Who is that woman in the mirror?

[alee_grrl]

As some of you may know at the end of July I started seeing a new doctor, one who specializes in chronic pain and fatigue. He eventually determined that the main underlying issues of my fatigue and pain were: late-stage Lyme disease and systemic overgrowth of yeast. Other less critical issues were an iron deficiency and a borderline low thyroid (which shifted into full hypothyroidism in November). To optimize treatment I stopped taking my usual multi-vitamin and other supplements (cod liver oil and herbal sleep aids), and started talking iron supplements. Additionally he put me on a low yeast diet and prescribed an oral antifungal to kill off the yeast in my system. Only after I had been on the antifungal and diet for a month did we start the antibiotic treatment, which has been a cyclical treatment that will continue for a year or two (low dose of one antibiotic for a while, then increase the dose and wait a bit, eventually switch to stronger antibiotic and repeat cycles).

This treatment has involved some massive lifestyle changes, many that I was uncertain I would be able to maintain. For treatment to work I have to follow Dr. C's prescribed diet very closes (which is harder than it sounds because the requirements are vague at times, and I get very sick of eating the same things). I have to be sure I take my pills precisely as directed and on schedule since some things cannot be taken near others (and some can't be taken with food and some have to be taken with food...and so forth). I have to keep in mind that the combined issues of fatigue and eating very few carbs means that I have no energy reserves and that I have got to pace myself. I have to maintain a rigid sleep schedule. One of the side effects of my illness is massive brain fog. So in order to accomplish these goals I have had to schedule my life on an almost obsessive-compulsive level. Since I already have some ocd tendencies, keeping lists and schedules helps me feel like I still have some control, and helps keep things manageable in my mind (which loves to blow things out of proportion and then spin off into a panic on "how the hell can I accomplish all the things!?" tangents). One of the first things I did was make a list of what I wanted to accomplish with these changes and what I was getting out of this treatment. It's posted rather prominently on my fridge so I can see it frequently.

That list is fairly simple:

• better health overall
• more energy
• less pain
• the ability to articulate thoughts quickly and clearly
• quicker thought connection (i.e. no longer thinking through molasses)
• not having a heart attack (high risk of heart disease, diabetes and other fun things in my family history
• regaining my taste buds (all food had started to taste like cardboard)
• more energy to do the things I love
• the ability and energy to go to concerts, conventions and other events

I wrote the list out just after I started seeing Dr. C, and have only added one thing in the meantime: the bit about going to concerts and events again. What is interesting is that nowhere on this list is loose weight. It wasn't one of my goals and wasn't really something I was anticipating or even really wanting. As weird as it sounds after twenty years I finally was comfortable with my weight and shape. About the same time I started developing breasts (at about 10 years old--I was an early bloomer in that area unfortunately) I started to gain weight. There are many things that caused/impacted/influenced the situation.

One, I had been teased from second grade onward about being fat because that is one of the easiest and quickest insults that kids throw around and it's a bit zingier than pointing and shouting "new kid" all the time. From second grade out my family tended to move frequently, which meant changing schools often. Even after my parents divorced and my mom settled into one place, I still ended up switching schools twice (the first time due to excessive bullying, the second because I had a chance to go to a kick ass boarding school. Until I went to college I never spent more than three years at a school.

Two, my mother, in her own psychotic way, decided to shield me from the attention of guys by encouraging me to eat more and exercise less. It was never an explicitly said or done thing, but the pattern was there when I look back. Food was always a comfort thing in our household, but when I was younger I was more active. One of the decent things my dad did was encourage this. He would take us roller skating and fix our bikes and generally encourage us to get outside. He wasn't home a lot though, especially from the time I was 10 and after. So as my mom slowly started to discourage physical activity ("We can't afford new roller skates and there is no where to skate anyway."; "Skating boarding is for boys."; "That's to dangerous for you, honey, you are such a klutz afterall."; "Why don't you just go up to your room and read honey?") and encourage emotional eating ("I bought you ding-dongs and soda, honey. Why don't you have some? That will make you feel better.").

Three, my body and illness that I most likely already had but knew nothing about likely contributed to easy weight gain and made loosing weight nearly impossible. Hormonal imbalances (Polycystic Ovarian Syndrome), yeast overgrowth (apparently yeast really likes to feed itself and will make you crave foods that feed it), borderline thyroid issues, and Lyme all contribute to weight issues.

When I was seven I had a wicked bad bug bite that we assumed was a spider bite, even though it didn't act much like a spider bite (hindsight is oh so useful). It was a large swollen red spot in the underarm area, and eventually resulted in a trip to the ER. My dad even remembers this event and notes that I was sick for days. However, it was the mid-80s in Louisiana, and the general thought at that time was that Lyme disease didn't exist outside of New England. Said theory doesn't taken into account the transitory nature of certain populations (like the ones we tended to live in who followed factory jobs all around the country), or the fact that many of those populations moved with family pets (who could be carriers of Lyme) which were generally not treated for ticks or flees (cheap flea collars at the most, and bug bombs for the house when the situation got out of control).

By junior high I started having problems with pain and fatigue, but was brushed off by my mother and most doctors. Essentially I was told that it was all in my head and I was making it up to get attention, or that it was stress and I should just buck up and deal with it. My mom had great taste in doctors. By the time I was old enough to start picking my own doctors I had internalized most of that and just thought my symptoms were a normal state of existence. Thankfully I made a really good friend in college who helped me realize that living in constant pain and fatigue is not a normal or good state of being for anyone and that I didn't just have to work through it.

Over the next twenty years my weight would fluctuate a little, but not generally more than 10-20 lbs. Except for two instances in my adult life I have been a size 18-20 since high school. Just after I graduated college, I moved to Vermont to live with the friends who helped me readjust my view on my life and health. This move put half a continent between my mother and I, which was a damn good thing. In the first six months I lost about 40 lbs without even trying (I was also sleeping well for the first time that I could remember). At that time I got down to a size 14-16, and was even able to buy some clothes that were not in the plus size section of the store. Then some shit happened, things escalated between my mother and I, some memories and events that I had done my best to forget really came to the forefront of my mind and I pretty much had a nervous breakdown. I gained all the weight back and my health went downhill. With the support of my friends and therapists I eventually worked my way back out of that dark period and really started my journey of healing. While I had periods of good health, my weight generally remained the same.

The second time I actually changed sizes, again dropping down to a 14-16 (plus size), was while I was in the Peace Corps. I didn't loose more than 30 lbs though, even though I was eating more healthy and far more active (you have to walk everywhere and hauling water and laundry around is a good upper body workout) for two years. At that time my weight steadied out at 190 lbs. When I got back to the states and suddenly had access to all the junk foods and less healthy foods I missed, I gained that weight back. Even while working with a personal trainer and carefully watching my eating I barely lost 10 lbs. I went back up to an 18-20 and remained there.

In the meantime, I spent a lot of time working on my mental issues and hangups. Right around the time I hit thirty years of age, I realized I was beautiful regardless of my size. I had finally learned to dress myself in ways that flattered my body and exhibited my own sense of style. I accepted that I was likely to never loose more than 40 lbs or be smaller than a 14-16 and was happy with that. I had been looking at the same woman in the mirror for twenty years. I knew my body, knew what would fit, what would look good, and how to move about the world. I could buy clothes, and keep them for years as long as I took good care of them.

Before I started treatment I was at approximately 235 lbs and most of my clothes were a size 20 (a few were even size 22). My focus throughout treatment has simply been on feeling better. I wasn't planning or even really wanting to loose weight. However, once I started treatment, especially the diet (which requires cutting out pretty much all of the things that feed yeast: particularly sugar (even fruit) and carbs), the weight has just kind of melted off. Within a couple of months my clothes were way too big, and I had to replace much of my wardrobe (thankfully someone had bags of clothing that were in the size range I was transitioning to that they gave me). Now, roughly six months after I started treatment, the 14-16 sizes are getting baggy and loose. I stepped on the Wii fit to weigh myself today (I try to only weigh myself once a month or so, I don't want to become obsessed with it, but am often curious where I am at). I was just over 186 lbs. I don't recall the last time I was this weight. I should be elated, but instead I'm just nervous and uncomfortable.

There are so many things that had become part of my identity, that I had owned and accepted, that are changing. So much is in flux. It makes for an odd mental state. My body doesn't look or feel like the one I am used to. I'm not used to being able to feel my hipbone or ribs under the cushion of fat. I'm not used to the shape of my face, or the way clothes fit now. I don't know where my weight or size will plateau at, and I have no idea what to expect of my body or clothes. Replacing a wardrobe is expensive and frustrating, especially when you don't know how long that size of clothes will fit before you need to find something else. Thankfully there are thrift stores, gifted clothes and clothing swaps to help out. However this often means less choice in style and look. So many of the clothes in my closet right now just don't feel like me. As I loose weight my body moves differently too. Overall I feel less like a confident beauty queen and more like an awkward ungainly teenager (which is a very strange feeling when your 32).

As my health improves, I have trouble figuring out what I can and can't do. I don't know where my boundaries are anymore. It is easy to overdo or alternatively not do enough. I like to try to plan out general goals and optional paths for the future, but right now I simply can't. I don't know how I'm going to feel tomorrow let alone a month or a year down the road. This has made it very difficult to plan class schedules, internships and jobs, and life in general (in law school you tend to plan out your schedule at least a year in advance, sometimes more--they tell you start looking for summer internships in the fall, and to start the post grad job search at least a year in advance). I might be able to do all the things I want and need to do for graduation next year, but I don't know for sure. So to save myself the aggravation and stress of trying to plan around things I can't predict, I have accepted that I am going to need to do an extra semester. I should be done or almost done with treatment before that extra semester, which would allow me to do one of the experiential learning programs (this will hopefully help me transition back into the working world and give me the contacts to help me find a job after grad).

I know that things will eventually settle back down; that with time I will become just as comfortable in this body as I was in my old one. I am hopeful and positive that things will eventually be better than I can even conceive at the moment. But for now I need to accept that for the near future I will likely feel unbalanced and out of sorts, and that is ok.

Comments

[sulien]

It is so very wonderful to hear that your treatment is going well! You still have a long road to tread, but hopefully this progress will keep you going and give you strength.

The body image issues are something I hadn't even thought of when you mentioned your treatment, but I don't know why, because I had trouble dealing with the reverse (becoming more and more decrepit as time passes from being very fit and strong). I would honestly suggest you join a Weight Watchers group or something similar, not to help with the weight loss, but to have other folks to talk to who are going through similar body image issues going from heavy set to more slender and fit.

As far as exercise goes, you might consider talking to your college counselor about the possibility of hooking you up with one of the grad students who is working on a degree in physical therapy, if your university teaches any of the medical arts/sciences. Otherwise, I agree with those who recommend dance, yoga and martial arts. Whatever you decide to do, start out slow and easy and work your way slowly up to more vigorous exercise and weight training. The last thing you need to deal with while going through your treatments is to have an injury to deal with as well.

As a fashion suggestion, broomstick skirts have not ever really gone out of style, especially on college campuses, and the drawstring waist makes them easy to adjust for size. They are also very cheap to buy and just as easy to make (you can Google a 'how to' and use whatever cotton, linen or rayon fabrices/blends you might like).

Hugs to you and I'll continue sending positive, supportive and healing vibes your way. Again, I'm so very glad to hear that you are making such great progress!

[alee_grrl]

One of my friends pointed out that this sort of readjustment of body image is something that happens to all women (and likely all people) as we get older. Fit or unfit, fat or thin, eventually we are all faced with the changes that age dictates to our bodies. Sometimes we get to deal with them a little earlier than others.

I'm being very cautious about adding exercise (beyond the walking to and from classes and lugging a bookbag around type of exercises I get on a daily basis) since I'm not sure my body is ready for that yet. Sadly we are a law school only, and unaffiliated with the larger schools in the area. At this point if I start added exercise it will be very little. Maybe 10-15 minutes of yoga every other day or so (the wii fit makes the basic poses pretty doable for me), and see how I do after that. Adding bits at a time as my body allows. I've definitely learned to listen to my body when it says I can't or shouldn't do something at that particular moment. Just keep reminding myself that slow and sure is the way to go.

The broomstick skirt idea is a good one. MY favorite skirts have been broomstick or prairie skirts. Long and flowy, easy to cinch in (or out if necessary), comfortable, and easy to style around.

Thanks for the positive energy and support! It means a lot to me.