Period Leave?

A company in the UK is giving women paid time off on their periods. The company director talks about replacing shame with positivity and letting employees work with their natural rhythm.

I’m all in favor of reducing period stigma, but I’m not a fan of this concept overall. First off, it reinforces the idea that women are fragile and need special treatment to achieve anything in the workplace. Guys are going to resent the hell out of it, and while part of me wants to say, “Dude, if you had these cramps, you’d call in sick, so hush,” it is reasonable to be miffed when you’re denied a perk based on gender.

Secondly, not everyone needs time off for their period. The level of pain and bleeding can range from “just annoying” to “only capable of curling up with a heating pad and sobbing.” And, as the OB/GYN quoted mentions, if you’re at the crappy end of that scale, there may be something medically wrong. I’m a little less sanguine than she is about the likelihood of treatment completely solving the issue. (I can’t count the number of b.c. methods I’ve tried in the hope of making my own monthly curse a little less miserable, with less than stellar results.) But, I can see where period leave could normalize bleeding or pain levels that are a problem. The flip side of that is that encouraging women to be open about their periods provides a basis for comparison. (You mean, everybody doesn’t have to use a pad and a tampon both for the first day or two?)

In my ideal world, everyone could take off when they feel too crappy to be productive. But I wouldn’t assume that periods always meet that, or that people who have periods need more time off than those who don’t.

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Real Food, Real Life

Michele, the Fat Nutritionist, has a fabulous post on why the idea of “real food” is problematic. She talks about how, for every food that’s viewed as unhealthy, worthless junk, there’s someone who depends on that food in one way or another.

Right this minute, there is someone going through chemotherapy shopping at your grocery store, buying popsicles and ice cream to help their sore mouth, and worrying what the cashier is going to think.

There is someone on hemodialysis buying white bread instead of whole wheat, trying to keep their phosphorus levels reasonable between appointments and hoping for the best.

There is a person attending intensive outpatient treatment for their eating disorder who has been challenged by their therapist to buy a Frappuccino.

There are dietitians picking up a dozen different candy bars to eat with their clients, who feel ashamed and guilty about enjoying them.

There is someone who just doesn’t have it in them to cook right now, and this frozen pizza and canned soup will keep them going.

There are people recovering from chronic dieting and semi-starvation who are buying chocolate and chips at their deprived body’s insistence.

All around us are people listening to what their bodies need and attempting to make the best possible choice within a context of overwhelming food pressure. All of their choices are valid, and every single one of these foods is “real.”

I think this is hugely important and can’t be stated enough. People vary. People’s needs vary. And just trying to get yourself fed is hard work sometimes. Trying to navigate your own particular health stuff, combined with your preferences, your time and ability to cook, all the messages you get about food. It can be overwhelming. And then, after you’ve done the work of making what really is the best choice for you at the time, and someone takes you to task for that choice, it’s incredibly discouraging.

One time I was out for dinner with family, having recently decided to cut out alcohol (interferes with meds) and caffeine (screws up my blood pressure and ramps up my anxiety). Everybody else was getting beer or wine or soda, and I missed being able to have the occasional drink. So, I’m sitting there pondering what can I actually drink. I settle on ginger ale. And my mother-in-law makes a comment about how she’s not sure she can approve me drinking soda. (I didn’t snap back with “That’s why I didn’t ask you,” but it was tempting.)

I feel like that, in a nutshell, is a perfect summary of our screwed up food culture. It doesn’t matter how “good” I’m being in avoiding things that aren’t good for me, it’s never going to be enough for the self-appointed health police. And my mom-in-law wasn’t even being mean–it’s just such an accepted thing to judge and moralize about food that it was a completely natural comment for her to make.

Predictably, a bunch of commenters on Michele’s post wanted to distance themselves from judging people who kale or low sodium is going to make horribly ill, but still judge anyone who “could” eat better (for that commenter’s definition of “better” of course).

There are, of course, lots of problems with that. First and foremost, adult human beings get to decide what they want to put in their mouths, and someone who *can* eat organic, free-range, whole grain homemade everything is under no obligation to *want* to.

Secondly, “sick” and “healthy” are not binary conditions. Neither are “rich” and “poor.” There’s a whole spectrum of both. Just because someone won’t die if they eat kale doesn’t mean it may not give them a little indigestion. Just because someone makes more than minimum wage doesn’t mean they feel comfortable paying twice as much for organic, or buying fresh veggies that may spoil before they can use them.

A side piece of this is that lots of people move in and out of those conditions throughout their lives. They may go through periods of illness interspersed with periods of relative health. You can go from being a broke college kid to a comfortable white-collar professional to a suddenly unemployed professional living on ramen all over again.

And the messages you absorb stay with you. If you cross that border from well-off to poor, or from healthy to sick, there’s no switch in your brain you can flip to turn off all the guilt and moral judgment you’ve picked up around food.

And, last but not least, as Rachel Held Evans is fond of saying in a completely different context, if your gospel isn’t good news for those who are struggling, then it’s not really good news. If your food gospel doesn’t work for people who are broke, or stressed out, or sick, or tired, then it’s not really the one true way of eating, and perhaps you should stop trying to preach it to everyone who will listen.

The Fat Chick Works Out – Week 2 (ish)

So, back in July, I started up with The Fat Chick Works Out, and blogged a bit about Week 1. I got a lot of good walking done that week, totally 6.65 miles and 2.68 hours.

And then life happened. The week of the 22nd, I only walked once, and got all of 2 miles in. And I didn’t crack the book at all. I was working a bunch of extra hours and trying to get ready for Pennsic.

Pennsic itself was a workout in and of itself, despite the fact that I didn’t fight this year. I wasn’t keeping track, but because of how spread out everything is, I’m pretty confident that I walked at least a mile every day.

This past week, after getting back from Pennsic, was also kind of “meh” workout-wise. I only got in an hour and a half, and 3.72 miles.

So, now, it’s time to get back on the horse, with Week 2, Chapter 4. This week, the focus is on ramping up gradually. Key word being “gradually.” The overarching metaphor for the book is a baby bird breaking out of its shell and learning to fly. Where last week was about “life in the egg,” that is, living completely in your head and needing to learn to focus on your body, this week is about cracking that shell open, slowly and steadily.

A real, live chick can take anywhere from 1 to 24 hours to emerge from its shell. It may peck at that shell hundreds or even thousands of times until it makes a small hole. The chick then gradually works its way up to making that hole bigger and bigger. The chick needs to rest from time to time in order to make it through the ordeal. The mama hen can’t intervene and break the baby chick out. There is no shortcut. The process itself is essential. The struggle to hatch allows the chick to develop strength in its muscles that eventually will allow it to fly. So we are going to talk about increasing your weekly exercise, but just a little bit at a time. We’re going to allow you to rest from time to time. We’re going to show you how to build up your muscles and gain the strength to fly.”

In this chapter, Jeanette talks about her two failed attempts to run a marathon, before she got it on the third try. Both those early attempts ended with injury after she started ramping up too fast. She explains the concept of ramping up by a *maximum* of ten percent a week (either in duration, intensity, or frequency), and includes a handy chart for calculating how to up your workout duration in 10% increments.

She recommends focusing on time rather than distance because it’s easier to measure in small increments, and because the amount of exertion it takes to go a particular distance isn’t actually a constant: “One mile may feel like a 5 on the sweat scale on Tuesday and an 8 on the sweat scale on Friday. This means that you are technically changing two parameters at once.” That does make a ton of sense, since lots of factors can affect your energy level and therefore your intensity level—stress, sleep, weather, illness, time of day, etc.

The flip side of that, and the issue I have, is that if you’re walking outside, distance is much more easily controllable than time. In theory, I can pick a duration for my workout, track my time, and turn around when I reach my halfway point. *But* that assumes I’ll do the second half as fast as the first, which usually doesn’t happen. If I reach my stopping time before I reach my house, I’ll end up overshooting that time goal because I still have to get home.

To use duration rather than distance, I think I’d need to use a shorter route and repeat it. So, instead of “Walk a mile and turn around,” it might be “Walk a quarter mile, turn around, get home, turn around, and lather, rinse, repeat until I hit my time goal.” I can see that getting frustrating, both because of the repetition of scenery and because it’ll make it harder to track my mileage, which I do still want to keep track of.

So, my current plan is to try to keep both my weekly time and mileage within 10% of the previous week—or, if the previous week was a slacker week, 10% of the best week in the past 2-3 weeks.

Another key point was that you only ramp up if you feel pretty good with your current level of exercise. If you’re exhausted and sore, then it’s not time to ramp up yet. So, I think I’m going to try to track how I feel after each workout to see if I should be pushing it harder the next week. That’s going to be hard to determine, because between the sciatica, the general pissiness of my ankle, and the hypothyroid, it’s sometimes hard to tell if I feel crappy because I pushed too hard or for completely unrelated reasons. And, for that matter, even if it *is* one of the other issues, whether it’d be better to take it easy or push through.

To make things even more exciting, there’s a distinct possibility that I have fibromyalgia, so my pain tolerance and how my brain processes pain may just be screwed up. I’m not sure what to do with that information, though, because it’s not like I can be in the middle of a workout and say, “Oh, yes, I can tell that my ankle is screaming *just because* and I totally have another mile in me,” or “Yep, this is screwing up my ankle—time to stop now.”

So, what I’m hoping is that keeping the 10% factor in mind and keeping track of how I feel after each workout will help me avoid overdoing it.

The Fat Chick Works Out – Week 1

I’m going to blog my way through Jeanette DePatie’s awesome exercise book, The Fat Chick Works Out. Jeanette is one of the co-founders of the Fit Fatties Forum, a discussion spot for fat athletes at all ability levels–everybody from the gym rat who does a marathon every few months to the person who just wants to try out this whole “exercise” thing without it being conflated with weight loss.

A main focus of the book is starting slow and not breaking yourself. There are a lot of activities to find out what your starting level of fitness is and guidelines on how to ramp up (no more than 10% a week, *if* you’re feeling good). I tend to do that to myself a lot–I push too hard, I regret it, and I get out of the exercise habit. Then when I come back, I forget that I’m out of practice and expect things to be as easy as they were before, and the lovely cycle starts up again.

So, here we go with Week 1. The first step is to pick an exercise and set up a schedule for yourself. I’m skipping the “Rock the Block” exercise because I’ve done it before, but it’s a really neat way to figure out your current level of fitness. You walk for 40 minutes, or until you’re tired, whichever comes first. Then you take that distance and duration, and that’s your starting point.

My plan is to walk 5 days a week, for roughly half an hour a day (getting my weekly 150 minutes of exercise) with a goal of 5-ish miles per week to start. My standard walking days will be Monday, Tuesday, Wednesday, Friday, and Saturday, but that will flex a little bit depending on my weekly schedule.

The theme for Week 1 is coping with panic and managing expectations:

We’re terrified of being fat, or out of shape, or headed for serious health problems. We’re terrified that we’ll never be slim enough or fit enough to be accepted by our peers or approved by our doctors. We alternate between despair from the failure of all the previous exercise programs we’ve started and discarded, and wild optimism that this will be the one time that everything is perfect. This time we’ll lose the weight, achieve fantastic muscled bodies like Greek Gods or Goddesses, attract a rich and gorgeous spouse who wants to sweep us off to a fantastic yacht in Monaco where visiting Hollywood producers will discover us and put us in blockbuster movies as long as this time, we don’t make one small mistake and blow everything.

So what happens next? We lose all perspective and fueled by equal parts panic and fantasy, try to do way too much too soon. This leads to pain, injury, frustration, burn out, and ultimately drop out. Which leads to more panic. Which starts the whole thing up all over again.

I love her focus on doing what you can do, then building on that one step at a time. It’s very realistic, and it has a much better chance of helping someone be active for life than a program that asks you to start with a ton of exercise all at once. And I really like the way she shoots holes in the Fantasy of Being Thin right from the get-go.

So, this week, I’ve walked twice so far, Tuesday and yesterday. (I didn’t start on a Monday, darn the luck.) Today is a rest day, but I may get in some yoga and PT stretches. Tomorrow, I’m thinking I’ll walk in the morning before work, hopefully before the temperature cracks 80, since it’s been in the 90s all week. Since I missed Monday, I’m shooting for two walks over the weekend, subject to change if my ankle gets cranky. I’m visiting my brother, four hours’ drive away, so that may make it tricky to squeeze a walk in. But I’m pretty sure I wake up earlier than he does, so I can get in a walk in the morning. He’s even got a treadmill, so I’m in luck if it’s stupid hot there too.

My assignment for the week is to come up with a little mantra that encourages incremental thinking, and say it to myself as I’m working out. Something upbeat, like “Every little step gets me there” or “Each step brings me closer” (the ones Jeanette uses). I’m kind of blanking on that, so I may just shamelessly snag hers. I may also use “I am already an athlete.” Although it doesn’t explicitly have the focus on each little step, it’s a way of accepting the skill level I have right now and working from there.

Beauty is kind of like health

The comments section of one of Ragen Chastain’s posts segued off into a criticism of any discussion of beauty.

beauty should not be a factor at all in movements like Fat/Size Acceptance. A woman should not have to identify as curvy, hot, sexy or beautiful to be accepted in Fat/Size Acceptance and this is what the movement is today

and

Still by stating that everyone is beautiful you are setting the grounds that being beautiful, a person’s looks are the most important thing about them. That the perception of beauty is the number one thing we need to change about the opponents of fat people.

Fat Acceptance spends most of the day on Facebook and Tumblr saying “you are beautiful” “Thanks and you are beautiful too”. That is not much better than the fat haters that say no fat person is beautiful or handsome.

Beauty is a outside issue that Fat Acceptance spends entirely too much time on, instead of dealing with Fat Issues.

First, I don’t know what Fat Acceptance sites the commenter is following where people sit around and tell each other they’re beautiful all day. If you look at the Fatosphere Feed right now, here’s what you’ll see:

  • a post about depression
  • a post about Star Wars filk
  • Body Love Wellness’s yearly roundup post
  • one post that talks about taking up space and being under constant public scrutiny
  • one about the medical challenges fat, older women face during pregnancy
  • an FA Christmas gift list
  • my completely non-fat-related post about the Newtown massacre
  • a post about the mixed messages given to fat people exercising

Take out the ones that aren’t specifically fat-related, and you’re left with 5 posts, only 2 of which have the slightest reference to beauty (the gift list and the Body Love Wellness roundup), and neither of which focus exclusively on it.

That doesn’t sound like an exclusive or overwhelming focus to me.

Yes, beauty is a thing that gets talked about in FA spaces. Sometimes in a warm, fuzzy “appreciate the beauty in everybody” way, other times criticizing the way women are judged so completely on their looks. I mean, I found “You don’t have to be pretty” through an FA blog. I don’t remember which one, possibly several.

I agree with some of the concern—that it’s easy to overvalue beauty and to buy into the idea that physical attractiveness is one of the primary goals people should strive for, especially if you’re a woman. We should recognize beauty as a nice thing but not a necessary one, and an optional one, not a duty.

But at the same time, freaking nowhere in FA do I see women “have to identify as curvy, hot, sexy, or beautiful” to be accepted. I think I recall, way back when, on Shapely Prose, some disagreement on someone calling herself ugly, because people have the same “oh my gosh, no you’re not!” reaction to “I’m ugly” that they do to “I’m fat.” And even in that discussion, I’m pretty sure it was widely accepted that beauty does not determine anybody’s value as a human being.

I think talking about beauty standards is valuable in FA for a lot of the same reasons that talking about health is valuable. Neither of them should be viewed as a prerequisite for being treated decently, but they’re both things that our fat-hating culture is busy telling us that we can’t have, and that we’re worthless because we don’t have. I really think the message of FA should be the same towards health and beauty both: neither is relevant to your worth as a person, both have value, and being fat does not disqualify you from either.

We’re allowed to be nuanced and multifaceted in response to cultural bullshit. It’s perfectly reasonable to say “That’s not true *and* it’s not relevant,” to messages like “Fat people are ugly” or “Fat people are sick.” Saying “That’s not true,” should not automatically make people assume that we’re agreeing that the statement is relevant.

Another aspect of this is that people as a whole are, unfortunately, pretty shallow. People who are viewed as attractive are more likely to be hired, more likely to be promoted, more likely to be viewed as smart or good. And looks discrimination is part of fat discrimination. It’d be an awfully hollow victory to have weight declared a protected class but to have “I didn’t refused to hire them because they’re fat; I didn’t hire them because they’re ugly,” be an airtight defense to accusations of weight discrimination.

So I see nothing wrong with trying to widen our definition of physical attractiveness at the same time that we challenge the notion that beauty has the slightest thing to do with worth as a person or is something we owe those around us. Just like I see nothing wrong with pointing out the errors and logical inconsistencies related to fat and health at the same time we challenge the notion that health has the slightest thing to do with worth as a person or is something we owe those around us.

Well, that went better than expected

So, I had my appointment with my new endo today, which I was more than a little worried about.

It went surprisingly well. No weight lecture whatsoever, even though I’ve gained 4 pounds in the past year (which the doctor said was “probably normal fluctuations.”)

My blood pressure was a tad bit higher than it had been the last time. Probably mostly the stress. The way being in a less privileged group interacts with having anxiety disorder is really unpleasant. I mean, I know I’m paranoid, but they kind of *are* out to get me. “They” in this case being the 60 billion dollar a year weight loss industry, most doctors to some extent, and even the freaking First Lady. So it’s difficult to use the techniques I would use to talk myself down from other worries, because this one is more grounded in reality.

On my patient consent form, I did cross out the “Pictures or video may be taken of me and used for educational purposes” line. I have no desire to be the headless fatty accompanying their Facebook post of some article on gastric bypass. (Odds are those are stock photos rather than their patients, but still, “education” covers a lot of ground that I may or may not be comfortable having my image used for.)

I hope this wasn’t a fluke, and that my follow-up in six months goes the same.

Doctors, Power, and Honesty

So, I have to make an appointment with a new endocrinologist, which I’m dreading the heck out of. (My previous endo finished her fellowship program and isn’t going to be at Hopkins anymore.)

With the previous endocrinologist, I pretty passively sat through a lot of weight lecturing because I really need someone to actually treat my thyroid issues. The previous one hadn’t, and I knew that if I got written off as the “non-compliant fat chick” there, I was pretty thoroughly screwed.

Since my current endo was extremely knowledgeable, polite, and helpful, I figured sitting through a yearly weight lecture and giving lip service to the idea of losing weight was a fair price to pay.

And, let’s be honest, I was freaking terrified. The power doctors have over you when you’re sick is a scary thing. I remember thinking, before I went to Hopkins, that if they blew me off like the last endocrinologist did, that my best option was probably to crash diet to lose 50 or 100 pounds, in the hopes that if I got down to a socially acceptable weight and was still showing hypo symptoms, someone would actually listen to me.

So, now that I need to make an appointment with the new fellow, I’m trying to figure out whether I’m brave enough to actually say I’m trying to approach my health from an HAES perspective, or if I’m going to just smile, nod, and get out with a prescription for the synthroid that keeps me functioning.

I may take a middle approach where I ask about research and studies without flat-out saying that I don’t plant to attempt weight loss under any circumstances. Because if you can show me a study where even half the participants lost a significant amount of weight, kept it off for five years, and didn’t experience worse health outcomes than the control group, I might be convinced to try *that* diet. To my knowledge, no such studies exist. But if I approach it from an angle of asking questions and being interested in evidence, I may be at least a little less likely to be blown off.

I’m also planning on going into the appointment dressed nicely and groomed as thoroughly as I would be for a job interview, make-up and all. It kind of is a job interview, where I’m applying for the position of “vaguely intelligent grown-up who’s allowed to make her own medical decisions.” And fat people, being supposedly stupid, lazy, and low-class, are generally disqualified from that position. So I’m going to shamelessly work on the markers that I can manipulate to be seen as a person worth helping.

I also have another medical thing going on. Polycystic ovarian syndrome, which seems to be preventing me from getting pregnant, despite a whole bunch of trying. (I kind of wish I’d known I had a condition that’s linked to infertility before I spent hundreds of dollars on BC pills that made me feel like shit, when we probably could’ve just used condoms and been more than fine.)

It’s been six months, which is the point at which you’re supposed to go to the doctor if you’re over 30. I’m thinking the first step will be to go back on metformin. I should also find out what other options are available if that doesn’t do it. I’m not keen on the idea of fertility drugs, since i really don’t want multiples. I also have my doubts that anyone would do IVF on someone with my BMI.

The one nice thing about the fertility stuff is that I don’t *need* to have a baby, not in the same way I *need* to have my hypothyroid managed. I want to have a baby, I will be very sad if I can’t have one, but my life will still be good. My awesome husband will still love me, I will still have a fantastic group of friends and a house full of furry critters. It would suck, but ultimately it would be okay.

That knowledge is a good thing, because it means that if any doctor I deal with in my quest to get knocked up is rude, or bullying, or manipulative, I’m completely free to walk away, in a way that I’m really not with my endocrinologist. I mean, I can walk away, obviously, but it’s not a risk I want to take unless I really have no choice.

It does make me wish doctors had a little more respect for their patients, particularly fat patients, and that they were a little more aware of the power they have over them.