Although my mother could not control what I ate—at least, what I chose to gorge on while she worked—she could make me get up and walk. We lived near the Centennial Trail, which flowed next to the Spokane River. We walked down the street, past the boarded up windows on our block, crossed the road at the meth house, and walked alongside the housing development.
We snuck onto the Centennial Trail through a hole in the fence, Mom holding the chain link above me, my sweater snagging. The trail was public, but the development pretended it was theirs. My community pretended right back, cutting holes in the fence next to the locked gate.
In total, the walk bobbed and weaved for two miles. Most of it flat, besides one big, killer incline that wasn’t really an incline. At the top, we were rewarded with a bench and wild Daisies, a nice view of the river sweeping by, calling me to fantasize about floating away.
I dragged my feet, huffing and puffing beside my mother, who listened to my doctor’s orders religiously. She began going to Zumba and eating baked chicken with broccoli. We only ate out on Friday’s, KFC, but she somehow managed to eat only one biscuit. The rest of us ate three. I listened to my doctor’s orders to cut out all carbs, then smothered their words in butter and honey.
When we came home from our walks, I rushed into the bathroom to wipe the sweat off my face with a dirty hand towel. In the mirror, I saw a round ten-year-old girl who hated her softness, who longed for strength and endurance, to have a strength she was born with, not one she had to work for.
My mother and I walked the same route every day for about three years. Over time, my walking did improve—my stride elongated, my lungs expanded and contracted to max capacity. Mom improved, gliding faster, talking and talking while I gasped for air beside her. I’m sure she noticed the sweat dripping down my face, my throat scratchy and dry, my cheeks flushed crimson, begging for rest.
I wonder if she cried after our walks, too.
When I was thirteen, or maybe fourteen, I went from obese to morbidly obese. I started to eat more and more food. Full pizzas when I spent the night at my cousins; broiled the last two minutes like a true chef, McDonalds with friends every day at lunch; three McChickens and a large coke, please, chips and soda hidden in my room; Little Debbie’s my closest friend.
I came home most days after school and took a nap. From three to six, I slept under my purple faux silk comforter in a twin bed while my dad napped on the couch in his whitey-tighties, arms crossed over his chest mummy style. I awoke to the aroma of dinner, ate what Mom made, had her check my plate for signs of missed corn or mashed up cucumbers, before eating my second dinner of Cosmic Brownies and Lay’s. Food only my father brought home, making him my saving grace. I snuck them past Mom, waiting for the sound of her bedroom door closing.
Every single day it seemed impossible to stay awake. I began fighting my mom on going for walks every night. Even the fights I lacked energy for. I half-heartedly explained how tired I felt, how I almost fell asleep in class, begging her not to make me walk.
I couldn’t take another day of sweat dripping down my back.
When I was seven, my father had his first heart attack. Dad spent most of the night grilling and chopping wood. His arms repeated the same motions: flip the burgers, chop the wood, flip, chop, flip, chop. The heart attack started with shoulder pain twisted into a mistaken torn muscle. Mom knew he did not tear a muscle. Gerad, my older brother, was left in charge of us kids while my parents rushed to the hospital. Dad left clutching his shoulder, viciously cussing out the door.
“Gerad, is Dad going to die?” I asked, expecting to sound fearful, but instead, genuinely curious of what was happening.
“He’ll probably be okay. Anything can happen, Case, but we just have to stay positive.”
As a distraction, Gerad turned on our favorite movie, Dazed and Confused.
We laid out on the pull-out couch, where my dad slept, next to each other like nesting dolls. Gerad, fifteen, to my right, me in the middle, and four-year-old Stephanie on the other side.
While my father awaited surgery and Mom paced back and forth in the waiting room, my siblings and I watched high school juniors on their last day of school party it up and test the limits. To play football next fall, many of them needed to sign a form pledging not to engage in drugs and alcohol. The form was meaningless, and most of them just signed the paper. Randall Pink Floyd, the main character, refused. He would not change his habits. He wanted to do whatever it took to have a good time.
After my father’s heart attack, my mom did everything in her power to make us a fit family: kale smoothies, walks after dinner, desserts only sweetened by fruit. But only one of my parents wanted to change. My father rebelled, slipping into the clutches of bakery brownies and Panda Express. I slipped right alongside him.
At that age, I couldn’t tell you what morbidly obese meant, just that a chart my doctors gave me went up and up and up. Various primary doctors began sending me to specialists: cardiologists, nutritionists, weight management coaches, another cardiologist. Each one of them described in great detail the fat smothering my organs, tightening around them, pinching and pinching until one day, I would die. I think they thought this would scare me into exercising and dieting. I told the doctor, my third one to treat my weight, that I didn’t care, I was happy with my body. She smiled back—the tightest I’ve seen—only a smile one has when repressing. In the charts I read, continues to resist diet and exercise—not sure if another PCP would help. She gave up on me and sent me to another doctor who specialized in adolescent medicine. We both thought it was a fruitless gesture.
Her name was Dr. P, and she did not give up on me. In fact, she wanted to know why I was so fat. What about my body did this to me? No doctor had ever framed it this way. They always explained what I did wrong, how I needed to change. Doctors before her tended to run the same tests: blood sugar levels, cholesterol, liver enzymes. They always frowned and nodded knowingly when they saw my elevated blood pressure, my heart pounding when I walked into the room. They always jumped in surprised when I didn’t have early on-set diabetes or a heart condition.
Dr. P ran everything she could think of, and then some more for good measure. She took my blood pressure at the beginning and end of my appointment, realizing I panic in the beginning, my fight or flight response engaged. We discovered I had a thyroid disorder. Your thyroid produces hormones that assist your metabolism. Essentially, I had no metabolism. It explained why I couldn’t stay awake, how, even with my walking I continued to swell beyond recognition, enlarge beyond children’s clothing, rip through my jeans and hang below my blouse.
I started taking Levothyroxine, which mimicked the hormone’s my body should have been producing. I stopped taking naps every single day. I began to enjoy the walks with my mom. I eagerly walked beside her, listening to the river flow, imagining my strong arms swimming across the stream, fighting the intense current. I still put all of my faith into food, slimming a bit, but not much. I knew I should have liked this, but I hated my body for betraying me. I hated that I had to take a medicine I didn’t want to take. Since my father’s heart attack, he was prescribed heart medication that more often than not went untouched. I found that option brilliant.
When I first began Levothyroxine, my mother watched the pill fall down my throat. Once she trusted me to keep it in my room, I stopped taking it. I knew the medication would help me, I knew it would change my body, but I hadn’t chosen to be healthy yet. I wanted choice, and not a medication thrust upon me, promising to deliver dramatic changes. Dr. P tested my thyroid levels every six months, so the two weeks leading up to the blood work, I would take my medicine.Besides that, I’d bring a few to school and dump them into the trash can in the restroom. A glance at the mirror revealed shame in my eyes, disappointment in my fly away hairs, a lack of sleep in the dark circles deepening above my cheeks.
Adderall was offered to me at my first job, Orange Julius. I tried it just like all of my coworkers did. Adderall gave me more energy than my prescribed medicine ever would, and I had the choice to take it, with no adult or medical professional forcing me. I buzzed. Floated. Practically ran around, half completing assignments and cleaning. I scraped strawberry syrup off the floor for two hours, ignoring all of our closing duties. Adderall made me care.
The biggest benefit of Adderall was that I walked every day with greater ease. I walked over an hour to my job at the mall, where I bought more Adderall to finish my homework during my break at work. My blood pressure and cholesterol improved, I seemed to be maintaining my weight instead of being at a steady gain.
When I looked in the mirror, hints of bone structure popped out. I like my cheekbones.
I also began to love walking. I could let my mind wander as I listened to music, and I made up little stories in my head. This is when I first began to think of stories as a craft. I thought Adderall was the most brilliant invention, but looking back, I was a mess. I stopped sleeping, I only ate hard candy and Redbull, and I gnawed at the inside of my lip until the skin ripped off. I hardly remember this time, which doesn’t feel like a drug induced erasure—it feels like protection.
The day my mom dropped me off at college, I stopped taking Adderall and began taking my thyroid medication. I’d been prescribed the medication at fourteen, but this was the first time I regularly took it. Having some distance from my father and his habits, I realized that his behavior wasn’t normal. He should have been taking his heart medication, he should have been changing his diet and exercise. He survived a heart attack (and more), yet was wasting his life away. I didn’t want to waste my life.
I want to be the best version of myself.
I finally had my own space, could fill my home with food I wanted, I needed to take control of my life. I bought dresses and blouses at TJ Maxx, a reddish purple lipstick I deemed my signature. I read articles about being healthy and plus size. I realized, I had choices.
How many hours did I spend applying and reapplying that lipstick in a spotty mirror shared with eight other women?
When I went away for college, my thyroid went from underactive to overactive: spurred by the sudden onset of beginning my medication again. Anxiety seemed to be the first symptom. My resting heart beat was around 120 for several days. I didn’t know how to calm myself down. Even when I indulged in stimulants, I never had this racing, erratic feeling going on in my body. I started walking. First to calm down, and then to hash out a plan. I thought the doctors were right, that I would die from being fat. Oh God, my fat is smothering my organs. I don’t want this, I want to live. No, it’s a heart attack—just like Dad.
At once, I was numb and a live wire. I lost sensation in touch, yet my chest burned from the inside out, snarling at my ribcage, threatening to break the ribs. I walked and walked, swiftly yet slowly, on autopilot, yet intent. Everything felt wrong, and everything felt right: predicted at age ten by doctors. Death.
By day four or five of having a racing heart, I started developing chest pains. I was eighteen, and freaked. I began popping Bayer, easily fifteen a day, since I had heard it would help slow the complications of a heart attack. I could not push myself to go to the hospital, or call a doctor. The thought of being told I would die from being fat seemed worse than dying alone.
In the mirror, I saw a disheveled, scared girl, with deep sucker punch bruises under her eyes, afraid to sleep. Afraid she would die in the night.
So, out on a walk, my fifth of the day, I called my mom.
“Mom, my heart has been racing for days. I don’t know what to do. I think I may be having a heart attack,” I breathed out in one huff.
“Casey, you’re not having a heart attack. It would literally be an attack, not prolonged, not a sorta, maybe. Honey, it’s okay. Bodies are weird. For all we know, it could be an allergy. But it’s not going to stop until you get treatment. Have you been taking your medicine?”
“Yes, but I wasn’t taking it before I came to college. I just started it again.” I knew she’d be angry, but if there was ever a time to be honest, it was now.
“Casey, that could easily be it. You can’t just take medicine when you feel like it. I really think this might be your thyroid. Do you have someone who can take you to the hospital?”
I said yes, and told her I’d write down everything the doctor said, text her throughout and call her after. She didn’t ask me to do all of this, but I needed her in the room with me.
Alec, a guy that lived on the same floor as me in my dorm, drove me. I interrupted him and a few people on our floor sneaking beers and playing Monopoly in the common room. He was the only person I knew who had a car, and we had spoken a dozen times. We drove in silence until he dropped me off.
“Um, I don’t even think I have your phone number, but here’s mine. Give me a call and I’ll come pick you up,” he said sheepishly, like he was ashamed we hadn’t talked.
“Thank you, it might be late. Hospitals take forever.”
“It doesn’t matter. Just call me and I’ll come.”
When I walked in, a thin, welcoming nurse in polka dot scrubs came up and took down my symptoms.
“You’re having chest pains and a rapid heart rate? Yeesh,” she cringed out. Everyone knows a heart attack is the big one, the one we all secretly worry about.
I sat in the waiting room, where I stared at an obese woman who spilled out of her wheelchair as she huffed from an oxygen tank. God, I do not want that to be me. I stared at her body, transfixed by her stretch marks, recognizing that may be me in thirty years if I didn’t take better care of myself.
When the nurses called me back, they explained they were going to do an EKG to make sure everything was okay with my heart. I’ve had this test done about fifteen times in my life, and I’m not even twenty-five. I nodded my head, pulling up my shirt, ready to hook myself up to the machine.
“You reported that you have a thyroid disorder. When’s the last time you had your levels checked?” one nurse asked while the other untangled the cords to the EKG machine.
“About three months ago,” I replied, aware that I should have said I started taking my medication regularly for the first time in years.
“Okay, I think we should check your thyroid before we do anything else.”
The nurse that had been untangling the cords shot her a look. The look said, she’s obese. I knew my weight would go into my care, and I couldn’t blame them. I agreed it may be my heart.
The nurse put the adhesive electrodes around my chest. I’d have marks for the days to come, a reminder of my damage. The test itself only took a minute, lines going up and down on a machine, similar to a lie detector.
“Well, your heart is racing, but everything else appears okay.” Air, frustration, and panic seeped out of my body, just enough that I could take a deep breath and smile. For the first time in weeks, I felt mildly calm.
“Let’s draw your blood and check out your thyroid.”
I sat in the waiting room for about four hours, switching between Facebook and texting my mom. Finally, a different nurse with polka dot scrubs called me back. While checking my vitals, a handsome doctor with sandy hair walked in. He was maybe fifty, very fit, and I immediately shrunk back, hoping he wasn’t judging my body.
“Well, Miss Casey, it seems your body decided to switch things up on you,” he chuckled, glancing at my chart, warmly smiling at me. Why are you smiling at me? I’m dying. “It seems your thyroid is producing antibodies that mimic the hormone it should be making. What this means is that once it’s done making the antibodies, that’s it. You and your primary will monitor it, but it may take years. Once it’s done, you’ll just have to take a pill once a day for the rest of your life.”
I would be happy to take a pill everyday if it meant I wouldn’t have to worry.
With that, he felt my thyroid and asked the nurse to bring me my discharge papers. I called Alec from the waiting room, and he said he’d be there in fifteen minutes. I thumbed through the discharge papers, sitting between two middle aged men each clutching their left shoulders.
Morbidly obese 19 yr old patient experiencing chest pains and shortness of breath. Reports no recent drug use, appears anxious.
Aside from those notes, it listed my insurance, my EKG results, and a copy of my blood work. Eleven hours summed up into 3 pages. I wish I still had the documents. I wish I would have burned them.
The next day, I knocked on Alec’s door and asked if he wanted to go to the gym with me. At the time, I wasn’t sure why I asked him. I was embarrassed by the way my body looked. I knew he worked out, I knew he was fit in a way I would never be. But, in the short interactions Alec and I had, he treated me like a person. He was empathetic, and he listened. He didn’t judge, he didn’t suggest a diet or exercise. He cared. We began going to the gym a few times a week. He ended up being one of my closest friends in college.
I’m not morbidly obese anymore, or even obese. I work out four or five times a week. I go to the doctor every six months, I go for runs, and track my food. I buy steak maybe once a year, and broccoli every week. Once I made the decision to make changes, it all fit into place. It’s not easy, and I slip up constantly, but I chose to lose weight. No doctor scared me enough, my mom didn’t force me to walk my weight off, I made a decision and stuck to it.
I miss my weight though. I have saggy skin that my partner likes to play with. When we have sex he lifts my hanging stomach. I have to move loose skin over to reveal my muscles. I will always have wrinkles on my face—baggy skin that won’t snap tightly around my bones. I want to be happy when I look in the mirror. I thought losing weight would do that for me. I lost the ability to call myself plus size, to fit into an identity that may or may not have been comforting. I traded that in for the luxury of going to a clothing store and always finding something that fits.
I often wish I didn’t count my calories and go for a walk after every meal. In a way, I feel like I have to. If I don’t, I’ll have my first heart attack at thirty-five, just like my dad. He is now disabled; he’s had three heart attacks, a stroke, and lost one of his big toes to diabetes. When I start to lose motivation, I think of him sitting on the couch, wasting away.
Now, before I go walking, I look in the mirror. I apply moisturizer with sunscreen, I examine my eyebrows, and pluck strays, I choose a nude or light lipstick. I stretch, and drink water. I think of what I can do differently to look like a healthy, happy girl.