First day back.

*Disclaimer: I will not ever be talking about patients, things that happen with patients, etc. Confidentiality is important. My reason for this post is to explain my experience and how it felt in general with being back at the hospital. Also, I know a joke about HIPAA, but I can’t tell you 😉

It was the craziest of days with emotions and everything. I’m not quite sure what all I expected, but my time so far at the hospital has surprised me.

It’s hard to explain, but once I stepped in the hospital and those doors closed behind us, it was like being transported back to 2 years ago. My heart started racing, there was a sinking feeling in my stomach. It felt a little like I was reliving my experience there as a patient. This didn’t last for a long period of time, but also recurred throughout the day. I saw all of these familiar places: the courtyard, patient rooms, dreaded lunch carts, nurses’ station I used to stand by, phones, room where ED met/ate, coloring pages (the SAME ones from before), etc. For many brief moments, it was like I was there again.

Feeling “there” is not a pleasant experience. It brought many panicky moments and racing thoughts. All I could think about was how I would be force-fed, locked out of my own room, and not let out again.  It was distracting to the point of zoning out multiple times. I had to keep repeating to myself: “I am a student. I have keys. I am free to leave.”

I only stayed inpatient for a week, plus about a month in partial (although we only went through a small portion of the hospital then). That is only a blink of time, especially compared to residential, but somehow it matters. It gives this place hold on me. I hate it, but I know it is also something I have to work through. I’ll be here the next month or so and I don’t think I will be able to gain as much from it if I’m stuck in a bad place.

There were many opportunities for me to disclose that I’ve been to FV before (not as a patient, we were asked if we have visited too). For whatever reason, I want to scream that I have been here and just let it be known. No clue where that’s coming from. At ALL. I truly don’t want my peers/prof/staff/patients to know that I was once a patient too, but it feels like I have to bottle up this secret and that I am wrong for having been sick. I obviously am not going to say anything. I guess maybe this could be related to wanting to push past stigma/show others mental illness doesn’t stop you/show my classmates they’re just like us? I have no clue and that paragraph is very embarrassing.

Lunch was a challenge. It probably helps a little that ED never ate in the cafeteria (that would be so much worse as a patient omg), but this was by far the most overwhelming part of my day. I have had the exact meal before and I saw all of the “amazing, lovely, wonderful” desserts displayed for us. Here, I was given the gift of choice: what I wanted on my burger, veggie or beef, vegetables or no, what type of dessert, salad or soup, finish everything or not, etc. Coming from an ED treatment background, this feels empowering. It made me think back to when we were handed these trays and basically forced to eat them or given an Ensure. I am thankful to not be there anymore. The meal was still scary, though. All I wanted was a support person to text during meals like I do normally if needed. There was conversation, but I pretty much made myself eat with little distraction available. This is probably not anything that will change unless I try to make it a point to get others to talk. I’ve never been very good at this, but we shall see. The worst part of the meal was caused by Ed. As per usual, sitting with a group of people led to me “needing” to eat less than everyone else. It gives me this sick satisfaction if I do “better” than others. This ended up causing me to be the only one who didn’t get dessert. Lunch could have gone much worse, of course, but I want to do better next time.

One of the most frustrating aspects of my day came at the end during our debriefing. We all met to go over what happened, get our assignments the next 4 weeks, and ask questions. My professor said this: “I do not want you working with eating disorder patients, especially not one-on-one. You could say one thing and they will crumble, completely unraveling their progress. I would rather have you stay far away, but if you do go to a group do not say anything at all.” The request here bothered me a little, but the way she explained her reasoning was what upset me most. I’m sure she was attempting to protect us from harming a patient, in her mind. I don’t agree with 95% of her statement. I don’t see people with eating disorders as weak to the point that 15 minutes with a nursing student could erase all progress made in treatment. The 5% agreement I have is over what exactly could be said. I’m pretty sure that any of us wouldn’t be oblivious enough to mention the patient’s weight, tell them they don’t seem like they have an eating disorder, or anything of the like. Those topics and others would absolutely have more power to harm. Anything else that would come up in a nursing assessment/general conversation doesn’t have that same potential really. I see those of us with eating disorders as strong, especially when facing your fears in treatment, so I am a little hurt by her insensitivity. I wish that I could let her know some truth of what this is like. I also would like to ask her rational (was it a guideline set by FV, her own feelings, etc). Maybe that will happen before the end of my time here, maybe not.

I’ve focused plenty on the struggles of returning to the hospital, but now I want to highlight some lighter things that came of my time there so far. Probably the biggest thing is that I have keys. I was absolutely shocked when my prof handed them out. It’s kinda crazy, right? Two years ago I was locked in and now I’m able to venture all over the hospital. The freedom is weird but also comforting in a way. After looking at patient charts to see how they lay out diagnoses, meds, group notes, progress reports, and more, I’m so curious about what mine looks like. This past time I had the psych doctor fudge my records somewhat so insurance would cover inpatient (for those who don’t know, I was admitted a week and a half before school started, so time in treatment was a huge priority). I wonder what he actually wrote down and just how nurses, my case manager, therapists, psychiatrist, and MHW’s talked about me. I’ll never get that opportunity, but it’s still entertaining to think about. One of the funniest/almost embarrassing things was when we were on our tour. She said where we were headed next without direction on which way. I remembered exactly which way it was, so I started walking towards it before I realized I’m supposed to act clueless like everyone else. I covered for it but I can imagine my classmate and prof’s faces if I had actually unlocked the door or something.

I head back tomorrow morning (at 7am, wayyyyy too early). Now that I have experienced my first day, I want to set some goals for the next month of clinicals. My hope is that I’ll be able to learn and also decrease the amount of fear and anxiety I relate to this place.

  • practice deep breathing, thought stopping, and other DBT skills in the moment when I start to panic
  • eat my correct exchanges and a freaking dessert at lunch (thanks to my therapist and dietitian for that one gah)
  • give each patient my full attention and take a few steps in their shoes
  • remember what it was like for me because it will help me understand patients more
  • ask lots of questions
  • take away as much as possible

 

Lumped into the “eating disorder” category

Living with an eating disorder is a constant battle between thoughts, urges, behaviors, emotions, etc. It can be claustrophobic where suddenly your entire life is clouded by Ed. Separation may seem impossible. I have felt this way for years. There have been times of strong recovery but also deep relapse.

Even with the eating disorder so intertwined in my life, I refuse to be “that anorexic girl” or “that girl with an eating disorder”(since no one would look at me and think anorexia). Yes I struggle with an ED, that’s pretty dang obvious if you know my story well. Being lumped together with all of the stigma and ideas about eating disorders is not acceptable. Unfortunately, I have been experiencing that more lately.

If the average person were to think about EDs and why they exist, there would be a few very common answers. The first obvious ones would be “they just choose not to eat” or “why would you make yourself sick like that?” I’m sure you get the idea. The characteristics will combine into one generic disorder or split into bulimia and anorexia. This leaves no room for the vast majority of people who struggle with BED, OSFED/EDNOS, etc. It really isn’t helpful to do so. While there are similarities between the different diagnoses, each case is individualized. There is no “one size fits all” when it comes to symptoms.

Expanding beyond that, I have many recent examples of what the perceived causes of eating disorders are. As per my abnormal psych prof, the four warning signs/precursors are: perfectionism, not wanting to grow up, avoiding sexuality, and control. My psychiatrist, almost every time I see him, makes comments about how I can’t eat because I think I look fat, as if that’s the only contributing factor. I won’t deny that many of these points are valid. I struggle and see others struggling with some of these issues. The problem I have with it, however, is that there is no room for other explanations. Under these assumptions, how could you ever account for someone who wants to look ugly by restricting, a person with BED who has pretty much none of the factors listed, orthorexia, and a million other circumstances?

This all being said, I do understand that it’s important to have some idea of possible causes for eating disorders. I have no problem at all with lists that begin as “common causes of” or something similar. This offers suggestions and examples to look for (especially helpful in exploring treatment at first). It gives those of us with eating disorders something to possibly make a connection to.

Unfortunately, the negative labels and automatic conclusions come up far too often when someone has an eating disorder. Some that I find most hurtful: “you’re just doing this for attention” “just stop eating/don’t purge/eat your food” “you can snap out of this” “you want people to feel sorry for you” “you don’t have it that bad.” These make me sick to my stomach. I know that the people behind them are most-likely uneducated and fully believe in the stigma behind EDs, but this excuse doesn’t cut it. We are real people with feelings.

Eating disorders are not one-size-fits-all. We struggle with similar thought patterns and behaviors, but you cannot ever lump us into one person. If you hear of someone or find yourself believing these examples and others, please stop and think. Realize how much harm this can cause. Consider our feelings.

I am unique. I am not just some girl with an eating disorder. My story is all my own. Please see it as that.

Important questions from Cristina Yang

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I’m binge-watching Grey’s Anatomy for the at least the 4th time currently, and I came across an episode that left me thinking about a lot. Cristina Yang poses 3 questions during multiple situations in the episode: Do you know who you are? Do you know what’s happened to you? Do you want to live this way?

Do you know who you are? In the simplest sense, yes. I know my name, where I’m from, social security number, etc, but that doesn’t truly define me. I don’t fully know me yet. How could I when I’ve spent years tearing myself apart? That being said, I am in the process of discovering myself. I want to be authentic and real, but I cannot do that before I dig deeper and explore myself. Not Emily the anorexic/depressed/anxious. While I feel this to be true often, I am NOT my mental illnesses. I have no doubt that I will find myself more each day if I stay in recovery. I hope to find who I am, because I think I may really like her.

Do you know what’s happened to you? Yesish. I say that because I am still learning all that has changed me, for good or bad. For example, I never realized how much my past relationship affected me and what actually happened back then. I am just now (after 6+ years) putting together those pieces. I also recognize many things that lead up to where I am today. I could list out everything that has happened in my life, but this isn’t the type of knowing I yearn for. I want to thoroughly explore – not just the “what” but the why’s too.

Do you want to live this way? NO!!!!!! I thought I should truly emphasize that, aha. If I wanted to, I certainly wouldn’t have wanted to spend my entire summer in treatment. Working hard in recovery would never be on my radar. If I want to live this way forever, I will end up dead. I don’t want to die, and especially not from this. This means a change needs to happen. It hasn’t been an easy ride so far. I don’t expect it to be, but I do know that recovery is going to offer me a life worth living. I will keep going for that.

I love how each of these questions are posed because they have been thought-provoking to me. These answers are much different from what they would have been if I were more into my depression, anxiety, and eating disorder (like last semester, for example). That in itself is progress. I want to be able to return to these questions in a few months, a year, or many years down the line to see what has changed. It’s hard to imagine all the progress  I may see.

Back to the hospital

Next week, I will be returning to FV in the inpatient unit for the first time in over 2 years. This time around is much different. I won’t be a patient there now (and hopefully never, ever again), but I will be completing the majority of my mental health clinical hours.

My anxiety has gotten pretty high over this. I’m worrying like crazy and trying to calm that down. After plenty of talking with some staff from IOP/friends I do feel a little better. I think what I need most is to write out some intentions so I can hold myself accountable.

What I will do

  • Act “normal.” What I mean by this is pretend that I’m just a nursing student and not a patient. At this point, it has been over 2 years since my one week inpatient stay and 3 for my PHP experience. I feel well removed from those situations and I fully believe I won’t suddenly revert to feeling like a patient once I am back in that place.
  • Cover up my scars – for obvious reasons. This will also protect me from looking like someone who suffers from mental illness. While my professor knows I have a history with mental health (no details there), the patients I interact with are not going to have a clue. I want to keep it this way.
  • Eat in the cafeteria. Gah this kills me. More than anything, food brings up the most negative reaction from things that occurred at FV. I can still picture the trays, being forced to eat things I didn’t necessarily like, those stupid desserts every.single.lunch, the staff “offering” Ensure if you didn’t eat every single bite. I realize this is going to be different. Instead of a room with just ED patients, I’ll be in the cafeteria with other staff. I will not be watched like a hawk. I get real choices to get whatever sounds best. It will be a struggle for many reasons, but I hope that I’ll realize that eating there will be a good thing.
  • Avoid VH aka Dr. VanDouchebag. If there is one person who I would absolutely avoid FV  again for, it would be him. He is the ED psychiatrist aka the guy who threatened me with inpatient, told me i would be tubed, and basically was the most frustrating hardass to work with. I will never be more thrilled that never having to see him again. Even if it was as a student instead, I just don’t wish to interact with him in any way. If only I could nonchalantly tell my prof being on his service isn’t an option, ha!

What I will stay away from

  • Telling my professor about my eating disorder. Maybe this seems counterintuitive. To me, it’s not. I don’t wish to be treated differently because of my past. I hope to have an experience there that will help me learn the most. I think her knowing about the ED would cause her to keep me off of 1-2 units out of 5, which would definitely hinder my experience.
  • Disclosing of my history at FV. I think this would be just as harmful, if not more, than talking about my eating disorder. I have a feeling she wouldn’t feel so comfortable with me doing clinicals there. (Fun fact: I specifically chose this site so I could experience the hospital from a different light)
  • Ask to change placement in the hospital. I don’t want special treatment and asking to change where I am assigned to would do just that. Dr. C is especially concerned with this. After needing it last year with missing classes, she doesn’t want a repeat. She believes it would negatively affect my nursing experience. There is no good reasons for that to happen, except…
  • Let my recovery be jeopardized. If it becomes absolutely necessary, I will reach out. I can’t see that happening at this point, given I’ve been in treatment for a million hours this year and am completely used to hearing potentially triggering things. In the minute chance it does occur, I will find some sort of excuse before I would actually disclose personal information. No clinical experience would be worth slipping backwards in recovery, especially considering all the hard work I’ve put in.
  •  Say hi to staff (unless alone/away from my prof and fellow students). There is one staff member I particularly love. She has worked during IOP as well and was there during the time I got accepted into nursing <3. I would absolutely love to update her and chat for a bit. I do plan on this if at all possible. On the other hand, I’m thankful for HIPAA and the fact that any staff who remember me cannot say a word. It will fully be my choice to acknowledge that past relationship or not.
  • Tell any fellow patients from my time there that I remember them. Unfortunately, these relationships aren’t really protected by anything. If someone recognizes me they have all the rights in the world to ask me about how I’m doing, say hi, etc. This one somewhat freaks me out. While I definitely care about them, talking to them for reasons other than a therapeutic one would clearly let on that I was a patient once too. I really hope to protect that information and not be the broken/unstable student.
  • Provide care for anyone I have talked to outside of treatment. I mostly doubt this would happen. I am not in contact with 90% of those I was at FV with. The ones I do still talk to are not there currently. Even if they became patients again I would probably see it first on Facebook or something. Still, I am prepared for the slight chance of this happening. I wouldn’t even have to disclose why or how I know them here, just that I do and therefore cannot be involved with their care. If there is a case of recognizing them without seeing them outside of treatment, that wouldn’t need to be avoided unless they would be uncomfortable with it.
  • Let my adviser (who isn’t the prof for clinicals) know about my treatment and struggles the past year. She is aware of my eating disorder and the fact that I went to residential. The last time I mentioned it was right after, so around a year and a half ago. I’ve considered talking about IOP, the semester from hell last spring, and the fact that I spent the vast majority of my summer in treatment. While this has been a significant part of my story, it really shouldn’t affect anything if she isn’t aware (at least I’m telling myself that). I can imagine Dr. C’s disapproval if I asked her advice on the subject. She would call that special treatment that would follow me through the next 2 years.

I’ll admit, I am uncertain about some of these rules I’ve made for myself. It bothers me that I can’t predict the future of what will happen the next month and a half. It could go fine, but it may also mean everything I’ve set up will be challenged. All I want is to get the very most out of my time at FV. I’m trying to believe in myself and my ability to make returning to the psychiatric hospital a nonissue.

The end of summer.

Tonight is he last night of summer for me. I have a myriad of emotions regarding this, and over how I spent my summer as a whole. I want to take some time to reflect on this summer, namely my treatment experiences and what I’ve learned from it.

By the numbers:

  • 33 days in residential
  • 27 days of PHP
  • 10 days of IOP
  • 2 months away from home
  • 1,058 hours spent in treatment
  • 70 total days in treatment/110 days of summer = 64% of summer days

It’s hard to believe that so much of my summer has been taken up by treatment. I never would have wanted this for myself. I honestly didn’t expect my break from school to play out this way at all. I thought that I was handling the eating disorder and school perfectly, and that it would continue seamlessly into summer. That quickly fell apart and residential became the only option. I remember mourning my loss of “freedom” (when I clearly wasn’t very free). At the time, I thought 4-6 weeks and then I would be healed and could return to just outpatient. Every option for a slower stepdown was taken and my last day of IOP was this past Tuesday, only 8-9 weeks later than I originally thought. This time that I once felt was so important now seems trivial. I spent 64% of my 110 days of break in treatment and I wouldn’t have had it any other way, given the circumstances.

I had much guilt and worry surrounding my return to residential. I wondered if I would even be able to accomplish anything this time around. These thoughts continued as I began stepping down. Here’s the crazy thing: I grew just as much, if not more, than last time. I want to share some different things I’ve taken away from this time.

  1. Treatment is scary, no matter how much you prepare for it. I felt this strange confidence about returning. I had done so well before. All I had to do was follow the rules enough to deal with it, right? WRONG. It was much more complicated than that. I wasn’t some pro at treatment who could zoom through the process. I wouldn’t say every single step was near terrifying, but treatment as a whole was. It makes sense, given the goal is to eradicate this thing that’s been controlling me for so long.
  2. Knowing how to put my needs above: other people’s, what I “should” be doing, etc. I could have been away at treatment 4.5 weeks and then IOP for a month. I was not at all planning on PHP, especially not one that involved being away from home. Towards the end of residential, it became increasingly clear that home wasn’t a good option. My therapist and I both had many concerns about returning to that environment. Sure, I had a month of growth under my belt, but that didn’t mean I was 100% ready for the real world. I felt strongly that I needed a better option. I decided this the very last week I was at CFD. Once I was at ERC, I once again put my needs first and stayed an extra week there. I added a month away, one that was absolutely needed. Some people were not so happy with that decision, but it doesn’t really matter. What does is that I stuck up for myself and gained immensely by doing so.
  3. I didn’t truly “miss out” this summer. Sure, I wasn’t able to have the “normal” experience. I do/did regret that; however, I gained so much more. I had many fun adventures during all 3 forms of treatment (and pictures to show of parts!). My time in treatment brought inside jokes, exploring cities, laughs, tears, growth, and more. It was so, so hard at times. Overall, though, I wouldn’t trade it. My version of summer is a lot different than others but that doesn’t mean it was bad or wrong.
  4. I am stronger than I ever thought. I’ve been through countless trials this summer: losing my grandpa while at CFD, a specific weekend where every bite was a struggle and Boost was involved, dealing with family, living in a new city and having to navigate that, losing another family member while in Chicago, choosing to stay longer in treatment, financial issues. Through all of it, I have survived, even thrived.
  5.  I am more than capable of recovering. I have done some hard stuff this summer. I was in treatment a majority of the most trying times, bu it doesn’t discount my progress. I had to choose recovery, no matter what, and I did. Even with struggling a bit being home, I am still fighting because I do believe in recovery. Another reason I have this hope in from being lucky enough to hear Jenni Schaefer speak to us at ERC.

I am so thankful for all that has made this summer one of healing. I know I can continue this and have a better semester than ever before. Tomorrow is a new beginning!

(So many) tears of happiness

Last Thursday, I happy-cried the entire 50 minute drive to my school before IOP. I could stop for no more than a minute, then I would get thinking and waterworks started over. It seems pretty weird, right? What’s so amazing about a quick errand to school before going to eating disorder treatment for the day? The answer: everything because today, I picked up my scrubs and equipment for nursing.

If you would have looked at me a year and a half ago, as I dropped out of my first semester of school, there’s no way you could have seen this day coming. A year after that, I once again had to take time off school, this time just a J-term. Then came the absolute worst semester possible. Looking just at my academic performance and participation in school spring term, no one would think I could be allowed into the nursing program. Here I am anyways.

The first couple weeks at residential were brutal for many reasons, a main one being that I didn’t have my final grades in yet. I was accepted into the nursing program, but I had no clue if that was jeopardized or not. I was not proud of the semester and this kept me up at night. I was a wreck. I went over every moment, every mistake from the previous 4 months. The day I logged in and saw my GPA was one of the happiest since receiving my acceptance letter. I had hung on, but only by around a tenth of a point.

I am not ashamed. I never thought I would be saying that; however, I cannot keep focusing on what I’ve done wrong. I’ll admit, I’ve been a terrible student for a good chunk of my time at Calvin. That isn’t all on me though, because I wasn’t really there. Instead, my eating disorder was in control. I have spent too many years trying to live with the eating disorder when I only end up barely surviving.

I am proud of myself. I am proud of my recovery. Without this hard work I’m putting in now, there’s no way I would be starting classes in 3 weeks. I don’t know where I’d be. What I do know is that I’ve spent too many years trying to live with this disease. Now is my chance to change that, and treatment this summer is only the beginning.

I am going to become a nurse. It still feels surreal, and probably will for a while yet. I thank God everyday for all that has gotten me to this point. I know this is my calling. I almost lost the opportunity, but I am never going to stop fighting to make my dream come true.

Long, long overdue update.

I really hate not blogging for so long (besides one off topic post), but I also needed a break. I’ve been spending hours upon hours of each day living and breathing treatment. 4.5 weeks in residential, another 3.5 in PHP, and now I’m back at IOP. It’s exhausting, to say the least, but now I am finally ready to explain the last 2+ months.

I left for residential on May 25th. Thankfully, I was able to once again be admitted into the same SoCal location as before. It felt like returning home. Around half the staff is the same, so I immediately received half a dozen hugs. Knowing everything about the program meant a hell of a lot less anxiety compared to last time. At the same time, I had plenty of worries about the other girls. The time before brought some not so great drama filled days, so I desperately wanted to avoid that. I was blessed with 5 of the most amazing women I have ever met. They made the experience better than I imagined. More importantly, though, was the staff and what happened because of them. My therapist was a perfect match. She gave me the confidence and safe space to speak about the most shameful memories and past that I’ve never talked about before. She listened and believed me. She comforted me, inspired me, pushed me, and supported me. I could not be more grateful, so I still update her now. One counselor in particular was a complete blessing to me. She’s a strong Christian and compassion just oozed out of her. I also shared some of the same things I did with my counselor, and actually with her first. There are about a million more things I want to write about regarding resi, but I’ll save that for another post (or 20 🙂 ). For now, I’ll just end with the fact that I learned more than I thought possible. I knew I would change, but I guess I just didn’t expect it as much as I should have.

I discharged from CFD on June 26th. I panicked when I first found out the date around 10 days prior. Suddenly, going home was actually on the radar. An immense fear of the same environment came over me. I felt stronger, but not enough to handle everything so soon. We had always planned on just starting IOP three days a week after. That Monday before I brought up the idea of heading to ERC’s Chicago PHP program. It was a huge risk to go there, but ultimately it’s what was best. After spending under a day and a half at home, I was off to Chicago, with the support of my treatment teams from CFD and home.

I struggled immediately after admitting to ERC. The program was completely different than CFD: three times the size, therapy just once a week, a new mealplan I hated. Those first almost two weeks were miserable. I had pretty much given up hope of gaining anything. I wasn’t open in the least bit. Something changed in me, and suddenly I wanted to work hard again. I took notes and participated and challenged my ED 24/7. I realized that the chance to come was a privilege. I could have been home, but instead I worked hard to get more treatment. My original plan was just under 3 weeks of time. I used money as the main factor in why I couldn’t stay. The team didn’t buy it, and offered financial help to keep me longer. I accepted. I ended up getting more out of the last 2ish weeks there than I imagined. I settled in, made friends, worked hard. I again am grateful for the opportunity to stepdown instead of coming straight home. I left the 24th with even more growth under my belt.

I started IOP the day after my discharge. Now I’m there twice a week for the full day and therapy 2 days. It’s been almost two weeks and I’m mostly used to being home. This certainly isn’t easy. Adjustments aren’t my favorite, and here I am with some huge ones. I am just beginning to mourn leaving treatment. I am “treatment sick” terribly. I miss it all: the support, staff, girls, safety, weather, adventure, challenges, essentially just about everything. This may be the hardest part now. I am figuring out how to do it (mostly) on my own. I want this. I need this. I will put all that I’m able so I can finally live.

It’s just over 4 weeks until nursing begins. This last bit of summer needs to have the same amount of effort as the first 10 weeks. My life, my future, and my freedom depends on it. Spending all of summer in treatment wasn’t anywhere close to what I had hoped going into it, but this has given me a fighting chance and a will to live. I am blessed.