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.

Weighing on My Mind: Not the Scale Again!

Anyone who’s been through cancer knows that the experience is not just about the cancer. The entire journey involves much more, revealing even the little anxieties that had been tucked away in dark corners.

One of those for me was that I was constantly put on scales. EVERY single doctor’s visit, I was weighed. And I hated it.

It’s worth mentioning that I don’t have what most people refer to as a “weight problem”. Unless, that is, you mean being exceptionally diligent that I not put on weight. For me, weight was tied to self-worth, and in my perfectionist view, I was driven by fear of shame to keep my weight down.

At every single (frequent!) oncologist visit: “Step on the scale and I’ll get your weight.”

Ironically, the positive side effect of this was that I became very interested in exercise and healthy eating, and that has served me well. But of course, it took a long while for all of this to shake out into a truly healthy mentality, and particularly in my teens and early 20s, my mindset was not the healthiest.

By my 50s, however, I had a great relationship with my active, healthy lifestyle.

And then I got cancer.

And all of a sudden, hospital scales were all over the place, and even not being overweight, I sweated the weigh-ins. I sweated them when I first went to see my doc about the lump, when my weight started plummeting even before my first chemo infusion (hello, uncontrolled anxiety) and when post-infusion I was retaining water and my weight crept up.

I could write an entire post (or several!) about how, while I religiously weighed myself twice a week at home, I had intentionally put off several doctor’s visits over the years NOT because I was 10-20 pounds over a reasonably healthy weight…but because I was about three pounds higher than I felt I should be. Those three or four pounds would have disappeared on my 5’11” athletic frame, but that was beside the point.

There was an “acceptable” number and I wanted to make sure I was there before heading to the doctor.

The number of cancer visit weigh-ins was staggering. Every.single.time I saw the doctor (which was a lot), I had to hop on the scale. I would purposefully not drink very much water or eat less beforehand. It DID NOT EVEN MATTER that we were dealing with a life threatening illness. I absolutely hated getting weighed in a doctor’s office and I hated what the scale meant to me – that I was somehow never good enough.

Since adopting a spirit of mindfulness, my perfectionism has softened and I no longer abhore the weigh-ins like I used to.

I had internalized that belief.

Gradually, the number of weigh-ins decreased. It was as if a pot that was at full boil slowly simmered down. My mindfulness practice showed me not only that anxiety was not a helpful reaction to a stressful situation, but that the slight weight fluctuations that I obsessed about weren’t apparent to anyone else. Nonetheless, I had taken them to be indicative of yet another way that I felt I had fallen short of the person I “should have” been.

And that helped me understand and begin to deal with those unreasonable and even meaningless expectations I had of myself that were still lurking in the shadows.

So now, when it’s time to go to the doctor, do I fret the scale?

Well, I still feel that twinge because it’s a deeply-ingrained habit, but now I understand where that twinge comes from. And once I get off the scale, I forget about it and go on with my day.