Me: “As you see here—” *tapping paperwork again* “—I have, over the past ten years, done the following: two years of sticking religiously to less than 1500 calories per day while also walking briskly for two hours each day, three attempts with professional dieticians via the doctor, the keto diet for eight months which I just stopped, three years of fasting for three days every couple of months, an intensified exercise program designed by a physiotherapist, and periodic further attempts such as ten months only drinking slim-fast for breakfast and lunch and then eating a minimal dinner. At the moment, I walk a lot and now that my sprained ankle will, after 11 months, finally allow it, I am starting my home fitness routine again, with a cross-trainer and resistance training as far as my back and other joint ills will allow.”

Rheumatologist: “You know what doesn’t cost money? Exercise!”

Me: “Yes… As I said — and wrote — I walk a lot and am working on starting my routine again. At the moment, I walk a minimum of one hour a day just in the normal way of things and I try to do more. I walk pretty fast.”

Rheumatologist: “I understand, but really, it’s not that hard to get started. Maybe just try with 20 minutes every other day and see how that treats you, then build up from there.”

Me: “I. Already. Walk. More. Than. One. Hour. Every. Day.”

Rheumatologist: “I understand. Well, I know you don’t want to hear this, but it sounds like you need to scrap all the fad diet kicks and just eat fewer calories.”

Me: “Yes, I just stopped the keto diet and I will now again do the calorie-counting, while walking more than an hour a day, but as I said, I have already tried reducing the calories and I haven’t had any luck so far. But yes, obviously I will be doing that; otherwise I would gain weight and I really don’t want to do that!“

Rheumatologist: “Well, I understand why you wouldn’t want to do it; if you eat fewer calories, you will have to suffer feelings of hunger sometimes. I understand that this is difficult, so you might not want to do it, but it really is important that you try.”

Me: “Um… Here–” *tapping paperwork again* “–is where it says that I fasted for three days every couple of months for three years. I am not afraid of feelings of hunger.”

Rheumatologist: “Well, okay… I just think it would be good for you to give it a shot. Maybe start with 20 minutes of light walking every day, and see if you can reduce your calories a bit at a time. Maybe cut out desserts a couple of times a week; start from there. Anyway, obviously it won’t cure your fibromyalgia or anything, but if you could lose some weight it would help with the daily toll on your skeletal system, and with the amount of wear-and-tear you’re dealing with that would only be a good thing. Do you have any questions?”

Me: *giving up* “Nope. I’ll do my best.”