Wheezing Around the Block

One of the recent rants I moderated out of the comments included something* about how “wheezing around the block doesn’t count as exercise.”

Wheezing is a symptom of asthma, bronchitis, sinusitis, pneumonia, and other illness. Deciding that wheezing is only treated by weight loss is dangerous.

I do wheeze. I have asthma. Now that  it is properly treated I can exercise without wheezing. My treatment plan is greatly helped by insurance to cover the not-available-in-generic Advair & other meds. One of my asthma triggers is exercise itself. This means I need to medicate pre-exercise. I’m also affected by things like air pollution and pollen.

If you’re fat and wheezing while walking around the block, you may need to see a doctor about your wheezing. It’s not necessarily “just being fat.” Waiting til you’re thin? A, may not help, and B, you could die in the meantime.

The fat haters of the world would have you believe you only wheeze if you’re fat and should lose weight to cure it. The fat accepters think that if you’re sick, you should be treated for that without having to lose weight first. I’m on the fat accepting side.

*Paraphrased to remove profanity & improve readability.

Saturday Ramblings

1am is still Saturday if you haven’t gone to bed yet, right?

Note to self: The expensive twice-daily asthma med works best if the evening dose is 12 hours after the morning dose, not 18 or 20. You carry it with you. See an alarm on your phone & use it, font just turn it off.

Kath posted about a current fat acceptance tag on twitter, if you haven’t seen it already. Also the HAES blog has a piece on activist burnout.

I started watching the first season of Mad Men on Netflix.  Is it weird that I’m describing it as “a grown-up Bewitched”?

N Things Make a Post

Thanks to This Is Thin Privilege for the shout-out.

Image from the Rudd Center Image Gallery

Image from the Rudd Center Image Gallery.
Not the blogger.

Jeanette took on the “Obese women get only an hour of exercise a year” thing.

…as did This is Thin Privilege.

…as did Marilyn Wann and many commenters on Facebook (signin needed).

On a personal note, my allergies are bothering me much less since Sunday.  Why? I spent over 3 hours Saturday doing “soak, rinse, repeat until the water is clear” on the electrostatic air filters for our furnace. Then waited about 4 hours for them to dry. Fortunately we replaced the windows in a few years back to the inside temp only went down about 10 degrees (and I set the heat UP about 5 degrees before I turned off the furnace to take out the filters).

Also on a personal note, I’m back into the swing of getting allergy shots once a week after an attack of life around November.

Tell Me Again How It’s “For My Own Good”

Lara Frater wrote about this and I wanted to boost the signal.  The Rudd Center recently came out with a study (PDF link) showing that weight stigma affects the stress hormone cortisol.

Exposure to weight-stigmatizing stimuli was associated with greater cortisol reactivity among lean and overweight women. These findings highlight the potentially harmful physiological consequences of exposure to weight stigma.

It doesn’t require being fat to have this kind of reaction, by the way. Both the lean and overweight women “were equally likely to report that they would rather not see obese individuals depicted in a stigmatizing manner in the media.”

What’s cortisol? Some highlights from Wikipedia:

Cortisol, known more formally as hydrocortisone is a steroid hormone [...] released in response to stress and a low level of blood glucocorticoids. Its primary functions are to increase blood sugar through gluconeogenesis; suppress the immune system; and aid in fat, protein and carbohydrate  metabolism.  [...] Cortisol counteracts insulin, contributes to hyperglycemia-causing hepaticgluconeogenesis and inhibits the peripheral utilization of glucose (insulin resistance). [...] Cortisol can weaken the activity of the immune system.

Being fat (“excess weight”) is considered a cause of insulin resistance.  And it appears that weight stigma increases cortisol … which increases insulin resistance.  Which is the chicken? Which is the egg?

This isn’t necessarily new.  Weight stigma  has been tied to weight gain before.  What this study highlights is one mechanism.  There may be others.  We know that fat bias prevents fat people from getting jobs, from getting raises, and from getting proper healthcare treatment.   Fat people are also often paid less and harassed more than similar-qualified people who are thin.  None of this improves health.

So when I hear people saying that fat people just need more “tough talk” to lose weight “for their own good”? No, I don’t believe them.

Health At Every Size Principles

I sometimes post about Health At Every Size®, both the concept (which is trademarked by ASDAH) and the book Health at Every Size: The Surprising Truth about Your Weight, by Linda Bacon.  So I am pleased to see that ASDAH has updated its HAES® Principles to be more inclusive of different abilities and backgrounds. Weight bias and weight discrimination is explicitly called out.  Supporting individual choices is more explicitly encouraged. A brief framing of the Health At Every Size® Approach has been added, as well, noting that health is NOT “simply the absence of physical or mental illness, limitation, or disease.”  It also states that

[H]ealth exists on a continuum that varies with time and circumstance for each individual. Health should be conceived as a resource or capacity available to all regardless of health condition or ability level, and not as an outcome or objective of living. Pursuing health is neither a moral imperative nor an individual obligation, and health status should never be used to judge, oppress, or determine the value of an individual.

I suggest you check the full statement on the ASDAH site.

 

Things I’m reading

Kath as a post at Fat Heffalump on the feedback from her recent interview by Jasmin Lill on news.com.au, Brisbane blogger speaks out against online bullies. Go Kath!

Closet Puritan has a thoughtful response to some of the conflation between “Fat people are more common in communities with a Walmart” and “Eating more processed food from Walmart makes people fat”.

This Adipose Rex has some musings on Christianity and the body:

This Advent I am thinking about how if my body is a temple of the Holy Spirit, then this flesh itself is sacred — this same substance worn by the God of the universe, and shaped into God’s image. If I really believe in the words I recite every week, the resurrection of the body, then this is not some temporary meat-costume I will abandon so my soul can flit off to an immaterial heaven, but the too too solid flesh that will dance in the hereafter.

This reminds me of The Unapologetic Fat Girl’s Guide to Exercise and Other Incendiary Acts by Hanne Blank, which I’ve been reading. From the introduction:

Exercise—by which I mean regular physical movement that puts your body through its paces—is crucially important because it is something that makes it possible for you and your body to coexist in better and more integrated ways. It builds a bridge across the mind-body split. [...E]xercise gives your body to you. [...] Most of all, it teaches you that your body is not just a sort of jar made out of meat that you lug around because it’s what you keep your brain in, but an equal and in fact quite opinionated partner in the joint production that is you.

And over on the HAES blog, there’s an interesting discussion on healthism & privilege.

Things to Read

You may have seen this poor as folk post on why poor people might not eat healthy.   There’s also a great post on why “healthy food vs junk food” infographics are inaccurate, misleading lies.

From Linda Bacon and Lucy Aphramor at the the Health At Every Size® Blog:

“Obesity-related” disease actually tracks your social status more than what size clothing you wear. In developed nations, data show, members of stigmatized groups, including those who are economically disadvantaged and people of color, are the most common victims of illnesses typically grouped under the “metabolic” umbrella. [...] With social status comes control over one’s circumstances – success at work, fostering loved ones’ well-being, being able to plan for the future, or even next week. The absence of those, no matter how punctilious our lifestyle habits, stresses our systems in disease-promoting ways. In contrast, being able to exert an influence over what matters to us is health-promoting.

And astronaut Karen Nyberg created a stuffed dinosaur in space.

Medical Equipment Size Limits

This article focuses on the weight limits of air ambulances, but it’s depressing anyway. The overall message of the piece is to lose weight (which we all know works so well! And immediately!)

Now, yes, most fat people aren’t very fat; most cutoffs are 300 or 350lbs; air ambulances appear to have lower-than-typical requirements.

But what can you do? Some ideas:

  1. Ask your local hospital about their equipment. 
  2. Ask you local doctor about their equipment.
  3. Ask local fat friends about their experiences.
  4. Research what is available and ask for it to be considered when new purchases are made.
  5. If there is an organization that fundraises for your local hospital, consider joining. 

I wouldn’t expect any of these to have an immediate effect, and some are long-term commitments.  These are also biased toward people who have the  time, money, education, and (possibly) public speaking skills to succeed.

Finally, you can move to an area with more choices.  This is definitely a long-term choice, and one that may also be impossible. But it may work for some.

Other thoughts?

You’re SORRY? Oh fuck you.

Dr. Peter Attia thinks about his former patient often, the woman who came to him in the emergency room at Johns Hopkins Hospital one night seven years ago.

She was obese and suffering from a severe complication of Type 2 diabetes, a foot ulcer, which required an urgent amputation. At the time, Dr. Attia admits, he silently judged her. If she had only taken better care of her health, maybe exercised more and eaten less, he thought to himself, this never would have happened to her.

But a few months ago, in a TED talk, Dr. Attia stepped onto a stage and offered a few words to his former patient: “I hope you can forgive me.”

WHAT THE FUCK?  Why should she forgive you?  You’re just another judgmental asshole in a nice long line of judgmental assholes.  Is it really such a stain on your self-image that someone might not worship you as the all-perfect person you want to be?  Why should she spend any pity or compassion on you?

“As a doctor, I delivered the best clinical care I could, but as a human being, I let you down,” Dr. Attia, his voice breaking, said in his talk. “You didn’t need my judgment and my contempt. You needed my empathy and compassion.”

Wow.   Just … wow.   He thinks his “judgment and contempt” did not prevent him from delivering the best clinical care?  Or is he admitting that the “best clinical care I could” might not be the best clinical care?

I still don’t see why he thinks an apology from just one doctor might MATTER at this point.  Maybe it would.  Maybe pigs would fly, I don’t know.

Apparently Attia’s now looking into research on whether “the precursors to diabetes cause obesity, and not the other way around“.  Interesting.  Did he read some genetic research on type 2 diabetes?

Dr. Attia’s insight was informed, in part, by the startling discovery a few years ago that despite paying close attention to his diet and exercising frequently, often for hours at a time, he had developed metabolic syndrome, a precursor to Type 2 diabetes. He had made all the right lifestyle choices, he thought, and yet he was overweight and on a fast track toward obesity and diabetes.

Oh for fuck’s sake.   Dr Perfect is SHOCKED, SHOCKED to discover his body is not 100% under his control at all times.  OMG, this is a REVELATION.

Sources:

NY Times article on Dr Attia, where I pulled most of the quotes from.

Dr Attia’s TED talk.

Itch, Itch, Itch

Ever use a long-handled bath brush to scrub your back?

Swap the brush for a dense sponge, and that’s basically the long-handled lotion applicator I got from Amazon. This morning I used it to put Aveeno anti-itch lotion on the itchy spot on the middle of my back. At bedtime I decided to try Benadryl cream – it’s definitely helping.

Part of me feels weird to use a lotion applicator (I can’t just reach?)  Yet bath brushes – which reach the same areas – are a bath staple. Strange what seems normal sometimes.

In the meantime, the itch is subsiding and I think I can sleep. 

Histamines in Food

A bit of background:

An allergen is something that triggers an allergy. When a person with allergic rhinitis breathes in an allergen such as pollen or dust, the body releases chemicals, including histamine. 

Histamine [...] causes dilatation of the blood vessels (flushing, rash, itching) and increased mucus production (runny nose, productive cough), and bronchoconstriction (wheezing, cough). Because histamine is contained in almost all body tissues, [...] it is able to cause a wide variety of symptoms.

So, allergies release histamines, and histamines causes the actual symptoms.

Well, I knew that it’s possible to be allergic to food.  I even knew that if you’re allergic to sulfites you should avoid wine.  But somehow I’d missed that some foods naturally contain … histamine.

There are many foods that contain histamine or cause the body to release histamine when ingested. These types of reactions are food intolerances, and are different from food allergy in that the immune system is not involved in the reaction. The symptoms, however, can be the same as a food allergy.

This also includes beer, wine and liquor.

The basic takeaway seems to be:  IF you have allergies, and your allergies are getting on your case? You might want to avoid food and drink with natural histamines.  There’s a long list here.  A couple studies linking wine (in particular) with more symptoms in allergy sufferers were discussed here.

(Those who do not have allergies are welcome to pour a glass of wine and rejoice in the comments.  Those with allergies, feel free to share other coping methods.)

Why I Think Declaring Obesity A Disease is Harmful

It’s inaccurate:

It distracts from the real issues:

It’s a win for the weight cycling industry

Unfortunately, what’s good for the weight cycling industry isn’t necessarily good for patients: 

There is a Change.org petition on this – I’ve signed, have you?

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