Saturday, July 18, 2015

The Work Pants

For most of my life, I was the skinny girl. I thought it was normal to be able to see my ribs. I thought a sunken in collar bone meant I was attractive. I assumed my thighs were supposed to be as thick as my ankles and my biceps were supposed to be as thick as my wrists. This was my normal, but it was not a healthy normal. My perception of reality was skewed.

Photo from 2004, a year before diagnosis.
Note the muscle wasting in my arms. Note how visible my collar bone was.
Before I was diagnosed, I weighed 118 lbs. I was clinically underweight with an unhealthy BMI of less than 18. After starting treatment, I gained 30 lbs practically overnight. That rocked my teenage world. I went from wearing size zeros and twos to have to constantly buy larger clothes. I hated that bathroom scale. I hated seeing the number it showed. That number seemed huge to me, and I cried almost every time I saw it.

Photo from 2005, a few months after diagnosis.
I was 30 lbs heavier here and incredibly self-conscious.
I learned quickly that I had to repeat to myself how I would rather be alive and healthy than a walking skeleton slowly dying. The scale does not tell the whole story. I was gaining muscle. This muscle was making me healthy. Although a BMI of less than 18 made for a pretty small number on the scale, it was not healthy.

Photo from 2007. I actually have muscle!
In 2008, I was switched to Qualitest. Suddenly, my medicine seemed to stop working. Endo #1 was beyond baffled so he just kept increasing my dose of HC. I gained an inappropriate appetite, and with that, I gained even more weight. The heaviest I saw that cruel scale read was 176 lbs. This put me as clinically overweight.

Photo from 2008, and the start of the additional weight gain.
Steroids are a very interesting and powerful medicine. There is a strong misconception that steroids instantly cause weight gain. That is a gross simplification of a very complex issue. If you are on the proper dose of steroids that closely mimics the circadian rhythm, you should be able to maintain a healthy weight. The first thirty pounds I gained on Cortef made me healthy. The second thirty pounds I gained on Qualitest were due to an ineffective medicine given in the wrong amount at the wrong time.

Photo from 2010. No collar bone visible here!
My health began to slowly decline again in 2011. Weight started dropping off, but I didn't really notice it at first. Eventually, multiple friends began to ask me about my change in weight. I decided to step back on that cruel scale and see what it told me. I was shocked when I realized that I was dropping weight! But I could not explain the weight loss, which made me nervous.

Summer 2011. Fall 2011. Spring 2012. Summer 2012.
I went from a size twelve to a size four. And I only tried on that size four as a dare.
I started working at my engineering job August 2012 with basically no work clothes. I am not a fan of shopping. The loud noises, the crowds, the act of putting clothes on just to take clothes off, the stupidity of how female clothing is sized- these are all extreme cortisol utilizers for me. I normally end up feeling very drained and sick after every trip to the mall. But I needed clothes to wear to work. My aunt visited me for my birthday in October 2012. When she learned about my severe lack of work pants, she took me shopping and bought me six pairs.

I remember that shopping experience being very overwhelming for me. My aunt asked me what size I wore. I said size twelve. The twelves fell off of me. We went down a size. The tens fell off. We went down another size. The eights fell off. We went down another size. The sixes fell off. But the size fours? The fours fit.

The size fours fit me. 

Never before was there a time after my diagnosis where I could wear a size four. I was secretly very pleased with this discovery. I was back to being the skinny girl. Naive me still thought I was healthy.

Photo from November 2012. My coworker and I realized we were matching one day.
I was so fatigued I could not stand up straight. Also, those size four pants were falling off of me.
I continued to lose weight and pretty soon those size fours were falling off of me as well. My close friends and family were growing more concerned. I ended up dropping down to 124 lbs. That is far too skinny for my body type. I was once again hovering around an unhealthy BMI.

Photo from November 2012. All the female engineers on the two teams.
I remember standing like this to try to hide my weight loss.
I was also too fatigued to stand up straight.
My body finally screamed "ENOUGH" and the Nightmare of 2013 happened. Slowly, we figured out why the nightmare happened. I made several lifestyle and treatment changes to help me regain my health. I started to gain weight. It was incredibly difficult for me to look at that scale, but I had to keep repeating to myself, "I am healthy. I am healthy again."

I then added a very dangerous additional sentence to my self talk.

"I am healthy, and guess what? Those size fours still fit! It is ok that I am gaining weight because my size four work pants still fit."

February 2015. I'm modeling how I broke my work ID badge, but I'm wearing those work pants!
You can also see my cortisol pump clipped to my pants in the picture.
I am now over ten pounds heavier than I was a year ago. I can no longer pretend that those size fours pants fit me. In reality, none of my work pants fit comfortably. I cannot tell you how many tears have been shed over this revelation, but I can say there have been quite a few.

Six pairs of pants that don't fit (and a cat).
This weight gain is GOOD. I am healthy again. My BMI is near perfect. My resting HR shows I am an athlete. I have very well defined leg muscles. I am blacking out less. My blood pressure has stabilized. These are all good signs!

I need to get rid of those size four work pants. I need to buy larger clothes. While this is an incredibly hard thing to admit, I cannot view it as a bad thing. This is physical proof that I am in a much healthier state. My self-talk needs to reflect that.

It is better to wear a larger size and be ALIVE.

I want to remain Clearly Alive.


  1. Love this blog, Amber. I've gone through the same thing. I have pants ranging from size 12 all the way down to size 2. I'm back in an 8 or a 6 depending on the pant. I still have 20 pounds to loose..all because of Qualitest...but I'm getting there. I've lost 20 so far! I am doing it in a healthy way. Hope you are well, my friend! <3 Debby Kaysen Hunter

    1. Yay for loosing weight the healthy way!

      I wish I still had my size six and eight work pants, because those were comfortable! I got rid of them in a closet purge back in 2012 before I realized how sick I truly was.

      I'm doing better now :)

  2. Wow, Amber-- I didn't even recognize that was you in the first photo. This made me smile: For you being brave enough to talk openly about body image, for being so incredibly gorgeous and healthy now (inside and out), and for giving hope to everyone with AI. Love ya'!

  3. I've followed your blog for a while now and this post really struck me as I've battled with cortisone weight but actually before being diagnosed with SAI. Too much prednisolone for too long :). Now when I'm on right dose of hydro I've finally been able to lose the extra weight and continue my journey as an athlete. Thank you for posting this <3
    I just started to blog about AI and fitness so if you're interested:
    Welcome :)


    1. I stopped by your blog and left a comment. I look forward to reading more about your adventures of training with AI :)

      ~ amber


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