam stands front and center of my inner conflict. Separating Islam from Muslims seems daunting, as much as separating Islam from cultural beliefs that are Islamic. I am just beginning to figure this stuff out.

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Transphobia

I will write about this extensively, surely over a several year period, but it has to come out. My former partner of (then) 25 years, came out transgender, medically and surgically transitioning from female to male. From announcement to phalloplasty was a little over 3 years. About 6 months after the phalloplasty, we separated, then divorced. So very much to say about the myriad of emotions that transpired during our transition time together.

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Internalized Homophobia

Even though I initially came out lesbian when I was 18-years old and then again when I was 25, dating only women… and being in (what I thought was) a long-term lovership/marriage (off and on) with a (then presenting) woman for 28 years, I know there are still stereotypes and -isms I need to look at and work through.

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Racism

This topic is so broad, it will take many different posts to work through. Even my own inner-Racism as a Latinx will need to be worked through. But the stereotypes of different races and cultures jump to the forefront of my mind when I least expect it… and that shit needs to stop.

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Xenophobia

Interestingly, I don’t feel I have a lot of xenophobia, but I could be deluding myself and need to work on it as well. I just don’t have issues with migrants, immigrants or refugees. I’ve worked with migrant Hispanic women (at the Farmworker Association of Florida and at Planned Parenthood as well as in midwifery school in El Paso, Texas), but that is a specific group of folks, leaving hundreds of other cultures and countries still mentally untouched.

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Fetishizing

Ugh. This one is going to be fucking difficult to work with since I am a sex worker who often creates scenarios and writes pornographic stories that specifically fetishize men and women… both cis and trans. I struggle with the line between attraction and fetishizing in my own mind. I adore black and Asian men. Love “Big Black Cock” and speak and write about it a lot. What are my values and am I contributing to the degradation of oppressed people by having my own desires and, more specifically, fetishizing it in my job.

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Reevaluating Law Enforcement

There have been police officers and Deputy Sheriffs in my family and friends since I was born. My disgusting police officer step-grandfather molested me (several times), in uniform once. My former partner was a Deputy Sheriff for 10 years of our relationship. I have been arrested and jailed twice, including being extradited back to San Diego, California from Orlando, Florida. Yet, my attitude towards law enforcement has generally remained one of a positive viewpoint.

And now, watching the videos of black men being killed for zero reason has jarred me into reevaluating my beliefs. And the really sucky part is until videos started being shown, I barely took notice of the mass of killings of black men, women and children. Even the mass incarceration of People of Color went over my head. I am horribly ashamed of this, but it’s the truth. This really, really is fucked up.

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Sex Workers

My sister was a dancer. I have several close friends and family members who were dancers as well. I am a Phone Sex Operator. One of my family members and I have discussed the inner confusion between feminism and sex work several times. I love what I do, but there are degrading moments that make me feel like I want to wash my mouth out with soap sometimes. Lots to think about.

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BDSM vs. Physical Abuse

I’ve been in the BDSM Scene since 1995, mostly as a submissive to my former partner Zack and now as a Domme in my sex work job. I consider myself somewhat of a pain slut, do bottom to others, have experimented with subbing to my fawn and much of my life is taken up in the Scene.

In 1990 or so, I wrote a piece in the San Diego Lesbian Press about how BDSM is nothing but a pretense for allowing/encouraging physical and mental abuse to vulnerable women (that was the angle; today I would say “people.”) For anyone following the Scene, this is a common argument and one I’ve considered (and reconsidered) over the years. There is ongoing inner discussion.

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Visible Dis-Abilities/Challenges/Differences

I have mobility issues because of being fat (a separate obstacle all on its own) and having brittle bones. As I write, I can think of about 20 preconceived thoughts about physically challenged folks that need to be purged. And not just my own.

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Mental Health

I have Bipolar Disorder 1 with omnipresent hallucinations, more depression than (hypo)mania and have had other psychiatric issues (anxiety & agoraphobia) fluctuate over the years. I honestly think this will be the area where I have the fewest concerns to work with/through. Being in therapy since I was 18 and starting on medication not long after that, I left the stigmatizing beliefs behind long ago.

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Size-ism & Fat Phobia

This will, most assuredly, lead to the most emotional posts of all (that I can predict at the moment). Having been fat my whole life, a gastric bypass in 2001 that initially was awesome, but now 15 years later is fucking with my body’s health and continues fucking with my head. Once in the Fat Activist Movement and still believing in a fat positive outlook, I also believe much of today’s Fat Positive representatives are deluding themselves about the long-term effects of being fat. Lots and lots to say about this.

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Cultural Appropriation

I was a Japanese Geisha Girl for Halloween growing up. I wore cornrows in the 70’s. I wore a medicine bag with crystals and sage around my neck in the mid-80’s. I did mendhi in the early 2000’s. I’ve participated in Blessingways over 30 years as a midwife. I’ve made flower crowns, worn harem pants and love Disney movies.

All of this before I learned what Cultural Appropriation was. It mortifies me seeing how disrespectful I was to so many people over the years. I look around and wonder what I am doing now that I’ll recognize in 5, 10, 15 years that will equally mortify me.

Know better, do better.

My Plan for Continued Inner Work

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I will continue reading articles, books and essays by people of different races, religions, cultures, socio-economic statuses, genders, abilities, sizes, etc. I will believe what they say even if what they say is different from what I know, what my experiences are and what I learned in school and/or in my white culture.

I will delve more into the histories of the people I am not familiar with, learning the things I did not learn in school. Actually, un-learning the things I learned in school.

However…

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Where I have an issue with exploring/learning on one’s own, is it requires some skills some/many people might not have or have access to:

  • Internet access
  • Ability to read
  • Ability to read English
  • Advanced English comprehension

I think there needs to be some alternative plans in place for those who need in-person learning/education of these social phenomena, especially when they are asked for.

Where I Struggle

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Where I do struggle, however, is in how to learn from the communities and cultures themselves. I absolutely understand the reasoning behind not asking the oppressed to educate me/us about their issues/concerns/struggles. I do promise to do my best in educating myself, but the reality is, with some of the exploited/misunderstood/unheard people’s problems/concerns, I am clueless where to even begin.

And then the black holes. Even as I research, digging deeper and deeper into subjects, learning new words to Google and building on my knowledge, there are still going to be gaping black holes I won’t even see until someone points them out to me.

Are there whites that I should ask instead? Isn’t that similar to playing telephone, getting the information second-hand? Wouldn’t speaking to the actual source be more appropriate? Wouldn’t I learn more hearing it directly? I will keep looking for the answer to this puzzle.

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If you see my bullshit, don’t hesitate to re-orient/correct/challenge me. (Without my expecting a lesson from you of any kind. I will be sure to research on my own and try again.)

I need to be more conscious. I promise to work on it every day.

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Fat Girl Whining

I’m fat. Really fat. Over 300 pounds fat.

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I also have Diabetes and have to see an Endocrinologist every few months. Endocrinologists take care of fat people. A lot of fat people. There has not been a time when I’ve sat in an Endo’s office that there were no less than 4 really fat people. I just left the Endo’s office (and I love the people there) and need to vent for a second.

Chairs

How can an office that caters to fat people not have chairs without arms on them? How?! The first time in there, I asked for a chair without arms and they brought out one of the bench chairs (that still had arms on it). Fine. They brought it in the exam room with me, too. Nice.

Today, the bench was there… with someone already in it. So I had to cram my fat butt into one of the tiny chairs… with the arms going INWARD instead of out! What the crap?

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I spoke with the office manager who said she’d already put a work order in for more benches and asked me to answer to survey I’ll get in my email with a comment about the chairs.

We’ll see how long that takes.

Blood Pressure Cuffs

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For fuck’s sake, I thought I had finished complaining about medical people taking my blood pressure incorrectly/painfully 2 decades ago.

  • Dealing with a stupid ER nurse using medical tape to try and keep the wrong size cuff on my arm, the tape splitting and the nurse huffing off to get his supervisor
  • Having too small cuffs bruising me dozens of times
  • Having large cuffs bruising me because I have really big upper arms with batwings

I thought I’d come up with a solution by insisting they use the cuff on my forearm. Techs and nurses balked at first, but for the last 5 years, it has been a matter-of-course to take my BP that way.

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Then today, the nurse came at me with a thigh cuff, easily twice as large as the large-sized cuff. I asked her to please take it on my lower arm and she said they had just had training saying it was required to take it on the upper arm because doing it on the forearm is “quite inaccurate.” I grudgingly said she could try, but if it hurt, I would cry.

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The cuff goes on and begins tightening. And tightening. And tightening even more. I said, “It hurts, take it off,” and it stopped pumping up so I said I’d sit still. Then it began tightening again and I nearly hollered, “GET IT OFF.” She did, charting, “Patient refuses BP.” I corrected her: I am more than glad to have my BP done, but on my forearm. She shrugged and left the room.

After my appointment with the Endo (which went really well), I asked how we were going to resolve this BP issue and she said it was “policy” and she would ask what to do. I said, “Patient requests forearm blood pressure,” please put that in my chart. She did.

Fat Anger

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We (our country) is fat… and getting fatter. What is wrong with healthcare providers that they do not make concessions for us? I’ve been writing about this since 1987!!! This is ridiculous.

Not accommodating fat people is yet another way to discriminate and intimidate fat folks. Healthcare providers not doing so prevents far too many people from obtaining care at all, care that can keep them healthier… and for you fat haters, even help fat folks lose some weight (if they want to or are able to).

Over the years, in the courts, this accommodating for “morbidly obese” people has been argued. The general consensus is now that fat falls under the American With Disabilities Act. One more thing on our side.

Please Speak Up!

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Many fat people in our society sit in these tiny chairs, put up with exam tables that do not go up and down and never ask for accomodations for their size. I speak up whenever I can, but I cannot do it alone.

Thinner/Smaller friends and family, please “see” things how we do. If you see people squished into chairs, quietly talk to the office manager, explaining how difficult the chairs are for fat people. Say you have a family member or friend (which I am!) or partner that won’t say anything, but that they get bruises every visit. If you work in an office, restaurant or anywhere people need to sit, please advocate for us to get the proper seating for fat folks.

Special mention to servers: PLEASE STOP SEATING FAT PEOPLE IN BOOTHS (unless they ask to be put in one specifically). It is humiliating to try and squish ourselves into the tight tight space at a booth.

And if anyone thinks the small chairs and small spaces are going to force us to lose weight, you are woefully incorrect. Fat-Haters, rue the day this issue is yours or someone’s you love.

Thanks for listening. Rant over.

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painter: Igor-Grabar

My Wall-E-esque Life: Part 1

“Fat Acceptance” has been a catch-phrase for at least 40 of the years I have been alive. In 2 parts, I share my experiences and lessons learnt being a part of the…

Fat Acceptance Movement.

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I’ve been fat ever since I got my tonsils out when I was 7-years old.

Fat kid, teen, adult and now a “mature” adult.

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Trials (and Errors)

I’ve done dozens of diets, been prescribed Black Beauties & other speed (starting at age 8), belonged to many gyms, taken Phen-Fen (with success, but with heart valve damage), tried Topamax (fail), used Wellbutrin (fail), had a Roux en Y Gastric Bypass (with fabulous success, then epic failure), done hypnosis & acupuncture (fail & fail), become a daily Mindfulness Meditation fanatic (fail for weight loss/huge win for pain relief), have tried to have anorexia, then bulimia, hand-written hundreds of thousands of journal pages, letting them “hold” my pain, shame, revulsion, self-hate, wishes, fears, hopes &, eventually, resolution with my size.

I remain in resolution.

I will never diet or take diet drugs again. Ever.

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Time & Money

Thinking about the masses of time and money I’ve spent trying to lose weight makes my head spin.

Time

  • Going to the gym
  • Writing out menus
  • Researching rules and techniques for success
  • Real life or online support group meetings, including social networks talking about losing/gaining weight
  • Shopping slower to read labels and make sure food is “appropriate”
  • Learning new cooking methods
  • Fighting with family about the change in foods in the fridge and cupboards
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artist: Sapphire4723

Money

  • Gym membership
  • New cookbooks
  • Membership fees & apps
  • Tools for success (exercise equipment, pedometer, walking/running shoes, gym clothes, etc.)
  • Tossing all the “bad” food in the garbage
  • Buying all the “good” food
  • Probably eventually buying more “bad” food for my family because they whined so much about foisting my diet on them
  • $28,000 cash for RNY gastric bypass (GB)

Can I include the time and money (including the taxpayer’s) for the years of therapy discussing and crying about all of this?

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Positive?

I was a Fat Activist in the mid-late 80’s, mostly in the lesbian community. I’ve written about being fat-positive for almost 3 decades.

In the beginning, when I was in my 20’s and early 30’s, I was healthy… labs were fine, no diabetes, my joints or feet didn’t hurt. I crowed (bragged, was arrogant) about how it was the fat-hating that made fat people sick and die, not the fat itself.

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Reality

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Now, at 56-years old, I see how delusional I was. I am well on the road to dying before most people in my family did, and they all had diabetes, too. My future resides in my memories of my Cuban relatives & the diabetes complications they endured before dying. Heart attacks, going blind, having toes, then feet cut off, eventually dying in a coma because the body just gave up.

I see it coming as if it was a roaring train heading right for me.

Litany of Pain

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Here are my fat-related illnesses and issues:

  • Type 2 Diabetes (diagnosed at 34 years old), now on 2 insulins and metformin
  • I heal terribly because of the diabetes, often needing antibiotics for residual infections
  • Stage 3 Kidney Disease from the diabetes
  • Pain with every step I take
  • Osteoporosis and arthritis in my feet, which have broken 3 times just from walking for exercise, and one foot breaking while swimming
  • Broke one foot falling off the Wii Fit Board trying to exercise… needed 3 surgeries to repair
  • Arthritis in my lower back, was on opioids for 8+ years for the back pain, becoming incredibly addicted, finally getting clean 3 years ago (yay me!) Now I use Mindfulness Meditation for pain relief, though many times I wish for some Norco.
  • It took me years to find surgeons I felt safe with to get my 4 hernias repaired (one surgery) and then my gallbladder out (a separate surgery, with 3 hospital visits afterwards because of infection)… several turning me away because of my enormous belly size (blessedly, I found the docs and those issues are resolved)
  • Bone loss from possibly 2 main sources: lack of exercise & the GB
  • Walking with a walker, but should be in an electric wheelchair, my feet hurting so badly
  • Using an electric wheelchair when I shop

Nautilus

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My world has gradually become smaller and smaller. After 32 years in birth work (where I hurt daily as well), I am now a sedentary Phone Sex Operator. I live in a small space and leave the house only for doctor appointments, physical therapy, shopping and seeing my doggies at mom’s house.

Writing that makes me sad.

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Part 2 On Its Way

In Part 2 of My Wall-E-esque Life, I will talk about the place the Fat Advocacy Movement does have in our lives. While it might not be health (despite the incessant refrain that it does), it is most assuredly have an enormous place in our physical and emotional world.

More soon!

Fat Girl Stories: Ugliness

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artist, Jenny Saville

Avoiding my reflection at all costs

No mirrors, no glass windows

Nothing form-fitting

Overlooking any signs of weight gain.

Self-consciousness submerges into unconsciousness.

At the height of ignorance

I spill secrets with abandon

Forgetting the flayed flesh

That comes with disclosure.

How stupid could I have been?

I whirl around with joy

And smash into the looking glass

Shattering my image into a million broken shards

I fall back to earth with a heavy thud.

Barely breathing, I do not move.

Slices ooze.

My raw hands hurry

To scoop up pools of blood

Mixed with tears;

It will not reabsorb.

I am fat.

Fat fat fat fat fat fat

Fat fat fat far fat fat fat

Fat, fatter, fattest

Loved, yet still so unlovable.

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Fat Girl Stories: O’ to Not Be Fat Anymore

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Fat, Weight Loss Surgery, Weight Loss Medications, Weight Gain all discussed.

I wrote and published this in my Navelgazing Midwife blog on May 3, 2007. Pictures have been added, but nothing else has been changed. I’m sitting here smirking about how arrogant I was throughout my life thinking I would find *A CURE* for my obesity. I was delusional, even in this post.

End result? NOTHING WORKED.

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Artist, Jenny Saville

Fat Angry Woman

  • Pacer. I was called Pacer throughout Junior High because I had a “wide rear end” like the GMC car of the 70’s.
  • I’ve had eggs thrown at me while walking around the block trying to lose weight.
  • Another year, I had a kid throw oranges at me while doing the same thing.
  • I’ve been moo’d at hundreds of times.
  • I’ve been laughed at, stared at, and ignored.
  • I’ve had to sit at a table and chair because I couldn’t fit in a desk at school (for years).
  • I’ve had to shop from a catalogue (pre-Internet) because no store had clothes large enough for me.
  • I went without bra and underwear for 15 years because I couldn’t find a decent-sized fit that didn’t cut the hell out of me.
  • I lived with yeast under my pannus and breasts for decades because I thought it was “chafing” – trying to cure it with powder, corn starch, Gold Bond, zinc oxide, keeping hankies or bandanas tucked under my pannus, struggling to keep it dry. I blew dry it half a dozen times a day and still it remained seeping moist. Once I learned it was yeast, in my thirties, and used Monistat on it, my life transformed!
  • My thighs’ friction burned each other to the point of losing skin, especially when wearing panty hose (de rigeur in the 70’s) and I used bandanas to keep my thighs protected from each other. I remember learning about bloomers and thought they were the miracle of the world. I never owned a pair, but quickly thereafter, bike shorts came into my reality and I have never been without them again.
  • I hobbled so badly a woman took me aside at a dance and told me about Birkenstocks. She said she hobbled from her fat, too, until Birkenstocks and they saved her feet. Poor, I asked her how much they cost and when she told me they were almost $100 I almost choked! She told me they were worth the ability to walk and somehow I manifested the money and have only worn Birkenstocks since. I now own 20+ pairs.
  • I’ve sat on airplanes and spilled onto two seats, using two seatbelts, almost needing three. I either flew on near-empty flights or flew with my partner so I could seat-share with her
  • I lived with the food voices speaking, whispering, and screaming inside my head my entire life except for three distinct times: when I was on Phen-Fen, during the first year after the gastric bypass and now, on Topamax. When the food voices are “on,” they are incessant and never-ending. They don’t take a breath, rest, relax, and stop even for a second to consider my feelings or sanity – they merely run and Run and RUN through my mind until I want to scream – or eat to make it shut up. And even if I eat and the voices recede to the background for a moment, it isn’t but a moment before they are loud and screaming yet again. Is it any wonder I wanted to make them shut up?
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Artist, Jenny Saville

From Whence I Came

I was dying of being 350 pounds. I am not dying of being 220 pounds. I can live easily and delightfully at 220 pounds. Would I like to eliminate the pannus I have from having three kids? Sure! Will I? Maybe, maybe not. Do I wear sleeveless dresses and shirts even though I have swinging arm skin? You betcha.

I remember what it was like being fat(ter). I remember the sadness, the anger, the feeling of being a victim I felt. I remember how I didn’t fit in – literally. I remember how I didn’t fit in chairs, through turnstiles, on rides, in booths. I remember how it felt every single time I would go out of the house, heave myself into my car, heave myself out of the car, walk into and out of a store, feel myself looked at by children and teenagers… and many adults. I remember ripping clothes because they were too tight, too old, I squeezed in the car and they got caught between me and the steering wheel. I remember being watched while shopping for food. I remember hating eating out because people watched me. I remember eating in secret. I remember hiding food because I didn’t want people to see how much food I ate. I remember hating how little control I had over myself. I tried, every day, to do better. To stop the voices. To stop eating. To stop eating so much. I hated being so observed.

Fat Acceptance

fatswing

I remember using my writing skills to move Fat Acceptance forward by outlining each ride at Disney World (I went by “gardenia” back then) and how fat people would do on them… writing about health care and fat acceptance… writing just using the word “fat” (which made some people [usually not fat] very uncomfortable) itself!

I’ve been to rallies and stood next to Fat Acceptance chicks and spoken on behalf of Fat Moms and Fat Dykes – asking (demanding) that we get decent chairs at the Gay Pride Festival, that we be remembered when tee-shirts are ordered at all events, and that everyone remember fat is just another way of Be-ing.

When I got really angry, though, was when I started seeing my lab work going downhill. For years I’d bragged about how great my lab work was even though I was fat. Until I was 34, everything was great. Then, my Hemoglobin A1C, my glucoses, my cholesterol… everything went to shit. I didn’t pay that much attention until I was hospitalized for a kidney infection that was complicated by extremely high glucoses. With a family history of diabetes (I am Cuban); I couldn’t just sit and watch the glucose/kidney correlation with abandon.

I’d always despised when people said they’d had Weight Loss Surgery (WLS). I disgustedly spat out the words, “Mutilating Surgery” as I watched a fat person choose WLS. I didn’t even want to hear their story. I didn’t care. There wasn’t reason enough to me for someone to cut apart their body that way. It was repulsive to me.

Weight Loss Medications

Drugs were no different. I’d been given Black Beauties at 10 years old and a variety of other weight-loss drugs over the years and none of them worked and all of them made me even fatter.

Diets were stupid and I’d long ago given up on any diets. (At least publicly.) Privately, I tried a couple for a week or so, but couldn’t ever do anything for longer than that.

But, when I was getting sick, I had to do something and chose the method of the moment and that was Phen-Fen. It seemed ideal and, at that time, it was.

phenfenpills
Phen-Fen (Phentermine & Fenfluramine)

Phen-Fen was a dream! Within 3 days, my mind shut up and the voices were gone. I couldn’t believe something could actually make the voices stop! I loved it. I was on Phen-Fen for 19 months and lost 111 pounds. I was still 230 pounds, so wasn’t any thin thing, but I loved where I was – in a silent world of normalcy.

When they took Phen-Fen off the market, the voices returned and came back in a furor I’d never heard before. It was as if they were so angry at being silenced for so long, they were going to tell me 19 months’ worth of what they wanted me to hear. I was forced to listen. And I ate. And ate. And ate. I gained 130 pounds in 9 months.

Immediately, my diabetes, cholesterol, triglycerides, sleep apnea, stress incontinence, PCOS, IBS became issues I would contend with for another 10 years. Sure, I’d end up with a heart defect from the medications, but even all these years later, I waver about whether I would take Phen-Fen or not if it were legal again. The drug’s quieting effect was that restful to my mind.

Weight Loss Surgery

When the illnesses overtook my body and I was so limited in mobility and I was really looking at the last days of a very unhappy and sickly life, I had to make a choice about what I was going to do and I chose the Roux en Y Gastric Bypass. It was almost cruelly ironic. I couldn’t help but laugh. My fat friends, long gone from my now world, would have been disgusted and would have been… long gone… just at the news of my choice.

roux-en-y-gastric-bypass

My choosing to have Weight Loss Surgery (WLS) reminded me of lesbian friends who went back to men or Christian folks who chose abortion or other such dichotic, head-twisting ideas that make one’s circle of friends wonder what got into us. If I hadn’t been in my own body and head, I’d have thought I’d lost my mind.

What was I about to do? What did I expect out of surgery? Did I think I was going to be a svelte size 6 at the end of the gig? What was I going to do with all my loppy skin? Could I love me smaller than the fat chick I had known and loved for 40 years? Would I even know me smaller? What would I fight about/for now? If I didn’t fight for Fat Chick Rights anymore, who would I be? If I fit in the chairs, who would I be mad at? I was so worried about being lost. So lost.

I had surgery April 5, 2001 and was meticulous with my post-op care and therapy. I lost 100 pounds in 10 weeks simply by being compliant. I wasn’t racing to lose weight, but was racing to save my health and within days, I was off most of my medications and within weeks, all of them. I ended up losing 190 pounds in a year, but wigged out when I put on a pair of size 8 jeans. I absolutely loved being able to shop anywhere, adored walking, crossing my legs for the first time in my life, sitting on my partner’s lap, fitting anywhere I tried (and it took years to figure out my own size in relation to things) and doing cartwheels (I have pictures). My kids didn’t know what to make of me!

Failure. Again.

By year three, I’d regained almost 100 pounds. I was still fairly healthy, but mobility was becoming an issue once again. The sleep apnea was returning as well. The voices had returned with a vengeance. It was the worst of all the returning difficulties.

covering

(I wasn’t like some of my co-WLS friends who were suicidal because of weight gain. I took it in stride, knowing that most WLS post-ops regain 50% of their weight back. It didn’t make me do more than shrug and sigh about my recurring health concerns. I had thought I’d had enough incentive to keep enough weight off to keep those at bay, but, alas, I was as human as the rest of the gang.)

I never had any illusions of being small forever, but I didn’t really think I’d have to diet again. And yet, I found myself considering diets – the most disgusting shit fat people are told they have to live on in order to be treated humanely in this society.

Blessedly, I still couldn’t eat the massive amounts of food I’d eaten pre-op. While many say they are fat without eating thousands of calories a day, I ate 8000-10,000 calories a day and was unable to see that – or admit that – until I’d had the gastric bypass. I was still able to eat plenty to weigh 250, though! Even with a stomach the size of a shot glass. How’s that for a food addiction?

Anyway, this isn’t really meant to be a play by play of my diet history, but know that through the last few years, I tried a few diets, drank that crap Slim Fast (recently), considered Opti-Fast, Nutri-System, and anything else I could think of that I couldn’t do before WLS and have failed just as miserably now as I did then. How could I think it would be different?

The Voices

What I really was searching for, however, wasn’t the loss of weight; it was the silencing of the voices inside. The screaming inside my head was becoming so loud; I could hardly hear myself think. Some days, I thought I would go crazy from the cacophony. I begged my psychiatrist for help, over and over again. Please, please, don’t you have something for these voices? You have something for the auditory hallucinations of my Bipolar Disorder, where are the medications for this? For a year, she worked with me to get my BPD and my extremely precarious depression into a place of balance before she would even begin talking about food voices. Once I was stable enough on the meds, she whispered a possible solution.

Her name was Topamax.

topamax

Topamax has become my/the new Phen-Fen and I am blessed to have it in my life/head/mind.

More Medication?

Since starting Topamax, the voices have left completely. I am able to eat when hungry, stop when full (to my pouch’s full, not my old stomach’s full), and not be hungry again until a real mealtime is supposed to be. Before Topamax, I grazed nearly continuously and ate meals inbetween the grazing. Since starting the medication, I have lost 30 pounds, sleep apnea, the feet pain, the knee aches, the glucose spikes and my periods are regular again. Just those 30 pounds made a difference.

I am not on medication to lose weight. I am on medication so I don’t try and crush my hands through my skull and make my head shut up its crazy never-ending screaming for food, Food, FOOD. I don’t know what it is in my bio-chemical make-up that creates those voices, but if I hadn’t ever had Phen-Fen before the Topamax, I’d never have known the voices could be quieted; I’d never have even known the voices had a name.

But, I know them now and they are what made me the fat, angry woman. The voices.

standing

So, this still fat woman isn’t so angry right now because the voices are quieted… drugged, if you want to say that. I don’t really care what you want to call it; they have shut their damn mouths! I can think, function, meditate, talk and even make love without hearing the continuous imploring to find food. I only hope the medication doesn’t have the same sad ending Phen-Fen had, of course, but I’m living in this moment… staying in the joy today.

Pondering

Circumstances surrounding my life have made me sad and even mad at times… the way people have treated me, not treated me, the way I have had to settle for less (so to speak) most of my life because of being so fat, being called names, kids thinking I was pregnant years after having had my babies, looking in the mirror and seeing someone I could barely tolerate looking at. I wonder now, not so fat, if I am still mad at those things. I am certainly unhappy that my fat sisters and brothers have to suffer those indignities I used to suffer – but I also see that people are far fatter today than they were when I had surgery 6 years ago.

(I have made the interesting observation that I spent my childhood as the fat freak and got WLS as an adult and soon enough, more kids will be fat than not and those who have WLS will be the thinner freaks!)

oralsex

As a fat chick, I also had such a great life as a very sexually active dyke… danced and played and support grouped myself silly! I might not have been able to walk all over the world, but I sure could ECV all over The World (Disney World, that is!)! My sedentary lifestyle left me plenty of time to write and develop Internet relationships, many of which are now a decade old. I am in a glorious relationship with my Sarah who loves fat chicks of all sizes and I am mom to 4 great and wonderful now-grown kids who loved their mom fat and who are extremely de-sensitized to fat people look-wise, yet highly sensitive to their needs when out and about. I am very proud of them and their love for people; I know that my fatness had a giant (har) place in their gentleness and amount of kindness for different people.

Making Space for Fat Folks

Fat acceptance certainly still has a place in my life. I still work hard to keep fat information in the forefront in my life. My holistic healthcare office accommodates fat folks as easily as non-fat men and women. We have gowns that fit people up to 600 pounds. We have chairs that hold 550 pounds. I made sure the massage tables held 500 pounds. We have a chiropractic table called a Hi-Lo Chiropractic Table that allows those with mobility issues to stand and be lowered gently instead of having to climb on the table. Our pregnant women use the Hi-Lo, too, of course – they can lay on it, belly down, because the middle drops out… sometimes the only time they ever get to be on their stomachs during their pregnancies.

I have a speculum that is appropriate for the women who might need that. I made sure the exam tables were situated in a way that the legs would be comfortable during an exam (I typically don’t use stirrups, but can if a woman wants to). I own a blood pressure cuff that not only has a large cuff, but also has a thigh cuff for a super-size person’s arm. I also learned how to take blood pressures in areas when the cuff is too small for the upper arm – and teach that to student midwives, nurses and doctors everywhere!

When interviewing practitioners, I make sure they are comfortable with fat clients. I use the word “fat,” so they quit startling when they hear the word.

A Fat Midwife

rachel
A wonderful former client & present beloved friend.

I am the rare homebirth midwife who takes “obese” clients and doesn’t automatically see them as high risk, sick, Gestationally Diabetic, or an automatic transfer to have a cesarean. I see women as they are and will work with them where they are. We have to address food and food issues – just like I do with every single pregnant woman – it just feels deeper with a fat woman because of how harsh it is in our society. But, being a fat woman myself, I have to believe I can make it somewhat softer, somewhat gentler than it could be with someone who has permi-glazed skinny eyes.

After-Musings

Today, I am a fat, joy-filled, life-filled, spiritually speed-growing woman. I am not perfect. My writing doesn’t adequately say what I want to say all the time. If you want to get to know all of me, come spend time with me… a lifetime with me… and even then, I suspect you won’t know a fraction of who I am.am still learning who I am. Every day, I see new facets of my Self, places where I think, “Ha! I didn’t know you were there!”

These conversations have allowed me to get thoughts out that have wanted to be written for years. I thank you women for the prodding to move forward. You still might disagree with me and my choices, but your disagreements can’t change them. They are made. I will still have had WLS. I will still have taken Phen-Fen. I will still take Topamax. However, I am listening to you all to be more careful to speak more personally and watch my language when I speak of “some women,” – and I ask that you also have a moment of patience with my prose.

I might still make you a fat angry woman, but I’ll keep writing if you’ll keep reading. I promise to keep listening.

Fat angry woman? Probably not so much anymore.

Fat, incredible, alive, powerful, amazing woman?

You betcha.

Blindsided: The Fat-Shaming Doc Visit

trigger-warning

Written 10/12/16 about 10/10/16 Gastro-Intestinal (GI) doctor visit.

fatshamedef

So, while I have been fat my whole life and have had my share of medical fat-shaming from fat-hating doctors, it has been a very long time since that’s happened… whether from their shifts in attitude via Continuing Education about inclusivity  (or at least learning to keep their mouths closed about their attitudes)  or because I learned to open my mouth to shut it down.

me-hospital-3
Unknown date of un-remembered hospitalization. PICC Line insertion successful.

The GI Doc

I had signed AMA out of the hospital 12 hours earlier when the doctor, small, a person of color (no clue the origin, but shouldn’t matter),very pretty walked into the Exam Room.

“Oh, my! You look awful,” she said. I’d seen her 3 times before, but I am memorable by what I wear (tie-dye) and being bald. And I am very, very nice to care providers.

“You look like you haven’t slept in weeks!”

“Uhhh, I am at the tail end of a 2-3 month Manic Episode, so no, not sleeping much.”

She went over the paperwork, labs & prescriptions from the night before. She looked at me pretty harshly and said, “You really need to be in the hospital. You are extremely dehydrated.”

I told her no one said anything like that the night before, but I would probably still not have stayed.

She said, “Stubborn.”

Dehydration?

water

The reasons she said I am dehydrated:

  • chronic diarrhea despite 20 Immodiums and 3 Pancreatic Enzymes a day
  • vomiting a couple of times a day
  • taking Lasix to pee! (because of the ankle swelling from the Risperdal)

I would have never recognized the signs of dehydration because they were in the labs! I guess the NP the night before didn’t think I was that dehydrated because she never even said the word to me. My pee is crystal clear; strange. She said that was why my HR was 124 upon discharge. I am sure I shrugged.

Medications

She said I needed to get the ER prescriptions filled (the Cipro and Bentyl) and she added Prilosec, Lomotil and Zofran.

gi-meds

This is what my New-Taking-Now meds look like (as they lay against my ballot which went in the mail yesterday!).

“Good-Luck with That.”

“You need to have your gallbladder taken out as soon as possible, before it gets infected.”

Okay, true. Emergency surgeries on fat people have an increased risk of morbidity and mortality.

But there was more to her sentence above.

She ran two of them together, “You need to have your gallbladder taken out as soon as possible, before it gets infected… but I am sure you won’t find a doctor to touch you because of your size.”

blinking as I watched the contempt drip from her lips

“What do you mean?”

“I don’t think you will find a doctor in our area to do the surgery because of (again with the disdain) – the risks.”

I told her I knew that Bariatric Surgeons (who do Weight Loss Surgeries) are ALL GI Docs and I would find one to take my gallbladder out.

“Good luck with that.”

She gave me my paperwork, prescriptions and her bulldozer-sized hatred of fat people… and walked out.

I sat there and cried.

tuckedin

raw Raw RAW

I am strong. Most of the time.

Right now in this (decreasingly) manic place, I feel flayed, nerves on the outer surface of my body. No ability to control what or who hits them. I merely react to the sensations.

This one was an animal claw dragging down my chest… slipping in and gashing my heart as it went by.

I had not felt such shame in eons. And I see doctors all the time! I mean, really, probably not for at least a decade have I been medically fat-shamed. (Many medical & personal fat-shaming experiences to come in future posts.) I felt hideous in those moments after she smashed shit down my throat, squishing it with her heel as she left the room.

Pondering

I stumbled out of the building, crying still, and drove home.

I began to find my Power, many minutes too late and useless at that point, but I thought, “For fuck’s sake, I cannot possibly be the fattest person on the face of the earth who needs abdominal surgery.”

And then I got mad, but it was a gradual dilution of the mad into the shame where, for a time, if they were able to be separated, you could see they were half and half. Now, 2 days later, I am more mad, but in retelling it to my Insurance’s Case Manager, I cried from shame so hard she kept having to say, “Breathe. Breathe.”

I have been given 3 Bariatric doctors’ names… one in Orlando, one in Tampa and one in Miami. I told my Case Manager I would go anywhere in Florida to get it done. Even if I had to go to Shands Teaching Hospital in Gainesville. I called the doc here in Orlando, explained the situation to the Office Manager and she said she would talk to him and get back to me tomorrow. I told her I knew it was not his usual surgery, that I had had Weight Loss Surgery (WLS) in 2001, but was fat again and needed help, please.

We’ll see what happens.

I will find a doctor to help me.

i-am-powerful