I Am Fat: Not Evil or Profoundly Personally Flawed

Dispatches from physical rehabilitation: Part Three

Wednesday 16th September

Today begins Week Three in which I am not allowed to plan my diet and exercise with military precision. Instead, I am to wake up each morning and see what state my body is in and how I can best work with it to continue recovering and rebuilding my fitness. Then I am to fuel it mindfully in ways that support both activity and weight loss. I find this rather daunting.

I sleep more poorly than I have done and wake early and tired. I also spent yesterday warding off a migraine so am aware I might still feel washed out. I do. I have tea and consult my body about what it would like to do. It tells me it would like to sleep and it is still only 6.30 so I take it back to bed for a couple of hours. Sleep is not forthcoming. I consult it again. It informs me that it would like a substantial breakfast so I make eggs on toast for 450 calories.

At this point, what my body appears to be telling me it wants to do is sit down and not be bothered by anything, but I am not sure if this is lethargy that should be pushed through or a need for rest that should be respected. I decide to take it for a gentle walk and see what it tells me then. I walk in the direction of the gym so that, if it suddenly springs to life, we are in the right place to do something about that.

It does not spring to life but declares itself to be competent if not energetic. I enter the gym and do my light, full-body weights workout, deliberately choosing lighter weights than I could potentially manage and pacing myself. An extremely young employee of the gym informs me I am ‘smashing it’ and tells me ‘well done.’ This surprises me a little as my own perception is that my workout resembles the movements of an elderly sloth who is not quite sure where it is or what it is meant to be doing. However, I then remember that he was the one on duty when I entered on my first day only to collapse on a sofa, gasp out that I was OK but that would need to be it for the day and then leave again. I have, indeed, made significant progress from that point and I really should try to remember that.

I receive another positive sign of progress on my way home. Normally, I have to take the short but steep hill in stages and then sit on a wall for five minutes to get my breath back. This time, I manage it in one go and, while breathless, am able to keep walking on the slight decline the rest of the way home and my breathing normalises and my heartrate slows by the time I get there. This is progress indeed.

I have lunch and work on my model for a couple of hours and, on rising for tea, find my body staging an immediate and dramatic protest. My back spasms and my heartrate escalates immediately. There is no need to carefully reflect on what it is telling me. It is screaming ‘lie down.’ It’s a bit frightening. For the rest of the day, I sit and get up once an hour to stretch gently. I heat a microwave meal for dinner and get carefully into the hot tub. This relieves the pain in my muscles but also makes me feel as though I am made of putty. Getting upstairs feels like a major expedition and I shower quickly and fall into bed. I sleep almost immediately.

Thursday 17th September

I wake up and immediately consult my body about how it is feeling and what it is up to. It expresses a wish to stay in bed, but this is not on the approved menu even for a recovery day so I coax it into clothing and downstairs with the promise of tea. It appears to be moving somewhat more easily and there is no alarming increase of heart rate, so I follow the rules for a recovery day and decide on a slow, gentle 15 minute walk to see what it has to say about that. It says, “NO! STOP! WTAF ARE YOU DOING? RENDER ME HORIZONTAL VOLUNTARILY OR I’LL DO IT RIGHT HERE IN THE FIELD.” I return to the lodge.

I have another big cry and spend the next couple of hours indulging despairing thoughts that tell me I am weak, old and useless and all that is left in my life now is decline, disability and death. Attempts to reason with myself that I am only 52 and have a potential three or even four decades of healthy and active life ahead of me are shut down immediately. A few weeks ago, I felt like this at the Buckingham conference, which taxed my mobility seriously, and was encouraged by the sight of Alan Sokal and Lee Jussim - both in their seventies and both defined by high levels of mental and physical energy - bouncing about enthusiastically on stage while arguing passionately for the need for rigorous empirical research. I try bringing both gentlemen to mind again before writing myself off as a decrepit and senile old fossil but I have an argument against that too. I have destroyed my own body by neglecting and overfeeding it for the last decade and it has now given up on me and is determined to consign me to the scrapheap. It is all hopeless and it is entirely my own moral failure.

I express these thoughts to one of my very closest friends, Carrie. My friends are distinguished by frankness and directness and I have rather encouraged this quality so she replies,

I empathise strongly with the feelings of vulnerability, and of course you have done entirely the correct thing by recognising the need to get on top of basic mobility and strength.

I wonder though if you’re overestimating the degree to which your decline is organic or underlying? By which I mean: are your present difficulties not largely a result of the gastrointestinal bleed, which led to enforced immobility, which led to poor mood, which led to over eating, which led to gaining weight? I just recall that when you were lighter you were very much more energised, which leads me to suspect that you are not currently vulnerable because you are old and decrepit and ready for the rubbish heap, but more because the excess weight is burdensome. Put another way: you are fat, rather than evil or profoundly personally flawed!

That statement, “You are fat, rather than evil or profoundly personally flawed!” causes me to laugh so hard that I immediately have no choice but to cheer up and stop being self-pitying and pathetic. To support this aim, I go briefly onto to Substack where I find somebody being wrong in an offensive way to another writer whom I respect and immediately inform them of the precise nature of their wrongness and the ethical failure represented by it. I then feel much more like myself. The rest of the day is spent gently stretching, reading and building my model and eating healthy food.

Friday 18th September

I wake after a good night’s sleep feeling absolutely fantastic. I consult my body about this and it confirms it. I bounce out of bed, throw on clothes, play earsplitting rock music and set out for a walk. My body endorses this decision enthusiastically and sends messages of “Yes!!! This is it! Use me!” We speed up and down hills and my heart rate elevates to 150 but it feels great and I remember that this is why I have always loved cardio exercise so much. Conveniently, I start to flag on the half hour mark and go back to the lodge stretch, hydrate and make eggs on toast (with tea, obviously).

Today the husband is coming for a long weekend so I get his food out of the freezer and prepare the lodge for his arrival and then sit to read until it is time for the cab to collect me for my physio session. On standing, my back registers a clear objection and this intensifies as I hobble up the hill to the meeting point.

By the time I get to Matt’s I am in a significant amount of pain but this is something he is equipped to deal with and we spend the session working on it as well as the cause of it. It seems I have a rather large diastasis recti - a separation of the abdominal muscles which almost certainly began during pregnancy but has since expanded due to fatness and the wrong kind of exertion - and now my abs are no longer abbing at all. The muscles of my back have been compensating to stabilise my trunk when I am upright and because there is rather a lot of me, they are protesting. I must undertake a lengthy course of physio for the abdominal problem specifically and, if this fails, have surgery. In the meantime, an abdominal brace can help. We also talk about the body signals I could have noted but didn’t which indicated my body was not in a good state to attempt resistance machines or charging up hills. Hmmm.

On the way home, we stop at the tiny rural station to collect the husband. As we turn in and I see his familiar, long, lanky form with its broad shoulders and narrow hips and his characteristic stance of standing with his toes turned slightly in, I am overwhelmed with a wave of love for him. It feels as though I have been away for months and I’ve been spending that time doing strange and alien things. My husband, my David, fills me with a sense of relief and home. He is a little bewildered but gratified to be met with hugs and declarations of love.

Dave is impressed by the lodge and begins to talk about building a mini-version of it in the back garden. I distract him from this topic as this is a variation on his hobby of the building of unique sheds and his ideas and plans for these can get very detailed indeed. I settle him in and, still feeling exhausted and in pain, go upstairs for a nap.

I wake feeling a little better and begin the romantic dinner I had promised him. He is a little wary of this as I am not known for my culinary skills but a rump steak is a rump steak and it actually turns out quite well. The romantic ambience may be marred a little by my model taking up 2/3rds of the table but he is accustomed to his wife being a nerdy weirdo and we have a thoroughly enjoyable evening.

Saturday 19th September

I wake to clattering in the kitchen and come down to find him making coffee. So familiar is this scene and so powerful the sense of relief and safety at seeing him there that I burst into tears. I had not realised how lonely and anxious I had been being in this lodge on my own with impaired mobility and a not inconsiderable amount of pain for the last 16 days. I have been operating with a constant sense of vigilance and knowledge that if anything were to go wrong, I’d have to deal with it alone while not very physically capable of doing so. It feels as though he is on duty now and I can stand down for a bit. Dave appears to regard this as entirely understandable and suggests, because our plans for axe-throwing and archery have been rained off, that we have a lazy day today.

I take this license to something of an extreme and go back to bed after breakfast and sleep until lunchtime. After lunch, I fall asleep again and wake feeling absolutely wonderful. I wonder how much of my low mood and aches have actually been a product of sleep deprivation. I feel a little guilty abandoning him on his first day but he tells me he has been thoroughly enjoying a lazy day too and this does seem to be the case.

We get dressed up (well, I do) and go out for dinner. I am allowing myself a treat day which means I do not have to have a calorie deficit but there must not be a surplus. As I have been asleep all day, I have only eaten 500 calories and this leaves me with calories to spend on fish and chips and wine! The husband accuses me of being tipsy but this is a scurrilous lie. I submit evidence of my utter sobriety and his faux disapproval.

We walk back to the lodge and cuddle up on the sofa and watch The Batman.

Sunday 20th September

I feel a little delicate today - thick-headed and groggy. I consult my body about this. It says, “Fermented grape juice bad” and then refuses to comment further. I tell it that what it needs is tea and feed it several gallons along with a bottle of water and a healthy breakfast. It responds well to this.

The abdominal brace arrives looking like a medieval torture device and the husband assists in strapping me into it. It feels great and I immediately feel the pressure being taken off my back. It does not show beneath my clothing and even gives me a more streamlined silhouette! I tell the husband that I could wear this all day and it would be particularly good for conferences. Then I sit down. A tremendously loud creaking ensues and my boobs are immediately pushed up into my face. Rather than addressing this problem with a gentlemanly seriousness, my husband of 25 years laughs so hard he has to support himself on a wall to prevent himself from falling over. This continues until I feel compelled to threaten to remove his testicles in his sleep.

Domestic harmony restored, we begin on our weekend plan of enjoyable exercise. It is a beautiful day so we set out for a walk across the hilly fields of the resort. I am pleased to find that I am able to walk in intervals at a moderate pace for an hour. I feel like me again! David is gratifyingly impressed by this and says I have made remarkable progress in 18 days. I suppose I have! The hours of sleep probably didn’t hurt either.

We make our way to the games hall where I have a rest and then we embark on serious competition. Our shared interests have always been walking, cycling and the playing of games. In the early years of our marriage, during which we were poor, we very much enjoyed “date days” in which we’d leave our little daughter with one set of her grandparents and walk 6 miles through Epping Forest to a pub which did a lunch deal and spend the afternoon there playing darts, pool and cards before walking home again. This afternoon reminds us of these days and some sentimentality ensues.

By the end of the afternoon, the husband has won one game of air hockey, the table tennis and the pool through underhanded practices and luck while I have won the other game of air hockey, the shuffleboard match and the croquet through superb skill and good judgement. He has threatened my person with a table tennis paddle, a croquet mallet and a pool cue and I have insulted his scorekeeping, ancestors and masculinity while engaging in highly inventive swearing. We make our way home for a romantic evening which is none of this diary’s business.

Monday 21st September

I sleep well again and the weather is still glorious so we decide to have another day of active fun. My body makes some objections to this but I tell it to shut up and stop ruining my fun. The husband observes my slower pace and stiffness but I assure him I will be fine once I get going.

Today, we have the choice of disc golf of foot golf. I favour the former and the husband the latter. We decide to do both and I reason that this will be a full body workout! Neither of us have played either before. It is quickly revealed that I am terrible at both while the husband is rather good at them. This inspires some more inventive swearing on my part.

There are 9 holes but by Hole 4, my back is becoming painful and I am having difficulty steadying my breathing. We sit for a while. We play two more holes but I become dizzy and uncoordinated and the husband becomes worried and match is abandoned. He declares victory simply because he consistently got his disc and football into their appropriate receptacles in way less tries than I did, but I maintain that I would have made a stunning comeback had the game continued to completion. I guess we shall never know!

We have booked a table for a pub lunch for which I had also budgeted calories but it is difficult for me to sit upright and I am not able to enjoy it. We finish quickly and made our way, slowly and painfully back to the lodge. I feel very dizzy and weak by this point so I immediately lie down and fall into a long and deep sleep.

I wake in considerable pain and a very low mood. The last two days had been so much fun and this one simply reminds me how weak and limited I am. I run the “I am a broken and decrepit old lady who will never be fully mobile again and whose future holds only disablement, decline and death” theory by the husband who refutes it forcefully. He reminds me that before the bleed, I was going on long walks, visiting the gym three times a week and decorating the house. He tells me to be patient and stop being silly. I remind him that I did not do the right things to control my weight and minimise the loss of fitness while recovering from the bleed. I call myself names. He gets annoyed and defends my honour telling me that nobody insults his wife like that, including his wife. This makes me cry again but in a happier way and we spend a quiet evening in which I work on my model, he offers helpful suggestions and I tell him to sod off.

Tuesday 22nd September

I continue to be in considerable pain when I wake up but stretches and a short, gentle walk ease it somewhat. I consult my body about how it is feeling and it expresses dismay at its continued existence and informs me that it hates me. I ignore it and prepare for today’s physio.

The husband is off home today. He has brought an empty suitcase which we fill with about 2/3rds of my belongings. I had packed rather anxiously in preparation for every eventuality and could not lift my own suitcase. He grumbles about being used as a packhorse and I lovingly tell him to shut up.

The station at Umberleigh is so tiny and seldom used that it has no ticket machine or office and is, in fact, just a platform. In order to get the train to stop, you have to listen out for it and then step to the edge and wave something at it until the driver sees you and sounds his horn to indicate that he will stop. I find this very endearing, if impractical!

After seeing Dave off, the cab driver takes me on to my physio session with Matt. He sets to work trying to fix the muscle damage I appear to have done to my back. While I am in a somewhat vulnerable and ludicrous position on the floor with my bum elevated on blocks, we talk about the failure of my week of intuitively listening to my body. I have made some efforts at this but mostly I have tried to reason with it in order to get it to do things it does not want to do. Bodies do not work like this.

Nevertheless, Matt says we need to work with the brain I have and that it is clearly not one that does well with intuitively attending to physiological signals. It is one that works on systems and models and schedules and data and measurements. Therefore he proposes a compromise between the “listening to the body” thing and my model-making, rationalising tendencies.

For my final week, I am to have a 15-minute walk in the morning and then carefully evaluate how my body responds to exercise that day. If it is raring to go and wants to push speed and distance, it is a 100% day. If it manages it without difficulty but is not energised, it is a 75% day. If it finds it hard going but manages it, it is a 50% day. If it protests and goes into cardio and things ache, it is a 25% day. If I am not sure which day it is, I am to round downwards.

Then I can have what he referred to as a “folder” of things to do on any given kind of day.
100% - feel free to push limits and go to my limit. (Only one of these in a row)
75% - do whatever was on the agenda - walks, gym, class etc. but no heroics
50% - do a downshifted version of what was on the agenda - a 15 minute walk rather than a 30 minute one and 20 minutes of light weight exercises at home rather than resistance machines at the gym
25% - exercise is now done. Just get up and move a bit a couple more times. Some stretching exercises and a tidy up perhaps.
0% - illness days - rest, avoid going online, have some kind of calorie deficit.

If I accurately evaluate my capacities on any given day and have a model of expectations for a series of levels I can succeed every day even if that day is mostly sedentary. Matt says he would not usually propose such a complex system, but he thinks it would work with my psychology. It does. I like this. I think I can do this.

Matt also takes issue with my pessimistic negativity about my recovery prospects. Again. He said my body is actually responding very promisingly and has made a huge amount of progress in a very short time. I could reliably not walk 15 minutes a day when I got here. I could not pick things up off the floor, do stairs in the normal alternating fashion or get my ankles onto the opposing knee to put socks on in the normal fashion. I have also lost 5.5 kg (about 12lbs) already and this makes everything easier, even if some of this initial loss is water. My cardiovascular system seems to be particularly responsive and is doing very promising things with regard to heart rate variability and resting heart rate.

This is not a body that is giving up, Matt asserts. It is a body that is bearing up remarkably well under the strain of having twice as much weight as it was built for, having got very out of condition from lying down for several months while recovering from blood loss, having a profound lack of trunk stability due to separated abs and also continuing to compensate for brain injury on my right hand side. It is a fundamentally sound and strong body and I can expect it to rebound particularly well when I remove some of the strain from it and gently retrain it into fitness.

For most of my adult life, I have been fit and active. My body remembers that and is doing its best to get back to being so. I just have to do the right things to help it. And I am mostly doing so! But one of the things I am not doing well enough is resting and recovering properly. If I shift my mindset to see light and resting days as part of recovery rather than a hindrance to it, continue to press forward intelligently and realistically and to lose weight steadily, I can expect to recover fully, walk a couple of miles on a daily basis and get myself up from the floor if I fall over. I can, in short, resume being a fully functioning biped if I am patient and sensible and accept that the timescale for this is not the end of September but Christmas.

Matt also felt that I should apologise to my body for not giving it credit for how well it is serving me under extremely difficult circumstances and appreciate it for coping exceptionally well under immense pressure and making remarkable progress.

Even though I have definitely just been told off, I feel a new sense of optimism and positivity as I limp out of Matt’s gym having been stretched and twisted in a variety of ways and told to go home and spend the rest of the day resting and soak in a hot tub. I go home and spend the rest of the day resting and I soak in a hot tub.

I am not in a state of permanent disability with an inevitably declining body. My inability to do all the active things I want to do right now is not evidence of laziness, vice, lack of discipline or absence of moral character. It’s a lack of capacity. As Carrie put it, I am not evil or profoundly personally flawed. I am just fat. And unfit. I can and will get less fat and more fit and I shall view this as a longterm project to be pursued sensibly and intelligently with the recognition that rest is a central part of recovery. The graded recovery plan goes into action tomorrow. Full mobility by this Christmas is the new goal and being a healthy weight and a fit and active 53-year-old the goal for next Christmas. Sorry, body. And thank you. Onwards!

.