Tag: Not Good Enough

A Date with the Oncologist…and the Office Scale

This past week I had my “9-years-since-biopsy” oncology appointment. I have sat in that same exam room numerous times since March 2017.

It still smells the same—I think it’s the cleaning solution the Cancer Center uses, but I’ll never forget that scent. On the other hand, numerous improvements in treatments have taken place since my first time there.

One thing that hasn’t changed is that I still get weighed before every doctor’s visit, just like I do for a lot of other health appointments. It’s also been my least favorite part of getting a check up. No, I am not overweight, but as a child I was taller than all my classmates; basically a lean kid with perfectionistic tendancies who was occasionally teased about having a higher number on the scale, which I can assure you is a shortcut to disordered eating. As a result, even now I am sensitive about how much my healthcare team reads into my weight numbers, even though my weight fluctuations tend to be only a few pounds up & down that are not reflected on my frame.

Yes, you would be correct if I seem to get a bit touchy about this.

I weigh myself twice a week at home with a pricey, high-quality scale that provides all sorts of other metrics. The bodyfat percentage is not accurate and tends to report a lower-than-truthful value, so I don’t swear by it. But I have a great deal of confidence in the weight measurement, especially because I control for as many variables (time of day, clothing, etc.) as possible when I weigh myself.

The scale in the exam room isn’t even one of the “good” ones!
(Photo by Samuel Ramos on Unsplash)

The scale in my oncologist’s exam room literally looks like a bathroom scale. It’s not even the typical mechanical doctor’s scale with the weights that you move across that “T” thing that stands in front of you, if you know what I mean. It’s just a basic electronic scale. I’m sure it’s relatively accurate but not what I’d consider a gold standard.

Why am I making such a big deal out of this? Because my weight at my appointment was about 5 pounds heavier than it had been when I weighed myself at home a few days before and about 3-4 pounds heavier than the last time I was at the oncologist’s office.

And my oncologist pointed it out. It struck a chord. Maybe I sensed concern on his part, maybe I interpreted it as disapproval, maybe I just imagined his reaction. But I immediately felt defensive. This was not a 20-pound difference. This was, for all intents and purposes, a few pounds higher than last time.

I work out 4-6 times a week. I lift weights. I do high intensity interval training. I row on an erg. I take the stairs two at a time. And I cannot shake the feeling that it’s never good enough.

I have been a pescetarian for the past 42 years. I eat mainly vegetables and protein. I don’t put sugar in my coffee. I rarely indulge in alcohol or rich desserts. I have been told that I’m TOO disciplined. And it doesn’t seem to matter.

So, yes, I’m sensitive about this because I’ve spent my entire adult life being very careful about diet and exercise. I have been big on avoiding the things that the general public may consider indispensible treats, even though they’re not healthy. And, quite frankly, I prefer it that way and regret nothing.

Eat healthy, exercise, get cancer—but will people believe you did your best?
(Photo by Nadine Primeau on Unsplash)

But still I feel pressure.

Now, if I were decades younger, this might have sent me into an “I-must-be-even-more-disciplined” state and triggered a clamp-down on myself. But I take a deep breath because I know what I look like naked. I can’t change how people think. I can’t change the healthcare system. The scale is here to stay.

But I can say that as judge-y as people get around weight, the negatives extend way beyond those who might be struggling with weight loss or seem not to care. The effects of perceived judgment touch everyone else too, no matter what shape or size you are. And numbers without context can ruin your day.

As cancer survivors we may already have a difficult relationship with our bodies: changes experienced through surgery, not being able to recognize ourselves after chemo, dealing with unexpected effects of endocrine therapy, even the beliefs of others that we did something to bring cancer upon ourselves. That’s a lot to handle when you’re worried about recurrence or a degraded quality of life.

Hey, it’s okay. I get why we get weighed. But sometimes I hate how it makes me feel.

Another Oncology Visit and “Not Being Good Enough”

(Title image: Photo by Nik on Unsplash)

“I see pharmacological interventions in your future” is a paraphrasing of what my oncologist told me at my last doctor’s visit.

So let me back up a bit. I had my “eight-years-since-finishing-chemo” appointment with my oncologist last week. Things went the way they’ve been going for a while. He was very pleased with how things have been going and that made me feel very positive.

Certainly, I have my share of stressors churning at the moment, but most of them are not health-related. Most.

When my oncologist reviewed my bone density reports, however, he made the same prediction that he has during my previous two visits with him (see his quote above). The issue is that my bone scan in 2019 showed osteopenia, which I have to say is pretty weird given my lifestyle, which includes a lot of strength training. We both thought that perhaps it was an issue with the way the numbers were calculated.

Unfortunately, my 2024 bone scan showed a significant loss of bone compared to 2019. Enough to really concern my oncologist and befuddle us both.

So despite my living the lifestyle that medical guidelines say I’m “supposed to” live in order to stay healthy and strong, it’s still not good enough.

Tried as hard as you could? Well, too bad, try harder.
(Photo by Mads Schmidt Rasmussen on Unsplash)

This harkens back to what I experienced after being diagnosed with breast cancer. It seemed like I had done everything I could to lessen my chances of getting cancer, including things that should have been protective, but there I was, a breast cancer patient, and a young one at that (which, I later learned, what one of the reasons the risk factors didn’t necessarily apply to me, but I didn’t know that at the time).

It drove my perfectionistic mind haywire.

It brought on feelings of helplessness and even despair.

The only thing that gave me a bit of a lift was learning to meditate. Meditation imparted a sense that I had a teensy bit of control, if not on the situation, at least in the way that I reacted to it.

I got through that period of my life, brushed myself off and went on. And for a while, I was feeling blessed.

But cancer treatments have long-term effects. And the repercussions of being pushed through menopause and being on endocrine therapy eventually caught up to me. Physical movements that used to be easy started to hurt. I lost muscle mass…and apparently, I lost bone too. I felt like I was treading water with a weight tied around me.

Never good enough.

So I am bearing down and reworking my diet and exercise program even more. And to be honest, this is also an opportunity to shed some of my perfectionistic tendencies. While I want to feel like I am doing everything I can to help stop my bone loss and avoid taking medication for it, I need to learn to give myself grace. Sometimes even doing everything “right” will not be 100% successful, and I have to be okay with that.