Saturday, July 25, 2020

The Art of Being Unproductive

In these times of surreality, I'm trying to remember how I somehow muscled my way through my generally unbalanced life. With plenty of naps and no structure, it seems like my productivity should have skyrocketed during the quarantine. Instead, I've barely dribbled out a few thousand words on various writing projects and have yet to reach any goals related to reading, running, or studying, not that I'm in school or anything, just glancing over some textbooks for the hell of it or "should" be.


I wrote that first paragraph during the shutdown and wasn't sure where I was going with it. Now I'm back at work with different hours but the same amount of time away from home. I'm pretty sure I started the post with the intent of reminding people that it's OK to lower expectations and not be exceptionally productive, especially under stress, but since I lost my way with the original post, I decided to go ahead and completely switch paths. The title no longer fits, but I'll leave it.

Over the years, I haven't been as involved with the eating disorder recovery community as I once was. It feels saturated with a few loud voices at the top and many deserving but mostly unheard voices everywhere else. Despite the increase in available information about recovery and an increase in the number of people attempting to grab a platform, I still see a lot of bad advice presented. I've stopped looking at "health" and diet culture on Instagram altogether. I will never care about the macros someone else eats, and seeing images of high-protein or vegan glop served on a plate or in a bowl or blended with other ingredients and served in a glass will never inspire me. It's probably because there's little to no joy in that kind of food. I don't need to see your every unimpressive breakfast, lunch, and dinner. Great if that shit brings you and other people pleasure. It's just not for me. If I'm looking for some food inspiration, I'd much rather watch a video put out by Sarah Kosca and her daughter because why not bring some elegance, creativity, humor, and fun into food preparation?

Blatant unhealthy or triggering social media accounts aside, I have seen some of the worst content coming from people who probably think what they're doing is inspiring or helpful. Some missteps I have encountered recently are listed below:

1. Pinching your thigh or other body part and showing that even athletes or thin people have cellulite doesn't help anyone.

What the hell? I mean, why do this? If you're doing this publicly, either you have no clue how absolutely unhelpful this is, how potentially triggering it could be to someone struggling, or you yourself have body issues. I never, ever need to see anyone grab her thigh to point out cellulite. The only action this will inspire in me is repeatedly banging my head against a hard object.

Maybe instead of grabbing body parts to expose "flaws" as one person put it, you could try focusing on, oh, I don't know, a fucking book you read, the weather, the places your legs can take you, performance, health, or anything else, really. If you have a problem with your cellulite or want to show it off to everyone, that's your business, but don't think that doing so is going to be helpful to anyone. It's not. At best people don't give a shit. At worst, you're causing stress in someone's life who will compare her legs to yours and may start to assume the worst about her own body.

2. Stop calling yourself a "big" runner when you're not.

I'm not sure if it's a body dysmorphic thing or what, but I see a lot of lean runners calling themselves big. I even saw one runner who has continually placed herself in the "bigger" category show off countless images of herself indicating that she is no bigger and has almost always been the same size or smaller than her competitors. Claiming you're larger than you are is unhelpful. Imagine being an actual bigger runner or larger person while watching a thin, elite runner call herself big. It's worthless to focus on size anyway when racing is about performance, but many athletes draw unnecessary attention to the female body by talking about size. Your size is irrelevant to how someone else will perform. The same kinds of comparisons happen as with the situation above. It's just not helpful, at all. People have eyes and don't need to be told stories about what they're supposed to be seeing over what they actually see. Focus on you, and if you have a distorted view of yourself, ask for some guidance from a professional.

3. Don't offer advice when you're not qualified and know nothing about a person's history and health background.

I see this way too often. I'm not talking big generalizations like most bloggers tend to do; I'm talking direct answers to specific questions posed by a specific individual. If you don't know about a person's health and background, there is absolutely no way to know if that person is healthy, and, unless you have a medical degree, you are not qualified to answer questions pertaining to his or her health.

Years ago, a runner posted a Q & A on a blog that was rather horrifying. A fan asked about losing weight before a big competition. There was no mention of his or her current weight or if anyone suggested the weight-loss, only that there was this desire to lose weight. The one posing the question admitted being prone to stress fractures, too. Without knowing jack shit about this individual, the blogger started off sensibly and then quickly veered into what-the-fuck territory by musing that maybe this individual only needed to lose a few pounds... or maybe more than 10 in order to run well. Here's a thought, what if weight-loss wasn't the answer at all? I admit that the overall sentiment was probably not harmful or at least not meant to be, but it only takes a few lines of triggering content to possibly lead someone who's reading the exchange, including the one posing the question, in the wrong direction.

This is a great example of someone meaning well but being completely unqualified to answer this type of question. Are you a doctor? Do you have a degree in nutrition science? No? Then shut the fuck up. There is zero need to go into how much better you might run if you lose weight, especially when you don't know what the person weighs or anything about this individual. The focus should have been entirely on running and performance goals, strength, and balance. It's uncomfortable for me to see anyone in the running community go into fantasy success stories about weight-loss and running better knowing that there may be young athletes reading the content. Weight-loss alone never leads to running success. You still have to do the training, and you can't do that if you're not fueling your body, period. That's all that needed to be said. Jesus Christ, so many people have a God complex, thinking they can play online doctor, coach, therapist, and general know-it-all in every situation.

4. Male coaches aren't the sole problem when it comes to the abuse of young athletes.

I know I'm not alone in thinking this. Other runners and athletes have already pointed out that female coaches can be just as much of a threat to the well-being of an athlete as their male counterparts. Additionally, there are deeper issues at play when it comes to the broken systems in the athletic community. Replacing male coaches or adding more female coaches won't solve issues of abuse if deeper issues and false narratives are ignored. I and others have already gone over some ideas around potential ways to address abuse, educate athletes about what abuse looks like, and provide a safe space for athletes to open up and share concerns, so I won't repeat myself here. I just see too many people trying to solve problems that have been going on for decades by focusing on a single issue, not the big picture. Doing this isn't likely to fix what's broken.

5. Girls are not women and visa versa.

It's not so much that I or most people get upset if someone slips and calls women girls. It's generally not a huge deal as long as calling a woman a girl isn't meant to be insulting or belittling, as in she, an adult, is immature or not as competent as a man, but if it's simply describing gender and the person speaking uses boys and girls as descriptors, one can hopefully see it's not meant to be offensive.

The bigger issue is when coaches or other adults treat young girls as if they are women who can handle more emotional and physical stress than youngsters may be ready for. This may be obvious when it comes to actual children, but athletes who are teens are also not mature adults.

Too often, people apply adult thinking to situations involving teens and children. If you're an adult addressing a situation that involves a child and start out by saying, "I would just..." stop yourself. Just don't go there. Consider the different types of stressors children face. When it comes to abuse, it's even more unbelievable that people on the outside expect a child to speak up or face her abuser in the moment. That's why it's important to provide outside checks for young athletes, a way for them to feel safe about opening up about general concerns and abuses.

Some helpful resources:
Safe Sport:
Rachael Steil:
Child Help:

A lot of this is nothing new. I and others have expressed similar sentiments before, but I keep coming back to the fact that too many individuals are throwing themselves in positions of authority without having the much-needed qualifications and could potentially end up directly or indirectly harming someone.

NCAR This Year

I haven't been timing myself in anything resembling a race or time trial since my last surgery. It has been a somewhat rocky road since then. After a while, I just got scared to see where I was. Like many athletes and former athletes, I still put way too much pressure on myself. I went back and forth on attempting a timed workout today. Usually,when I'm aiming for something harder, I go by arbitrary time, not a particular course or distance. When I didn't feel too terrible during my first few steps, I thought, "What the heck, why not do NCAR?" Things started out OK, but by the time I hit the base of the big road, I was already struggling with thoughts of quitting. Fatigue doesn't help a person dig deep, and I'm out of practice. That's for sure. Long hill story short, I got to the top in like 20:55, but then I remembered my start time was off by a little bit since I accidentally started my watch at the sidewalk instead of the parking lot of the little library on Table Mesa. It's amazing how much you can forget in a 20-minute grunt up a big hill. The reality is that I probably ran about what I did last year, closer to 20:50, which kind of sucks, but isn't the worst thing ever. I got it done, so I guess that's something.

Wednesday, July 15, 2020

Flat and Fabulous

 In the years since I first intended to write this, I’ve discovered how hard it is to chronicle the difficulties of someone I greatly admire and respect. I'll start with an apology to Ann (not her real name) for taking so long -- I just didn't know how to explain what she went through while properly acknowledging her and her experiences. Having not gone through what she has, I worried that I couldn’t convey her story in a way that honors her in the way she deserves.

More than artistic perfection, Ann deserves a story.

We met many years ago in Boulder. Ann has since moved, but we used to do some training together as part of a local running group. Anyone who’s met her would agree that she is one of the sweetest ladies in the world. She's smart, funny, adorable, and talented in all kinds of ways. This isn't excessive flattery; it's the truth.

Ann approached me after she had already gone through a bilateral mastectomy to remove cancer. Going through the diagnosis and facing the removal of both breasts was difficult enough, but what occurred afterward compounded Ann’s grave challenges in a way familiar to far too many women.

Endless reconstructive surgery cycle

Life doesn’t go back to normal after breast-cancer treatment ends. The most common treatments are partial or total mastectomy, radiation or chemotherapy, then hormonal treatment, followed by reconstructive surgery, a cosmetic procedure designed to bring back the shape of the breast. Technically, the procedure is not considered cosmetic since the surgery is reconstructive, but it serves no functional purpose. It's important to note that these operations don't bring back sensation to the area, though sometimes sensation eventually returns with or without the procedure. Despite this, most women aren’t encouraged to stay flat.

For Ann, the whole process seemed more like a financial benefit to cosmetic surgeons than a way to restore health and confidence, or to reconnect her to her sense of femininity. Whenever part of the body is surgically removed, a physical and emotional adjustment period always follows. Some in the medical field seem to prey on this vulnerability and rarely offer breast cancer patients emotional support in lieu of a mammoplasty.

Reconstructive surgery is on the rise, but is it because women truly want it or because they are being pushed into it after mastectomies? With cosmetic procedures now normalized and on the rise almost to the point of pathology, it’s hard to pinpoint all the sources of pressure women experience when it comes to their looks.

Ann's reconstruction failed, and the implants had to be removed. After two additional operations within a year of the mastectomy itself, bringing the total number of surgical procedures on that part of her body to five, others tried to encourage her to undergo yet more operations.

"Unfortunately,” Ann says now, “although it does give you something to cling to as a silver lining through the initial shock of it all, the reality should be better presented to women that the surgeons really cannot or choose not to have a favorable outcome with one or two surgeries.” Instead, it turns into a cycle of "just one more," with patients seduced into continually thinking that they are approaching, but have not yet gained, personal perfection. “I am adjusting to a life with no breasts and additional scarring and damage that could have been avoided entirely,” Ann says.

What's shocking is that women endure these things after they have already battled cancer. Some undergo an unreasonable number of surgeries in order to try to restore their breasts. Ann told me about one lady she encountered in a Facebook support group who had experienced 36 such operations. Ann had endured enough with four and decided to "stop the assault" on her body and her health so she could attempt to return to a better, healthier life. While grateful today to be cancer-free, she was left with cut pectoral muscles that scarred and took time to heal. Her recovery has been ongoing.

Another sexually predatory business

Like the multitude of other money-driven businesses that prey on women's self-image to stay in operation -- the beauty industry in general, for example -- cosmetic surgery and, specifically, breast cancer reconstruction facilities take advantage of women in vulnerable positions who are facing a life-threatening illness. At $10K plus per surgery, as of a few years ago, it really shouldn't take more than a few tries to get it right, and if it does, each one shouldn't cost as much as feeding a small family for a year. Understandably, most women want to feel more normal after going through such a harrowing ordeal and are pressured by society to look a certain way, so they are willing to endure multiple surgeries in an attempt to improve their self-image and feel more like they did before their mastectomies. And this is the carrot dangled in front of them, the "silver lining" as Ann put it, that they will feel better about themselves, more beautiful and womanly after they subject themselves to these expensive surgeries. Who wouldn't want to feel better after facing cancer?

"I am disgusted by the entire 'breast cancer industry,' which I am certain prays upon most women's self-image issues,” Ann says. “This in turn propels them to continue with reconstruction attempts to achieve what should be possible with fewer surgeries."

But the push for women to have breast augmentation surgery started before the procedure was used for reconstruction. Fans of the Swindled podcast or those who remember Dow Corning’s big legal battle in the 1990s, will recall how as early as the 1960s and 1970s, millions of women had already undergone breast augmentation surgery. There has been a long history of deception by companies promoting the use of breast implants, often with no adequate testing. Using implants for reconstruction gave breast implant companies a larger market.

One of the worst frauds related to breast implants was committed by the company PIP, Poly Implants Prosthetics, founded in 1991 by a French man, Jean-Claude Mas, who was really more of a salesman than anything. He aggressively pressured companies to purchase his inadequate breast implant products, which ruptured at double the rate of others on the market and contained his own recipe of silicone, not the medical-grade version he insisted it was. Even PIP’s saline implants were faulty. Cutting corners to make a profit was more important than women’s health, apparently. Imagine going through cancer, having reconstructive surgery, and later facing additional illness caused by ruptured implants and cheap, industrial-grade silicone leaking into your body. This happened to more than one woman. Other women developed autoimmune disorders, fatigue, painful lumps, and even cancer.

Mas is no longer producing implants, and PIP was shut down in 2010. But this doesn’t mean all breast implants are now safe. In 2017, the FDA gave a warning about certain types of implants being linked to a very low but increased risk of developing BIA-ALCL, a rare type of cancer. It should be noted that a French woman died after developing this type of cancer after her PIP implants leaked.The FDA’s warning is not to say implants cause this type of cancer, but there is an increased risk of developing it when certain types of implants are used.

The fundamental problem is that most doctors don’t go into detail about all the risks involved with reconstructive surgeries.

 Complications and contradictions

While Ann has been able to look at her entire situation as a learning experience and has adapted phenomenally well as a member of the "flat and fabulous" club, some women aren't prepared to face outside pressure to have surgery so soon after battling cancer. Obviously, these kinds of decisions are difficult, personal, and depend on more than a simple desire to look a certain way. There is much to consider before undergoing any operation, but women battling breast cancer are pressured to make a decision right away.

"They want to do the surgeries quickly when you are diagnosed,” Ann says. “You are just in such a state of shock trying to process it all that you accept what one or two doctors tell you without probing more." In Ann's case, given her small, athletic stature, she was never a good candidate for reconstructive surgery, but she wasn't told this by her first surgeon.

The surgeries resulted in other complications, ones that eventually led Ann to do her own research and eventually demand the implants be removed. According to Ann, the first error was that, even though her first plastic surgeon knew she was an athlete and runner, he should not have cut her pectoral muscles to put the implants underneath. Plastic surgeons need to consider each patient individually. A good surgeon will look at the implant size, the implant type and shape, the patient's body type, and how much breast tissue is available to cover the implant. In Ann's case, being a petite, post-menopausal runner with a low BMI made her a poor candidate for breast reconstruction surgery, period.

Initially, she asked her surgeon to remove the implants, stitch her muscles back down, and put the implants on top due to severe animation deformity. Animation deformity is a complication of breast reconstruction associated with subpectoral implants. Contraction of the pectoral muscle can lead to disfigurement caused by implant displacement. What reconstruction surgeons don't often tell their patients is that women who have battled breast cancer are far more susceptible to this condition. Around 78% of them struggle with this issue.

Ann’s exit from “the system” and reflections

After everything she had already endured, Ann didn't expect her surgeon to do a "totally lopsided, shitty job" that would force her to have to come back for more corrective surgeries. At this point, she switched to a different surgeon whom she liked and respected more, however, he was the first one to tell her honestly that she was a poor candidate for reconstruction all along. Regarding her first surgeon, she said he made her cry every time she left an appointment, but she looked at the experience as a way to learn how to stand up for herself.

She allowed the second surgeon to try to fix what the first had done, but, unfortunately, she developed complications from the surgery due to the lack of fat and circulation in the area. This meant she had to have another operation. Her surgeon was going to try to go ahead with the repair, but shortly before the operation, she changed her mind and decided to just have the implants removed without the added steps of trying to fix anything.

Ann had to be very firm about it. "I was realistic that, and he agreed, one more surgery probably would not do it, and I said I was done and wanted to get on with my life,” she says. “Unfortunately, the damage had already been done."

After all of this, Ann has gradually been able to feel more comfortable in her skin and confident with her body image, and, over the years, the emotions around her experience have changed. "You can google what other ‘flat’ women look like,” Ann says, “and you will see that the biggest problem for me is that those visible folds are not fat or extra skin that can be removed -- they are my pectoral muscles that were cut from the sternal attachments and then stitched back down in a straight line.”

This was the only way the procedure could be once the lower attachments were removed. Also, she says, all of the extra surgeries dissolved any remaining fat she had. But she had made a positive decision for her health. Although she wishes she had done it sooner, she has adjusted. She states, "I do not wear prosthetics--do not even own a pocket bra and refuse. To me it seems to further support the entire industry. I want to be proud of my body the way it truly is!"

None of this touches on Ann’s financial consequences, which have been staggering.

Ann's message to others is to avoid rushing into any surgery. She suggests, "Do the research first or at least look for surgeons with a track record of less versus more surgeries. There is definitely a miscarriage going on here. In my opinion, too many women are being subjected to too many surgeries."


 Thank you to the individuals who helped me with this post including friends who read it and those who helped with editing.