In just over two months from now, in February, 2019, I will be nine years post brain surgery. I mention this because I have a couple hundred pages of unedited, raw memoir about the recovery experience. In those pages is beginning of a discussion about the need to lose weight.

At the time of the surgery I weighed over 300 pounds. At the time, my weight meant little to me other than as a body image issue, or a clothing issue. Shoes wore out faster, clothes had to be larger and of more limited selection. Physical activities were often more limited, although I was generally doing everything I really wanted to do, including backpacking. Comfort was issue. Most chairs are still designed for an average body weight and size of 160 pounds.

Whatever the problems, they were really only mine.

While in neuroscience ICU I realized my weight did impact others. It had significant impacts on those taking care of me. This became clear to me in the comments of one night nurse who frequently complained about her back. This bothered me so much, that in the middle of one night when I fell trying to get off the bedside commode, I refused to ask for help. Despite the weakness, the wonky head, and all the tubes connected to my arms, nose, and head, I refused to call for help. Instead I struggled, slowly and painfully, back into the bed.

All of this was on my mind two years ago today when I started with a weight-loss clinic. It has been a successful relationship and program for me as I have lost 100 pounds. I have put a few pounds back after ending the active weight-loss phase and significantly increasing my strength training in the gym. I feel stronger and healthier than at any point prior. I know for a fact there are things I can do now that I could not do 35 years ago, like pull-ups and chin-ups. My weight is about 25 pounds less than it was when I left the Army in 1985, but despite being older and probably having less muscle mass, I am stronger. Probably because I am making more effort at being strong then I did then.

And today all this matters a great deal. My wife, Melinda, is temporarily wheelchair bound. A month ago she tore muscle or connective tissue in her hip. Instead of resting and healing, as she had been advised, she got a bit carried away preparing for the holidays and collecting gifts for our newly announced grandchild. This aggravated her injury. A road-trip to southwest Missouri for Thanksgiving aggravated her pain to the point that she could not get out of the car at a motel in Evansville, Indiana on the way home. We found our way to emergency room, spent 12 hours there getting her pain somewhat under control, and a wheelchair.

We slowly made our way home. Fortunately we had taken her car, which is significantly larger than mine, to accommodate her walker. Otherwise we would not have gotten a wheelchair in and out of the car.

We’ve been home a week now. Returning to a mode of existence that we lived a few years ago during her different surgeries. Only now, instead of intentionally trying to use her leg to encourage healing, it’s the exact opposite. She cannot stand at all without a great deal of assistance. So, it’s really important and fortunate that I am strong and healthy right now. It takes a lot of strength to help her, and a lot of effort to protect my back.

My point is not to shame anyone. Losing weight is hard. Extraordinarily hard. Keeping it off is harder still. But there is a reality that our weight does have impacts. One of those impacts is the ability of others to care for us. More to the point, it affects our ability to receive care. This matters.  It may be long-term, it may only be the case if something bad happens, but it matters.

Being a caregiver is hard work.  Some things are harder than others. If nothing else,  a caregiver needs to be fit and strong. Strong enough to let the frequent cries of pain wash over them without interrupting their work. You’ve got to be strong….and so this is easier than it was four years ago.