Protected: Dress Shopping with Zoey
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As a psychologist, especially one who was a researcher for many years, I know a lot about probability. The efficacy of our treatments are assessed using probabilities. For example, in a study assessing the efficacy of a treatment for depression, the question for the treatment group would be, “How probable is it that improvements in the group that got the depression treatment were due to chance rather than from the treatment itself?” If the probability is low, less than 5%, it is taken as positive support for the treatment. I am oversimplifying here so that you don’t pass out with boredom before I get to my point.
In my clinical work, I work to select strategies that maximize the probability that a child will be helped. There are no absolutes. We can’t control other people, we can just look for the avenues where we have the best chance of influence and focus our efforts there. I also can make predictions about long-term outcomes for kids with particular issues but I can’t tell parents absolutely what the future reality will be. For example, I can tell a parent if he/she has ADHD, there’s nearly a 50% chance that any child he/she will have will also have ADHD. I can also tell them that if a child has ADHD, there’s about a 66% chance that he/she will have some other diagnosable condition. I can tell a parent of a child whom I’ve diagnosed with ADHD what the best practices are for treatment, for example that stimulant medication has an 80% efficacy rate. (I know that ADHD meds make a lot of people uncomfortable but if you wouldn’t mind, please don’t use my blog as a forum for expressing your views on this subject.) I can give a list of possibilities and sometimes I can even make pretty good predictions based on information I already have about the child but I can’t know for sure. In talking to parents about these numbers, I have to balance a tight rope of providing them with enough information so that they can make informed decisions, convey the information in a way that will encourage relatively quick action, but not scare them silly. This is a different balance for each parent, which can make it difficult if I am talking to two parents who have very different coping styles. It also depends on the child’s particular situation. Some situations are more dire and urgent than others. Oops, I’m blathering on and on again. Back to the main point.
So I know a lot about numbers, predicting, identifying risk and protective factors, treatment effects, etc. I also know that the numbers can be extremely useful but there is a balance between keeping myself knowledgeable and borrowing trouble. I will be getting my genetics testing results back in a couple of weeks. I know that my chances of having any of the genes is low based on probabilities for the general population as well as those based on my family history. I know the probability is low but I can’t tell you the exact number. And I’m not going to look it up in my notes from the genetics counselor. I have learned the hard way in my life that worrying about something I can’t do anything about is a recipe for crazy. When the time is right to get lots of information, you know I’m going to get lots and make the best decision I can based on the information that is available. So until I know what the findings of the test are and can develop a plan for dealing with it, I’m going to fight the urge to spin my wheels on the Internet or keep myself up at night worrying. Obviously, this will be harder as I get closer to the two week mark, but I’m going to do my best.
Wish me luck in keeping this balance between information-collection and sanity preservation.
Protected: Awww and Aaaah
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So my phone alarm went off this morning as it does every month to remind me to do something very important. Is it to pay the mortgage or the rent on my office? No silly, it’s to remind me that it was time for my monthly breast self-exam. When the alarm went off, I laughed a little. What was I going to find that three mammograms, two ultrasounds, a biopsy, and an MRI would have missed? Then I thought, “What the heck? I’ll just do it and keep up the habit. Plus, lefty has not gotten nearly the attention that righty has gotten.” So I did my exam and not surprisingly I felt nothing, even in the area that has a known tumor.
So ladies, you will soon tire of hearing me say this if you haven’t already, be sure to get regular mammograms. Yes, they are awkward, yes, they hurt, yes, you may feel that you are the star of some really weird fetish film. Plus, almost all of us have given birth by the time we start mammograms. That’s a lifetime of awkward physical exams for each kid. Finally, for the 12% of you that will some day get breast cancer, all that boob squishing will likely save your life.
Yes, I know I turning into a zealot. I’m going to dye my hair pink, wear only pink clothing, and get a pink ribbon tattooed on my right forearm. Feel free to dodge my calls if this happens but don’t forget to get your mammograms.
Although my husband may disagree in matters related to my attitude toward his contributions to housekeeping, I am a pretty positive person. I believe in the inherent value of people even if they do “bad things” or worse, even if they annoy me. Even with my above average rosy view of humanity, I am absolutely blown away by the kindness I have received regarding my cancer. There is at least one person praying for me (a chaplain at St. James’ Cathedral) who has never met me. My friends and relatives have been beyond kind and helpful. The various technicians and nurses at Swedish and their partner health care offices tend to my comfort, ask me for the names of my doctors, and tell me that I have an “excellent team” caring for me.
I sure don’t like being seriously ill but this is pretty sweet. No wonder Huck Finn (or was it Tom Sawyer) faked his own death so he could hear all of the nice things that people said about them. No wonder people have trouble with malingering or Munchausen’s by proxy. All of this attention could be addictive to some people.
But no worries. As much as I am touched by the kindness around me I look forward to the day it will not have to be so obvious and necessary. I look forward to being taken for granted. (Okay, that last bit is dishonest. I hate being taken for granted! Ah, the song of a mom of a teenager.) Let’s just say, I look forward to the day when I am not taking up so much space in the worry parts of people’s brains.
In the meantime, keep the prayers and positive vibes coming. I’ll send mine your way, too.
I may actually have a week without any appointments or test results. What will I do with myself? I guess I can just peer back into my memory banks to 8 days ago and remind myself of what I did with my time. I can deal with that.
Okay, actually that’s a bit of a dream. I’m still working on cancer stuff. I’m trying to guess how much I can work this summer, whether I need to cancel folks I already have scheduled, and what to tell people in my practice. Fortunately, I have just a handful of long-term therapy clients since I mostly do testing and booster sessions for old clients.
Looking on the bright side, I’d have to take care of planning my workload and dealing with my clients whether I had medical appointments or not so it’s nice to have a few days breather. Plus, my right arm, which was poked three times in the span of 5 days is happy to have a little rest from blood draws, etc.
I had a meeting with a genetics counselor today. I had mistakenly thought that the purpose of the testing was to go over the results of my genetic testing. However, I apparently have not yet done this testing. I wonder what last Friday’s blood draw was for? I know it was explained to me. I must have gotten confused. Anyway, the purpose of the meeting was to go over my family history and discuss the pros and cons of doing the genetic testing. I decided to go ahead with the testing, had my blood drawn again, and will hear back in a couple of weeks. (There is only one place in the country that does these tests and it is in Salt Lake.)
So I told Zoey about my cancer last Friday. She had a pretty hard weekend. She was really anxious, moody, and complained of “not feeling well,” especially when we wanted to go some where or do something rather than watch tv. My parents had a dinner party yesterday. She was complaining a little about going. Zoey doesn’t always really “listen” to what I say so even though I told her who was going to the dinner, it didn’t really register that her beloved cousins would not be at the dinner until about 20 minutes before it was time to leave. She was disappointed, but did not balk at going. Then we got into the car and I accidentally slammed her fingers in the car door! She ran out from the car and into the house. Many 13 year-old type declarations were made about how she was declining her invitation to the dinner party. However, we have a policy in these incidences of not allowing her to stay home by herself. She took issue with family policy as only a gifted 13 year-old Zoey can, by running out the door and climbing the Douglas Fir in the back yard. My father-in-law happened to be in the front yard and holding her coat. When he saw her run out the door he said, “Wherever you’re going, you’re going to need this coat.” So she put it on while on her way to the tree.
Our Douglas Fir was planted when the house was built in 1958. It’s TALL. She goes there for fun or when she needs time away. When I was a teen, I did the same thing. I went to nature when I was upset, though we had woods not just one tree. Anyway, I wanted a couple of minutes before walking to the tree and looking up. She had climbed 25-30 feet up that tree. (I was silently relieved that she was able to scale that tree after having accidentally slammed her fingers in my door.) I said, “It’s not too late to change your mind.” Then I went back inside. I came out after another 5 minutes and said, “You are up pretty high. You’re a really good tree climber.” She said, “Is it too late to go?” I replied, “No, come on down.”
We ended up having a really good time at my mom and dad’s. I was proud of Zoey for turning a bad situation around so fast. It’s got to be awfully upsetting to have a mom with cancer when you are trying to be a fearless master of the world.
I told you this tree is tall! Photo by Zoey.
So my other project is Weight Watchers. As some of you know, I have had trouble maintaining a healthy weight since I was a teen. Sometimes I dread going in for my annual physical because if I’m overweight, I know my internist will ask me about my weight loss plans. Even though it is totally her job to talk to me about this and she does it in the kindest way possible, I still feel dread. Just last Friday, I was weighed at the beginning of my consultation with the surgeon. I was slightly surprised as I had asked the day before whether I would be given a medical exam and the woman whom I had spoke with told me that it was just a consultation. So, the nurse escorted me from the waiting room with the first stop being the scale. I quipped, “Ugh, getting weighed is worse than having cancer.” Crickets. I am known for my gallows humor under extreme stress. After all, I was the the person that upon opening a letter at work informing me that I was one of the people being let go in a round of lay offs who stood in the hallway, waved the letter, and exclaimed, “I thought this was a bonus check!” People laughed then but not this time. And perhaps I was imagining things but I thought I even saw a bit of a pained look on the face of one of the RN’s that passed me so I lamely said for all to hear, “I really don’t think it is worse to be weighed than having cancer.”
There are periods in my life when I’ve been overweight and periods when I have been at a healthy weight. I also have a long history of a poor body image. I didn’t really believe that I could possibly be good looking until I was an older teen and even that was a tenuous realization. There were also periods when I viewed myself as downright ugly. I used to get bullied about the way I looked, too. NOT HELPFUL. I remember when I was a 5th grader, there was this 6th grader who purposely sat on the bus with me for what seemed like days on end to tell me how ugly I was. He once said, “You’re so ugly, you don’t deserve to live.” Now this was not one of the popular kids, he was, objectively speaking, a pretty homely kid with a lot of problems and not many friends. Nonetheless, I can still remember the way my face burned and my stomach turned, just listening to him. In the 7th grade, some of the 8th grade boys used to tease me by pretending they liked me by derisively flirting with me. They also gave off the impression that they thought I didn’t know they were insincere.
When I was in the 8th grade, I lost about 25 pounds and grew a number of inches. I also started wearing make-up and stylish clothes. When I wasn’t wearing my velour top, white painter’s pants, and high heel Candie’s slides, I was wearing my Brittania’s with my blue Nike swoosh running shoes. I got my hair professionally cut into a Farrah-esque mane, except with more curl and brunette hair. Anyway, you get the picture. The world changed for me. Some of my old friends were no longer friends and then some kids who wouldn’t have previously given me the time of day, acted like they wanted to make friends. I pretty much stuck with the friends in the third group, the ones who stayed my friends throughout my physical transformation.
When I got to high school, some of those former 8th grade boys did not recognize me because I had changed while they were high school freshman. One of them actually tried to ask me out a few years later and our band teacher was even trying to be his wing man. I did not explain myself. As it turned out, I actually didn’t end up dating a lot in high school. I was loud and a good student. I was considered a “brain” and in adolescent black-and-white thinking, if you fit in one category, it was hard to be in another category like “pretty” or “fun.” I remember, too thinking that I would have a better dating life if I weren’t doing as well at school. As much as I wanted a boyfriend and doubted whether I was attractive or not, I knew that if I worked hard at school I would have a lot more choices later in my life. I also remember having a strong sense of financial responsibility for supporting myself someday. (This was more than a little unusual as I was 1) thinking far ahead into the future and 2) there were still a lot of stay at home moms back then, including my own.
By the time I got to college, I got a lot of attention for my looks. I had never really experienced a lot of positive attention like this. Men I didn’t know would see me walking up the steps to U.W. buildings and open the door for me! I have to admit, it was pretty cool. I remember during one week of my sophomore year, I had two young men asking for dates. I thought, “Why shouldn’t I be able to date two men?” So I went out to lunch with one and out to dinner with the other all in the same week. SCANDALOUS! This will sound ridiculous but the idea of dating two guys felt like juggling 100 items at once and like I was doing something wrong. I liked both of them. After a week I chose one of them for a stupid reason, too (he lived closer to me.) Ironically, this boyfriend was also one that when mad at me, complained that I was too fat and not pretty enough. This is a lesson to you, young ladies out there. It is perfectly okay to casually date more than one guy especially if you are simply eating meals with them. And don’t pick boyfriends based solely on convenience.
My husband and I met when I was 20. He’s a dear and has always sincerely complimented my looks no matter my age or weight, which has fluctuated quite a bit over the past 25 years. It was with ample embarrassment and some shame that I recently admitted to him that even now during the overweight periods of my middle aged life, I think negative thoughts about my weight and appearance several times a day. I am extremely careful to avoid saying these things aloud, especially in front of my daughter. But despite the fact that I have a wonderful husband, career, and family as well as the fact that I am a pretty happy person, I have yet to eliminate the negative self-comments from my head.
It is easy to say that this is ALL the doing of the media or our culture for it’s ridiculous emphasis on beauty, sex appeal, and youth in women in defining their value to society. And although I was hardly immune to this influence, I was able to counter so many other cultural influences. I didn’t take drugs, smoke, or drink. I did well in school. I was very ambitious in my schooling and career. Further, I have experienced myself as being valued for so many substantive characteristics, for being intelligent, for being kind, for being smart and fun. I know there are other ways to be valued as a woman than for beauty. I am a happy and outgoing person. When I walk down the street, people often smile or say, “hello.” My experience with the world, even of people I don’t know is so overwhelmingly positive. Why do I still have these thoughts of being less than? Is it really so important to me that I be valued specifically for beauty? Or is this voice in my head just an old tape that plays when I am feeling the negative physical and emotional effects of not eating right or exercising? Maybe it is really closer to the latter and I am not so superficial deep down after all. I’ve never thought about it that way before. Thanks again, Mom this blog was a great idea!
Some of you may read this and be tempted to provide me with reassurance, to tell me, “Don’t be ridiculous, you are beautiful.” I’m not looking for reassurance. Whether I am beautiful or not is beside the point. Whether I am physically beautiful to others is irrelevant. All of us know women who are breathtakingly beautiful and even make money at least in part for being breathtakingly beautiful and are still horribly unhappy about their looks. (I’m looking at you Uma Thurman.) No amount of outside reassurance is going to fix those insecurities and doubts.
Finally, I may never fully rid myself of that negative body image tape. But maybe I need to stop feeling so embarrassed by and ashamed of it. I will never be perfect so I don’t need to beat myself up for beating myself up. The tape is one of the things about my life I would like to be different. I’ve already proven that I can live with it and be a happy, well-adjusted person. And yes, I know that my project is bigger than Weight Watchers. But the Weight Watchers project is helping me be physically healthier and there’s no shame in that.
My Eyes Are Up Here 