MEMOIR: THE SCALES (Partial Rewrite)
One of the things you don’t often hear about bipolar disorder is that as well as all the fun and laughs with the mood swings and so on, you can also get paranoia and delusions. You can find yourself believing all kinds of wrong and crazy bollocks. Like the time, when I was sixteen, and I believed my dad could read my mind.
And like the time, last year, during my second hospitalisation, when my anxiety was so bad, so off the freaking charts, that it started to hurt my relationship with Michelle. And it was all because of our bathroom scales. I have been on a weight-loss campaign for a long time. I weigh myself at least once a day (sometimes more than once). Accurate, reliable data is crucial. I had our bathroom scales in my hospital room. They’d always been a bit iffy, bit in a consistent way. You could correct for it. But during this time in the hospital they seemed to go off on their own, making up all kinds of crazy figures. It made no sense. I found I could no longer trust the scales. The scales were suspect.
This was, as I say, my second hospitalisation last year. In many ways it was a familiar, even comforting sort of experience. I knew in large part what to expect, what the daily routine would be, from morning meds around 8 am, to morning obs, to breakfast and so on. More confounding was why the air conditioning in my room seemed so broken. It was the middle of winter, but the air conditioning was pumping cold air into my room. I felt so cold I imagined myself refrigerated. I took to referring to my room as “the Tupperware” because I often felt like I was in storage, in a Tupperware container like leftovers stuck in the back of the fridge.
The crisp freshness of my room, though, was the least of my troubles. I was much more agitated and bothered about the scales–and Michelle was tired of hearing about them.
She understood that I was sick. She was doing everything she possibly could to help me. It was hard for her, visiting me and then going on to do her shift at the pathology lab. It was an exhausting double-bill. I was only too aware of the toll my illness was taking on her, and I was very keen to get “well” as soon as humanly possible, to reduce the pressure on her.
But, well, the scales…
To explain about the scales, and about my weight-loss saga, I need to go back to 28 December 2012, one of the days the trajectory of my life radically changed. There have been several moments when, looking back, I can see my whole life swing, like a bank vault door, heavy but perfectly balanced, around a pivotal moment. 28 December was one such moment, one of the most significant of my whole life, when just about everything changed. The morning of that day I weighed myself. The result was 165.5 kilograms.
It was a shocking figure. I had given up weighing myself years earlier, because it had been so depressing, back when I had been weighing myself daily, seeing the total go up every day no matter what. So I stopped doing it, and tried to get used to being fat and more or less happy or at least comfortable with my roly-poly self. I felt as sexy, as desirable, as a blob-fish, but I could go about my business. I wrote books, lived my life, travelled overseas to promote my books, and tried not to feel burning shame when asking flight attendants for seatbelt extenders (I always felt the burning shame; the flight attendants were always extremely good about just handing it to me without comment).
My psychiatrist had been encouraging me for some time to consider some kind of weight-loss program, but I was the fat guy who resisted all such suggestions, or who made only half-hearted, soon-forgotten “commitments” to it. I was a writer, too, and spent most of each day at my desk, in front of the computer, sometimes actually working, and sometimes goofing off, usually on Facebook (mortal enemy of writers everywhere). I was pleased, once my broken arm healed, to have my arm back working again with full flexibility and function, and loved to tell the story of what it took to get it back, because it made me look good. What didn’t make me look good was my ballooning body. Having the busted arm made me even less active than usual, a level of inertia matched only by the likes of materials frozen to absolute zero. I was a bin bag of dirty laundry dumped on the couch, watching TV, eating something bad, feeling lousy but kidding myself that things were fine.
Even worse, my knees had been screaming in pain for ages. So loud, so intensely, that I was inclined to believe that other people could hear them crying out in agony at having to support their unbearable burden. My GP had diagnosed osteoarthritis. I had been having cortisone shots, and was chewing through major painkillers. My screaming knees were a big factor in my inertia: activity hurt.
My psychiatrist, one day, in the course of talking more about the need for me to lose some weight, suggested iced coffee protein shakes. There was this whey powder stuff, he explained, and told me all about it. I had tried commercial high-protein diet shakes, and had not liked them. They left a nasty chemical aftertaste in my mouth. Combine that with a general sullen refusal to deal with my weight, and that was that. But this thing my doctor was talking about sounded different. He convinced me to have a go.
The whey powder was a body-building product, which puzzled me. I had been expecting something from the weight-loss industry. It smelled good when I opened the giant container, and when I mixed it up as directed and tried it–it was good! No chemical aftertaste! It tasted better than iced coffees I’ve paid upwards of $6 for in actual cafes! I could not believe my, well, my taste-buds! This was something that might work.
As well, I signed up for adult swimming lessons. I never quite learned how to swim properly when I was a kid, so had never been much of a swimmer, and never went near deep water for fear of drowning (see my post, “Drowning”). And swimming lessons, though exhausting, were marvellous fun.
The weight started to shift. The protein shakes twice a day plus a bit of exercise made a difference. I stuck with the shakes, and the swimming lessons. After a while I added pool-walking as well, charging as hard as I could up and down the 25 metre lanes 80 to 100 times, trying to get my heart pounding as fast as possible.
People started to comment about how I looked like I’d lost weight. They started commenting about my face. My swimming shorts appeared to grow so large and hot-air ballon-like that I needed new, smaller ones.
Then one day I noticed that my knees had stopped screaming. When I went to see my GP, my vital numbers were good. At the pool I was racking up literally thousands of walking laps. People would stop me on the pool deck to tell me how I’d lost an amazing amount of weight, and it looked so good. I needed new clothes. I could finally get all the funny and geeky t-shirts I’d always wanted but couldn’t get because I was too big. So many things I hadn’t been able to enjoy because I was too big.
Example: after I finished my first term of swimming lessons, I felt deeply empowered, that I’d really done something good for myself. What else, I wondered, could I do? What did I want to do? One thing occurred to me. I’d love to try sky-diving. But when I looked up sky-diving services here, they all insisted on a weight cut-off of 115 kg. And at that time, I was still a gelatinous monster.
So I decided: I was going to get to 100 kilograms, and when I did, I was going sky-diving. This would mean a total weight-loss of 65.5 kg.
And, flash-forward four years, I was in hospital (ostensibly to get my medication changed to something more effective, and with fewer nasty side-effects), and, as I had been doing every day for years, I was weighing myself every day, at noon.
I had gotten my weight down to 114.3 kilograms. This was a loss of 51.2 kg over that four-year period.
I was so proud. If I had climbed Mount Everest I’d be less pleased with myself.
People would tell me I’d lost a whole person. In the supermarket I saw 25 kg bags of rice, things the size of mattresses, so heavy I couldn’t shift them. And I thought, I’ve lost two of you bastards. I was on my fourth pair of swimming trunks. The shirts I was buying were two sizes smaller than I used to need. My knees were silent. At IKEA, I could race up the stairs to the first floor without even breathing hard, and with no knee complaints. My wife could hug me and reach her hands all the way around. I felt light. My older clothes hung on me like curtains, or circus tents.
But I was now in a psychiatric hospital, and the doctors were changing my medications around. They were all agog that I’d managed to lose that much weight while on 250 mg of Clomipramine, notorious, like all the tricyclic antidepressants, for its weight-gain side-effect. My psychologist said I was probably the only patient in that hospital who was losing weight, because psychiatric medication is often a total bastard about weight-gain.
And that was the problem, right there. I was terrified, after four years of continuous, obsessive, grinding effort, of the weight coming back. The thought, and the fear, obsessed me. What if it all came back? What if, in fact, it not only all came back, but brought even more with it? What if I ended up even bigger than I had been? I had read a great deal about obesity science. I know that people who manage to lose a great deal of weight often wind up regaining it all, and more besides.
It was all I thought about.
I needed to know what my weight was doing from day to day. Needed it like oxygen. Needed it like water. Like heroin.
And I could not trust the scales.
We had bought them years ago, once my weight-loss campaign showed signs of success. Prior to that I borrowed my parents’ bathroom scales. It was on their scales that I first learned about the 165.5 figure. A figure so horrifying, so mortifying, that when I posted about my weight-loss efforts on Facebook I referred to it as OMG! kg, and each successive milestone as OMG! minus the total I’d lost, such as OMG!-51 kg.
That figure was and is important to me. Everyone in the family understood that, but even I didn’t understand how OBSESSED I had become about it.
We bought our own set of scales. When they arrived, the first thing to do was to calibrate them against Mum and Dad’s scales. The new scales showed they varied from the others by about +1.3 kg, so whatever figure they showed, I had to subtract 1.3 from it, and the data would be consistent.
This was fine for a long time. I periodically checked again with the parental scales to see if the error remained the same. Here you can already see the beginning of the obsession, the madness.
Because, after a while, the amount by which our scales varied from the parental scales changed. Sometimes it was +0.8 kg, and sometimes as much as +1.5 kg.
By the time I was in hospital last year, our scales were about four years old, and they were showing truly distressing numbers that made no sense. My weight appeared to be climbing. I asked my parents to lend me their scales. They showed I was not gaining weight.
But sometimes they did show that I was gaining. During my first hospitalisation, at one point I was put on Seroquel to help me sleep, and to help with anxiety. This first hospitalisation was also the worst, the most harsh and distressing. I was in a terrible, deeply fragile state, barely holding myself together, even worrying my doctors. Seroquel was a wonderful drug for sleep, but it has a dreadful reputation for weight-gain. I keep a daily chart of my weight, and it showed a sharp upturn corresponding to the time I was put on Seroquel.
There were, across all three hospital stays, and even since then, since I’ve been home, numerous incidences where a medication seemed to make me gain weight. Between the effects of being strung out as I went from drug to drug, and my worries about my weight, and the NEED to preserve the weight-loss I’d achieved, I needed above all else reliable data. I needed to know where I was from day to day, week to week.
Michelle allowed me to buy new scales. Because, like a Cold War spy in a LeCarré novel, I could no longer trust the old scales. I lashed out and got the Fitbit Aria scale, which looked truly space-age, all white and sleek, and supposedly just bursting with all kinds of chewy data, and dying to work with my Fitbit Flex wristband thingy. It was fabulous, and I was dead excited.
Except, once it arrived, Michelle rolling her eyes by this point because she had had a gutful of me and ScaleGate, it didn’t work. In fact it would not work. I Googled support forums, and found loads of disappointed customers, who had found, as I had found, that the scale used a different wifi protocol from what we used in our household wifi. I either needed to buy new scales (Michelle’s patience gossamer-thin by this point), or buy an older modem that supported the older wifi protocol.
I could see this was deeply upsetting for Michelle. My parents, too. They essentially gave me their trusty, reliable scales to use in the interim. Michelle took the Aria unit back, and got a refund. I swotted over the JB HiFi and Officeworks sites online, looking for new scales, because I had to have reliable data.
And all the time I could see in Michelle, when she came to visit, how stressed she was. It made me ache and burn with shame. I was doing this to her. My stupid, pathetic, useless anxiety, and my even more stupid, pig-headed pride, was doing this to her. And yet I could not let it go. I had to have reliable data. Had. To. Have. It.
Michelle agreed to one, final set of scales. But she told me This Was It. I felt cold all through. I found a new set of scales, a German brand which looked reliable, and the unit seemed to offer lots of data. It was also much cheaper than the Aria. When it arrived, it worked. When checked against Mum and Dad’s old reliable unit, the new scales agreed with it perfectly. It was weighing-machine kismet.
Peace reigned across the Kingdom. Birds chirped, bunnies hopped, and the sun shone. All was well.
Then, right at the end of my third hospitalisation, my doctors, in despair over what they could give me that was strong enough for my “treatment-resistant major depression”, and yet whose side-effect profile was “weight-neutral”, they fell back on another tricyclic antidepressant, of all things. We had gone through everything, and now we came back to the tricyclics, and of those, Nortriptyline was said to be the least obnoxious in its side-effects.
Except for the weight-gain.
And the increased appetite.
The struggle against my weight continues. Nortriptyline seems to be a terrific drug. I give it four stars! But my weight is nuts. Since leaving hospital last November (as I write it’s mid-July) I gained 13 kilograms, my weight rising from 114 to 127.1 kg. I panicked. I was desperate. The weight was coming back, like a tide coming back in, refilling the bay. Nothing seemed to help. I was doing a lot of emotional eating, and that would have added to the gains. I was telling my doctor to Do Something, that I was up for anything. Because, as I say, I am obsessed. I am my own white whale.
My doctor put me on a drug called Topamax, which is mainly an anti-convulsant and anti-anxiety drug, but which has the unexpected side-effect of weight-loss.
I also looked into what measures I could take on my own. I’ve hit upon an eating and fasting pattern I call the “low-food diet” which involves about one meal a day, lunch, and fasting much of the rest of the time, as well as daily exercise. Since I started this regime, and have been on the Topamax, my weight has come back from what I called “the Peak of Madness” of 127.1 kg to this morning’s reading of 117.9 kg. I’m close to where I got to last year, the 114.3 kg figure. If I can hang in with this admittedly extreme system for another month, I’ll likely get there. But it’s hard.
This long climb back down from the Peak of Madness has been good for my anxiety and panic. It’s also been good for my waistline and hips. I’m now physically thinner than I was last year at my lightest. I’m eating myself.
It does occur to me that this may not be healthy. All I know is that four and a half years of weight-loss has killed my metabolism stone dead. If I eat more than a bare minimum each day, I gain weight. That’s the crux of the problem. Anything other than near-starvation means weight-gain.
My doctor today ordered me to double my Topamax dose, and to increase it still further next week. I told him I miss food. I miss eating. I wanted to lose weight, but I’ve lost food as well.
But at least I have reliable data, and a beautiful graph. Yay.