This post was a hard one to write. Besides the actual weight gain itself the pain which manifested from my body from carrying the extra weight was extremely difficult for me. When I spoke to my therapist about this she told me to re-frame my thinking. She told me to stop blaming my fat for my pain, but rather ask myself, “If a skinny person had the same pain, how should it be treated?”. I get it, I GET IT. Of course that’s how I have to re-frame it, otherwise I’m blaming my fat for my pain and I can’t stop my fat well, from being fat. But it’s not easy.
Case and point, when I was in my 20’s, I had a job where I had to stand 15 hours a day from 7 am to 10 pm. I got to sit for 30 min for lunch (don’t talk to me about how horrible those conditions were, I know). I developed something call “post-tibial tendentious” which basically meant the tendon which runs from my knee to the little bone on the side of my ankle was damaged, badly. I could barely walk, I was popping pain pills trying to keep the swelling in line. At the time, I was not “heavy, overweight or obese” so I knew what the care plan was. I was given cortisone shots, I was given rubs to help with local swelling, I was fitted for ankle braces that I wore to keep my ankles up (they would slope inwards due to the weak tendons). I also did physical therapy to help as well. At the end of the day after 6 months of this, my doctor finally told me that the best treatment would be to quit my job and stop standing 15 hours a day. I was lucky enough to be able to quit, I did, and within 3 weeks I was back to my old self again. Over the years, if I would stay on my feet or walk to long (a trip to Italy walking around Rome, a trip to the zoo, a trip to Disney, etc) would aggravate the injury, but ultimately I was able to keep it in check by avoid the very conditions that caused the injury to occur in the first place.
Fast forward to present day and low and behold, guess what flared up again. My “post-tibial tendonitis”. I went to my doctor and not surprisingly, I asked for help and her first response was to lose weight. When I politely told her that wasn’t something I could do right now, I asked her to formulate a treatment plan for me that would not include weight loss. She gave me the cortisone shot, I got the rubs, I got the ankle braces and signed up for PT (and to note – every single person told me that the treatment they were offering would work much better if I lost weight). Nothing worked. And unfortunately, like I had done 20 years prior where I just quit the job, took pressure off my tendon, and healed, I could not do that. I could not magically lose the excessive weight I had gained that was causing the inflammation of the tendon. So I now live in pain. That’s my alternative. I wish I had this magical answer for you, but I don’t.
I struggled a lot with this concept – on the one had, my body is getting the food it needs, I’m feeding it whenever it wants, it gets whatever it wants. At this point in my journey I am eating balanced meals with all my macronutrients in play. I’m not starving her anymore. In response, she gained A LOT of weight and this caused another part of my body to incur an injury. I keep asking myself, why would she trade one for the other? She likes being nourished, but now she’s so large that she hurts her lower legs and ankles? When I asked this question to my therapist, she circled back to what I had stated previously – the body’s main goal is to survive. So if you asked her, would you rather be smaller & starving or larger and in pain, she would chose over and over again, larger and in pain. Why? Because she’s alive and will continue to be alive despite the larger body.
Now, I’m going to dabble a bit into the set set-point weight theory. This theory, like I’ve spoken about briefly in the past, states that ALL of us have a weight that our body will naturally stay around (within 5-15 lbs or so) without interference from restriction or excessive exercise. I have no idea if where I am at now is where I’m supposed to be. Many will tell you in anorexia recovery that I am in the “overshoot weight” category and that over time (anywhere from 5-7 years) I should lose the overshoot protective weight and end up at my set point weight. And that in theory, this set point weight will be light enough as to not aggravate my tendonitis. Boy, do I ever wish this is true. I have no idea. So for now, I tell myself that I can go back to my anorexia, lose the weight and stop my legs from hurting or I can live the way I am and mitigate the pain. It’s not as easy as you think to make that decision. I wish it was.
The other main issue is my diastasis rectithat reared it’s ugly head after my weight gain. During both my pregnancies, my kiddos kicked the crap outta my ribs and dislocated them on the upper right hand side, right along the stomach/rib line. During pregnancy, it was pretty painful, requiring weekly trips to the chiropractor to push my ribs back in and nightly massages with my tennis ball along the wall. Once I gave birth, the pain stopped and the rib stayed in place. Over the years if I tried to exert that area (think ab exercise like sit ups, planks and superman’s, etc) I would feel a “pop” of sorts in that area and I had to place my hand and almost push things back together. For the longest time I thought it was a hernia (yikes!) but I was finally told it was an in-operable diastasis recti from the constant rib dislocation. Treatment? Don’t do the movements that aggravate the diastasis recti. Simple enough right?
Well, after I gained my recovery weight, it seems the extra pressure from my enlarged stomach aggravated the diastasis recti and I was once again in constant pain from it. So now EVERY time my stomach is bloated from either my monthly period or from eating a lot of food or foods that cause bloating, my ribs hurts like hell. There are also random days I wake up and it just hurts. Hurts from the pain of holding up the extra weight from my stomach on an already weak area. I have to use a tennis ball on the wall to reduce the pain from the back and use heating pads and Voltaren gel to help with pain and swelling. That’s all I can do. Especially since it’s inoperable.
Something else that I forgot to write about in the initial post – ACNE. OMG – this has been horrific. I have always had bad acne. In fact, the first time I was ever put on birth control was for acne. I spent most of my teens, 20’s and early 30’s on some sort of medication. I tried it all and it never truly worked. I wish I could say when I cleaned up my diet, everything got better. It did not! So, I waited until I was done having kids and finally asked my dermatologist. to go on Accutane. It was LIFE CHANGING. I can’t tell you how happy I was to have fully clear skin for the first time in my adult life. I would get 1-2 pimples every now and then before my period, but it was totally manageable.
Fast forward to my recovery and my acne is RAGING. Bad! I get painful, swollen pimples everywhere. On my face, my neck, my back. They don’t just show up before my period either. It’s a constant battle. I have stuck to topical treatments from now – think Retin-A, chemical peels, salicylic acid, cleansers and washes for acne prone skin. I know I have to go back on Accutane. But I hesitate, WHY, you ask? Because Accutane dosing is based on weight. And the last time I went to my dermatologist for Accutane I was 100 lbs lighter. I’m scared and I just don’t want to do it. But the hit to my self-esteem from layering on makeup to cover the active acne and the subsequent scars I have is hard to deal with on a daily basis. I’ll keep you posted on what I decide to do!