Diagnosis Roulette: Cautious Optimism vs O FRABJOUS DAY

So far, in 2016 I have had:

  • surgery to correct an abscess
  • an MRI, recommended by a doctor at the outpatient clinic after the surgery who was horrified that no-one had ever actually tried to figure out why I’ve been getting regular abscess since I was fifteen (implied: “The A.F.? Your GPs are all hacks?”)
  • an “examination under anaesthetic” combined with an extremely minor incision to correct the proximal cause of that particular abscess
  • A colonoscopy to look for signs of Crohn’s Disease in large intestine (possible ultimate cause of abscesses): clean.
  • Another MRI to look for signs of Crohn’s Disease in small intestine (possible ultimate cause of abscess): clean.
  • Blood test to look for signs of Crohn’s Disease (when advanced, it causes various deficiencies): clean (in fact, my B12 is amazeballs)
  • Stool test (sigh) to check for signs of inflammation: came back borderline. Definitely over the “normal” range, but not comfortably in the “holy crap, something is wrong with your crap” range.

At this point, I took a break. I’m reasonably sure that “Diagnosis Fatigue” is a real and common problem, and I was so tired of being told that everything was more or less normal. I’d spoken to a colorectal surgeon and a gastrointestinal surgeon and a gynaecological surgeon so far and there were no solid plans or answers.

I went on a holiday, diving in Vanuatu. I mostly stuck to keto, except when I was on holiday. I was in pain more or less constantly, but the nausea and fatigue were much worse when I ate carb-heavy meals. I went to a conference in New Zealand. I signed up for another year of national committee service, about which I feel conflicted as I have been too exhausted, sore and miserable to do much productive work on that.

The pain steadily got worse. I put some of it down to endometriosis, which I’d been diagnosed with in 2012. I’d had a laparoscopy, which had corrected the endo, and had a year or so of much easier periods, and just figured it had come back.

So I got back into the game, because who needs to put up with that shit if there might be answers? I girded my loins (there’s a pun in there somewhere), and picked up my Diagnosis Bat (it’s like a cricket bat, but way more metaphorical), and went back to my specialists.

In the second half of the year, I’ve had…

  • A second laparoscopy to correct endometriosis. There was no endometriosis. My intense period pain can potentially be attributed to gut issues (they interact in a fairly intense way – particularly if one is an inflammatory disorder. Any inflammatory disorder can potentially make your periods hell).
  • …another poop test (SIGH).
  • A CT scan of my small intestine (mmm, delicious barium sulfate): clean (the tech thought there might be a small region of “narrowing” but it wasn’t certain and my surgeon thought it was probably just peristalsis).
  • A gastroscopy: small spots of inflammation spotted in jejunum (first loop of small intestine). Biopsies taken. Biopsy came back clean.

These last two procedures happened very quickly, largely because I went back for another consult with my G.I. surgeon, and in contrast with my previous consult I was able to say with some confidence that I was literally in pain all the time. The previous appointment, a few months prior, had merely involved being in severe pain intermittently.

We’d progressed from “intermittent” to “all the time.”

While all this was happening, I was more likely to become nauseated after eating, no matter what I ate (again, less nausea with high fat foods). I was more likely to get what I refer to as “stabby pain” which needs to be distinguished decisively from “burning, cramping pain.” The latter is really awful and is constant. The former is genuine agony, which last week rose to indescribable heights and I would have ended up in the Emergency Department if I’d been able to think clearly instead of just sitting on the couch crying and screaming and upsetting my dogs.

My G.I. surgeon is a lovely man. I had no troubles about reporting pain, and at no point did he assume that “I can’t find an obvious cause” correlated with “the pain is all in your head” (which happens to a lot of people). He has taken this very seriously at all turns, and he also knew I was about to head off on fieldwork (I fly out tomorrow), and some action needed to be taken. He was comfortable diagnosing inflammation in my small intestine, regardless of what the ultimate cause might be (still could be Crohn’s. Still could be something else, although names for those Something Elses escape me presently).

He prescribed me 9mg Budesonide.

This is a corticosteroid that is mostly processed in the liver (about 90%), so unlike prednisone, the excess drug doesn’t just wander around causing systemic side effects. It’s much more target specific in that sense. The drawback to this is that it takes a lot longer to take effect. Prednisone can result in improvement within 48 hours. Budesonide takes – on average – 10-14 days to kick in.

I have been dutifully taking my three capsules, half an hour before food, every morning when the alarm goes off. I’ve been curiously watching out for ‘roid rage and mood swings (got a wee bit manic a few days ago, but there could be alternative explanations for that).

This was before my horrendous “stabby pain” (which I am cautiously and relucantly putting down to possible pancreatitis or gall bladder issues secondary to the Undiagnosed Inflammatory Issue, as the pain profile matches exactly, and also this is why I am not drinking alcohol of any kind for a while because I am just too scared of that happening again).

Today is Monday. On Saturday night, I was out at a show with a friend (Matilda. It was awesome). I was in quite serious pain – not hospital-level pain, and not “stabby pain” but serious pain – throughout the entire evening. I took some Panadeine Forte and it took the edge off it a wee bit, but the burning cramping agony was there, in the background, until I went to sleep that night.

Saturday was day nine of the Budesonide regime, and I was starting to reluctantly conclude that it wasn’t working. My mood was starting to plummet. I’d had a pretty awful day on Friday as it was, and this was making me feel a bit hopeless. I was struggling to maintain any kind of psychological equilibrium.

Sunday (yesterday) was a reasonably good pain day from a gut perspective. I had a lot of joint pain and inflammation and fatigue, so it was hard to really assess what else was going on. There was stomach pain, the kind of pain I’ve come to think of as “normal” rather than the increased levels of the day before.

And I’ve taken three pages and over 1100 words for a recap. Why are we re-capping, Kate?

We’re re-capping because I woke up this morning with no pain at all.

Alright, that’s a slight exaggeration. My ankle feels a bit sore, my lower back is still strained from an injury that took place about a week ago, and my left hip is wonky, but I have no belly pain.




I noticed this when I first got out of bed.

I then ate actual food. No nausea. No pain.

I drove into the city with Husband in the car and marvelled, occasionally changing position, hunching, straightening, shimmying (look, if you don’t dance in the car, what are you doing with your life?), taken deep breaths and holding them, exhaling sharply, basically doing everything I could to compress my abdominal region to see if there was pain.

Nothing. Perhaps some very faint, mild tenderness on the left, under my ribcage.

It could all go to shit (pun intended). I could be wrong. This could well be false optimism. I am trying not to get excited.

But… at day eleven, of a drug regime that takes 10-14 days to take effect, I have a very sudden cessation of gut pain.

I don’t know if this is diagnostic of anything other than “You had inflammation and now we gave you steroids and there is no inflammation.” I don’t know if this means we can say what caused the inflammation – whether it’s Crohn’s located more deeply in my ileum than the gastroscopy could examine (apparently he managed to look at a good 80cms of intestine, but with 4.2m of ileum, that leaves a lot of mystery), or whether it’s some other cause.

All I know is that I am not in pain and it makes me staggeringly happy.

Cat Quest: Archchancellor Mustrum Ridcully and the Immortal Vampire Cat

On 20 June this year, Jabba, my fluffy little grey cat, passed away from lymphoma. This left an enormous cat shaped hole in my heart – not to scale, since Jabba was very skinny by the time he curled up in my lap and stopped breathing. I grieved. I missed him. I wondered who would now reset my computer and walk on my keyboard and curl up in my lap and regularly “mrrp?” at me and try to steal my breakfast (actually, Amos is very good at taking on that latter task).

I stopped working or studying or playing computer games in my study. It was just too hard to be in that cosy, pleasant room that I associated so closely with my cat. Yes, Lestat was still around, and he is a lovely old man, but he is Husband’s cat, really, not mine as much. He likes me. He loves Husband.

After a couple of weeks of grieving, we looked into adopting another cat (while still grieving. It’s not a linear process). Rescue agencies were not keen, mostly because of Abby. This is fair. We are quite confident we can keep a cat safe from her (in fact, as I write this, there is the sound of drilling in the background as a carpenter builds a door in our corridor for that very purpose of keeping cats separate from dogs), but it’s hard to expect foster groups to trust in that when they hear the worst disasters of pet management every day in their work. Even those who trusted in that plan were concerned that it might not be the best thing for Lestat – getting another cat might just stress him out too much.

Except… Lestat was already stressed. After Jabba died, he started yowling. Lots of pacing around and wailing. We picked him up and put him on the bed. More meowing. We put him off the bed. Meowing. More food. More water. More brushings. More pats. The minute we stopped? Meeeowwwwwwww.

Eventually I concluded that – as shocking as it was – Lestat actually missed Jabba. The reason I was surprised was that when we first brought Jabba home, in 2006, Lestat sulked for three weeks. Jabba occasionally challenged him, and Lestat would have to put him in his place. Again. Jabba would wander over to Lestat and start sweetly grooming him, and Lestat would grumble, because there goes the goddamn neighbourhood. Lestat came to us in the first place because he was beating up all the other cats he lived with.

I’d always thought that “one” was the best number of cats to have, at least as far as the cats themselves were concerned.

Turns out I was wrong. Cats are, apparently, far more sociable than we give them credit for. Not all of them – and making allowances for past experiences and personalities – but on the whole, having one other cat in a nearby space seems to be comforting. Especially, I suppose, if you’re 96 in cat years and that’s what you’re used to.

Husband and I decided not to get another cat, at least not for a while.

Then… a friend of mine (who knew about that cat-shaped hole I was living with) said that some friends of hers needed to find a new home for a cat they’d adopted. He was being rather decisively rejected by their existing cat, and their existing cat was utterly miserable about the situation and not adjusting. They didn’t want to get rid of him, because he was lovely, but it was just not working out.

This news came in the day before my birthday.

On my birthday, Husband and I went to see about a cat.

We met some lovely people (hello, if you’re reading this!), and an enormously fluffy, fat, talkative golden/cinnamon tabby cat with a gigantic wizard-ruff. We were warned that he was very talkative, and would make “mrrp” sounds.

We played the pouncing game with a piece of yarn. We discovered that he liked belly rubs. We basically said, “So, we’re taking your cat to see if it works out… are you cool with that?” and shovelled the giant furball into the cat carrier we had brought with us just in case.

We named him Ridcully, as he is large, bearded, and fit (for a wizard). Although he was nearly called George (it suits him, but it was too close to “Jabba” in my head), or Gandalf, or Merlin, or Albus.

Ridcully can be shortened to Riddles, or if he does something spectularly clever and badass, Riddick.

He is quite a stunning cat. Behold him in all his bearded, wizardly glory!

He is extremely playful. He loves belly rubs. He purrs very loudly. When the mood hits him, he is extremely snuggly. And he lets Lestat push him around when it comes to food, which is important because he is twice Lestat’s size and a third of his age, and a bit of a guts.

In fact, since Ridcully came to us, Lestat seems like he is much happier. He meows less. He snuggles and purrs more. Most startling: he actually plays. We thought his ribbon-pouncing days were behind him, but after watching Ridcully play a particular exciting game of “attack the dangling strip of cloth”, he apparently decided that it did kind of look like fun, and the next thing we know a little black paw swiped out to stab the ribbon. He’s even eating more (which is good, because he has lost weight and I was concerned).

And Ridcully looks like he gets along with him well enough, as long as he can restrain the urge to pounce on Lestat’s tail (which has happened once or twice. I can only imagine it must be very tempting to pounce on a tail if you are a cat).

We are still getting to know one another, but I think that once again we have managed to adopt an excellent cat.


Because it’s not long enough to justify another entire Cat Quest post, I’m adding here a little note about Lestat. I took him for his Old Man Cat check-up yesterday (remember, he is nineteen years old this October). This involved the vet weighing him, examining his teeth, listening to his heart, giving him his annual vaccination, and finally taking his blood for a geriatric blood test (testing of liver and kidney function). We added on a thyroid test, since he’s lost about a kilo in the past year (I wonder if he has lost most of it since Jabba passed away).

He passed his test with flying, nay, dashing colours. I am starting to wonder if he really is a vampire cat.

Morning Coffee Feminism: Coffee and Salad

Husband and I are having lunch at a café, as we often do. We’ve brought laptops, but they’re still in our bags for now. We’ve ordered coffee, and food. The waitress trots over holding two coffees: a frothy cappucino, sprinkled with chocolate, and a long macchiato, dark and silky black with a thin ribbon of milk along the top.

She sets the long macchiato in front of Husband, and the cappucino in front of me.

Husband and I laugh, and swap. The waitress laughs, and apologises for the mistake.

This happens all the time. At every café we go to. I actually find it hilarious; the idea that a strong dark coffee is a manly drink and that adding froth and chocolate sprinkles to a drink somehow makes it more feminine, as though some strange chemistry of chromosomes, hormones, genitalia (or not?), and sexual identity affect one’s taste buds profoundly. The mysterious gender binary of coffee. You think it ends with the toy aisle in Target? With steel-toed boots and construction hats? With nursing and teacher biases? God, no. No, it’s so much worse than that. The patriarchy has taken our coffee, people. Rise the fuck up! Wave your flag of rebellion! SIEZE YOUR COFFEE OF PREFERENCE.

Yeah, as Rebel Yells go, that might not be one.

But read on.

The food comes out. For reasons described elsewhere, I generally eat keto. My gut, it appears, doesn’t absorb carbohydrate properly, and this leads to an abundance of upsetting symptoms.

The waitress (and due purely to the gender dynamics of the service industry, it’s usually a waitress, but waiters do exactly the same thing) comes out with two meals: a delightfully prepared lamb salad, and a plate heaped with scrambled eggs, bacon and – if we’re very lucky – haloumi.

She sets the lamb salad in front of me, and the pile of protein and fat in front of Husband.

Once again, we laugh, and swap.

Women eat salad. Men eat piles of protein and fat.

This happens all the time. It happens everywhere. And, again, I do find it kind of hilarious. Don’t think that I’m in any way saying it’s a huge deal.

But I am what I am, and I do like to unpack things, so let’s unpack this.

A long macchiato is seen as a serious coffee. For people who take their coffee seriously. In the Melbourne hipster coffee culture, a long macchiato garners you respect! Not as much a short black or espresso, of course, but a bit of barista cred ends up in your folio.

By contrast, a cappucino is a frothy, frivolous sort of coffee. It’s had the taste altered enough that some people question whether you really like coffee at all.

Alright, that’s a stretch. It is actual dialogue that I’ve encountered, but it’s more funny than anything else.

Let’s get to the food, because that is the one that bothers me.

Here’s the stereotype:

Women eat salad. Women eat salad because they’re trying to be healthy, because women care more about their health. Or women eat salad because they’re trying to lose weight, or watch their weight, because all women are trying to lose weight. Or anxious about fat. And they won’t let that go even to go to a café for a fun lunch, which does make me wonder why they’re ordering cappucinos.

To be clear, in case my tone isn’t crystal: I do not in any way support this stereotype. I’m guessing that a lot of people, regardless of gender, order the salad because they like salad. Husband is a bit of a salad fan. He’s quite selective. He has all our local cafes carefully pegged as to whether he likes how they do salad or not. There’s good salad and boring salad and salad with quinoa (which, according to Husband, is The Devil). He’s not eating it because he’s trying to lose weight. He’s eating it because he likes salad. Also, he’s drunk some of my keto Kool-aid, and most salad tends to be pretty keto-friendly.

I, in fact, hate salad. I cannot eat salad. My sensory processing issues mean that any salad-like substances I attempt to ingest will return to the outside world in short order via the gag reflex.

The idea that I might voluntarily be eating a plate full of delicious protein and fat (and let us not forget that haloumi might be involved, if I am lucky)? It’s weird. It’s unexpected. It’s unfeminine. And it makes wait staff (at least, wait staff who are not familiar with me) blink and pause for a moment. Even if it is just me in the café and Husband is nowhere to be seen.

Here’s the flip stereotype:

Men don’t care about their health. Men eat artery-clogging delicious food because paying attention to their body state in any way other than pumping iron is somehow showing weakness; it’s soft; men don’t eat salad. Because no self-respecting man actually gives a crap.

This one feels a bit more complicated, probably because I’m on Fitocracy and I constantly see buff gym bros discussing nutritional planning and swapping meal prep tips, so maybe it’s more of a sub-type and a bit less universal. I have seen older men ordering the salad and crossing their arms over their chest and staring at me defiantly and talking about their health, as though daring me to criticise. Perhaps it’s generational. I certainly grew up with my dad mocking joggers and so on, but then, it was the 80s; that was fairly standard, as I recall.

Also, eggs and bacon don’t clog your arteries, and salads aren’t always the “healthy” choice, and it’s obviously a wee bit more complicated than that, but that’s an entirely different story to be told another time.

So what is all this?

This is ridiculous, that’s what it is. If anyone wants to pooh-pooh and say what a silly thing it is to get upset about, let me repeat again: I’m not particularly upset. In the actual moment, I do find it kind of funny. I don’t take offense or think anything less of wait staff for applying what is probably a perfectly reasonable Bayesian heuristic to their serving habits. It’s fine.

What I think is interesting is the plethora of underlying assumptions that lead to this behaviour, and even what may well be a correct pattern of food and coffee ordering. I think these little assumptions and patterns are worth thinking about, as great examples of unconscious bias. Why do we make these assumptions? Are they correct? Are women more likely to order the salad? Are they more likely to order the cappucino? If that’s the case, why would that be?

Is it self-reinforcing? That’s another question. If a woman or a man finds that the wait staff continually swap the food around, do they start to feel uncomfortable, and order something different next time? There are a lot of very shy, self conscious people out there who aren’t comfortable violating gender norms in any way – do they end up missing out on their favourite foods and coffees due to an understandable mistake?

I think it’s easier just to find it funny, but that’s true of a lot of things.

Meanwhile, having written this, I believe it’s now time for me to go make myself another espresso.


Diagnosis Roulette: What It’s Like

Sometimes I try to run from the pain.

It hit as I drove up the driveway. I got in the car and turned the key, thinking that I was feeling alright. A bit rotten. A bit run down, because of the prep I’d had to do for the scan. A bit sore. A bit achey. Mostly, though, I was alright.

About halfway up the driveway, I felt a slicing pain across my stomach.




It got to the third throbbing “slice” before I actually just said, out loud, in the car, by myself: “Ow. Ow. Ow ow ow.

I parked at the top of the driveway, and picked up the note I intended to drop into the neighbours’ mailbox, inviting them over for tea (we hadn’t really got around to catching up with them, and I thought the fact that their dog jumped the fence to play with our dogs was a great excuse to have tea. Or coffee. Or whatever).

And I ran to their mailbox. I ran away from the knifing in my stomach, a pain with which I am increasingly familiar, a pain I refer to as “knifey pain” to distinguish it from “stabby pain” or “throbbing burning pain.” If I could run, how bad could it be? I ran in my low-heeled leather boots and my jeans, wonky, and tired; maybe fifty metres there, fifty metres back to the car, to drop that friendly note – that promise of future conviviality – in the mailbox.

I’d never been able to run, as a child. I’d never been able to move, not really, not with my joints, and I hadn’t even known why, but I can run now, and if I can run, if I can get my body to fly the way I sometimes feel when I’m singing, how bad can the pain be?

When I got back to the car, I was shaking, the edge of tears in my eyes, and I was thinking, “but this isn’t that bad. How can I be crying? It isn’t that bad.”

This is the problem. This is what I’m torn between. When you don’t have a diagnosis, when you don’t know why it hurts, and when the pain is intermittent – sometimes it’s there, sometimes it’s all you can think about, and sometimes it’s conspicuously absent and you wonder if it was ever there, if it was ever that bad, if you’re imagining it, if you’re being dramatic, or overreacting, or hysterical – and then it comes back, and in those moments you know it’s real, and it’s awful, and you wish it wasn’t, but part of you thinks “Thank fucking Christ, it’s not all in my head, it really does hurt.”

Having a high pain tolerance makes it worse in a way, because up to a certain point, you can set it aside. I found out recently that I can set it aside for six hours of knifing pain while I get necessary work done. I don’t have so much paid work that I can afford to say “I’m sorry, I feel like someone is dragging a sharp blade ever so lightly across the external surface of my stomach – or perhaps my small bowel, I’m not clear, honestly – so I can’t come in to work today.” People would understand. Of course they would. And Husband’s job is an excellent one, and can keep us in gadgets and premium dog food and house mortgage quite nicely without me having to work while clutching my gut in pain.

But that’s not how I want to live. I want to work. I want to get things done. I like my job (my various jobs, honestly). It’s fun. It’s interesting. So I go in, and I get things done.

Then I end up in a space where I’m distracted by the pain, so I have to take pain killers. The only useful painkiller I have ready access is codeine which is, yes, a narcotic, and monitored, and addictive. I have to decide how bad the pain is and weigh that up against my need to, well, drive and operate heavy machinery. I generally try to avoid taking it. I only take it when the pain is quite severe, when it’s overwhelming, when it’s becoming acute.

When it’s all I can think about. When I try to run to prove to myself it’s not that bad. When I lift weights to prove to myself that it’s not that bad. As if what I’m trying to prove to myself is that I shouldn’t complain, because it could be so much worse.

Because I’ve had pain that is that bad. It’s not common, but I’ve had pain where you can’t think past it. It’s rare. It’s horrible. And I do breathe; I set my lungs against the pain, and I breathe past it, as though I am the tide rolling over the rocky shore. In, and out, and in, and out, endless and strong and overwhelming past all the sharp edges.

And anything less than that, anything less than excruciating, is, by my scale, not so bad.

Except that of course it is that bad, and I have every right to complain.

I complain because I don’t know what’s going to happen every day. I complain because I just now opened up my packet of Panadeine Forte and there’s only five tablets left and I want to cry, because that’s two and a half doses, and I am trying not to take these, but it just hurts.

There’s no benchmark for this. There’s no good way to measure this. I’ve had an examination under anaesthesia (EUA). I’ve had a colonoscopy. I’ve had multiple MRIs. I’ve had ultrasounds. I’ve had blood tests, urine tests, fecal tests. I’ve had spirometry tests and a stress ECG. Today, I had a CT scan of my small bowel. If that shows nothing, then I get to have a gastroscopy.

When you have pain, when you can’t just say “I have… (disease name here)”, when you can’t point to a scan or a test result or a surgeon who gave you a name for what’s wrong with you, you start to wonder. You wonder what’s wrong. You can’t cut yourself slack for not getting anything done when there’s nothing wrong with you – or when what’s wrong with you doesn’t have a name yet.

Names and labels have power. They define things, and they limit things. They give space and shape and tangibility to concepts, to ideas and, yes, to sickness.

Names have power. Knowledge is power.

Right now, I am powerless.

And that is what it’s like.

The Descent into Hypocrisy and Confusion: Weight Loss, Internal Conflict, and Scuba Diving

Content note/tw: discussions of weight loss and stigma.

That’s it. I’m finally frustrated and cross enough to post about this. I’ve been putting it off. I’ve honestly tried to write this post – or a post that is very similar to it – about five times. The beginnings are in my blog draft folder (along with an awful lot of other things). The reason I never finish this post is because, while I have no trouble outlining the problem, I fall short when it comes to resolving the conflict.

I think it’s better to accept that resolution is just not going to happen.

Here are the bare facts:

Firstly, I am a big proponent of HAES (Health At Every Size). If you think this is a movement that promotes obesity, then you’ve missed the point. HAES is a movement that proposes the radical notion of getting “weight” out of the framework we use to think about health. It’s about thinking about health independent of weight. It’s about promoting healthy lifestyle choices – whatever that may be for the person in question! – like good exercise, quality nutrition, and let’s not forget, good mental health as well – and not caring what happens to weight throughout any process of change. If someone adopts healthier habits and starts to shrink? Goodo, whatever. If someone adopts healthier habits and all that happens is they become healthier? They became healthier! That’s a win.

There is literally nothing bad about saying “Let’s focus on healthy lifestyle habits, won’t that be excellent, and focus on testing whether people are getting healthier,” while leaving out the body-shaming bullshit.

This is my basic framework for thinking about these things. I’ve only adopted it in the last few years.

Secondly, I’m losing weight.


Which is a little bit at odds with HAES.

Let’s backtrack.

At first, the weight loss wasn’t especially deliberate. I’d finally sucked up the gumption to look at my eating habits, because I wanted to be fitter and stronger. I wanted to be able to get more out of my workouts, and I was having trouble with energy levels. So I started tracking food and monitoring macros. This meant I started snacking on delicious treats a bit less, since I could now look at how much I was eating and think “Uhm, yes, Portuguese custard tarts are AMAZING, but perhaps I don’t need quite so many of them in my life. That pushes my sugars way too high.”

I started to shrink a little.

Then I cracked it about feeling sick after eating and, after what felt like a tonne of research and the blowing of my mind by various sources, I decided to try keto. This had the marvellous result that I no longer felt sick after eating! I had more energy! I started bouncing off the walls! I felt fed after a meal instead of simultaneously hungry, bloated and nauseated! What a glorious win!

The rate of weight loss increased markedly. I have a graph. It’s a little intimidating.

And now we get into the body image issues, and the background. I’ve always been on the chubby side, and as anyone who can make that claim knows, it can make life difficult and upsetting in a number of ways. It didn’t help that I was hypermobile (undiagnosed) and that high impact movement was literally painful all over my body, and that there was a physiological reason for me being hideously uncoordinated. It wasn’t until I got to my early twenties that I really made my peace with my body as it was, and decided to focus on just getting strong and fit instead, and screw everything else.

Discovering that people could actually be attracted to me – actual sexual interest! – made a big difference in how I saw myself. Suddenly being a wee bit chubs wasn’t the end of the world. Whoop!

Fast forward to my thirties, and here I am losing weight without effort (or at least, without trying to lose weight. I was tracking food and carbs and exercising a lot, but I was doing those things for other reasons). It was unprecedented. I’ve never crash dieted. I’ve never dieted. I avoided such behaviour on the grounds that being hungry is very unpleasant (saying that obviously as a person with the privilege of never having to worry where my next meal is coming from).

In fact, it’s not just unpleasant. It’s all-consuming. If I get a hunger crash, I can’t think about anything else. Need food. Need it now. And I can’t spend my life hungry – I have shit to do. I need to be able to think. It is literally my job. So sod that.

And I stand by that philosophy. Being hungry all the time is just nasty shit. No-one needs it. People should have access to the food they need, obviously, and people shouldn’t have to deny themselves food that they need for bullshit reasons.

But here I was again, somehow losing weight. And I wasn’t hungry. I wasn’t uncomfortable. I wasn’t even peckish. It was all just happening. I think that part of the reason it was happening was because (1) keto promotes fat mobilisation, especially if your body might not normally be good at mobilising fats for energy, say if you are mildly insulin resistant (ooh, me! Me!) and (2) I’ve never crash dieted, and thus never yo-yo’d or put my body through the kind of deprivation that promotes a braking, screeching metabolism.

And what happened?

I got curious.

Big changes happen in my life when I get curious. That’s how I roll. “I wonder if I would be good at this?” “I wonder if this would be interesting?” “I wonder if that would solve the problem?” It generally starts with a bucketload of reading, but I’d already done that, and I refused to search for information on weight loss on the ground that the internet is, as a friend put it, a “big ol’ bucket o’ crazy” when it comes to all that shit.

And I thought, “I wonder how far I can push this?”

So, instead of setting my tracker and my macros to “maintenance” (under which regime I was, remember, already losing weight very slowly), I set it to a very modest caloric deficit.

There have been hiccups, certainly. There was the time when I got too sick or injured (can’t remember which) to exercise for a while, so I recalculated my macros for a person who sits on their butt recovering. That was fine. The problem was when I returned to intense working out, I forgot to recalculate, and for few days I was desperately tired, and I couldn’t work out why until eventually I got a sudden newsflash from my body that I was abruptly, out-of-nowhere, stupidly-hungry and if I didn’t find something to eat then I might have to chow down on the nearest co-worker (fortunately I located a Quest bar in my bag). I then recalculated my macros. Whoops.

There have been bonuses to this process. In particular, planning my food ahead of time has meant that we eat out less as a household, and save money (not heaps of money because we buy expensive ingredients, but a significant amount). It’s also hugely reduced my anxiety around food, because now I have a framework I can plan around, and as long as I can fulfil my requirements without having to run headlong into my disastrous sensory processing issues, I don’t have to worry about how or what I’m going to eat or whether people are going to judge me for not eating salad.

But what happened to my commitment to Sparkle Motion, here? I’m still keen on HAES, I still believe in Size Acceptance (which is a different thing). I still believe that people shouldn’t have bullshit diet advice flung into their face every thirty seconds, or be made to feel miserable and less than human because of the way they look or move or honestly anything other than being an actual asshole (I am totally down with stigmatising assholes). I still don’t believe that being smaller is necessarily healthier. I still believe that the stigma needs to go, and needs to die, and people need to learn to be compassionate and mind their own business.

And yet here I am, deliberately losing weight, because of curiosity.

Curiosity is how it started.

Then it became vanity.

I’ve never been slim. I wanted to know what it would be like to be slim. It’s not quite that, though; it would be more accurate to say that I work very hard on my muscular development, and I’m vain as a peacock and shallow as a puddle, and I want to be able to see those muscles. In order to be able to see those muscles that I work so hard on, I need to remove some of the padding that blocks them from view.

That’s a surrendering to the arbitrary common aesthetic. I’ve had our various socially constructed beauty standards drilled into my vulnerable little brain the same as everyone else has, and sometimes I’ve surrendered to it, and sometimes I’ve stood my ground, and I was surprised to realise I did want to cave a little.

There’s more.

I have a pretty good medical clinic nearby. I know most of the GPs there pretty well. They all know that I work out a lot and they know my basic health and they know how I eat (it’s all in my file), and we’re good.

Sometimes, though, you run out of a prescription and abruptly need a new one and for some reason you can’t go to your usual clinic – due to the timing, most likely. So you walk into the office of a GP you’ve never met before, and they try some bullshit like weighing you before prescribing you the fucking oral contraceptive pill.

A doctor should take your blood pressure (or be otherwise aware of your blood pressure) before prescribing you the Pill. This is a basic standard of care. That’s no problem. My blood pressure usually makes doctors smile (when I am very sick it is sometimes high, but more commonly it is low. Depends on the illness).

There is no reason – ever – to weigh someone for a Pill prescription. It is bullshit. So walking into the office of a doctor you don’t know to get a script for the Pill on the way to work because you lost track of when you were going to run out and then being told you need to lose weight? Not the best start to the day.

And I thought, “If I get my BMI down [literally an index of height/weight ratio and that is all], they’ll shut the hell up and I won’t have to deal with this crap.”

That’s what we call surrendering to stigma. And I started to wonder if, instead of just calling Crappy GP on their bullshit, I was somehow throwing my fat friends under the bus. This is where I feel conflicted.

I felt like I wasn’t standing up for them. And I felt like, by being vain and wanting to lose weight to show off muscles, I was saying that my fat friends couldn’t look pretty or fit or strong without losing weight. I don’t actually believe that. I actually do think my fat friends are pretty and in many cases do look fit and strong, and actually are pretty badass.

Where do I draw the line between what I want to do with my body and what message that sends to people who need support and backing?

There’s more.

15kgs down, with a BMI shifting from 27 (technically – sigh – overweight) to 22 (comfortably in the arbitrary land of “normal”, a magical word that solves all problems!), I’ve found there are significant pros and cons to this shrinking business.

In terms of pros, yes, it is nice that it is a bit easier to find pants that fit. It is not 100% easier, because apparently my waist hip ratio is still odd (my waist is apparently both smaller and higher than expected for my size/height relative to the position and width of my hips. This leads to some odd looking pants issues). It is nice that it is easier to find appropriate tops – although, once again, it is not 100% easier. My boob/shoulder-waist ratio is apparently as problematic as what happens with my hips, so button down shirts are still a no-no unless I get them tailored (which I have never done. One day I should try that out).

It is nice not to feel self conscious in more revealing clothing (by which I generally mean tank tops, anything which shows shoulders and upper arms – I always wore these things, but now I don’t have weird moments about it. I do not like sleeves. I feel they are an imposition on my person).

It is nice that the pretty bras are, once again, within my reach (depending on brand).

There has been a significant improvement in the health and stability of my joints. There’s this idea floating around that the less weight your joints have to carry around, the better, and there’s some truth in it, but it’s also vastly exaggerated in significance. Many fat people, for example, are very strong – they are carting around more weight, after all, and their muscle development reflects that. In particular, fat athletes might do extra work to strengthen the supporting muscles to increase the amount of high impact work their joints can take, just as non-fat athletes might also do.

As a hypermobile person, I already do shitloads of work stabilising and strengthening my supporting muscles, so it might be a bit of a furphy, but let’s not forget: I have a degenerative connective tissue disorder. It’s a mild to moderate presentation, but even so, I’m a very active person and my joints need all the help I can get. If losing the non-contributing insulation makes it easier for me to do what I need and want to do with my body, then sure, I’ll take advantage of that.

As for diving (the reason I started working out in the first place about eleven or twelve years ago), well, fat is positively buoyant. The more body fat you have, the more floaty you are. This means you need to wear more lead to weigh you down, and you need to walk around in that lead. It can be a very serious request you’re making of your body.

So, that pretty much covers the pros. Doctors not giving me crap – check. Sheer vanity (cringe) – check. Less stressed joints for high impact work – check. Less weight needed to dive – check. More clothing stores catering to my every whim but apparently forgetting that women have different shapes regardless of size – check.

So what about the cons? How could there be cons?

Spoiler: There are cons.

Firstly, there’s some weird identity issues. There was a very disorienting period when the first, very rapid weight loss was happening, where I didn’t quite recognise myself in the mirror. It wasn’t the “Hey there, slender hotty!” reaction you might be expecting. It was “Who the fuck are you and what are you doing in my bathroom?!” It was discovering that my knees are actually bony as fuck and want to stab me in the night.

It was wondering how much I’d integrated “chubby and quirky” into my identity and worrying if I was going to be boring if I ended up “looking like everybody else.” Yes, it’s stupid. Yes, I shit you not, that thought actually passed through my mind. To be fair, think about how often body type seems to determine personality in any sitcom or TV drama you’ve watched, in books you’ve read. There’s a lot to be said about that which is beyond the scope of this essay, and I’ve internalised most of it.

It took a while for my anxiety about my new size to die down – a few weeks of feeling very odd, like a stranger in my own skin.

The con of feeling like a total hypocrite is still hanging about. That’s a worry.

The con of having a collection of beautiful dresses I’ve built up over the years that now hang off me like tent canvas – that’s upsetting. I buy cheap shirts, but save up for pretty, quality dresses for special occasions, and having these lovely garments no longer fit is actually upsetting. The same goes for various shirts, pants and skirts. Many of these items have been bequeathed to happier homes, but some I have surreptitiously kept aside. I’m not naïve enough to believe I’m going to stay this small, after all. The statistics are fairly clear. And if I do gain weight back, I still want to be able to wear my Lucksmiths shirt.

The con of having to buy new clothes – yeah. I’m still losing, so I’m a frequent visitor to Target, trying to find the cheapest jeans and shorts and shirts that will fit my person. This means navigating Target’s notoriously inconsistent vanity sizing, which also drives me bonkers (can you just make a 10 or an 8 mean the same thing NO MATTER WHERE I GO IN THE STORE?). This has played havoc with my credit card pay-off plan. I could go to secondhand stores, but I’m not as much of a fan of those as I used to be (I find them stressful for some reason. It’s weird. And some of my friends are really, really good at secondhand shopping and for some reason I suck at it).

The con of discovering that you can lose weight from your feet (what. the. Fuck?) and, alright, tightening a few buckles and laces on shoes here and there is not too bad, but if it keeps up, I’m going to have to replace some very expensive items. I wear orthotics. I don’t have the option of cheap shoes.

But the greatest con – the con that is pissing me off – the con that has me jokingly suggesting that I might as well just commence eating pizza and trying to get the extra body fat back on as quickly as I possibly can – is related to diving.

“But Kate!” you cry. “You just said that losing fat was good for diving, because you’re less buoyant!”

Yes, and that’s still true.

But I’m also fucking cold.

I can’t believe I never made this connection. For years I’ve looked at people who refuse to dive or snorkel in Melbourne because it is too cold for them year-round and thought “Huh. It doesn’t bother me. Oh well, everyone’s different,” and never worked out that most of them were very slender. They mostly – not all, but mostly – tended to be ectomorph body types. Not a lot of body fat on them. I look at the guys that tell me I’m soft for wearing a dry suit in Melbourne in winter and, okay, yes, they’re a bit more well-insulated than the average, as a general rule.

I wear a Lavacore (a thermal undergarment) underneath a 7mm neoprene semi-dry wetsuit. That’s the equivalent of 10mm insulation in total. I used to wear just the wetsuit when the water was about 14 degrees, and I was pretty comfortable. The first shock of the water took a moment to settle, but I tended to get through one hour dives at that temperature with little difficulty. I just didn’t feel very cold.

Obviously, when I started to wear the Lavacore, my tolerance got even better. How marvellous!

And I admit that, when I sold my faithful dry suit, this was some of my thinking. I hadn’t dived in Melbourne in winter in years – I’d always meant to, but somehow never got around to it – and thus hadn’t used my dry suit. A friend needed it for a course, and I felt I could certainly use the money, so I sold it to her. Besides, I was okay with my Lavacore and my 7mm wetsuit, so I didn’t really need it, did I?

And then, like an idiot, I went diving in Melbourne in winter.

It was 12 degrees.

My feet went numb in under five minutes.

Between dives, I walked to the toilet block, and because I couldn’t feel my feet, I broke my toe. I stubbed my toe on the gutter so hard that I broke it, and I barely noticed other than to think “Huh, that seems sort of painful. Oh well.” It wasn’t until I woke up the next morning to find it still throbbing that I decided to hobble down to emergency and get an X-ray. Avulsion fracture of the big toe.

Look, when I do things, I don’t do them by halves. This apparently includes toe-stubbing.

I recently went for a dive in 14 degree water. Again, wearing the Lavacore and the 7mm neoprene.

By the end of the second dive, I was shivering violently. I was cold enough that, if it hadn’t been a training dive (that you just have to get through) and a safe shore dive, I would have aborted the dive.

So what’s the lesson?

Fat keeps you warm. Fat is a fucking insulator. Fat is useful and don’t let anyone tell you different. When it comes to diving, I miss my fat. Fat is, sadly, really good at absorbing nitrogen, so the more fat you have, the more risk you have of decompression illness (dammit), and even so, I think the fat was a net win.

The other problem, of course, is that my Lavacore is now too big. It wrinkles up and presses into my skin under pressure. My wetsuit is also too big by about three sizes and I think the only reason I’ve been able to continue wearing it is because the Lavacore bulks it out. When your wetsuit is too big, not only does it not seal properly (meaning that, instead of just reheating the water once with your body heat – the way a semi-dry should work – you’re constantly reflushing it with cold water), but it obviously holds much more water relative to your body volume (meaning that it is much less efficient for your body to heat it).

So I’ve just lost weight to the point that I am now too small for eight hundred dollars worth of exposure gear – the gear that I wear in the summer.

And I’ve lost weight to the point that a new dry suit is rapidly becoming an absolute essential item, instead of a “nice-to-have” – and they tend to run about two thousand dollars.

So yes. Changes in weight and size are not minor things.

[Edit: since I wrote this post, I have bought a lovely new wetsuit and some new thermal gear to go under it. I have plans to buy a new dry suit before next winter. I suppose at least it’s tax-deductible, since I need it for work…]

Morning Coffee Feminism: I Don’t Know How To Wear Clothes

This post was inspired by two recent events (well, one was a recent reminder of much older events).

The most recent was my brother giving me a couple of photos he found at my mother’s place. They show me and my best friend (and my brother, in one shot, with a really cool hat), at what I presume is age eleven or so. We are rocking those early nineties denim jackets. She is wearing all pink. I am wearing a t-shirt and blue parachute-material pants. So cool. Much hip. Wow.

I love this photo for what it represents, but I also winced a little. You’re allowed to have no sense of fashion at eleven; I, however, took it too extremes.

I always tucked my shirts in. I did this until I reached high school and actually realised no-one else was doing it, and panicked. One of the reasons I did this was because I hated, hated, hated the feel of waistlines on my bare skin, and tucking the shirt in made a buffer. I now know this was probably due to some spectrummy (it’s a word, shh) sensory processing issues. My eventual solution was to wear jeans and other pants with more tolerable waistbands – the parachute material and a few others were too scratchy for me.

At the time, however, I not only tucked my shirt in, I pulled my pants up. Way up. So they would sit on my waist. Now, I’m quite comfortable in my body these days, which I wasn’t then (as a chubby eleven year old who was regularly picked on for said chubbiness), and while the chubbiness has more or less disappeared, the basic anatomical ratios have remained: I have tall hips. The distance between my crotch and my actual waistline is – according to the world of fashion – vast. For waistbands to sit on my hips, there’s a … wedgy … issue. This is why I don’t wear pants that aren’t jeans (except at gym). It just doesn’t work.

I was seriously bullied for this. I couldn’t understand why. I just wanted to be comfortable. Didn’t everyone want to be comfortable? That was all I cared about with clothes. I was bullied for wearing skivvies (again, not sure why – it was the early 90s, they weren’t uncommon). I was bullied for tucking my shirts in, for having a fringe, for pretty much any way I chose to prepare my body for public viewing. This basically meant that I absolutely hated my body by the time I was nine years old.

Let’s contrast this with another recent event.

I was out on a drinkies night with a few friends of mine, several months ago. I took the opportunity to get a bit femme, and a bit glam, because since I don’t feel obligated to do so, I really enjoy it from time to time.

“I must say,” said one friend, later in the evening after we had imbibed a few whiskey cocktails, “that is an amazing tit top.”

“Why thank you!” I replied, delightedly.

See, because I was only going out with women, and going out in a group of them, and I was good friends with all of them, I felt safe to wear a “tit top”. It’s one of my favourite tops. I love it. It is a bit dated now, made of chocolate brown lace with little flowers, and it has a tie-back (which is good for those of us who go out at the top and bottom of our torsos, and go in at the middle, and do not like to look like we are wearing sacks). I love the lace. I love the style. I love the tie-back (which also makes it easier to wear after significant weight loss).

But I have nearly donated it multiple times (and no, you can’t wear something under it, it completely ruins the style).

Because it is – so to speak – a “tit top.” Serious cleave. All the cleave for me. Select your bra carefully, it may be visible during the evening.

I used to not give a crap. I honestly thought it didn’t matter. Until I was wearing a similar top at work, and I bent over a map as I was discussing fieldwork with the older curators and I looked down and realised I could see my navel through my neckline (from my perspective, of course, at the top).

It all rushed through me. Self-awareness, horror, self-consciousness, embarrassment – nay, humiliation – a deep fear of unprofessionalism, and I not only never wore that top again at work – I only ever wore t-shirts and long-sleeved shirts at work. Ever. I suppose the awareness that it actually mattered had been creeping up on me for some time, but it just showered through me and overwhelmed me. Fortunately my work is one that is happy for scientists to roam around in jeans and t-shirts and that is my uniform.

I come to these realisations a lot later than most people. Years later. See reference to spectrummy issues. I get there in the end.

I keep thinking about that brown lace top. It’s lovely. I want to wear it more often. But I wouldn’t even wear it around some of my guy friends – they’ve probably grown out of it now, but years ago I vaguely recall a “where do I look?” issue, and I can’t forget that. I will go to great extremes to avoid having to be self-conscious around my people, because it is honestly exhausting.

I still remember deciding to be slightly modest, and wearing a singlet top (actually equally cleave-y) under another top, and having a female friend lean forward and whisper “Kate, your bra’s showing,” at which point I made a puzzled face, lifted up my overshirt and revealed that – lo and behold – it wasn’t a bra. It was another shirt. She went “Oh!” (well, that’s alright then) It was nonsensical. It’s like the difference between bikinis and bras. It’s all context, with no substance.

Maybe I’m revealing my own addiction to logic here, but I still don’t see why this matters. Embarrassment for me is about what other people think, not what I think. I don’t care if someone can see my bra strap (it’s pretty obvious I’m wearing one at all times – I’m a reasonably well-endowed lass and I wear fitted shirts). I don’t really care if there’s cleave happening. I care that I am comfortable and that I feel pretty (or athletic, or capable, or whatever adjective I have decided upon that day).

But again, as a spectrummy lass, I’ve learned that violating social norms is dangerous. The results can be horrifying – everything from bullying and social ostracisation to physical violence and being approached by arseholes on the street asking to see your breasts (yes. That happened, in response to another lovely dress I no longer wear. My response was pithy and less than eloquent. I may have suggested he go do something to himself that I am reasonably convinced is physically impossible, or at least quite challenging).

And no, what you wear does not actually affect the likelihood of sexual assault (if you don’t believe me, there are peer-reviewed papers on the topic. It makes literally no difference); but it does seem to affect people coming up to you and commenting on your body, and I don’t have a script for dealing with that (which is why I told Arsehold Number One to go fuck himself).

It’s a fucking warzone, people, trying to decide how to dress in the morning. I think most other women will know what I mean.

I wear jeans and t-shirts because they are comfortable, and because the fitted shirts make me feel pretty (especially sleek, soft, cottony material. It just makes me want to hug myself in happiness. I’m extremely tactile).

But mostly – literally the main reason I wear them – is because they get zero attention. No-one is going to give me shit. They are literally the most neutral option I can think of. It gets me off the hook and away from the male gaze. I don’t have to worry about violated social norms. I don’t have to worry about someone else’s cultural baggage. I don’t have to spend the morning wasting my limited supply of executive function trying to anticipate all the different people I will run into all day and what their expectations may be and how I am supposed to fit into that without getting attention I don’t want and don’t know how to deal with.

I love love love my “tit top”. But generally I will only wear it around my lady friends, who will appreciate it for what it is. Who will admire its prettiness, appreciate its construction, sigh over the romantic lace, and possibly – in a way that I do not find threatening – comment on how amazing my mammary glands look in it.

It’s never-ending, this war of clothing. I had a laparoscopy less than two weeks ago, which means that I have a healing incision in my navel. I can’t wear jeans. I wear mid-rise jeans, which means that when I sit down (and recovering from surgery, I sit down a fair bit), the belt and button press into said navel. It’s painful. So no jeans.

I had to go to Target two days after my surgery and buy skirts (only two skirts survived the Mighty Decluttering). It’s winter, so I also bought some footless tights. I hate being cold. I dug out my Nice Leather Boots (that I never wear), swapped my orthotics into them, and wore those, because hiking boots and runners (my usual winter footwear) do not work with skirts. Then, of course, I needed tops that matched the skirts. Given that I don’t actually like having unnecessary material against my skin, I hardly have any long-sleeved winter appropriate tops (I just wear jumpers and coats). So I bought two long-sleeved shirts.

Suddenly, I felt dressed up. Swishy black skirt. Tights. Boots. Classy stripey shirt ($8 well spent). So I ended up putting in fancy earrings and donning a necklace every morning.

This has been quite fun, but it’s meant that I think about clothes and presentation a lot more than I normally bother with, and it’s a little tiring. As I said, I have a limited supply of executive function to throw around each day, and I don’t want to have to use it on clothes.

I watch Husband roll out of bed, grab a pair of pants and a t-shirt, and consider that His Work Here Is Done. Some days he decides to get a bit fancy, and he wears one of his Nice Shirts (defined by the fact that I can’t put them in the tumble dryer, but to be fair, I suppose I do occasionally buy dishes that he can’t put in the dishwasher, so all is fair in love, war, and housework).

That’s it. Seriously. He cares about presentation (and has strong opinions on suits and appropriate interview wear), but he doesn’t have to think about whether someone is going to comment on his body based on what he does or does not show.

And I’m jealous.

I wish that clothes were irrelevant. I wish people could just wear what made them feel comfortable, or pretty, or sexy, or powerful, or fun. I wish it didn’t matter, outside of practicality (jeans are great lab wear for safety reasons). I wish no kid was ever mocked for pulling their pants up high over their shirt, no matter how silly it looked; I wish no woman would get approached by gigantic muscle bound terrifying guys on poorly lit streets and asked to expose her breasts; I certainly wish that things like the fucking burkini ban were unanimously seen as the ludicrous, patriarchal, wear-what-we-tell-you bullshit that they are. I wish that more people understood that a “bikini body” is simply a body that you put in a bikini. I wish that the male gaze weren’t a thing, that it wasn’t constantly assumed that you are wearing what you wear to appeal to men in some way.

Believe me, a huge number of men assume this and comment accordingly – dude, did I ask for your opinion? What made you think I give a crap what you think of my body? It is mine. It carries me around. It is literally none of your business what I put on it. Men that I know have commented to me – and yes, they’re being catty; blokey men are perfectly capable of being catty – about what other women are wearing, assuming I’ll agree with their snark, and I reply: “Oh! You’re right. When they chose their outfit this morning, they wore something that [name of male acquaintance] didn’t approve of! Clearly that’s what they should have been thinking of. Not what they, personally, wanted to wear. Is that what you’re suggesting?” And of course the absurdity of the situation is made clear.

Being the sort of person I am, neurologically speaking, I don’t like extra nuance in my social customs. I like things to be very blunt and straightforward, and I like things to be fair. I don’t feel like I should have to be responsible for where other people’s eyes go, but apparently I am. I don’t feel like it’s my job to fit into an increasingly narrow category of how I should look based on my sex, profession and the time of the fucking day, but apparently, it is.

And, finally, I don’t think it should be assumed that I am “advertising” or “showing off my tits to men” if I decide to wear a really pretty shirt that I love, based on the cut. Seriously, the only reason I think about the male gaze is to protect myself, and that is a giant can of bullshit.

Edit: I am aware that the menfolk are rigidly policed on their clothing as well. That’s a thing, which also can involve beatings and death if norms are violated in an extreme manner in the wrong place (ie, around homicidal, homophobic, gender-policing arseholes, who sadly do not wear identifying signage). It really supports my main point though – men often have to dress for the Male Gaze as well. For some, they don’t really have to think about it. For others, it’s a horrible shitty imposition on their life and self-expression. And we’ve reached the edge of what I can probably say about it in broad strokes without actually being a dude.

This Keto Life: A Little Bit of Sweet

I go through phases where I bake a lot. It’s not because I have an extraordinary love of baking – I wish I did. It’s because I like baked goods, and I can’t just go out and buy baked goods that I can eat. If I want muffins, or cheesecake, or biscuits, I have to make them myself. There’s just no way around it.

I have a pantry stocked with almond meal, coconut flour, xanthan gum, arrowroot powder and all the accoutrements of a low-carb and wheat-free life. I do actually have sugar in my pantry, but that’s basically in case visitors want sugar in their coffee (never let it be said that I will not assist in the appropriate caffeination of guests).

I’m aware that, in terms of chemical precision, I do not lead a sugar-free life. Raspberries contain sugars. Many things contain very low level of sugars in some form, and naturally any carbohydrate I consume (digestible carbohydrate, that is) will get broken down into sugars eventually. Fructose, lactose, glucose, sucrose – they’re all around in low levels. I don’t get rid of them completely.

When a person gets into ketosis, however, and maintains it for a while – getting past the usual carb cravings and need for chocolate or biscuits or whatever a person’s particular sweet poison is – they generally notice a profound change in the way they taste things: they become more sensitive to sweet tastes.

Or, to put it another way, just about everything with an un-altered level of sugar (think biscuits, cakes, chocolates, lollies) tastes way too sweet. Nauseatingly sweet. I had a mouthful of regular Coke at one point; it tastes like someone had poured crude oil into a vat of syrup and then carbonated the lot. It was intolerable. It was nauseating. And this is from someone who occasionally drinks Diet Coke (mmm, aspartame. But more on that later).

I still craved biscuits and cakes, however, but when I sat down and thought about it carefully, I realised it wasn’t really the sweet taste I was craving – oh, I wanted a little bit of sweet, but mostly what I wanted was the textures. The crumbly, chewy texture of a really good choc chip cookie; the smooshy filling and crumbly base of a cheesecake; the flaky, fluffy choux pastry of an éclair; these are things I wanted. I wanted textures, with a little sweet, and the other associated flavours.

Enter: artificial sweeteners.

Artificial sweeteners get a lot of flack. They’re blamed for everything from cancer to migraines to gut flora disruptions to laxative effects, and to be fair, these associations are (with the exception of cancer) pretty airtight for people who have these responses.

I can announce that I’m looking forward to making a low-carb sugar-free raspberry cheesecake (it is amazing), and I’ve had the response “Ugh. Why would you want to?”

Uh… because then I can eat cheesecake without getting sick? Why, is this rocket science?

I can’t help but think this is how vegans feel when someone says “Ugh, vegan cake, why would you eat that?” Because they want to eat cake without consuming animal products? This is not a difficult question. Also, even though I am a person who consumes vast quantities of dairy, eggs and meat, I’ve had some pretty delicious vegan cakes.

As a side note here, can I ask that people not do that? If someone tells you they’re excited because they are having delicious vegan cake or low-carb protein cookies, can you just not act like it’s disgusting and awful and like you feel massively sorry for them? They’ve found tasty food they can eat. Just be happy for them. Be nice about it. Don’t be a douchebag.

These days, when I serve people slices of my low-carb sugar-free raspberry cheesecake (now that I’ve perfected it, that is; initially I made some hilarious mistakes and it tasted like bicarb soda and licorice. Ugh), they make happy noises; and if they didn’t know it contained stevia, I tell them, and they are flabbergasted. Well, if they had any preconceptions about stevia and non-sugar sweeteners, at any rate.

I’ve learned, over the last year or so (two years in November!), a little bit about artificial sweeteners and how to use them successfully, and which ones I, personally, can and cannot tolerate. I am a connoisseur of sweeteners. Allow me to share my (admittedly idiosyncratic) experience.

When it comes to sugar alcohols: I can’t tolerate maltitol. My gut says no. There is bloating. My belly puffs out like a white marshmallow. It looks like I am pregnant with a little maltitol baby. It is very uncomfortable. So no, even in small amounts, no maltitol for me. Sadly, this cuts out the majority of mass-produced low-carb sugar-free snacks – they all use maltitol. I don’t know why. Maybe it’s easy to work with. Maybe it’s cheap. It has – to me – a horrendous aftertaste. But some people tolerate it just fine. It has the highest glycaemic index of any artificial sweetener, which may be a concern for people attempting to maintain ketosis.

I can sort of tolerate xylitol. Xylitol (birch bark extract) is very popular among the keto and low-carb and I Quit Sugar crowd, as it’s a one-for-one swap. This is really quite convenient for baking purposes. It turns out that I am okay with xylitol in small quantities; not “chocolate mug cake” quantities. Don’t ask how I know. You don’t want to know how I know. But never again. Many people are good with xylitol, and it has a moderate GI response.

I can definitely tolerate stevia. Mind you, I did try liquid stevia for a while, and I am sad to say that I hate it with the fire of a thousand suns. I can’t handle the backtaste. Instead, I use a powdered blend of stevia and erythritol (Natvia). Erythritol is generally not absorbed by the gut, so it has a fairly negligible impact on blood sugar, and although it has a slightly cold taste that some people are bothered by, I generally don’t get a stevia backtaste when I bake with it. Natvia is actually my baking sweetener of choice.

Sucralose – Splenda – is a funny one. I didn’t used to tolerate it well – it seemed to send my blood sugar up – but now it doesn’t? Perhaps I misunderstood what was going on? Who knows! Regardless, I’ve done a few tests, and I’m actually fine with it, to the point that I now carry around little Splenda tablets to add to tea when I’m out. I don’t add sugar to coffee, but when I have tea I really like a little bit of sweetener in it, and Splenda does the trick nicely. It doesn’t work well in coffee. Maybe that’s because I’m a coffee snob. It seems to add a weird tang to the coffee. Still – fine in tea.

Aspartame – oh, poor aspartame. Maligned. Shown to – apparently – cause cancer in rats in large quantities. Very large quantities. I’m really not sure where the science falls – up and down and back and forth. It’s bad for you. It’s not bad for you. It’s bad for rats. It’s only bad for small rats. What? Honestly, at this point, I don’t care. I seem to tolerate it well and don’t get headaches, so I drink it in Diet Coke when I have a craving. I can’t have a lot of it – mostly because, to me, it tastes too sweet (yes, it’s a sweetener. Shaddap).

The final sweetener I consume in any quantity is sorbitol, another sugar alcohol. It’s the key ingredient in my “No Sugar Added” Vanilla Ice Cream (Peters). It turns out I can tolerate the amount in a standard (50g) serve of the ice cream. If I go wild, and have a double serve (100g), the binge will have consequences. Unpleasant consequences, much like the xylitol.

This really covers most of them (I haven’t covered “acesulfame K” because even though I found out I consume it, I haven’t noticed any real pros/cons, and I forget what it’s in). Essentially, I don’t have the headache/migraine response to any of them, and mostly if my body objects, it objects in a gut-oriented sort of way, although occasionally it objects in a blood glucose insulin spike sort of way.

All of which are way better for me than consuming “pure, natural” sugar (“Why don’t you just have sugar?” “BECAUSE I DON’T LIKE BEING SICK, YOU KNOB.”). When it comes right down to it, I don’t give a crap how “natural” my food is. I care whether it will make me sick or not. Given that so many foods make me feel sick, that has to be my primary concern. Having found a diet that doesn’t make me sick, I’m pretty happy.

I do, however, have one extra tip for anyone embarking on the sugar-free baking journey: use less sweetener than the recipe calls for. If you’re keto-tastic, your palate has probably adjusted, and the last thing you want is to overwhelm it with sweet tastes you’re not used to. Also, a lot of these sweeteners do have some sort of backtaste, and you don’t want that to overwhelm the deliciousness of your cakes and biscuits!

Generally speaking, I use half to 2/3 the amount of sweetener the recipe calls for (if it’s an American recipe, it’s closer to half – you guys have one hell of a sweet tooth!). This can be a bit problematic if it’s a powdered sweetener and you’re also using it for bulk, but a bit of trial and error should resolve the issue.

Then, at the end of it all, you get the little indulgences that make it possible to live with a restrictive diet like keto – and you get a little bit of sweet.