The Seesaw

People who are "getting healthy" love to talk about all of the things they gain as a result of their "lifestyle changes". They talk about increased energy, feeling stronger, and gaining health. In many cases, it is true that changing your habits will add to your health in appreciable ways. However, it's not all sunshine and roses.

I try to be honest about what it has been like to lose weight, and part of that honesty is talking about the bad along with the good. While the benefits have outweighed the demerits, there have, nonetheless, been things which have been a problem. Sometimes I feel like I'm on a seesaw in which one problem vanishes, and another pops up on the other side. Here is some of what I'm talking about:

• Walking has largely eliminated my back pain (as has weight loss), but the increased movement has left me with strong and painful knee issues. Before I started walking, I occasionally had knee pain, but what I have now is persistent and troubles me at night when I'm trying to sleep, especially if I lie on my side. Even modest exercise (just regular walking, usually for between 40 and 90 minutes most days) can cause difficulty depending on your age and history, and I have a history of two or three accidents in which my knees have been slightly damaged/twisted.
• I have not caught a cold since improving my diet and exercise. I have, however, suffered from persistent cold sores on and off (one in my nose at present which I'm having problems shaking). Losing weight is very hard on your body. My husband used to catch a cold shortly after going "on a diet" in the past. It stresses your immune system, even when you are following a nutritious diet. 
• I have patches of an itchy rash on both of my hands. These are not contact rashes, but due to stress. I've had this sort of rash before in very small spots on my fingers during times of difficulty, but the patches are bigger and in greater number than before. This is because my increased ability as a result of decreased disability has me doing more than I have for quite some time which has resulted in stress. My body is reacting with this rash and in a slightly more severe fashion than before.
• I have increased stamina, but I still experience fatigue which comes in waves and is stronger on some days than others. This is likely related to age, but it's also probably connected to weight loss since, as I said before, it is hard on your body and immune system. It takes it out of you, especially over the long run.

I'm going to have a very complete physical exam in four days. If there are any underlying issues, all will be revealed. Frankly, I don't expect any serious issues, but rather that this is all a reflection of running at a caloric reduction for a long time. Though my caloric reduction has been quite modest (1500-2000 calories most days, hitting near 1600-1700 more often than not), it's still enough to cause bodily stress. 

When I see a doctor in the next several days, I will mention it, but I expect any mention of my knee issues will yield the advice that I always get, "lose weight". I think a doctor is unlikely to do anything for me until I ring a bell on the scale and "deserve" treatment, but it would be nice if I was taken seriously. Since my expectations of getting any help are so low, I'm trying to deal with the knee issue as best I can on my own. This mainly involves painful exercises in which I attempt to stretch what feels like very tight muscles over the inside of my kneecap and efforts to strengthen supporting muscles in my legs. 

So far, this has resulted in more pain overall as the muscles are so sore and not really feeling any stronger, but better flexibility than before. I've been doing these exercises both in the tub while soaking in warm water and while working (I can stretch and hold muscles under the desk while talking with clients). Over time, it is my hope that there will be a reduction in pain. I've only been at it for about a week, so it's  hard to tell if this is helping. It doesn't feel like it is making it any worse though.

I wanted to make this post because so many people act like weight loss is a form of refreshing rebirth. They underplay other issues, such as poor skin health or hair loss (neither of which I have suffered in any way). On balance, I'm certainly better off now than I was two years ago, but I'm not waking up every day bursting with energy and thinking how great it is to be alive. I'm waking up wishing my knee pain didn't cause me to sleep poorly and that my sinuses weren't screwed up or my hands weren't itchy. I'm going off to work knowing there will be two or three times throughout the day when I'm going to feel so tired that I'd like to lie down. Things are definitely better, but far from perfect. However, it's not like going back to things as they were is even an option. 

Random Sadness and the Pain Seesaw

When I started changing myself to lose weight, my initial problem was crippling back pain. Aside from a very painful blip earlier this year, my circumstances in that regard have greatly improved, though they are not 100% better. Surely, weight factored into the stress on my congenital spine condition and caused more pain, but losing weight hasn't made it go away. All it has done is reduce the stress and bring on better fitness and muscle strength from walking everyday.

Since late last year, I've developed an issue with my right knee which has been incredibly painful at night. My guess is that lying on my side places stress on damaged joints or resting causes inflammation of what is becoming an increasingly arthritic knee. The "cure" for this is to build up support muscles, but this is not so simple. The exercises which may help my knee are exactly the sort I was doing before my back problems temporarily surfaced.

I'm on a seesaw. If I attend to my knee, my back responds with pain. If I respond to my back, my knee becomes excruciating at night. Sometimes the pain is so intense that any mere movement while I'm asleep is agony and I wake from pain early in the morning and can't go back to sleep. The able-bodied don't know or care that some people have to live with this sort of difficulty. They just want to blame us for our weight problems.

For now, I have little recourse but to ease back into exercises for my knee at a glacial pace and hope things slowly improve without the seesaw tipping in the other direction and sending me back to my bed in terrible back pain. It's like walking a tightrope. If I step just a little too far in one direction, or move a little too fast, I will fall. This used to frustrate me back before I controlled food as a primary approach to weight loss. Now, it's merely about pain rather than weight, and, of course, that's of great consequence. I might lose weight faster if I exercised more, but I'm not convinced that the pace would be appreciably better.

Beyond the issues with pain I'm dealing with, I've had some experiences as of late with random and intense sadness. I'm not sure if these are biochemical in nature, or if they are the emotional equivalent of stopping to catch my breath after a psychological marathon. I have a strong sense that it is the latter given the frequency and duration and the circumstances.

These moments of intense and profound sadness, during which I feel so devastated that I put my head down and weep, only occur when I'm alone. They also tend to come about after I have performed a task which is atypical. The most recent one came after I cleared out a bookshelf in preparation for leaving where I'm currently living (which will happen early next spring).

Clearing this shelf was something which gave me great pleasure and even tossing out two giant bags of trash made me feel like I was making some good progress toward the inevitable paring of possession for our move. On a conscious level, all of this purging was joyful and filled me with a sense of accomplishment. As the job moved within an inch of completion, and I was sitting down and listening to some rock music, I suddenly had an uncontrollable urge to cry and was filled with fear.

It's my feeling that this is all tied up with what I have been saying about security, poverty, and fear of change. Growing up poor meant the things I had filled my life with some sort of value. Indeed, my mother was a shopaholic and a low-level hoarder who refused to throw items which had no utility and were in poor condition away. She role-modeled acquisition as a path to happiness (though it didn't make her happy) and as a way to give one the illusion of a rich life.

While I never embraced her view, I did collect things several times during my life and divesting myself of them was always difficult, even when those things no longer brought me joy. I think that, in those cases, it was because my identity was so weak that I connected it to those things rather than to the one that was forced upon me (disgusting fat girl). I wasn't the bad, ugly person people said I was, I was (fan of rock group/user of certain computer system/wife of my husband). The bottom line was that I wasn't any good, but I could attach myself to good things and elevate myself in the process. I'm not talking about the sort of raising of oneself which confers superiority, but simply bringing myself up closer to the level of other human beings. After all, I knew I was sub-human. People let me know that every day, but maybe they'd let me into the club as some sort of red-headed stepchild if I was connected strongly enough to something better than me.

I realize that leaving the place I'm in is going to bring about another extreme identity change as it has forced the status of an outsider upon me. I'm intellectually prepared for this, but emotionally, perhaps far less so. Divesting myself of useless possessions in preparation for departure is tied up in this loss, but also in change and the resulting loss of security. That loss is wider than a loss of money, though that is part of it. It is also the loss of health insurance (not that I ever go to doctors since they loath me and have nothing of value to tell me), loss of operating in a routine which I feel some mastery of, and loss of relationships that I've established. It is, in many ways, a forfeiture of power as well as identity and security.

I think these moments of profound sadness are coming on after I dive in with both feet and push toward a change I fear because of all of the losses. The inertia of the dive carries me through and success is invigorating, but all of the effort that it took to get there, and where I end up after taking the plunge relative to where I started fills me with unconscious anguish which bursts out in an explosion of tears.

There's not much I can do about this besides be aware of my feelings and work with them. These are the sorts of things that food smothered away and extreme fatness redirected. I could be sad because I was loathsome and there was nothing I could do about it. Now, I have to find out why I'm really said, as opposed to hanging it on my body issues.

Breakthrough, but not a good one

As my last several posts have made it clear, I've been having a very hard time of it psychologically as of late. Losing weight solved some problems, and it created new ones. It reminds me very strongly of something I once read about "even thin people have problems". I'm not thin, but I'm also no longer abusing food for emotional purposes.

Several days ago, I had a snapping point from all of the tension and problems I've been dealing with. In the past, that snapping point brought on an incident where I had a disconnect and mindlessly ate. That was a "cry for help" in which I turned to what I always turned to, self-destructive over-eating. This most recent point had me do something different because food no longer does it for me.

The "something different" was that I lashed out at someone else and did something quite inappropriate. Instead of turning my destruction inward, I turned it outward. I realize in retrospect that both the eating and the lashing out were attempts at self-protection and control. Eating protected me by adding padding to my body and provided a false sense of control because I decided I was choosing to overeat to give me pleasure and comfort. Lashing out at someone else did not comfort me, but what I did (and no, there will be no details) made me feel that I could put up a wall that needed to be in place to reduce the hurt I was feeling. I did what I did fully believing that it was an act of emotional protection and that if I didn't protect myself from this pain, no one else would. It was irrational, but I didn't see it that way at the time.

It was a bad thing to do, and caused no amount of upheaval in my life. The next day, I deeply and sincerely apologized for what I did and explained the circumstances that brought about my actions. My apology took full responsibility and revealed private information about myself and my weight loss which made me deeply vulnerable to this person. I also offered a hand in mending the damage I'd done. The apology was coldly rejected and the hand slapped away. That was fair enough, but I was surprised since I made it clear that this was a mental health issue and the person involved had mental health assistance training. I didn't deserve better, but I had hoped for a little more empathy and compassion from someone who was in a business which requires such things when dealing with people with psychological issues. However, this person was fully entitled to withhold forgiveness and to choose not to exercise understanding or empathy.

What I realize now in retrospect is that I've made a breakthrough in how I handle my stress and pain, but that it isn't necessarily a good one. Instead of hurting myself, I hurt someone else. Note that this isn't something which happens often, and occurred in the depths of deep, deep psychological pain and turmoil. Since not several days ago, I was wishing I'd just die in my sleep to escape my pain, that shouldn't be too surprising.

I've learned a lot from this and feel now that I "shattered" in a way and figured out something of value from how the pieces fell. I need to not allow the situation to get so bad that something like this can happen if it can possibly be prevented (which may not be possible, but it's important to try), but also I need to be careful about acting impulsively when in deep distress. That being said, I'm not sure that it's 100% within my control at such times, but I need to be more aware of the potential for this to happen. The truth is that it is the first time that this has happened since I was a child. I didn't expect it of myself so it was harder to stop. If you can't see the train coming, you don't know it's going to hit something until after the collision has occurred.

What I know now is that, for the first time in a long time, my anger and loathing isn't entirely directed at myself in times of pain. The reactions I had (eating) were grown from the sense of worthlessness that was bred into me since starting to gain weight in childhood. The first response to pain was to hurt myself, because I was not worth preserving. Now, I realize that I don't hate myself enough to hurt me first, foremost, and unconsciously, but have to be very careful to not lash out and hurt someone else. In the fallout of all of this, I told my husband, "this is not me," and I know that I was pushed to this place and acted in opposition to who I am as a result of all I have lost along with weight. I have never been the type of person to hurt others, and in fact have always put others interests before my own to the point of greatly harming myself.

All of this reasoning and explaining in no way makes what I did "okay", but understanding the dynamic is the only way I can grow from it and diminish the likelihood of doing something like this again. It's a new piece of the puzzle, and one that I acquired at the expense of more than one person.

Overdoing Exercise

About 16 years ago, I was having problems with my knees and having difficulty walking around our home. At that time, I probably weighed less than I do now, but perhaps was having pain due to lack of fitness, age, or early arthritis. As I hobbled around, I complained and my husband in our twenty plus years of marriage said his one and only criticism of my weight. He said that I wouldn't be in pain if I "did something about it."

I was crushed and full of even more self-loathing than usual. I decided to push myself to exercise harder and do better because I was so upset that he disapproved of me. We had an exercise bike that I used despite knee and back pain, and the consequences were pretty disastrous. My back pain, because of the pressure on my spine from using this particular bike, got even worse as did my knees. I undoubtedly did more damage to my body through pushing myself (damage that may still be with me to this day), and my husband felt terrible that he'd said anything at all and contributed to that result. He never said anything to me like that again, which is much to his credit and a testimonial to his patience and compassion.

Since that time, I've tried to know my exercise limits, but every once in awhile, something really bad happens unexpectedly. Yesterday, my husband and I went out for an extended sojourn which included a fair amount of walking. It wasn't fast paced, but I had mildly strained a muscle in my back about 4 or so days ago and we were just out for too long. The muscle pain was one of those things you don't anticipate where you turn your body in some manner that you'd turned it many times before and suddenly there is pain. Since the initial strain, the pain wasn't too bad and tended to come and go. My daily walks of between a half hour and hour didn't aggravate it terribly, though it did get tender in the evenings. The pull is in my middle back and much higher than my usual back pain. I think it actually is related to the redistribution of my weight now based on weight loss so far. Muscles higher up are being effected differently, but also I move so much more that all of them are being tasked more.

Yesterday's ambitious walking and standing, which probably totaled close to two hours or so of time, aggravated this strained back muscle horribly. I was okay until I laid down to go to bed (though it was very sore during the last half hour of walking). Within about 20 minutes, I rolled over and was in agony. I couldn't lie down or move my right arm without incredible pain. I've had very intense pain like that before with my back, but this set off a strange response whereby I got very cold and my teeth started chattering. The pain was truly overwhelming and I decided to sleep on the sofa so that my labored movement and painful utterances didn't disturb my husband's sleep.

Overnight, the muscle mellowed out some. It's still very painful, but I can now move around more normally without soul shattering agony. That being said, I really need to take it easy for awhile and let this muscle heal more thoroughly. I'm thinking that this means doing nothing more than housework today, and keeping my walks down to less than 40 minutes until the pain is completely gone.

This was a case where I had a little problem that got exacerbated by overdoing it, even though what I did was relatively mild exercise. At my age (45), I need to be more careful with listening to my body's signals even when it doesn't seem that the problem is that serious, but the truth is that everyone needs to be careful about pushing themselves too far too fast. In this age of "The Biggest Loser" and slogans like "no pain, no gain", people think that pushing your body hard despite pain is best, but pain is a signal for damage. I'm not talking about discomfort or aching from using muscles, but authentic pain.

One of the things my earlier experience has illustrated is that a lot of people, including caring, loving, and concerned people like my husband, make the mistake of thinking that you would suffer less if you worked harder (i.e., exercised more) to lose weight. They also don't see health issues with invisible symptoms and show disgust or disdain when they see a fat person take the elevator or escalator instead of the stairs. My knees are still fairly wrecked, and while I do my best to get around as much as I can bear, I have a lot of problems with walking up steps.

Yesterday (and today as I'm still in a lot of pain), I was reminded that I can suffer serious consequences because my back is so messed up. People who see me in public don't know that I go home at night after walking just a bit too much and am in so much pain that I get uncontrollable chills as my body can't manage the intensity of what is happening to it. They just see a fat person who they think should move more. My message to them is that some of us are doing the best that we can, and are in no condition to be doing anything more than we are.