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Obesity triptych

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Obesity. I know that lately I’ve been thinking a lot about it, talking a lot, and writing a bit.

I was inspired to do so by a recent report on the treatment of overweight people and fatphobia in the Polish healthcare system. I wrote about it on Instagram and Facebook – a little bit, from my own experience. About the first of the stories below. I didn’t expect to receive such a response from people. Well, „you are not alone” is an understatement… „I understand” is more precious to me than a million pieces of advice anyone could give me. Thank you <3 I know there are more overweight or obese people among us. But not only them – those who also, let’s call it gently, have a difficult, unhealthy relationship with food. I understand you too.

Furthermore, I am preparing for bariatric surgery, which involves reducing the size of the stomach. But I’ll devote more space to that at some point.

Now I invite you to a triptych ;d Written in three different places, depicting three different things.

I’m sitting on the floor in the hospital. Today, I have three appointments related to qualifying for bariatric surgery. It’s terrible, and somehow I can’t think of anything other than my obesity. It reminds me of one of the worst incidents I’ve had related to my obesity.

I
How was it?

I was on a bus with a friend for work purposes. I’m not sure what happened there, but I was awakened by comments from some woman about my weight. I was lying on the floor, all wet, and she was commenting on my weight. It turned out she was a doctor from the ambulance.

She was talking to the bus passengers, saying that I weigh at least 150 kg (I’m still far from 150 kg…) and that she’s losing her spine over us (not that the paramedics were helping me, not her), that I’ve let myself go. She was talking about all of this, not to me, but to everyone gathered around. EVERYONE WHO WAS A WITNESS TO MY SEIZURE could hear about how fat I am. The doctor who came to help me was commenting on my appearance in front of everyone.

Just then, I opened my eyes after the seizure. In a slight daze, I started to defend myself. I remember (confirmed by a friend who called the ambulance) that I told her how much I weigh, and that stupid b**** (I can’t think of her any other way) was saying that she weighs the same and that I should see how much better she looks.

GET IT?

Supposedly, she stopped when my friend told her that, as far as she knows, I am struggling with major health problems. The paramedic(s) (I don’t remember, really, I’m disoriented and in pain for several hours at least after seizures) were rather okay. She less so, but when she found out that I had three strokes and epilepsy, she also kept quiet.

I defended myself unnecessarily in that daze, really. I shouldn’t have told her how much I weigh, since diagnostically, it didn’t matter to her, as she brought up my „150 kilos” to mock me, accuse me, or get some sympathy from my fellow passengers.

That doctor messed up big time.

I have no idea what she looked like. I didn’t see her. I wasn’t even interested. I should have let it go. Just like I never bid on health problems, I don’t compete over ailments, I don’t engage in conversations about who has it worse. But I had just had a seizure. I didn’t know where I was. I felt ashamed, humiliated, angry, and closed off in my post-seizure helplessness, unable to stand up on my own, unable to think clearly. I probably cried from shame in the ambulance. But I don’t know because it was another ambulance ride I don’t remember at all.

I do remember, however, that the paramedics were really lovely to me, and I told them about my illnesses, about how I usually don’t have high blood pressure… I also know from my friend that my fellow passengers behaved really well. They moved away so I could have access to air, someone gave me water, and someone poured water on me to revive me. I don’t know how it would have been if my friend hadn’t been with me. I know that at that moment, people really behaved nicely, and I’m grateful for that.

Of course, the situation with that woman wasn’t the first time a doctor commented on my weight in an unpleasant way. I’ve been patted on the thigh, grabbed by the belly, and shaken with words like, „This needs to be taken care of/you need to lose some fat/with this weight…/anything else.” Unpleasant or even humiliating situations with doctors have happened many times.

But it was only with that woman that I cried.

On the other hand, there are doctors and paramedics who really know how to behave. Just. I don’t know if it depends on their mood or the upbringing they received at home. I notice it. And I appreciate it. I appreciate it when a doctor informs me rather than judges me. Doesn’t condemn.

II
Recently, I accompanied someone to a psychiatric visit as an extra set of ears (this person is hard of hearing, and I am well-versed in all of their health problems). It was already another visit, we went for a check-up, for a prescription, to clarify doubts. During part of the visit, the doctor dealt with her. For most of it, she dealt with me. My weight.

She commented, inquired, recommended, and talked. I wanted to scream at her to focus on her patient and then on her own business, to put it mildly. So many thoughts in my head, but nothing on my tongue.

She offered me her weight-loss bread, but I declined.

Later, of course, I thought about it, talked to my brother, and my psychologist, and sorted things out in my head… I know how I could respond to her, but you know how it is – it never comes at the right time, especially when you’ve had strokes and quick analysis of the situation is not your strong suit.

I don’t know if I want to assist again at that doctor’s appointment in three months. I’ll probably feel obligated because I’ve been taking care of this person since the beginning of their health problems. I’ll probably go to that doctor, but there’s so much anger in me that it’s hard to describe. This time, not shame, just anger. That woman shouldn’t be dealing with me, seriously.

III
The day before yesterday, I went to see ‚The Whale’ with Arun (my partner) and Michał (a friend from high school). You know (or maybe you don’t), that new Aronofsky movie. A movie about a guy who weighs so much that he doesn’t leave his house.

I’m not a critic, so I’ll steer clear of a review. I’ll just write a few words about how the film resonates with me as an overweight person.

Was it shocking to me? Not really, but that’s thanks to its immense theatricality, which works better in theaters than in movies. Well, compulsive eating wasn’t shown as drastically, but it was important that it was shown at all.

Was it a portrayal of obesity? Well, not really.

I saw other things in it, tensions between selfish sympathy and empathy. Help and violence. Surrender and acceptance. And also cause and effect.

I could elaborate on each of these points for pages. About one thing, though. I wanted to write about them, at least a few points, but I don’t feel like it today. However, I feel that as an overweight person, I could somehow feel this movie differently than friends to my right and left. I’m not saying better, more, just differently. I extracted from the film these tensions and thin but clear boundaries.

I could talk about it and talk about it, and then talk some more, and for dessert, talk even more. But you have to put a period somewhere. So I’ll put it here. There will be more later 😉

I ask you to keep your fingers crossed for my qualification for the surgery. I can use every warm thought!

in my opinion loosing weight my stroke rehabilitation stroke survivors strokes

Secondary prevention after stroke

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regardless of whether you are a stroke survivor, a caretaker or just a good friend, the “never again!” thought will cross your mind sooner or later. This thought will transmute into fear once you are told that chances of a second stroke are pretty high. You can reject and deny it, you can agonize about it, but the most reasonable thing to do is try hard not to fall ill again.  A haunting vision of a second stroke (and every successive stroke) gives most of us sleepless nights.

Frankly, can we be sure that it will never happen again? Can we minimize the risk of a second stroke? Absolutely. Preventing the disease from recurring is called secondary prevention.   

kasia lewaczka.pl in the truck full of carrotsIt’s much better worded at the portal: PZH

Secondary prevention (2nd phase) is about early diagnosis and prompt intervention in order to arrest the disease process – and thus, about identifying risk factors and their elimination. It is addressed to persons at risk and encompasses, among others, screening tests like screening for breast cancer (mammography) or cervical cancer (cytology), periodic check-ups, control of risk factors, counselling.

It is commonly divided into secondary and long-term prevention – and the latter has to become a regular part of our lives. However, this doesn’t mean that every single day of your life your mind will go “oh gosh prevention prevention”. I believe, we can’t go on like that:) What I mean is rather the need to integrate new habits into our lives.

In the case of stroke survivors, the secondary prevention process starts (at least, should start …) in hospital. From the very beginning we, along with our closest family, are instructed what to do, what not to do, what to eat, what to avoid. Is it helpful? Sometimes yes, sometimes not too much, it depends on the medical staff. In some cases, doctors find the time and attention to give us some useful advice, sometimes not. How do I know that, me being the lucky one that, in most cases, received sound advice? I know it from your emails, and believe me, over these last 5 years (yes, this May it’s exactly five years since my first post on Lewaczka.pl!) I have mailed and talked to many people who felt like they were wandering in the fog, surrounded by darkness, after they had left the hospital.

The hospital discharge form contains a line which says: medical recommendations and patient care recommendations. I can’t recall anymore whether they come in the same line, but this is where the attending doctor puts what should be done next, e.g. consult a specialist in XXX, further diagnostics  …Generally, what needs to be checked and treated. Patient care recommendations, on the other hand, can be detailed or limited to just three words, e.g. “Mediterranean diet recommended”.

Ok, ok, let’s get to the point. There are a few basic rules to follow to help you regain health, strength and prevent strokes from recurring. And so

How to prevent a stroke from recurring – basic rules:

  1. Quit smoking. Sorry, chain smokers, and you, social smokers! Cigarettes are the biggest (along with age) risk factor for stroke. So start here. Quit. I did:) And I believe you too will manage to quit. Fingers crossed!
  2. Take your meds regularly – unfortunately, most probably, we will take some of them (e.g. anti-platelet drugs) until our very last breath. Sad, but true.
  3. Diagnostics and treatment of other diseases – knowledge about diabetes, hypertension, blood coagulation diseases, arrhythmia, aneurysms etc. – gives you a chance to treat them in time or limit their effects, including – surprise! – the chance of another stroke:)
  4. Regular medical checkups. We all understand their importance.
  5. Weight loss – insert a sad face here; I have been fighting this battle for years and at the moment I’m the fattest I’ve ever been. Nothing to boast about, and a lot to worry about.
  6. Move more – physiotherapy won’t do it all. You need to move more at home, outdoors, just about anywhere. Of course, this is super difficult for bedridden patients, but those of you who use a wheelchair or are able to walk, can move more. Although I’m doing pretty well, sometimes I sink into depression and I can’t drag myself out of bed. Fortunately, I found a solution. I got myself a dog! So now, I have to go on walks a few times a day, even when my body is heavy like a sack of flour and every step feels like a Mount Everest climb. And now guess: who walks whom?
  7. A healthy, well-balanced diet – yes, diet is very important. I mentioned above the Mediterranean diet, but generally it’s about eating healthy – fulfilling one’s nutritional needs in a balanced way, including foods that reduce the risk of stroke. Take vitamins! Vitamin deficiencies are one of the stroke risk factors.
  8. Of course, those of you who are able to exercise, would benefit from 3-4 cardio sessions a week, but now I can see some of your faces saying “yeah, sure”. It’s good to do that routine, but sure – after TIA your workout is limited to dangling a cane – so what you can do then is just a walk, some stretching or swimming. Let’s stay reasonable.
  9. Stop or cut down on alcohol consumption. Sorry!. After my first stroke, my attending said to me, roughly: „Miss Kasia, stick rather to a wine of glass with your lunch and not a bottle of vodka at a party, ok?” I’m fine with that:) These days I don’t drink at all because of the antiepileptic meds. From a party girl (university days) I turned into a teetotaler. And I’m fine!:)
  10. Less stress – yes, really. Again it’s something that’s easy to say, difficult to incorporate in our lives. By the way, there is no hard proof that stress leads to strokes, but… ongoing, constant stress undoubtedly exhausts human body, and according to some doctors, increases the risk of stroke.
  11. Drink water – plenty of it – it’s incredibly important for our bodies. If I remember right, research shows that 60% of patients admitted to stroke wards is dehydrated. And in such case, blood becomes thicker. You well know what it means for patients who were hospitalized because of a thrombus (blood clots). No need to convince you any further how important it is to stay hydrated, right?
  12. Change your lifestyle – I find this point hilarious, as this one is usually a summary of all the previous tips. Cause a change of diet, quitting smoking, almost daily exercise etc. sounds like a revolutionary change, right?

A lot of new habits need to be incorporated into our lives, but nothing is too much or too difficult to prevent another stroke.

The list may look daunting, but in fact it can be shortened to just two points: take care of your health and change your lifestyle. The rest may be intimidating, but let me tell you why it’s just a first glance impression.

All of the above things are interconnected; one stems from the other, and the other from yet another one. And still, the most important thing is to make changes in your lifestyle.

Ultimately, it’s about creating new habits and routines. It’s tough, but doable. And yet, if you ask me if I have changed my life to incorporate all of the above points – I have to say, not really. Not all of them. Unfortunately. But I’m still working on it! I know how important the new routine is.

PS

This post is based on my experience and input I found here:

https://neurologia-praktyczna.pl/a517/Wtorna-profilaktyka-udaru—–nowe-wytyczne.html

https://podyplomie.pl/medycyna/31904,prewencja-wtorna-udaru-niedokrwiennego-mozgu?page=4

https://journals.viamedica.pl/polski_przeglad_neurologiczny/article/viewFile/20071/15774

https://www.mp.pl/oit/krazenia/56313,rozpoznanie-leczenie-i-profilaktyka-wtorna-udaru-niedokrwiennego-mozgu-i-napadow-przemijajacego-niedokrwienia-mozgu-wytyczne-european-stroke-organisation-2008

KTYKA WTÓRNA PO UDARZE MÓZGU

 

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Lose that weight, Kasia! I’m 15 kilos smaller:)

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I would do (almost) everything to have a better recovery. As we know, there is no ‚magic cure’ for regrowing brain (fingers crossed for stem cells therapy!), we have to just take the best care of what’s remaining and work hard to regain/improve what’s left.

For me, big weight isn’t simply an aesthetic issue, its connected to health and preventing next diseases.

I mean: by obesity may not affect many things, but sooner or later it will.’

So i’m losing weight. 15 kilos so far!:)))))))

you can sing with me. Wow! Wow! Wow!

It’s a hard work, it’s a daily struggle, but the reward is huge. I’m not going to complain then:)

 

Life’s been crazy recently, so I’m bit absent. I think i’m going to be back with you soon.

My Polish blog is doing well, but it’s hard to find time to translate things… Ill try harder. I promise!:)