Generally speaking, I like the Globe and Mail as a newspaper, but I have to say. wouldn’t a better headline be “Millions on Canadians STILL Can’t Get Access to Regular Healthcare”

The Canadian Press

June 18, 2008 at 9:09 AM EDT

TORONTO — A new report from Statistics Canada says an estimated 4.1 million Canadians aged 12 or older are without a family doctor.

The 2007 Canadian Community Health Survey found that among those who have no primary-care physician, about 78 per cent seek medical care elsewhere.

The federal agency says 64 per cent reported going to walk-in or appointment clinics, 12 per cent went to a hospital emergency room, while about 10 per cent went to a community health centre.

The remaining 14 per cent chose to use other types of health-care facilities or services such as hospital out-patient clinics, telephone health lines or doctor’s offices.

The president of the College of Family Physicians of Canada says walk-in clinics, emergency departments and other alternatives are a good safety valve in the system for those unable to access medical care any other way.

But Dr. Ruth Wilson says they are not the best choice for patients who need long-term management of chronic diseases like diabetes and high blood pressure.

Where Canadians without a family doctor went for health care varied across the country. In Ontario and most of the western provinces, the choice was a clinic. In New Brunswick and Nova Scotia, nearly one-quarter of residents sought help in a hospital emergency room.

The use of community health centres by those who did not have a regular medical doctor was significantly higher in Quebec and in Newfoundland and Labrador than in the rest of Canada.

The annual survey takes the pulse of 65,000 Canadians on a wide range of health issues.

Make sure you visit the site and read the comments. I’m betting some folks will want to rant.

Cricket & I have been working at establishing a regular schedule of exercise. This is something that has always been difficult for me to stick to. I have a tenancy to go all out on day one and day two and then hurt myself, sometimes fairly seriously, on day three and be unable to continue. Cricket understands this about me and so having her there keeps me from running amok. We’ve decided for now to do something every week day. That’s five days a week. It usually works out to about 3 or 4. This week, because of work schedules and my ankle still a little tender, we’ve taken it a little easier. We’ll do better next week. We alternate swimming and walking. About an hour of each. We’d like to work up to longer distances in the same amount of time and then add some distance periodically.

Cricket is, well, a very PERKY person. I tease her about it–alot–and judging from her responses, I’m not the first to think so. She’s good for me: it’s hard not get catch her enthusiasm, even when I’m cranky and hungry and PMSing. She lets me go on and on until I exhaust myself or get sick of myself but she never loses that PERKY-ness. She’s been a good antidote for the discouragement that inevitably sets in; I don’t like exercise just for the sake of exercising so “taking a walk” or “going swimming” with a friend–especially a friend like her is always preferable to doing it on my own.

Which brings me to the subject of tonight’s post. FatLady floats! If you aren’t fat, you probably don’t know this and if you are, but you haven’t been in a bathing suit for a long time, you may not be aware. Fat is really, really, (really) seriously, amazingly buoyant. I can hang out in the deep end without even treading water. It’s just too funny! I am a Human Buoy! I am unsinkable! On the downside, I can’t swim under water very well because I can’t seem to keep my big butt UNDER the water. I’ll just let you mull over that image….

I am swimming though, not just hanging out and amusing myself by NOT treading water in the deep end or by allowing my giant ass to bob up out of the water to scare the kiddies. I really am swimming. I’m tired when I get out of that water–and let me tell you–after being so wonderfully buoyant–gravity really sucks for a minute or two!

But swimming I am and loving it. Of course, my form is no good anymore. I’m pretty sure my front crawl looks more like just aimless thrashing around; my backstroke is a little better but doesn’t seem to get my heart pumping as much. I can’t quite remember how the breast stroke works but maybe I’ll figure it out eventually. Buy hey, I’m working the shoulders and kicking the legs and I thinks it’s even possible I might actually be getting a bit of cardiac benefit from it too.

Best of all, my back & knees don’t hurt like they do when we walk. Blech, I hate walking.

Swimming rocks. Oh and no worries about the pool not being clean. First of all, there is almost never anyone in it and second, there is so much chlorine in the water, my new suit is getting bleached out already.

A few days ago, I wrote about my difficulties with the pre-weight-loss surgery diet. I continued to try to follow the strict diet until yesterday. I continued to be hungry and crabby and to bitch and moan to whoever would listen. I asked for help on the forums at obesityhelp.com. and I got it in the form of some kind, supportive comments as well as some practical tips about substituting protein drinks for the snacks.

Last evening, after our walk though, my friend Cricket* and I went to Swiss Chalet. I ordered the Health Check Special which is 1/4 of a roasted chicken–white meat–and I couple sides. I had veggies & a baked potato which I planned to eat with just salt & pepper. During dinner, we talked about our issues with weight, as we often do. I was, as usual, bitching and moaning about this restrictive, depressing, unrealistic diet.

While we chatted, I was toting up everything I was eating in the back of my mind. As I pulled off the chicken wing, intending to put it aside, I thought to myself, “I’ll probably never be able to have another chicken wing as long as I live.” Suddenly I understood WHY the nutritionist prescribed this stupid diet to a room full of RNY candidates: If she hadn’t, I might be running amok right now–pint of Ben & Jerry’s in one hand & a giant turkey leg in the other! I’d be up to my armpits in lemon meringue pie or…well, chicken wings! I’d be running around thinking we had to go to every restaurant in town and bring home every flavor of ice cream and not pass up anything.

And they’d wheel me into surgery with an extra 20 pounds.

Okay, okay. I get it. I’ll be good. I swear.

Now. There’s still the little problem of the “food diary.” I guess I’m going to have to lie my ass off because I’m not going to go hungry for 60+ days. I’ll be good. I won’t go crazy but dammit I can’t survive on the AFTER surgery portions BEFORE the surgery. It just isn’t possible. If I could, I’d be one of those bitchy, skinny women and we wouldn’t be having this little chat.

Perspective. That’s what I needed. Phew.

In addition to being hungry and crabby, I also had a stupid, clumsy accident a couple days ago; I twisted my ankle and fell down on both knees in the parking garage. I thought it was only twisted but after a day of trying really hard to ignore it, it was clear to me from the size of the swelling that it’s more than just twisted–it’s a sprain. Not a bad sprain, but a sprain nevertheless. I’m not going to sacrifice a day to sit in the emergency room to have them ultimately tell me what I already know so I’m just icing it and trying not to move around too much.

I apparently missed a good party on Saturday at the home of WMTC and The Joy of Sox. I’m really sad about that–because I’ve been wanting to meet them and their fur children for like a year now. Crap.

I am so damn hungry, I might just lose my mind. 60 days of this hell? Sh*t! I need some effing help with this! I should not be this hungry. I’m not insulin-resistant to my knowledge. This is what happens every time I go on a G.D. diet. I’m hungry, I’m cranky and I don’t know how long I can stand it. I’m not even getting on a damned scale because I know I’m not losing anything.

I’m afraid to leave the house. I’m especially afraid to leave the house with any money in my pocket, or any plastic either. I’m not really the binging type, but being hungry to this degree for 4 days is enough to prompt a stop at McFatAss.

I did cheat yesterday I’m sorry to say. Sweetness went to the new Mediterranean place down the street and came home with 2 orders of #6 Combo. That’s one Kabob, a little Chicken Shawarma, a little Beef Shawarma, some Tabbouleh, Baba Ganoush, and rice. They forgot to put the pitas in the bag, thank god. Oh, and a piece of Baklava. What’s wrong with this you say? Well according to the diet from hell, I should be having not more than 3 oz of protein with a meal. I should be having no more than 1 TEASPOON of oil. No, this was not fake, diet Mediterranean food; it was the real deal–with lot’s of olive oil and tahini. I did okay at first. I ate a little of it. I stayed away from the garlic mayo sauce entirely. I didn’t add any of the tahini. I had a little of the Tabbouleh, a bite of the Kabob. I put it away–all except for the baklava, which I ate. I enjoyed every damn bit of it too.

That was dinner and DAMN was it good. Supposedly my last meal of the day. I was fine–not stuffed but completely satisfied.–until the hunger set in again about 3 hours later. It was still way too early to go to bed. Sweetness was hungry too and he went for his leftovers. I couldn’t stand it; I went for mine too. It was the first time since Wednesday that I didn’t go to bed hungry, but I felt guilty as hell.

Part of my problem is that I don’t know how to cook for this no-fat, no-sugar, no-fun plan. I’m a damn good cook–but not if I can’t put some olive oil in the pan; not if I can’t sneak a spoon of butter into a sauce once in awhile. Yes, we’ve cleaned up our act with regards to processed foods and junk food and fast food. That stuff is gone from my life. But I don’t know how to make food on this restrictive of a diet. It sucks. Please don’t tell me that bullshit about how plain steamed vegetables are better and how a nice piece of fresh fruit is the best possible dessert. I’m a little cranky and I might beat your ass.

A friend told me a story once about her friend who had a gastric bypass. She said her friend was really sad for a long time right after the surgery–because she missed the food. She was apparently from a large family that has a lot of family gatherings that centered on food and they were all very good cooks. After the surgery, she couldn’t do it any more. She couldn’t cook, she couldn’t eat. She didn’t know how to celebrate without food. Here’s me. I don’t know how to cook low-fat food either. All my treasured family recipes are out the window. I don’t know what to do to make the food interesting. If I eat another piece of poached chicken this week I will gag.

I looked yesterday at some recipes on a well-know light cooking website. Most of them have something in them I won’t be able to eat. To be able to cook anything suitable, I will have to weed through a lot of recipes. Right now, I’m not in the mood. Can you look at cookbooks or watch “food porn” when you’re hungry? Me either.

A few weeks ago my bloggy-friend over at WMTC wrote this post. In short, some asshat wrote a quote- scientific-unquote paper about how fat people “contribute” to global warming. Yeah, and I’ve been pretty “warm” about it ever since.

Doesn’t is just make more sense that it would be the industries, not the individuals who are causing the biggest problems for the environment? Methinks Mr. Asshat did not think through his equations, nor did the allegedly prestigious medical journal who printed the tripe.

This morning I came across this, regarding a new book, Sick Planet: Corporate Food and Medicine, by Stan Cox. In it, he goes after the corporations who place profits above the public interest. Here’s a favorite:

Atkins was just one phase, if an especially newsworthy one, in the long, meandering evolution of Western dieting. In the years since Marty and I did our analysis, traditional low-carb regimens in the Atkins vein have largely given way to diet plans more focused on the “glycemic index” of carbohydrates and foods. Diet plans, diet foods, devices, drugs, treatments, organizations, and facilities come and go, but one thing never changes: the weight-reduction market never loses economic weight.

In the US alone, sales were $58 billion in 2007, and Marketdata Enterprises, Inc. predicted that they would reach $69 billion by 2010. With the low-carb boom fading, Marketdata saw continued growth in diet plans, diet-food home delivery, diet pharmaceuticals, and bariatric surgery (which drastically reduces the capacity of the stomach).

Marty and I analyzed the ecological impact of the Atkins diet in only one dimension: the nutrient composition of the food consumed. To my knowledge, the total environmental burden has not been estimated for Atkins or any other weight-loss strategy. The foods and other commodities they offer are generally heavily processed, with high packaging-to-product ratios. Anything having to do with medicine can be ecologically pricey, as we saw in Chapters 1 to 3, and health clubs and weight-loss centers have an impact as well.

and

Nutrition schemes make excellent commodities because they are perennially popular whatever their failure rate. (And failure is the norm; according to a National Institutes of Health panel, “In controlled settings, participants who remain in weight loss programs usually lose approximately 10% of their weight. However, one third to two thirds of the weight is regained within 1 year, and almost all is regained within 5 years.”
If they did their job well, or if people swore off them for good whenever they failed, the market would slow to a trickle. But the success of weight-loss plans isn’t entirely the result of failure; their tag-team partner, the food industry, ensures a steady flow of lapsed dieters seeking a second or a fourth chance. Newly overweight customers seem to grow younger every year. It takes the ideas of entrepreneurs, an excess supply of fattening foods, and plenty of sedentary jobs and couch-potato pastimes to keep the weight-loss game going.

and of course

America and other Western nations — and even some poorer ones — have broken out of the historical pattern that says the rich shall be fat and the poor thin. Here, food, especially low-nutritional-value, fattening food, is plentiful and cheap while commodities advertised as “solving” the problem of excessive weight gain are not. In 2006, Forbes magazine surveyed the costs of ten of the most popular weight-loss plans. Not surprisingly, all of them added significantly to the dieter’s weekly food bill, with the median increase pegged at 58 percent. The Jenny Craig plan was the most expensive, boosting food costs by 152 percent. Atkins was number three, with an 85 percent increase. Nutrisystem added 109 percent, Weight Watchers 78 percent. The strategy of eating low-fat sandwiches at Subway restaurants, heavily publicized on TV, was the cheapest, adding 26 percent.

While I’ve been mostly suspicious of the packaged-food diet plans, I will admit to pretty much living on Lean Cuisines and Weight Watchers Frozen Crap Dinners back in my single days. All the while I was wondering why my blood pressure was so high and why I had a tendency to retain water all the time–not just at certain times of the month–but the crazy amounts of sodium aren’t the subject of this post. Meanwhile, Sweetness was living on ramen noodles and Vietnamese take-out.

Since shortly after the wedding, we pretty much stopped eating processed or packaged foods–diet or otherwise. It was already too late for me to lose much weight just from making that switch, but most of what we eat, if not organic, is at least un-processed. It’s more work for sure but the food tastes better, we put less into the garbage/recycling systems and we feel we’ve made some small contribution to a healthier planet. We’ve saved money too which is never a bad thing.

So, who uses more of the planet’s resources? Us with our modest mid-sized vehicle, which we use for work and errands (which we combine) and not much else and our un-processed foods? Maybe the Skinny Bitch, driving her Hummer to the gym 4 days a week? Or the GIANT SOULLESS CORPORATION whose only motivation is profit no matter the cost to humans or the planet?

Yeah. That’s what I thought.

Long time, no post, eh? Sorry, I just haven’t had anything much to say that isn’t whiny and conflicted. No one needs to listen to read any more of that.

Yesterday was my nutrition seminar–in preparation for the gastric bypass. I’m a little confused–not by the actual eating plan which is fairly straightforward–but by the portions. Of course it’s low fat and low sugar. Both fat and sugar cause problems post-surgically. I understand that and I accept that I will need to either completely eliminate fat & sugar from my diet or have them only in moderation and probably not for at least a year.

What confuses me is that I’m supposed to adapt now to very nearly the quantity of food I’ll be eating post-surgically. Listen kids, if I could have survived on a self-deprivation diet, I would have done so a long time ago. I’d have saved myself all the pain and humiliation of walking around this size for so long.

The diet is very similar to the old, basic Weight Watchers Plan except for one thing: Weight Watchers always said you could eat all the vegetables you want. This plan didn’t. I have an idea I will need to adapt the plan and just fudge on my “food diaries.” Yes, I have to write down everything I eat and I have to plan out all my meals. Of course this is also one of the pillars of WW, but this is the one that always causes me to stumble. Planning and writing down every morsel leads to me obsessing about food.

Crap. Well they did say I couldn’t gain any weight between now and the surgery, but it’s okay if I don’t lose. Hell, maybe I should just follow the old WW plan and do the best I can.

Break-through my ass. I’ve been eating EVERYTHING for a few days now. I’m not sure what the hell is going on. Maybe it has something to do with my decision to have the WLS? Have I given myself permission to wig out and pig out? Damned if I know, but I have been like Pacman lately. I can’t seem to stop eating! ..and cooking…and eating.

Oh and I’m scheduled to attend a nutritional seminar in THREE weeks! I need to bring 3 days of food journals. I certainly won’t be wring down some of the things I’ve been eating for the past three days!

Yikes!

Cruising my blogroll yesterday I came across this post. It’s a rant I’ve actually ranted myself a few times–about the insulting and deplorable state of Plus Size “Fashion”–particularly here in Canada. The writer says she’s pissed. I’m pissed too. I’m 50, not in my 20’s like she is, but I don’t feel it and if you knew me, you’d know that I don’t look it in spite of my excess poundage. Even on my worst day, I sure as hell don’t FEEL like I’m 78 and I totally agree that I should not have to dress that way. I especially do not think I should have to look like a 78-year old granny on her way to frigging BINGO! (No offense to any of you 78 year-old grannies on your way to BINGO–just trying to a make a point here.)

Here in the Greater Toronto Area, there is very little choice with regard to Fat Lady clothes. The Big Girl stores while they are numerous, are apparently owned by the same corporation. They therefore peddle the same, or very similar crap, in all their many store locations.

Also, and here’s what bugs me the most–the quality sucks! We are not poor. I do have a little money to spend and in that I am trying to build a job interview-slash-work wardrobe, buying clothing should be considered a kind of investment. Instead, my only choices seem to be ill-fitting and poorly constructed of inferior fabric. Not so much an investment as just flushing money down the crapper.

I just spent two days dragging my fat ass around to stores trying to find something suitable for a job interview, should I ever be lucky enough to get one. In any case, I am trying to re-energize my job search so it seemed to make sense to have some clothes at the ready in case someone calls. The skinny girls might be able to run out to just any store and grab something off the rack at the last minute, but that has never worked for me. I need to plan ahead and leave myself enough time for any alterations that might need to be done.

I went out looking for fairly conservative but not dowdy, reasonably well-made clothing suitable for the office and the upcoming HUMID season. I spent about 2 hours at Pennington’s last weekend, Poor Sweet Hubby in tow (Really, the man needs to bring a book to read; I don’t even know HOW he amuses himself over there in the Husband Chair.)

The store nearest us has apparently been turned into an outlet for both Pennington’s and Addition-Elle, and was chock full to the rafters, not that it did me any good. I went through the place and grabbed just about anything I thought might fit. then I retired to the dressing room for the Icky Part, the trying-on-and-hating- myself-in-the-mirror-part.

It was a huge fiasco. I hate dressing room and I hate cheap schmatas! I tried on several pairs of pants and jeans, trying to make sense of their sizes and their new pant fitting guide. I don’t get it. They all looked the same–shitty. I’m 5′4″; Why is it that everything I put on is MILES too long? I don’t even bother with regular length pants because there is always at least 12 inches of extra length. I’ve tried having pants altered; when there is too much length cut off it ruins the line and only a really good seamstress will taper the leg to mitigate the damage. If they don’t, I end up looking like a tree stump–short and wide.

The petite pants usually have too much rise for my low-wasted body and I swear they are narrower in the hips so they pull too much through the pockets–unless I pull them up to where the waist of the pants is located just under my bra. If there is anything worse than looking like an old, dowdy granny, it’s looking like an old, dumpy grandpa! Argh! Oh, and while I’m bitching–why the hell are the blouses all so freaking short? Do they not realize that us Big Broads often have Big Boobs too? The bigger the boobs the higher that blouse hikes up in front. Believe me when I tell you, you DO NOT want to see me in a belly shirt. Blech.

I tried on about 50 items; I found one sheer blouse that I didn’t hate and a tank to wear under it. It isn’t something I’d wear to an interview and I really needed pants so we continued on.

The trip to Maximum Woman was a waste of time and gas. I’m not 20 and I wasn’t looking for club wear. I wish I had realized that’s their whole line before I went there and humiliated myself further. I know the website has all that goth stuff and such, but they also carry Iggi, which seems to be quite a good line so I thought maybe I had some hope of finding the right outfit there. Wrong again! The girls were very nice, and if goth or club wear is what you are looking for then please do go there and enjoy, but for me–not so much. I swear they did not have two items in the whole place that went together–you know–like a jacket and pants or a jacket and skirt or a dress and a sweater….not a damn thing. I tried on the things the nice young woman brought to me but it just went from the sublime to the ridiculous to the sublimely ridiculous so I put on my own damn clothes and got the hell out of there. Nothing like leaving a store feeling too old and too fat for even the Big Girl store.

We went home after that. I was disappointed and disheartened. Very Grim mood ensued.

On Thursday, I steeled myself for further self-flagellation and went to a different Pennington’s. Some choice, huh? I dragged a bunch more crap to a dressing room and decided on the least offensive of the lot. I ended up with regular length CAPRI pants that come to my ankle. How sick is that? They are not of the quality I prefer but they will have to do for now. I’ve ordered some wrinkle-resistant blouses from eBay. I hope they fit when they get here. I hate going to interviews without a jacket but I guess I’ll have to suck it up.

For a FatLady, there is no such thing as Retail Therapy. For us, it’s usually more like Retail Masochism.

As you might guess, I have have a subscription to O, The Oprah Magazine. O lives in my…uh…bathroom. I read a little here and a little there and I usually get through one month just in time for the next one to arrive in the mailbox.

I read, but I don’t always retain exactly what I’ve read. I don’t think it has that much to do with the uh….ambiance…as it does the time allotted and the fact that I rarely read one whole article from start to finish in one…um…sitting.

Anyway, some time back, I think I read a quote in O from a food critic (I think) who said she does not eat what she does not love. I think I said, “Hmmmm.” (as apposed to “Aha” which is what you are supposed to say when you read Oprah.) Now just put a pin in this thought for the moment; we’ll come back to it later.

I’ve blogged before about my mother and the “Clean Plate Club” so this pick and choose, don’t-eat-what-you- don’t-love concept is quite foreign to me. I learned a long, long time ago to just chew and swallow, chew and swallow, and, if absolutely necessary, just swallow. I came to understand, to internalize if you will, that taste was of no consequence and the “choice” was not mine to make. There were no alternate dinner menus and Mom’s table. Also, I learned that resistance was futile, that I had no power over the food, either the taste or the quantity. That learned behavior has become the unconscious part of my eating, the part that has nothing to do with the food itself, nothing to do with hunger.

Now, as I mentioned in the sidebar awhile back, I’ve been reading, along with the rest of the known world, Eckhart Tolle’s A New Earth. If you haven’t been reading along with Oprah and I and everyone else, I won’t get all new age on you here but I will say I’ve learned a little something. I learned that I’ve been holding on to my weight, my unhappiness about my weight, and my….victimhood…as the major part of my identity, my ego. It’s time to rethink all of that.

It occurred to me that the whole clean plate thing was probably, okay definitely, also a part of my ego. Suddenly, I remembered the bit a about the woman who didn’t eat what she didn’t love and I thought “aHa!” It occurred to me, in a momentary flash of clarity, that I don’t have to eat anything I don’t want, or don’t like. There is no one here who is going to chastise me, punish me, or otherwise make my life miserable if I leave something on my plate or say, “I don’t like this; I don’t want it.” the clean plate rules no longer apply. How incredibly simple.

So I’ve started an experiment: when I put food in my mouth, I’m deciding on a case by case basis whether or not I like it. If I don’t, I spit it out or just get rid of the rest. I’m allowing myself, in a way my mother never did, to be a picky eater.

I don’t remember to practice this with everything I eat every time I eat. I’m still unconscious much of the time but here is one shining example: I gave back a cannoli last week (a cannoli!*). Sweet Hubby ate it; not me. It was sweet, it was pastry and I might have eaten it and then regretted it later, or turned it down and felt deprived all day. Instead, I tasted a tiny bit, decided it wasn’t a good cannoli and realized I didn’t love it. When I gave it back I didn’t feel deprived at all.

AHA!

…………..

*BTW, the best store-bought cannoli I ever had in my life are from this place: Vaccaro’s Italian Pastries in the “Little Italy” of Baltimore, Md. If you’re ever in B’more, you better go there….or else.