Something that I’ve never actually seen talked about is the way that a chronic health condition can affect the way that one views their own body.
I consider myself incredibly lucky as a young female, that I’ve never particularly struggled with having a positive body image. In some ways I suppose it’s because that, to some extent, I conformed to what the media deems “acceptable”, in that I was reasonably petite, and fit comfortably in most size 8 clothing (I say ‘most’ because, as anybody who wears women’s clothing will know, measurements differ from retailer to retailer, even if they’re labelled as being the same). There were various aspects of my body that I perhaps wasn’t overly keen on, but I wouldn’t go as far as to say that I had a negative image of myself. I never had any qualms about wearing a two piece swimsuit on the beach for example, and since I started adding tattoos to my skin, they generally made me feel much less self conscious. I’ve never struggled with my weight and I had a fairly decent metabolism – which was handy because I’ll be the first to admit that my diet was complete rubbish for quite a long time.
This isn’t me bragging about being thin, or attempting to “body shame” anyone who happens to be bigger than me, not at all. I want to stress early on in this post that there is absolutely nothing wrong with you if you don’t conform to the media stereotype of being slim and slender – and I am not in any way saying that my weight gain (or indeed weight loss) is a bad thing. I can not and will not pass judgement on the shape and size of anyone but myself – and I can only write from my own perspective on how the way my body is changing makes me feel.
Before I was diagnosed with Fibromyalgia, I was pretty active. I worked 40 hours a week doing an intensive, physical job (grooming may not look intensive when we’re thinning out the feathers on a long-haired Chihuahua, but if you’ve got a 40kg German Shepherd that REALLY doesn’t want it’s nails clipped, then it’s pretty heavy stuff), and then going to the gym twice a week to try and improve what I thought was my poor physical fitness (but turns out it was just fibre after all!). My diet wasn’t great – it was definitely high in fat, saturated fats and sugar but, somehow, I managed to avoid gaining too much weight. In the few months before my diagnosis, I consistently weighed 50kg, or 7.8st. – the average for my age and height being between eight and ten stone. The last time I was weighed, eight months after my diagnosis, I was at 57kg – or 9.1st. While that’s still very much within the healthy average, and nowhere near being “overweight”, seeing that number flashing up on that little screen made my stomach drop through the floor – but I honestly can’t tell you why.
I’d noticed slight changes as time went on. There were stretch marks on my thighs that weren’t there before. There was a little more poking over the waistband of my trousers, and the zip on my Topshop Joni Jeans kept undoing itself without warning. While drying dogs in the salon, I could feel the backs of my arms rippling more, and I’ve gone up nearly two cup sizes. I’ve put on nearly three stone in two months – and there’s a number of reasons why.
Firstly, my exercise and general mobility has decreased massively. I know that there’s a running joke that exercise is evil and the average Joe/Jane is horrendously unfit and that people that exercise regularly and enjoy it are either mental or viewed as some kind of superhero – but even something as simple as getting up of the sofa can feel like a marathon to someone with chronic fatigue. I hate using that term, because unless you genuinely have run a marathon (which I haven’t) then it’s not a particularly relatable comparison. I was trying to explain this to someone the other day – and the closest every-day situation I could think of was The Supermarket Shop.
So you’ve done your shopping, got it all in bags and you drive home, park your car and start to unload your shopping. You reach Full Capacity – by which I mean you run out of hands, and you’ve got maybe six or seven bags full of shopping – some are heavy, some not so much – but there is no way in hell you’re making more than one trip, so you’re committed to stacking up as many as is humanly possible. You’ve got a bag on each wrist, then at least two in each hand, and you’re struggling down the driveway like a human donkey.
You know that weak wobbly feeling you get in your arms and/or legs when you’ve been carrying something heavy for a long time, and you start to think “oh God this is actually really heavy, I need to put this down or I’m going to drop it” – that’s how chronic fatigue feels, except it takes a great deal less weight for us to reach that breaking point. It happened to me the other day when I was stirring a cup of coffee – suddenly my arm was so tired that it felt physically impossible to keep stirring. If I walk slightly too quickly, my legs feel like I’ve just walked up a dozen flights of stairs, when in reality I’ve walked from the living room to the kitchen (which is awful when you consider that in our flat, they’re literally in the same room). Because my body gets so, so exhausted from the tiniest little bit of activity, I have to consciously dedicate a great deal more energy to exercising than the average person – which feels impossible, because I still have to function on a daily basis and go to work, look after my home, cook and clean, go shopping – all the every day things that it’s already very hard for me to do without the added thrill of running a mile. I never know how my body is going to react one day from the other – I may wake up the following morning and feel absolutely wonderful, but the next time I could wake up and need three days to rest and recover before I feel “normal” again. It’s unpredictable – and a lot of the time, it’s not worth the risk. If I go up the stairs a bit too quickly and tire myself out, it’s impossible to differentiate between “I’m tired because I’m unfit” and “I’m tired because I have Fibromyalgia”
Secondly, I take medication. I take three different ones to try and keep things under control. The first one – and the main one – is Amitriptyline, which is traditionally an antidepressant. When I first started taking it, the Doctor told me to “start off with 10mg before bed and see how you feel. Continue that for a week and then, if you need to, increase it to 20mg. Again, after a further week you can increase it to 30mg.”
The first night I took it I prepared myself, popped my pill and within an hour, I was dead to the world. I woke up to my alarm the next morning because I’d arranged to go for coffee with a friend, and I felt properly weird and woozy. The friend in question knew about the situation and had some understanding of the side effects so was super flexible and sympathetic so we pushed it back a little bit. Even after another hour or so of just dozing and generally trying to stay awake, I still felt drowsy and sleepy, and that feeling hung around until early afternoon before I started to feel normal again. “Great”, I thought, “I’m going to be an absolute space cadet for the rest of my life”
Fast forward to now, and I’m taking 100mg every night before bed – 10x that starting dosage. While it does help me sleep, it doesn’t always make me feel any more drowsy than I do in general (although the amount of activity I’ve done over the course of the day seems to affect it), and one of the many, many inconvenient side effects is weight gain – and not just weight gain, but RAPID weight gain – which makes things an awful lot harder to control.
Another drug that I take on a daily basis is Citalopram, an SSRI. I’ve been on and off Citalopram for a number of years for various reasons – a long time before fibromyalgia took over my life. It was originally a remedy for anxiety and depression which I stopped needing after a while, but I started taking it again towards the end of last year to treat what I now know is Seasonal Affective Disorder (or as it’s sometimes known, Seasonal Depression. I’ll do a post about that at some stage during the future). Within days of starting to take it again, I noticed a massive difference in the way I was feeling – I’d been tearful and overly emotional for months, but I hadn’t realised the extent of it until then, when that feeling suddenly went away. To be honest it was a little bit alarming how fast my mood improved, because it usually takes about six weeks or so for SSRIs to kick in. I’d assumed that it’d had a more instantaneous effect this time because my body was already used to it, due to my having taken it so many times in the past – but my doctor pointed out that it was more likely to have been because both Citalopram and Amitriptyline are antidepressants, so the combination of the two together sped things up a bit. It made me feel a bit mood-swingy to start with, but once things had settled down then I felt so much better. It’s another drug with a lovely list of side effects – so when I was comparing the two (long) lists, I was disheartened to learn that it also has “weight change” listed as a side effect.
A slight sidebar here – it turned out that being back on the Citalopram has not only done wonders for my mental health, but it’s helped me out MASSIVELY with the Brain Fog and cognitive impairments that typically come with fibro. It’s made it easier to think more clearly once I’ve taken it, and I can process information more quickly and accurately than before. I also think that because it’s caused my mood to increase, I’ve been more productive and creative, and I’ve felt more inspired. I will write something about SAD and my antidepressant journey at some stage – but for now, I’ll stick to talking about my increasing muffin top.
The third and final prescription drug that I’m using to help keep things under wraps is actually an oral contraceptive called Loestrin. I realised pretty early on that my flare ups and pain levels seemed to be linked to my menstrual cycle, and that the times of the month where I’d feel worse would generally line up with certain points in the cycle, particularly when I was ovulating. My doctor suggested that an oral contraceptive to try and control my hormone levels would be a good starting point, and I started taking Loestrin, which contains two female hormones. Initially I was taking one every day for three weeks, then stopping for a week – during which time I would (theoretically) have a “period”, and then after those seven days I’d start a new pack. This started out okay, but after a few months when my body had gotten used to it, I began to get flare ups during the week I wasn’t taking the pill. We then tried a different angle – do three packets one after the other and then take a four day gap. To be honest at this point, I have no idea if that’s worked or not because I haven’t been doing it for long enough – but maybe I’ll do another post about that once I’ve figured out what’s going on.
Guess what one of the main side effects is with oral contraceptives?
Yup, it’s weight gain – but I’ll admit that I did know that before I started.
Basically I don’t have a hope in hell of maintaining my previously perfectly toned and sculpted abs* when the odds seem to be stacked against me like pancakes.
The other aspect of this that’s made me a little more self conscious about the way I look is the pain that typically comes with conditions like this. It’s always very difficult to point out “what hurts” when I’m asked, because it’s literally everywhere – and I don’t mean everywhere like “oh it’s my joints” or “oh it’s my arms and my legs” because it’s honestly, everywhere. I’m constantly hyper aware of parts of my body that I wasn’t before – because I can constantly feel them. For example, the backs of my hands – I’m willing to bet that most people don’t think about how the backs of their hands feel on a daily basis, unless you were to specifically ask them (although why would you, that’s weird), but I quite often have to stop and take a second to regroup, because I get constant shooting pains that seemingly come from nowhere and go vertically across the backs of my hands. The joints in my toes as well – and my collarbones, that’s quite a big one. The most recent one to stitch me up has been my jaw – I’ve found that if I’m having a bad day for pain and I eat something that’s chewier than say, soup – the pain juts from the hinge (?) of my jaw in front of my ears, and up the sides of my face to my temples. I literally get out of breath from eating something that’s too chewy – which is an irony that I honestly didn’t think I could reach.
Because I can feel each individual part of my body aching in some way, it means I constantly think about them – and by extension, I sort of have to be aware of what they look like.
I can sit here and complain all I want about this weight that I’m gaining – but in truth, I haven’t done a huge amount to try and lose that weight. While exercise is difficult for me, it’s not impossible, and there are activities that are actually quite Chronic Illness Friendly to a certain extent. I was recommended to try Tai Chi, and myself and Clark did briefly go swimming regularly – which was actually a lot of fun, and I turned out to be a great deal better than him to start off with because the first time we went, he over exerted and made himself sick.
He literally got out-done by someone who can’t pick up a pen without having to lie down.
We did continue to do that about twice a week – until we both got colds at the same time and missed a couple of weeks, promising ourselves that we’d go back and try again once we’d gotten over it. That day has yet to arrive – and truthfully, I don’t know where my swimming stuff has gone since we moved.
Conditions like this are a vicious circle, in that you’re too fatigued to exercise so you put on weight, and because you’re then carrying more weight, it’s more tiring to exercise. When I was healthy, I had the mindset of toning myself up and becoming “strong not skinny.” I don’t think I ever really fully committed to that school of thought, but I also didn’t ever think I was fat or needed to lose weight – more that there were aspects of my body that I thought weren’t quite the shape that I wanted them to be. Looking back on photos that I took at the time to “track my progress”, I realise that there was absolutely nothing wrong with the way I looked – and there isn’t now either, but despite that I find myself wishing that I could be that size again.
I have always been a big fan of promoting body positivity, but I felt like because I was thin, young and white, I didn’t really have the appropriate platform to do so. I think the reason that I, personally, felt happier when I was thinner is because I fit the stereotype just enough to be ignored. I wasn’t too much of each extreme to stand out, or to have people scrutinise my body the way they might others. Obviously I know that it’s wrong to shame anyone for the way they look, regardless of age, gender, skin colour or size – but I was lucky enough to not really experience anybody trying to do that to me. I know that I will continue to put weight on with the way my lifestyle is at the moment, and ideally I want to start making tracks to change that. While a lot of it is down to my condition and the medications I use to control it, I can’t place 100% of the blame on those things, and I know that I need to take some responsibility for that – but I also hope that if my physical condition does get worse my mobility gets drastically reduced and I continue to gain weight faster than I lose it, I hope that I can learn to love my extra curves and feel comfortable and happy in my skin, no matter how much of it there is.
Am I going to commit to making Fibro Friday a regular thing? Who knows.
Once again, thank you very much for reading.
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