Friday, 16 April 2010

The treatment of patients and "Patience"

Advice to bariatric nurses

The weight loss hasn’t been going too well lately, as you know – since surgery in December 2008 I was just managing to eat and exercise enough to ensure a modest but regular loss, and the first 3 stone/42lbs/20 kg came off relatively easily.  But it must have been borderline, because after I got it back together and settled down (…ish) to what I was doing before - no diet but reasonably careful, moderate exercise – I’m keeping level, but can’t manage to lose very much. 

The reason has been emotional, and I have tried to document this as honestly as possible in my blog.  My head tells me that comfort eating is no consolation in the long term, but if you feel sad, then feeling hungry as well is adding insult to injury.  And when low, it’s harder to get organised so that there are low calorie solutions to your hunger.  This isn’t a whinge, I’m perfectly aware that losing, however slowly, will make me feel better.
I asked the bariatric team at Taunton if as part of the deal I could visit them more often than once a month for a while, to help myself get back on track, and they were very encouraging.  I have 10ml in my band, with reasonable restriction, so the purpose was not to have any more fills for the moment.  The people with whom I have appointments at the hospital are women who themselves have had bariatric surgery, and they understand the way the minds work of people such as me.  I have been going every two weeks, they weigh me, have a chat, and on one occasion I’ve seen a nutritionist as well.  They encourage me to be patient, take my time and recognise that keeping level is an achievement in itself.
That is until about a month ago, when my favourite morale booster on the bariatric team, a lovely lady called Margaret who is a bandit herself, was not available, and ever since I have been seen by a bariatric nurse with many years experience.  Fills by her really hurt, so she was never flavour of the month anyway, and she had told me on my return from Argentina (before which holiday I had an unfill for special reasons) that “it’s not a designer band you know”. 
The time before last I had lost a kilo, which she remarked was “very modest but at least it’s a downward trend”.  I would have liked to reply that at my age losing a kilo in two weeks wasn’t going to break the sound barrier, but was more than FINE with me.  However I kept my counsel. 
Last visit 2 weeks ago I had put the kilo back on.  She then said something like “I think you’re going to have to accept that the band doesn’t work for everyone, and it may not be right for you.  Obviously we can’t look over your shoulder and police what you’re eating, but you’re going to have to think about what you really want from this band, and how much you’re depending on it to do everything for you.  Here’s a diet sheet to recommend what you should and shouldn’t eat.”
I don’t expect her to be a mind reader, but merely to assess with all her experience whether or not I’m an airhead who will give any old excuse for not losing weight (of the honestly-I-hardly-eat-a-thing and I’m-ever-so-constipated variety), or whether there's an underlying reason. 

I’ve had the band for 16 months and have been becalmed for the last 4… I think it’s way to soon to suggest the band is not for me.  I always used to give up in the past (we all do) – but if to imply that I’m destined to be obese the rest of my life is her way of using jump leads, then she needs a bit of re-training.  In addition, to say this to a person who is obviously very subdued and down is so crass. 
But I didn’t see it like that at the time, and her words had the desired effect.   I wept most of the way home because for the enth time I was being told I might as well give up, and it was simply too much to bear.  I rallied later and felt angry, and since then I feel that I simply can’t be counselled by someone who may well have her own jaded issues – i.e. bored to death and heard-it-all-before. 
How many times have I observed on the blogs I read that when bloggers actually care what happens to you (on whatever subject) it really does help you to carry on?  I can’t understand why professionals fail at what amateurs like us know instinctively.  We may not do it for a living, but then they shouldn’t either.
I’ve tried to change the next appointment to be seen by someone else, but haven’t been able to, nor do I want to cancel my appointment next Wednesday – I’m no coward.  The best thing may well be to just face her and find a way to get across to her, with dignity, that her attitude has had a very negative effect on me.  I need to do it in my own style – which is (to paraphrase a quote well known to baby boomers) to speak my truth quietly and clearly.  Any advice or ideas on thoughts or phrases which might help would be very much appreciated.
On to more cheerful things.  The Bristol Gilbert & Sullivan Operatic Society has been staging its annual production this week, Patience, and yours truly took the dress rehearsal pictures.  Using a digital camera is lethal for someone like me.  No longer restricted by the cost of film, I snapped till my finger hurt, and came away with about 750 pictures.  Much burnt midnight oil later I had whittled it down to 400, and thanks to Picasa and Photoshop removed the strong orange-red cast you get when photographing a heavily lit stage. 
Here are a few examples, but first I thought you might find it interesting to see a ‘before’ and ‘after’ to show what can be achieved with digital photography – by anyone, because I’m certainly no professional.

...and after...

After correcting the colour I realised that the principals were too bright, not looking their best and Patience herself is hidden behind the hero – and the Dragoons on the right were OK but there were an awful lot of other pictures of them.  So I cropped the picture as an experiment, and realised that the ladies were well positioned for a good composition.
Here are some others - corrected to remove the rather violent orange cast -
Patience - a milkmaid

John on the right, fighting a heavy cold, and not
aware till he saw this picture just how full of
pancake makeup his white gloves were!
The Dragoons seem forever to be on the stage, prompting
the performance to be called "The Dra-goon Show"...

I like the way the differential focus seems
to tell a story...

The finale


Photo Finish
- from Lonicera's non-digital archive

From other shows

I thought it might be interesting if in this section I show you for comparison scans of old slides which were taken at dress rehearsals.  Gilbert & Sullivan productions, being lighthearted, tend to be brightly lit, but in past years I've taken pictures at amateur productions of grand opera, where moody lighting meant I got a lot of duds, but occasionally a good one that was more interesting than the brightly coloured ones.

La Traviata (Verdi), 1998 Wedmore Opera

A Masked Ball (Verdi), 1995, Bristol Opera Company


Macbeth (Verdi), 1988, Bristol Opera Company

Aida (Verdi), 1998, Bristol Opera Company
Samson & Delilah (Saint Saens), 1987, Bristol Opera Company



tessierose said...

First, I'm so sorry the way you were treated by that nurse. I remember once I was doing a weight loss program in my town, called LA Weightloss, there were weekly weigh-ins and talks with a councelor. There was on woman who was so ill-equiped to be in that position, she was always saying hurtful things to me, I was down 50 pounds and went in for her to insult me and I just lost it and quit. I told the manager that I could no longer in good conscience pay good money to be insulted and walked out. I eventually gained all my weight back, but still, that makes me so mad, I don't know why she was in that line of work if she had so much contempt for the overweight. Secondly, your photographs are beautiful. What a wonderful eye you have.

Tina said...

I have seen the attitude at my Dr's office as well. From two different people I have gotten attitudes you are doing so well-how unusual. I have read the statistics and know lapband works (maybe not 100% weight loss in 10 years but a far cry from where i started). I don't know if their behavior involves a lack of bedside manner? some information about the lapband that I am not aware of? or some belief that if yo8u are hard on someone it will put them in line?...whatever the reason they are ineffective as heck and hurtful on top of it. You should really tell the nurse and others perhaps it will in some way make them think about the behavioral aspects of what they are doing.

The pics are lovely!!

Cindylew said...

I'm terribly sorry that someone made you feel that way. These people truly don't belong in their chosen profession.
I've been back-reading your blog and it's amazing and so are you. You were one of the first to comment on my first blog and I'll remember that always.
Keep your chin up...tomorrow will surely be better.

Nola said...

It is so annoying that one person can set the tone for our whole day, week, month or even year!! She shouldn't be in that position at all.... I would certainly have a talk to someone who is her senior and let them know how her comments made you feel...or write it. You are very good at writing,. I also loved your photos:)

Lonicera said...

Thank you all. Tessierose - I phantasise about reacting like that, but I can't keep it up. I can look at someone squarely in the eye and tell them they're wrong/unkind/unfair, and particularly if they're bullies, which I can't stand, but tend to back down (by being 'very understanding') afterwards. Tina I know you're right - I have to find a way of making her see what the consequences of her words were. As Nola says, perhaps it might work better to speak to someone else in the department who is senior to her. It will depend on the circumstances presenting themselves at the time.
Thanks for your comments Cindy, much appreciated.
So glad you like the pix, I do enjoy deciding which to upload, and which might be of interest.

Zanna, travelling tart said...

I feel for you Caroline - and no-one should make you feel that bad. I'm a bit like Nola - I'd probably write her a letter and perhaps copy in a supervisor. The nice things about writing is that you can do it at your leisure and choose the best words to get your message across - it removes all the emotion that a confrontation would have and I usually find is a cathartic process for me and allows me to get closure on the incident.

But her bad manners and lack of understanding made you feel angry and unhappy - now try to turn that around and use this anger as fuel to help you get you on the trail again - motivation has many guises and anger at someone or something can be useful as a kick start.

Hope you have a great week - and I too love your photos Zxx

Reddirt Woman said...

Caroline, your photography and photoshop skills make me envious. But I'm struggling to learn. At my age and not being an analytical person you might say I'm feeling a bit techno-challenged.

As to your nurse... she obviously has issues that she needs to leave at home and to understand that negativity is so defeating and demeans her knowledge. You are much kinder than I'd be to try to gently lead her to enlightenment. I would probably have told her to sit on it and spin if she can't be of a more encouraging nature.

CJ, in a fit of anger, after an argument with his parents, committed suicide. He shot himself and was brain dead and died on April 15th. My heart breaks for the family. If I hear more I will drop you an e-mail. Sorry that I have not been posting as much... Been going through a pretty bad stretch and fighting the depression that goes with it.

More later, my friend, and don't let the negative people get you down. It's not a fun place to be...


Lonicera said...

Thank you Zanna and Helen - I'm doing a post to tell you how it went this evening. And special thanks Helen for explaining about CJ - it's put me in shock as well.

Julie's Journey said...

I am so sorry about the way that nurse treated you. Basically telling you to just give up??? Unacceptable.

Thank you so much for all those beautiful pictures. You do good work ;))

Lonicera said...

Thanks Julie... My feeling now, several weeks later, is that it's important that I exclude from my life those people - professional or not - who have a negative effect on what is so important to me. I don't want to have to pick myself up any more than is strictly necessary...
I'm so delighted that readers like my pictures - it really does mean a lot to me. Thank you.

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