I firmly believe that a part of the healing after a mastectomy, or any other body transforming surgery for that matter, is not only to get to accept your new body, but to have the right to love it. And even more importantly, to not be defined by this body alone. That requires confidence and one thing society does not hand you is the opinion that you are good enough as you are. Instead you are endlessly told to lose weight, be beautiful, work out, be strong and eat healthy from both commercials but certainly also from healthcare personnel and society as a whole.
The day after my cancer diagnosis I was going to work on my bike. This was my way of keeping some form of normality. After three months of increasingly bad news and never ending appointments at the hospital, going to work was a sign that something was still functioning in my everyday life. I instinctively trod harder on the pedals than usual, I had a need to use my body physically, I had a lot of energy that I needed to point outwards somehow; I had an urge to exhaust myself physically. I guess everyone reacts differently in a situation like this. Mine was kind of funny since the last thing I normally like is exercising. I live an active life, but I’ve distanced myself from the kind of efforts that done for the effort alone. To me personally it seems preposterous to set aside several hours a week to exercise inside a fitness temple in an already busy life, especially since I’ve never found any joy in working out. I could point at a million things that would be more fun.
At the oncologist I was told that exercising during chemo could lessen the side effects and would be very beneficial in many ways. Since I already felt a need for working my body hard, I jumped on the idea immediately and signed up for every program I could. But reflecting upon this after some days I do think that the whole focus is off. It should be on living as tolerable, or even nice and positive, as possible. I think that this is what adds the most value to a person’s life under these circumstances. Exercise could be a part of this, but it should be secondary to well being.
I’m at my first meeting with my cancer centre coordinator, my point of entry into the system. I need to note down a lot of numbers on paper, including weight and height. “Well, I see from your figures that your weight isn’t a problem right now, but we need to keep an eye on the figures so that you don’t lose weight during chemo. And after that, when you start on anti hormones, we need to look out so that you don’t gain weight. There’s a dietist you can talk to if you want to.” Not weighing enough, then weighing too much.
At this point it strikes me that there’s a lot of talk about weight in the hospital world. Even though my weight is not problematised, it’s mentioned nonetheless. First time was before and after surgery. The surgeon was telling me how good the scar would look because I’m so slender and petite. I’m sure she meant it in a good way, but I couldn’t help thinking of people with different appearance than mine – what message was she giving them? Was she really thinking that they were looking worse after surgery because they had a different fat percentage? Was it even important if I was beautiful or not after surgery? I just wanted to get rid of the (at the time) potential cancer. The thin norm was definitely (also) ruling here and it made me uncomfortable, feeling once again a judgement on the (female) body of what is right and what is wrong. The subject of appearance keeps surfacing in a potential life threatening situation; this should really be the last thing you’d have to think about.
Health-care and society in general are putting good health equal low weight or BMI, without thoroughly knowing and understanding all the consequences which is described in depth in this article by the magazine Slate from 2015. It explains that focus of weight can be more devastating than the weight itself; which is still true when dealing with cancer and chemo, the burden of potential weight issues or insecurities is not something you want to risk putting on top of all the other challenges that chemo patients are facing. Talking about weight and especially losing weight is so normalised, that we don’t even see it anymore. Diets are a part of so many people’s life – I used to diet when I was younger. I have never been told that I weigh too much by others in my life, but I have been very attentive to my weight nonetheless. I never lost weight to be healthier, or to be more fit. It was pure focus on weight and appearance. Now this weight focus comes up again and I honestly think it’s is very misplaced. My number one agenda right now is to be happy with myself and my body. To much focus on all this on top of chemotherapy, or the antihormone treatment after that, just becomes counterproductive and it risks putting the blame on the individual for failing to be the right weight, exercising or eating healthy enough. I decided that I won’t feel guilty at any point if I do not have the energy to work out, I will only do things that feel good to me. Sometimes that’s going to be just sitting in my sofa all day and I’m fine with that.
At the intro of my first workout for one of the programs I signed up for at the cancer centre I was shown around all the machines and I got a little log to put down all the settings, numbers of reps and which weights for each machine. “Here you can also note down your weight. We have a scale you can use to weigh in every time you’re here.” That puzzled me. At the next session I asked what function this would have? “Some cancer patients should watch out they don’t lose weight, the dietists had recommended having weight measured regularly”. I tried different angles, asked if they had considered how weight could be problematic for many people and that it is not a precise measure of health any way. Asked if they could target only those who were in the risk zone instead of targeting all patients? I think he could see my points, but kept on stressing the need for control over weight loss. In my case I’m supposed to come and do work out two times a week. Checking my weight has no function other than making me obsess about weight. If I would loose weight I would be aware of this without using a scale, but for others this might not be true. The best solution would absolutely be to look at each individual patient to find their needs. Each fragmented part of the health care system means well when pointing to weight and exercise, but the accumulated impact can become greater than intended. Like in many other areas you would hope for a more coordinated and personalised effort to achieve the best result.
The most important thing to me right now is how I feel. To tune in to my body. Am I ok? Do I have energy enough? I’m I happy? The scale does not have a answer for that! To learn how to listen to my own body and what it needs instead of being fixated by numbers. To get to be more than just a body to be regulated. That is what I’m practicing and what’s getting me through.
FedFront is a Danish body positive movement that documents and fight body hatred. They post a lot of interesting articles if you want to read more (in Danish).