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War on Patients

For all the various experiences I’ve had as a disabled person, a long distance move is a relatively new one. I’m lucky in a lot of ways because the place I’ve moved to isn’t completely new. Although it has been 13 years since I’ve lived here, my parents have been here that whole time. As a result, I have access to certain resources that I wouldn’t have otherwise had. Among these resources is faster access to a family doctor – the same one that has served my family since I was a kid.

I’m lucky because that’s not the case for most people. There is currently a pretty significant shortage of Family Doctors or General Practicioners as they’re sometimes called. Your GP is meant to be the point person of your medical care. They’re responsible for managing the big picture of your overall health – receiving updates from all your specialists, all test results, providing referrals to specialists, and in many cases managing the vast majority of your prescriptions.

As part of my move, I had to transfer my prescriptions from Ottawa to here. Since I was using the same chain of pharmacies, I didn’t much foresee a problem. That’s because I didn’t know about a law that prevents pharmacies from transferring prescriptions that are categorized as narcotics. It’s part of the ongoing war on patients masquerading as the various wars on drugs. The problem is that narcotics are the recognized treatment for a variety of different conditions including ADHD. If I needed a refill of my medication, in this case Vyvanse, I would need to find a family doctor and get a brand new prescription.

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War on Patients

How Not to Trigger Your Friends

With current events being such as they are, your social media pages must be overrun with Kavanaugh hearings. And if you’re a survivor of sexual abuse you may be feeling a bit under attack. I know I and a lot of my friends are. Because of the abuse I survived, I have PTSD. I pretty much have a handle on it most days but when you’re being constantly bombarded with triggering content it can be hard. It’s made especially hard by people who do not tag the content they post properly or not at all.

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How Not to Trigger Your Friends

A Short Update on Me

Earlier this summer, I wrote about my on-coming homelessness.

After I wrote that article, I went into gear getting myself on the subsidized housing list, getting endless notes and forms from my doctors stating my disabilities, my accessibility needs, the fact that it was medically dangerous for me to either go back home, or end up in a shelter, not to mention looking for a place to go. At the start of August it seemed I had a place, then less than two weeks later it seemed that it was not to be, then it looked like I had found a place not just for myself but for two others – but they received over six applications and decided to go with someone else.  For a month, what I was going to be doing for housing kept being jerked around. My landlord agreed to extend the lease two weeks to at least give me until mid-September to find a solution.

In the end, I was left with moving back to the Niagara Area, with my parents.

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A Short Update on Me

How Can Pain Cause Weight Gain?  

For years the assumption has been that “obesity” leads to pain. Many patients have had the experience of looking for explanations of pain issues, only to have the problem never investigated and told to lose weight instead. Then years later, find out that their pain was actually the result of an underlying issue, made worse through a lack of early treatment. You might have seen a comic or visual joke involving a visibly injured patient and the doctor saying “have you tried losing weight?”

In my book, Young, Sick, and Invisible, I discuss how this same trope was directly responsible for my own autoimmune conditions being ignored long enough to cause long term and severe disability and damage.

In a recent post, I had responded to an intentionally insulting comment with a long explanation of how their assumptions about my use of a mobility aid and my weight was influenced by a series of misunderstanding about obesity, pain, and disability. Included among this explanation was the statement that “obesity” or rather weight gain, can often be a symptom of chronic pain rather than it’s cause.

In response to this statement I received a question, and while the phrasing made it clear the comment wasn’t actually a legitimate inquiry but another chance for the commentor to engage in fat shaming, the underlying question sparked my interest.

Heavily edited, the question was this:  

“I understand how obesity can contribute to pain by putting stress on joints, but I don’t understand how the opposite can happen. Can you Please explain it to me and help me understand? How does Pain cause Weight Gain?”  

To begin, the concept of “obesity” is widely misunderstood and is oppressive in and of itself. As a knowledgeable friend recently explained it –  The word is based on the Body Mass Index scale (BMI) where the ratio of height and weight was determined and everyone who scored within certain parameters was considered as having a healthy BMI while anyone whose BMI was above this range was deemed obese. A person who had very little body fat, but was very muscled, especially in relation to their height, would be classified as obese. In fact, since muscle tends to weigh more than fat, a body builder is more likely to be classified as obese than what most people consider to be representative of an “obese” person.

The concept that obesity is synonymous with fatness is a misunderstanding that has become accepted as a standard, and is used by doctors to excuse their own medical negligence when it’s the result of internalized biases regarding fatness.

What’s more, more and more evidence suggests that body fat percentage is not actually a reliable indicator of an individuals health, nor is there actually a reliable standard as to what fat percentage can be considered healthy and which is unhealthy. That rather fat distribution and percentage is really just a variation in body type much the same way that shape, height, etc. are.

The attempt to pathologize fatness ultimately makes as much sense as claiming that a certain eye colour is an indicator of overall health. Contrary to popular belief, just being fat is not in itself unhealthy.  A fat person can be just as healthy as someone who is considered slender. What is unhealthy is when there is a sudden significant increase or decrease of body fat percentage outside of regular growth and development. In the specific case of an increase in body fat levels, what is unhealthy is when it is spurred by malnutrition, stress, and immobility which in addition to spurring weight gain also have a measurable negative impact on blood pressure, blood sugar, and arterial plaque. Even in this case, it’s not the weight gain in particular that is of actual medical concern, but rather the specific effects on those measured stats.

The medically accepted myth that fatness all by itself is unhealthy is another example of the fallacy that correlation signifies causation. Additionally, this accepted fallacy has had significant impacts on our social understanding of body size and health. 

A more accurate way to look at the connection between a high body percentage and pain would be that it can contribute to pain when an underlying problem exists, and when the specific individuals natural body fat percentage is significantly lower than what it is now. There are many people out there who are fat, who not only experience no pain whatsoever, but also have perfectly healthy stats.

In fact, the social convention of proper weight is so distorted, that the little abdominal bulge many women spend years trying to eliminate, is actually not the result of fat but is actually their internal organs pressing up against their abdominal wall.

Weight on it’s own, doesn’t cause pain. Rather, in an event that someone has an underlying condition that may cause pain, carrying more weight than their body naturally would under optimal conditions, can put additional stress on the injury site and make pain more intense. The impetus for the pain however, is still the initial underlying injury or condition.

What many ignore is that pain and its related symptoms can actually be the cause of accelerated weight gain and that the best way to address both is to treat the underlying cause of pain and to treat the pain itself.

How can this be?

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How Can Pain Cause Weight Gain?  

Stolen Freedom

Last year, I received one of the best gifts I’ve ever received. A kind family donated their departed matriarch’s wheelchair to me, after I had previously been told that my pain and inability to stand or walk far distances was not valid criteria to qualify for the accessibility device program.

Having access to the chair opened up worlds to me that I had long been unable to experience. I was able to go back into nature again, to explore my neighbourhood, my city, more thoroughly and comfortably. I was able to enjoy the outdoors more thoroughly than I had in years. I could even play Pokémon Go, without having to be the passenger in a slow-moving vehicle.

I met many of my neighbours and became an actual part of my community.

Although I was facing the fact that my marriage was falling apart, that I was facing even more financial vulnerability and hardship than I had already dealt with for the past seven years, I felt better about myself than I had in a long time.

I felt more a part of the world than I had before.

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Stolen Freedom