My beautiful daughter stood up and gave a talk with this title at the end of last week.  Of course I’m biased when I say beautiful because I’m her mum, but with her petite, shapely frame, huge eyes and long blond hair we see the boys sneeking looks when we are out (although her brothers would never admit it!).  What I’m really referring to though is her lovely personality – she is caring, compassionate, the peace keeper in the group, always fighting for a cause or the underdog.  No, she isn’t perfect – she leaves her clothes over her floor, needs nagging to do her homework, is disorganised, spends too much time on her ipad – in other words is a teenage girl.

But she doesn’t like what the selfie culture is bringing out in her friends.  The obsession with posing in crop tops and layers of makeup.  So she went away and looked at statistics, including anorexia, suicides and body dysmorphia, and stood up to speak to her friends.  She doesn’t find this easy and initially the girls laughed as they thought she was joking when she started with the words “Selfies – good or bad?”, but she talked and they listened.  Hopefully it made them think for just a few minutes.

Years ago as a post reg nurse studying for a Head & Neck cancer qualification, I chose to write my dissertation on body image, or rather the effects of altered body image.  There was very little literature – mainly studies by the American Mary Jo Dropkin and the book by Mave Salter.  Body image was a touchy feely subject that we didn’t really talk about, and certainly not in relation to ourselves.  How times have changed!  The impact on my patients undergoing major, disfiguring facial surgery should not have been underestimated – for not only was there the obvious physical changes (removal of voice box, tongue, nose, eye, mandible, sinuses or a combination) but the alteration to voice and speech, the ability to eat and drink, the impact on relationships and social lives.

Today I think about the impact of hidden illness on body image and self esteem.  The increasing need for perfection in our social media culture is tough enough on the healthy, but when an illness creeps insidiously into your life it can rob you of so much that we take for granted.  On a course in the ’90s for the care of people with HIV and AIDS, the lecturer asked us all to define ourselves in a list.  Most comprised of nurse, girl/boyfriend, wife/husband, parent, child, lover, friend, sibling………..we were then challenged to imagine chunks of this personality being eroded away with no hope of cure.  Of course the outlook with an HIV diagnosis is today very different, but since finding myself living with chronic pain, worsening EDS etc, I have thought back to that day often.  To find that your partner’s relationship has changed from that of your lover to that of your carer, your teenagers have undergone a role reversal and are taking you to the toilet, helping you to walk and dressing you and, most importantly my father would tell you, as parents of the nurse daughter who was supposed to look after them in their old age, he doesn’t know what they will do now!!  But writing seriously, my own self worth has shifted significantly.  I no longer feel like the person that I was supposed to be.  Yes we can all say this as we grow older and our lives don’t take the course that we had envisaged – after all I hear you sigh, how many lives do pan out just the way we dream in our teens??

Chronic pain and back surgeries have robbed me of my independence.  This is probably my most prized possession that I have unwillingly lost.  It affects all areas of my life from just throwing on my coat, grabbing the car keys and popping to the shops to needing help to sit up in bed in the morning.  The reality is that I constantly have to rely upon other people to take me to places, to remember to ask if I would like a lift because I feel like a nuisance for constantly asking, to wash my hair, blah, blah,blah….I miss my able body.  A mixture of drugs and immobility have caused me to pile on the pounds – about 3 and half stone in total.  I have never struggled with my weight, even after babies, but this has been so tough.  Initially I managed it and only gained a few pounds, but as the pregabalin/lyrica dose increased so the weight did.  I always knew that my patients said the dreaded pregabalin piled on the pounds, but you cannot understand until you experience it – the fluid retention, one day being able to wear a watch and the next not – and the fact that the weight may go on very quickly with the drugs, but it doesn’t come off easily when the drugs cease.  I know that other people think I’m mad, I’m tall and carry it easier and that this should be the least of my problems.  But staring at a wardrobe full of clothes that no longer fit just adds to the decreasing confidence and at times self loathing.  I miss my able body.  The tiredness, lethargy, feeling like I’ve run a marathon when I’ve actually only been to the cinema – catching a glimpse of myself in a shop front creeping along with a walking stick, albeit a pink, sparkly one!  I have turned 80, aging at an ever increasing rate, giving new meaning to the aging process.  I miss my able body.

Yet I know I’m still one of the lucky ones.  There is always someone worse off than you, isn’t there?  So back to my lovely girl’s dilemma and I read in the press that young girls are now taking selfies of their waist sizes…..by measuring them with a piece of A4 paper!!  Yes, you read correctly and if this isn’t going to have a negative impact on the body image of healthy youngsters, god help the unhealthy amongst us!!