Saturday, July 4, 2015

The Myth of "After"

I sat in the doctor's office, flinching as one needle was inserted into arm to take my blood.  Then in went another needle for a local anesthesia.  Terrified, I waited for them to centrifuge the blood and remove the platelets so that yet another needle could be inserted into my right arm and inject my blood right back in.  Once the doctor began sticking me repeatedly, I was glad I had had that second needle.

It's called PRP - Platelet Rich Plasma - and it's a highly controversial and experimental treatment that isn't covered by insurance.  My generous husband had to write me a hefty check (we are fortunate that we don't have to pay for our own vacation this year).  My doctor and my hand therapist both recommended this treatment saying many patients have had success with their pain from this.  I still have my doubts.  I do know that there is a recovery period.  I'm going to be in pain for a while and I will have to back off activity for quite some time.

The post-surgical pain in my hip is 90% gone.  Only very extreme or deep movements cause me pain now.  Occasionally I overdo it and I will have sharp pains with everyday movement.   It has taken far longer than I expected to feel better.  Back in November I wondered where my body would be once I came out on the other side.  I am learning there is no other side.

When I first planned my surgery I imagined that I would rest as long as I needed to, but I would return to whatever levels of activity I could handle as soon as possible.  I imagined I would spend the winter resting my hip while working on my bench presses and pullups.  I would not get out of shape. I would stay firm and fit.  There was no reason to heavily disrupt my workouts.  Sure my lower body would be weaker, but I wouldn't be losing significant amounts of muscle.

By now everyone reading this now knows the story.  In my eagerness to keep my upper body conditioned, I overdid it at the gym before I even had the surgery.  I did some serious damage to my elbow and for the past 9 months have had a raging case of medial epicondylitis (AKA Golfer's Elbow).  A recent MRI showed not just inflammation, but a tear.

How did I spend my winter?  I spent it doing low impact cardio and rehab exercises for my leg, building up strength over time, but having to lay off upper body work completely.  If anything my lower body is probably stronger than my upper body now.  Unfortunately, even though my surgeon cleared me for normal activity, I still can't bring my lower body to its previous strength levels.  I can't hold weight as it puts pressure on my elbow.  At best I can do a back squat with a light barbell behind me or a front squat with the lightest Body Bar, but I can't deadlift with any weight. 

My body has officially returned to its 2012 state.  Actually, it's even worse than it was in 2012.  When I was previously at my heaviest, I was at least in good muscle condition.  Now I am back to my heaviest weight and my body has become soft and flabby.  Two weeks ago at the gym I had trouble picking up a 15 pound weight with my good arm, which means I am significantly weaker as well.

In 2013 and 2014 I threw away what I thought of as my "fat clothes", believing I could maintain my weight loss and would remain at my smaller size.  After all, why shouldn't I stay that size?  I had the skills.  I had the habits.  I had killer exercise routines.  Those old clothes were my "before".  I was living my "after".

It's summer now and I took the seasonal shorts out of storage.  Most of the shorts I own now are ones I purchased last summer.  The first hot day we had I tried them on.

Every last pair is too tight.  Some are just a little tight.  Some are unwearable.  Some are not only tight in the waist, but tight in the thighs as well, making my legs look stuffed into them.  The crotch rides up on the shorter pairs, exacerbating the "chub rub".  The longer ones are too tight in the waist to sit down without pain. The pain I feel from the binding waistbands of last year's shorts is nothing compared to the pain I feel of how far I have fallen away from where I was.  I am going to have to replace my wardrobe once again with bigger clothes.

Every weight loss program out there promises a Before and After.   Even the sensible, moderate, Lean Eating program had me take pictures at the beginning and the end of the program.  Before and after implies a certain permanence.  The "before" is what you were.  The "after is not just what you are, but what you will be."

As children we read fairy tales and are told, "They lived happily ever after."  No one tells us how.  What did the prince and princess do to live so happy forever?  Did they argue over whose turn it was to do the dishes?  Did they have bratty kids?  Did they suffer any tragedies together?  We learn to accept "after" as a ongoing, blissful, unchanging state at an early age.

The painful lesson we need learn is that there is no "after".  There are no guarantees that you can change your body forever.  Life throws curveballs at you all the time.  The fitness industry - and really society at large - teaches us that we have complete control over our bodies.  How we feel and how we look is completely dependent on our own choices.  If we are overfat or out of shape or simply unhappy, it is because of what we are doing or not doing.  We are taught a nutritious diet and plenty of exercise is the cure to all ills.

So what happens when we see people who were once fit fall out of shape?  What do we think of someone we don't know who is appears to be obese? Do we assume that person eats too much and doesn't exercise?  Are we kinder and wonder if she has an illness or takes medication that keeps her fat?  Do we think he has a hormone problem?  How do we know that fat person didn't use to be much fatter and is still doing well on a weight loss journey?

I wonder what my fellow gym goers think of me.  Many of them complimented me on my weight loss.  Now that I'm 20 pounds heavier again, they don't say a word.  Hardly anyone asks me how I'm feeling.  Do they just see the chubby girl doing pathetic workouts?  Do they see I'm injured?  Do they think I couldn't hack it?  Part of me thinks I'm being rather egotistical to think anyone notices me at all, but part of me knows that in the gym we're always judging bodies - even when we don't mean to.  If they noticed me when I was in shape, they must notice that I'm out of shape.  Do people who don't know my story see me gain weight and fall out of shape and think that I just gave up?

I have little control about how people perceive me, but I have learned I have to change how I see myself.  My belief used to be that I may never have been the thin girl, but I could be the fit girl. I could be the active girl.  I could be the girl who was always doing something.  What exactly am I now?  Perhaps I'm the girl who did too much?  Maybe I'm the walking example of why exercise and fitness obsession is dangerous.  I never thought of myself as unhealthfully obsessed.  I just thought of myself as someone who liked being fit.  I was never one of those women who worked out two hours a day and shunned all sweets.  I was just someone who liked to make sure her daily, reasonable, workout was done to the best of her ability.

Now I am second guessing myself as to whether or not I was too obsessed? Was I too hard on myself?  I have told my story about how I injured my elbow in compensation for not being able to use my lower body to many friends. They came back with the same responses.  "You need to relax."  Take it easy on yourself."  "Just rest." How much rest and relaxation have I allowed myself? There is always a part of me that feels compelled to keep doing something - anything.  I don't like sitting still for long.  Where do I draw the line between taking care of myself by resting and taking care of myself by making sure I don't fall into unhealthy weakness?

That's why there is no "after".  Everything is a process.  Nothing is final.  "After" is the big lie the fitness industry sells you.  The process that gets you to that final photo may have been filled with moderate exercise and nutritious food, or it might have been filled with starvation and excessive workouts.  Once you take that "after" picture, what process is in place to maintain it?  Is the process sustainable?  Even if it seems sustainable (it seemed to be at the time I finished Lean Eating), you never know what can happen to change it.  Illness, injury, and major devastating life events can intervene when you least expect them.

So what am I doing now?  What is my current process?

I ride a little bit, although I have to back off making my horse do a lot of advanced work. Heavy usage of my right leg can be painful.   It can be useful in lessons when I'm struggling to get my pony to do a haunches-in and I can stop by honestly telling the instructor it hurts.

I do low-impact cardio.  It's warm enough and light enough for long morning walks.  I use the bike and elliptical and can handle some pretty intense intervals with them.  I even do my old Core Rhythms DVDS as it miraculously doesn't hurt my hip (but I avoid Zumba because it uses too much arm movement).

I use my lower body work to focus on movement rather than strength. For example I deadlift without weights by doing single-legged deadlifts.  I concentrate on extending my leg and pointing my toes when I reach behind me, which I hope will keep my legs in form when I return to dance class.  I also do plie squats with (low) side leg lifts, which help me with turnout as well as the previously-mentioned leg extension and toe pointing.  I do the glute bridges that my surgeon has had me doing all along.  I can squat as long as I don't go too low and I can even hold some light weight in front or behind.  It's not much, but it's what I can do, and I keep doing it because I know a little bit is better than nothing at all.

Fitness experts and mental health gurus (sometimes ironically) tell us to love our bodies no matter what.  Love is a pretty strong word when it comes to my body.  I haven't reached a love stage yet.  I tend to grow angry with my body for insisting on holding on so tightly to its fat.  I am angry that it takes to long to build muscle when some women put on muscle just thinking about dumbbells.  I am angry with my body for constantly breaking down when all I am trying to do is keep it fit.  Still, it's the only body I have, so I understand the need to take care of it.  I keep exercising it to the best of my ability.  I try to eat well.  I spent the last few months on The Habit Project, just trying to keep my diet nutritious,although it did nothing to change my weight (which wasn't the point of the program). 

The hard part is learning to simply accept where I am, but that's what I need to do.  I often seem to be looking at the future, waiting for that day when I am pain free.  I gather training programs and make notes of exercises people do at the gym for that glorious day when I will be able to get back in shape again.  I don't know when that day will come.  It could come in three months or it could be another year.  It is entirely possible that day will never come.

For the next few months or the next few years, I have to live with being fat.  I have to live with a BMI that is well over overweight and borders on obsese.  It's not just the numbers.  I have to live with how I look.  I don't like the way I look right now.  I see my photos from my previous post regarding my Stitch Fix box and I just want to cry.  That's not supposed to be me.  That's not what I want to look like.  Regardless of what I want, it is what I look like.  I can't do much to change it unless I'm willing to radically change my eating habits.  I take far too much pleasure in food to do that (and I don't want to be "skinny fat" anyway).   I have to learn to deal with it.  I must buy clothes that fit instead of mourning the clothes that don't fit anymore.  I need to learn to adjust to seeing what I look like.  If I'm going to have my picture taken, then it's time to find something positive in each one.  I can avoid having my picture taken (something I have done all my life) but I can't go on vacation without being in photos.  One important aspect of enjoying vacation memories is having photographic proof I have been there.  As for the dreaded swimwear - I will not let body image stop me from enjoying the water on a hot day (or an indoor pool on a cold one).

When it comes to fitness, when it comes to changing our bodies, there is no "after".  There is no magical place you will come to at the end of a journey.  The journey has no end and there is only now.