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Entries in fat acceptance (4)

Monday
Aug232010

Taking a Fat Woman's Blood Pressure

(A short word about the term "fat." As I use it, it is not a negative, but merely a discriptive adjective. Using euphemisms like "plump," "fluffy," and "full-figured" are much more insulting to me than the word fat. Many of us who've dealt with fat prejudice for way too much time have come to "reclaim" the word fat so it doesn't have the biting sting it once did, especially when hurled as an epithet. If you are terribly uncomfortable with the word, first, look inside and see why... and second, feel free to substitute the euphemism of your choice.)

 

It happened again. 

I went to the doctor for a follow-up appointment and was called into the ante-cubicle-room, sat down and was asked what my "complaint" was. It's always such a funny question to me because it says exactly what I'm there for on the screen in front of her. But, I suppose if the complaint has changed from "ankle pain" to "hair falling out," that would be something to note.

"I'm going to take your blood pressure" as she grabs the cuff, a small one (for my big arm) and heads for my forearm (at least she didn't consider putting it on my upper arm!). "It's not going to fit," I say, yet she continues her forward movement. "It's not going to fit," I repeat -and watch her wrap it around. I didn’t let her get to the Velcro, pulled my arm out and said, more sternly this time, "It's. Not. Going. To. Fit." She huffs a little and has to (oh my god! the difficulty of the chore!) unscrew the small cuff and then, (tell me it isn't so!) has to pick up the large cuff and (argh!) screw it on the cuff thingie.

Knowing my arm (it's really flappy floppy - I really should tattoo the American flag on it or something), even the large cuff dorks out, electronically squeezing the hell out of my flesh, reading, "Good god! What is that under there! I have to do it again." And again. And again. I don't even go there anymore.

Instead, I have the Fake Nurse (the Tech who thinks she owns the hospital) just put the darn thing on my lower arm.

But, can I tell you how many medical people have no idea that that can even be done? A lot of 'em.

I've taken to watching them, amusingly (when I'm bored), try to figure it out. Where does the tubing go? Oh! up where it's supposed to be like the upper arm cuffing (antecubital), right? "It's not reading there, either." sigh (With a manual cuff, I expect a "Hmmm I don't hear anything," but [and I'm not kidding] there are techs that will make up a number instead of admitting they don't know the answer.) No, this is the wrong way to put a cuff on the lower arm.

The Correct Way to put a blood pressure cuff on the lower arm:

Holding the cuff, let the tubing fall towards the floor, the place where the tubing goes into the cuff closest to the floor as well. Then, as you wrap the cuff around the lower arm, the tubing goes over your inner wrist; the tubing can rest in your hand (don't grab it, though!). This can be done with both electric and manual sphygmomanometers (the technical name for the cuff contraption).

Once the cuff is on, the electric cuff can have its button pushed to get it going, no muss no fuss. With the manual cuff, the technician/provider needs to use a stethoscope to listen for the heart/pulse beats.

(An Aside) Sphygmomanometer Tutorial

When we take the blood pressure manually, once the cuff is on securely, we pump it up beyond what we think will be the highest/top/systolic/when the heart squeezes number. I was taught to pump it up to 200mm Hg in fat folks... WAY too tight and high for the fat women I've had in my practice... a nasty assumption that fat women will have high blood pressure. (I have notoriously low blood pressure, so low that, on more than one occasion, the tech thought the cuff was broken!) When I am the pumper-upper, I usually go up to about 170-180mm Hg, then begin the release of pressure.

When we release the pressure, it needs to be done slowly because we’re listening for the thumping of the pulse in the stethoscope (please don’t talk to the person doing your BP; we’re counting.) We’re listening for two things: 1. when the pulse begins (the systolic/upper number) and 2. when the pulse ends (diastolic/lower number). So, say I pump the cuff up to 170mm Hg then release the pressure (with the twisty button) and hear the first thump when the gauge is at 128. The thumping continues, but when the gauge says 72, all of a sudden, the pulse disappears. The person’s BP is 128/74… the 74 being the last number we heard a heartbeat. While we’re doing the blood pressure, we memorize the numbers (repeating them over and over and over) until we write it (the BP number) down. Note the above numbers are all even. It’s not amusing to hear people use odd numbers with manual cuffs because there are no odd number choices. What they are trying to say is: I don’t know what the hell I’m doing. If that happens, ask for someone else to take it.

For typical blood pressure cuff placement, the stethoscope goes right below the cuff at the bend inside of the elbow (antecubital). When putting the cuff on the lower arm, the stethoscope listens inside the wrist (ulnar).

(Aside over)

 In order to get an accurate blood pressure, there are a few “rules.” If any of them are amiss and you are told your BP is high, think about the steps, tell the nurse/aid/doc you want to wait 5 minutes and re-take it again. Then begin the steps.

When they return to do your blood pressure,

  1. MAKE SURE THEY ARE USING THE RIGHT SIZED CUFF!!

This should give you a much more accurate reading.

If a practitioner takes your BP, doesn’t like the number and re-pumps the cuff on the same arm without removing it for awhile, they are doing it incorrectly. That dorky/stupid machine automatically will do the same thing if it doesn’t get a good reading. Ask for a few minutes to rest, without talking, etc., then have them put the cuff on the other arm. If they whine or balk, tough caca; this is your health, in your records. You have a right to have your BP done correctly.

Elevated Blood Pressure Readings During Pregnancy

When the blood pressure is elevated during pregnancy (130/90 is the dividing line, but is arbitrary depending on the person’s baseline… another discussion for another day.), the above steps can be extremely important to do.

For some women, getting their blood pressure done is the most stressful part of their prenatal visits, especially if they are in that borderline or high BP place. If your blood pressure is always higher at the doctor’s or midwife’s office than it is when you take it somewhere else, this is called “White Coat Syndrome” –it has a name it’s so common. The breathing and visualization can help ensure you’re getting an accurate reading. Everyone can practice lowering their blood pressures at will, doing the above steps, with or without having the real BP taken, but these practice sessions can be really important for those with White Coat Syndrome so a diagnosis of hypertension/Pregnancy Induced Hypertenion/Pre-eclampsia is not assumed.

But, what if you’ve done all the steps and it’s still high? The standard of care is to have mom lie on her left side for about 15 minutes before re-taking it, usually with mom still on her left side. This has long been the standard in medicine as well as midwifery. However, I’ve seen a few studies that de-bunk the myth of using the left lateral position’s blood pressure reading as accurate. Perinatologists I’ve spoken to agreed; the practice of putting a mother on her left side, for readings is a false sense of security because the true reading needs to be done with a mom sitting. The issue of left-side bedrest is another issue I’m not going to get into here. This is already too long!

One more short story. In 1993, I fell at a birth center where I was working and went to the ER. The tech, a young guy, took the small cuff and put it on my upper arm. I told him, over and over, it wouldn’t fit, but he kept pumping it up anyway, the cuff’s Velcro noisily unfastened each time. He was getting pissed, so put it on again, roughly, even though I told him to get a large cuff and proceeded to use medical tape (not kidding) to wrap around the cuff to hold it on. He must have used a roll! When he pumped it up, sure as shit, the tape ripped, the cuff fell off –and I started crying. Why I cried because he was the asshole is beyond me, but I wasn’t as “evolved” about fat as I am now. I told him to get his supervisor and when the Nurse came over and saw what he’d done, she was the sweetest and kindest woman, grabbing the large cuff that wasn’t even 2 feet away, talked to me like I was a human and not a blob of flesh and told me she would absolutely correct his behavior as well as explain to him about human dignity for everyone, our prejudices be damned. I hugged her before she walked away.

After that, I realized I had to take the reigns with regards to my fat care; not leave it in the hands of those who should know better. They don’t. But, hey, we can educate them, can’t we! 

Tuesday
Feb192008

Leonard Nimoy & the Fat Chicks

Look at the beautiful photography of Leonard Nimoy!

The Full Body Project: Photographs by Leonard Nimoy came out in December 2007 and takes gorgeous fat women and exposes them in all their beauty. Some of the poses come directly from fine art paintings, such as Matisse's "Dance" seen below.

A wonderful article about the making of the book can be read in this New York Times article.

Simply amazing!


(Thanks to my BarbFriend in New Orleans for sending the links to me!)

Wednesday
May162007

Dark Daughta Responds to Fat Talk

For several reasons, mainly because she is such a fucking amazing writer, but also because she has so many things to say that I wish I'd said - or say inside my head - that I wanted to have her say them for me (or rather, for her Self), I am sharing her comments to two of my posts below. Sure, she "sides" with me, but I believe it is because she GETS what I was saying.

I write an additional small post below her two posts - relevant to Dark Daughta and how she has impacted my writing life each day since I've "met" her, but specifically in relation to these issues and posts.

One of the things in all of this Fat Vagina talk that I realized and have been saying in my private life is that I am astounded the fat activists are upset AT ALL about my saying ANYTHING about a fat vagina. What IF there are women out there with fat cunts?!? And now these women in my blog are screaming about this slim tampon and that tiny speculum and their walls don't fall in and they orgasm just fine and dandy. Well, goodie for y'all! What of the fat chick who IS like the ones I see?! The ones like me? (And don't toss at me that thin women have the same issues because you, fat women, know they don't.)

Shouldn't it be a good thing I am speaking out about women's genitals at all? And marginalized women's at that? And, if I am to be corrected by the few very vocal women who have commented in my blog and the few other who vitriolically wrote about me in Fatshionista's blog (don't try commenting, she only allows "friends" to post... I tried to respond), some REALLY marginalized women?! (I don't believe this is so, but if they do, then let them think this.) (Post-script: I have since been corrected about what Fatshionista is. See "Comments." Thank you for taking the time to explain this to me!)

Anyway, beautiful Dark Daughta (and I am tempted to call her "Tenacious" the way she calls me "Navelgazer") wrote her words first in response to Fat Vagina and then to Fat Angry Woman. I needed to share her posts here because so many of you keep telling me, "Oh, I never read the comments." Well, y'all who don't read the comments - a whole WORLD happens in there! READ THE COMMENTS!

From Dark Daughta:

sigh...
Oh, Navelgazer...
I like when you gaze at your navel and write frankly about what you see there. You are right - we are kindred. It's difficult after years of fire storms real and in blogland to feel the iron bands around a hurting heart loosen at the sight of another using "voice" and blog to just tell it. We live in a fearful time a strangely pc time where speaking messy truths is frowned upon. I heard some of these wimmin (noverbally) saying to you: Shut the fuck up! Who do you think you are? Let's keep stuff hidden if it doesn't line up. Let's just keep putting on a brave face. Don't talk about mess. Don't be messy. There are party lines you are supposed to be following.

Navelgazer, you are a messy, real, confident (which, for the naysayers is really different than fucking being self-centered...internalized patriarchy reigns supreme and only men are supposed to speak their truths assertively without fear...wimmin must quake and hesistate and self doubt so that they can seem sufficiently humble, sufficiently subservient and submissive so that other may know that they are not a threat to their own domination...they're safe)...

You are trying to create space beyond theoretically based party lines that have been extremely useful for fatty wimmin trying to not be killed off by the fat phobia of others. We need(ed) to know that we were beautiful, that nothing was "wrong" with our bodies, that the clothing they made for us was insulting and uncomfortable, that their furniture hated our bodies...the list goes on. In short, they needed to know that they had developed a system of half-truths and out and out lies that harmed us, pathologized us and damaged our possibilities for safe passage through this world. We, not them, gave it a name - Fat phobia.

But the work couldn't stop there. See, we're human, actually collectively along with the weirdo thin people completely imperfect. We're messy. We ooze. We drip. We smell. We bulge. We rub and squish. We're animals, though those who dominate try to forget this fact and attempt to construct realities that say some people are more like animals than others.

That shit is messed up. They are messed up. Actually, we're all messed up.

Navelgazer. Your pooni was fat? Good on you for finding out. Your a midwife and you've encountered lots of fat poonis? Good on you for noticing and sharing what you've seen. Good on you for allowing what you've noticed about your body and the bodies of other wimmin to permeate your practice. Hugs and squeezes for being intelligent and not some sort of shut down medibot health care professional.

You're offering space not inviting obeisance. You even said it somewhere, the writing can serve as a place anyone who reads can fly off from. They don't have to stay where you are. Simpletons.

I'm tingling because the writing I've read over the years of my life have served as so many jump off points. I prefer to bungee jump, choosing only to fly occasionally. :) I've created myself out of explorations, questions, screams, meanderings written out and published by brave wimmin thinking and exposing things no one else ever thought to or had the balls...unh ovaries...to commit to paper or the screen.

You're brave in your vulnerability. Powerful. I feel the earth shake...in good ways...when you walk and gather and distribute what you find, what you know.

Amazon woman. There are too few left. Grow larger. Grow more powerFULL. Write more mess. Write more truths. Your voice(s) are smart wimmin. You've been listening to them. I can tell because some of the herd members are restless.

I used to gauge how bang on I was by how many people wrote in complaining. But now that I've mostly been ostracized...by the political ones who really know what time it is...I just use clustrmaps.

This is me saying that for the few who are here complaining about you saying something that perhaps few noticed, there are thousands reading who are thanking you for just trying, for just having the guts to try.

If it counts for anything, I think I have a fatty pooni, too. I remember one pap smear when I was in my twenties, when I was still a dyke, the woman asking if I'd had children because the spec was just sort of sagging out of my pooni. I giggled and said: No. But, I felt a little stigmatized for having a giant pooni. So, I can see why *some people* commenting here, might be having REACTIONS to what they're reading that might have more to do with their lived experiences and less to do with your observations. It's okay to have reactions. It's not okay to harm other people or make them feel like they shouldn't be speaking or writing because of it. Note to self: Talk more about my own reactions. Locate more buttons pushed by my own shit when this happpens...which is fairly common.

Just because some of you are upset, or feel vulnerable to fat phobia...we all are..., or just because Navelgazer may have written something that invites a broadening of our analysis of fat phobia, invites us to look at the reality of our fatty bodies inside and out doesn't make her the fucking anti-christ!

Navelgazer, I'm not one for drugs or medication. I always believed that drugs would disturb my relationship to my muses, my voices and that surgery would fuck up my insides and forever link me to the medicorp and force me to rely on them.

But, I need to tell you...You are as sharp and brave and honest and unblunted a person as I have found. You are seeking. You are telling.

I don't know the meds you've mentioned. But they don't seem to have put a kink in your program one bit. This is cause for me to re-evaluate my political position and to perhaps think more in terms of continuums of medical intervention.

I can't say it enough: You just tell.

I've only told Papi that sometimes I think about lip for my pannus. I've felt guilty. Not strong enough. Not political enough. Not able to have my anti-fatphobia politic line up with my real life. I've felt haunted and conflicted.

I'm still on track to find ways to continue shifting and decolonizing my perceptions of beauty. My gaze is still infected with fat phobia. I yearn to fully love all of what's here. I've never dieted. I credit being in wimmin's community with having what affection I have developed for my body. It was always so affirming to be gazed on with affection and desire by other large, powerfull wimmin who shoke mama earth when they walked.

Nonetheless...
I have other voices and pieces who occupy space inside me who are not so politicized, not so interested in my bodily love program. I'd like to be able to give them space to speak what they've learned and felt about our body, too.

You had surgery and it felt right for you? You noticed an improvement in your quality of life? You're content with the sizeable fatty woman body you presently occupy? That is enough for me. I'm happy for you and I can see your contentment in your writing and in that wonderful, graceful, beautifully robed photo you published.

One last thing?
*People* need to pay close attention to what you wrote and what you didn't write. You talked about the existence of fatty poonis. You wrote about how best to take care of them. You wrote about the fact that you experienced a loss of erotic sensation.

I'm not convinced that the loss of sensation was about the fat. However, I think that we make do, meaning I've seen stuff written in various wimmin's erotica magazines either in on our backs or in Black lace, which was a black dyke mag I used to read (I'll have to check to make sure) which talks about positions fatty girls could use to increase sensation and pleasure. Now, this might be about the presence of fat or about where the fat is located. But nonetheless, I do remember wimmin writing in asking about positions they could use to maximize access and pleasure.

Navelgazer, you're not out to lunch. You're not fat phobic. I think you're super practical and as a medical health care provider, this comes through in the approaches you use.

I want to have more creative, confident midwives who utilize their own experience to build consciousness which transforms their ability to give care.

You done good.

---------------------------

Dark Daughta left a comment on your post "Fat Angry Woman":

I came here last week, wrote something to comment on your post, signed in and lost it all. Shit.

But, I'm back reading again. Thank you for pannus. I googled it and also found panniculus. I have a flap from child birth, it's called a pannus which is a pouch of skin. When it's on the stomach and from child birth, it can also be called a panniculus. I've been trying hard to love it.

See, I've had a belly all my life. When you wrote about school and the children who made fun of you...tears...more tears...okay I'm typing through the tears...
I remembered how their comments, the way they poked fun at me, how defenseless I felt, how ugly I felt...bigger tears...I still have a cold spot in hell reserved for them...I know I'm grown, I'm supposed to be mature. But my little girl, she's eight, sometimes you read her...she's one of my voices, she's very smart and well-behaved...she just didn't understand why they'd do that. She's still upset about it.

It's been part of my work all these years to try and make space for what she says so she can finally be heard and have her feelings. I'm sitting on a mountain of upset.

Sometimes my teenager, which is another voice I've identified sets things on fire. You read her a lot. She's witty, opinionated, powerful, unrepentant, gleeful. She doesn't give a fuck about people's fat phobia, nope, not one little bit.

She, too, wants to have her voice heard. She, too wants to speak. She can type really fast and likes to put up pictures of our body doing wonderful courageous birthing and just being a fat queer girl who is Black and so unlike the rest of her family.

I have other voices too...my writing is layered with their glorious cacaphony. Sometimes I get annoyed when people in real time drown them out. I think: Hush! I'm listening to a bunch of really cool, smart, insightful, powerful, crazy, pissed off, emotional wimmin. They're all in me and they want to speak. They own my fingers.

When I don't listen they get uncomfortable. They feel erased. They get up to mischief. They seek other outlets. They like peanut butter...a LOT. Hee, hee, hee! I call it my comfort food. When I'm eating it, I don't have to type. I can't just sigh. They like carbs. More toast...with peanut butter.

I have insecure fat hating voices that measure me and my size. I don't own a scale. The teenager absolutely refuses to buy one and the little girl who is logical agrees with her that it will cause more pain and harm than good.

But I do stand in front of the mirror and measure with my eyes. The voices, the positive ones who at this point in my work are much louder than the insecure ones explain again that my feeling this way sucks. They shush the simple, insecure little voices who don't realize that fatty girls very gazes are colonized by those weirdo thin people and the clothes they make to upset us and harm us.

I'm also a tall girl. So finding clothes is doubly difficult. I'm only a size 18 and my fatty self mostly resides around my middle, belly, butt, thighs, waist...

My arms are long, I have some flesh around my upper arms, but it's minor. My hands are thin like my father's. My calves and ankes and feet are thin.

People get confused and distracted when they see me. I often dress to play that up, distracting away from my flesh. I want to stop relying on tromp l'oeuil to dress and feel comfortable leaving the house.

sigh...
I feel less goaded by the voices now. I said some of what's in me, some of what they think and they're at peace...for probably the next few seconds until they start again.

Did I tell you they're in communication with the goddess and with my ancestors. I was going to say: You should see some of the things all the gang pour into my head for me to type when they get ready. They ride me, occupy me, possess me on a regular basis.

This is the first time, I've actually written about the "mechanics" of how and why I write. I'm literally driven. If I didn't the voices would eat me from the inside out. They are ravenous about being heard and I am their vessel.

Thanks for writing about your voices. They seem ravenously craving of attention and a venue, too. From the looks of what you're writing, it seems as if they have your ear and space at your keyboard, too.

-----------------

Thank you, dear sister in writing. You drive me.

I was feeling so shitty about all this misunderstanding stuff the other night after reading what the women wrote about me in Fatshionista's blog... stuff that included words like, "I HATE HER, I REALLY HATE HER," all addressed at me... I was so amazed that these women who had no clue who I was, how hard I fight for fat women's health care rights and how much I love what I do - how their words were blades into my heart... that I registered with LiveJournal because I had to comment to them all. I had to explain to them who I was/am. Apparently, I hadn't shared enough words yet... if I wrote enough, they would understand, right?

I wept as I wrote, reading their words over and over, trying so hard not to take them personally, wondering if anyone ever critiqued The Four Agreements in a negative way and how Don Miguel Ruiz handled it if there was. How could I be so hated because I sneezed a tampon out my coochie? I was so confused.

I kept writing, determined to make it all better.

I thought if anyone lived in Southern California or were planning on visiting in the next year or so, I would take them out to lunch and they would see how much they would love me. I would show them around my center, do a Pap for free, they could pick the speculum size, and we'd be great friends forever.

I began having hints of how absurd this was beginning to sound.

I mean, people who know me in my own midwifery community can't stand me; how do I know a complete stranger is going to take to me just because I take them to lunch and smile pretty. Hmmm.

(Of course, others in my same midwifery community are my dearest friends... same odd political climate as too many female organizations nowadays.)

Finally, I thought of the perfect way to fix it all.

I'd re-write the article to make it all better. I'd take it and remove all the mistakes I'd made, change the language to be less inclusive and voila! Everyone would love me!

Those words HATE HATE HATE chirped around my head like birdies in cartoons after someone's been bonked in the head.

I finished with my complete name, licenses, city and state and hit send to Fatshionista. It said I had too many words. Sheesh. So I had to do it in two parts. I broke it apart and sent part one - and that was when I was told I wasn't allowed to post to her site.

Fine then, I'll post it on mine. All that thought, writing, tears wasn't going to waste! So I moved on over here to Blogger and threw it up.

Exhausted, I proofed it and corrected everything. Was satisfied. Felt so good hitting PUBLISH at 2:30am and went to bed. I couldn't wait to see the comments and couldn't wait to get started on re-writing the article!

Lying in the bed, Sarah's soft rumbles next to me, my long-haired Daschund Cash snuggling up on my hip, I found myself growing more and more awake instead of sleepier.

What the FUCK are you DOING?!

I could hear Dark Daughta in my room.

You are going to re-WRITE something? To PLEASE someone? What mistakes are you talking about fixing?! Those are your experiences. The others are theirs. STOP THIS SHIT! Just because they HATE you?! WHO CARES! Get OFF your ass and grab that post and don't let ANYONE read it.

So I got up, turned the computer back on, and yanked the post about 8 minutes after I'd posted it.

In those 8 minutes, my emotions changed completely because of knowing that someone else knows what it is like to be so disliked, so yelled at, so hated for saying something people disagree with. I've never had that before in my life. I've never ever had a soul in my life that understood the pain of being a writer (and I mean that in the joyous way!) - and it was in the comfort of this one woman, whom I've never met (and probably never will meet) - that I was able to find my spine again and say to the hate mongers: SO WHAT! You don't even know me! You haven't even given me a chance. It makes me sad that you judge someone by 300 words. How does this bode for your voting skills?!? You and I could have been lovers for all you know. We might be in an orgy one day and then talk afterwards and you realize the chick in your arms is me and you really dig me after all because I am not that horrid bitch you judged me to be without ceremony or a wisp of thought.

Oh, sure. You could still think I'm a turd, but who wants to think about that part. laugh

I think the Goddess was soooooooo on my side that night... that I couldn't post to Fatshionista's site! How flippin' cool is that that I had to go to my own blog to put it up? So I could come right back and yank it down!

Oh, Ms. Tenacious. Thank you for coming to me in the early morning darkness, unbidden, but so, so necessary. You were wonderful in that moment that I needed you. You, once again, transformed a moment in my life.

We all need a Tenacious. I'm clinging to the one I have.

Thursday
May032007

Fat Angry Woman

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?

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.

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.

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.

Her name was Topamax.

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.

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.

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.

Fat angry woman? Probably not so much anymore.

Fat, incredible, alive, powerful, amazing woman?

You betcha.