Old habits really die hard

I'm talking about overeating and grazing of food. I'm back onto that wagon again. I wasn't able to graze or mindlessly eat in the first few years after my gastric bypass, but I have found in the past year, that I am grazing more and more.

And what has that led to? Yes, weight gain. Only about ten pounds in the past year, but it's still ten pounds.

I have read about obese people having food addictions (yep, I can definitely relate to that). And then after weight loss surgery, we (the former obese people) have transfer or cross addictions. For some, it's shopping (been there, done that), others it's alcohol or drugs, and for others it may be something else entirely - maybe a caffeine addiction (hello! That's me!). Or maybe even a transfer addiction to sex.

I tell you, just when you think your brain has been rewired enough to not have a food addiction, it pops back up again. I think that THIS is probably one of the least discussed subjects BEFORE weight loss surgery takes place. Or, you think it won't happen to you.

But it does.

And it sucks.

I do not want to ruin my "tool" a/k/a my re-routed, malabsorptive GI tract. I don't want to have the overdistended pouch that can tolerate larger and larger quantities of food. But most of all, I don't want to be obese again.

The key to fixing this problem? Realizing that it's a problem, and that it exists. Getting my ass back into a regular exercise regimen. Yeah, I have definitely let exercise sliiiiiiiiiiiiide to the back burner since I've been in school. Especially this past year!

I need to find that inner motivation, and get moving more. I wonder how much I will sacrifice to find that motivation? Family? School?

I fear that school will get worse before it gets better. In other words, clinical time is going to be pure hell when it comes to neglecting my family and myself. Physically, I anticipate it will be very draining, and the lack of sleep during that time may really get to me. You see, I have to work - I have no choice. I am the major breadwinner. It will be work and clinicals - which will be a very draining schedule.

So much to consider, so much to worry and think about.

Bias in healthcare

For one of my classes, we had to write a forum post about specific instances of bias in healthcare that we have either experienced or have witnessed. I wrote about weight bias in healthcare - specifically on L&D.

Obesity is a huge issue. Not just in one area of nursing, but in all fields. Bias against obese people is also another huge issue. (No pun intended.)

Without totally copying and pasting what I wrote for my assignment, I'll just hit the highlights.

Nurses have biases. We are not supposed to, but we're human. It doesn't make it right though.

I get frustrated when trying to maintain continuous EFM on obese pregnant women. It's frustrating for me because: the signal for the fetal heart rate doesn't stay consistently in place due to the difficulty in transmission through the extra adipose tissue. Sometimes I cannot even find a FHR on a very obese woman - that is just how difficult it can be, at extremes. I find that I cannot "allow" the woman to move out of a supine position, or I cannot trace her baby. This is especially so if she is on pitocin. If I can't trace the baby, I can't run the pitocin.

Physically, it's getting harder and harder on my own body to push a 300+ pound woman on a stretcher. It just about kills my back, legs, knees and feet.

Same thoughts on holding a leg on an obese woman when she has an epidural and is pushing. I just don't do it anymore. I need to save my back.

The irony of my own biases and judgments that I sometimes think in my mind: I used to be that 300+ woman! How can I - of ALL PEOPLE - make assumptions and judgments on obese women?

Some interesting reading:

Puhl, R., Moss-Racusin, C., Schwartz, M., & Brownell, K. (2007, September 19). Weight stigmatization and bias reduction: perspectives of overweight and obese adults. Health Education Research. doi:10.1093/her/cym052

Schwartz, M., Chambliss, H., Brownell, K., Blair, S., & Billington, C. (2003). Weight bias among health professionals specializing in obesity. Obesity Research, 11 (9), 1033-1039.