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Friday, 7 September 2018

Inositol for PCOS anovulation: 2018 Review

It's September, and that means it's time for PCOS Awareness Month. We have a continuing series on Polycystic Ovarian Syndrome (PCOS) that looks at various PCOS issues from a weight-neutral point of view.

One of the most exciting treatments on the horizon for Polycystic Ovarian Syndrome (PCOS) is inositol, either myo-inositol or d-chiro-inositol, or a combination of both. We've discussed it before, but now there is a recent meta-analysis of the literature.

New Review of Inositol for Fertility

Here is a review of the best research we have so far on inositol for fertility issues in women with PCOS. There are other studies, but these studies met high enough standards for quality to be considered for this analysis.

The good news is that the results so far are quite encouraging. The bad news is that it's clear we still need better-designed trials.

Let's start with the bad news. There was little uniformity in the protocols. Some studies used myo-inositol, some studies used d-chiro-inositol. Some studies compared inositols with metformin, others did not. Trials are also fairly small, which makes it harder to know how reliable the data is. Most importantly, no trials reported on live birth rates, which is the most important outcome.

The good news is that overall, the review was quite positive. The review's authors found that use of inositol improved ovulation rates and regularity of menstrual cycles. 

The review found that inositol was better than placebo (sugar pill), and was also more effective than metformin. In one study, it also increased pregnancy rates (3.3x compared to placebo, 1.5x compared to metformin), but we don't know how many of these ended up as live births. The authors concluded:
Inositol appears to regulate menstrual cycles, improve ovulation and induce metabolic changes in polycystic ovary syndrome; however, evidence is lacking for pregnancy, miscarriage or live birth. A further, well-designed multicentre trial to address this issue to provide robust evidence of benefit is warranted. 
So there are reasons to be cautiously optimistic about inositols, but a lot more research is needed. Come on, researchers, get this work going! Inositol's preliminary results look very promising so far, but we need much more data before it becomes standard of care. In particular, we need to know whether it improves the live birth rate in people with PCOS, which is the ultimate measure of successful treatment.

Still, it's another tool in the toolbox that can be considered for women with PCOS who don't ovulate regularly. And on the whole, that's good news.


Reference

BJOG. 2018 Feb;125(3):299-308. doi: 10.1111/1471-0528.14754. Epub 2017 Jul 14. Inositol treatment of anovulation in women with polycystic ovary syndrome: a meta-analysis of randomised trials. Pundir J, Psaroudakis D, Savnur P, Bhide P, Sabatini L, Teede H, Coomarasamy A, Thangaratinam S.  PMID: 28544572
...Systematic review and meta-analysis of randomised controlled trials (RCT) that evaluated the effects of inositol as an ovulation induction agent... We included ten randomised trials. A total of 362 women were on inositol (257 on myo-inositol; 105 on di-chiro-inositol), 179 were on placebo and 60 were on metformin. Inositol was associated with significantly improved ovulation rate (RR 2.3; 95% CI 1.1-4.7; I2 = 75%) and increased frequency of menstrual cycles (RR 6.8; 95% CI 2.8-16.6; I2 = 0%) compared with placebo. One study reported on clinical pregnancy rate with inositol compared with placebo (RR 3.3; 95% CI 0.4-27.1), and one study compared with metformin (RR 1.5; 95% CI 0.7-3.1). No studies evaluated live birth and miscarriage rates. Inositol appears to regulate menstrual cycles, improve ovulation and induce metabolic changes in polycystic ovary syndrome; however, evidence is lacking for pregnancy, miscarriage or live birth. A further, well-designed multicentre trial to address this issue to provide robust evidence of benefit is warranted. 
Tweetable abstract: Inositols improve menstrual cycles, ovulation and metabolic changes in polycystic ovary syndrome.



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Thursday, 6 September 2018

Autumn is in the Air, Dammit!

I know, I know, the sun worshippers of the world are latching onto their last precious rays of summer’s glory days. But I didn’t choose the Victorian/Morticia/Pug life…it chose me! Ha-ha! I am an autumn baby; late October, thanks. When the days begin to cool and the leaves begin to turn, I swear it is then that my soul truly awakens. Yes, Halloween is my favorite holiday, but I haven’t been able to really celebrate in years! That’s gotta change!

I woke up this morning and was excited to try a new (to me) dandruff shampoo from Biolage I had ordered online. The reviews swore it was the best thing ever! I also splurged, slightly, on a nice conditioner by Nexxus. I had a new pair of shoes, earrings, necklace, and a dress, too. I hadn’t put these things together in my mind yet, but as I was getting dressed, well, it all just worked out!

You see, my work bff, and honestly the biggest cheerleader in my life (and that is a high bar, lemme tell ya!), came back to work today after a vacation. They took one look at me this morning and flipped out! They always do, but this time did feel more special. They insisted I was glowing and needed a pic. I gushed over my new shoes that I’m now in love and obsessed with, and they immediately gasped as they’d never seen me in pointed toe shoes.

So I was super feelin’ myself today, and why not?! I haven’t had many of those as of late. I do have a bit of a shoe addiction, always in search of the most stylish and most comfortable shoes. I may have found them! No idea how my shampoo worked out yet, I got to work with my hair still wet so I threw it up into a top knot so the back could dry and just left it. As always, I was in a rush this morning, so my makeup was a quick thing.

These shoes, though?! OMZ! Naturalizer had a sale, I think 25% off or something. I looked at their entire line, there’s some cute flats but nothing exciting, until I saw these babies. I kept going back to the page, telling myself, “No! No more shoes! You are out of control!” but it didn’t stick. The free shipping on top just made matters worse. They come in wide widths! They’re leather flats, pointed toe, mules! I got an 8 wide and they fit like a fucking dream right outta the box! That never happens. I expected some initial discomfort, but I’ve had zero. ZERO! I wore them without socks today, but may try those half-liner style ones, so my toes are protected. Not sure I’d even need it but I want these shoes to last forever and I hate when the insole gets wrecked before the outsole does.

My lovely work bff takes great pics, even if they are just using my phone. They told me where to stand and just kept clicking away. Such a pro! Ha-ha! Honestly?! I love these pictures! I love this outfit and these shoes and everything about today’s outfit! I’ve really been into inexpensive jewelry lately. I got a 4-pack of cheap hoop earrings on Amazon. (Also got this amazing deal on these huggie style hoops!) The sweater is discontinued but it’s my absolute favorite thing, it’s from ModCloth. The dress is also Torrid, but couldn’t find it on their site, maybe it’s gone. My glasses are from Coastal (dot com) and are also my favorite ever (they might also be discontinued, sorry)!

I bought this rose gold-tone, caged heart necklace at Torrid a couple of months ago but couldn’t work it into an outfit until today. Wooo!

The ring is from Minette and is 14k rose gold, with two small onyx stones on either side of a tiny white pearl. It makes me so happy, this little ring. I have another of their rings that I also adore. I love the daintiness of their rings, but all of their stuff is great quality, fast shipping, affordable prices, truly sweet packaging!

I even did my nails kinda fancy last night. I’ve been growing them out to see how long they can get until they all break. Ha-ha! I do my nails myself, usually just a solid color with the occasional glittery accent nail. It’s sort of meditative for me, doing my nails. I enjoy it in any case. Also, it’s hard to take a pic of your nails. Just sayin’! Ha!

Just look at these colors?! And it’s a lovely warm and breezy day outside. I know many of you are not excited about cooler weather. Honestly, it hasn’t been a very hot summer here in the San Francisco Bay Area. I’m grateful for that as I cannot be in the sun (allergic to sunscreen + natural redhead = instant spontaneous combustion). I think I’m in a good place, physically and mentally, for the most part. I’m making some progress which I hope to write about soon. Someone even brought in some cakes for someone’s birthday at work. Woo cake! Ha-ha! I dunno, I’m just lookin’ good and feelin’ fine and pretty dang contented with that at the moment.

I’ll be forty-one soon, and I gotta say it ain’t bad, this gettin’ older thing. Though my grandma always told me, “Never get old, Sarah!” I know she only meant the tough stuff. I’m grateful to have the life that I do and more so the people in it. This may seem like some silly outfit of the day post, but for me this was a pretty big deal. Sounds shallow or superficial, perhaps. I don’t dress up for the validation or approval of others. I dress for me. I love how I feel when I love how I look. It’s a collection of things, really, and fashion is a big part of that for me. I also sit at the front desk of a major tech startup in silicon valley, so I take a little pride now and then with my appearance.

I find it both empowering and liberating. For me it is a part of a myriad of things I consider to be in my own self-care arsenal. Sometimes it’s just jeans and a t-shirt and getting my ass out the door in the morning. Other times it’s a bit much, but I don’t care. If I’m feelin’ it I try to go with it, when time permits.  I was quite pleased with today’s ensemble, though it came together through happenstance. Having a friend cheer me on is the best! They will be moving out of state at the end of this month and I don’t know what I will do without their presence everyday. We’ll text, of course! Ha-ha!

Rad Fatty Love to ALL,

<3
S


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Wednesday, 5 September 2018

On fat kids and physical education

At the end of May, I travelled to Queenstown, one of the loveliest towns in New Zealand, to attend the Critical Health Education Studies Conference.

 

It was a last minute decision; I hadn’t planned on attending. But Professor Richard Tinning (a distinguished Professor in the area of physical & health education), invited me to fill a vacancy on symposium he had organized on “Critical health education and the affect of physical education”. This invitation was an honour, and even though I knew I would have to self-fund the trip, I accepted. The symposium also included Darren Powell, lisahunter, and Michael Gard; all scholars I admire a great deal.

I was pleasantly surprised by how much relevant scholarship was shared across the three days. Standout presentations came from Melinda Webber on the role of stereotype threat and cultural identity in the success of Māori as Māori and Gareth Treharne on the need for healthcare providers to be trained to meet the needs of trans New Zealanders.

I was, as usual, one of the few fat people in attendance. And I was the fattest person who spoke across the three days. It made my topic, fat kids, ethics, and physical education, especially relevant. I realised, in that space, that I was talking on behalf of all fat kids for these physical and health educators. And this is common for Fat Studies scholars and fat activists; we are the few speaking from the position of being fat. Most research around fatness doesn’t centre fatness or fat people – this is also true for most conversations around the topic. This is why growing the field of Fat Studies is so important. And why so many of us use autoethnography in our work; it provides a method in which the researcher remembers and reflects on personal experiences through a framework of theory and literature.

 

My talk, Losing the love of movement: Fat kids and physical education, explored the violence done to fat kids in PE and the disservice we do as we teach them to associate exercise solely with the pursuit of weight loss. I considered my own experiences with movement; how much I enjoyed physical activity as a kid, until I began compulsory physical education classes. In those spaces, I lost my love of movement. Uniforms that didn’t fit, activities that haven’t been modified for my fat body, taunting from my peers, and the anti-fat bias of my teachers; the end result was a hostile environment that removed the joy associated with movement and exercise for me.

This was reinforced by the idea that physical movement was meant to produce weight loss, rather than being allowed to enjoy physical movement for enjoyment’s sake. If I wasn’t losing weight, then what was the point? I was doing it wrong. Or not enough. Or not in the right way. (This approach is counterproductive to supporting fat kids to engage in physical activity, but understandable given the obesity epidemic lens that frames how most everyone thinks about fatness, health, and activity).

 

These experiences in physical education taught me that exercise was for the purpose of weight loss, and so from then on I would engage in regular exercise only during the times of my life when I was at war with my body. And during these times, I became militant about my activity. During my last war on my body, I took no prisoners. I was exercising between 3-4hrs every day, and would berate myself harshly when I took a day off due to illness or travel. (It’s amazing to me that during this time I was also completing my qualifying exams and my PhD research).

 

While I’ve left warring with my body behind me, I’ve yet to repair my relationship with movement and exercise. On the few times I’ve tried over the years, like when I did my first (and ONLY) mini triathlon, I found myself moving into unhealthy habits and thoughts quickly. But even though I’ve yet to work this out for myself, I’m hopeful. Because I know lots of fat adults who engage in movement they enjoy. Like the members of Aquaporko (a fat synchronised swimming group in Melbourne) or fat Olympians like Sarah Robles and Raven Saunders.

I concluded the talk by imaging a different future for fat kids in physical education. Spaces where fat kids could learn new ways to move their fat bodies without shame, or ridicule, or chafing. Spaces where fat kids could use their size to their advantage when appropriate in sporting situations, and learn modifications for other activities when necessary. Spaces where fat kids weren’t left out, left behind, or left feeling less worthy, because of their fatness. I can imagine these spaces. Can you? How can we support physical educators to make these spaces a reality? How can we support fat kids to not dread spaces of physical education? How can we support fat kids to be fat kids?

 

(I’m revising my talk into a paper appropriate for inclusion in an upcoming special issue on critical health education for the Health Education Journal – submissions are due in October)

 



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Monday, 3 September 2018

Fat (Plus-Size) Travel Review: Skala Eressos, Lesbos Greece

 

General Thoughts:

Skala Eressos is one of my favourite places on earth.  This review is going to skew heavily critical because I aim to give the most thorough examination that I can (from memory, at least) of the practicalities of traveling here in a larger body. That said,  I want to clarify that there’s no beach where I feel safer and more relaxed and there’s no town where holidays have felt easier and more truly restful.  I don’t feel like an outsider here.  Also, I feel like I’m making a concerted effort to contribute to a struggling local economy and community so ethically it feels collaborative and mutually beneficial rather then exploitative and uncomfortable.  Living in London means international travel is less expensive than it was from the States, and you’d think I’d be off seeing as many other places as I can (and certainly I have and will do more) rather than returning to the same place time and again – but Skala always pulls me back! It spoils you, really, for other holidays! So I highly recommend the experience if you can manage it.

[See image gallery at stacybias.net]
 
My Stats for comparison: 
Height: 5’8″
Weight: Somewhere between 350 and 380
Distribution: I have a bigger belly and upper body with narrower hips.
Mobility: Currently compromised. I am healing from a leg injury and walking long distances is tough. 
 
Flight Route: London Gatwick to Mytilene, Lesvos Greece
Airline: Thomas Cook
Airplane Model: Airbus A321-200 (Seats 17.6 with 28-30 pitch)
 

The Airport:

Getting from Security to the gate is a minimum of a mile of walking and incorporates a few moving sidewalks. I didn’t see any inter-airport shuttles during our early morning flight but I’m sure they can be arranged if required.
 

The Flight:

 
Seatbelt Extender: I needed one. It was given without fuss or judgement.
 
Armrest: I could get it down easily and it didn’t hurt my thighs. That said, the recline button is on the inside and my leg pressed against it, making my seat go back. This is a problem because seats upright and armrests down is the required take-off and landing position. Managing both at the same time was problematic. I had to lean forward and/or raise the armrest just slightly.
 
Tray Tables: Fuggeddaboudit. 
 
Bathrooms: Didn’t try as it was a short flight.
 
Aisles: Quite narrow but manageable for boarding. Wouldn’t have liked to traverse them when the flight was full, however.
 
General Thoughts: Thomas Cook flights are a budget flights and while the seat width is better than some, the pitch is terrible, especially for those of us who are tall with big bums that push us forward in the seats. My knees pressed against the seatback and I had to take my shoes off to get my legs low enough to be able to straighten them under the seat in front of me. It was tight and if I were not next to my partner, I’d have been very uncomfortable.
 

Arrival:

 
Mytilene Airport is quite small and doesn’t have concourses. Planes land on an airfield and stairs are brought to fore and aft of the plane. For those with mobility impairments, this is something to make note of as there is no obvious accessible entry or exit from the airplane.   
 
From the airplane, passengers board a shuttle that drives them literally 30 seconds to the doorway of the airport.  The wait at passport control can be long and sweaty as there are only 2 windows. There is minimal walking as the airport is quite small.
 
NOTE: Do not flush your toilet paper anywhere on the island of Lesvos.  The sewage system can’t handle paper. Place your toilet paper in the bins next to the toilets. They are emptied regularly.
 

Transport between Mytilene and Skala Eressos:

 
The drive from Mytilene to Skala Eressos is 1hr and 45 minutes. It’s a gorgeous ride through the countryside and up/around mountains. It’s winding, so if you’re prone to motion sickness, take measures (I use dramamine). 
 
I travel with a large group of friends.  Because of this, we tend to arrange for a shuttle to pick us up rather than taking individual taxis. This is great for cost-effectiveness but bigger shuttles are less common and more prone to breakdowns. It’s never actually gone smoothly – either reservations have been forgotten or the shuttle has needed repair. This is part of the experience of traveling to an island. You have to adopt a go with the flow approach. The good news is the airport is right across the street from the sea so you can wander over and dip your toes in while you wait for repairs or replacements.
 
To arrange airport transfers, contact Sappho Travelhttp://www.sapphotravel.com/  (real-talk, you need to quadruple-check any reservations you make here. Call, call again, call a few days before and call again the day before. They’re your best option but they’re DISORGANISED. I am NOT kidding.)  Shuttles vary in costs but private transfer (taxi) is around €120. Not cheap.
 
Taxis/Shuttles will generally not take you directly to your hotel. They will drop you at the car park in the middle of town. Google Maps is not great for Skala Eressos but the good news is that the town is literally a mile across from tip to tail so wherever you wander, you won’t be far from where you need to be.
 

The Town of Skala Eressos:

 
As mentioned, the town is literally a little over a mile across, from the furthest tip of the boat pier to the end of the public beach. The streets are cobbled so be advised for those with balance or mobility concerns – bring sensible shoes to help compensate. Nearer to the boat pier, the town is hillier and hotels tend to be up several flights of stairs, so if you want to avoid inclines and stairs, stay on the opposite end of town.
 
Near the car park are all the grocers and bakeries as well as places to procure beach items like snorkels and beach mats and sarongs.  Walk towards the sea and you’ll find yourself on the boardwalk entrance where seafront restaurants and bars stretch to the left and right.  There are stairs and a narrow boardwalk in the sand that separate the two sides of the boardwalk. If you want to avoid the stairs,  just walk back towards the shops and then take the street that runs parallel. There are entrances back to the boardwalk between the buildings.
 
There are feral cats everywhere but they’re generally well-behaved. They’ll circle your ankles at restaurants and say hello to you on the streets. It’s great if you’re a cat lover! Do be mindful when feeding them as some have better table manners than others.
 
Restaurant Seating:  Most restaurants have the same typically greek restaurant chairs. The good news is, no arms! The bad news is, they’re still really uncomfortable. They’re wooden squares with a woven seat and the legs tend to poke up above the seatback, which means they poke into your bum and upper thighs. It’s great for restaurant turnover, I’d imagine, but not so great for a relaxed meal. I actually bring a little inflatable pillow with me ‘cuz ow!  
 
Bar Seating: Most bars have a mix of short couches/benches and narrow director’s chairs.  The benches are nice but tend to be wet from swimmer’s butts, so check the cushions before you sit. The director’s chairs are hit and miss for me. Sometimes I fit, sometimes I don’t. There’s no method to it, it seems. Just luck.
 

Restaurant/Shop Reviews: 

 
Toilets: There’s no ‘downstairs’ in the seafront restaurants (‘cuz downstairs is the actual sea), so you needn’t worry about stairs down to the loos. However most of the toilets are tiny and wedged into the storage areas near the kitchens so do bear that in mind and plan ahead. Restrooms at the bars are often better than those at the restaurants.
 
Local specialty: Saganaki – it’s a pan-seared greek cheese starter and my group writes actual songs about it. Also the tomatoes in Greece are something else entirely. Eat all the greek salad you can!
 
The local bakery is gorgeous and stuffed full of traditional Greek delights as well as fresh bread daily. They also have a little freezer cabinet of 50p ice creams in various flavours that people can’t stop going on about.
 
There’s a little Frozen Yogurt shop next to the bakery that’s a delight on hot evenings. The Pistachio syrup is weird and amazing. For the lactose intolerant, they have blended ice drinks as well.
 
For quick, cheap meals – there are two Gyros shops very near the seafront and down a little side street from the boardwalk. Delicious, fast, and affordable if you’re watching your budget.
 
The best fresh seafood is the Blue Sardine where Kostas takes special care to attend to every table and will sit down at the end with you to figure out the bill. 
 
The slow-cooked Lamb at Adonis nextdoor is also wonderful.
 
The Flamingo Bar is lesbian-owned and tends to cater to the 50+ crowd. Their blended margaritas are amazing on a hot night but their mixed drinks are a bit clumsy.
 
The Belleville Bar is lesbian-owned and has a nice bar with comfortable seating but the food service is SLOWWWWWWW (over an hour’s wait) and disorganised.
 
The Parasol Bar wins for ambiance and cocktail quality but is difficult to get into in the evenings. Their brunch is lovely as well.
 
Margaritari has lovely cakes and nice toasties when you want a light lunch or snack by the sea.
 
Buddha Bar is lesbian-owned and home to the famous daily women’s rock swim and has a lot of healthier food options and nice cocktails.
 
On the interior of the island, there are a few smaller bars and restaurants – a jazz bar whose name I can’t recall, a lovely place called The Garden that does gorgeous slow-cooked meals (it’s a long night but a lovely setting — though bugs do tend to drop from the overhanging foliage!) and it’s perfect for a date night, and a gorgeous open air cinema showing feature films. (Get there early to secure a bench if you’re wider in the hips.)
 

Accommodation: 

 
For those who require wheelchair access, I would recommend the Aeolian Village. While it’s largely separate from the town of Skala Eressos, it’s definitely more clean, accessible and well-maintained. I’ve not stayed there so I can’t speak to its level of accessibility but a cursory google sounds much more promising than the town itself.
 
As an aside: the Aeolian Village is an all-inclusive resort with its own pool and private beach and it’s much more heterosexual and family-orientated. It’s very closed-off from the local community and a source of contention within the struggling local economy so if you’re looking for an ethical holiday and you don’t require it for accessibility purposes, I’d avoid it.
 
In town, I’m not going to review any particular place because we’ve stayed at various spots and they’re all similar enough to generalise. Wherever you go, there are likely to be some stairs – either up to the entrance from street level, or a full flight to a second story. Request ground level if you want to minimize stair usage, but expect there still might be at least a few stairs to your doorway. 
 
Shower situations can be tight but most hotel bathrooms are wetrooms so if you pack up the toilet roll and use water sparingly, you can get away with leaving the shower curtain partially open for extra space. Maybe ask for extra towels if this seems like something you’ll need to do.  I’ve not yet seen a hotel in town with a truly accessible bathroom or entrance. 
 
Most places have some kind of balcony where you can sit out and hang laundry to dry. These will have some variation of table and chair, most likely plastic. True sea view hotels are rare as the town is rather flat and the hotels are all behind the boardwalk so don’t be too fussed about this. You’re never more than a few feet from the beach in any case and there are plenty of opportunities to sit and watch the sea.
 
The beds are generally double beds or two singles pushed together. Americans will be surprised by the size as we’re used to queen beds. Doubles are a fair bit smaller.  The mattresses are thin and a bit hard going. Definitely not a luxury sleeping experience. I bring my own pillow ‘cuz I’m fussy.
 

The Beach

 
The beach is a mix of sand and small pebbles. Sometimes there are bigger rocks. It’s not firm ground so it’s a workout to walk on  and if you have sensitive feet, I’d recommend you not take the sand barefoot and have water shoes to help getting in and out of the sea.
 
There are a couple of beach snack stands. The one nearest the nude queer beach is the Turtle Bar and it has a mixture of bench and director’s chair seating. You can purchase drinks and snacks there and there is a public toilet, utilised by the camping grounds just behind the Turtle Bar, whose keys you can ask for at the counter. (though the last time I went in, it was literally just a massive hole in the ground inside a building. I’m not sure what it is now as I’ve never been brave enough to go in again)
 
From the street to the Turtle Bar, on the left-hand side, is a small wooden boardwalk that can minimize beach walking if you need it.  There is another wooden boardwalk from the street to nearly the water near the kayak rental nearer to town, and you can also rent daybeds there.
 
Sea entrance is a mild slope — deeper in some places, shallower in others. There are rocks on the sea bottom that vary in size from baseballs to footballs (though, you know, not actually ball-shaped) and they can be a tad slippery so watch your step in and out.  
 
The water itself is super salty so you’ll be very buoyant and it’s a good temperature – bit chilly on entrance and then amazing in the hot sun. It’s beautiful clear water and generally quite calm. Honestly, my favourite place in the world to be!
 
The nude queer beach resides in the space between the terrapin pond and the volleyball net. You’ll know what I mean when you see it.
 

Culture

 
There is definitely some fat-related staring that happens amongst the locals but I expect it’s as much that I am tall and have a high undercut and I wear a lot of black and am generally in a gaggle of queer oddballs as it is that I’m fat. No one’s ever been outright rude to me and I feel safe on the beach in various states of undress. So really, no greater or lesser frequency of fat-hating jerks in Skala Eressos as anywhere else.
 
The Sappho Women’s Festival happens in September every year. In the weeks leading up to it, the town is more populated with greek families and less so with lesbian/queer folks, though there is always a small presence, especially amongst those that spend months in Skala over the summer.  For those who make a cultural distinction between Lesbian and Queer, this place leading up to and during the festival is more heavily Lesbian than it is Queer, and the organisers of the women’s festival are about 15-20 years behind the times in terms of queer politics. I witnessed some tone-deaf racist and fatphobic ‘banter’ at the fashion show in 2016 and did not attend the festival this year (2018 – this was due to timing and not necessarily a specific avoidance of the festival period as it’s easy enough to choose not to go to events even while the festival is happening).  I travel with a large group of Queer/Trans/NB folks and we’re our own insulation but I do wonder if it could be uncomfortable for Trans and NB folks traveling on their own or in smaller groups, though I have never witnessed outright TERFy behaviour. I mention it only to be mindful but not to discourage travel.
 
There is a large population of 50+ locals in Skala Eressos and I actually don’t see many young children around. I expect tourist families with young children stay at the Aeolian Village as they have a creche. Also, we tend to eat late and the nude beach isn’t often attended by families, so we might just not be running into many. So if you’re looking for a more ‘adult’ holiday, this is a pretty good bet.  Attendees of the Women’s Festival run the gamut but I do think the age range skews slightly older – 30+ at least.
 
 
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Friday, 31 August 2018

Keep Children in Rear-Facing Car Seats Longer

Image from Consumer Reports article cited below
As we head into the new school year and the holiday weekend, it is a good time to remind parents and guardians to double-check their car seat usage.

The American Academy of Pediatrics (AAP) has issued new guidelines suggesting that parents keep their young children in rear-facing car seats until they reach the height or weight limits of that seat. 

In other words, don't be so eager to get those children front-facing because children really are safer rear-facing. 

In the past, AAP recommendations were age-based. Generally they recommended that children become front-facing at age two. But there is such a wide variation of size in children, even at the same age, that going only by age doesn't make sense. Also, research shows that rear-facing remains the safest position even for children older than two. Instead, parents should consult the height and weight limits of the car seat they use and use those to guide when to switch to front-facing.

Why Rear-Facing?

It's important to keep children rear-facing as long as possible because it protects the child's head and neck more completely. If a young child is front-facing and an accident occurs, the child's body is restrained but the head is thrown forward, placing tremendous stress on the neck and spine at a time when they are not very strong or developed. If the child is rear-facing in the same scenario, most of the force pushes the child's head and back into the support of the car seat behind them, lessening the stress on the back and limiting extension of the neck.

Research clearly shows that children are safer in rear-facing car seat positions whether the impact is from a head-on collision, a side-impact collision, or a rear-impact collision. This really is a no-brainer.

From the Consumer Reports article on car seat safety:
“Parents and caregivers should never be in a rush to move kids along to the next seat type or orientation,” says Emily Thomas, Ph.D., auto safety engineer at Consumer Reports’ Auto Test Center. “Each move to the next step can actually be a step down in terms of a child’s overall safety. In this case, making the transition to forward-facing too early exposes your child to head and spine injuries during a crash.”
General Car Seat Guidelines

Most parents do a pretty good job these days of using infant car seats correctly when babies are young. However, there is a distinct drop-off of proper use as the child gets older.

Car seat safety doesn't end when the child becomes a toddler or goes to preschool. Research shows that during routine car seat inspections, about one-third of children over 4 years of age were "suboptimally restrained." There's a lot of room for improvement here.

Consumer Reports suggests:
Parents can expect to need a minimum of three seats to best protect their children through the car-seat years: a rear-facing infant seat, a convertible seat (used rear-facing first, then transitioned to forward-facing when appropriate) and a booster seat.
Here are some suggestions for safer car seat use:
  • Start with a rear-facing infant seat or convertible car seat. Always place it in the rear seat. The middle of the back seat is the safest spot in the car for a child
  • Switch from a rear-facing infant seat to a rear-facing convertible seat "no later than your child's first birthday" This is because most babies outgrow their infant seat due to height, not weight, so be sure you pay attention to the height limits as well as weight limits
  • Get the best convertible car seat you can afford, one that goes up to the highest height/weight limits you can find. Children really are safer rear-facing when they are young so find the car seat that will let you keep them rear-facing the longest
  • Children should remain rear-facing until they have reached the height or weight limit for rear-facing children in that seat. At that point, switch to forward-facing in the convertible seat
  • Stay in the forward-facing convertible seat until the height or weight limit is exceeded for the forward-facing position. Only then should you switch to a booster seat
  • Use a booster seat until the child outgrows the height or weight limits of that seat and a lap/shoulder belt fits them properly. Most resources advise that children should be at least 4'9" tall and weigh at least 80 lbs. before they transition out of the booster seat. In some areas, 20% of child injuries under age 8 in car accidents resulted from using adult restraints instead of booster seats
  • Keep children in the back seat until the teenage years (at least 13; in some states it is 14). Air bags in the front are rated for adults and can seriously injure or kill children. Older children may look fairly grown but their skeletal systems are still more vulnerable to force injuries. Restrained children in the front seat are about 40% more likely to sustain an injury than restrained children in the rear seat
There are so many car seats brands and types; each has its own height/weight guidelines. When in doubt, follow the guidelines that came with your car seat.

Always keep the car seat's guidelines with the seat so they are easily found for reference. Tape them to the back or side of the seat. Some experts also recommend writing or attaching an ID tag to the car seat with the child's name, parent names, and pediatrician's name/number. That way if there is a significant accident and a relative is unable to give information or medical contacts, first responders have a lead on who the child is, their medical professional, and a way to find medical history. If your child has special needs, this is particularly important.

Remember that there are many car seat safety inspection clinics available in the community. Please use them. You can be very well-educated and still make mistakes that could be deadly.

Many hospitals host car seat clinics regularly, and many fire departments and police departments sponsor them as well. Many parents go to these inspections when their kids are babies, but do not attend them once the child reaches pre-school or school age, thinking that they now know what to do. Yet frequent errors are found in children between ages four to twelve, and faulty restraint is a major cause of trauma and mortality for children of that age. Don't assume you have it all down; rules change at times and it's easy to overlook a recalled seat or a change in guidelines.

Dealing with Pressure About Restraints

One reason parents don't restrain their children optimally is due to a misunderstanding of the current guidelines. Guidelines do change over time as a result of research, but they represent the best current science on car seat safety that we have. As the research evolves, so do the guidelines.

Unfortunately, many family members and community members aren't familiar with the latest research or minimize its importance. Many parents give in to pressure from family members or peers about car seat rules or simply get lax about them as children grow older.

I know that car seat safety was a continuing source of discord in our family as we raised our children. My husband and I are in agreement on most parenting issues, but not always on safety issues. He and his family felt that many car seat safety guidelines were excessive and unnecessary.

Front-facing vs. rear-facing was one of our biggest ongoing arguments. My husband and his family felt that I was being way too cautious by keeping my children rear-facing, especially once in a convertible seat. They wanted that child front-facing sooner than later. This was probably one of the most contentious parenting battles we had.

It certainly was very tempting to turn the seat forward so I could see the child better when I was driving. I hated not being able to see what was going on with my infant when it was just the baby and me in the car. Also, once they were a little older, the children themselves wanted to be forward-facing so they could feel like Big Kids. It became like a rite of passage emotionally, both to the kids and to other family members. These are understandable reasons why parents ignore the guidelines ─ but the safety of the child should be the top priority. Rear-facing is safer.

The fight over car seat safety didn't end there. My husband and his family also strongly pressured me to switch my children to a booster seat long before they outgrew the height/weight guidelines on the convertible seat. They felt I was being too much of a worrywart and the current safety recommendations were excessive. They also felt the children would be more comfortable in a booster. Still, I didn't give in. I knew the children were safer in a 5-point restraint than using an adult seat belt on a booster.

Then of course, as the children got well into grade school, the family thought it was ridiculous to still have the kids in a booster. They pointed out how much more convenient it would be not to deal with boosters when carpooling or going on field trips. This argument resonated with me because not having boosters would certainly be easier, and I saw many of my children's peers starting to go without boosters. But again, boosters were safer and that's what really mattered. I gritted my teeth and held strong.

The battle continued as the children became pre-teens. They were no longer in boosters, but now they wanted to ride in the front seat instead of the back. My husband was particularly susceptible to this argument. We had to have this discussion multiple times until the law mandated that pre-teens had to be in the back. Then he had no choice but to follow the rules or risk a ticket.

He and his family always had good intentions and they were loving, supportive relatives, but they had a real blind spot about car seat safety. They simply refused to believe the guidelines. However, this was one thing I would not compromise on. 

The safety of my children was always the MOST important thing and I knew the research. So I put my foot down on this battle and would not budge, but let me tell you it wasn't easy sometimes. In the end, it was a battle worth sustaining.

Before you head out to school or on family trips, take a moment now to review the guidelines, review the height/weight limits on your current car seats, write in your children's IDs, and make sure they are properly restrained. Better safe than sorry.



Resources


J Trauma Acute Care Surg. 2015 Sep;79(3 Suppl 1):S48-54. doi: 10.1097/TA.0000000000000674. Car seat inspection among children older than 3 years: Using data to drive practice in child passenger safety. Kroeker AM, Teddy AJ, Macy ML. PMID: 26308122
BACKGROUND: Motor vehicle crashes are the leading cause of unintentional death and disability among children 4 years to 12 years of age in the United States. Despite the high risk of injury from motor vehicle crashes in this age group, parental awareness and child passenger safety programs in particular may lack focus on this age group. METHODS: This is a retrospective cross-sectional analysis of child passenger safety seat checklist forms from two Safe Kids coalitions in Michigan (2013) to identify restraint type upon arrival to car seat inspections... Just 10.8% of the total seats inspected were booster seats. Child safety seats for infant and young children were more commonly inspected (rear-facing carrier [40.3%], rear-facing convertible [10.2%], and forward-facing [19.3%] car seats). Few children at inspections used a seat belt only (5.4%) or had no restraint (13.8%). Children 4 years and older were found to be in a suboptimal restraint at least 30% of the time. CONCLUSION: Low proportions of parents use car seat inspections for children in the booster seat age group. The proportion of children departing the inspection in a more protective restraint increased with increasing age. This highlights an area of weakness in child passenger safety programs and signals an opportunity to strengthen efforts on The Booster Age Child.
J Pediatr. 2017 Aug;187:295-302.e3. doi: 10.1016/j.jpeds.2017.04.044. Epub 2017 May 25. Factors Associated with Pediatric Mortality from Motor Vehicle Crashes in the United States: A State-Based Analysis. Wolf LL, Chowdhury R, Tweed J, Vinson L, Losina E, Haider AH, Qureshi FG. PMID: 28552450
...Using the 2010-2014 Fatality Analysis Reporting System, we identified passengers <15 years of age involved in fatal MVCs, defined as crashes on US public roads with ≥1 death (adult or pediatric) within 30 days. We assessed passenger, driver, vehicle, crash, and state policy characteristics as factors potentially associated with MVC-related pediatric mortality. Our outcomes were age-adjusted, MVC-related mortality rate per 100 000 children and percentage of children who died of those in fatal MVCs. Unit of analysis was US state... RESULTS: Of 18 116 children in fatal MVCs, 15.9% died. The age-adjusted, MVC-related mortality rate per 100 000 children varied from 0.25 in Massachusetts to 3.23 in Mississippi (mean national rate of 0.94). Predictors of greater age-adjusted, MVC-related mortality rate per 100 000 children included greater percentage of children who were unrestrained or inappropriately restrained (P < .001) and greater percentage of crashes on rural roads (P = .016)... For 10% absolute improvement in appropriate child restraint use nationally, our risk-adjusted model predicted >1100 pediatric deaths averted over 5 years....



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TrolloLOLOL!

Oh my sweet, lovely readers! It is not everyday that I have the pleasure of a halfway decently written troll email. Yeah, email! Novel! Ha-ha! This morning I had a message from our new “friend”, Duncan. Here, take a look:

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Prepare yourself for the science of internet trolls…

Hello,

I was wondering about the whole idea of fat pride. Is the idea just that you accept yourself for who you are and your weight? I looked up some statistics from the Center for Disease Control and Prevention, and I found some interesting information. It said that obesity is linked to the following problems:
  • All-causes of death (mortality)
  • High blood pressure (Hypertension)
  • Type 2 diabetes
  • Coronary heart disease
  • Stroke
  • Osteoarthritis (a breakdown of cartilage and bone within a joint)
  • Sleep apnea and breathing problems
  • Some cancers (endometrial, breast, colon, kidney, gallbladder, and liver)
  • Mental illness such as clinical depression, anxiety, and other mental disorders
  • Body pain and difficulty with physical functioning
I want to know if you know that these risks that come with obesity, and how a lot of people in the fat pride movement still choose to accept themselves although obesity leads to many negative health problems. Can you explain why people still choose to accept themselves even though obesity is not good for the human body?
 
Thanks
Image result for internet trolls
Troll make internet mad. Troll like anger. Troll want people as miserable as troll.
It gave me such a smile. So I took another sip of coffee and replied. I’m a writer, after all, it’s kind of what I do. Ha!
Look at you, Duncan. You didn’t bother to read my blog, didn’t bother to post a comment publicly. You felt yourself to be such the expert that you had to reach out to me personally and directly. Why you think it’s any of your business at all, well, I already know why. You’re a cis-male human (I’ll assume you’re caucasian as well since you showed up at my virtual door with a sack of assumptions yourself). This world was ravaged and then rebuilt by your kind. Every system, societal or otherwise, was made by and to benefit you. Social beauty constructs? Yep! That too!

You see, Duncan, and I’m giving you the benefit of the doubt here, though I already know how you’ll respond, the word “obesity” as you’re using it and modern medicine chooses to use it, means to over eat. You’re assuming (and we all know what happens when we assume) that I as a fat person must over eat and that is how I got a fat body to begin with and maintain its unseemly physique. Nope. That’s the easy answer for you to tuck yourself in with at night. Life isn’t so simple. I don’t owe you or anyone an explanation for my existence. I don’t owe you or anyone an appearance of your preference.
This is my life and my body. I don’t come into your space, virtual or otherwise, and demand a single thing of you. If you’ve even read this far I hope you will take that alone into consideration. You came into my virtual space and demanded to know personal details about me. Had you read my blog you’d see that I don’t use terms like “fat pride” and there is zero science to back up your ridiculous list of scare tactics that you’re blaming on simply having a large body. Correlation is not causation. You know nothing about the lives of fat people. You only know your own life, as we all do.
It’s a matter of human decency and respect that I ask you to apologize, excuse yourself, do some heavy self reflection, and hopefully be willing to see that other people’s lives and bodies and appearances are no one’s business at all. Period. Try thinking for yourself instead of repeating the marketing buzzwords of profiteers.
If you want to google all the made up stuff you hear and soak in beliefs that only affirm what you already believe, regardless of hard scientific facts, and call it research, so be it. But don’t bring your bullshit to my door and expect me to grovel. Fuck off, Duncan!
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You do NOT have to explain yourself
Oh I forgot to congratulate him on his cut and paste skills! My bad! He didn’t bother to reformat what he grabbed directly from the CDC website to even make it look like he knew what he was talking about. It’s so close to almost being effort. We should totes give him brownie points for trying to try, no? Ha-ha! I find it completely sad when someone has nothing better to do with themselves or their lives than to get mad that fat people exist. I hope he finds the love and support in his life that he is so painfully lacking currently. I do want that, for everyone, though. I hold no hate in my heart for the haters, they seem to have that whole hate-side of things covered, ya know?
I genuinely want people, all people, to think for themselves. I want everyone to question things and to think critically of all we are “told”. When you come from a place of such privilege to feel it your absolute right to talk to someone in the way you see above, it is pointless to even attempt to respond how they would like you to. They already feel that they are better than or above the person they are attacking, and though mildly worded, that was a personal attack. I don’t take these things lightly, though I do take them with a grain of salt, as they say.
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Is ‘fat’ really the worst thig a human being can be? Is ‘fat’ worse than ‘vindictive’, ‘jealous’, ‘shallow’, ‘vain’, ‘boring’ or cruel’? Not to me. J.K. Rowling
Look, I get trolls telling me to kill myself, that I should be put out of my misery by gun or cannon, shipped to a deserted island, and worse. This mostly happens here on this blog. However, this person emailed me directly, not through my blog. They came at me with this bullshit and I am not here for that or them. I share this to illustrate that it doesn’t matter who we are or what we do in the world, some jackass white guy will always pop up to push us down. Fuck them! Live your life on your own terms, friends. These fuckers will never change. We don’t have to respond or react to them. That is our choice.
Rad Fatty Love to ALL,

<3
S


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