*I will do my best, as always, to keep anything I believe is triggering out of this post; however, I want to put a warning for the general behaviors and thought patterns that will be mentioned. There are no numbers or specifics ahead*

So.. I don’t want to be writing this post, but then again does anyone? Is it everyone’s dream to slip back into something that’s nearly taken everything from them multiple times?

I don’t see this as so bad.. but I have been in denial before. The signs are there, but I haven’t been able to admit it yet. Instead I’ll write about it here.

• The number of exchanges I’ve had is making K and R concerned. It’s below a percentage of my CFD mealplan that’s just not okay with them.
• It’s scarier to eat the amount of food I normally do and the maximum has been lowered. This goes along with the above.
• Other than when I’m at home (and even then, truly) I eat the same things over and over. I actually at the same protein for 4 meals in a row this weekend/yesterday… so that’s a pretty good explanation of where I’m at.
• The possibility of a higher level of care has been mentioned more than once. I hate that. Bring on the guilt/shame…
• I am hungry. I know this sounds weird to determine how well I’m doing, but I haven’t had hunger unless I’ve restricted since this summer.
• Going along with the hunger, I feel full much faster than before. This has to do with the amount of food my body is used to which is much smaller than before.
• Some physical symptoms have returned or worsened: feeling cold, hair falling out, dry skin, dizziness, headaches, weakness. I also have a hard time with concentration and thinking in general.
• I’ve always loved yoga, BUT it may be getting out of hand at this point. The intensity has increased as well as the amount. My team isn’t happy about it and I see Dr. C this week so I’ll know of any changes then.
• My weight is down. This is not an indication for everyone. For me, it is. Once my weight gets to a certain range, I end up in treatment. Note: this weight range is well above underweight, just proof that you don’t need to be a low BMI to be sick enough for a higher level of care. If it continues I know somehow I won’t make it outpatient. Still, I have a certain “healthy” goal for myself, so I’m stuck and Ed is enjoying this decline.
• Many (most?) of my waking hours are controlled by ED thoughts. They’re in the background always. R once told me you can have close to 12 hours of disordered thoughts per day and I would say I’m getting there.
• Rigidity is getting worse. I have to do things exactly the same to feel in control. This extends to everything from specific exchanges per day to amount of exercise.
• The last time I ate out was on Thanksgiving and I felt like I was going to die just by going there. I was intent on skipping church 2 weeks ago because my parents wanted to do lunch out. I faked sick until they finally decided against going.
• Once again, I am staying in my room more and more, I haven’t even gone to the library to study or something just to be somewhere else. I also have skipped all floor dinners and eat alone too. I was already pretty isolated before but it just gets worse when I’m more into the ED.
• Rationalizing is my current superpower. It’s okay I skipped X because it’s close to X meal. This was just one bad day. A little weight loss is fine. I can find an excuse for anything and everything.
• Spending time at home brings lying, manipulation, and lots of sneaking around. I don’t want my parents to know what’s going on. The idea of having to eat more there is terrifying, so instead I find ways around that.

I don’t know exactly what to do right now, but something does need to change. My future is on the line now. It isn’t like Fall 2015 where I could take off a semester for treatment. I’ve not yet come to terms with all of this. What I do know (and don’t want to admit) is that this is relapse. It isn’t just “not doing well” or “struggling some.” It’s time for me to get back to a stable point where I can start spring semester in the best health possible.

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I’ve had 2 very hard days of treatment. Thursday was a little bit of a wake up call. R had some no BS words for me. On my red, yellow, green, and in between scale, she believes I am now firmly planted in the red. This means full relapse. I do have one category after red, which is when treatment becomes necessary and nonnegotiable. She also said I cannot stay here, especially with the real semester starting so soon. After this we talked about what my options are currently. I ended up deciding to step up groups on the two days each week I am already there. I don’t fully want this or believe I fully need it, but I’m agreeing because waiting will only make things worse. Spring semester is coming fast. I have to be stable. The only real goal she gave was to increase by 1 exchange until Monday and then add another exchange. That didn’t really happen..

Yesterday was rough. I knew it would be going in. I had no doubt that there would be difficult conversations and possible ultimatums. I wanted to tell myself this wouldn’t happen, though. I wanted to prove to my team that I didn’t need the extra support. That didn’t work one bit.

First, I met with R for lunch and therapy. I barely had the right amount of exchanges for the meal and had to many Ed thoughts to finish. In IOP I would have been given a supplement. Here, she couldn’t force me but reminded me of that fact anyways. She was concerned with my exercise. Her emphasis on weight is that it’s not the only thing they are considering. I know this logically, I just don’t believe it. Unfortunately, she will also be contacting Dr. C so she’s in the loop about my treatment plan and struggles. The message she tried to instill in me was needing to trust my treatment team. I absolutely agree here, especially with K. Why would I ever listen to someone if all I see if them lying? I’ve got to work through these Ed thoughts that tell me otherwise.

K and I met right after. I really liked a metaphor she used. If you imagine a raft in a river, it will continue floating down the river unless you do something about it. You can paddle slowly and stay in place, or work really hard to swim up the river. Recovery is like that. Without the hard work, you aren’t going to make it. She was not happy with my weight or the way that I keep rationalizing/arguing that it’s okay. I was pretty surprised to hear that, in her opinion, if I drop much more I could be put inpatient (or residential). My immediate reaction was huge disbelief. I still don’t get that at all, especially if it were inpatient. Like I’ve heard (and hated) before, my healthy weight for my body probably doesn’t fall here. It’s a bad sign if the only way I can maintain it is by doing what I am now. Another interesting point she made about weight is that she would never want me to continue gaining. Sometimes that’s all I have believed about dietitian’s goals for me. I need to bring up my exchanges, and even though it isn’t much I feel hopeless/fearful/disgusted about the increase. Like I’ve heard a lot lately, she ended with reminding me that I cannot survive here, at least not for long.

After both appointments I joined back into the group one of my favorite activity therapists I have ever met was running.  I’ll call her K-AT here to distinguish between her and my dietitian. She’s known me for even longer than R, ever since my first FV days. The other two girls left the room for about five minutes, and she took that opportunity to have a little heart-to-heart. The first thing she did was ask me what I am doing here. I knew exactly what she meant. Honestly, I don’t really know. It seems like It’s been getting worse for a long time but also all at once. She fully believes in me and said that I can turn this around, I have it within me, and I need to remember that I am going to be a nurse. She reminded me that I am a child of God and so loved, needed, a masterpiece, and fearfully and wonderfully made.Another thing I really appreciated was that she challenged my thoughts about treatment being a waste if I just ended back here again. Despite all of the encouragement, I felt like she was almost disappointed. It was a look that I saw before, right when I decided to go to residential. I don’t think she truly is judging me or anything. My guess is that’s just her concern shining through. Our conversation started the tears. I haven’t cried in therapy since summer when my grandpa died. It feels raw and vulnerable and a little scary. I’m very thankful I was able to spend that little chunk of time with her. I know that she will also be the best person for me to have lunch with Thursday.

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My new plan:

• Monday and Thursdays will be my treatment days
• This Thursday I have lunch with K-AT, a group where a girl I was in IOP this summer is coming to talk about her strength in recovery, therapy with R, then group therapy and art.
• Monday is lunch with K, therapy with R, then joining in for all groups of the day. I told her yesterday to make me supplement if I don’t finish, since that would happen if I did it in group lunch. That was the brave thing to say and I have a feeling it may happen..
• Next Thursday is my first group lunch (not excited/totally freaked out) and the full day of IOP minus therapy
• Up until the semester starts, I’ll continue with this schedule. After that, I have Thursday’s free. It may be a full treatment day, but nothing has been talked about yet.
• Basically I’m doing IOP two days a week without calling it IOP and being pulled out for therapy/dietitian. This means no switching to the IOP dietitian though hallelujah!!

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If you made it all the way to here you deserve a medal. It feels really good to write that all out and kinda process it here while doing so. I’ll be sure to update on how everything goes and just overall progress too. This feels different than every time before, so I don’t know what all will happen.