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Monday 27 November 2017

ASDAH 2018 Conference: Call for Proposals

CALL FOR PROPOSALS
Come Speak—connect with friends and colleagues!

DUE: DECEMBER 21, 2017
LINK: http://ift.tt/2k4kYlc

ASDAH is seeking proposals for the 2018 Conference
August 3-5, 2018 – Portland, OR

Uniting Against Oppression:
Navigating the Learning Curves in the Health at Every Size® Movement

Submissions in the following areas are particularly desired:

• Use of the HAES® approach as it intersects with specific populations
• Navigating online spaces and social media in the HAES® movement
• Addressing privilege and centering diverse voices in the HAES® community
• The HAES® movement past, present, and future
• What does it mean to practice the HAES® principles in an environment that does not support it?
• Utilizing a HAES® approach in transdisciplinary healthcare settings
• Training and equipping the next generation of HAES® scholars, practitioners, and activists
• New and emerging research on HAES®

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Tagged: activity, advocacy, bioethics, bullying, children, community, diabetes, diet, eating, exercise, fat, fitness, food, gratitude, health, human rights, media, meditation, multiculturalism, nutrition, obesity, pregnancy, social justice, spirituality, statistics, support

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Monday 20 November 2017

You Can’t Change Someone

(White text box with black text that reads: “You can’t change someone who doesn’t see an issue with their actions.”

Aprox. 9 minute read
I came across the above-unattributed statement whilst scrolling my Facebook feed and whoa did it strike the nail right on the head! Whew! We need to talk about the people in our lives who abuse, shame, blame, and frame us! I would say especially this time of year, but no, these assholes are always dragging us down and we just allow it until, well, we don’t. I’m definitely of the “don’t” group more often than not, as I have learned far too many times the hard way that sooner is better than later with these jerks. Yeah, jerks! 😛
Okay, first of all, you can’t change someone else, in my opinion. You can influence, you can encourage and reinforce, but you can’t actually change another human being. Like, yes by knowing someone we all over time change, but that’s not what this is about. This is about the people in our lives we may, in fact, love, but who simply refuse to see how damaging or unreasonable their behavior is. Typically at first, it’s easy to forgive a misstep or misunderstanding. I am not an unforgiving soul, but I’m also not willing to be complicit in my own oppression. That is what this is really about!
I know it’s easier for some than others to cut someone out of your life. I have sort of become known for this trait. I don’t hold this as a positive or negative, only something that is necessary from time to time. Some may view this as heartless, cold, or unreasonable, but in most ways, for me, it’s been a matter of sanity and survival. Personally, this has been my bio-mother, friends, romantic partners/interests, and later my step-mother and finally my father. It’s never easy, or something you truly want to do. You want the other person to see how much they are hurting you or how they make you feel. I think all anyone really wants in their relationships is to be seen and understood and supported. When you look at the people in your life, do they make you feel seen, understood, and supported? Do you think you do that for them? It’s something to think about. (And Gaslighting is a real thing that happens more often than we can tell, check out this article on the topic, it was an eye-opener for me.)
I think it’s very telling (and vital) to pay attention to how you feel, that first natural feeling when someone’s name pops up on your phone (call or text). I think most of us ignore that fleeting feeling and move onto action mode, which is unfortunate. If you take a beat and a breath after that name pops up, what then? I think it’s a moment of honesty and self-reflection. If someone makes you feel gross, about anything, maybe give some space and time to that relationship and see how you feel in a few weeks. It will give you time to process your feelings and assess the relationship from a new perspective. It’s healthy! And often by doing so you can improve and strengthen that relationship! It’s not all doom and gloom! Haha! I have often advised friends who were uncertain about whether to break up with someone or end a friendship that they should change their phone contacts’ name for that person to how they make them feel. This way when they get a call or text they’ll see, “betrayal, shame, hurt” instead of Pat. Kinda forces you to think about it if it’s something you were avoiding. I have heard it helps. I’m just glad that Android and most social media settings allow for blocking certain people all together!
My step-mother lied to my entire family (had 3-4 different stories, depending on whom you asked) in order to get them to stop talking to me…for three years! What did I do? NOTHING! In fact, I went out of my way at every opportunity with her (agreed to let her legally adopt me as an adult) in order to keep peace within my family and make my dad happy. Ha! No one was fucking happy, doubt anyone is now, but I digress. No one ever told her that her incessant lying and manipulating was wrong. When my little brother asked her calmly and plainly why she lied to him as she was in the middle of the lie she would start to cry and go right into the next lie to get out of the first. Maddening! When my then-husband and I would meet up with my  family for dinner at restaurants, even when there was no present drama (she once burst into tears and threatened to make us all leave because her shrimp was spicy…she ordered the Cajun shrimp. *sigh*), I would fall into a deep depression for sometimes two weeks afterwards. Mostly due to how both parental entities interacted with my brother (telling him to shut up the moment he said a word), or outdated and offensive jokes they would later deny knowledge of. I didn’t even catch it myself, but my then-husband did. He hated seeing me suffer, and we talked about it.
Guess what? You’re an adult! (I’m guessing, but perhaps not. No biggie! I still think you get to decide for yourself who you allow in your life.) You get to decide who you let into your life and share space with. With the exception of work, I suppose. Can we all just agree to try to nip toxic behaviors in the workplace in the bud collectively? Cool. If you’re not one for confrontation, it is perfectly okay and acceptable and grown-up to let someone know that they are making you feel uncomfortable. There’s no argument against stating your immediate feeling. I prefer to tell someone to their face that their behavior is unacceptable, but your mileage may vary. Another helpful phrase I recently heard was, “We don’t do that here.” It’s a plain and neutral statement, no need for further explanation. Solid! In a society built upon white supremacy and misogyny, we all need to work together to keep these clueless assholes from continuing their reign of violence and idiocy!!! Ahem.
Yeah, I’m going there because we all need to fucking go there!!! Because some people who find themselves with a particle of power will find a way to abuse it! More often than not, this goes unchecked, maybe forever. I say fuck that! Life is too short and too precious to put up with that bullshit! Seriously, even in small doses or minor-seeming offenses, these things add up and they can tear people and families and companies and democracies apart! Microaggressions are real and they chip away at our self-esteem and hold us back from having the lives we work so hard for. It’s important to take a moment to pause and really consider how people impact us. Sometimes it’s our own behaviors exacerbating a problem or perhaps we’re just not seeing eye to eye and a sort of relationship stalemate occurs. This is pretty common, I think. Two of my oldest friendships are definitely there. I don’t think any of us actually hate or condemn one another. It’s just that we live very different lives and kind of forgot how to relate to each other now. This is natural.
Substance abuse has a huge impact on all of our lives. Though I haven’t struggled with addiction myself, I have been very close to many who have. It is heartbreaking what it can do to otherwise brilliant humans. After spending five years as a hostage in an abusive relationship with someone addicted to many substances, I became hyper-aware of those behaviors in others. I once had to walk away, though temporarily (thank the universe), from even my oldest friendship because I felt unsafe and was at the time unable to process those feelings and associations. I felt bad about it at the time, but I see now how integral to my survival it was, too. I do think it is okay to walk away from something you just know you can’t handle. It’s extra hard when you know that the person you’re walking away from isn’t the person you truly cared about, to begin with. Substances change people and turn them into monsters, though not always. I have a lot of compassion for anyone’s life’s struggles, it’s not an easy feat for anyone to go through.
At the end of the day, you have to look out for yourself. You can’t help others if you’re suffering, too! This is a life lesson I have learned, the hard way, repeatedly. I expand and contract with each new human I allow in my life and bond with. I trust until I can’t and then I never want to again, over and over. It feels sometimes as though everyone only wants to take from everyone else or they’re out to get you. I know it’s not true, but dammit if it doesn’t feel that way at times. Especially when going through tough times, it feels as though folks would rather watch you go down flames than offering any actual compassion or support. Yeah, that’s part of the reason why I haven’t been able to write for so long. When people make you feel unsafe or gross about being yourself: RED FLAG! I worked hard to become the person I am today, hot mess that I am. It is a journey and I don’t need fuckers throwing nails on my road, dammit!
Truth is, I’ve written about this subject before, but it was centered around fatness. I think this post does a bit deeper dive into interpersonal relationships, rather than our bodies. Our bodies are not the cause of other people’s behaviors, though they will claim that it is and that it’s all our fault, every step of the way. It’s not. You and I and everyone deserves to exist in the world and live the best life that they can! There will always be fat haters, but you don’t have to allow them into your actual life! You can tell them why, or not, whatever works for you. Fat acceptance is about autonomy, plain and simple! That’s it! Live and let live, ya know? I’ve had a few people cut me out of their lives without explanation, a couple even said that they honestly didn’t know why, and then continued to not want to communicate after and I respect that. It’s not for me to decide what’s best for them. Nor is it anyone else’s to decide for me. Autonomy! Woo!
Are you struggling with certain relationships in your life? Are you dreading interacting with certain people? Are “The Holidays” giving you anxiety because of certain people you feel you can’t avoid? Have you cut someone out of your life? What other relationship struggles are you dealing with? Let’s talk, discuss, and share!

Thank you so much for your continued love and support! I have been truly touched by the kindness and generosity of the readers of this blog. My fat community has been such a bright light in a dark time. You have my undying gratitude and affection!

Rad Fatty Love to ALL,
<3
S

P.S. Check out and use the hashtag: #FatAndFree on Insta & FB!

If you are able, please consider donating any sum you see fit to support and keep the blog alive until I’m back on my feet again. It isn’t much to raise ($150 for hosting), but I am hoping enough people can donate a buck or two in order to keep this little safe space alive another year. I have more things I want to share with you and some exciting fat projects I’ll be partnering on soon! Stay tuned!

Donate here: http://ift.tt/2zKvPnQ

My blog’s Facebook page for things I share that aren’t on this blog (and updated daily): http://on.fb.me/1A18fAS 

Or get the same “shared” content on Twitter: @NotBlueAtAll

I also have an Instagram, I rarely use it but would like to more…encourage me to?:
http://ift.tt/1NpWevR

And as always, please feel free to drop me a line in comments here or write me an email, I love hearing from readers. (Tell me your troubles, I don’t judge.): notblueatall@notblueatall.com



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Friday 17 November 2017

When “The Holidays” are Triggering…or worse!

(Image of small illustrated holiday tree with the following written above it:
Reminder: we don’t have to continue holiday traditions that leave us broke, overwhelmed, and tired.)

*Aprox. 7 minute read

I came across this image and text whilst scrolling my FB feed and I instantly clicked and shared it to my own timeline, but then it wouldn’t leave my mind immediately and I realized just how much I’m processing and working through so much of my own stuff around this time of the year. My own current circumstances may differ than many/most, but I hope to alleviate some of the negative things we all think about and carry with us through this complicated season. This isn’t about religion at all, for me or for this post, but more about family dynamics, consumerism, societal obligations, and general toxic behaviors. I hope you will comment below with your own thoughts and feels and advice if you have them to share. These thoughts and feels are my own, no matter how unpopular. Ha!

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The media and marketers want us to buy into the idea that “The Holidays” are about family, togetherness, giving, kindness, celebration, gratitude, helping those in need, etc. What that really looks and feels like in our actual lives is often very different. And even if it is still about those things, it doesn’t mean that’s what we’re actually feeling while in the midst of it all. It’s more often than not the most stressful, saddest, toughest, coldest, rudest, and most triggering time of year. I personally feel that the brunt of this hustle and bustle and work and emotional labor (not to mention the shopping, gift wrapping, housekeeping, cooking and such for these gatherings) falls on women almost exclusively, but that isn’t what this post is about. This is about the toll these things take on us. The impact they have on our quality of life and most of all the trauma we endure and ultimately have to carry as a result of it all.

Yes, I said Trauma. It’s a heavy word, but necessary. We are exposed to people, places, and things at this time of year that we just aren’t the rest of the year. There’s the travel aspect if that’s something you must go through to visit with family. As a fat bodied individual, you are subject to an entirely different set of rules if traveling by aircraft on a commercial airline. You may be forced to buy two seats, you may be forced off of a flight you’ve already boarded, you may be abused or assaulted by fellow travelers and even airline personnel. This is something we accept as part of the privilege of air travel, but it is traumatic. You can plan for everything, but the world still chooses (IT IS A CHOICE!!!) to oppress fat people throughout the world. It might be the only time of year you travel because of this. You might be preparing for your travels now and considering if it’s truly worth it or not. This doesn’t even bring the financial impact of air travel into this equation, but I’ll get to that shortly. You do this to be with Family! Your Loved ones! They would do it for you…right?!

Family traditions! Oh, the warm and fuzzy wholesomeness of being Home with Family for The Holidays! Right?! Isn’t that what this is all about? Every family has their own traditions and rituals or ceremonies. My family would go to Midnight mass after spending Christmas Eve at one of my grandparents’ home for a big dinner. The next morning we’d open our gifts at home but then rush over to our other grandparents’ house for the opening of more presents, followed by a full day and evening of family revelry. We’d usually get home late, exhausted (I often had to be carried to the car or into the house after passing out), but full of that family love that everyone hopes to have in their lives forever. I just didn’t realize I would only have it for 13 years. Ha-ha!

That’s not always so close to reality, that wholesome image. Often, families at this time of year consist of a variety of personalities, values, and beliefs. Sometimes those beliefs are outdated and downright damaging. But we’re expected to remain silent (especially women!) and “just try to enjoy the holiday!” So what exactly are we getting together to celebrate here? If we have to just shut up and sit down for this shit, we become part of our own oppression. Wait! Aren’t we supposed to be celebrating togetherness?!

Okay, okay…Family! Maybe your extended family isn’t toxic. Awesome! You sit around the dinner table passing all those delicious homemade dishes you’ve been looking forward to. Grandma’s pie and Auntie’s casserole, but the minute you take a helping for yourself all eyes are on your plate! If it’s only that you’re lucky. Often our worst food and body policing come from those who claim they love us most, Family. If it’s not monitoring your portions or actual food choices, it’s comments on your body, unsolicited diet advice, mentions of abusive ex-boyfriends (okay, that one’s personal), and more. I don’t care what they say, they are not concerned about your health at all! If they were they wouldn’t make you feel like absolute shit for simply inhabiting a fat body! It isn’t your fault! You have done nothing wrong!

The foodstuff doesn’t seem to end, really. If it’s not one holiday feast it’s another, or a potluck at work, it’s always something! And there is always some miserable ninny who will ooh and aah at all those delightful and delicious delectables, only to loudly shame and blame anyone actually eating the fucking food! I hate this person, and I don’t care who they are! This person hates themselves, hard! This person is mad at you for not feeling as bad as they do. This person will steal joy from a toddler! Seriously! Unforgivable! There must be some requirement for every company ever to hire this person. UGH!!! Anyway, fuck them, enjoy and nourish yourself!

The financial impact of this season is perhaps toughest of all. How many of us have gone into debt all in the name of giving? Or had to go without necessities yourself so that you could give to those you love? I get it. It’s hard to make those choices. And I don’t know what it’s like to have the added pressure of having kids who expect things this time of year. I grew up poor, but my grandparents always made sure we didn’t go without too much. Though being an 80’s kid (born in ’77, after all), it was the height of the toy craze. I’m kind of glad about this part in a way, I mean even now I never really want or expect the newest/coolest/hottest/top of the line anything! Ha!

For me, one of the worst parts of this time of year is the societal obligations and phoniness. People you know who outright hate you will somehow make you feel as though you should be buying them a special gift just for knowing they exist. Then there are the competitive gifters! You know the type. You think you got them a nice, thoughtful gift and then they get you something ridiculous like fucking plane tickets or some nonsense (I realize how that sounds, I’m a very untrusting human, because that very thing happened to me). There’s just so damned much you’re “supposed to do” because of what time of year it is and that just stinks, in my opinion! Even if you aren’t religious, there’s this whole American way of consumerism that drives folks out in hordes, and often against each other, all in the name of bargains. It’s disgusting. (I worked retail for ten years.)

Look, it isn’t all terrible. I love the smell of the crisp, late-autumn air! Few things in this world exhilarate me like that or fresh and new rains (it’s so rare in California, I cherish every drop!). The scent of douglas firs and pine and veggies roasting in a hot oven. I love giving gifts most of all and take it very seriously! But the pressures of the holidays are just too fucking much, dude! Gift giving is my love language and let me tell you, I have been hurt and burned far too many times. Now I hold back, I can’t just give because I want to anymore. Not just because I’m broke as fuck, but because often folks don’t know how to handle a thoughtful gift, given directly from the heart. It can be too intense for some.

I’m voluntarily estranged from my family as I write this. I’m also divorced, single (no romantic partner to speak of, not that I’m prioritizing that at all right now, obv.), and unemployed, living alone for the first time in my life.  I don’t know how to feel this year. Mostly just terrified for my survival, but aside from that, how does one celebrate when all of the trappings of the season do not apply? How can I not let all the past traumas of my life drag me down in my darkest hour as these dates approach? I am fortunate to have an incredible friend group who feels more like family (most of the time) than my own ever has. But they each have their own families to celebrate with. I’m not “Oh woe is me!” over here, I am simply looking at patterns and behaviors and society more critically these days.

I used to love Christmas! I would wear Santa hats and eat a candy cane every day with glee! In my town, we have a Candy Cane Lane where all the houses in the neighborhood decorate and the fire department gives out candy canes to the kids, and families and couples stroll along the sidewalks in the evenings. It’s really lovely and special (and you probs have one in your town, too), and I miss all of those feelings that used to go along with all of that. I miss my grandma and my aunt Jo and I can’t ever think about this time of year without them, their warm and inviting homes and arms, their cooking and hilarious banter. This year especially! I have never felt more alone in the world in my entire life! Not lonely, mind you. I just miss what family meant back when ya know? I miss the matriarchs of my family in a deep and cutting way I can’t quite put into words.

This time of year also brings up a lot of memories of my adolescence, like my first love. We met just 1 week before Christmas. I’d sneak out at night and walk around my neighborhood with them or sneak them in my window and just kiss and hold each other for hours. I don’t know how I never got caught! Ha-ha! It felt so romantic though, to be freezing cold out, but so full of warmth from a connection between two people. It didn’t last long, but it is still fresh in my mind and I just haven’t ever had to think about this time of year as a single, solo, independent human. It feels complicated! Ha! I’m glad to have my own space and safe place to live. I just miss having someone to stay in and keep warm with.

Facing December without a job is so tough! Most companies won’t start hiring until mid-January when the new budgets come out. So I have to just stick it out and hope for the best. I have been applying to allllll the jobs and have already had a bunch of interviews, but these things take time. Patience I have, but money I do not. I’m actually far worse off financially than ever before in my life, and I know I have published those exact words the last time I would out of work. I can assure you that this time it is far worse. C’est la vie!

I share all of my absurdities because I want you to know that it’s okay to question what has “always been”. It’s okay to not want to do things that you didn’t or don’t get to have a say in. It’s perfectly awesome to start or create your own new traditions and rituals, with whomever you choose! Seriously, what other point to adulthood is there?!  You get to decide what you will and won’t stand for in your life and in your celebrations. There will always be hard times, complicated feels and so much to navigate through this time of year. You can choose to opt out or to opt-in, in whatever way feels right for you!

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If you do not have a support system of your own for the coming festivities, I offer my unbiased and empathetic ears/eyes. Send me an email, take a load off your mind or chest or whatever, I get it and I’m here for ya! notblueatall@notblueatall.com I’m also on some other apps and things if you need real-time support. I don’t yet know what my plans are for celebrating if I even feel like it at the time. But I’m always glad to be able to provide some emotional support for someone who truly needs it.

What gets you through a difficult holiday season? How do you prioritize your own self-care? What helps you stay away from self-destructive behaviors when it’s so easy to fall into those traps? What is your favorite part of this time of year? Least favorite? How do you stay true to your beliefs when surrounded by others toxic behaviors? Do you have a new tradition or ritual you started? Do you have a fave handmade item or recipe you’re proud of? I wanna hear it all!

Thank you so much for your continued love and support! I have been truly touched by the kindness and generosity of the readers of this blog. My fat community has been such a bright light in a dark time. You have my undying gratitude and affection!

Rad Fatty Love to ALL,
<3
S

P.S. Check out and use the hashtag: #FatAndFree on Insta & FB!

If you are able, please consider donating any sum you see fit to support and keep the blog alive until I’m back on my feet again. It isn’t much to raise ($150 for hosting), but I am hoping enough people can donate a buck or two in order to keep this little safe space alive another year. I have more things I want to share with you and some exciting fat projects I’ll be partnering on soon! Stay tuned!

Donate here: http://ift.tt/2zKvPnQ

My blog’s Facebook page for things I share that aren’t on this blog (and updated daily): http://on.fb.me/1A18fAS 

Or get the same “shared” content on Twitter: @NotBlueAtAll

I also have an Instagram, I rarely use it but would like to more…encourage me to?:
http://ift.tt/1NpWevR

And as always, please feel free to drop me a line in comments here or write me an email, I love hearing from readers. (Tell me your troubles, I don’t judge.): notblueatall@notblueatall.com



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Thursday 16 November 2017

Aidy Bryant Puts the Problem Where it Belongs

ShamelessBefore we get to the post, please take a moment to sign and share (or re-share) the petition for Esquire UK to pull the piece in which an author calls his 4-year-old child a “chubby fucker” and a “fat little bastard” and then says that he would kill all fat people. We’re starting to get some good traction and the media is starting to bite at the story! Another huge help would be Tweeting the celebrities who Giles Coren used in his article to fat-shame his 4-year-old son and asking them to speak out.

They are:
@JKCorden, @onebiggins, @Adele, @PaulHollywood, @THERussellGrant, and @HackneyAbbott

Sample Tweet (you can either send one big Tweet or send one for each person:)

I hope @JKCorden, @onebiggins, @Adele, @PaulHollywood, @THERussellGrant & @HackneyAbbott tell @EsquireUK to stop letting Giles Coren use them to body-shame a 4-year-old boy. Sign the petition http://ift.tt/2yPbYmh #GilesCoren

Now for today’s post:

We live in a world that is chock full ‘o fatphobia. Some of it is at the hands of random people – the person who screams a slur at you from the car, the busybody at the grocery store who comments on the contents of your cart, or the group of teenagers who moo at you in the mall. Sadly the opportunities that people take to mistreat fat people seem to be frequent and varied. Other fatphobia is systemic and institutionalized – it’s healthcare facilities that don’t have chairs, beds, or even blood pressure cuffs for fat patients, staffed by doctors who can see past their own size bias It’s clothing stores that advertise that they make clothes for “all shapes and sizes” but definitely don’t. It’s airplanes that don’t have seats that accommodate fat people and try to make that fat people’s problem. Sadly, they are often successful, and that’s a bigger problem.

Perhaps you’ve heard the saying “fat is the last acceptable prejudice.” Well, that’s crap. There is a ton of prejudice — racism (including at the hands of the police), xenophobia, homophobia, transphobia, ableism, misogyny, ageism, Islamophobia, anti-Semitism and plenty of other oppressions are far too common to suggest that they aren’t acceptable. What may be more common with sizeism (though it can happen with all types of oppression) is internalization.

This happens when fat people become convinced by fatphobia that fatphobia is correct and our bodies are the problem — that we deserve derision, that we don’t deserve a seat on an airplane or competent, evidence-based medical care. Too often, even if they haven’t actually internalized oppression, fat people who are in the public eye will toe the fatphobia line rather than risk the pushback that they can receive by fighting back against fatphobia.

That’s why Aidy Bryant’s recent interview with The Cut is so refreshing! Aidy is crystal clear that the problem isn’t fat bodies, but rather fatphobia. Starting with her decision to move away from the pursuit of thinness:

She recalls the moment that she stopped focusing on trying to be skinny as “a switch flipping.” “I finally was like, what if I put all of that energy into just trying to like myself and focus on the things I actually want to do as opposed to this thing that’s like a made-up concept? And I’m not kidding, my entire life changed after I did that.

Within two years, I was hired by Second City; two years later I was hired by SNL,” says Bryant. “I stopped letting it be an all-day, everyday thing that defined everything that I did,” she says, snapping her fingers. “And it worked.”

And she got clear fast on the total unfairness that it the world of plus size fashion:

Click here to read the rest of this piece!

Like this blog?  Here’s more cool stuff:

Sign and share the petition to tell Esquire UK to pull the article and the column written by Giles Coren – who used his column on fatherhood to fat-shame his four year old son, and then say he would kill and burn all fat people.

Become a Member! For ten bucks a month you can support fat activism and get deals from size positive businesses as a thank you.  Click here for details

NEW!!! Wellness for All Bodies Program: A simple, step-by-step, super efficient guide to setting and reaching your health goals from a weight neutral perspective.  This program can be used by individuals, or by groups, including as a workplace wellness program!

Over the course of eighteen self-paced, content-packed, quick videos you’ll get the tools you need to create healthy relationships with food, movement, and your body, and you’ll map out a path to health that makes sense for you, in an easily digestible format. Built-in tools allow you to track your progress and keep notes individually or as a group.
Click here for all the details and to register!

Book and Dance Class Sale!  I’m on a journey to complete an IRONMAN triathlon, and I’m having a sale on all my books, DVDs, and digital downloads to help pay for it. You get books and dance classes, I get spandex clothes and bike parts. Everybody wins! If you want, you can check it out here!

Book Me!  I’d love to speak to your organization. You can get more information here or just e-mail me at ragen at danceswithfat dot org!

If you are uncomfortable with my selling things on this site, you are invited to check out this post.



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Tuesday 14 November 2017

Support This Blog If You Are Able

Dear Readers,

It is with a heavy heart that I must inform you that this blog’s hosting bill ($150 for the next year) is coming up in a few short weeks. I’ve lost my job and my unemployment benefits have not yet begun. I’m faced with the possibility of having to shut down my blog entirely and that breaks my heart. I know I have not written much in awhile, but I see my stats and the archives are still read, relevant, and valuable to many.

If you are able, please consider donating any sum you see fit to support and keep the blog alive until I’m back on my feet again. It isn’t much to raise ($150), but I am hoping enough people can donate a buck or two in order to keep this little safe space alive another year.

Donate here: http://ift.tt/2zKvPnQ

*Edited to add that one donation of $15 has already been received! Thank you! <3

I have never accepted advertising or sponsors of any sort. I have always been a firm believer in creative freedom and ownership of my writing. I want to write more, but the stresses of life have been incessant obstacles to that as of late. I am a better human for having this blog for nearly ten years. I have struggled and grown with the love and support of my readers. My readers have become friends and confidants, over the years.

I am working on a few stealthy projects with other incredible fat activists that I hope to share with you here very soon! If for some reason this blog must go dark, I will continue to share links and articles on the FB page, but doubt you’ll find much personal writing or content there as their advertising and privacy policies are, well, bullshit. I hope, if you are able, that you will support this blog in some small way, and other writers and artists and activists who also believe that we are more than just a Fat Body. We are multifaceted individuals born to stand out and to make a difference in this world.

Rad Fatty Love to ALL,
<3
S

P.S. Check out and use the hashtag: #FatAndFree on Insta & FB!

My blog’s Facebook page for things I share that aren’t on this blog (and updated daily): http://on.fb.me/1A18fAS 

Or get the same “shared” content on twitter: @NotBlueAtAll

I also have an Instagram, I rarely use it but would like to more…encourage me to?:
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And as always, please feel free to drop me a line in comments here or write me an email, I love hearing from readers. (Tell me your troubles, I don’t judge.): notblueatall@notblueatall.com



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The New #FATANDFREE Pictures

2017 FAC StickerBefore I get into the post today, I’m excited to tell you that got over 7,000 signatures in just two days on our petition to get Esquire UK to publish Giles Coren’s article on “fatherhood” in which he fat-shames his 4-year-old son and then says he kill all fat people.  This is really great momentum! The more people who are involved, the more pressure we put on Esquire UK so please take a moment to sign and share (or share again) http://ift.tt/2Ax6pcL

On to today’s post!

If you haven’t heard of the #FATANDFREE campaign, you are missing out. The project was Ccreated by plus size model, fat activist, and body positive influencer Saucyce West and according to the press release:

“Saucye presents a campaign that is showcasing fat, proud and beautiful women. What is different? She is telling women that once you embrace and love your body that will give you true freedom. She expresses that fat women are often kept in a box. Often told what they shouldn’t wear, what they shouldn’t eat. Even express fears of going outside and showing their arms!

“It’s time for us to be limitless in the way we view ourselves. If we see no boundaries we will be free to flourish and love ourselves without apologizing for it”- Saucye West

The campaign started on New Year’s Day, photos with women toasting and celebrating. Instead of giving resolutions for the New Year, they made a pledge to live fat and free for 2017!

Since then women have started using the hashtag on social media, showing the world they are living in and loving their bodies.

There will be #FATANDFREE events throughout the year along with photoshoots. So that this can become a mantra for women. And begin to heal and create self-love that will last far beyond

  1. It will become a way of life.”

You can see the stunning pictures here! (Some pictures may not be safe for work.)

Like this blog?  Here’s more cool stuff:

Sign and share the petition to tell Esquire UK to pull the article and the column written by Giles Coren – who used his column on fatherhood to fat-shame his four year old son, and then say he would kill and burn all fat people.

Become a Member! For ten bucks a month you can support fat activism and get deals from size positive businesses as a thank you.  Click here for details

NEW!!! Wellness for All Bodies Program: A simple, step-by-step, super efficient guide to setting and reaching your health goals from a weight neutral perspective.  This program can be used by individuals, or by groups, including as a workplace wellness program!

Over the course of eighteen self-paced, content-packed, quick videos you’ll get the tools you need to create healthy relationships with food, movement, and your body, and you’ll map out a path to health that makes sense for you, in an easily digestible format. Built-in tools allow you to track your progress and keep notes individually or as a group.
Click here for all the details and to register!

Book and Dance Class Sale!  I’m on a journey to complete an IRONMAN triathlon, and I’m having a sale on all my books, DVDs, and digital downloads to help pay for it. You get books and dance classes, I get spandex clothes and bike parts. Everybody wins! If you want, you can check it out here!

Book Me!  I’d love to speak to your organization. You can get more information here or just e-mail me at ragen at danceswithfat dot org!

If you are uncomfortable with my selling things on this site, you are invited to check out this post.



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Monday 13 November 2017

Preventing Complications After Cesarean in All Sizes of Women


In the United States, about 1 in 3 pregnancies end in cesarean. In some areas, the rate is even higher. Many women who have their first baby by cesarean will go on to have other babies by cesarean. That's a lot of cumulative exposure to cesareans, and a lot of potential complications from this common surgical procedure.

Therefore, learning how to prevent complications from cesarean surgery needs to be a high priority among care providers. Fortunately, there has been an increased emphasis on preventing post-surgical complications in the research in recent years.

It has been established that certain risk factors increase your risk for complications like surgical site infections (SSIs), endometritis (uterine infections), hematomas or seromas (collections of blood or fluid in the wound), and wound separations. These risk factors include things like:
  • having your waters broken for a long time before labor
  • waters broken for a long time during labor, especially with numerous vaginal exams
  • being a smoker
  • pregnancy complications like diabetes, gestational diabetes, hypertension, or pre-eclampsia
  • preterm labor
  • an unplanned cesarean
  • having had a prior cesarean
  • use of corticosteroids
  • a high BMI and/or >2 cm of subcutaneous tissue thickness
  • prolonged pushing stage
  • twin gestations
  • a lot of blood loss before or during surgery
However, even if you have multiple risk factors, there are many things that can be done to lower the risk for post-operative complications. The question is whether your hospital and caregiver do as many of them as they should. 

Improving Cesarean Outcomes in General

Not all post-cesarean complications can be prevented, but many of them can. There is recent new research on simple steps that hospitals can take to lower the risk for post-operative complications. These steps include:
  • Antibiotics administered before skin incision
  • Adding an additional antibiotic to the standard cephalosporin
  • Using chlorhexidine-alcohol for disinfecting the skin instead of iodine products
  • Using clippers on body hair instead of shaving the area
  • Removing the placenta through gentle traction instead of by manual removal
  • Closing the skin with sutures instead of with staples
Let's discuss each of these interventions in turn and the data that supports them. 

Timing of Antibiotics


Research is very clear that giving antibiotics helps prevent many infections. A 2014 Cochrane meta-analysis found that giving antibiotics reduced infections by 60-70%. This has become standard practice in modern days, though antibiotic use is still not 100% in some areas. But chances are very strong that if you had a cesarean in recent years, you probably had antibiotics.

Timing of antibiotic administration is probably important. Hospitals used to give antibiotics after the baby was born and the cord was clamped; now the standard of care has become to give antibiotics 30-60 minutes before the first incision.

Giving antibiotics before the first incision has lowered the rate of surgical site infections in a number of studies but not in all. Still, most hospitals now opt to give antibiotics before the operation actually begins. 

Additional Antibiotics

The most recent advance is the addition of extended spectrum antibiotics.

It is customary to use a narrow-spectrum cephalosporin like cezafolin for cesareans, but now many hospitals are adding additional antibiotics that cover a wider spectrum of bacteria. Antibiotics like azithromycin, metronidazole, and others have been added in recent studies.

Adding an additional, wider-spectrum antibiotic has been shown to lower the rate of SSIs in several studies. In one study, the addition of azithromycin to cefazolin during surgery lowered the risk for infection by 60%.

In another very large, randomized, multi-center study, the addition of azithromycin to the usual cephalosporin lowered the risk for infection and serious complications by about half compared to a placebo. The azithromycin group and the placebo group differed in rates of endometritis (3.8% vs. 6.1%), wound infection (2.4% vs. 6.6%), and serious maternal adverse events (1.5% vs. 2.9%).

A different option is to continue antibiotics for a few days after surgery. This can be done either orally or through I.V. fluids. A post-operative course of antibiotics has been shown to lower the risk for SSIs and wound complications in certain populations

If you have a cesarean and are in a group that is at higher-than-usual risk for infections and complications, ask about extended spectrum or longer regimens of antibiotics. If you develop a really serious infection, ask about IV antibiotics instead of oral ones. 

Skin Preparation

How the skin is prepared for surgery may make a difference in Sugical Site Infections as well. 

Some guides recommend showering the night before surgery with chlorhexidine gluconate soap (Hibiclens), but this has not been found to lower the rate of SSIs. It probably won't hurt, but it doesn't seem to help either. Showering with usual soap is probably good enough. However, showering in the morning before a cesarean seems to be common sense and is recommended by many hospitals.

Pre-operatively, the area will be cleaned even more thoroughly. The use of a chlorhexidine-alcohol preparation (instead of povidone-iodine) to disinfect the surgical site has been found in some research to lower SSIs after cesareans, especially when given adequate time to dry before operating. Not all research has found a difference, but even when statistical significance was not reached, a trend towards fewer SSIs and complications has been seen.

The jury is still out on a final answer about the best way to prepare the skin before surgery, but many experts believe that chlorhexidine-alcohol with adequate drying time is the way to go. It may also be that a combination of the two is superior. More research is needed. 

Using Clippers Instead of Shaving 

It used to be that the nurses shaved your body and pubic hair with a razor before a cesarean. Now it is thought that this makes many micro-cuts in the skin that serve as potential entryways for bacteria.

It has become standard practice to use electric clippers just before most surgeries to remove body hair before all different types of surgery, including cesareans. A meta-analysis of research shows that shaving increases the odds of infection as compared to clipping. However, some surgeons still insist on razors, against all evidence.

The very latest thinking is to leave most body hair intact and not shave or clip at all, unless the hair is substantial enough to interfere with surgery. The trend towards a slightly higher transverse skin incision (Joel-Cohen) in cesareans these days often makes hair removal unnecessary. 

Placental Removal Method 


In a normal vaginal birth, the placenta separates on its own and if left alone, the uterus contracts to push it out of the vagina. However, giving birth by cesarean bypasses this process, and caregivers must offer assistance.

In the past, doctors used to go into the uterus to forcibly remove the placenta, scooping it out in a hurried manner ("manual" removal). They reasoned that time was of the essence and there was less risk for infection if they hurried the process.

However, recent research clearly shows that manual removal results in more infections, blood loss, and other complications than spontaneous separation and traction. Research strongly suggests that a little more patience for spontaneous separation and gentle traction to remove the placenta results in less infections and complications.

An additional benefit of waiting a bit longer (at least 1-2 minutes, preferably 2-5 minutes) before cutting the cord and removing the placenta is that the baby gets more blood from the placenta. Delayed cord clamping improves the baby's transition to air breathing (especially in cesareans with no labor). It also lowers the chances of the baby developing anemia and increases the stem cells in baby's circulation.

Still, many care providers resist waiting a couple of minutes to let the placenta deliver spontaneously and to delay cutting the cord, but there is no medical justification for this, even in cesareans. The American College of Obstetricians and Gynecologists (ACOG) now endorses a small delay in cord clamping (at least 1 minute), and the World Health Organization advocates at least 1-3 minutes. 

Sutures vs. Staples vs. Glue

For many years, surgical staples were the standard of care for closing skin incisions after a cesarean. The two edges of the skin incision are approximated and then stapled together. This is much easier than taking the time to stitch together the edges.

Using staples is fast and easy for surgeons, and surgeons do take pride in how quickly they can perform a cesarean. In addition, they point out that a shorter surgery has been shown to lower the risk for infection ─ the longer a patient's insides are exposed to open air, the more time there is for infection to start. As a result, many automatically use staples for skin closure unless the patient requests otherwise.

However, new evidence suggests that using sutures instead of staples results in superior outcomes, both in lowering the rate of wound separations and in preventing infections. One California hospital considerably lowered its wound complication rate when it switched from primarily staples to primarily sutures. 

Two different meta-analyses found that sutures lowered the rate of wound complications considerably. This adds to the argument that most women should receive sutures instead of staples for skin closure.

Sutures do take longer to do, so some doctors are concerned about the risk for infection. However, the difference is usually only 5-10 minutes. Furthermore, if the increased time for suturing really did raise the risk for infection very much, it would show in the studies, yet using sutures decreases the risk by nearly half compared to staples.

Using sutures is probably the research recommendation most resisted by surgeons. Many of the other recommendations found in surgical evidence bundles are being implemented, yet many women today still receive staples instead of sutures after a cesarean. 

Some surgeons are using surgical glue to close cesarean skin incisions now too. There is less research comparing results from glue with sutures or staples, but what research we have is conflicting. A Cochrane meta-analysis of tissue adhesives (glue) in all types of surgical incisions had more problems with wound separations, but a recent randomized controlled trial found similar outcomes in wound complications between sutures and glue. More research is needed but for now, sutures should be the standard of care. 

Summary

Research is clear that there are many things providers can do to lower a woman's risk for complications after a cesarean, even in the presence of multiple risk factors.

Some of these interventions have been adopted quickly by the obstetric community, while other interventions are still struggling to find widespread acceptance. Usage is quite inconsistent, despite research.

One recent review of over 1,000 patients found that only one-third of cesarean mothers received all four of the evidence-based bundle recommendations in that study (prophylactic antibiotics within 60 minutes of cesarean delivery and before skin incision, chlorhexidine-alcohol for skin antisepsis with 3 minutes of drying time before incision, closure of subcutaneous layer if ≥2 cm of depth, and subcuticular skin closure with suture) to reduce wound complications. These are extremely basic precautions, and yet two-thirds of women receiving cesareans did not get them! Obviously, there is huge room for improvement here.
  • Antibiotics administered before skin incision - This recommendation seems to have been widely adopted now. Hospitals have done excellent work in quickly changing long-standing protocols
  • Adding additional antibiotics to the standard cephalosporin - This is based on very recent research so it has yet to be widely adopted, but evidence suggests that it is time to expand the use of adjunctive antibiotics, especially in those patients with strong risk factors for infection
  • Using chlorhexidine-alcohol for disinfecting the skin instead of iodine - This is mostly in place nowadays, but personnel may not be allowing proper drying time yet
  • Using clippers on body hair instead of shaving the area - This practice seems to be inconsistent and up to the preferences of the doctor, even through research shows clipping is safer
  • Removing the placenta through gentle traction instead of by manual removal - This practice seems to be left to the preference of the surgeon, though fewer are using manual removal these days
  • Closing the wound with sutures instead of with staples - This practice remains widely unadopted in many areas unless the patient specifically requests sutures. The difference in operating time is minimal, so hospitals need to start emphasizing switching to sutures whenever possible
In addition, there are things that can be done during labor to minimize the risk for infection, should a cesarean be eventually needed. One review suggested:

  • Avoid unnecessary vaginal examinations in labor
  • Avoid unnecessary instrumentation in labor (including fetal scalp electrodes and intrauterine pressure catheters)
  • Maintain strict glycemic control in diabetic women
  • Consider early removal of bladder catheters postoperatively

Of course, the best way to prevent post-cesarean complications is to do fewer cesareans. However, if a cesarean does occur, it's good to know that there are ways to lessen the risk for complications. Now it's up to hospitals and caregivers to ensure that best practices are actually followed.

*Next post: Preventing Complications After Cesarean in High BMI Women

References

General References
Combinations of Interventions

Am J Obstet Gynecol. 2017 Jun 8. pii: S0002-9378(17)30734-2. doi: 10.1016/j.ajog.2017.05.070. [Epub ahead of print] Impact of evidence-based interventions on wound complications after cesarean delivery. Temming LA, Raghuraman N, Carter EB, Stout MJ, Rampersad RM, Macones GA, Cahill AG, Tuuli MG. PMID: 28601567
...Risk of wound complications in women who received all 4 evidence-based measures (prophylactic antibiotics within 60 minutes of cesarean delivery and before skin incision, chlorhexidine-alcohol for skin antisepsis with 3 minutes of drying time before incision, closure of subcutaneous layer if ≥2 cm of depth, and subcuticular skin closure with suture) were compared with those women who did not...RESULTS: Of 1082 patients with follow-up data, 349 (32.3%) received all the evidence-based measures, and 733 (67.7%) did not. The risk of wound complications was significantly lower in patients who received all the evidence-based measures compared with those who did not (20.3% vs 28.1%; adjusted relative risk, 0.75; 95% confidence interval, 0.58-0.95)...Other risk factors, which include obesity, smoking, diabetes mellitus, chorioamnionitis, surgical experience, and skin incision type, were not significant among patients who received all of the 4 evidence-based measures....
Matern Health Neonatol Perinatol. 2017 Jul 5;3:12. doi: 10.1186/s40748-017-0051-3. eCollection 2017. Surgical site infections after cesarean delivery: epidemiology, prevention and treatment. Kawakita T, Landy HJ. PMID: 28690864  Free full text available here.
...Many risk factors for SSI have been described. These include maternal factors (such as tobacco use; limited prenatal care; obesity; corticosteroid use; nulliparity; twin gestations; and previous CD), intrapartum and operative factors (such as chorioamnionitis; premature rupture of membranes; prolonged rupture of membranes; prolonged labor, particularly prolonged second stage; large incision length; subcutaneous tissue thickness > 3 cm; subcutaneous hematoma; lack of antibiotic prophylaxis; emergency delivery; and excessive blood loss), and obstetrical care on the teaching service of an academic institution. Effective interventions to decrease surgical site infection include prophylactic antibiotic use (preoperative first generation cephalosporin and intravenous azithromycin), chlorhexidine skin preparation instead of iodine, hair removal using clippers instead of razors, vaginal cleansing by povidone-iodine, placental removal by traction of the umbilical cord instead of by manual removal, suture closure of subcutaneous tissue if the wound thickness is >2 cm, and skin closure with sutures instead of with staples....
Antibiotics

N Engl J Med. 2016 Sep 29;375(13):1231-41. doi: 10.1056/NEJMoa1602044. Adjunctive Azithromycin Prophylaxis for Cesarean Delivery. Tita AT, Szychowski JM, Boggess K, Saade G, Longo S, Clark E, Esplin S, Cleary K, Wapner R, Letson K, Owens M, Abramovici A, Ambalavanan N, Cutter G, Andrews W; C/SOAP Trial Consortium. PMID: http://ift.tt/2w0eJjU
...METHODS: In this trial conducted at 14 centers in the United States, we studied 2013 women who had a singleton pregnancy with a gestation of 24 weeks or more and who were undergoing cesarean delivery during labor or after membrane rupture. We randomly assigned 1019 to receive 500 mg of intravenous azithromycin and 994 to receive placebo. All the women were also scheduled to receive standard antibiotic prophylaxis... RESULTS: The primary outcome occurred in 62 women (6.1%) who received azithromycin and in 119 (12.0%) who received placebo (relative risk, 0.51; 95% confidence interval [CI], 0.38 to 0.68; P<0.001). There were significant differences between the azithromycin group and the placebo group in rates of endometritis (3.8% vs. 6.1%, P=0.02), wound infection (2.4% vs. 6.6%, P<0.001), and serious maternal adverse events (1.5% vs. 2.9%, P=0.03)...CONCLUSIONS: Among women undergoing nonelective cesarean delivery who were all receiving standard antibiotic prophylaxis, extended-spectrum prophylaxis with adjunctive azithromycin was more effective than placebo in reducing the risk of postoperative infection.
Am J Obstet Gynecol. 2016 Jun;214(6):751.e1-4. doi: 10.1016/j.ajog.2016.02.037. Epub 2016 Feb 18. A comparison of 3 antibiotic regimens for prevention of postcesarean endometritis: an historical cohort study. Ward E, Duff P. PMID: 26901276
...OBJECTIVE: The purpose of this study was to compare 3 different antibiotic regimens for the prevention of postcesarean endometritis. STUDY DESIGN: This retrospective historical cohort study was conducted at the University of Florida, which is a tertiary care facility that serves a predominantly indigent patient population. In the period January 2003 to December 2007, our standard prophylactic antibiotic regimen for all women who had cesarean delivery was cefazolin (1 g) administered immediately after the baby's umbilical cord was clamped. In November 2008, we began to administer the combined regimen of cefazolin (1 g intravenously) plus azithromycin (500 mg intravenously); both were given 30-60 minutes before the skin incision. In the period of January-December 2014, we continued the dual agent regimen but based the dose of cefazolin on the patient's body mass index: 2 g intravenously if the body mass index was <30 kg/m(2) and 3 g if the body mass index was >30 kg/m(2). The surgical technique was consistent throughout all 3 time periods. Our primary endpoint was the frequency of endometritis in each time period...RESULTS: ... In the period January 2003 to December 2007...16.4% (95% confidence interval, 14.4-18.4%) developed endometritis. In the period November 2008 to December 2013...1.3% (95% confidence interval, 1.0-1.7%) developed endometritis (P < .0001 compared with period 1). In the year 2014...2.3% (95% confidence interval, 1.3-3.3%) developed endometritis (P < .0001 compared with period 1 and P > .5 and <.10 compared with period 2)...CONCLUSIONS: When administered before skin incision, the combination of cefazolin plus azithromycin was significantly more effective in the prevention of endometritis than the administration of cefazolin after cord clamping; the rate of endometritis was reduced to a very low level without increasing the rate of neonatal sepsis evaluations.
Placental Removal Techniques

Acta Obstet Gynecol Scand. 2005 Mar;84(3):266-9. The effect of placental removal method and site of uterine repair on postcesarean endometritis and operative blood loss. Baksu A, Kalan A, Ozkan A, Baksu B, TekelioÄŸlu M, Goker N. PMID: 15715535
...This prospective randomized study involved 840 women who underwent cesarean section. The patients were grouped into four: (1) manual placental delivery + exteriorized uterine repair; (2) spontaneous placental delivery + exteriorized uterine repair; (3) manual placental delivery + in situ uterine repair; (4) spontaneous placental delivery + in situ uterine repair...The decrease in postoperative hemoglobin (P < 0.05) and hematocrit (P < 0.001) was significantly greater in the manual removal groups (groups 1 and 3) than in the spontaneous expulsion groups (groups 2 and 4) at 48 hr postoperatively. The incidence of postoperative endometritis was significantly higher in manual removal groups (15.2%) (groups 1 and 3) than in spontaneous groups (5.7%) (groups 2 and 4) (P < 0.05). CONCLUSIONS: Manual removal of the placenta at cesarean delivery results in more operative blood loss and a higher incidence of postcesarean endometritis.
Cochrane Database Syst Rev. 2008 Jul 16;(3):CD004737. doi: 10.1002/14651858.CD004737.pub2. Methods of delivering the placenta at caesarean section. Anorlu RI, Maholwana B, Hofmeyr GJ. PMID: 18646109
...CONCLUSIONS: Delivery of the placenta with cord traction at caesarean section has more advantages compared to manual removal. These are less endometritis; less blood loss; less decrease in haematocrit levels postoperatively; and shorter duration of hospital stay.
Sutures vs. Staples

J Matern Fetal Neonatal Med. 2016 Nov;29(22):3705-11. doi: 10.3109/14767058.2016.1141886. Epub 2016 Feb 26. Subcuticular sutures versus staples for skin closure after cesarean delivery: a meta-analysis. Wang H, Hong S, Teng H, Qiao L, Yin H. PMID: 26785886
...RESULTS: Ten RCTs were included in this analysis. Subcuticular sutures were associated with significantly decreased incidence of wound complications compared to staples (RR 1.88, 95% CI 1.45-2.45)...CONCLUSIONS: Compared with staples following cesarean delivery, subcuticular sutures are associated with decreased risk of wound complications and better long-term cosmetic outcome, but slightly prolong duration of surgery.
Am J Obstet Gynecol. 2015 May;212(5):621.e1-10. doi: 10.1016/j.ajog.2014.12.020. Epub 2014 Dec 19. Suture versus staples for skin closure after cesarean: a metaanalysis. Mackeen AD, Schuster M, Berghella V. PMID: 25530592
...Twelve randomized trials with data for the primary outcome on 3112 women were identified. Women whose incisions were closed with suture were significantly less likely to have wound complications than those closed with staples (risk ratio, 0.49; 95% confidence interval [CI], 0.28-0.87). This difference remained significant even when wound complications were stratified by obesity. The decrease in wound complications was largely due to the lower incidence of wound separations in those closed with suture (risk ratio, 0.29; 95% CI, 0.20-0.43)...CONCLUSION: For patients undergoing cesarean, closure of the transverse skin incision with suture significantly decreases wound morbidity, specifically wound separation, without significant differences in pain, patient satisfaction, or cosmesis. Suture placement does take 7 minutes longer than staples. 


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Fat-Shaming Game on KickStarter

 

 

Angry FrustratedBefore we get to today’s post, please consider signing and sharing the petition to ask Esquire to pull the article and column written by Giles Coren – who used his column on fatherhood to fat-shame his four year old son, and then say he would kill and burn all fat people.

Onward to today’s fat-shaming ridiculousness. There is a new game on Kickstarter called Hey There Fatty! It comes packaged in a stereotypical Chinese food delivery container complete with a fat-shaming fortune cookie. The game just won DreamHack 2017’s Best Multiplayer Experience Award, which is a shame because it’s a terrible, fat-shaming disaster.

According to the game’s description, Hey There Fatty! is “a game unlike any you have played before. By counting calories, going to the gym, and yes, even hosting a potluck, you can strategize to beat your friends and family. Or if sabotage is more your style, go for it! Just don’t end up a fatty!”

Look, the idea that fatphobia is the “last acceptable prejudice” is complete crap. Racism, homophobia, transphobia, classism, ageism, Islamophobia, anti-Semitism, and more run rampant. But fatphobia is one of the prejudices that people still seem to find completely acceptable.

The creators of Hey There Fatty! claim to have worked on this game for over three years. They dedicated time and energy for three years toward creating a game that has the express purpose of fat shaming and is based entirely on stereotypes about fat people.

In case you needed a reminder that internalized oppression is a thing, the creators have claimed that they are “overweight,” that they’ve played it with “overweight” friends, and that everyone thinks it’s hilarious.

Let’s be honest here — the game is not even clever. It’s hardly “unlike any you have played before” if you are someone who has been stuck on the diet roller coaster, been fat-shamed(supposedly) “for your health,” or had every bit of their food intake scrutinized and commented on by family and friends.

Speaking of food scrutiny, with cards for binging, over-exercising, and a goal of food restriction, this game could just as easily be called Hey There Eating Disorder!

The fat shaming is bad enough, but the connection between this kind of fat shaming and eating disorders is real and dangerous.

If you find this game inappropriate you can report it by logging into kickstarter, going to http://ift.tt/2zEGfp6 Scroll all the way to the bottom and click the “report” button.

To read the rest of this piece, click here!

Like this blog?  Here’s more cool stuff:

Sign and share the petition to tell Esquire UK to pull the article and the column written by Giles Coren – who used his column on fatherhood to fat-shame his four year old son, and then say he would kill and burn all fat people.

Become a Member! For ten bucks a month you can support fat activism and get deals from size positive businesses as a thank you.  Click here for details

NEW!!! Wellness for All Bodies Program: A simple, step-by-step, super efficient guide to setting and reaching your health goals from a weight neutral perspective.  This program can be used by individuals, or by groups, including as a workplace wellness program!

Over the course of eighteen self-paced, content-packed, quick videos you’ll get the tools you need to create healthy relationships with food, movement, and your body, and you’ll map out a path to health that makes sense for you, in an easily digestible format. Built-in tools allow you to track your progress and keep notes individually or as a group.
Click here for all the details and to register!

Book and Dance Class Sale!  I’m on a journey to complete an IRONMAN triathlon, and I’m having a sale on all my books, DVDs, and digital downloads to help pay for it. You get books and dance classes, I get spandex clothes and bike parts. Everybody wins! If you want, you can check it out here!

Book Me!  I’d love to speak to your organization. You can get more information here or just e-mail me at ragen at danceswithfat dot org!

If you are uncomfortable with my selling things on this site, you are invited to check out this post.

 

 



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Lost for words: Esquire publishes horrific hate fest column – and what you can do about it

As a stigma research and advocate I sometimes think I’ve seen it all. apparently not. Esquire have published a column by Giles Coren called “I Don’t Care What My Son Becomes… As Long As He Isn’t Overweight.” That sounds bad, but you literally can’t begin to imagine how much worse the article itself actually is.…

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Sunday 12 November 2017

Today in Terrible Parenting

I have nothing to add to Ragen Chastain’s excellent piece on the asshole father who thought it was *hilarious* to write an article fat-shaming his freaking three-year-old, in which he literally said he wanted to kill all fat people, except perhaps incoherent swearing. But you should read the piece, and you should sign the petition.




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Giles Coren: Garbage Human, Fatphobe and, Horrifyingly, Father

NOGiles Coren writes a column for Esquire about fatherhood. His most recent piece is titled: “I Don’t Care What My Son Becomes… As Long As He Isn’t Overweight.” I thought I couldn’t be shocked by fatphobia anymore but I was wrong.

Before we get into his advocacy of child abuse and killing fat people, let’s take a look at his kid, who he calls “morbidly obese”

giles

I’m going to take his letter and break it down. Please consider sighing and sharing the petition to get this piece, and Giles’ column, pulled from Esquire UK. If you’d like to give Giles some feedback on his piece, you can find him on Twitter here . If you’re a dad, it would be particularly helpful if you would step it up and let him know that this is completely unacceptable, and let the world know that whatever the hell he’s doing, it’s not fatherhood.

I’d also like to be clear that this isn’t Giles first day as a human-shaped piece of garbage, having previously published a piece (also for his Esquire column) where he said it was ok if his daughter didn’t do well in school because she could just marry a banker.

Finally, the quotes from his piece will be indented. All are offensive, many cross the line into blatant, violent, hate speech, including discussion of burning. They may be extremely triggering. If you want to skip this post entirely, I don’t blame you. If you want to skip the quotes you will still get the gist of the post without reading all of his bigoted drivel.

I know what you’re thinking. You’re looking at that picture of my son and you’re thinking, “Fat little bastard”. Sure, he’s cute. He’s got a nice little face. He looks a bit of an idiot because his mum took him for a haircut on the morning of the photo shoot (completely failing to grasp the first rule of shoots which is, “never have a haircut closer than two weeks before, or you’re going to look like a chump”) but on the whole he is a good-looking boy.

Wrong right off the bat there Giles.  What I’m thinking is “Please, please, please don’t let this article be about a dad who is taking out his size bigotry on his four year old son.”

Except he’s fat. Arse on him like Vanessa Feltz and a full frontal presentation at bath time that puts one in mind of a Gavin and Stacey-era James Corden or a well-waxed Christopher Biggins, all giggly on too much rosé.

At this point (while I know full well that regardless of his kid’s size it’s wildly inappropriate for Giles to think of him this way, or to involve so many other people in his blatant size bias) I am compelled to look again at the picture. While it would be perfectly fine if his kid fit this description, he absolutely does not. I’m forced to assume that Giles wanted to splash around in a pool of fat hate and decided to facilitate that by pretending that his kid is fat. Regardless, there is no size his kid could be that would possibly justify fat-shaming him.

It’s all very well to say that it’s puppy fat. It’s all very well to pinch his cheeks and go, “Who’s a cheeky chubby-chops? Awww, wittle fatty boom-boom…” and nuzzle your face in his tummy and blow raspberries and feel how they ripple through him like a fart in the bath, but what if… IT DOESN’T GO AWAY?

If it doesn’t go away, then you will have a fat kid. If he doesn’t have a growth spurt, then you’ll have a short kid. The thing about kids growing up is that they grow up into adults of all kinds of shapes and sizes and none of that requires ALL CAPS HISTRIONICS because all bodies are good bodies.

You know what I’m saying? Adele’s parents probably thought it was puppy fat too. And Paul Hollywood’s. And Russell Grant’s. No doubt Diane Abbott’s family assumed that she would change shape when she was out of nappies. But the change never came.

Giles seems really, really angry that fat people are allowed to exist and he continues to try to involve as many of them as possible in his bigoted farce of an article.

It’s reasonable to assume that the parents took their eyes off the ball, let their porky pups feast on a shitty diet and do fuck-all exercise into adolescence and now look at them: ostensibly successful, yes, but laughable to behold with their untucked shirts and stretched, shiny faces.

It’s not reasonable – it’s fatphobia and stereotyping. People, including young people, come in lots of different sizes for lots of different reason. People of all sizes eat whatever Giles’ definition of a “shitty diet” is, and people of all sizes choose not to exercise. People’s choices and sizes are none of Giles’ business. People of all sizes wear untucked shirts and have shiny faces. Giles, needs to get ahold of himself, he has completely failed at keeping his blatant bigotry subtle while pretending that he cares about his son.

The sort of people you want to follow down the street playing “Flight of the Valkyries” on a tuba.

No dude, YOU want to follow them down the street playing the tuba because you are an absolute garbage human.  I continue to be absolutely stunned that Esquire would allow a piece that is nothing but hate speech to be published, especially under the guise of how to be a father.

And I’m worried as fuck that my little Sam could go the same way. Not only because of how it will ruin his life but because of how it will reflect on me.

I don’t give a single solitary fuck about Giles. I’m worried that Sam “could go the same way” because his father is a raving fatphobe who will undoubtedly do unimaginable damage to him every day until he can escape. (Pssst, Sam, find the Fat Acceptance Movement, a lot of us grew up with parents who were worse than useless as well, we’ve got your back!)

For while obesity as a demographic phenomenon can be classed as disease, epidemic, socio-economic tragedy, whatever, on an individual, case-by-case basis, each actual fat person is blatantly just a badly brought-up, greedy little son of a bitch committing the unforgivable sin of gluttony in a world where there is not enough food to go round.

Being fat doesn’t ruin your life. The thing that ruins your life is this kind of (fact-free) fatphobia. “Obesity” isn’t a disease, it’s not an epidemic, or a tragedy – it’s just a ratio of weight and height. Granted, a ratio onto which some people (many for profit, others for attention, others because they are simply bigots) have heaped tons of negativity.

Also be clear that there is plenty of food to go around. Hunger is a complex issue that has to do with things like capitalism, nationalism, racism and more. And even if it wasn’t indisputable fact that there are thin people who eat far more than fat people, it would still have literally NOTHING to do with fat people existing. This is just another way that people who want to be bigots try to justify their bigotry, and using people who are starving to do it is particularly despicable.

I’d kill them all and render them down for candles.

Let’s be absolutely clear what he is saying here.  He is saying that, given a chance, he would kill all fat people, then burn us. It’s not funny, it’s not cute, it’s a call for genocide. (People will immediately suggest that I’m going to far in saying this, those people are a part of the problem. “I’d kill them all” is not an unclear statement.) Anytime you say that everyone who shares a single characteristic should be killed, you are going down a very bad road. I would love to know the name of the editor at Esquire UK who read that sentence and said “Sure, kill all the fat and burn them, that’s totally reasonable. Leave that in.”) Here, again, is the link for their complaints section.

It may sound harsh but how else are we to recoup the tens of billions of pounds they cost the NHS and the wider economy each year with treatment needed, working days lost, hospital beds broken, chairs smashed to splinters and good workers accidentally killed when fat people sit on them?

Here Giles seems to be trying to make another wild stab at justifying his bigotry (won’t somebody please think of the tax dollars?!)  But he’s so overcome with his desire to say horrible things about fat people that he can’t even keep it together for a single paragraph.

It is no business of mine what Sam does with his life. I’m not ultimately bothered whether he’s rich or poor, artist or scientist, crackhead or alcoholic, married or unmarried, gay or straight… I don’t care if he runs every letter of the LGBTQI spectrum to the end and back, and comes home with a cock in every hole and says he’s changed his name to Rita. As long as he isn’t fat.

The first sentence may be the only correct and appropriate thing he says in the entire piece. The rest is obviously total bullshit. Now might be a good time to remember that someday, who knows how soon, Sam (who might end up being fat) will read this. The idea that he would be more upset if his son had a larger body that if he was addicted to crack is obviously incredibly troubling, but also troubling is – again – Giles’ tendency to feel free to use some marginalized groups in his quest to oppress fat people.  Here he uses people who struggle with addiction as well as queer and trans people showing that while he’s is definitely a fatphobe, he’s certainly not a single issue bigot.

My daughter I am less worried about. Possibly because she is as skinny as a cricket. But if at some point in adult life she pulls the ripcord, well, there are uses for a fat woman. She can be kind of cosy. Whereas a fat man has nothing to offer but his ability to consume. To bring forth upon the world a fat son is indeed a shame before God.

Not satisfied at simply inappropriately (some might say abusively) using his son for this ridiculous exercise, Giles brings his daughter into it and makes the transition to blatant and disgusting misogyny. Unfortunately he doesn’t even have enough new ideas to support the entire diatribe, so we’re back to the old “fat people eat a lot” crap. Even if this was true it would be a tired argument at this point but, again, it’s simply not.  And once again I’d remind you that his son will someday learn just how conditional his father’s love for him really is. So while I’m angry at Giles for being such a blatant and vocal bigot, I’m terrified for Sam growing up with an abusive, misogynist, fatphobe for a father, and I would support child services if they removed the kids from the home.

But it’s hard to know what to do about it. I’d put him on a strict diet and buy him a hamster wheel but my wife is not the moral absolutist that I am and she is the one who does the Ocado orders. And cooks most of the food. But is a bit of a lazy tart. Sorry — a busy working mother with many other important things to think about, who knows her way down the path of least resistance.

So Giles also doesn’t respect his wife. This is my not-surprised face. In good news, it looks like Sam may have one decent parent.

So the boy eats a lot of white carbs, sugary cereals, pizza, fried chicken… much like a poor child in America’s morbidly obese central heartlands. Which is why Sam looks like one of them. He doesn’t like fruit or veg and none of us can be arsed to force them down him. But he does like a tub of ice cream and a long run at the television of an afternoon. And on even the shortest car journey he expects his iPad and a sack of Kettle chips.

So he gets them. And I say, “Can’t you give him a carrot instead?”

And my wife says, “If you want him to eat carrots, you try feeding him a fucking carrot!”

So I let it go. And I feel ashamed. But then I see these middle-class kids with their weekday screen bans and their steamed fish and vegetables and no chocolate or sweeties and 10 hours’ oboe practice a day and it makes me want to puke. And I find that I’m kind of proud of our somewhat slutty stance on it all, or lack of one. Otherwise, I suppose, I wouldn’t be admitting to it here.

This is quite the juxtaposition of bigotry – marginalizing an entire swatch of America, middle-class kids, and those who play the oboe is not beginner level oppression. Giles is a piece of shit, but at least he’s good at it? Let’s be clear – giving kids (of all sizes) lots of food choices and helping them to develop a healthy relationship with food is a positive thing, giving kids food and then shaming them for eating it is just fucked up and is basically trying to give your kid an eating disorder.

I try to look on the positive side. Such as the possibility that having a fat adult son — who I will unquestionably continue to love with all my heart no matter what — might help me to lay aside my prejudices regarding fat people and bring me to a more respectful place vis-à-vis the fat and ever fatter future we unquestionably face as a race. And that being grotesquely flabby, sweaty, knock-kneed and impotent would mean that Sam was unlikely ever to have a girlfriend or any mates or be invited to parties, so he’d have more time to work at becoming a nuclear physicist or getting filthy rich and supporting me in my old age.

And then other times I think, “I’d best get the chubby fucker’s jaw wired before he’s old enough to stop me.”

Classic abuser technique. First he spends the entire article being clear that if his son is fat he would be perfectly happy to kill him and burn him, that he would rather he struggle with a drug addiction than be large, that he would consider him to be a “shame before god,” and that his son would (continue to) be the recipient of every piece of fatphobia with which Giles’ little essay is dripping. Then Giles does the whole “I still love you, maybe I can be better” rap. But, as we’ve learned, Giles can’t hold it together for long, so he throws in a few more stereotypes and then leaves a little reminder that he is capable of physical abuse.

My heart goes out to Sam, I hope that he can somehow escape this situation clinging to a  healthy relationships with food and his body, and I also hope that he can avoid becoming the super bigot that his father is modeling to him and anyone else who will read his work.

As far as Giles goes, I think we all know where he should go:

Move to Trash

Red box around a picture of a trash can with the text “Moved to Trash”

Final reminder to take some action here:

Sign (and share) the petition

File a complaint with Esquire UK

Here is the link for Giles Twitter. 

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