The weighting game

I’ve written a number of times about the waiting game that those of us with chronic illnesses play, but today I’m talking about its homophone.

The weighting game.

I feel like I need to add a million disclaimers to this post. Weight is such a sensitive subject for so many people so let me just say that I can’t know what it’s like for everyone else, but this is what it’s like for me. And I know I’m not alone.

Since I first got sick six plus years ago now, I feel like I’ve slowly surrendered more and more control of my body. At first it was just little things. A few vials of blood. A camera down my throat. A tube in my abdomen. Now that I rely on TPN, there is a team of health care professionals who determine the exact number of calories and the exact volume of fluid I receive every day. Without my central line I have no way of getting the nutrition I need. This means that unless I lie on a table wide awake and naked from the waist up while some strangers dig around in my neck and chest, I don’t get that nutrition. And when something goes wrong with this line I don’t get to eat, sometimes for days, until someone can fix it.

I’m not telling you all this so that you’ll feel sorry for me, rather I just want to describe a reality that may not be familiar to you, a reality in which your body is not entirely your own. Even though this reality is familiar to me, there are still times when that lack of control can be really unsettling. Weight, for instance.

I know weight fluctuations are very normal. Healthy people aren’t the same weight every single day, rather bodies have a range of average, day to day weights. Chronically ill bodies are the same. I’ve been a couple pounds up and a couple pounds down countless times over the years, but I’ve also had some pretty radical weight changes. When I first got sick I lost 25 pounds in a matter of months. After I got my feeding tube I gained 25 pounds, also in a matter of months.

125 pounds. That’s what all of the big swings up and down in my weight since I first became sick add up to. 125 pounds. And I had no control over any of it. It had absolutely nothing to do with lifestyle, and everything to do with an illness that was out of my hands.

Let’s try and make this relatable.

Do you remember how awkward and terrible puberty was? Do you remember how uncomfortable you felt? How foreign your body seemed to you? I’ve basically been living through that again and again for the last six years.

I can honestly say I didn’t like the way I looked after losing all that weight, and I am genuinely happy not to have a BMI below 16 anymore, but that doesn’t mean it wasn’t unnerving to watch the numbers on the scale quickly climb 25 pounds and it doesn’t mean I didn’t feel a little fat when I couldn’t button up my pants.

But I could never express any of that because for all the years I’ve been playing the weighting game I’ve also been continually worried about being labelled with an eating disorder (another very serious medical issue but one that requires different treatment than a GI motility disorder). It’s a justified worry considering that it’s happened multiple times. Believe it or not my surgeon once actually withheld necessary medication in the hospital because of that misjudgment.

As soon as you’ve been underweight because of a GI condition, it feels as if you are never allowed to have your own opinion about your weight again. You can be unhappy that you’re underweight, and you can be pleased that you’re gaining weight, but that’s it. Everyone else in the world is allowed to want to lose a few pounds, but not you. Everyone else in the world is allowed to be uncomfortable with rapid weight gain, necessary or not, but not you. You’re just supposed to be glad that you’re “healthy” and if you seem anything but people start to get suspicious about what’s “really” going on. Even if you find yourself overweight because of your illness, you’re not supposed to worry about that and instead just focus on the more important things like keeping your symptoms under control. You can’t win.

It’s not just GI conditions. The weighting game is played by patients will all sorts of diagnoses for all sorts of reasons. Medications, steroids, nutrition, mobility issues, metabolic disorders. Any number of factors can cause the numbers on the scale to bounce all over the place.

Okay, now back to puberty for a minute. Do you remember how embarrassed you felt when adults in your life would comment on “your changing body” and how those words made you cringe? Ladies, do you remember how you blushed when people noted that you were filling out or gave you that all-knowing smile as they talked about how you were becoming a woman? All you wanted was for people to stop looking at you and let you be. Remember that? Okay, well for all the times I’ve lived through puberty again and again thanks to gastroparesis weight changes, I’ve relived that awkwardness.

Just because I needed to gain weight doesn’t mean I wanted the whole world watching me while I did so. Constantly having people comment on your weight can honestly be very hard to deal with. And I know all the comments were intended to be supportive and encouraging, but that doesn’t make them okay.

We don’t just go up to people and say, “Oh hey! You’ve gained weight!” And if we’re trying to compliment someone or tell them they look healthy we never use words like pudgy, chubby or plump. We just don’t, yet I’ve lost count of how many times I’ve heard all of those things. So not only does it feel like you’re never allowed to have an opinion about your own weight again, but it feels like the rest of the world has an opinion about your weight and you’re supposed to just smile and thank them for sharing it with you. You know, since it’s a compliment.

I’m sure what I’m saying here could be extrapolated to make a statement about society, culture, beauty standards or something along those lines, but I’m not here to analyze that. I’m here to offer you my shoes to walk in and to talk about something that others with similar shoes and I don’t often feel we can talk about.

Confession time. Do you know what I did last weekend when I stepped on the scale and realized that I’ve gained 10 pounds in the last 5 months, and that even though we adjusted my TPN my weight is still going up? I cried. I don’t cry very often, and I honestly can’t remember the last time I did, but over the weekend I dissolved into a puddle of tears. Twice, actually. It’s not that I’m unhappy with the way I look, it’s that the way I look is not up to me. The way I look is determined by illness, medicine, science. And the way I look is not necessarily a reflection of the way I feel, a truth that I feel I always have to justify.

So I cried. I cried because I have no control. I cried because my body is not my own. I cried because I’m so ridiculously done with finding that my entire wardrobe is all of a sudden too big or too small. And I cried because I hate that I let this bother me. I hate that I care about what I look like or about what others think. But I do. I feel like with everything else I’m dealing with, something like weight should be trivial. But it’s not.

I cried because I’m tired of playing the weighting game. And because I’m tired of it being a spectator sport.

Self-image is not just about how we look, it’s about how comfortable we are in our skin. But it’s hard to feel comfortable when you don’t feel in control, and for so many of us with chronic illnesses that is the position we find ourselves in. We’re stuck in these bodies that not only don’t work the way they used to, but also don’t look the way they used to. The more that illness and everything it comes along with takes over your body, the less it feels like your body anymore. It’s a challenge to feel comfortable in your own skin when your skin no longer feels like your own.

IMG_3496

Appointment time, where waiting game meets weighting game.

I didn’t write this because I need you to reassure me that I look fine or healthy. Please don’t tell me that I’m not fat or that I shouldn’t care what I look like. I don’t want you to tell me any of that because I know all of that.

I wrote this because this isn’t something that gets talked about. Because there are others like me, living in bodies that have been changed by illness, who are tired of feeling like their body is on display, not just to the medical world but to the rest of the world, too. For so many of us the weighting game is one we will continue to play throughout our lives against opponents we have no control over, and for medical reasons, we have to keep score.

Please, just respect that it’s a closed gym.

When you know someone who can’t eat

Alright friends, I have one last post for Feeding Tube Awareness Week! My previous two posts this week talked about what it’s like when you can’t eat, and today I’m talking about what to do when you know someone who can’t eat.

To recap, as many of us with feeding tubes know, we live in a very food-centric society, a fact that becomes painfully obvious when all of a sudden you find yourself unable to eat like everyone else. Think about it — family dinners, lunch with friends, coffee dates, dinner dates, picnics, treats at the office for someone’s birthday, happy hour, Halloween candy, wine tours, chocolate on Valentine’s Day, Thanksgiving dinner, meeting for drinks, juice cleanses, summer barbecues, going for ice cream, wedding toasts, cheers-ing. As a society, our social lives are built around food.

For those of us who are unable to eat, we don’t want to miss out on everything, but it can also be really awkward to be surrounded by food all the time. And for those of you who are able to eat, it can be awkward to know how to include us. There are many different reasons for someone to need a feeding tube or be on TPN, so it’s not a one-size-fits-all situation when it comes to having a friend or loved one who is unable to eat, but here are some basic guidelines on how to approach it.

For starters, whenever possible, try to hang out with us in a way that doesn’t revolve around food. Many of us with feeding tubes are dealing with chronic illnesses that leave us short on energy, so low-key activities are great places to start. Think movie afternoons, coloring parties and craft sessions. We also likely spend a lot of time going to appointments and running boring medical errands, but your company can make these tasks a little more exciting.

As for the rest of the time when food is a focus?

Respect our restrictions. Sometimes “just one bite” really can be a problem. If we say “no thanks” or turn down your offer, it’s not personal, it’s self-protective. Please don’t keep encouraging us to try something, because we might feel pressured to please you but then end up suffering consequences later.

Keep inviting us. Acknowledge that we might not want to join in, and try not to take it personally if that’s the case, but please keep giving us the option. Not being able to eat while everyone around us eats is hard, but missing out and not being invited at all is hard, too.

Shift the focus. When possible, create a situation where food isn’t the only focus. For example, if it’s warm enough outside, eat dinner on the deck so we can enjoy nature and have lots to look at rather than not knowing where to look while everyone else at the table is eating.

Let us take the lead. Don’t make it a requirement that we sit at the table while everyone is eating, and if we choose to leave the room, let us be. We may need to leave the room if the smells are strong or our symptoms are acting up, but we also may need to leave the room if we’re having a bad “I really miss food” week and we just can’t stand to watch you eat our favorite meal.

Enjoy your food. And don’t feel bad for doing so! In fact, we want you to enjoy what you’re eating because we would give anything to be able to eat it, too. There’s no need to apologize for enjoying your food…please don’t take a taste, look at us sympathetically and then say “I’m sorry, but this is so delicious!” All that does is draw attention to the fact that we’re not eating and remind us that we’re missing out. Feel free to exclaim over your food all you want, but the apology isn’t necessary.

Resist the Q and A. Avoid questions such as, “Is this just torture for you?” or, “Oh man, I would just die if I couldn’t eat! How do you do it?” while you’re eating in front of us. One, it likely is slightly torturous. And two, if it’s not torturous, that’s because we’ve managed to focus on something other than food, and we don’t need you to keep reminding us of it.

Our illnesses are not enviable as weight loss strategies. Joking that you want our condition so you won’t eat so much or so you can lose weight is not funny, it’s insensitive. Usually when people say things like this they are trying to make us feel better, but it usually just makes us feel misunderstood.

Appreciate. Appreciate your food. Appreciate your body. Your body can take the food you eat, digest it and turn it into fuel, all without making you sick and miserable. Do you know how incredible that is?! Now and again, take a second to recognize how totally cool it is that your body does what it’s supposed to do.

Basically just carry on as usual and don’t draw attention to the fact that we’re not able to eat, because I can guarantee you, we are well aware of it already! Asking questions and trying to understand how it all works and how it all feels is fine, and honestly appreciated much of the time, just try and do so at a time and place when it won’t single us out as the only one not eating.

One last thing! Thanks for loving us. Thanks for reading this. Thanks for trying to understand us a little better. It means more than you know.

12647142_10153509508781478_6433098437491336785_n

When you can’t eat part two: the feels

Whenever someone asks me a question related to what it’s like not being able to eat, I usually shrug and say, “I don’t know, I’m just used to it,” and then change the subject.

I am used to it, but that doesn’t mean I like it or that I’m always okay with it. Not being able to eat can be really tough, but trying to put it into words is also really tough so a one sentence reply is just easier. However, I’m going to give it a go, here. Yesterday I covered the facts. The logistics. I talked about how it all works, not being able to eat. Time to delve deeper now. Today, let’s talk about how it feels.

First of all, I want to eat. I ate normally for 18 years so I know what things taste like and I have favourite foods. I get cravings and when I watch people eat I want to be eating, too. I know I’m part medical device at this point in time, but I’m still human, and as a human I’m hardwired to eat in order to survive. Not being able to is frustrating and sad, and that part never goes away, it just becomes part of your normal.

I cycle through different this-is-what-not-eating-feels-like phases.

There are times when it honestly does not bother me, when that frustration and sadness are easy to forget about. I sip on my ginger ale, I eat a lifesaver here and there, and I don’t really give it a second thought.

Then there are times when the absence of food in my life is impossible to ignore. Imagine going on a roller coaster that’s really fun at first but then you start to feel sick and you just want to it be over. Afterward you think “yikes, I don’t want to do that again.” Except everyone else had so much fun and wants to go again. You still feel sick and don’t want to feel worse, but you also don’t want to miss out on the fun, so you go with them once more. This time you have an even worse experience and so you decide you just cannot ride that roller coaster anymore. But everyone else is still having so much fun and they decide to ride it again. And again. And again. And you just have to sit there watching and waiting for them to stop riding the roller coaster. Yes, you are glad they are having a great time, but you feel so left out and it seems so unfair how something that is supposed to be easy and fun makes you feel so terrible. You hate your body for getting in the way of your ability to enjoy life. You’re stuck there just watching and waiting for everyone to get tired of that roller coaster, but they never do. Sometimes not being able to eat is like that, and during these ‘roller coaster phases’ I often find myself wishing I hadn’t gone to the theme park at all.

And then there are the in-between times. During these times I feel somewhat removed from it all, kind of like when you drive someone to or from the airport. You might think, “Oh I wish I was the one going away,” but it doesn’t really phase you that you’re not. Overall you’re just happy for your friend or family member who gets to go on an adventure. Except the thing is, when all you ever do is drive people to the airport without ever actually getting to take a vacation yourself it can be hard not to feel bitter. Lots of the time I don’t mind driving people to the airport, but I do get disheartened when I realize that I can go to the airport all I want yet I can’t ever actually get on a plane. Still, when I’m in this so-called ‘airport phase’ being part of the experience in some way, even if it’s just being along for the ride, is usually better than not being part of it at all.

The thing is, though, I wish I didn’t have to choose. I wish it didn’t come down to driving people to the airport or not spending time with them at all. I wish it didn’t have to make the choice to gather with everyone and watch them eat, or to not be part of the gathering at all.

But I do. I do have to make that choice because our social lives are built around food.

It’s one of those things you don’t realize until you’re on the other side, but think about it. Family dinners, lunch with friends, coffee dates, dinner dates, picnics, treats at the office for someone’s birthday, happy hour, Halloween candy, wine tours, chocolate on Valentine’s Day, Thanksgiving dinner, meeting for drinks, juice cleanses, summer barbecues, going for ice cream, wedding toasts, cheers-ing.

Sure, I can be present for all of that, but it’s not the same as being part of it. I’m watching, not doing.

As a society we gather together around food. We celebrate around food. We sit around the table or cozy up with our coffee and tell stories, recount memories, and discuss topics of all different depths. If I want to be part of that then I have to put up with being around other people eating while I fight against the basic human instinct to do the same. And that sucks. I hate being the only one not eating, but I also hate missing out on anything. I don’t want to watch my friends and family eat food that I wish I could eat, but I do want to spend time with them.

It’s an impossible situation.

RCH TPN (3)I make a conscious and consistent effort not to think or talk about this too much for two reasons. One, I don’t want anyone to feel like they can’t eat in front of me or feel bad when they do. As hard as it is not being able to enjoy food like everyone else, it’s even worse knowing that they are enjoying it a little bit less because of me. I already feel a lot of guilt knowing how my health problems spill over into other people’s lives so the very last thing I want is for those people to have to adjust their lives for my sake even further. I don’t expect people to avoid eating in front of me and I think it would be unreasonable of me to do so. People gotta eat! I have to eat, too, I just happen to do so via my veins.

The second reason is that thinking about this all the time doesn’t help matters or change anything. Some days are harder than others, and some days the constant fight wears me down, but at the end of the day I try to be very accepting and matter of fact about it all. I can’t eat and that’s just the way it is. I can’t sing either. Or whistle. I let myself feel sad when I need to, I let myself lament sometimes that life isn’t fair, I stay away when I need to, and then I just do my best to focus my energy elsewhere. Life is hard enough without constantly thinking about how hard it is.

Now here’s where this sad posts gets happy. I don’t have food, but I do have people. Not only do I have awesome friends who also can’t eat and who understand what it’s like, but my friends and family who can eat also happen to be awesome. And not only do they understand when I don’t want to sit at the table with them, but they are just so delightful to spend time with that they make sitting at the table worth it. I would give almost anything to be able to eat, but I wouldn’t give up the people in my life.

Sure, I wish I lived in a world where I didn’t have to choose between food and people, or rather between being around people while they eat food and not being around them at all, but that’s not how it works. I do have to make that decision. When I lay it out like that, though, it doesn’t seem quite as impossible a choice to make. People with food or no people at all? People win.

I may not be able to eat, but I do have a reason to be at the table, and for that I am grateful.

Reason to go to the table

Sister, brother-in-law and brother. My all time favourite reasons for being at the table!