Month: February 2015

Uncategorized

Testing athletes for “too much” testosterone shows how inadequate the sex binary really is

Tracy I3 Comments

As if elite women athletes don’t suffer enough indignities just from media coverage, journalists who would rather see them twirl than ask about their tennis game, and being either hyper-sexualized or having their sex and sexuality challenged and questions. No, that’s not enough. Because people are so convinced that women have more limited athletic potential than men, even at the elite level, women who do excel must prove that they do not have “too much testosterone.”

Caster Semenya knows all about this type of challenge. In 2011 her fellow athletes challenged her accomplishments by questioning her sex. This led to mandatory sex testing, and the whole thing was handled badly. Initially banned from competition, Semenya has since been allowed to return. But her treatment left a permanent mark, and the major governing bodies in international sport, including the International Olympic Committee, the Fédération Internationale de Football Association and the International Association of Athletics Federations, recognized that they needed a new approach.

According to this New York Times report, that new approach, has made things worse:

Rather than trying to decide whether an athlete is “really” female, as decades of mandatory sex tests did, the current policy targets women whose bodies produce more testosterone than is typical. If a female athlete’s T level is deemed too high, a medical team selected by the sport’s governing bodies develops a “therapeutic proposal.” This involves either surgery or drugs to lower the hormone level. If doctors can lower the athlete’s testosterone to what the governing bodies consider an appropriate level, she may return to competition. If she refuses to cooperate with the investigation or the medical procedures, she is placed under a permanent ban from elite women’s sports.

No longer do they need to prove they’re women. Instead, it’s a simple test for the amount of testosterone in their bodies.  The idea that there is a “normal” amount of testosterone beyond which competitors have an unfair advantage is questionable at best, and simply pushes the question “is she really a woman?” back a step.

The new test has so far “caught” four athletes, all from what the NY Times article describes as “developing countries.”  These athletes are not being accused of doping. Rather, they have been deemed to have naturally occurring testosterone at higher levels than is acceptable for elite competition. Here’s what happened:

Sports officials (the report does not identify their governing-body affiliation) sent the young women to a medical center in France, where they were put through examinations that included blood tests, genital inspections, magnetic resonance imaging, X-rays and psychosexual history — many of the same invasive procedures Ms. Semenya endured. Since the athletes were all born as girls but also had internal testes that produce unusually high levels of testosterone for a woman, doctors proposed removing the women’s gonads and partially removing their clitorises. All four agreed to undergo both procedures; a year later, they were allowed to return to competition.

The doctors who performed the surgeries and wrote the report acknowledged that there was no medical reason for the procedures. Quite simply, these young female athletes were required to have drastic, unnecessary and irreversible medical interventions if they wished to continue in their sports.

One of the main things this state of affairs challenges is the very simplistic sex binary that our world operates under. If and when we do recognize that sex is a continuum not a binary, it’s used against. If nothing else (and there is a lot else), the recurrence of this type of challenge in sports is excellent evidence that our normative sex, as expressed in the male-female binary, isn’t right. Read on:

Many conditions can lead to naturally high testosterone, including polycystic ovarian syndrome or an ovarian tumor during pregnancy, but women with intersex traits tend to have the highest T levels. And it is these intersex traits that sports authorities want “corrected.”

In other words, you only get to play if you conform with the M-F binary.  The microcosm of elite sports on this issue is a perfect parallel for how things go in every sphere for people who don’t fully conform to the false picture we have that everyone is either male or female, and that fitting into one of these so-called biological categories is a (minimum) requirement for full global citizenship. I emphasize that it’s minimum, because even then you’re not guaranteed full entry.

Where sports is concerned, the argument has always been that testosterone is the key factor distinguishing men’s athletic potential from women’s. Male elites usually outperform female elites. Men have more testosterone, so, as the reasoning goes, women with higher testosterone have an unfair advantage over other women. But not so fast, the article reports:

…these assumptions do not match the science. A new study in Clinical Endocrinology fits with other emerging research on the relationship between natural testosterone and performance, especially in elite athletes, which shows that T levels can’t predict who will run faster, lift more weight or fight harder to win. The study, of a sample of 693 elite athletes, revealed a significant overlap in testosterone levels among men and women: 16.5 percent of the elite male athletes had testosterone below the lower limit of the so-called male range; nearly 14 percent of the women were above the female range.

This calls into question the assumption that testosterone levels are responsible for the differences in performance. The authors of this study suggest that it’s lean body mass rather than testosterone that makes the difference. The article goes on to say:

Some might argue that the procedures used to lower T levels are simply part of the price athletes must pay to compete at the elite level. But these choices aren’t temporary hardships like training far from home or following a rigorous diet. The required drug and surgical treatments are irreversible and medically unjustifiable. Clitoral surgery impairs sexual function and sensation; gonadectomy causes sterility; and hormone-suppressive drugs have side effects with potentially lifelong health risks.

Moreover, the policy places a disproportionate burden on poor women who may have limited career opportunities and are likely to face enormous pressure to submit to these interventions in order to continue their athletic careers. Under the current policies, more and more female athletes with naturally high T levels will be confronted with these harsh choices — and not just at the elite level. The I.O.C. requires that each country’s Olympic committee investigate cases of female athletes with high T levels before naming them to national teams. Some countries, like India, now apply such policies to all female athletes, not just those competing internationally.

As we can see, there are lots of inequities at play here, and the burdens are falling more heavily on women whose economic standing limits their opportunities and perhaps forces them to undertake a drastic intervention to be able to compete.

At the very least, the obsession with sex and testosterone levels is yet more evidence of the gender policing that women are subject to, and that our fixation with the need for everyone to fall neatly into strict normative categories before we can take them seriously.

weight loss

Doctors and unwanted weight loss advice

Sam B11 Comments

Why do doctors weigh patients and offer weight loss advice? Other than “eat less and move more” which is kind of like the weight loss equivalent of “buy low and sell high,” what recommendations do they make and why?

I’ve wondered about this before. See Well-intentioned lies and doctors and concluded that,

Doctors shouldn’t prescribe weight loss to overweight/obese patients, especially not without mentioning the long term likely effect. Would we recommend any other treatment with these odds of success? Medical professionals should spend more time emphasizing weight maintenance. Second, especially if you’re a normal weight or overweight person, the last thing you should try to do is lose weight. That looks like a clear fast train to getting fatter.

Here’s the more interesting question, if doctors know this, why don’t they act on it? Here is my guess at an answer. Doctors hate problems they can’t solve. I saw that when they were dealing with a family member with incurable illness. They want to hold out hope.

So that’s part of it. Doctors are also human and reason as everyone does. The simple mathematical model of “eat less, move more” seems obviously true. Weight loss looks like just simple math plus will power. How could it go wrong?

Finally, doctors also know that healthy eating does matter and so too does exercise. Indeed a recent study in the British Journal of Sports Medicine concluded that  for women and heart health exercise matters more than any other factor including obesity. (See Study: Exercise Trumps Body Weight When It Comes To Women and Heart Health.) Doctors fear that without the promise of weight loss, no one would be motivated to eat well and stay physically active. As the article about the impossibility of weight loss says, “Health experts are also afraid people will abandon all efforts to exercise and eat a nutritious diet — behaviour that is important for health and longevity — even if it doesn’t result in much weight loss.” But I worry that this reasoning gets it exactly wrong. People aren’t idiots. Tell them to exercise and eat well in order to lose weight. What happens if they don’t lose weight? They’ll quit exercising and quit eating well. That’s because you told them to do it to lose weight. And clearly it wasn’t working so why stick with it?

I’ve written about this recently. See If inactivity matters more than weight, why the focus on the scale?

And then there’s a great letter in the British Medical Journal here, Why there’s no point telling me to lose weight?

I am one of over 97% of people for whom dieting does not lead to sustained weight loss.1 2 3

I’ve experienced health benefits from increased exercise, and from switching to a wholemeal vegetarian diet. My blood pressure’s normal, as are my fasting glucose and my lung function—as far as I can tell, my health is great. But my body mass index (BMI) has been above 30 my entire adult life.

When I worry that I might be unwell, I often try to avoid visiting a general practitioner. Almost every consultation I’ve ever had—about glandular fever, contraception, a sprained ankle—has included a conversation about my weight; and that’s inevitably the conversation that destroys any rapport or trust that might have existed between me and my doctor.

Fighting “the obesity epidemic” is supposed to be about making me—as a “severely obese” person—more healthy; but the impact of obesity rhetoric on my life has been quite the opposite

 

Go read the whole letter. It’s great.

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And now there’s this, from doctors themselves:

Expecting all obese people to lose weight solely by “eating less and moving more” misunderstands the nature of the condition and will never solve the obesity epidemic, leading doctors have said.

In a staunch rebuttal to commentators who argue obese people have brought the problem on themselves and should rely only on diet and exercise, experts from leading American universities said that, even after actively losing weight, biological mechanisms kick in that make it extremely difficult for previously obese people to stay a healthy weight.

Writing in The Lancet, they say recommendations just to cut back on high calorie foods might be “no more effective for the typical patient seeking weight reduction that would be a recommendation to avoid sharp objects for someone bleeding profusely”.

Uncategorized

Bahama-Bound

Tracy I1 Comment

Sunset in the Exumas.

While Sam is in Arizona this week getting a head start on biking season with an active vacation, I’ve also headed to warmer climes, but without my bike. As I write this, I’m sitting in the Miami Airport getting ready to head to George Town in the Bahamas.

I had a good 5K run on the South Beach boardwalk yesterday morning in Miami. I’m easing back into it after knee pain on my last two long Sunday runs (23K and 19K) made me get sensible and take some time off.  An easy 5K on solid, dry pavement, wearing shorts, a tank top, a cap and sunglasses, felt almost other-worldly.

But the Caribbean is usually a different story. I’ve seen overhead views of Stocking Island, the tiny island in the Exumas where we will be spending the week at a little resort with 8 rooms.  As far as I can tell, there are a few little roads but it’s not clear in advance that I am going to get much of a run in on any of them. If I can figure out a 5K route that doesn’t feel like laps around a track, I’ll be lucky.

But I’ve packed my wetsuit in case the water is cool, swimsuits if it’s not, because if nothing else, I can get in a few swims in the clear blue water of the Caribbean Sea out in the bay in front of our place. I am after all a triathlete, and I do love swimming!

I recognize my immense privilege here.  When I checked the weather back home yesterday, it was minus 40 degrees with the windchill. Chances are, even if my knee had been in good shape, I would have bailed on the run in those temperatures.  I may be Canadian, and I may be a stalwart winter runner, but even I have my limits.

So have a great week everyone.  I will try to post on Thursday, but really, I have no idea what kind of internet connection I will have on Stocking Island.

cycling

Arizona sunshine

Sam B4 Comments

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I think this is good biking weather.

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Clean dry pavement. Woo hoo!

Though I was reminded yesterday about how fussy cyclists can be about the weather.

I watched a group of cyclists, in close formation wearing team kit, pull into campus last night looking like they were coming back from their evening training ride. The topic of conversation?
The bad weather! It’s too windy apparently.

No snow. No cold. Lots of sunshine. I’ll deal with the wind, thanks.

I’m here for an Arizona cycling holiday with Bike Escapades. It’s a return engagement so you can tell I like the place. Like Canberra, Australia it combines warm, dry weather with mixed terrain (flats and hills) and both a terrific cycling community and a very active community of smart, engaged philosophers with interests close to mine. I get to give a talk and ride my bike. Perfect.

You can read about my first trip here.

 

Fasted cardio, fat adaptation, why?
sports nutrition

Fasted cardio, fat adaptation, why?

Sam B4 Comments

Talk of fasted cardio and fat adaptation is all the rage these days in fitness communities as diverse as CrossFit and the ultra endurance athletes set. Those are usually strange bed fellows (one says “too much cardio is pointless” and the other says “run all the miles”) so when something has caught both their attention it might be worth listening.

What’s fasted cardio? Basically exercising–running, biking, rowing, etc–first thing in the morning before eating.

Why do such a thing?

See Gretchen Reynolds, The Benefits of Exercising Before Breakfast

Exercising in a fasted state (usually possible only before breakfast), coaxes the body to burn a greater percentage of fat for fuel during vigorous exercise, instead of relying primarily on carbohydrates. When you burn fat, you obviously don’t store it in your muscles. In “our study, only the fasted group demonstrated beneficial metabolic adaptations, which eventually may enhance oxidative fatty acid turnover,” said Peter Hespel, Ph.D., a professor in the Research Center for Exercise and Health at Catholic University Leuven in Belgium and senior author of the study.

One warning: Some say that fasted cardio is as likely to use muscle for fuel as fat so while you’ll lose weight you won’t get any leaner. See Fasted Cardio Eats Muscle. There’s also the claim that you’re better off not fasting and doing a high intensity workout instead. See Is Fasted Cardio the Best for Burning Fat? There’s lots of skepticism out there. See AM Cardio Myth Exposed.

But for now let’s just set the worries to one side and continue.

The goal isn’t just to lose fat. It’s to change how your body works. You want to train your body to rely on fat stores for fuel rather than carbohydrates.

You want your body to become, as they say, fat adapted.  What does it mean to be fat adapted? Read this from Mark’s Daily Apple. You get the idea pretty quickly from the language. Sugar burners have it all wrong. Those who are fat adapted have got it right.

Okay, so my story. My past experience with fasted cardio isn’t great. Food is a real challenge for  me and morning exercise. In the past it’s been enough to stop me running in the morning even though that’s when it best fits my schedule. I wake up hungry and have to eat before exercise. But I can’t run on a full stomach so I have to set my alarm for early, early and then wait. I used to cycle with a young woman with the same issue. She used to set her alarm for 4 am, get up, eat breakfast and then go back to bed and nap til our 6 am ride.

I’ve tried to change my ways, really I have. I blogged about intermittent fasting and wrote, “A few years ago on the advice of a personal trainer I experimented with morning workouts on an empty stomach but that was a bit of a disaster. ….Halfway through my morning run I was prepared to go knock on doors in search of breakfast.”

I’m hungry a lot. It’s part of why intuitive eating hasn’t appealed to me as much as it has to Tracy. I’m hungry when I wake up and often I go to bed hungry. I don’t feel like there’s lots of non hungry eating to get rid of in my life. Weight loss for me has always involved hunger. I can manage it, make peace with it. Hunger isn’t an emergency. But I can’t exercise when I’m hungry.

I’m jealous of people who can get up and go. Many years ago when Tracy was two hours a day in the gym, in the morning, I once asked her what she had to eat first. She said she had a glass of orange juice.

That made me laugh. I was eating the full fruit and oatmeal breakfast and still needing 2nd breakfast after morning workouts. Morning swim workouts were worse yet for managing hunger.

But on the bike things are different for me. I can go a long while without eating if we’re not going fast. I have smaller friends–Hi Eaton! Hi Tracy!–who need to eat more often but I can do some pretty long rides without food. If I slept in and you showed up on my doorstep with your bike, ready to go, I’d be happy to leave the house with a banana and a Cliff bar in my pocket and eat on the bike. I can’t eat while running.

Cyclists vary about this. Me and another larger woman cyclist once sat watching in shock as we were eating poached eggs and english muffins as the some of the young men we’d been riding with were chowing down waffles, pancakes and french toast. How could they eat that much?

There’s two sides to this, good  and bad.  On the good side, they were eating like that because they can. On the bad side, they were eating like that because they had to. Our upside is that we can ride on very little food.

It’s hard for me to lose weight but on the bike I can ride without constantly refueling.

I’d never go without adequate carbs in a race. No, not ever. You’re slower, for sure. There’s lots of debate about high fat/low carb diets in the cycling community but all the evidence shows that when racing you’re faster if you’re consuming adequate carbohydrates. Your body can use other sources of fuel–i.e., fat and muscle–but it’s less efficient doing so. You slow down.

But training, why not?

Well, first. Why? Weight loss.

Second, the ability to go long distances with minimal fuel.

Women are better at this than men apparently. It’s part of the story, along with higher body fat stores, about what makes women better ultra endurance runners. The longer the distance the closer the gap between men and women and at the very long distances, women win.

But here’s my reason, which is neither of those, convenience.

I want to be able to run in the morning without setting a 5 am alarm. I want to run at 6 am so I can be home by 7 am to wake teenagers. (Yes, waking teenagers is a big thing in my life.)

So my experiment is to start by taking it easy. Go out there on an empty stomach and walk/run. This morning I even did walk one block, run one block. I didn’t get dizzy or woozy and I ate a normal breakfast after.

The plan is to increase gradually and see if I get used to it.

I’ll report back and let you know how it goes. Maybe one day I’ll be able to run run after a glass of OJ!

cycling

Do I need to worry about base miles if I’ve been riding the trainer through the winter?

Sam B5 Comments

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Old school cycling wisdom says that base miles matter. If you’ve been off the bike over the winter, come spring you should spin for hundreds and hundreds of kilometers. The idea is that you ride lots and lots in a nice easy gear putting in “base miles” before big gears, sprinting, climbing and the like. Of course, there’s those youngsters who question this. See Is base training a myth?

How many base kms? It depends what your goals are really. Some road cycling websites recommend 500 miles but surely that’s for the very serious distance racer.

I have bunch of old school cycling buddies who offer very strict advice on such matters as never ever riding without knee warmers when it’s less than 20 degrees. They dutifully log base miles.

Mostly these are older men in their sixties and seventies. Mostly I listen. After all, they’ve been at this much longer than me.

I might not get enough base kms but I try not to push too hard when I first get back on the bike. I do ride easy for the first few weeks

However, this year I’ve been riding my bike on the trainer and taking spin classes. I’m wondering what difference that will make? What does official wisdom say? Can I forgo the base miles thing?

I’m in Arizona for a week riding. Not training, no formal goals. I’ll let you know how it feels.

azhighway

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fashion

The tyranny of choosing and my happy Saturday sweater

Sam B2 Comments

There’s lots to love about Saturdays in my life.

Let’s start with the later than usual beginning. My Aikido club runs a kids’ class 9 to 10, an open adult class 10 to 11, and then a second hour, for coloured belts only, from 11-12. I usually arrive midway through the kids class and catch up with Aikido friends on the side of the mats. Then it’s time for the adults to play.

Whee! Thump!

After Aikido, I go to lunch with friends and family. Often the market, sometimes Edgar and Joes cafe, sometimes Organic Works. All well known local haunts with food to keep vegetarians, vegans, and omnivores happy.

Then shopping and errands, some weekend chores, and maybe even a nap. In the summer there might even be a late afternoon bike ride.

It’s a well worn routine that works.

I was reading this piece the other day on lifestyle minimalism and finding the perfect breakfast.

I was 31 when I figured out breakfast, and after that life’s overall difficulty level declined a bit.

Every month I buy a bag of bulk steel-cut oats, a bag of trail mix and a six-pound bag of Royal Gala apples. Every morning I make a heaping half-cup of the oats and cut an apple into slices. About six months ago I added a cup of Ceylon tea to that.

That’s breakfast every day now. I used to keep my options open, figuring that going with what I “feel like” in the moment is going to naturally lead to a more appropriate, fulfilling breakfast experience.

After years of being confronted with a decision shortly after waking, I decided to be done with deciding what was for breakfast. My usual is now the only thing on the menu, and since I stopped deciding what’s for breakfast, mornings have had a significantly different feel. They are clearer and more spacious.

It reminded me that part if what I liked about Saturdays is the routine. It’s routine even down too what I wear. Yes, the Aikido uniform. But after that jeans or yoga pants, maybe my sparkly converse, and a fan t-shirt.

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T-shirt choices:

Where are my minions? (Thanks David.)
Don’t make me use my philosopher’s voice. (Thanks Sally.)
Or one of my aikido t-shirts. Or a firefly shirt.

But then always my Saturday sweater. It’s fuzzy and warm and feels like the weekend. I almost never wear it to work. It feels too relaxed somehow. You can pretty much guess what day it is in photos if I’m wearing that sweater.

I like new things. It’s true. I crave and enjoy travel and adventure. New foods and new people.

But sometimes happiness is just about finding what works and going with it. I like knowing what I’m doing on Saturdays when I’m in London. Right down too what I’m going to wear.

(I think I was prompted to write this when I realized I’m away every weekend in February, March and all but one in April. I might have to pack my Saturday sweater! )

Happy Saturday sweater with bonus silly hats!

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body image · Guest Post

Do These Pants Make My Butt Look Big? Hockey Equipment and Body Image (Guest Post)

apetropanagos5 Comments

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I love to skate. I grew up figure skating, but when I started to teach power and hockey skating classes nearly a decade ago, I got myself a pair of hockey skates– and I loved them! Since then, I’ve always wanted to play hockey, but it took me up until a few months ago (when I moved to Halifax) to actually gain the courage to give it a shot.

All these years, I’ve avoided playing hockey because I was skeptical about finding equipment that would fit my curvy, short, and muscular body. I was afraid that if I did manage to find equipment, I wouldn’t be able to skate with the extra bulk on my already bulky body. And I was terrified that I was going to look ridiculous with all that equipment on. I imagined that my body in hockey equipment would look more like the Michelin Man (yup, that big puffy tire mascot), than a hockey player.

Deep down, I told myself that it would be less embarrassing and easier if I just lost some weight before I started playing hockey. Ugh… my feminist-self is embarrassed that I felt this kind of body shame!

Waiting to lose weight before trying a recreational sport (or living your life!) is silly. I know. But, it still took me years (of not losing weight) and moving to a new city (where nobody I knew would get to see me playing in full hockey gear) to finally try something that I didn’t think I had the “right” body shape for.

When it came time to actually buy the hockey gear, it turned out to be less embarrassing, but way more challenging than I had imagined.

I curbed some of my embarrassment by bringing a hockey-gear-shopping buddy. I told her that her job was to make sure that my butt didn’t look “too big” in my hockey pants—ha! But really, she was the moral support that I needed. It was nice to have someone on my team when exposing myself and my body to the sales guys at the sports store. With her support, it felt easier to tell the sales guy that something didn’t fit and to explain what I needed for my body. (Telling the teenaged sales guy that “my boobs and butt are too big for this gear” felt less embarrassing with my friend’s support). Most of all, it helped having my friend there to tell me just how exciting my new hockey adventure was going to be. She told me that I looked like a hockey ninja with all my gear on. And it helped.

Finding gear that fit me properly was a different story. Before I started I Googled “best hockey equipment for curvy women” and nothing came up. I wasn’t that surprised. I don’t look anything like the men or women I’d seen playing hockey.

Here’s what I learned about hockey equipment: In general, the men’s gear is too long for my body. The women’s gear is too narrow. Most stores don’t carry that many options for women’s gear, anyways. Some children’s gear (like the XL hockey pants) fit okay, but the straps and padding on most of the other children’s gear are way too small. I haven’t been able to find should pads and chest protectors that fit my shoulder to boob ratio. It seems that to women’s chest protectors don’t have cup size options. Nor have I been able to find elbow or shin pads that are short enough, while providing good coverage with straps that are long enough to go around my arms and legs.

I’ve chatted with some of my teammates about this. And some of them had similar problems with finding hockey equipment. If there are any hockey gear manufacturers reading this, how about you make some equipment for differently shaped women!?

In the end, I settled on some combination of men’s and children’s hockey gear. Still, none of my gear fits me perfectly, but it will have to do—because I’m excited to play!

On the ice, I adjusted pretty quickly to wearing hockey equipment. The hardest thing to get used to was wearing a helmet with a cage. For the first few games, the cage made me feel nauseous, but at least I could skate.

My concerns about what I look like in full hockey gear are fading. In the beginning, however, I did catch myself checking out my reflection in the rink glass a few times. But the more I play and the better I get, the less I give a shit about what I look like.

And it turns out that no one else cares about what I look like either. When I finally let some of my friends come to watch me play they didn’t think that I, or anyone else, looked ridiculous or out of place. To them, we all looked like hockey players, because we were playing hockey.

Surprisingly, I still don’t know what I look like in my gear. Because it doesn’t matter.
What matters is that I get to play. And this little hockey ninja wishes that she hadn’t waited so long to try playing in the first place.

Angel is a postdoc at Dalhousie University. She completed her Ph.D. at the University of Western Ontario. She is a feminist philosopher. She is also a skater— and the rink is where she feels most at home.
Follow her on Twitter @APetropanagos

Guest Post · injury · yoga

Guest Post: “You Might Think It’s Only Your Little Finger, and Only the Tip of It…..”

Sam B6 Comments

by Anita Superson

I had just returned from walking Muskie the Labrador and was trying to get the leash off my hand when he bolted for his friend, jerking the tip of my little finger on my right –and dominant– hand.  That was in mid-August, when I was in good shape from doing lots of (sometimes intensive) yoga, cardio, weights, 10 mile walks, gardening in three yards, and caring for two properties.  It’s just a bad strain, I thought, and figured I’d heal quickly.  Five months later, and three hours of physical therapy each day since the end of October, I am first now getting back to the things I like to do and, well, being myself.

 

By the time I got in to the surgeon, the bone below the fractured bone was already starting to heal over it.  Apparently, bones heal in four to six weeks, mine a bit faster.  I didn’t learn this as a biology major, nor did I learn anything about repairing fractures.  I went to my appointment thinking my finger would be in a cast for a short time and I could do everything I was doing while it was fractured.  Reading my mind, my surgeon said, “You might think it’s only your little finger, and only the tip of it, but this is major surgery and you will need lots and lots of physical therapy.  Your finger will be very, very stiff for a long time.”  I told myself he must be talking about someone else – I was in good shape, my bones heal quickly, my finger only hurt when I typed, and I could bend it a bit.

 

Anatomy books can teach you the names of the parts and show their connections through diagrams, but there is nothing like learning these connections by learning how to re-live your life when they are impaired.  I learned that the little and ring fingers share a tendon (which is why they “buddy tape” them together inside the cast) and the tendons from the fingers join at the wrist and then reach up to both the inner and outer bones of the elbow (which is why the cast reaches almost that high up the arm).  If you break your little finger, you lose the use of half of your hand.

 

Of course, I underestimated the real effects.  I couldn’t do the simplest things, for starters.  Half a hand does not give enough pressure to get your teeth clean, and you need to keep the cast dry.  Pumping a spray bottle, opening bottles and cans, wringing out towels or clothes, even carrying my French press to the study in the morning had to be done left-handed or not at all.  I couldn’t chop vegetables, but discovered that you can buy a lot of these frozen, though soups and more complex meals were not an option.  Putting change on a store counter was impossible because it requires wrist action.  Yoga, weights, machines were out of the question – no bending at the wrist, lifting, or gripping with half a hand.  I tried to go for walks but my hand would swell and I would have to hold it up which threw off my balance making me feel like a three-legged cat.  I couldn’t type or write notes, let alone sign my name, so research was out.  But I’m a professor.  I thought I could use the time to catch up on reading books and journal articles, but discovered that I couldn’t even underline because that would require holding up my arm at an odd angle and applying pressure I couldn’t.  And I couldn’t write notes in the margins, which is my usual way of engaging with the text.  I taught my classes, sometimes with a bag of ice on my hand to quell the pain after the cast came off, and managed to do some one-handed gardening, however.

 

When I got the cast off, my once bound fingers were square and as hard as concrete.  My surgeon pulled out the pins that looked like the ends of thick sewing needles without my feeling a thing.  I didn’t know until my excellent physical therapist told me that the pins were actually through the bones.  Thanks to my very skilled surgeon, the three fractures and torn tendon healed completely perfectly.  Apparently this kind of surgery is very difficult because in the fingers, the nerves, tendons, muscles, connective tissue, ligaments, and blood vessels are extremely tightly packed and one small wrong move can result in loss of movement in the finger.   It took two days to peel off the dead skin from my hand, and by day three, the pain set in – not in the finger, but up my arm, from the tightness of the tendons that are concreted by the connective tissue.  The nerve endings were so jumbled from the connective tissue that when I washed my hair, it felt smooth with my left hand and like sand paper with my right hand.  I learned that your immune system rushes to the casted part of your body in an attempt to heal it.  But there is nothing there for it to work on, and through some process it stiffens the connective tissue. Part of the physical therapy is to scrape the tight areas of connective tissue with a tongue depressor and lotion.  This releases fluid (the histamines), which causes swelling.  I wear a compressive glove or tape up my fingers to keep the fluid out because it contains protein that lays the scar tissue right back down again.  I will have to do this and other finger and hand exercises for about one year, which is how long I’m told it will take for the swelling to go down.  Fortunately, most of this is not painful, though working my fingers down to my palm several times daily can be, even with a lot of heating.

 

For active people, injuries are particularly bad because they try to infest their psyches with couch potato-ness.  Before my injury, my typical Saturday was spent doing an hour and a half of intensive yoga, followed by several hours of gardening or house projects or a 10 mile walk, followed by more gardening or reupholstering or some other chore – a 12 hour, almost non-stop day.  After the injury, my Saturday was spent watching TV or puttering around in shops.  While many people would welcome the “vacation,” I couldn’t stand it.  It was depressing, boring, aimless, making me gain weight, depleting my strength, and just not me.  People who know me say they never see me sit down – I always have some project going.  Well, I do sit, when I’m researching or preparing classes, and I’ve done a lot of this in my life, which might be why I balance it out with physical activity, which I love.  And I like being strong, and the exercise gives me the strength to do all the gardening, and so on.  I can’t be a couch potato, and no little finger is going to turn me into one!

 

I’m getting back into my normal routine slowly but surely.  A week after my cast came off, despite the pain in my arm I painted some awnings and railings with my half hand and a slightly bending wrist.  A few weeks later, when the pain was subsiding (ironically, because of very painful physical therapy aimed at bending the concrete fingers), I painted a couple of rooms, though I had to use both hands on the roller.  A month later I made my usual hundreds of Christmas cookies, and kneaded lots of bread dough which was therapeutic for my wrist.  I got back into yoga slowly.  Poses are coming back, but my favorite plank pose that I used to do with ease makes my thumb and wrist go numb if I hold it too long.  Stiffness from the cast lingers, and I lost some of the strength and flexibility that took so long to acquire. Gripping weights is hard because my fingers don’t bend down even half way so I’m still not using my full hand and arm.  Tightness in the whole body is an issue.  Connective tissue runs from the base of your toes to your eyebrows, and tightness is one area can make other areas tight. (Check out this excellent video: https://www.youtube.com/watch?v=BUNcQMP2gwE).  The plantar fasciitis I had in my right foot flared up three weeks after getting the cast.  Zen yoga, a new yoga for me that I would have previously written off for “less athletic types,” turned out to be just what I needed, because it stretches your body deeper than the muscles and into the fascia or connective tissue. I recently found out that I likely have a recurrence of Dupuytren’s, which is a genetic disease that causes parts of the connective tissue in the hand to knot up under the skin, eventually pulling a finger down.  That might require another surgery, but at least not a cast.

 

When I tell people that I broke my little finger, most of them respond as if it is a “cute little injury.”  Much like sucking your fat out with nerves and blood vessels is just “plastic surgery.”

 

My surgeon hit the nail on the head.  He could have added that when it comes to your body, there is no such thing as “one little part.” It all works together, and the way and extent to which you use your body defines you.  You can’t capture that in an anatomy diagram; you have to live it.

Anita Superson is a Professor of Philosophy at the University of Kentucky, where she teaches and does research in ethics and feminism.  She enjoys long walks along Chicago’s lakefront, yoga, and working out at the gym.  She refinishes and reupholsters good quality old furniture, and is an avid baker.

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eating · training

Vegans and Protein: Yes, We Like It, Too

Tracy I11 Comments
Photo of a vegan chickpea burger from Jamie Oliver, with lettuce, an artisan bun, and tomato.
Jamie Oliver’s best vegan burger.

Last night I went out to one of the best restaurants in London (Ontario). It’s the only place in town that makes it onto lists that get national recognition. Even on a Wednesday night, there was a group at every table in the compact, dimly lit space. My two friends were already sitting at the table in the warm and bustling room when I arrived for our late dinner.  The restaurant offers a delicious winter vegetable salad, a heaping portion of beets and carrots, turnips and leeks, peas and even corn, all roasted or grilled, served in a dressing with fines herbes and excellent olive oil.

That was a definite for my starter. But I’d been at a lunch event earlier in the day where the lack of vegan options meant I’d had only a dinner roll and two kinds of salad, and I’d been rushing around ever since.  So by 7:30 last night I had in mind a more substantial meal. I scoured the menu for something else I could make vegan and came up short.

After ordering a bowl of olives for the table, I mentioned to the waiter that I was vegan, that I wanted the vegetable salad, and then asked what else they could do for me.

He started talking about a mixed veggie plate and demoted my starter to the house greens if I wanted two courses. I actually did want two courses, but I wanted one of them to be the salad I’d been thinking of for the past few hours.  Following that with grilled veggies didn’t seem like it would do it for me. So I opted for the good salad (not that the greens wouldn’t have been tasty) and left it at that. My companions ordered it too, as a starter.

So when the starters came — those salads I’d been dreaming of all afternoon — they each got their winter vegetable salad and the waiter plunked a bowl of warm and plump green olives in front of me. I promptly moved it to its intended spot at the centre of the table. I guess my salad was coming with the mains. Which it did. Almost one hour, twelve fat olives, and at least three slices of high-end white bread later.

The most common question vegans are asked (other than “how could you give up cheese?”) is “where do you get your protein?”  Well I can tell you this: not at the majority of the fancy restaurants “foodies” like to frequent. It astonishes me every single time I go to one of these places with a supposedly talented and award-winning chef and they can’t come up with something even a little bit creative that includes vegan protein.

We live in a world where protein is synonymous with animal protein. We picture a plate divided into sections with the starch, the veggies, and the meat. But that view of it all demonstrates a lack of imagination. It’s not even the way the plate looks in most national cuisines. And yet our best chefs can’t manage to break from that pattern.

Last night’s restaurant is just one example. Every single “main” had some sort of animal protein taking centre stage. Then you could order some sides to go with it — olives, potatoes roasted in beef fat (that’s one way to ruin a vegan option!), roasted vegetables topped with a dollop of goat cheese (that’s another, but granted they can leave that off), polenta “fries” (sadly, and I know this because I asked, they’re made with milk).

Now I know most places won’t happen to have a tub of tofu or a block of tempeh or some freshly made seitan just sitting around. But what? You don’t have a single legume in the back? No lentils or chickpeas? No black beans or, come on, edamame? Work with me, people!

I know I’m in the minority.  Heck, I chose the restaurant because we wanted to go somewhere special and the places I normally frequent, nice though they may be, aren’t in that high-end bracket. You know the places. The ones with the good wine lists.

But it frustrates me to no end.  I know too that most people don’t think of it. And I can forgive them for that. But most people aren’t chefs! I can’t imagine that most of the people who call themselves chefs would construct a regular main with no protein. But somehow, when a vegan walks into the room, they don’t need protein to have a satisfying meal.  No, no. They can be happy with a plate of vegetables.

Well you know what? I’m training. I had a tough bike class the night before and didn’t eat in time or enough after it. And that always makes me hungry. Famished. For at least a day. That’s why when I went out with a friend for breakfast yesterday, I had a bowl of oatmeal AND toast.

A lot of vegan primers tell us not to be too preoccupied with protein. They say we’re likely to get it along the way. Well, yes, if you add legumes to your salads and take a handful of nuts with your afternoon snack or eat soy products fairly regularly (I have no gripe with soy). But if you’re eating green salad and grilled veggies all day, then you will have a problem with protein. You at the very least need to eat a varied diet. See this article about vegan protein.

So here’s a quick list of vegan protein sources:

  • legumes like lentils, chickpeas, kidney beans, pinto beans, black beans, lima beans — all manner of beans qualify and are chock full of protein
  • nuts and nut butters
  • soy products like tofu and tempeh and plain boiled or steamed edamame
  • TVP (textured vegetable protein)
  • seitan (otherwise known as “wheat meat,” made from vital wheat gluten). Read about it here.

I’ve blogged about vegan protein before.  See “How to Get Lots of Vegan Protein.” But I still haven’t really figured out how to get the amount recommended for someone in training (1 gram per pound of body weight, which would be over 125 pounds of protein per day for me. If I reach 100g that’s a probably good day, though I’m not counting right now).

Of course, yesterday was a perfect storm of bad dietary moments.  First, it’s a rare day that I will be out for all three meals. I usually prepare at least two and usually three of my meals every day.  Not so yesterday. Second, I hadn’t properly re-fueled myself after that 90 minute class on my bike trainer the night before. Third, my day got away from me, with back to back meetings and errands that meant I had no time to fend for myself. I had to make do with what was available. And finally, I chose a restaurant that I knew wouldn’t be a great vegan destination. But I hadn’t planned the rest of the day well enough to create balance.

I still don’t see why chefs have such a block about this. There are plenty of excellent things you can make with vegan protein sources. And the plant-based diet has certainly gained a healthy following in recent years.  It’s got to be possible to love food and eat this way. I wish our more exciting and inventive chefs would get on board with it.

I mean, even Jamie Oliver has noticed that it’s a thing.  On the Jamie Oliver Blog, there’s a post called, “Our top five vegan recipes.” It says:

For a long time, veganism has had an unfairly bad name in the food industry. If you’ve been keeping an eye on the web and its foodie communities over the last few years, however, you’ll know that followers are growing in numbers quickly, and the creativity and resourcefulness of its chefs, from independent bloggers to specialist restaurants, is blossoming. With recipes like these gorgeous ones from Jamie and his food team, it’s no longer only omnivores who can enjoy a varied and satisfying diet – dig in!
Read more at http://www.jamieoliver.com/news-and-features/features/top-five-vegan-recipes/#QW1kYzbq3tQJLuQu.99

And the shepherd’s pie and the “best vegan burger” both have legumes as a base.  Three cheers for chefs who try!

I’m taking the leftovers from my delicious salad with me to work today. I have another catered lunch meeting and I expect my meal to be inadequate. I’m adding chickpeas to the winter veggies this time, and taking a side of hummus just in case I need more.

If you’ve had a better experience finding satisfying and balanced vegan meals at fancy, omnivore-type restaurants, please share them.