OB clinical eve!

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

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

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,

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

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.

Intention assignment

It has been a crazy two weeks. I was pretty busy during spring break (treatment 2 days, recovery book club, trip to the butterfly exhibit/GR, movie, shopping x3). I also ended up with a sinus infection and lung infection of some sort. I got antibiotics called in Wednesday and then actually went to the doctor Friday (more on this soon) and added steroids. Also, Thursday I went to treatment even though I felt like I was half dead… I’m still on the mend from that but I feel a ton better. Now that I’m not so exhausted I’ll definitely be posting again 🙂

Yesterday I was at (basically) IOP. We had experiential group which has always been a favorite of mine. The focus was on intention. We went to the library and each chose our own little area to sit. There was an article to read and then an assignment with 4 questions to think about. I kinda loved it. I was able to get some good insight. I don’t often think of these things. Here are my responses, although I probably will expand on them at some point:

Who am I? I am a human being who has value and purpose in this world. I am a daughter, nursing student, writer, Christian, animal lover, and friend. I struggle greatly with my mental health, but I am not defined by it and I will not allow these struggles to hold me back. I am resilient. I have overcome many hard things. I am stubborn, which can be used in positive and negative ways. I am a dreamer. I have plans for my future. I can imagine a healthy and fulfilling future for myself. I am going to be a nurse. I cannot wait to combine my love of medicine and caring towards others into my career. I strive to help and support others, especially my friends. I try to see the best in others. I am learning more about myself every day and I know this is a lifelong journey. I believe in God and lean on Him because I cannot do this on my own. I am a survivor. I will not let my past hold me back.

What do I want? I want freedom. I am held back by my struggles now. I don’t want this to define my life anymore. I want to explore my passions fully. I want a family one day. I want to be a wife and a mother. I want to be the best nurse possible. I want to be an inspiration to others. I want to rescue animals.

How can I serve? I will be a light others who have similar stories of struggle as I have, and I want to be able to show them that things get better. I will give them support and be someone to lean on. I will be an advocate for mental health and EDs. I will fight to decrease stigma and encourage others to seek out help. I will share my story. I will care for my patients and provide them with the best possible care. I will help to save and foster animals. I will use my voice to fight for causes I believe in. I will be Jesus’ hands and feet. I will strive to show empathy and compassion towards everyone I come across.

What does the universe want from me? What is my purpose/God’s plan? To be authentic and honest, so I can encourage others to do the same. Using my story as a testimony. Fulfilling my vocation of nursing to the best of my ability. Raise my future children to be the best little people possible.

A note: in being authentic, this is exactly how I wrote and isn’t the most grammatically correct/best word choices ever

NEDA Walk Ann Arbor

My mom and I will be attending a NEDA Walk in April. I am beyond excited to participate this year, it’s been on my bucket list for a long while now! I know it will be a fun day and awesome opportunity to get together with others in recovery/raising awareness, but that’s not why I’m walking.

NEDA walks raise money for the National Eating Disorder Association. The funds will support individuals and families affected by eating disorders. Some programs and services offered by NEDA include an online screening tool, support groups, legislation advocacy, research grants, connecting sufferers to treatment options, and funding initiatives to prevent eating disorders.

As you may already know, I am one of the 30 million Americans who will struggle with an eating disorder in their lifetime. I have spent years in this battle. It’s affected every area of my life – friends, family, school, passions, and overall well-being. It’s been a long journey, but thanks to some amazing support and treatment programs, I am still fighting strong. My hope is that I will be able to help others like me in pursuing recovery and spread awareness about eating disorders.

I am walking for myself and everyone else who has struggled or will struggle with an eating disorder. I hope that through the contributions I can make I will be able to impact others.

I hesitated whether to ask for donations here on my blog, but I’ve decided I would, since this is why I’m walking. If you are willing and able to donate, please let me know. I won’t be posting the link publicly but I’ll send it to anyone who asks via my email revivingemily@gmail.com

Thank you!

For information about NEDA, NEDA walks, eating disorders, and more, visit www.nationaleatingdisorders.org

Halfway there!

The semester is officially half over and I’m on spring break! It’s crazy how long/fast the past 6 weeks in pediatrics were. I’m thankful for every second (okay, maybe not the stress) and it is by far my favorite placement in nursing so far.

I remember back to my first surgery, in 2009 when I was 14. I was naturally pretty terrified and uncertain about the decision. I’d never stayed in the hospital or had surgery before, and here I was about to have a major operation with 3 nights there. My experience was nothing short of wonderful. The staff was all amazing, especially my nurses. I have the fondest memories of how kind and helpful they were. Other than the whole pain thing, I enjoyed my stay. I vowed then that I would one day work in the medical field, but specifically at Devos. While my mind has changed a thousand times since then, I’ve now come to that same conclusion. I would love nothing more than to work in pediatrics (hopefully NICU!) in the very hospital that changed my life.

I’ll admit, I’ve cried more than a couple of times during this first half of the semester. I dealt with a ton of frustration, anxiety, some panic, stress, and exhaustion. There were late nights and some missed assignments. I made plenty of mistakes (which only added to my frustration). I lacked motivation at times. Despite everything, I ended Tuesday in the happiest of tears. I did it! I’m content with my grades overall and I feel like I put in as much as I could, considering my #1 job right now is recovery. It wasn’t an easy thing to balance, so I am trying to be proud of the accomplishment.

I am beyond grateful for peds rotation as a whole, my professors, the off unit experiences I had, and the floor nurses and patients. These 6 weeks confirmed a thousand times over how much nursing is my calling. Nursing school is tough. I’ve wanted to give up, but the interactions with patients and glimpses of the future I’ll have makes it all worthwhile.

After break, it’s OB time, and I’m getting pumped for that too! It’ll be weird to work with adults again, but I’m excited for the opportunity to witness birth and see more babies, of course. I already can tell I will like this area as well. Still, I think peds will hold my heart 🙂

If only…

I wasn’t born anxious. My cousin never lived with us. I loved myself. No one teased me growing up. My aunt didn’t constantly call me “skinny minnie.” I never self-harmed. I didn’t have pectus excavatum or the Nuss procedure to correct it. The media was less focused on the thin ideal. I started therapy years earlier. Someone noticed that there was something very, very wrong. My depression didn’t exist. I had more self-confidence and higher self-esteem. My family didn’t have a history of mental illness. I never had GI issues and lost weight because of it. No one told me that my chest was weird or that I have the body of a gymnast. My family was different. I had more support. I didn’t push myself so hard in everything. I leaned more on my faith. I never dated my ex. I opened up more.  I lived in a different school district. I had more friends. I cared a little more about my own well-being. I had better body image. I wasn’t a major perfectionist. I never signed up for early college. I reached out to someone, anyone.

These things didn’t happen, because then, maybe I wouldn’t have developed an eating disorder.

For a long time, I wanted an answer, a cause. I longed to have this “aha” moment in therapy so I could finally make some sense out of it.

I’ve realized that eating disorders don’t have just one cause. My anorexia makes sense. Because I didn’t love myself, I had no problem harming myself. Perfectionism fed into the need to count every single calorie. I had no healthy coping skills, so using ED behaviors instead was much easier than dealing with emotions and stressors.

When my brain had all of these things coming at it, the response was to turn to food, exercise, restriction, and numbers. Someone else in the same situation may have gone down the path of addiction, or maybe they would have come through just fine.

I’ve often asked why – why did this have to happen to me? Why couldn’t I be strong enough to deal with everything? Why can’t I just be normal? Why can’t I get over this? Why am I so messed up?

I no longer ask these questions, and part of this is because I’ve begun to accept my eating disorder. It happened. I struggle. I can grow through it. There is nothing I could have done differently. It’s okay that I didn’t take more positive steps. I am not a failure because I got sick. This doesn’t need to be the most important, defining aspect of who I am. I will win. I am strong enough to do it.

Boycott the Before – Why transformation posts aren’t all that helpful

We are accustomed to seeing before and after photos – in weight loss commercials, on personal Facebook/Instagram posts, and pages advertising the next miracle drug/diet/magic fat-shrinking wrap. Most of these involve a before body that is “less desirable” in many ways (“fatter,” less fit, larger, etc) juxtaposed to the “better” body picture in which the person is always smiling. This is so common in the media that it’s easy to glance over and not realize what effects it may have on us. While I could go on about this more, I am instead focusing on a different sort of body comparison: before and after eating disorder recovery posts. This is especially important to talk about considering the numerous posts I’ve seen during NEDA week.

Full disclosure, I was one of these people a few years back. I felt that if I could post a picture of my lowest weight and where I was then it would prove my recovery and validate my struggle. I now realize this isn’t the case, and I would like to encourage others to reconsider the perceived benefits that come from these posts.

I do not feel adding in examples will do good for anyone, so I will instead describe the typical images you may come across. On the left is typically a clearly malnourished and emaciated person, sometimes one who looks more like a skeleton than a human being. The right will show the same person but with added pounds and a “normal weight.” There will be smiles, much like with the weight-loss versions, and a caption that explains their recovery and how much better they feel at the new weight.

I am in no way trying to bash those who make posts like these (remember, I did this too!), just give a little insight on why I believe they can be harmful. A quick rundown on how this can be problematic:

  1. Promotes the belief that eating disorders and recovery are both defined by weight. I have run into this countless times before. Many people are not very well informed on eating disorders in general. There are many myths about the correlation between BMI/weight and how they relate to eating disorders. One is that you need to be underweight to suffer from an eating disorder. Considering just one eating disorder diagnosis has a weight requirement, this simply isn’t the case. Naturally, this thinking leads to weight restoration being proof of recovery. If you’ve gained back the weight, you must be cured! Personally, I have struggled at a pretty large range of sizes/weights. My sickest period in thoughts, behaviors, and overall state of mind weren’t at my smallest. I actually haven’t been underweight for a majority of my eating disorder. You simply cannot judge how well someone with an ED is doing by looking at how their body has changed.
  2. Comparison, comparison, comparison. If there’s one thing eating disorders are great at, it’s comparing in nearly everything. The before and afters open up additional dialogue for the ED to run with. Was I smaller than them? Why did I have to gain so much more? Who is the sickest? The answers to these questions may lead thoughts into a pretty dangerous situation.
  3. Too much focus on the physical side of these mental disorders. Quite obviously, changing eating habits, exercise, and use of behaviors all tend to have an effect on the body. Often times this is a visible marker for the eating disorder. While it must be noted that this is the case, adding more emphasis is not helpful. Having “sick v recovered” photos out there magnifies the outward signs of EDs, while we should be focusing on psychological warfare that those struggling experience. This reduces a multifaceted illness to a superficial view.
  4. The before as a goal instead of a cautionary tale. Some viewing these images will flip the entire meaning of them around. They will idolize the “before” as something to work towards. The hopes of a smaller body become possible, as long as they follow disordered eating and mirror the opposite of how the transformation occurred.

There is a movement that I absolutely love and support called Boycott the Before. This week, #BoycottTheBefore, is meant to change what eating disordered recovery is seen as: a mental change, not just the physical one (that may or may not be present!). I love that their aim isn’t to shame anyone who posts transformation photos, but simply educate how they don’t show the full picture. (Side note: I really support and have posted a transformation that was just of my face before and after recovery because you could tell I was miserable based on my expression, bags under my eyes, etc.) I think it’s so important to emphasize all aspects of eating disorder recovery. The mental and emotional healing that takes place is for the most part way more important than the physical side of things.

If you are in recovery, I challenge you to consider posting something this week to show that there is so much more to recovery than weight!

Here’s mine:

IMG_20180307_102026
The first time I started treatment and recovery, I remember thinking that if I just gained back some weight and no longer “looked sick” I would be recovered. I was so wrong. I haven’t been at or near my lowest weight since the very beginning of my eating disorder (5ish yrs ago), but since then I’ve seen way more struggle. I have been a walking, talking eating disorder with no real Emily present. Yes, my journey from sick to healthy, and relapse to recovery many times has included some weight gain. That part truly doesn’t matter, though. What’s the most important are the mental and emotional changes I’ve gone through. I am way more than the physical part of my transformation. 
I’m so happy to be a part of the #BoycottTheBefore movement. The goal here is to focus on where you are in recovery and the triumphs you’ve had without posting a before/after transformation photo. It’s not that those are wrong to post, but more so the importance of opening up a conversation about ALL aspects of recovery. 
I go into some more detail about this in a post on my blog too. {Link in bio}
I hope that by sharing a little bit of my story and thoughts I can promote awareness about and the truth behind eating disorders. #edrecovery #edawareness

NEDA Week 2018 – my anorexia struggle (it’s not what you think)

I really love the theme Let’s Get Real because it opens up the opportunity for each individual story to be shared. Every person who struggles with an eating disorder is unique, yet we can also relate to one another. My story, along with everyone who has ever struggled with an eating disorder, is important and needs to be told. Today I’ll be doing it in a little bit different way by sharing some stereotypes about anorexia that I don’t fit into.

I have anorexia, but…

  • I’m not underweight, emaciated, or anywhere close to it. In the 5+ years I’ve had this illness, I was only underweight for around 8-10 months. I came into treatment for the first time with a lower BMI, however; since then I’ve been in the normal range. I went to residential twice without even losing a substantial amount of weight because the outside representation doesn’t matter as much as how you’re struggling on the inside.
  • I don’t feel overly affected by the media. Do I think that what we see in the media influences self-esteem, diet culture, judgment of bodies, etc? Absolutely. Has it played a huge part in my life? No. I do compare myself to people in advertisements, but that happens as I’m walking around campus or the grocery store too. I know enough about how manipulated these photos can be that I basically just take them as false and made up.
  • You cannot tell just by looking at me. I don’t have the “typical anorexic body.” I don’t think anyone would be able to tell I have an eating disorder by analyzing my appearance. I may be thinner as behaviors increased, but I am nowhere near the image most think of when they picture anorexia. I am not alone in this. A huge number of those with anorexia and eating disorders in general don’t look like they have an eating disorder.
  • I have never used laxatives, diet pills, etc. I know many people who have turned to these measures in order to lose weight. It’s just an area where the eating disorder hasn’t fixated on. I definitely have felt that pressure, though.
  • I haven’t needed (or come close to needing) a feeding tube. There are some who wear their feeding tube as some special badge you’ll only receive if you’re a “very good anorexic/bulimic.” I’ve seen countless people and treatment friends who use this as profiles or brag about it. There have definitely been times that I felt like a fraud because I hadn’t been sick enough to receive one. I can see now that being malnourished enough to need artificial feedings isn’t something to be proud of, and I am more than 100% okay with not having one.
  • I’m not on the brink of death. More than any other eating disorder, I see a ton of images and stereotyping that someone with anorexia has to in a danger zone. In reality, complete organ failure and other fatal conditions don’t actually show up until a very critical point. Most people, like myself, are relatively medically stable.
  • I do not enjoy being this way. Eating disorders are often glamorized. I have been told that I must have great discipline in order to lose weight the way I did. In reality, anorexia has taken over my life and made me feel empty. When I’m deep in the ED I become a shell of myself. I would never wish this on anyone or encourage them to treat their body this way. It is absolutely miserable, expect for the brief moments where ED praises me for how “well” I’m doing. Anorexia is not just a way to effectively lose weight and bask in your shrinking body. It is a slow and painful suicide.