Month: April 2018

I am not a great friend.

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No, this is not a self-depreciating post. Instead, I am objectively focusing on the facts and reasons why I could be a much better friend.

When I think of the qualities I would like in a friend, I go to past or current relationships and what made them meaningful. One of the most important aspects of friendship to me is that we are there for each other: to listen, give advice, motivate, and sometimes provide tough love. I don’t want to feel like I’m always taking, nor do I enjoy feeling like all is being dumped on me. There’s a balance that allows for a healthier friendship where each person is cared for. Another quality I value is honesty and authenticity. I want to feel safe to open up and be accepted for who I am. Spending quality time together is also important, even if that just means Skype calls every once in a while. This is the part of friendship that makes me feel connected and happy. It’s truly a blessing to get together with others. Consistency is an aspects that I’ve had trouble with in the past. I remember my mom describing someone in elementary school as a “fair weather friend,” someone who is there when it’s convenient for her or when no one else is around. This only leads to me feeling alone, which is pretty shitty when you expect to be close to a friend. Respect matters in any relationship. There are various areas where this comes into play, from viewpoints to lifestyle. I want to note that I absolutely do not expect anyone ever to meet all of these qualities. They aren’t full on requirements truly. I have never found someone perfect which is 10000% okay. There is no need to be perfect for someone to be an amazing friend.

Now that I’ve explained some of what I look for, it’s time to talk about how I often fail to meet these areas. Specifically, I am the worst friend when I am deep into the eating disorder, like where I am currently. I am unable to invest in the other person when I’m struggling so much. If I do end up sharing, I feel like a burden because of the sheer amount of stuff I have to unpack. I am rarely honest or real about what I’m going through. There are some people who know, but others I stay away from it entirely. This makes things more surface level and impersonal. I get that not every person is going to be right to share with, but I think as a whole I need to work on vulnerability more. I isolate all the time. I haven’t even spent an afternoon in the library or anything like that. I start feeling pretty low about myself and also avoid any situation with a .2% chance of food being involved. I have little consistency. I can go weeks or longer without so much as a hello text. Usually I don’t initiate contact, which I’m sure is frustrating on the other side. One area I don’t lack in regardless is respect. It has a lot of value whether I’m in a bad place or not.

I don’t want to use the ED as a scapegoat. No matter how much I’m struggling, it isn’t the sole cause of any negative consequences. The thing that actually affects my ability to be a good friend is my mental state. If I am withdrawn, depressed, anxious, and full of guilt/shame, how could I give to someone else?  Just like when I am physically sick, mental and emotional exhaustion takes a toll on my relationships. Some of this is specific to the ED, like avoiding social gatherings, but the rest just isn’t.

I don’t want to consider myself a bad person because of the situation I’ve been in. I know this isn’t the real me. My values are completely the opposite of how I’m acting. If I can work through these things and be healthier, I will give more into my friendships. It happened when I was further into recovery before and I believe I’ll get there again.

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“That person”

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Before I start this post, I wanted to give a little clarification (that will make more sense as you read). I in no way, at all, feel that those who are “that person” struggling are bad people, weak, or anything else negative. I have compassion and empathy for them, and I get how hard it can be. When I’m talking about how I feel being “that person” is a negative thing, this is solely my perception of MYSELF. I’ll explain that more, but I just want to clarify how these thoughts/feelings/judgments I’ll be sharing don’t apply to others. It’s a very personal fear.

“Emily, it’s time to get your Ensure”

“All of my clients are kicking butt, but it doesn’t sound like you have been”

“I’m doing pretty well.” “Me too!” “How about you Emily?”

“Are you sure you wouldn’t like to eat with the group and have more support?”

These are some of many blurbs I wish I never had to hear.

I have had 7 supplements in the past 4 weeks at IOP. Four of those have been in group because I couldn’t manage an entire lunch plus supplement at one time. I hate it.

Sometimes I wish things were like when I was in PHP the first time around. For whatever reason, I felt very comfortable in my struggle then. I wasn’t concerned with being this perfect person. I allowed others to see my struggle. I didn’t finish meals because I couldn’t always handle that at this point. I didn’t for nearly two weeks of lunches. Despite all of this, I never felt embarrassed or wrong because of it. There were others doing way better than me, some around the same, and a few having a really hard time. I didn’t pay attention to that, though. The only way I judged my progress (somewhat) was when it came time to meet with the psychiatrist, and that’s only because he held my fate. If I didn’t improve I would be forced inpatient. Luckily, I kept making progress and that never came up again. I felt proud of myself at the end and that was it.

I don’t know if I was naive or truly didn’t care or something else, but the next time I found myself in treatment yielded different results. I was inpatient the last week of summer before I moved in to Calvin. I knew I had basically zero time and I wanted to make the best of it, since I figured a week IP would be a cure-all. I decided I absolutely was not allowed to refuse any Ensure, which quickly became never be offered one. My reasoning for this was valid: there was a serious threat to my schooling if the doctor felt I wasn’t making progress. It was a mix between the motivation for school and drive to just get out of there that helped me that week. I don’t think I fully realized what changes my decisions then made.

Fast forward to residential round 1, November 2015. I went in with a completely different attitude. I (falsely, oh so falsely) believed that being “good” was going to get me moved up levels/further into my recovery. It was then that I decided I would never do anything that could come with a consequence: not finish a meal, get caught using a behavior, failing to complete a snack pass, etc. Again, some of this came from a valid and reasonable place. I did want recovery and I was putting in the hard work. I even earned the nickname “Challenge Queen.” My drive for perfection mostly helped my recovery to a point, and I never did get offered a supplement or forced to do a chain analysis.

A year went by and then I began coming to groups then IOP at my current treatment center. I’m not sure why, but this only increased the shame when I showed I was struggling in any capacity. There were countless meals/snacks where I was having a really hard time but looked fine to everyone. Everyone assumed I was doing okay because I never said otherwise. One time that stands out is when we had a random food challenge. It wasn’t a snack or anything, but we were each given a bowl with peanut butter, a couple of apple slices, and some pieces of chocolate. I was terrified. I hadn’t eaten peanut butter in a long time. Instead of reaching out for support, I choked it down. I finished a little before everyone else. One person was particularly outwardly struggling. I remember her saying something like “I’m the only one having a hard time.” This was far from the truth, but I couldn’t own up to that.

This summer I tried to let go. I challenged myself to be more open about how I’m really doing. I knew that my recovery depends on it. No one will know what’s going on unless I tell them. It took a lot of work and vulnerability, but I slowly began to speak up. Much of the time this was with staff and not the other girls, but that’s still a huge step for me. By the end of the summer I was no longer afraid to be “that person,” and I truly wasn’t. I found strength in recovery. I didn’t struggle like before, so I had no reason to be dishonest. I felt safe to share. I am truly proud of myself for how much I faced my fears of being imperfect.

I have been terrified of being “that person” again for a few months now. I think it stems from how much I’ve slipped backwards when I *should* be far into recovery. I don’t want to show that I’m struggling. I avoid the topic if at all possible and I’ve flat-out lied to so many people. I find it hard to share the truth in a group setting (although I can with my treatment team). Often times what I’ll talk about in group one hour after therapy is a completely watered-down version of the truth. That way, I don’t bring attention to myself. I can pretend and fit in with how others are doing.

Drinking my supplement in art the past 4 weeks has cracked open my facade. No one is given these just because. It’s an obvious clue that someone isn’t doing the best in recovery. I’m embarrassed, ashamed, disgusted with myself. I’ve wanted to cry every single time, but that would draw attention to me, too. So I sit there and pretend that it’s all fine, hoping no one else will notice.

I have been terrified of what consequences would come if I dare spoke my truth. Wouldn’t that just expose my brokenness and lead to judgments? While some EDs desire to be the sickest in the room, I am the exact opposite. I would rather no one know anything and keep the disordered parts all to myself. I hold in a lot of guilt and shame this way.

In order to put off this image of doing well, I am ignoring some of my core values: namely honesty, connection, and authenticity. Without exposing some of my truth, I am choosing to hide behind my fears of being “that person.” This is only harming me. I don’t need to share every intimate detail of how I’m doing, but I think it would help to at least  open up a tiny bit.

First, I need to let go of my belief that perfection is necessary in recovery. I don’t need to have it all together. Why else would I come to these groups? I’m not there for ~6-8 hours a week for fun, but to grow and get help. I can only receive as much as I decide to.

If I don’t judge others when they’re experiencing what I am so afraid of, why am I holding myself to these standards? Why am I so convinced that the truth is going to prove I’m a terrible person? It’s time for me to challenge this. I can leave space to struggle. It’s okay to be “that person” sometimes.

Dealing with disappointment in clinical

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Monday, I got to observe a cesarean section. I saw a tiny little peanut enter this world. It was messy and involved more fluids/tugging than I would have thought, but the second baby girl was out none of the “yuck” mattered. The tone of the room shifted as the nurses and doctors talked about how long her toes were, her perfect lips, and her curly hair. It was amazing that there was suddenly this new human being, the one her parents had dreamed about for months. The miracle of birth and experiencing so many new things should have been more than enough energy and excitement to get me through the day. The nurse I was assigned to actually gave me the tasks of 15 min vitals checks, the hourly assessment, and generally helping out in any way possible. My confidence grew because she could trust me and I was competent. That stopped once another nurse told my professor the patient was no longer wanting a student (aka me) to be a part of her care.

I wanted to cry. I didn’t consider any of the million reasons she could have made that decision. Instead, I decided that it was ME. I did something wrong, so wrong that she didn’t even tell me herself that she wanted to be left alone. I was a failure of a nurse. I am not competent. I annoyed her and said the wrong things. I didn’t make her feel comfortable. I was too peppy or shy or awkward. I was so focused on this belief that I had no room to consider other options, even when evidence arose.

I can separate this out better now, so I want to do that. I don’t need to believe these automatic negative thoughts just because they exist and seem true in the moment.

Evidence against these beliefs: my nurse continued to teach me and involved me in med preparation, my professor telling me that I had done a great job today, doing super well on charting and everything, positive responses from patients in the past.

One thing that really helped snap me out of it was a conversation with my mom. I called her, like almost every day, to let her know how things went. I told her about the incident and how down I felt about it. She immediately fought back with other reasons that the mom would request me to leave: emotional, sick of being at the hospital, tired, cranky, had visitors, didn’t want to be touched any more than necessary, wanted to avoid the questionnaire I mentioned. Those few minutes we spent talking about it helped me to realize that there wasn’t just one logical explanation. I’ll never know for sure why she made the decision, but I have to accept that I’m not some terrible person no matter what her reasoning was.

I have to remind myself that I am a student and I will make mistakes, tons of em. That’s why I’m a student. I am learning, not just the book stuff. I have to apply that to real people and situations, which is way different. I’ll have good days and bad, but I have already learned from when things haven’t gone well in the past. I am going to be a nurse one day and I won’t get there without stumbling because it’s part of the process.

I don’t want that small part of my day to linger and ruin the experience I had. Spending time in guilt and shame that I don’t deserve only brings more self-defeating behaviors. I have to move on and keep going.

Delayed graduation shame

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I tend to push away anything that’s uncomfortable and makes me think about the hard things. I’ll completely “forget” about it, only for whatever emotions to bubble up due to some trigger. Today, that happened in regards to schooling. I wanted to share my processing of this and what I’ve come to.

I graduated in 2014. In the perfect world, you spend exactly four years in undergrad and come out with your degree and all is well. With how competitive my high school can be, this plan usually includes amazing opportunities, scholarships, honors societies, and varsity athletics. Just like high school, it isn’t enough to simply graduate. If you would have asked me sophomore or even my 6th grade year, my plan would be exactly like everyone else’s. The expectation in our school was to go above and beyond if you wanted to prove yourself as one of the “smart ones.” By junior year I had a new, more prestigious and impressive plan. I was part of early college which meant taking half college and half high school classes junior/senior year, then doing one more year at community college to get my associates degree a whole year early. I clung to that idea and goal, right up until it wasn’t possible anymore.

Switching to nursing was absolutely the best decision I have EVER made in regards to academics, but this meant having to accept that I was no longer above and beyond. It meant having to do lots of prerequisites and instead getting my degree on time. I learned to be okay with this, considering I was on track still.

I am no longer on track to graduate with my class. I haven’t been for over 2 years now. I’ve been shoving those feelings of disappointment, shame, frustration, and inadequacy down ever since then. I’m able to forget about it most days. Today was not one of those. I logged into Facebook (which is an absolutely terrible place if you want to feel proud of your own accomplishments and not play the comparison game). A friend from high school posted a status update about his events today, including the last meeting with his advisor and trying on cap and gown. It brought up everything all over again.

I immediately went to all of the reasons I’m not enough. How could I be smart if I did really poorly in classes, couldn’t even handle my first college semester away, and am not in the honors program? The only conclusions coming from this line of thought put all of my worth in school, and since I “failed” there, I must be a complete failure of a person. I sat here for a while. I wallowed. I cried. I felt super shitty about it all. Then, I really started thinking.

Besides my eating disorder in itself as a barrier to my education, quitting halfway through my first fall semester is the reason why I had to take an extra year. I could do a few things with this information, but today I chose to explore why things are how they are from a lens of understanding and compassion.

I can’t deny the facts that I dropped a semester or had a terribly low GPA last spring. I can pretend all I want that I was this perfect student who never missed class, gave 110% in all work, turned in everything, and didn’t even need to study. I could sit there and lie to everyone about how amazing school has gone, but I don’t want to now.

I hate the idea of ever using my eating disorder as some crutch or excuse for my behaviors, but it truly did/does impact my schooling. Not a single moment of the past 3 years have been easy from an academic standpoint. Instead of the normal college experience, I got constant ED thoughts and behaviors that took over my life. I look back at this time and wonder how I even got through it.

The fact that I’ve gotten this far isn’t a miracle, but a culmination of a lot of hard work. I overcame every battle to get to where I am today. This isn’t the route I would have chosen, not even close. No one wants to actively seek out the most difficult path, but it’s what I was given.

I choose to stop the comparison game and look towards my future. In 5 or 10 or 20 years, no one is going to care what my college GPA was or how many years it took me to finish.  What truly will matter is what kind of nurse I have become, who I am as a person, how I treat others. School is important and will allow me to pursue my dreams, but it’s only a stepping stone. In 5 or 10 or 20 years, I don’t want to be able to brag about what I did in college. Instead, I will speak about the roller coaster of a journey it took to get there.

TFHR – 4/10/18

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Thoughts

  • I can’t believe how fast time is going by right now. It feels like just yesterday I was starting out in my peds clinical, but now I’ve finished 2 weeks of OB! Before I know it, the semester will be over and then it’s senior year. Receiving an email on registration addressed to seniors was surreal. It won’t be long before I graduate and finally work as an RN.
  • I’ve been thinking a ton about all of these big questions: who am I, really? Why am I working towards recovery? Am I meant to be here forever? What do I need in order to move forward? I hope to do some posts soon on this. It’s been helpful to talk about this in therapy some. I need to tap into what I truly want. I don’t think I can continue as I am forever.
  • It’s still so crazy that I’m actually working with patients and doing nursy things. I’ll go from feeling like I have no clue what I’m doing in lab to doing all of the things (with conficdence, after time!?!) pretty well. Every single interaction has proved more and more that nursing is for me. I was the girl who would barely speak to anyone unless I knew them and now I am able to approach people I’ve just met and complete assessments on them. I love it and I love how I’m growing as a person.
  • OB is so far not as awkward/terrible as I thought, thank God. I was prepared for yesterday’s clinical to be painful, but it wasn’t even close to that. I loved my mom and she didn’t at all mind the invasive questions/assessment. Also, we don’t need to go as detailed as I thought, which is a huge plus. Hopefully, the rest of my experience will be like this, too.

Feelings

  • Stressed. Honestly this should just be a given for anytime I’m in school and probably outside of that too. I’ve accepted the things I cannot change there and I’m trying my best to cope in a semi-healthier way. The main source currently is this new change in schedule. I HATE change and this involves way too much in my mind, even if plenty of this change is bringing great things.
  • Grateful. So far, the nurses in this new hospital/unit are amazing. They’re way more willing to give me learning experience, help to guide me if I look lost, let me observe procedures, etc. I can tell that I’ll gain a ton from them.
  • Frustrated. It seems like every single appointment lately has been a struggle start to finish. I feel like I’m getting nowhere. I hate this. I’m not the most willing to make steps toward recovery, but it’s still hard. I know my team means well, they just clash with the ED voice which is strong right now. Also, needing to supplement/be on a weight again protocol is just gross. I’m not a happy camper wither, and that makes everything worse. Blech. Hopefully things will get better soon.
  • Guilt. This just comes with the hellish time that is recovering from an eating disorder, specifically the food part. The ED screams all day to eat as little as possible and only safe foods, then gets even louder when that doesn’t happen. Some days I’m able to fight back, but most lately haven’t gone well. That actually adds to the guilt so it’s this big ball of fun. I’ve had some shame too, but at this point not quite as present.
  • Proud. I’m clearly not in a good place. That’s not even debatable; however, I am still doing some very hard things every day. I could have given up by now. I’ve wanted to many times. Still, I press on. I finish my meals, drink the ensure, talk about everything in therapy, sit through difficult appointments, face the uncomfortable, keep up on schoolwork, take care of myself the best I can. I haven’t been doing better in recovery, but for the most part I’m stable. That’s a cause for celebration right now.
  • Worried. I sometimes get some feelings of worry and concern over how things are right now. I know it isn’t great and I don’t think I can stay where I’m at. Some things scare me. Maybe if I used that to propel me into recovery I would be more successful?

Happenings

  • Veronica Mars <3. Over about 2 weeks I rewatched all 3 seasons and the movie with my mom. I absolutely love this show and it’s the best to watch again and again.
  • Sleeping in my hammock. Last year when I was looking up how hammocks can be beneficial with sleeping, I was intrigued. I already loved relaxing in it, so why not try to sleep all night? I used my single as a bed for nearly all of last spring, then stopped. I began sleeping in my double hammock just before break and it’s wonderful. It seems to support my joints well which helps with pain. I hope to continue this once school’s over too.
  • Yoga recovery book club group. I was really anxious about joining this group. It’s run by my old dietitian (talk about coming full circle). We’re reading through a book and most importantly talking about how the concepts relate to our lives and recovery. The insight and support I’ve gotten are invaluable. R still knows me so well and can challenge me/see through the bullshit (which is also hard, but necessary). Another nice thing is that I have this group and support group rotating each week so that I always have a recovery-focused activity every Monday evening.
  • IOP. This one pains me/is embarrassing/annoying/etc. I wish that I didn’t need to be there so much, but I know I need it. I’m just not in a place where i can step down more right now. I’m trying to just make the most out of it even though things are really hard in the treatment front.
  • Day in GR with my mom. Over spring break, my mom and I got to hangout in GR for the day, which never happens. I’m always home on the weekends and she doesn’t like to make the drive, so it was a special occasion. We went to the butterfly exhibit at Frederik Meijer Gardens, World Market, and lunch. The butterflies are amazing and the rest of it was pretty good too.
  • My brother, his girlfriend, and I went to see The Greatest Showman and I actually loved it! I’m not huge into musicals but it’s really well done. I went with my mom this weekend too! I would definitely recommend (especially in theater), but don’t look up the real story because it kinda ruins the magic a bit.
  • Met a reader! This is was so cool to me because the only ones I know that read my blog are friends irl. I can’t believe that there are others in the US and around the world that see my posts. p.s. Mindy, it was nice to meet you! 🙂
  • All the breaks. I had 8 days of school in March, and two of those were just exams! Between spring break and Easter break, this is the first full week of school since mid-March. It’s weird to be back but also nice because schedules make me happy.

Ramblings

  • Winter needs to be done now. I know that I live in Michigan and I should expect this blah, blah, blah. It’s April now and it snowed 2 days in a row. That is NOT OKAY. The whole in like a lion, out like a lamb thing for March was wrong too. We had nasty sleet and wind on the last day of March. It feels like there’s no end in sight to this nastiness but there’s hope? I mean the cold has to end at some point? /endrant
  • This isn’t where I wanted to be right now. I shouldn’t need to spend ~8 hours a week in treatment on top of school and clinicals. I should just eat like a normal person. I should be so much further in my recovery journey. I wish, sometimes, that it was all just a walk in the park. I’m beyond tired of all the energy this is taking. I can’t imagine what life would be like if I put effort into recovery and not the ED, or even didn’t need to put so much energy into recovery because I was doing so well. For now, I just have to keep dealing with this. It doesn’t have to be this way forever, though.
  • I find it so hilarious that I’m the speeder in our family now. I’ve been informed I “drive like a true GR person,” apparently. I basically just go 80ish on the freeway for nearly the entire drive between home and school, plus on the way to the hospital. There are rarely cops and it’s kinda the speed of traffic at times, so I don’t see a problem there. 😉

That’s a wrap!

OB clinical eve!

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This is my 4th first day of clinical experience. Every time has brought this crazy anticipatory/excited/terrified feeling that’s somewhere between the night before Christmas and a root canal. Currently leaning a tad more towards the latter, aha. This has a ton to do with the fact that I’m dealing with postpartum women because A) adults after only having kids for 2 months and B) the awkwardness of areas that need assessing.

I truly am freaking out about a lot of the assessment stuff. The acronym BUBBLEHEP is intimidating as anything and includes all of the areas we need to look at with moms. I have this terrible vision of everything being incredibly awkward when I have to ask her invasive questions or perform exams. I’m afraid that I’ll screw up, break down, and cry.

Excitement, on the other hand, is very palpable as well. I can just imagine how squishy and sweet the babies will be. I love babies and specifically newborns so much. I get to be a part of some of the happiest times for moms/families. I’ll be able to teach on a variety of skills and information that can be invaluable to a new mom. Starting now, I will see if OB nursing is something I could find a passion for.

Tomorrow (and the 4 weeks following) is going to challenge me. I want to push through to learn as much as possible. I need to use my voice and ask the hard questions. My professor will be there to support and guide me. I have the nurses too. One regret I had from peds is how little I interacted with my patients some weeks. I don’t want that mistake again now. I have to savor each patient interaction (especially when that includes my littlest patients).

I feel so honored that I am getting a look at new life: the sweet hours or days old babies and their incredibly strong mamas who brought them into this world. I’m not just there to complete my assessments and move on. I can be an educator and help mom learn how to care for herself and her baby. I can give her support if she’s overwhelmed and help in any way possible. I can make sure baby and mom are both doing well throughout the entire day. I will devote my day to one mom and her baby and make sure they both get the best care possible.

I have so much more to say and I’ll try to edit it in later, but for now I’m leaving it here. If I fall asleep in 10 seconds immediately have around 4.5 hours of sleep. Time is most definitely ticking.

Ed’s coming back to bite me

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I got an email yesterday that immediately made my heart sink. I have a significant academic scholarship (those years of slaving away in HS paid off, ha) and it’s renewed each year. The past 2 have been no problem at all. My GPA was wonderful, until last spring. It was the hardest semester of my entire life and an extremely low point. I was deep into the eating disorder and depression wasn’t well medicated either. I missed classes, had no motivation, worked my body too hard, never slept, ate very little, missed assignments and papers, etc. To be quite honest, the fact that I got through the semester and my team didn’t end it early is amazing. It was truly miserable. One of the only reasons I could stay in school was the contingency of a higher level of care afterwards. I left for residential before our final grades were even posted. In the first week or so there I was able to find out what my GPA was: not good but .1 above what’s needed to stay in nursing. I thanked God, rejoiced, and tried to forget how terrible I did. I mostly was able to accomplish that, until today.

I can no longer hide from the failures that happened last spring. It doesn’t matter that this past fall was a huge improvement and return to my normal GPA range. I still failed to make the quota, by just .05 this time. Small difference or not, it isn’t enough.q

I can’t change that spring semester, as much as I want to. There is still a chance to get my scholarship back, though. This is through an appeal process for “extenuating circumstances. ” I will need to explain the situation and provide documentation (whatever that means) I’m terrified that nothing will change their minds, but I emailed anyways to find out specifics. I know that R and Dr. C will be in my corner. I just hope that my eating disorder doesn’t take this from me too.

In this limbo period, I’m going to try to take care of myself. If I don’t do that, this semester could he a repeat of 2017 and even more would be at risk. Nursing is so important to me. I can see myself as a nurse in just a year and a half. The whole struggle has been worth it. I just don’t want my eating disorder to cost anymore than it already has.

I haven’t cried yet about this. Maybe I’m still in shock. It’s honestly hard to believe it’s real at this point… It feels like one minute I was a straight A high school student and the next barely scraping by. I’m going to try my best to be kind to myself and allow tears to come.

Now is the time to fight for myself. I can use my voice and be vulnerable here. In the meantime, I’ll try not to completely freak out (easier said than done). Worrying and overthinking won’t help. I have to put more effort into recovery because a repeat of last spring would only end up with me in treatment. I can’t have that happen ever again, so I’m going to fight: for my scholarship, schooling, overall wellbeing, and recovery.

I have to do hard things

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I haven’t been doing so hot. I’m trying to accept that this is relapse and not just a slip backwards. If it was just a small slip, I probably would have crawled back out of it by now.

Things have become more crucial at this point. My team has been more concerned lately, and last week I got some news that I’m not thrilled about. My eating disorder has always included solely restriction and exercise, so my weight trends can be predictor of how I’m doing, to a point. It has been trending down for a while now, and I am now out of the range my team sees as good for my body. I only just found this out last week.

Thursday was rough. I had my phone session with K, lunch and therapy with R, and IOP stuff the rest of the day. I wasn’t fully expecting the news they both shared: I am on a weight gain protocol, starting today. In our treatment facility, this means that if I have lost weight or maintained below the cutoff I will be given an ensure on top of my meal plan. I’ve voiced my opinions of Ensure before, but I’m definitely more upset about the principle of being forced to have them (if needed) and not the disgusting taste.

I know what to expect today. My eating wasn’t great over the weekend. I don’t believe I necessarily lost, but I also am 99% sure I didn’t gain. Ed thoughts are strong. All I can think about is having to supplement. I imagine how I could be defiant and just refuse, but I know that can only lead to a higher level of care or being kicked out of IOP/outpatient.

I don’t have any options other than fight. I have to do the hardest thing and drink the damn Ensure. More than that, I need to find motivation to put serious effort into my recovery. Slipping more jeopardizes all of my dreams. It’s time for Emily to become stronger than Ed again.

Dear medical assistant,

reviving emily10 Comments

Thank you for being friendly. That’s really the only compliment I have for you after our brief encounter last week.

I know that I shouldn’t have looked at my weight. As we walked back to the room it was all I could think about. I prayed that you would ask me to list my meds or symptoms or something, anything to distract me. Instead, you asked what my weight was because you had forgotten. I told you, and you immediately said you didn’t believe me. Instead of trusting that I really did pay attention, you walked out to recheck the scale.

You came back and told me what I weighed before (almost 2 years ago now) and the huge difference between then and now. At that point I truly wanted to cry. I didn’t need to be reminded of any of those numbers. I am controlled by numbers like those every single day.

I wish that was the end of the story, but unfortunately, it’s not. I breathed a little sigh of relief as you left, because those were a difficult 10 minutes. I pulled out my phone to distract when I heard you talking in the hallway. Loudly. About my weight. You named the two numbers and mentioned the difference between them. I don’t know who you were sharing this with or why, I just know it wasn’t my doctor.

I’ll admit, part of this problem could have been prevented by me. If I had done the right thing (recovery-wise), the first half could have been avoided. I would instead choose to turn around on the scale and ask to not be told the number because I have a history of an eating disorder. Because that didn’t happen, there was no caution around speaking the weight out loud.

The rest of this is on you, though. I don’t understand how you felt your comments would be helpful. Yes, my weight has changed. Yes, my doctor should know that (btw she did not mention it AT ALL). Did you really need to have that discussion with me? I don’t think so.

What really bothered me about our interaction is that it was just a one-sided conversation. There was no asking about anything that has changed between this visit and last, whether I was aware of the weight shift, etc. It didn’t seem like you wanted to know why my weight was so different. I, like many people with eating disorders, wasn’t about to give that information up unless you actually looked in my chart and asked specifically.

I’m not going to blame you for our private conversation. Yes, things could be better, but I’m used to this by now. Having an eating disorder means that weight will always be one of my least favorite parts of any appointment. I am always terrified of the comments that may come. I’ve had many people handle things worse than you did, and some better. I expect it at this point. It didn’t shake me horribly, but what came after did.

It makes me extremely uncomfortable knowing that any of the doctors or nurses (even patients!) out in the hallway could have heard your comments about my weight. The fact that they may not know my personal information doesn’t make this feel any better.

You shared something highly personal even if it didn’t include identifying information. My weight is not taken so you can provide your opinion about it and share that with the world. It doesn’t matter what the difference is, higher or lower, because making a huge deal about it isn’t okay.

I hope that you will realize that you are projecting your voice significantly when you talk. Maybe you simply don’t notice it, which is understandable. It’s hard to judge how loudly you’re speaking sometimes, I suppose. (That still doesn’t excuse talking about my weight out there in the first place, but moving on…)

I hope that you will aim to approach the topic of weight with some more caution. It’s okay to ask some questions when they are helpful medically. It isn’t bad for every patient to be told their weight (but respecting those who aren’t interested is important too). These type of measurements can be important to overall assessments at times but don’t need to be the focus of your responsibilities.

I hope that you will choose to keep your comments about a patient between you and their care providers. If there was one thing I want to teach you from this, it would be to stop and think. If you are announcing something about a patient, who is the audience? This includes anyone within earshot because they can tune in as well. Who is meant to be the audience? Who needs to know this information? How can you keep the information as confidential as possible? These things are truly HIPAA 1.0. It can be pretty annoying to go through all the training, but these regulations are essential when it comes to patient safety and trust. I honestly do not trust you now, and even finding comfort in the practice is tough. I am now terrified that this could happen again or that another office I go to will do the same thing.

Making a huge deal out of my weight, talking extensively about the changes, using a judgmental tone, and the excessive sharing of it made a simple trip to the doctor a very uncomfortable experience. I hope that if I ever return to this practice you don’t check me in. If it does happen, however, I’ll know what to expect and advocate for myself better than I did this time.