“Health and wellbeing” seems to be the new favourite phrase. It’s being bandied about at my workplace, and whilst I am sure it comes from a good place, people do need to get a grip on what it means, not just generally, but individually.
It may come as a surprise to many, but thin doesn’t automatically equal healthy, and fat doesn’t automatically equal UNhealthy.
I know. Shocker, right? Who knew that a thin person could have chronic heart disease? Or that a fat person could have great blood pressure and cholesterol levels?
Or…what else? Oh yes. Did you know that both fat and thin people get the same illnesses? Yes, really. But did you also know that if I get an illness, I will get told to lose weight to cure it, and maybe given medicine but that when a thin person gets the same illness they will (mostly) be given a treatment without the body advice?
Appearance based healthcare should not be a thing. Actual medical evidence based healthcare should be a thing. The only thing you can really tell from what a person looks like is what they look like. (Apart from the obvious physical things like rickets, or decapitation, let’s not be silly about this.)
This week we had a Know Your Numbers session at work. What those numbers in relation to blood pressure, blood glucose levels etc., really mean.
Hurrah! says I. Useful stuff at last! and then I spied the devil in the detail. Those 3 letters that spell doom, gloom and lectures for most people who are not olympic athletes or star rugby players.
B M I
There were tape measures on all the tables, and little charts to help you work out your BMI. My heart sank.
Mostly it was ok. The Dr was an interesting speaker, and did a good job of explaining what most ‘normal’ numbers should be. BMI = 25, blood sugar = 5/6 and blood pressure more than 90 over 60 (90/60) and less than 120 over 80 (120/80). He did also say that BMI is of no real use. But then said it was a good measuring tool, which confused me.
I do not drink. I do not smoke. I rarely eat white bread, or pasta, or huge amounts of carbs. Junk food isn’t a thing in my house, and processed meals don’t really feature at all unless I have really run out of time and energy. I do not eat crisps, or even the latest ‘healthy’ snack, popcorn.
I follow, mostly, the Mediterranean diet because it’s what I love, it’s what I’m used to and who doesn’t love a good olive? (It’s ok, I know lots of people who do not.)
I decided to play with the blood pressure machine that the Dr had brought along, rather stupidly forgetting for a moment that I was going through two of the most stressful, upsetting, grief inducing weeks of my life, the culmination of which was going to be the next day, and which had a high probability of having a very bad, life altering outcome. Plus three people were crowded round staring at me while the machine was working.
I think my numbers were 142 over 91, then 140 over 90 the second time a couple of minutes later.
“That’s high blood pressure, you should get to your GP and get on statins. “
“But it’s never read like that before, it’s consistently within normal range whenever my GP checks it.”
“Well that’s just the numbers, that’s what it is.”
“So why, whenever I had had it checked, in all my 45 years, has it always been good? Even after a bike crash, it was perfect? Surely my GP would have said something?”
“Well, it’s just the numbers, go to your GP asap or get a blood pressure machine to use at home and keep an eye on it.”
But you know, it wasn’t his words. It was the look on his face. I know that look, I’ve seen it countless times over the years. It’s a slightly indulgent smile, and an expression that says
“Of course you’ve got high blood pressure, you’re fat.”
It doesn’t matter what I say, or how well I document what I eat, it’s never quite believed, because my appearance shouts the contrary, according to society. In fact one of my friends who kept a food diary, showing exactly how little she ate – and I know how she eats, she lived with me and was UNABLE to get to the shops herself to buy anything other than what was in the house – was told OUTRIGHT she was a liar.
The most stupid thing, the thing that I am angry with myself about, is that he actually managed to scare me, so I bought a portable blood pressure unit, and used it today. I could feel my heart racing as I put on the cuff, and of course…my BP was higher than when HE tested it, so has he now put so much fear in me that I’ll skew the result each time? Have I given myself some sort of white coat syndrome so that my adrenaline spikes at the very thought of the machine?
I feel fine, I eat well in a way that I know is good for me – the way my very first GP told me to eat when I was diagnosed with PCOS at age 16 – I try and walk as much as I can in the time I have each day, I try to not sit for too long at work, which is hard when you’re a PA whose job is mainly email and computer based, and I’m trying to lose weight for my own peace of mind but this whole thing has made me feel very scared, and about to run to my GP for statins.
This is not how properly done healthcare should make you feel. Whose wellbeing are they looking after, really, when one 10 minute meeting can leave a person upset and scared for days and spending money that they probably didn’t need to.
But, as ever…