First day of treatment

I seriously thought I posted this… about a week ago. Whoops. Anyways here is how my first day went!

I have tried (and failed) to write this post more times than I can count. Nearly 5 months later and I still feel an overwhelming amount of emotions every time I think or talk about my three and a half weeks there. I have never had an experience like it. It’s a very weird feeling since it is a treatment center and not meant to be a “good” experience, but I truly do miss it there and I look back on my time there with happiness. There have been many points where I wanted to go back because I felt so secure and cared about there.

I’ve decided to break this into different chunks. I honestly don’t think I could ever fill enough pages to explain everything that Forest View was. I’m going to start the very first day there. I’ll explain a bit of how everything went and then talk about all of the “firsts” I experienced.

My first day in PHP was actually the second day going there. I had an assessment the day before and was told I qualified for PHP. My mom had to pretty much force me out the door that morning. I had gone from restricting meals a ton before having my wisdom teeth pulled to barely having anything. Anorexia decided the whole hurting mouth thing would be perfect to restrict even more. I felt dead. I slept probably 80% of the day. I didn’t care if I lived or died. My mom had had enough though, and so I ended up at FV. The assessment honestly freaked me out. I don’t remember much. I don’t think I talked to my mom the whole ride home because I was furious with her. I didn’t need this, I was FINE.

I cannot describe the fear going into my first day. I cried the whole way there. I faked breakfast and I still felt like throwing up. I wanted my mom to turn around and drive me back home. I was greeted by the most amazing staff, which calmed my fears a tiny bit. I received my name tag and a folder. They explained the daily routine for ED patients in PHP: check-in with all of the adults, then head to the ED unit where we would do morning snack, ED group, a second group (activity, art, or nutrition), and support lunch; then back to the PHP unit for two groups and snack. I was called out I believe four times before check-in was done. I had an EKG, met with a nurse and answered my first set of questions, met with the dietitian, then saw internal medicine. After this, I was led down to the ED unit and a world of unknowns.

First meal plan. I was given the first of many yellow slips of paper with all the categories and serving amounts I was expected to eat for each meal and snack. I don’t really want to list the full breakdown but it consists of two snacks with 1 dairy and 1 grain, breakfasts with 1-2 grains 1 dairy 1 fruit and 1 other, lunch with 2-3 grain 1-2 protein 1 veggie 1 fruit and 1 other, and dinner being the same as lunch without an other and adding a grain. As I continued treatment my meal plan was bumped up accordingly and I learned that the “huge” amount I started on was very mild compared to what could be. I also learned that my meal plan is just minimums and I was absolutely not allowed to exercise.

First snack. I was pulled out so many times my first day, and unfortunately that meant being late to morning snack. I wasn’t used to eating before lunch. I hated milk, which I soon would discover is a staple at Forest View. As I entered into a room full of other patients and a therapist I didn’t know, I wanted to cry. On top of the overwhelming fear and anxiety about being there in the first place, one of the girls (who I completely HATED that first day) called out “Make sure she gets her snack” and I could have slapped her if I didn’t already have a thousand other things on my mind. This is the same girl who, five minutes later, tattled (I use this word because I seriously felt like i was in elementary school again) on me for using “Ed behaviors.” I didn’t even know what that meant or that we had rules at mealtimes. Turns out, you aren’t allowed to break your muffin into tiny pieces and hide your bowl under the table while eating. Whoops. I finished the muffin eventually (way after our 15 minute limit I had yet to hear of) and thankfully was pulled out of group by the ED nurse. I was kind of wrong to be thankful at that point, ha. I think I had taken one sip of the dreaded dairy portion of snack so I had to bring it with me. I’ll talk more about my meeting in a bit but I still hadn’t finished my milk at the end of it. Apparently this is a huge no-no when it comes to being in treatment and the doctor threatened me with an ensure. Luckily the activity therapist let me off the hook since I didn’t know any of our rules yet.

First meeting with the Dr. and ED Nurse. Nurse Erin, bless her heart, was so kind to me. She is definitely one of my favorite people working there. She could tell how fearful I was and that I needed more of a loving touch to feel more comfortable. Her sense of humor is great and she got me to laugh a bit. Overall, I am just thankful I got to be alone with her before having the doctor come in. The doctor there is strict and cold at times. He pushed me from the start and gave no slack. I wished he would have been a little more understanding that first day but I think it did me good… eventually. He always made it a habit to threaten me with hospitalization and a feeding tube which was great. If I hadn’t had the wonderful excuse of my parents not wanting to pay fo inpatient, he would have had me stuck in there and a tube shoved up my nose after day 3. In just three days I exceeded their number of “refusals” and I was starting to lose weight. He was so angry at one point that he set the papers out in front of me and claimed he was going to call my parents. Didn’t happen and also didn’t make me want to do much better. Ah well. I was thankful for his pushing by the end of it but even moreso that Erin was always there to balance out the harshness.

First time admitting I had an eating disorder. In the short time I was actually in ED group that first day, I had to do one of the hardest things of my entire treatment. I never said the word out loud. I knew, deep down, I had a problem. I never said the words out loud though. Since I was new, we went around the table and introduced ourselves and what we struggled with (anorexia, bulimia, or both). When Hannah (ED therapist) got to me I couldn’t say it. Holding back tears and mind racing, I squeaked out that my name was Emily but then burst into tears. The first piece of advice from her came then: say it out loud, because the more you admit you have a problem the more you can try to fight it. So I did. It took a few tries and what felt like forever but I said it for the first time ever: “I have anorexia.” It felt real at that point. I wasn’t okay. I didn’t fully agree I needed to be at FV, but it was a start.

First time hearing meal rules. That first lunch, it all seemed incredibly complex and confusing but by the next week I already had them memorized and even wrote them out for one of the activity therapists. Only two glasses of water/other beverage per meal. Jacket/sweatshirts must be removed or the pockets checked after meals. No bathroom use for two hours after. Don’t compare with others. It is expected that you finish the entire meal or will be given a supplement. No talking about food, calories, weight, etc. No looking at nutritional info for foods that have them. No cutting food into tiny pieces, counting chews, etc that would be considered ED behaviors. Napkins will be checked after meals. You cannot exchange food with others. Only one of each condiment can be used. Try to support anyone having a hard time. If there is anything wrong with your meal (mainly dealing with allergies or one of your 3 dislikes) you have to say it right away or you’ll be forced to eat it anyways. Well maybe not with allergies but definitely with dislikes (learned that one the hard way, yuck). You get 15 minute for snack and 45 for lunch. You have to fill out an eval after meals. Do the board before and after.

First time doing “the board.” Oh goodness was this weird the first few times. I found it helpful, well kind of, eventually but before then it seemed pointless. We would put an affirmation (hated that part), rate our hunger, and write an emotion (which couldn’t be anxious or nervous or anything related to food, dang it!). After the meal we would again rate hunger and emotions. I see now it was a good way to gauge how the meal affected us and what our bodies were telling us, but I hated it back then. I swear I put the same emotions most days because I was pretty numb before most meals and disgusted, uncomfortable, discouraged, etc after. I actually still go through the checklist now, especially on hard days.

First support lunch. When the activity therapist plopped my tray down in front of me, I wanted to run and hide. It seemed huge and impossible. All I remember from that meal is that it included an italian sausage and bun, veggies, fruit, and, luckily for me, no dessert. For anyone not in their first day, a dessert during lunch was mandatory. I didn’t cry or talk. I ate safe foods first (veggies and fruit). I took one tiny bite of the sausage and nearly threw up. I gave up. After the therapist realized there was no way she could get me to finish, she got out our meal sheets and prepared to return us to the inpatient or PHP units. She also informed me I would be receiving an Ensure.

First taste of Ensure… and first “refusal.” I’m not quite sure what I expected Ensure to taste like, but I certainly didn’t see it tasting that disgusting. To this day, my scale of taste for food is 10 to Ensure. I can still taste it if I think about it hard enough or if my mom happens to try to freak me out by bringing me one at the store. It is that bad. I was given a choice of vanilla or chocolate, then she emptied an entire one into a foam cup. I was immediately nauseas at the smell but she forced me to take a sip. I couldn’t stand it. I’m not sure it was entirely it being disgusting, because the thought of all the calories in those little bottles made my head spin too. I think I made it to two sips and then declared I couldn’t do it. She actually let me off pretty easily that day, as everyone had been. I had all of the terms of refusing explained to me and that if I were inpatient or got put inpatient 3 refusals meant a feeding tube. I really didn’t listen that much and just wanted to go back in the PHP room with everyone else.

First adult PHP groups. I think I missed 75% of the first one and about half of the second, so I didn’t learn much from these that day. I also was just so confused and scared and everything that I couldn’t focus anyways. To be honest I don’t remember or acknowledge 90% or more of our adult groups anyways, most just weren’t that applicable or meaningful.
First accidental-on-purpose skipping of afternoon snack. Being in PHP we are “privileged” to have more freedoms like going outside during breaks, no bathroom monitoring while in the outpatient unit, not being forced to attend all groups, and no afternoon snack monitoring. I was informed about snack a little late because I got pulled out for something, and right after that I met with Hannah so my snack ended up in the garbage. Not going to lie, I threw out at least half my snack each afternoon.

First meeting with Hannah. I really, really liked Hannah from the start. She is the first therapist who truly helped with the ED and a huge help during my treatment. Most of our first session was answering the same 50 questions I already was asked ten times that day but we did get into real talk towards the end. She made me feel a little better about being there and gave me hope that I could get something out of it.

Overall, my first day was a whirlwind. I came home that night exhausted and scared for what the next few week would bring.


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