Contradictions!

An article in the Melbourne Sun-Herald on May 20th was headed: Fat Patients Thrive

Gosh - I had to read that one. Most news items in the newspapers, magazines and television current affairs all deal with the fact that being "fat" is a bad thing. Here's one that goes against conventional advice.

I'll quote the article:

"Overweight heart attack victims should stay fat as they are more likely to live longer, say researchers. The controversial claim goes against conventional advice to patients that they should lose weight.

Evidence from a review in the Journal of the American College of Cardiology suggests being fat can be useful for heart patients.

"Obese patients with heart disease respond well to treatment and have paradoxically better outcomes and survival than thinner patients," said author Dr Carl Lavie, medical director of Cardiac Rehabilitation and Prevention at the Ochsner Medical Centre.

Dr Lavie said it was possible extra weight might help because patients had more reserves to fight disease."

.....© 20/5/2009, Melbourne Sun-Herald.

Reading - you never know what you'll learn

I love reading. Ever since I was a tiny tot. Before I could say the alphabet or knew what it meant, I would sit for hours looking at picture books (which were few and far between in those days - mostly handed down from cousins or other families) or the occasional "word" book. Even though I had no understanding that the dots on the page were actually words I would make up my own stories by turning over the pages like the grownups.

So I've grown up with books - they are my friends. Some I have had since childhood, others I've collected over the years.

You can gather from this therefore that I enjoy reading - a lot. I love the pictures that words conjure up in my mind. When I read I inhabit other worlds, both imaginary and real. I gain knowledge, I can easily fall in love with a hero or dislike intensely a rogue (even vice versa). I can laugh and I can cry.

At the moment I'm re-reading my series of Precious Ramotswe books. Written by Alexander McCall Smith who has a deep love and understanding of Botswana and it's people, Precious is a woman of our time. Independent, morally strong, valuing good manners, kindness, a love of her country (even though she recognises some faults in both the country and its people). Her intuition and instinctiveness to see behind untruths and pretenses reveals to us many of our own characteristics.

But what I love about Precious Ramotswe is her self-awareness. She is under no illusion that to be happy and to be a contented woman she has to be thin. Quite the opposite. She describes herself and is proud to be spoken of as being "traditionally built". She finds no reason to even think about her weight as a negative within her life. She is fat.

Let me quote from "Morality for Beautiful Girls".

"She finished her tea and then ate a large meat sandwich which Rose had prepared for her lunch. Mma Ramotswe had got out of the habit of a cooked lunch, except at weekends, and was happy with a snack or a glass of milk. She had a taste for sugar, however, and this meant that a doughnut or a cake might follow the sandwich.

She was a traditionally built lady, after all, and she did not have to worry about dress size, like those poor, neurotic people who were always looking in mirrors and thinking that they were too big. What was too big, anyway? Who was to tell another person what size they should be? It was a form of dictatorship, by the thin, and she was not having any of it. If these thin people became any more insistent, then the more generously sized people would just have to sit on them. Yes, that would teach them! Hah!"

I couldn't have said it better!

Even for a self confident woman, there are times ......

All the women in this group have been through times of anguish, despair, fear, rejection, emotional abuse, discrimination in all its forms. I'm glad to say that we've all "come through" these times, and we sit happily and healthily (in the main) quite aware of our sense of self, and confident in how we feel and how we look. We've accepted our bodies.

So it came as a bolt out of the blue the other day when one of our team went in for a cataract operation earlier this week. She has been on the "waiting list" for more than 4 years, so she was somewhat excited about the whole thing.

All the preliminary tests had been carried out, including measurements for the eyes a few months ago. Those tests also included height, weight and other matters relating to any allergies, and a list of medications that she is on. The usual procedure in fact. She was told all she had to do was "front up" at the day surgery section at the hospital at a certain time on a certain day, and the operation would be performed.

Simple.

Oh, yes? No.

Because when she had undressed and given a hospital gown, processed through confirmation of details,re-weighed and her height confirmed, the nurse came out with the words, "sorry, we can't operate on you, your BMI is too high". How can this be, when she had even lost some weight between the initial visit and the day for admission?

Well, it seems the hospital had put in place "considerations" to reduce the BMI acceptable for any sort of operation a month ago. Without notifying scheduled patients for our out-patient procedures, this means that there would be many patients attending the hospital only to be told that their operations cannot be performed.

In this case, it wasn't the surgeon who refused to operate, and after all it was a local anaesthetic not a general one, but the hospital staff.

So this means the patient now has to be put onto a waiting list of another city hospital who MAY accept a higher BMI - what this means in anyone's guess.

So it is a little understandable that this patient felt disappointed. Because in amongst everything else, she was rudely reminded that "size" is still a no-no and that acceptance which is taking a long, long time, is most probably a long way off. (And we're not naturally pessimistic - usually!)

But as an aside, this means that this particular hospital (and there must be thousands that have similar policies) will not do cataract operations, colonoscopies or other procedures which up until this time were considered to fall within the acceptable operations performed on a regular basis if the BMI is above a certain figure. We wonder what the policy is with women are BELOW the acceptable BMI, because there's a lot of talk at the moment about women who are considered to be malnourished with BMI's in the vicinity of 15, but who the medias and the fashion industry think are "ideal".

Another aside too, we've since learned that the Victorian Government have decided to withdraw many of their subsidies for visiting specialists from Melbourne to outer country hospitals, which means patients will have to travel into Melbourne (one train a day), probably stay overnight (more expense), have a procedure, and then return. The costs and time involved will be high. Especially when it comes to the elderly.