Thursday, April 28, 2011
Watching Our Girlish Figures
One thing we hear a lot about these days is having a positive body image. I do, I'm positive my body image is not good. This concept is important, though, especially for teenage girls who are prone to eating disorders. That is beyond dispute. Once again, however, a truism of health and wellness does not apply to Maggie. First of all everything about Maggie's self image is positive, so that's not a problem. Also, she is so small she is not even on the charts.
When I was expecting my kids I never once considered the possibility that anyone of them would be anything less than perfect. It really ever crossed my mind that any of them would have any health or developmental issues. I had no preference for boys or girls and I just presumed they would be healthy, so what did I worry about. All I wanted was for the kids to get Steve's metabolism instead of mine. Steve is tall and very thin and has never had an issue with weight in his life. I am not, not and have always had an issue. Even then I knew it was shallow and vain, but a girl wants what a girl wants. Ahh, ignorance really is bliss.
Both the boys are big, but not over weight. They eat healthy and exercise but I wouldn't say they have Steve's metabolism. The only one that really got it was Maggie. She is like a hummingbird. She has always been so tiny that it has exacerbated her other health issues. Obviously that's not just attributable to just metabolism but also to her overall health history.
I remember a three year period from about age 4 to 7 where we could not get her weight over 25 lbs no matter how we tried. She would gain a pound or two and then get sick and lose it again. We tried different formulas, adding oil and all sorts of other tricks to put weight on her. Nothing worked until her health stabilized. Then she slowly starting putting on weight until she hit the 50lb mark. She stayed there for quite a while too. At age 13 she got the trach and suddenly wasn't using so much energy and burning so many calories just to breathe and we were finally able to increase her weight. She's still small but growing. Good.
Yesterday she had her semi annual check up at the GI clinic where they monitor her size, weight, ratio, feedings, and nutrition. Maggie is now 17 years old, weighs 75.3 lbs and is about 4'7" tall. Not exactly statuesque, but
definitely an improvement over her past. Imagine my surprise, then, when the nurse practitioner said, "OK, it's time for a diet." My mouth fell open. I said, "WHAAAA? She's just a slip of a thing." (though I have to admit lifting her a dozen or more times a day is not fun).
The issue is not the number on the scale, but the ratio to her height. She will likely not grow anymore in stature, so the feeds have to be adjusted to keep her from gaining weight. In the past six months she's gained 5 lbs and that is just too big of a jump in a short period.
So Ms. Maggie is on a diet. She doesn't need to lose weight, we just need to slow down the pace of her gaining. This really threw me for a loop. After 17 years of doing everything possible to get every calorie into her, we have to change our thinking. And, naturally the normal rules don't apply. Instead of celery and salads, it means cutting her overnight feeds. She has feedings pumped in while she's sleeping, but we will cut those in half. Hopefully she won't even notice the change.
Hmmm. Maybe I should try that.