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Iron deficiency anemia and self-gaslighting: a story of physical and mental health



Even though I warned her, my new doctor was still startled by my iron levels. “The low end of normal is nearly twice this number,” she insisted, educating me even as I nodded along – I knew this already.

“Last time it was a point lower,” I told her, but she (like most people) didn’t seem to care how bad it used to be. She cared about getting me healthy now.

“People get blood transfusions around these numbers.”

I raised my eyebrows in surprise – not mock, but a bit exaggerated, trying to give her the reaction I felt she was after. It wasn’t that I didn’t care, but rather that my anemia had been a concern for so long, and nothing had really ‘fixed’ it for long. I eat boatloads of dark leafy greens and iron-rich meat, and I go through phases of supplement discipline too (they rarely last long because iron pills are brutal on my stomach). So I just didn’t feel empowered to change anything.

When my doctor finally gave up on trying to impress upon me the seriousness of the situation, she asked if I’d been feeling worse than usual – was I especially tired or sluggish lately?

I laughed. “Yeah, for a couple years. It’s one of the reasons I wanted you to run these tests: I was pretty sure my iron would be low.”

She frowned and asked why I hadn’t seen anyone sooner, and rather than make the usual excuses about moving states and changing insurance providers and struggling to find a doctor who was accepting new patients, I launched right into the core truth:

“Well, even though I know I have a tendency to be anemic, I still thought…I thought it was my fault. Like, the reason I was tired was because I was lazy – it’s cyclical, right? I just needed to exercise more, get my stamina up…I guess just ignoring the fact that after nine months of yoga three times a week it seemed to be getting harder instead of easier? You know…blaming myself…woman stuff.”

What I didn’t say, mostly because I work very hard these days to avoid cracking that particular* Pandora’s Box unless I have the time and emotional space to let out all the crazies, was “fat people stuff.” While I suspect my self-neglect was born at the intersection of growing up female and never quite reaching official ‘not fat’ status, the latter is the issue that feels more responsible for my intense drive to gaslight myself.

For months leading up to the blood tests, I’d been telling everyone who’d listen that “I really need to do more actual working out” and “my cardio is so bad.” I’d give examples: panting uncontrollably when I walked up three flights of stairs to my office (even though everyone else I worked with did it multiple times a day with relative ease); my heart thudding in my ears when I climbed the hill from downtown to our house; being so dizzy during yoga that my vision blurred. My face would burn with shame as I described these effects, certain I’d let my fitness slide too far, ‘indulging’ in vinyasa yoga instead of punishing my body with interval training and walking five miles a day.

It wasn’t until after the blood tests came back (and my doctor’s reaction to them), when I was panting up a slight hill on my way to work, that I decided to Google the symptoms of iron-deficient anemia. There on the screen in my quivering hand was the medical truth: “fast heartbeat or shortness of breath, especially with exercise…dizziness or lightheadedness…weakness…extreme fatigue…”

I took a screenshot and texted my husband, who sent back a string of emojis illustrating his exasperation. He did include one word: “Anne.” Just like that – including the period. The most damning text.

I can’t really blame him; I can be very stubborn about my body issues, and it must be infuriating to watch the person you love choose to neglect her health in favor of emotional harm. His sympathy ebbs in these moments, and no amount of insistence that I’m so much better than I used to be** will force him to embrace a perspective he hasn’t earned through experience.

There is an argument to be made that how far I’ve come is no excuse for resting on my laurels now; there’s always more work to be done. A couple of weeks ago I went to London to visit friends, and as I was desperately trying to drag myself and my bag up the stairs at Canada Water station – my second tube change after 24 hours and five legs of travel – I came very close to tears. My heart was racing so fast I’d swear my throat was visibly pulsing, my vision was blurry, and my lungs felt like they had the capacity of a thimble. But I kept lifting one leaden leg after another, pressed on by the constant crowd, and (if I’m honest) by my pride in the face of an arbitrary, possibly fabricated jury of thin people.

By the time I reached Forest Hill and met up with my friend Magda, I was completely emptied out. I knew her walk-up flat was on the British-second/American-third floor, and that more generally London is an inhospitable city for anyone not in the peak of health, so I did the only thing I could trust: I outsourced caring for me to someone who loves me. I told Magda about my anemia, and the symptoms, and she listened and slowed her pace; she also reminded me to take breaks on the stairs when we got to her building.

When my friend Brittany arrived a few days later I told her too, and she was even more of a watchdog, practically bullying me into putting my health before my pride. At one point, as we trudged up an insanely steep hill to the Greenwich Observatory, surrounded by throngs of people, Brittany insisted I stop moving and breathe, forcing the hoards to flow around us – I’m certain if she hadn’t forced me to stop I would have passed out. She also pushed me to share a car to the airport with her rather than going through the three-train public transport route to Heathrow all over again.

I’m so grateful to my friends for helping me through that week, and to my husband for picking up the slack and bullying me into resting at home, but one of the many things I’ve learned from this experience is that others shouldn’t have to police my self-care. I need to be a grown-up and learn to advocate for myself, whether against others*** or (harder) against the mean, gaslighting voices in my own head.

I keep saying I don’t believe in resolutions, but I think that would make a pretty great goal for 2020.

* Obviously my word salad and follow-up explanation of ‘woman stuff’ counts as its own Pandora's Box

** I really am, though, as you know – if you’re new here the archives will enlighten you.

*** I’ve started declining to be weighed at the doctor’s office and while it was very tough at first it gets easier every time.

PS I am currently on a treatment plan of IV iron infusions once a week throughout the month of November. With any luck, that’ll fix me up for at least year or two.

PPS I can't believe it's been nearly two years since I've posted! OMFG. I guess most of my updates have been happening over on the author site – but this one felt particularly suited to this venue. The short version of a long story with lots of plot points: I got a full-time job that paid well but was a total nightmare; six months later we signed on a house, had our wedding, and I quit that job all in the same week; a couple weeks into 2019 I got a different job, which I'm still doing (more on that here).
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