What. Just. Happened: Professional Denial (Part 1)

I can’t pinpoint exactly the day it started; honestly, not even the week. If you held a gun to my head I might guess January 15th, 2014 – or some day in the middle of January, perhaps. But of course that would have meant that I went up to 6 weeks before diagnosis, which also seems wrong; too long. The whole thing was so ridiculous, so ridiculously unbelievable that when I think back on it I’m able, at best, to pull out specific moments in the madness – memories that stick out like sores on an otherwise murky landscape of confusion.

December 2013: an excruciating trip to look at bridesmaids dresses for my sister’s wedding, one she carefully organized to elicit the minimum of discomfort (only she, myself, and my mom were there; stops at wedding salons were buffered by rewards like a trip to a bookstore or lunch out) – which, despite her best efforts, was traumatic. I struggled to shove my body into miniscule sample sized dresses; often my smaller sister (the bride, for gods sakes) had to put on the dress so we could see how it would “really look” when it actually fit the person who would be wearing it.

And isn’t that the worst thing about being overweight? You want nothing more than to not care, to forget about it, to accept yourself and not have your body issues and crippling self-consciousness be a drain on the people around you, but it is simply not possible. To the people around you, you are bafflingly self-absorbed; the energy you expend directing hate towards yourself is so all-consuming that you become this incredibly selfish person, when, in reality, I’ve never met an overweight person who was actually selfish. Except for the few that have “figured it out” and managed to rise above the impossibly powerful force of societal expectation (and god bless you, you gods and goddesses), mostly we just want to be ignored, to take up as little space as possible, to live through the “real lives” of those people around us with smaller, tighter, cuter, more societally acceptable bodies.

Goddamn it Advertising! NO ONE REALLY LOOKS LIKE THIS.
Goddamn it Advertising! NO ONE REALLY LOOKS LIKE THIS.

Anyway. The result of this trip to look at bridesmaids dresses (besides some tears – mmm, a lot of tears), was the moment when I, in a pit of despair and self-loathing (and wanting to punish myself as much as possible for being fat, disgusting, disgusting) stepped on the scale for the first time in… oh, six months? A year? and saw the number that, blah blah blah (even to write it feels so obvious and cliché) I swore I’d never see : 211.

At the end of 2013 I realized I was settling into my weight with a complacency brought about by 22 years of unsuccessful weight struggles and yo yo dieting. I was accepting it, relaxing into that comfortably awful self-loathing, assuming that this would be “my issue”; assuming that all the unhappiness I felt, day in and out, was just the price I was going to have to pay for the rest of the privileges I enjoyed in my life – good friends, good family, comfortable socio-economic status. I had spent every day since I was aware that I was an overweight kid (which probably started around 6) fighting my weight and losing the fight, but by age 26 my fight was dying out. It didn’t feel good, but maybe life wasn’t supposed to feel that good.

Maybe this was adulthood: accepting the things about ourselves that we hate, and accepting the misery that comes along with that acceptance.

Looking back on it now the irony is almost too perfect: in fact, if I were writing this as fiction I would probably “mess it up” a bit to make it more believable. Here I was, 26, overweight, unhappy, accepting my damaged vanity with this complacency that bordered on self-righteousness, unaware that at the same time I was also accepting – no, taking for granted – so many other wonderful things about my body without the tiniest bit of gratitude or wonder. At 211, I didn’t feel amazing, but I certainly didn’t feel bad. I got winded when I worked out too hard at the gym, but so do out-of-shape people who weigh 120 pounds. I didn’t have high blood pressure or cardiovascular concerns; when I visited doctors they warned me about the dangers of being overweight with a weariness that conceded that, besides my BMI, my overall health was fine – cholesterol was creeping up, but I was 26 and mobile and relatively active and unlikely to suffer the risks of my extra pounds for many years to come.

I could write about why I was overweight. I mean, I could try. But honestly, that would be a whole other blog – about 50 times the length of this. It would probably be called something like Why I was overweight most of my life: A Story with a million causes both unique and universal that would probably be repetitive and boring to anyone who has ever struggled with their weight. I would ramble on for page after page about emotional eating and food cravings and cycles of self-loathing and binge eating and the hate, the self-hate, my god the self-hate, and those of you who know what I’m talking about would get it after 2 sentences and those of you who don’t would struggle through the whole thing and finish it a bit puzzled and probably wondering why, if I were so unhappy, I didn’t just “do something about it.”

But that’s not the story I’m telling.

The story I’m telling picks up again in January 2014.

January 25, 2014: I went to see a play downtown and realized towards the end of the 1st act that I was having a trouble focusing on the actors on stage. It wasn’t terrible, but unless I concentrated very hard their forms started to blur and I easily lost the picture. It forced me to concede that in recent days I had also noticed I was having trouble reading the titles on the Time Warner TV Guide when I sat on my couch and stared across the room at the TV. I wasn’t incredibly worried about this development – in fact, if I’m honest, I was a bit excited. I already wear glasses for reading, and I like them. The idea of adding another pair to my lineup was appealing – when you’re overweight, accessories, especially one-size-fits-all accessories, are some of the few wearable things that are actually fun to buy. Perhaps I’d become marginally cuter if I had glasses I wore for distance, too. I made an appointment with an optometrist for the end of February.

Mid February, 2014: Again, this is a guess. It all blurs together. I wish I knew the moment I felt the first symptom, but it was probably small and I probably didn’t recognize it for what it was. All I know is that it was mid-February by the time it became pretty hard to deny that something was up.

The major symptom was the peeing. The exhaustion was easy to explain away – yes, I was exhausted, but it was a busy time at work. I’m 26. I live in New York. We’re all exhausted, all the time. The grievance that you’re “exhausted” is a pretty lame complaint among my friends, and I’d guess almost anyone with a job and hobbies and interests between the ages of, like, 12 and 112.

The peeing, however, was hard to ignore.

I was peeing a lot.

Like, a lot.

I’ve always been a pretty robust pee-er. I drink a lot of water and make what I’ve always felt was a healthy number of trips to the bathroom everyday. But suddenly my number of trips was doubling, then tripling. It was as though everything I put into my mouth passed immediately to my bladder – if I took a drink it would be mere minutes before I was struck by the sudden urgent need to pee.

And that was the thing – it wasn’t the normal need to pee where you think “huh, well, I’m on the subway; I should probably get to a bathroom when I get off in 5 stops.” It was peeing with an urgency that I’ve never before experienced. It was “I need to get off this subway NOW to find a place to pee”. I remember one night walking home to my apartment and being, oh, maybe 200 feet from the front door and the need to pee struck with such ferocious desperation that I wondered if I was going to make it.

When I was 200 feet away.

And then it started waking me up at night. I mean, that’s happened to me occasionally – once or twice a month, maybe – but suddenly it was happening every night, and then twice a night, and then three or four times. It’s easy to deny that you’re peeing more often during the day, when you’re not paying as much attention, but harder when your nighttime habits begin to resemble that of the average 70-year old man with extreme prostate problems.

And my god, did my mouth get dry. I would wake up in the middle of the night (for one of my frequent bathroom trips, of course), and my mouth would feel caked and dusty and completely arid. I would struggle to get some saliva in there so I could move my damn jaw but usually I had to reach for the bottle of water that I’d taken to stashing next to my bed.

Then there were the charley horses. Have you heard of those? It’s that thing where the muscles (usually in your calf, I think) tighten up suddenly in the most excruciating way. They tend to wake you up in the middle of the night, and all you can do is lie there while your muscles are screaming in pain and wait for it to go away. If you aren’t sure if this has happened to you, it hasn’t. It’s the kind of thing you’d remember.

nothing like google image searching "charlie horse"
nothing like google image searching “charlie horse”

Have you diagnosed me yet? If you’re in healthcare, you probably have. If you’re not, just try googling “excessive thirst peeing a lot” and you’ll probably get there. I can’t remember if I’d done that yet by this point – I probably had. I probably knew at that point.

So did I make an appointment with my doctor? Did I get in to see someone to get some tests done to see what the hell was happening?

Nope.

So then, what critical and important steps did I take to counteract these strange and disturbing symptoms?

I bought a humidifier.

The cure for what ails ya
The cure for what ails ya

Yeah, that was about it. I bought a humidifier and placed it by the side of my bed, having convinced myself that my peeing was a result of drinking so much water, and drinking more water was the result of wanting to soothe my dry mouth, and my dry mouth was a result of it being winter, a season when it’s dry (I strategically ignored the fact that I had already lived through 25 winters without these bizarre symptoms, natch…), and that the best way to solve all of these problems was to put a humidifier by my bed so that my mouth retained moisture while I slept.

And when I woke up the first morning after I’d used the humidifier and felt marginally (and I mean marginally – like, 5%) better, I figured I’d solved my problem.

But it didn’t get better, not really. The peeing was still intense, the dry mouth intense, the charley horses intense.  And by then, like any human being who lives in 2014, I had googled the symptoms.

This was the website I found.

And as I scrolled through the list, it was hard (but NOT IMPOSSIBLE!) to deny that this could be a reasonable explanation for what was going on. The symptoms, at least, were looking very familiar.

Frequent urination: check.

Increased thirst: check.

Unexplained weight loss: Hmm…No. Right? I hadn’t weighed myself since mid-January when the scale held frightfully steady at 211.

Increased hunger: NO! A resounding NO! I breathed a sigh of relief – I’d noticed no change in my hunger at all. If anything, I was less hungry.

Foot pain and numbness: Score! Another resounding no!

Frequent infections: Another no! Dude. Obviously, this couldn’t be what was going on. Two “yesses”, but three “nos”. The balance was in my favor.

Blurred vision: Well shit. I couldn’t deny that there was something going on with my vision.

Suddenly it was a tie. Three “yesses”. Three “nos”.

There was only one symptom I hadn’t checked: weight loss.

And so, somewhere probably around February 17, I stepped on the scale.

And unlike the thousands of other times I’d stepped on the scale, I had no fear. Normally I step on the scale crossing my fingers for weight loss, for the miracle of weight loss despite knowing, deep inside, that I’m not going to see it. Like everyone else who’s ever been overweight, I know what I need to do to lose pounds. It’s not a secret.  I could write another blog all about the insanity that is the bathroom scale, but suffice it to say that nothing short circuits denial quite as effectively as a bathroom scale.

But today was different! Today I knew the bathroom scale, always my enemy, would be my ally. I had done nothing new in my ever-present quest to lose weight – in fact, my eating had probably veered towards the less healthy end of the spectrum in the craziness of the past few weeks of work. There was no way, quite literally no way , that I was going to have lost any weight. I know what it takes for my body to shed a pound; I even know how to fake weight loss with a day of fasting or excessive water intake, and I had done NONE of my pre-weigh-in rituals. To further stack the decks in my favor, I (gasp!) didn’t weigh in first thing in the morning, buck naked, after peeing. Instead, I weighed in after dinner, before peeing, and wearing jeans. For anyone who’s ever struggled with their weight, you know what it means to get on a scale in jeans.

THE HEAVIEST PANTS THERE ARE
The heaviest pants there are…

So I steeled myself for a particularly vile number – I expected 215, maybe even 218 if I were unlucky, but hell, it meant that I’d earn another NO in my “could I/don’t I” quiz, and I could solidly put the matter to rest.

And then, the number. Which I will never forget for as long as I live.

193.

The one time in my life I would have welcomed the insistent abuse brought on by an unmoving scale, and it provided a number that, in any other context, would have been a fucking miracle that I would have celebrated with every fiber of my being.

But not that night. That night, 193 was disturbing. 193 meant I had lost – shit, 18 pounds in… how long had it been? Maybe a month? I couldn’t be sure – the last time I had weighed myself had been a month ago, but the symptoms hadn’t been that bad until recently. It could have been 18 pounds in much, much less than a month. This was getting bad. And 4 “yesses” and 3 “nos” meant I finally had to consider that I could have – it would be rare, I thought, but fuck, I could have it – type 2 diabetes.

Type 2 fucking diabetes.

So what did I do next? I went to the doctor, right? I finally put the matter to rest and got a blood test that would solve the problem, right?

No. Instead, I found this website. And I convinced myself that, in fact, while unexplained weight loss might be a sign of type 2 diabetes, unexplained weight gain CAN also be a sign! It says it, right there on the website (no, really – scroll down, all the way to the bottom, where they talk about “Other Signs of Type 2 Diabetes Might Include” … you know, the much less common symptoms.) But listen, I didn’t have weight gain, so I obviously didn’t have type 2 diabetes. Clearly.

Other memories swim to the surface in the ensuing days. One tearful conversation with my boyfriend, where I sat him down and before I would tell him what was bothering me I made him swear that he wouldn’t tell me I had to go to the doctor, no matter what I said. And then I burst into tears and told him I was worried I had type 2 diabetes.

It was the first time I had said the word “diabetes” out loud. And it didn’t feel good.

See, it’s one thing to hate yourself for being overweight because it makes you feel disgusting and undesirable. But when you start to consider that your fatness has also made you sick – sick with diabetes – the shame is literally crippling. The thought of telling my parents, my family, made me want to crawl into a hole forever. The thought of having to admit, out loud, that I had diabetes, of having to say it to someone who would look at my double chin and my fat arms and my big belly and think “obviously – yeah – look at her” made me want to die. Just die.

So I hatched a plan. In my plan, I looked ahead to my annual physical in June. It was mid-February. Realistically, I could probably lose another 20 pounds by June. I knew how to lose weight, of course. And in the reading I’d done (shamefully, in secret) about type 2 diabetes, I learned that one could potentially reverse the course of the disease – “go into remission” if you got really lucky and strictly controlled diet and exercise.

If this was indeed what was happening to me, perhaps I could make it go away without ever getting an official diagnosis. Only Stefan, my boyfriend, who, being that he lived with me, had to know what I was doing in order to help support my efforts, would ever know – would have ever even heard the word “diabetes” coming out of my mouth. My family would remain unaware. Actually, they’d just see that I’d lost some weight – instead of feeling disgusted and ashamed by how I’d eaten myself into a chronic disease, they’d observe me getting healthier, fitter. And hell, maybe I’d even be a bit skinnier by my sister’s wedding.

It was a foolproof plan. Some serious diet and exercise changes and I could sweep this entire event under the rug. Hell, even my doctor wouldn’t ever know. I could consider these first bizarre 18 pounds a gift from the gods, and capitalize on them to put a serious dent in my weight.

The problem was, exercise was getting a hell of a lot harder. That exhaustion I could so easily deny before was starting to really interfere with my life – I slept constantly, and often could barely muster the energy to get to work, let alone get to the gym. Plus, there was the incredible craving for fruit juice that I’d developed – although I knew that fruit juices were loaded with calories (anyone who’s ever dieted knows that drinking your calories is no-no number 1), I couldn’t deny these unbelievable cravings I had for them. I would go into a convenience store for a bottle of water, and stand in front of the Snapple case, salivating. The sight of a fruit punch made me stop dead in my tracks, fantasizing about the taste on my tongue. So I compensated by eating a bit less, but I knew, the way all dieters inherently know the effects of the food and exercise choices they make, that the amount of calories I was taking in in juice alone probably wasn’t going to help me lose any weight any time soon.

would you commit murder for this drink? i would have.
would you commit murder for this drink? cuz i would have.

Then there was the day that, unable to muster the energy to walk to the gym, I found a youtube class of Barre exercises (those ballet-inspired workouts). I attempted the class by myself, in my living room, and although it was only 27 minutes long I found myself, 16 minutes in, collapsed on my living room rug, unable to move, so crippled was I by exhaustion.

Instead of taking this as a serious sign that something was wrong with me, I used it as fodder for my ever-expanding roster of self-hate techniques. God, I was out of shape. How disgusting; I couldn’t even finish a youtube video of exercises that was less than a half hour. I lay on the floor of my living room, waiting for enough strength to return to my body that I’d be able to stand up, all the while watching a ticker tape of all the reasons I was a fat, disgusting, gross mess scroll across my field of vision. Work harder, it said. Stop drinking fruit punch; you know so much better. And then, the ultimate fear – the idea of having to admit to my parents that, in my disgustingess, laziness, fatness, I had eaten my way into Type 2 Diabetes. That they would have to spend the rest of their lives with a kid with Type 2 diabetes, despite their best efforts throughout my childhood in sending me to Weight Watchers, nutritionists, programs for weight loss. The shame they would have to feel admitting it to their friends. The obvious example of my fat, sick failed self next to my slim and healthy sister.

Once again, the shame of it was overpowering enough for me to find some reserve of strength to get to my feet, and, on shaking legs, make my way to the shower, planning what calorie-controlled entrée I would make for dinner that night, even as my vision flickered in and out.

Tuesday, February 25th, 2014: The date of the eye doctor appointment I’d made the month before. Although part of me was hoping for the novelty of more glasses, at this point the wish was superceded by the need to confirm that I didn’t have another symptom of Type 2 Diabetes. And to my great surprise and joy, the optometrist confirmed that my eyesight was just fine – the focusing problems I was experiencing was probably just dry eyes from the winter (aha! Dry mouth from winter might be plausible, then, too, right?!), and would be easily solved by over the counter eye drops. As I waited for my eyes to dilate, feeling pleased, I made small talk with the resident who was working on me. He was a graduate fellow, and his field of study? Retinopathy problems that developed in diabetics.

I smiled, happy to talk about diabetes given that, with my perfect eyesight, I could now be sure I didn’t have it. I asked about the challenges of his work, and he admitted a major problem was that by the time people with these problems made it to the eye doctor, it was often “too late” – the retinopathy was too advanced.

“Ah,” I said, smiling smugly and wisely, “I assume it’s because so many people have diabetes without knowing it?” Not me, suckers!

“Yes,” he answered sadly.

And so I stumbled home, but convinced myself that the stumbling was a result of my blurred vision from the dilation at the eye doctor, nothing more. Even as I called out of work, because I had to sleep – had to sleep – I chalked it up to the exhaustion of the work project we’d just finished. It didn’t matter – my eyes were fine! The score had shifted back – three “yesses” but four “nos”. I couldn’t have diabetes.

Wanting to confirm this happy news, thinking of all the high-calorie juice I’d guzzled in the past week, I figured before I collapsed into bed and slept off the rest of the day, I’d hop on the scale again. It had only been 7 days since my last weigh in, but I wanted to see if the 193 had perhaps been a weird aberration, some crazy combination of dehydration or something, and that my real weight of 211 would show up again, now that I was sure I couldn’t be a diabetic. Maybe I’d hallucinated 193.  Or my scale had malfunctioned.  What if it was nothing more than a weird fever dream of bizarreness? Deep down I knew – just knew – that me actually having Type 2 diabetes was too insane to be true. It couldn’t be. It just couldn’t. And the eye doctor had all but confirmed it.

So I stepped on the scale. And this time, instead of feeling uneasy, or confused, I felt it for the first time: fear. Just straight up, undiluted fear. Fear so powerful that even my expert-in-denial brain couldn’t throw this one away.

184.

In a week, I’d lost 9 more pounds. More than a pound a day. While guzzling calorie-laden fruit juice and eating mostly unhealthily. As much as I had become a professional denier, this was getting mostly impossible to ignore. Something was very wrong.

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