A History of Wake-Up Calls

Almost four years ago, I stepped on the scale in my reproductive endocrinologist's office. Having had several miscarriages, I was determined to find out what was wrong with me - what was wrong with us, as Z might be a factor - and have a healthy pregnancy. At this point, I knew I was heavy; I just don't think I realized how heavy I was.

The number glaring back at me from the scale seemed unreal, impossible: 213 pounds. There had to be a mistake. I hadn't weighed myself for months, but there couldn't be any way that I had toppled over 200 pounds...was there?

My RE, Dr. H, held a copy of my driver's license, being standard procedure to have copies of all patients' licenses. He frowned at the picture in front of him, and then frowned at me.

"How long ago was this picture taken?" he asked. I knew where he was going, and I felt my face flush.

"About 3 years ago," I mumbled. I remember well. It was driver's license photo taken after I returned from my honeymoon where I was "wedding-thin". Brief pause.

"You mean, you've gained almost 80 pounds in 3 years?"

"Maybe less," I argued. "I think I might have weighed a little more than 135 at that point." This fact had no impact on Dr. H. He proceeded to explain that I was almost 60 pounds overweight and was about 30 pounds into the obese zone.

Obese? Not me. Other people were obese. People who had to have custom made clothes, who had to use scooters because they could no longer walk. There was no way I could be obese. I still fit into most stores' clothes, albeit from the "women's" section. As this was before my RA became bad again, I was still able-bodied and could moderately exercise still, if I choose. So, no, I couldn't be obese.

But I was, and in order to not be obese anymore, I needed to lose about 30 pounds. Then, and only then, would I not be obese. Just overweight. Fantastic.

Dr. H's orders were clear, no-nonsense, and included a thick handout of instructions to follow. I was to lose 30 pounds (at least) while following what can best be described as a diabetic diet. No refined sugar or starch, lots of whole grains, veggies, complex carbs, etc. He explained that having a healthier weight (and, by virtue of following the diabetic diet, a healthy blood sugar) could only help my pregnancies, that it wasn't necessarily my weight that caused my miscarriages, but why not increase my chances all I could?

I sat, crying in his office, feeling ashamed, mortified, in disbelief. Obese had never been a word that I thought would apply to me, and never had I thought it might, in any way, impact my unborn children. But my tears were tinged with motivation and desire, an early indication that my health was no longer my own and belonged equally as much to my children, whether born or not.

I started my diet that night, and the next day, the scale slipped down 3 pounds. My body liked this new diet. The weight shed incredibly fast, and once I threw in some treadmill walking, it slipped even faster. Weeks later, I became pregnant with my daughter. I started heparin (a blood thinner, as I have a history of blood clots), continued to eat healthy throughout my pregnancy, and boom, healthy baby. I suspect the heparin is primarily responsible for carrying to term, but I have no doubt that my healthier weight contributed, too, if only by not causing as much wear and tear on my body.

Everyone has their own wake-up calls. For some, it's seeing photos of themselves. For others, it's being told by a concerned loved-one that it's time to start monitoring the scale. Others, like me, have their attention brought about by a doctor, but with health implications. For me, it was more than my own health; it was my kids'. Double health implications.

Today, it's easy to turn a blind eye to what obese actually is. Many (such as myself) just picture morbidly obese but happily ignore those who are on the lower-obese (yet still make-no-mistake-about-it obese). I remember seeing old episodes of "Friends" where they flashback to Monica's "fat" days. To me, she never looked fat. Chunky, sure, but so was I. On the show, she was continuously riddled for her weight, implying she was enormous, unfathomably huge. Then it was mentioned she weighed 200 pounds. 200 pounds! Heck, I weight MORE than 200 pounds! So, what did that make me? And thus was born yet another (yet, perhaps somewhat ridiculous) wake-up call. I was heavier than I thought I was. The depiction of poor Monica was unfair, to be sure. I'll be first to admit it, as will others who fight their weight who never thought Monica was as heavy as they described her. But at the same time, it proved the idea that I so stubbornly resisted: obese is a lot smaller than most of us realize. And I fit the criteria.

For over two years, even throughout my pregnancy with Thor, I've maintained a healthy to semi-healthy (read: slightly overweight, not obese) weight. This most recently weight-gain, though, had me on the fast track to obesity again. The scale was sliding too close, and stepping on that scale for the first time in weeks was the latest wake-up call. These days, I weigh myself daily. For the past almost 5 weeks, I haven't missed a morning of stepping on my scale. Some may advise against daily weighing, but for me, it is a necessity. I need the daily reminder. I need the daily wake-up call that I can no longer just sit aside and pretend that the number isn't creeping up. For me, it's about accountability. It's when I avert my eyes that my weight becomes an issue. Whether I like the number in front of me or not, I at least need to know what I'm dealing with so I no longer become as happily ignorant as I was 4 years ago.

In happier news, I saw my rheumatologist yesterday and my Humira dose got increased to every week from every other week. That means more days of feeling well with fewer days of feeling icky in between. In one month, if I'm not better, I'll start Imuran, the disease modifying agent. I'm not terribly thrilled at this prospect, but will do what it takes to feel better. After not feeling well all of last week, I took my Humira injection on Friday and felt better within hours. This is a good sign. It works, just wears off quickly, hence increasing the frequency. I just hope this works.

This weekend, I managed to eat healthily and the scale reflect my progress: I'm almost 17 pounds down from when I started. Amazing how just changing little habits makes such a big difference! My desire is just to make these "little habits" permanent, so no wake-up call is needed in the future.