The Dose Makes The Poison

[A study], published in 2011, followed 28,800 subjects with high blood pressure aged 55 and older for 4.7 years and analyzed their sodium consumption by urinalysis. The researchers reported that the risks of heart attacks, strokes, congestive heart failure and death from heart disease increased significantly for those consuming more than 7,000 milligrams of sodium a day and for those consuming less than 3,000 milligrams of sodium a day.

Gina Kolata in the NY Times

Wow, it’s almost like the extreme might be the problem.  Sometimes “the dose makes the poison” is worth remembering.

I’m a grownup, right?

Forty-seven years old.

Working in software (not rocket science, but involves brains) over 20 years.

Employed and promoted by a company that prides itself on “hiring and promoting the best.”

Have been taking various meds for allergies for over 30 years.

….so why did I forget the Flonase again???

(I’m sure it has nothing to do with flonase being a nose spray, which I inhale better after my shower, vs the other morning meds which I have trained myself to take right after getting up. Nope. :P )

Things to Read

By way of Slacktivist comes a piece on recognizing silencing techniques.  Some are definitely too familiar.

Security guards do not always improve the learning environment.  Art teachers might be better.

Petition to drop the charges against Keira Wilmot for a science experiment gone wrong and re-enroll her in school has over 36000 signatures — does it have yours?

From an article on mammograms, and why they haven’t dropped the incidence of metastatic breast cancer: 

Mammograms, it turns out, are not so great at detecting the most lethal forms of [breast cancers] a treatable phase. Aggressive tumors progress too quickly, often cropping up between mammograms. Even catching them “early,” while they are still small, can be too late: they have already metastasized. That may explain why there has been no decrease in the incidence of metastatic cancer since the introduction of screening.

At the other end of the spectrum, mammography readily finds tumors that could be equally treatable if found later by a woman or her doctor; it also finds those that are so slow-moving they might never metastasize. As improbable as it sounds, studies have suggested that about a quarter of screening-detected cancers might have gone away on their own.

 It’s a long article, but worth reading. 

N things make a post

17) It’s the 17th week of 2013. I think.

12) I’ve been married 12 years.

11) My car (which currently isn’t starting) is 11 years old.  Probably needs a new battery.

8) I’ve interviewed eight potential coworkers recently.

5) Five loads of laundry today. This is not counting the mattress cover and comforter, which went in the dryer on high to kill dust mites.

3) I worked late 3 nights last week. (Planning not to do that this week.)

2) Two electrostatic air filters washed.

1) Sounders won their game 1-0.

What’s notable with you today?

Series of Quotes: Disease

Everything that used to be a sin is now a disease.
Bill Maher

Variability is the law of life, and as no two faces are the same, so no two bodies are alike, and no two individuals react alike and behave alike under the abnormal conditions which we know as disease.
William Osler

I have a disease, but I also have a lot of other things.
Teri Garr 

The doctor has been taught to be interested not in health but in disease.
Ashley Montagu 

What some call health, if purchased by perpetual anxiety about diet, isn’t much better than tedious disease.
Alexander Pope

So I can’t show you how, exactly, health care is a basic human right. But what I can argue is that no one should have to die of a disease that is treatable.
Paul Farmer 

Allergist update

Image from the Rudd Center Image Gallery

Image from the Rudd Center Image Gallery

Had a follow-up appointment with the allergist last week.

It was nice to confirm that the new meds and cleaning regimen not only feels good for me, I did better on the lung capacity test this time than on my first visit.

It was nice to confirm that needing to use albuterol prior to aerobic exercise is expected (exercise is an asthma trigger, especially if combined with cold air).  Albuterol is also my “rescue” med, which I use when my asthma symptoms worsen.  I haven’t been needing to use it as a rescue med for weeks, which is great.

I also agreed to start immunotherapy shots for my allergic triggers (dust mites, grass, pet dander).  It’ll take a few years, but hopefully it will reduce my allergic triggers in the long term.

Five Things Make A Post

1) I am sooo looking forward to tomorrow morning, when Mark Reads will post the second-to-last chapter of Deadline.   Mark Reads reviews books a chapter at a time, progressing through books every other weekday, and it’s been building to this OMG HUGE second-to-last chapter for weeks.  (Need I say “spoilers”?) Some of the books he’s done this with in the past are the Harry Potter books, The HobbitThe Lord of the Rings,  and The Hunger Games.  Deadline is the middle book of the Newsflesh trilogy & Mark’s reading the whole thing, starting with the first chapter of Feed here.

2) I got myself a Fitbit Zip to help me be more consistently active — I use it as a pedometer that does built-in recordkeeping, so I can get a sense of how active I am in general, not just a single day. Since I got it I’ve found myself at work focusing deeply for one to two hours and then getting up to walk and get water or coffee or tea or something.  I’d quit feeling guilty about it because I found that a brief break to walk and stretch lets me focus better afterward.  This article helps me rationalize it more ;)

3) A year ago today I signed my father’s hospice paperwork as his medical power of attorney.  The anniversary was a bit freaky this week.  At the moment I’m at peace with it all, but I know my reactions will likely continue to change.

4) I’ve been posting on fat discrimination at http://fatdiscrimination.tumblr.com. It’s not a subject I want to dive into a lot, so posts are somewhat sporadic.

5) Like Paul Campos, I probably wouldn’t vote for Chris Christie.  But it’s not about his weight.

What I do with asthma

image

  • Advair inhaler, twice daily.
  • Spirivia inhaler, once daily.
  • Flonase nose spray, once daily.
  • Singulair & antihistamine, once daily.
  • Rescue inhaler, 2 puffs before exercise or as needed.
  • Vacuum several times a week.
  • Weekly wipe down surfaces in bedroom.
  • Weekly wash sheets, comforter cover and pillowcases in hot water to kill dust mites. (Dust mites is a major allergy for me – bigger reaction on a scratch test than the straight histamine.)
  • Weekly spin comforter and mattress cover in hot dryer to kill dust mites.
  • Mattress cover is washed monthly; pillows & mattress have dust mite proof covers.

….and we also dust more often in other rooms, but the bedroom gets the most attention since I am physically there more than anywhere else.

But of course, “choosing” to be fat shows I hate the idea of improving my quality of life & I want to be sick.

Things To Read

From Dani Kelley’s “The body I have”:

I stopped eating in the eighth grade.

People complimented me on how much weight I was losing, how much prettier I looked, how much better I was.

They didn’t know something was wrong until I started passing out. And when my eating disorder finally came to light, it was largely seen as me going through a phase to be popular or noticed, much like with my cutting and suicide attempts.

Because, you know, depression and suicide and self-harm and eating disorders are only a phase.

From The Nearsighted Owl comes remakes of diet ads  with fat-accepting messages:

Courtesy of The Nearsighted Owl

Courtesy of The Nearsighted Owl

And Closetpuritan has a thoughtful discussion of whether fat acceptance is a “denialist” movement.

Fat Acceptance proponents range from those who think that the link between fat and “obesity-related” diseases is overhyped and not looked at critically enough, to those who flat-out say that fat does not cause any diseases. (One problem with the latter statement is that just as correlation does not prove causation, it doesn’t disprove causation either; saying we don’t know for sure that fat causes* something does not mean that we know for sure it doesn’t cause something.)

You may guess from her parenthetical, and my including the parenthetical here, that I happen to agree that the link between fat and health is overhyped and not looked at critically enough.  I also think that links between fat and health are questionable at lower sizes of fat (which are most fat people).

I do probably face greater health risks than someone of “normal weight”.  

However: I do not think those risks make weight loss any easier or any more likely to last.  There’s no proof that maintaining weight loss improves health in general (unlike quitting smoking or starting to exercise).  And, finally, the pursuit of health is not an obligation we owe to the world for existing.

Update: Closetpuritan has posted another post on this topic, exploring “denialism” and “skepticism” regarding Fat Acceptance/Fat Liberation and HAES. 

Conflating Dieting with Eating Healthy

[Feel free to skip if you don't want to think about dieting right now.]

Image courtesy of the Rudd Center Image Gallery

Image courtesy of the Rudd Center Image Gallery

It’s January and there is the usual plethora of diet commercials extolling weight loss. Google “dieting” and up comes Special K’s “Healthy Eating Plan”!

That said, it is a bit refreshing to see someone write:

As a lifelong dieter, let me tell you from experience: A diet need have nothing to do with “eating healthy.”

[...] It’s possible to lose weight by eating more healthily. But losing weight and eating more healthily can also be two totally different goals.

The cultural conflation of “eating healthy” and “dieting” has a lot of built-in assumptions.

There’s certainly more (and I haven’t even gotten into all the debate over what “healthy eating” means).

One result of the end-of-year crunch at work is that I haven’t been eating lunch regularly.  I’m going to work on permission to eat what I want, and eating at regular intervals.  But I am still avoiding diet commercials.

Today in Don’t Read The Comments

Marilyn Wann takes on weight bias in healthcare in “Big deal: You can be fat and fit” on CNN.COM:

…People are telling their stories of weight bias in medical care on websites like First, Do No Harm, This Is Thin Privilege and Obesity Surgery Gone Wrong. The National Association to Advance Fat Acceptance has been speaking out on behalf of fat people’s civil rights since its founding in 1969.

Health professionals of good conscience are joining this effort in increasing numbers. They’ve developed an approach called Health At Every Size that is proving to be better for people’s health than weight-loss attempts. The Health At Every Size professional organization,Association of Size Diversity and Health, this week launched the project Resolved, a response to New Year’s weight-loss resolutions. It invites people to share stories about weight discrimination in health care and opinions about what needs to change.

Weight bias has been documented among doctors, nurses, fitness instructors and other professionals on whom a fat person might need to rely for help. Last year, researchers who themselves are part of an anti-”obesity” institution (Yale’s Rudd Institute) surveyed medical professionals who specialize in caring for fat people and found that they had high levels of weight bias, viewing us as “lazy, stupid, and worthless.”

Image courtesy of the Rudd Center Image Gallery

Image courtesy of the Rudd Center Image Gallery

Paul Campos uses the latest “obesity paradox” study with “Our Absurd Fear of Fat” in The New York Times to argue that policing fat is worthless:

The study, by Katherine M. Flegal and her associates at the C.D.C. and the National Institutes of Health, found that all adults categorized as overweight and most of those categorized as obese have a lower mortality risk than so-called normal-weight individuals. If the government were to redefine normal weight as one that doesn’t increase the risk of death, then about 130 million of the 165 million American adults currently categorized as overweight and obese would be re-categorized as normal weight instead.

[...]

Now, if we were to employ the logic of our public health authorities, who treat any correlation between weight and increased mortality risk as a good reason to encourage people to try to modify their weight, we ought to be telling the 75 million American adults currently occupying the government’s “healthy weight” category to put on some pounds, so they can move into the lower risk, higher-weight categories.

In reality, of course, it would be nonsensical to tell so-called normal-weight people to try to become heavier to lower their mortality risk.  [...T]iny variations in relative risk in observational studies provide no scientific basis for concluding either that those variations are causally related to the variable in question or that this risk would change if the variable were altered.

Both articles are well worth reading, but I would skip the comments on those sites. If you must discuss with someone, chat about it here ;)

Operation (de-)Dust Mite a Success

The quest to cut down dust mites in our bedroom was a success.  I woke up Monday morning without a headache and without needing to blow my nose.  I hadn’t noticed these symptoms much until they were gone, but they were.  Even better, I seemed better able to handle other asthma triggers the rest of the day.  It was even better than the additional meds (Flonase and Spiriva) had been alone.

Today I again washed the bedclothes in hot water.  I didn’t wash the comforter, but it did get a spin in the max-heat dryer, which kills dust mites as well.  Yesterday I did more thorough cleaning in the living room than I had in months.

Amazing how breathing better makes all the difference.

Operation de-Dust Mite

In October I noticed I was having more anxiety about the whole “going to the doctor” thing.  I ended up calling the asthma specialist I’d been referred to at least six months previously and going in on Monday.

This was stressful in many ways. I’m freak-folks-the-hell-out fat.  I’ve got the whole mental “You mean it’s asthma, not just that I’m fat and out of shape?” thing going. There’s getting through my first Thanksgiving without my father.  There’s that fall is the most stressful time of year at work.

But I went.  Some of it was new to me, such as being handed a tissue with a length of plastic wrap on top and being asked to blow my nose.  (Ruled out infections.)  Also a lung function test, where I breathed out, in, and out through a measuring device.  As weight can factor into dosing of asthma meds, I did get on the nifty digital scale .. which displayed the ever-useful “ERR”.  Oy.  I did tell the nurse my weight, and she made no comment.  Blood pressure was fine, both in terms of my specific measurement, and that the room I was in had the proper-sized cuff and the tech taking my blood pressure used the large cuff without me needing to request it.  I met with the doc to discuss my history and current symptoms.  We agreed to doing some skin tests to confirm and/or rule out current allergies.  My biggest responses were to dust mites, grasses, and dog dander.  Hence Operation de-Dust Mite, which included encasing our king-sized mattress in a “protector” to keep the dust mites inside it.

Side note: wrestling a king-sized mattress into a giant zippered pillowcase?   Hilarious.  Ended up putting the mattress on its side, propped against the headboard, to get the thing on.

What struck me the most, though, was that the doctor did not blame anything on my weight.  No question that exercise is an asthma trigger for me.  Not “Are you sure you’re just not used to exercise?”  Doc accepted that it’s a trigger, saying something like, “Smoke, exercise, going out in the cold, those are very common.”    I half expected to hear “Exercise will help improve your lung capacity” but there was no mention of exercise or weight loss.  Treatment plan added a few new meds to better control my asthma and reducing overall exposure to allergens, especially in our bedroom.

I’m glad it was a good experience.  I am less thrilled that it was a surprise and not business as usual for me.

Reducing Heart Attacks

A Minnesota  county reduced heart attacks by 33%.   Was it due to a county weight loss campaign?  A “Let’s Move” push?  A trans-fat ban?

Nope.

The research, carried out by scientists at the Mayo Clinic in Rochester, Minn., found a 33 percent drop in heart attack rates in one Minnesota county after public smoking bans were enacted.   [The study] examined medical data in Olmsted County, which has a population of about 144,000, over two periods: the 18 months before the county banned smoking in restaurants in 2002, and the 18 months after it extended the ban to bars and all workplaces in 2007.  Dr. Hurt and his colleagues found that while rates of hypertension, diabetes, high cholesterol and obesity remained constant or increased after the bans, the incidence of heart attacks dropped sharply.

Source: The New York Times

Decrease indoor air pollution and suddenly there’s fewer heart attacks!!  It’s like pollution affects health or something!!

Medical Things

Those following along on twitter know that I went to the Urgent Care near work to deal with a UTI. This, of course, brought up the “Seeing the doctor issues”.

So. Sitting at the urgent care near work about a possible uti. Filled out patient history. Waiting to be called. Panic state: anxious.Fortunately the actual appointment went well, with no weight fight.

Panic state: calming. I did get weighed. No comment on 425lb weight from providers. #wtf #relief #SadThatIAmRelieved

Then it was off to the pharmacy.  The nice part was that the UTI pain relief pills are over the counter now, so I could get them right away and not have to wait for the backed-up pharmacy.

Realizing that I was freaked, but still needed to go, got me thinking.  The Urgent Care didn’t give me a bad time for being fat.  They had furniture that fit me.  There were multiple sizes of blood pressure cuffs in the exam room. There was not only a scale that could weigh me, but again, it was in the exam room, so privacy.  It wasn’t a bad experience at all – but it still stressed me out, because it was a medical situation, and my history is that medical situations are where I am judged, rejected, and hated.

And I started thinking about other medical things I’ve been putting off.   I have a referral to an allergist.  I’ve had it since spring.   I’ve been putting off scheduling a physical longer.

Yes, I also have a work schedule that puts a large lake between my work and my doc.  I’m finishing my father’s estate. And so on.  But I’m wondering, again, just how much that one extra thing tends to result in people not getting standard, basic care.

The Fat Life Isn’t

Internet is part of life, but it’s not all of life.

The people I know offline aren’t surprised that I am married, employed, and co-own a house.  The emails I get from this site often assume these aren’t possible, or that I must be some sort of exception.  There’s also am assumption that my fat is the biggest problem I have.

No.  So no.  A world of no.

This is a blog about fat acceptance and demystifying fat.  I write about fat, but it’s not the biggest thing.

In February my father went into hospice and my husband nearly died from an infection.  My father did die, barely a month later.

My fat is much smaller than that.

I may start posting more about the non-fat parts of my life. Or not.  But no, me not posting as much here doesn’t mean I’m not fat anymore.  It can mean I’m preoccupied with estate stuff and new hire training and crunch mode and volunteering and and.

The disconnect may be that I announce my weight here. In real life people see it, but I don’t throw out the Big Scary Number.

PS leg lifts love me.   :)