“Be kind to the children, for they are close to the other side.” – unknown
When my father was given 3 months to live when he had the intestinal cancer, everyone had an idea of what he should do. Take this herb! Try chiropractic! I was in the “Call Hospice” camp. But my father had a different plan. Instead, he wanted to do chemotherapy. Those of us in the medical arena of his life, holding the labs in our hands, shook our heads at the futility of that… and it might/probably will make him feel much worse. We did what he wanted anyway.
My dad did 2 sessions of chemo and then said, “Call Hospice.”
His death 2.5 months later was peaceful and gentle. And he was so so loved.
When We Need to Listen
In my life right now are a couple of people who have family or friends with terminal diagnoses. Those around them are rushing to help with all sorts of remedies, diets and even insisting on the “power of positive thinking.”
Instead, perhaps this is a time to ask the dying person what they want, not foist on them what we want.
Being near those that are dying is an amazing honor and privilege. For one thing, it isn’t a sudden, unexpected moment where there are always regrets about things not said or done. When you are at the side of a dying person, you have the opportunity for completion and the giving of your heart in a way you might never have before.
It is not a time for airing grievances that will never be resolved. Not a time for your confessions of guilt (find a Priest for that). It isn’t even a time to just sit keening and crying your eyes out, the dying person trying to comfort you in their time of need.
Holding the Space is a concept I learned in midwifery, but had been doing a long time already with men dying of AIDS decades ago. Holding the Space is sitting quietly, perhaps praying silently, seeing golden light of love surrounding them or just Be-ing with the person heading to the other side (into parenthood/through death/in illness/etc.). Allowing the person to say what they want… rambling speech or exquisite poetry. I like to keep notes, but not at the expense of my complete attention.
One caveat: Take as many pictures as you can… with each person separately, everyone together… take pictures holding the person’s hand… get video of them if they are still talking. I have nothing with my dad’s voice on it and regret that terribly.
Mindfulness is a buzzword right now, but if there was ever a time to be Mindful, it is when with someone in transition. Not worrying about getting to the store, checking your phone or even talking to others in the room about mundane life crap. BE with the person. Give your full attention to them. Watch them. Witness their transition completely.
If you get tired, you rest. No one can be expected to be Mindful or present 100% of the time. Do go for walks outside. Walk the dog. Eat a good meal. Be mindful of your needs, too.
There But for the Grace of God Go I
When I am with someone in this holy place (which does include childbirth, of course), I want to share with them how I hope to be treated during my own transition through death. Not that it is my prescribed way of dying, but simply respectful and kind attention.
My family knows how I want to go. At home. People happy, laughing, music blaring, telling fun stories, remembering all the wondrous things I have done in this life. I also want to be read to. Read to me when I am tired and need to close my eyes for a moment.
But that is me. Not everyone wants the levity part that I have requested.
Perhaps the person you are with wants to smoke again, drink until they are drunk every day, wants to go out to a forest and dig their toes in the dirt one more time. Take them! Even if you have to hire an ambulance service and need to push dirt through their toes while they are on a gurney. Be creative to give the dying their wishes. If they want to watch a favorite movie on a 24-hour loop and it makes you crazy…
…so what?!? Let them!
Talk to your loved one. Ask them what they want and need from you.
Then do it.
An added note: I understand that children dying slowly can be another aspect entirely. I have not lost a child to cancer or another illness or malformation, so cannot speak to it accurately. But, as with everything anyone in the world writes or says:
I was given 2 Sacagawea (Sah-cog-uh-wee-uh) dollars this morning, reminding me of the resilience of women.
On the coin, Sacagawea, a Shoshone Native American, is wearing her baby Pomp, who was 2 months old when the Lewis & Clark Expedition continued their journey with her as one of their guides (along with her husband).
I often gave this coin to my pregnant clients, especially those who were really nervous about childbirth and parenting, letting them know that if Sacagawea, at 14-years old, could toss her baby onto her back and traipse across the wilds of the pre-United States, leading a group of men and saving many lives along the way, they, too, had the inner strength to be a parent. I was told it comforted many of these women.
So how does this relate to today’s times when so many human rights are being destroyed within days of the new administration, so many more to be lost soon as well?
Sacagawea reminds me of the resilience of the human spirit. Stolen as a girl, married at 13-years old, birthing Pomp at 14 and onward with 33 men (with only one dying during the 2.5 year journey), assisting the Corps of Discovery as they ventured forth on their SCIENTIFIC Expedition. She helped them tremendously with the foods and medicinal plants, helping them chronicle everything for President Jefferson… much of the knowledge still relevant today.
These times are indeed dark, our most basic knowledge, love and understanding for others, many of whom unlike ourselves, are being vilified and negated. But, our country has had other difficult times (albeit not with the threat of annihilation by nuclear weapons) and overcome them. I believe if we cling to each other and, with guidance and support as we traverse new territories, we will make it through.
I will make it through with your help. I need you all.
Fat, Weight Loss Surgery, Weight Loss Medications, Weight Gain all discussed.
I wrote and published this in my Navelgazing Midwife blog on May 3, 2007. Pictures have been added, but nothing else has been changed. I’m sitting here smirking about how arrogant I was throughout my life thinking I would find *A CURE* for my obesity. I was delusional, even in this post.
Pacer. I was called Pacer throughout Junior High because I had a “wide rear end” like the GMC car of the 70’s.
I’ve had eggs thrown at me while walking around the block trying to lose weight.
Another year, I had a kid throw oranges at me while doing the same thing.
I’ve been moo’d at hundreds of times.
I’ve been laughed at, stared at, and ignored.
I’ve had to sit at a table and chair because I couldn’t fit in a desk at school (for years).
I’ve had to shop from a catalogue (pre-Internet) because no store had clothes large enough for me.
I went without bra and underwear for 15 years because I couldn’t find a decent-sized fit that didn’t cut the hell out of me.
I lived with yeast under my pannus and breasts for decades because I thought it was “chafing” – trying to cure it with powder, corn starch, Gold Bond, zinc oxide, keeping hankies or bandanas tucked under my pannus, struggling to keep it dry. I blew dry it half a dozen times a day and still it remained seeping moist. Once I learned it was yeast, in my thirties, and used Monistat on it, my life transformed!
My thighs’ friction burned each other to the point of losing skin, especially when wearing panty hose (de rigeur in the 70’s) and I used bandanas to keep my thighs protected from each other. I remember learning about bloomers and thought they were the miracle of the world. I never owned a pair, but quickly thereafter, bike shorts came into my reality and I have never been without them again.
I hobbled so badly a woman took me aside at a dance and told me about Birkenstocks. She said she hobbled from her fat, too, until Birkenstocks and they saved her feet. Poor, I asked her how much they cost and when she told me they were almost $100 I almost choked! She told me they were worth the ability to walk and somehow I manifested the money and have only worn Birkenstocks since. I now own 20+ pairs.
I’ve sat on airplanes and spilled onto two seats, using two seatbelts, almost needing three. I either flew on near-empty flights or flew with my partner so I could seat-share with her
I lived with the food voices speaking, whispering, and screaming inside my head my entire life except for three distinct times: when I was on Phen-Fen, during the first year after the gastric bypass and now, on Topamax. When the food voices are “on,” they are incessant and never-ending. They don’t take a breath, rest, relax, and stop even for a second to consider my feelings or sanity – they merely run and Run and RUN through my mind until I want to scream – or eat to make it shut up. And even if I eat and the voices recede to the background for a moment, it isn’t but a moment before they are loud and screaming yet again. Is it any wonder I wanted to make them shut up?
From Whence I Came
I was dying of being 350 pounds. I am not dying of being 220 pounds. I can live easily and delightfully at 220 pounds. Would I like to eliminate the pannus I have from having three kids? Sure! Will I? Maybe, maybe not. Do I wear sleeveless dresses and shirts even though I have swinging arm skin? You betcha.
I remember what it was like being fat(ter). I remember the sadness, the anger, the feeling of being a victim I felt. I remember how I didn’t fit in – literally. I remember how I didn’t fit in chairs, through turnstiles, on rides, in booths. I remember how it felt every single time I would go out of the house, heave myself into my car, heave myself out of the car, walk into and out of a store, feel myself looked at by children and teenagers… and many adults. I remember ripping clothes because they were too tight, too old, I squeezed in the car and they got caught between me and the steering wheel. I remember being watched while shopping for food. I remember hating eating out because people watched me. I remember eating in secret. I remember hiding food because I didn’t want people to see how much food I ate. I remember hating how little control I had over myself. I tried, every day, to do better. To stop the voices. To stop eating. To stop eating so much. I hated being so observed.
I remember using my writing skills to move Fat Acceptance forward by outlining each ride at Disney World (I went by “gardenia” back then) and how fat people would do on them… writing about health care and fat acceptance… writing just using the word “fat” (which made some people [usually not fat] very uncomfortable) itself!
I’ve been to rallies and stood next to Fat Acceptance chicks and spoken on behalf of Fat Moms and Fat Dykes – asking (demanding) that we get decent chairs at the Gay Pride Festival, that we be remembered when tee-shirts are ordered at all events, and that everyone remember fat is just another way of Be-ing.
When I got really angry, though, was when I started seeing my lab work going downhill. For years I’d bragged about how great my lab work was even though I was fat. Until I was 34, everything was great. Then, my Hemoglobin A1C, my glucoses, my cholesterol… everything went to shit. I didn’t pay that much attention until I was hospitalized for a kidney infection that was complicated by extremely high glucoses. With a family history of diabetes (I am Cuban); I couldn’t just sit and watch the glucose/kidney correlation with abandon.
I’d always despised when people said they’d had Weight Loss Surgery (WLS). I disgustedly spat out the words, “Mutilating Surgery” as I watched a fat person choose WLS. I didn’t even want to hear their story. I didn’t care. There wasn’t reason enough to me for someone to cut apart their body that way. It was repulsive to me.
Weight Loss Medications
Drugs were no different. I’d been given Black Beauties at 10 years old and a variety of other weight-loss drugs over the years and none of them worked and all of them made me even fatter.
Diets were stupid and I’d long ago given up on any diets. (At least publicly.) Privately, I tried a couple for a week or so, but couldn’t ever do anything for longer than that.
But, when I was getting sick, I had to do something and chose the method of the moment and that was Phen-Fen. It seemed ideal and, at that time, it was.
Phen-Fen was a dream! Within 3 days, my mind shut up and the voices were gone. I couldn’t believe something could actually make the voices stop! I loved it. I was on Phen-Fen for 19 months and lost 111 pounds. I was still 230 pounds, so wasn’t any thin thing, but I loved where I was – in a silent world of normalcy.
When they took Phen-Fen off the market, the voices returned and came back in a furor I’d never heard before. It was as if they were so angry at being silenced for so long, they were going to tell me 19 months’ worth of what they wanted me to hear. I was forced to listen. And I ate. And ate. And ate. I gained 130 pounds in 9 months.
Immediately, my diabetes, cholesterol, triglycerides, sleep apnea, stress incontinence, PCOS, IBS became issues I would contend with for another 10 years. Sure, I’d end up with a heart defect from the medications, but even all these years later, I waver about whether I would take Phen-Fen or not if it were legal again. The drug’s quieting effect was that restful to my mind.
Weight Loss Surgery
When the illnesses overtook my body and I was so limited in mobility and I was really looking at the last days of a very unhappy and sickly life, I had to make a choice about what I was going to do and I chose the Roux en Y Gastric Bypass. It was almost cruelly ironic. I couldn’t help but laugh. My fat friends, long gone from my now world, would have been disgusted and would have been… long gone… just at the news of my choice.
My choosing to have Weight Loss Surgery (WLS) reminded me of lesbian friends who went back to men or Christian folks who chose abortion or other such dichotic, head-twisting ideas that make one’s circle of friends wonder what got into us. If I hadn’t been in my own body and head, I’d have thought I’d lost my mind.
What was I about to do? What did I expect out of surgery? Did I think I was going to be a svelte size 6 at the end of the gig? What was I going to do with all my loppy skin? Could I love me smaller than the fat chick I had known and loved for 40 years? Would I even know me smaller? What would I fight about/for now? If I didn’t fight for Fat Chick Rights anymore, who would I be? If I fit in the chairs, who would I be mad at? I was so worried about being lost. So lost.
I had surgery April 5, 2001 and was meticulous with my post-op care and therapy. I lost 100 pounds in 10 weeks simply by being compliant. I wasn’t racing to lose weight, but was racing to save my health and within days, I was off most of my medications and within weeks, all of them. I ended up losing 190 pounds in a year, but wigged out when I put on a pair of size 8 jeans. I absolutely loved being able to shop anywhere, adored walking, crossing my legs for the first time in my life, sitting on my partner’s lap, fitting anywhere I tried (and it took years to figure out my own size in relation to things) and doing cartwheels (I have pictures). My kids didn’t know what to make of me!
By year three, I’d regained almost 100 pounds. I was still fairly healthy, but mobility was becoming an issue once again. The sleep apnea was returning as well. The voices had returned with a vengeance. It was the worst of all the returning difficulties.
(I wasn’t like some of my co-WLS friends who were suicidal because of weight gain. I took it in stride, knowing that most WLS post-ops regain 50% of their weight back. It didn’t make me do more than shrug and sigh about my recurring health concerns. I had thought I’d had enough incentive to keep enough weight off to keep those at bay, but, alas, I was as human as the rest of the gang.)
I never had any illusions of being small forever, but I didn’t really think I’d have to diet again. And yet, I found myself considering diets – the most disgusting shit fat people are told they have to live on in order to be treated humanely in this society.
Blessedly, I still couldn’t eat the massive amounts of food I’d eaten pre-op. While many say they are fat without eating thousands of calories a day, I ate 8000-10,000 calories a day and was unable to see that – or admit that – until I’d had the gastric bypass. I was still able to eat plenty to weigh 250, though! Even with a stomach the size of a shot glass. How’s that for a food addiction?
Anyway, this isn’t really meant to be a play by play of my diet history, but know that through the last few years, I tried a few diets, drank that crap Slim Fast (recently), considered Opti-Fast, Nutri-System, and anything else I could think of that I couldn’t do before WLS and have failed just as miserably now as I did then. How could I think it would be different?
What I really was searching for, however, wasn’t the loss of weight; it was the silencing of the voices inside. The screaming inside my head was becoming so loud; I could hardly hear myself think. Some days, I thought I would go crazy from the cacophony. I begged my psychiatrist for help, over and over again. Please, please, don’t you have something for these voices? You have something for the auditory hallucinations of my Bipolar Disorder, where are the medications for this? For a year, she worked with me to get my BPD and my extremely precarious depression into a place of balance before she would even begin talking about food voices. Once I was stable enough on the meds, she whispered a possible solution.
Topamax has become my/the new Phen-Fen and I am blessed to have it in my life/head/mind.
Since starting Topamax, the voices have left completely. I am able to eat when hungry, stop when full (to my pouch’s full, not my old stomach’s full), and not be hungry again until a real mealtime is supposed to be. Before Topamax, I grazed nearly continuously and ate meals inbetween the grazing. Since starting the medication, I have lost 30 pounds, sleep apnea, the feet pain, the knee aches, the glucose spikes and my periods are regular again. Just those 30 pounds made a difference.
I am not on medication to lose weight. I am on medication so I don’t try and crush my hands through my skull and make my head shut up its crazy never-ending screaming for food, Food, FOOD. I don’t know what it is in my bio-chemical make-up that creates those voices, but if I hadn’t ever had Phen-Fen before the Topamax, I’d never have known the voices could be quieted; I’d never have even known the voices had a name.
But, I know them now and they are what made me the fat, angry woman. The voices.
So, this still fat woman isn’t so angry right now because the voices are quieted… drugged, if you want to say that. I don’t really care what you want to call it; they have shut their damn mouths! I can think, function, meditate, talk and even make love without hearing the continuous imploring to find food. I only hope the medication doesn’t have the same sad ending Phen-Fen had, of course, but I’m living in this moment… staying in the joy today.
Circumstances surrounding my life have made me sad and even mad at times… the way people have treated me, not treated me, the way I have had to settle for less (so to speak) most of my life because of being so fat, being called names, kids thinking I was pregnant years after having had my babies, looking in the mirror and seeing someone I could barely tolerate looking at. I wonder now, not so fat, if I am still mad at those things. I am certainly unhappy that my fat sisters and brothers have to suffer those indignities I used to suffer – but I also see that people are far fatter today than they were when I had surgery 6 years ago.
(I have made the interesting observation that I spent my childhood as the fat freak and got WLS as an adult and soon enough, more kids will be fat than not and those who have WLS will be the thinner freaks!)
As a fat chick, I also had such a great life as a very sexually active dyke… danced and played and support grouped myself silly! I might not have been able to walk all over the world, but I sure could ECV all over The World (Disney World, that is!)! My sedentary lifestyle left me plenty of time to write and develop Internet relationships, many of which are now a decade old. I am in a glorious relationship with my Sarah who loves fat chicks of all sizes and I am mom to 4 great and wonderful now-grown kids who loved their mom fat and who are extremely de-sensitized to fat people look-wise, yet highly sensitive to their needs when out and about. I am very proud of them and their love for people; I know that my fatness had a giant (har) place in their gentleness and amount of kindness for different people.
Making Space for Fat Folks
Fat acceptance certainly still has a place in my life. I still work hard to keep fat information in the forefront in my life. My holistic healthcare office accommodates fat folks as easily as non-fat men and women. We have gowns that fit people up to 600 pounds. We have chairs that hold 550 pounds. I made sure the massage tables held 500 pounds. We have a chiropractic table called a Hi-Lo Chiropractic Table that allows those with mobility issues to stand and be lowered gently instead of having to climb on the table. Our pregnant women use the Hi-Lo, too, of course – they can lay on it, belly down, because the middle drops out… sometimes the only time they ever get to be on their stomachs during their pregnancies.
I have a speculum that is appropriate for the women who might need that. I made sure the exam tables were situated in a way that the legs would be comfortable during an exam (I typically don’t use stirrups, but can if a woman wants to). I own a blood pressure cuff that not only has a large cuff, but also has a thigh cuff for a super-size person’s arm. I also learned how to take blood pressures in areas when the cuff is too small for the upper arm – and teach that to student midwives, nurses and doctors everywhere!
When interviewing practitioners, I make sure they are comfortable with fat clients. I use the word “fat,” so they quit startling when they hear the word.
A Fat Midwife
I am the rare homebirth midwife who takes “obese” clients and doesn’t automatically see them as high risk, sick, Gestationally Diabetic, or an automatic transfer to have a cesarean. I see women as they are and will work with them where they are. We have to address food and food issues – just like I do with every single pregnant woman – it just feels deeper with a fat woman because of how harsh it is in our society. But, being a fat woman myself, I have to believe I can make it somewhat softer, somewhat gentler than it could be with someone who has permi-glazed skinny eyes.
Today, I am a fat, joy-filled, life-filled, spiritually speed-growing woman. I am not perfect. My writing doesn’t adequately say what I want to say all the time. If you want to get to know all of me, come spend time with me… a lifetime with me… and even then, I suspect you won’t know a fraction of who I am. I am still learning who I am. Every day, I see new facets of my Self, places where I think, “Ha! I didn’t know you were there!”
These conversations have allowed me to get thoughts out that have wanted to be written for years. I thank you women for the prodding to move forward. You still might disagree with me and my choices, but your disagreements can’t change them. They are made. I will still have had WLS. I will still have taken Phen-Fen. I will still take Topamax. However, I am listening to you all to be more careful to speak more personally and watch my language when I speak of “some women,” – and I ask that you also have a moment of patience with my prose.
I might still make you a fat angry woman, but I’ll keep writing if you’ll keep reading. I promise to keep listening.