Tag: dietitian

“Kinda miserable”

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As I was meeting with my dietitian on Monday, she ended up asking me how I think this really is going. I knew she didn’t want my BS “okay” or “pretty good” answer. There is no fooling her. (The woman reads my Recovery Record logs where I write what I’m actually feeling/eating, so she definitely can see through it all.)

I thought for a minute and ultimately landed on “kinda miserable.” I only realized after thinking about it for a couple days that this too is a pretty downplayed answer.

When I think of miserable, I start to imagine some situation so bad you would do anything to get out of it. Miserable is how I felt when I had swine flu, lost my grandpa, went through a hard breakup, and had my Nuss procedure. Those times in my life held lots of physical or emotional discomfort, to the point where even thinking about it brings a shudder. I would never choose to repeat those situations and many others I consider bad enough to call miserable.

So why then, did I use “kinda miserable” to describe how I’m feeling now?

I guess the miserable part fits to an extent. I did just provide K with a list of signs and symptoms of starvation I’m experiencing, and those are not exactly fun (unless being cold with bruises all over and thinning hair is your idea of a good time). It is definitely bothersome dealing with ED thoughts all day long. Sometimes I just wish that I could eat like “normal” people and not be so bothered.

At the same time, the eating disorder is 1000% providing me good things, too. If that wasn’t the case I probably could have recovered years ago. I think that’s where the “kinda” part comes through. I’m not sure if its more me being in denial or what, but I cannot say that I am fully miserable in the ED. I’m just not.

My answer here may not be the full truth, because I am not at a point where I’m willing to completely denounce the ED. Maybe I need more time. I can imagine my team asking “what will be enough, then?” to which I have no clue. Right now, it is enough to admit that sometimes, in some ways following the eating disorder has brought me discomfort.

I wanted to start with a catch up post, given that I have missed nearly 6 months of my life in this absence from blogging. I do plan on an update or two, but for now this was on my mind and I needed to write about that. I’ll be back with more soon!

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Tag teamed by my dietitian and therapist

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Monday mornings truly are something. I see my dietitian and therapist back to back, before heading to lectures at 10:30 and 12, then lab at 2. Yesterday marked the third week of this schedule. While I am extremely thankful to be back with my dietitian K, I did not expect how she and R work together each time.

It goes like this:

  • I see K at 9, talk about how I did with the MP, exchanges, challenge thoughts, and make ~3 dietary goals
  • R comes in at the last-minute or two and K tells her what we’ve talked about
  • I have a half hr session with R where we talk in  general sense of what’s going on and then make ~3 goals regarding whatever I need to work on

Today went a bit differently. I have been slipping the tiniest bit when it comes to number of exchanges. It has a lot to do with change and school stress, but it is still considerably higher than where I was last year. We talked about that and she stuck with my same mealplan, despite Ed’s protests. Side note: I was brave enough to tell her how I manipulated my dietitian last fall with exchanges. Our long-standing goal is my exchange values. The second goal is eating in the dining hall 7x, which means I get one meal off. I’ve done better the past week with this, compared to eating there maybe 7 times the first 2+ weeks. Our third goal I protested. After clinicals last week, we stopped at this farm stand/bakery/corn maze place right nearby. They have famous donuts and everyone there bought one, minus me. FV also supposedly has the most wonderful desserts. At lunch, I was the only one who didn’t try them. K and I went back and forth about which of these needed to be a goal. She voted both, but I finally decided on the donut. Neither of them are easy, but it seems more doable. I reluctantly wrote these all down and headed into therapy.

We talked as per usual, mostly about my weekend highs and lows, BB stuff, and then worries towards returning to the hospital. I brought up lunch again because that is one of my big stressors. I ended up mentioning the whole dessert thing, and I swear it was like a lightbulb went off in her head. She didn’t say anything, but the way she smiled led me to guess something was up. The second I got my paper out for goals she told me she has the first one: eat a dessert at FV. Usually her goals don’t deal with food, so I immediately tried to challenge it. I explained that I was already supposed to do the donut (which she already knew, of course) and this was way too much. R didn’t budge, so I finally agreed. She seemed pleased with that and we continued a few more goals involving talking more to a support person and using skills at the hospital if needed for anxiety.

The funniest thing was when I was walking down the hall to leave. K came out to tell me something and R immediately blurted out how I am doing a dessert in addition to my donut. They looked so happy and a little mischievous, ha. I get that I am supposed to be challenged and everything, but I’m definitely not happy like they aer with this week’s goals. I’m still going to try. At the very least I will grab/buy the challenge food.

My two team members having this close relationship in regards to my well-being is something I actually appreciate. I no longer have to be the one to explain what one said to the other. I know I’m receiving the best possible care they can both offer this way. I’m certainly not allowed to slack, though!

A “fun” dietitian appt

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Oh man was I fun for L to deal with on Thursday. I am stubborn, resistant to change, doubtful, and and in denial when it comes to nutrition and my meal plan. I would say that my largest pitfall is believing every word she says is a lie.

I was pretty grumpy going into our session which didn’t help the situation. Most of it was the same things I’ve heard again on repeat for months: you need to eat more of fats/carbs/protein, eat enough if you want to exercise, keep completing your food log, follow your meal plan.

I look in the mirror and judge the excess food I’m consuming. All I can think about is the fat and weight I must be gaining. I voiced my concerns and how I’m convinced my treatment team is trying to make me fat. She attempted to reassure me by sharing I haven’t gained anything since starting out there. I so don’t buy that. It just doesn’t make sense with the amount of food I have been eating, etc.

L fought Ed with logic, which is the only way to actually convince me of anything. When I claimed she was trying to make me fat, her response was pretty shocking: “if my goal was to make all of my clients continue to gain weight forever I would be out of a job.” I haven’t heard that before. Usually it’s questioning why they would want to make me fat, which can be answered and explained in a disordered way. This has proof. She’s right, there is no way anyone would stick with her if they ballooned out forever on their meal plan. This was the one point in our conversation where I was able to combat the ED.

How do you feel about my meal plan? 8 words that I could have refrained from saying. I hate her answer. L doesn’t believe that my meal plan is enough. It’s currently ~2/3 of what I came out of CFD with, exchange wise. Her exact words were “You are on the lowest amount that I am ever okay with.” Obviously, she needs to increase it, probably to what it was before restriction happened. The problem is that I’m not meeting my meal plan as it is. I’m coming off pretty serious restriction for the last few months, but apparently not fast enough. She is not allowing me to do next semester unless I am able to increase my meal plan back to an acceptable amount. To be honest, that really pissed me off. I don’t think she has a right to keep me from my future when my physical health is fine and I’m going in a better direction in general. Deep down I know that this isn’t a normal or healthy amount I’ve been eating. More than anything, I’m terrified I won’t be able to do this.

L has her work cut out for her. I can talk back and give some nasty “Ed” looks while fighting every word she says, which she has already seen many times. The healthy part of me hates that I’m ignoring and defying the help that she is offering. I really do need to work towards building trust with her and my entire treatment team. Until then, we’ll be stuck with the wrath of my ED shining through. Sorry, L.

All the treatment last week.

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I am just now writing about all 3 appointments and group therapy that happened last week. I’ll touch on each separately as I’ve made notes for each one.

Tuesday – Group Therapy

I only decided to call and attend group around 2 hours before. I had just finished with my bone scan. My new therapist hadn’t called about me joining group as I hoped/assumed, so I called them back. Having only a small amount of time to worry beforehand definitely made things better.

Going in, all I knew is that the other women would be from IOP and it was likely going to be a small group. I walked in and felt uncomfortable. I didn’t say a word before group and barely even looked up. Thankfully I was able to relax once we started talking and had introductions.

My new therapist, R, leads the group. I’m thankful I was able to meet her before our first session. We talked about values and how Ed’s values and ours differs. It reminded me of our groups with T at CFD, and he was amazing. Our first step was making our own lists of values. For me, I had authenticity, helping others, hard work, compassion, and faith. Ed was perfection, thinness, weight loss, secrecy and self-hatred. Next I made a pie chart of what I out my time in now v. what I hope for in recovery. Mine was drastic. ED thoughts and values took up over 2/3 of my time now and in my ideal recovery <2/3. That gap is scary but also shows me that I need to change. I came out feeling more motivated because my dreams are so much better than this.

Wednesday – Dietitian

It was a hard one with L. Each week has been getting progressively worse in my eating. I’m slipping and I honestly don’t fight back too much. It was time for a reality check and she helped with that. I was  so angry with her (more so Ed was) and argued back and forth on different points. She didn’t let these thoughts get by. I appreciate that.

I found a scale at home and told her about this. I said it was okay to weigh myself since I won’t have too much access. Of course this didn’t fly with her. Part of my goals for the week was not stepping onto it. She asked about my goal weight which I said will make me happier. I had some time assessing the situation and part of me does believe her. A positive that came from our meeting was her feelings about group. She was incredibly proud of me for taking initiative in my recovery.

L’s no BS policy both annoys me and supports my recovery. I need to be pushed. I don’t think I’m able to do this on my own currently. I think realizing this is better than attempting to tackle it myself. One last conversation that killed me was learning L is leaving in January. I HATE change to the nth degree. It

s extremely difficult to find a dietitian in the first place so that’s just another stressor. Overall, the appointment was helpful but scary.

Wednesday – Dr. C

This was only my second meeting with her but I already know she’s going to be a valuable part of my treatment team. She was able to encourage me in many ways. I see her as a cheerleader for my health.

Something I appreciated was her going through all of my blood work. I love to hear it explained since I’d such a health nerd. I’m glad everything was okay. I was worried I would have another thing to worry about but it isn’t. I am okay, for now.

I was comparing last fall to this one when Dr. C stopped me mid explanation. She told me that I’m not as deep into the pit. I can see the light and i am asking for help. I thought differently from that point on. She also encouraged me that I can get through the semester. I had around 2.5 weeks from the time. In reality, that really isn’t a terrible amount of time. I need to believe that I can and I  will. I mentioned taking our J term off and as of now I believe that will happen. I really think I should try to take time for myself. I don’t meed all the interim classes so this year could be the time I put my health first.

Other tips I believe would actually work: get 7 or more hours of sleep, using all  of the knowledge I already possess, set emotions aside and make school and this semester a priority, believing in the real Emily and knowing she’s there. I have to work on separating Ed from myself. My bad enough means medical issues or emaciation. I don’t deserve treatment or want it if I am still so huge. One of the scariest thing she told me is that I need to consider other options. I cannot fathom doing it all over again. I don’t have the time o money to do so. It makes me terrified. I have to break out of the rigidity of the ED or risk more consequences.

Thursday – Therapy with R

I really enjoy R so far. I think she’ll be a great fit for me. Grateful doesn’t begin to describe that considering how little hope I once had. In all honesty, she’s going to help me more than S could. Amain point is that I need to put more into my recovery. I cannot do the same and assume it will be okay. She was yet another member of my team to say no the scale. One of the best things I came out with is all the groups the center offers. They have IOP MTR and you can walk in to any group during the time. I would love to do art therapy or any group with K, and amazing OT from FV. She’s seriously the best. I need to do more. Going to groups, therapy, and a dietitian each week means many more opportunities to dig into my recovery. I will do my very best to fight against Ed.

And that’ all for this week! I think I may end up writing each time I had an appointment or group. I find it therapeutic and a way to keep track of what I’ve learned and felt over time. 

Well hello there, Ed.

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Nope, not referring to some dude I’ve met, a weird uncle, or the older guy at church. This is someone I’ve known for years: my eating disorder. 

This may sound vaguely familiar for those of you who’ve been here since the very beginning. If not, you also may have heard this tactic of naming the eating disorder in the ED community (Jenni Schaeffer books, some treatment centers, etc.) Though I haven’t talked in terms of “Ed” for over 2 years, I did spend the first almost year of treatment doing so.

Forest View was adamant about Ed. We wrote letters to Ed, consistently talked that way in groups. It taught me to separate who I am from my eating disorder for the very first time. If I could see these thoughts weren’t me, that gave me fuel to fight. I needed that. I needed any ounce of motivation and tools to kickstart my recovery.

Naturally, I brought Ed along for the step-down to outpatient therapy. J was supportive of the usage and it helped create progress in discovering who I was beyond my illness. I often would write letters to Ed, sometimes thanking him, others of submission, and sometimes fighting like hell. I wrote up my divorce papers and signed them on December 3, 2014 (one year in recovery from self-harm as well). Whenever the eating disorder voice got loud in session she would respond with “Hello, Ed” to remind me who was really doing the talking.

I’m not sure I would have gotten through those early months had I not used such a drastic change in my view of the disorder.

It ended pretty abruptly when my greatest physical support at the time told me I should stop. She claimed it only was making my eating disorder bigger than it was and giving it more power. Anorexia wasn’t a person and didn’t deserve a name. I listened to her and told J that we no longer were using “Ed.” I trusted this woman so much then and I think that was the main reason I gave in to what she said. I honestly don’t know if that was the right decision or if it was for the right reason, but either way it did happen.

Fast forward to my very first meeting with L. As I later found out, she was a meal support at FV and worked with the “Ed” technique. I hadn’t referred to Ed in over 2 years, so it was a surprise when it came up in our conversation. Even more surprising, I went with it.

I talk and think about Ed every day. One of my assignments, alongside food diaries and thought logs, is to write a short letter to Ed each day. I’ve had many different responses to him. Sometimes I am angry and tell him how much I hate what he does to me. Others it’s the exact opposite with praise for his role in my life. A few days ago I had a very sarcastic passive-aggressive letter which I find hilarious. Lately I have had more positive ones since I am growing more into my behaviors and thoughts.. Regardless, how I feel about my anorexia isn’t as important as recognizing what it does to me.

Sessions with L are definitely a flashback to 2014. L will tell me that it’s Ed talking just as J did. She sees the contrast from my true self. At this point, the healthy part of me rarely gets a word in. It can be pretty surprising at times. I believe these thoughts completely, yet they are Ed thoughts and not mine. I’m thankful

I am giving this faceless disorder a name. I am taking away its power by separating out my voice, the real me. I need to use Ed to distinguish between me and it. I’m so thankful L has brought this back to my recovery.

The “T” word

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“Am I going to be able to offer you the support that you need, or should we look at other treatment options, IOP, PHP…?”

Well, I certainly wasn’t expecting that one when I met with L last week. I actually haven’t wanted to bring this up on the blog, but it’s been eating at me all week so here we are.

Anyone who knows me or has read here for a while can pretty easily guess my response: “I can’t do it because of school. I don’t need it. I’m not there yet.” Naturally, I made excuses. Were they truly valid? Yes and no. It is important that I complete my classes this semester and next since I need to get into nursing for next fall. I can’t just go off to treatment and have another last year. If it really got to that point, where it was life or death and I was too sick to function, I would go.

School is pretty darn valid. I’m not so sure about the other half of my argument. Last year at this time I was barely functioning. I have little memory of the entire month before I left for residential. I was so sick and stuck in anorexia. It wasn’t just that I needed more support. No, I needed a complete overhaul, accountability, 24/7 support, a variety of health professionals weekly. Sitting in PHP groups half the day or being stuck inpatient wasn’t going to cut it. Residential made sense, complete sense.

Looking at the present I just don’t meet these criteria. I could certainly use more support: therapy every week for starters. I wouldn’t be able to justify the time and money required to do PHP or IOP. I’m not eating enough but I am eating. Yoga is my form of exercise which is used in a (mostly) healthy way. I do not need a more intensive outpatient approach.

Selfishly, unrealistically, I want to get back in treatment. What I would give to have another week with the staff at CFD. What I would give to be around people like me. What I would do to get away from this new story of hell I am experiencing currently.  But I can’t, and that’s it.

Dietitian

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I have never had a dietitian who has worked with me and pushed me more than L (and also N at CFD <3). I’ve met with her only twice so far but I can just tell that this is exactly what I need. I admit, I was extremely skeptical and just assumed it would be terrible and I would have to pay hundreds to see someone else. Thank God I was very wrong about that.

The first moment we sat down was kinda terrifying. I’m not sure what all was going on but I do know how nervous I was. Would she make me go on a huge meal plan? Could I use my CFD meal plan still? Did she believe in the FV mealplan? Was it going to be once a month or something and not even be often enough to help at all? Did she really even know EDs that well?

All of that anxiety and worry was for nothing. We clicked right away. I’ve only had the experience of going into some form of treatment and being so comfortable/optimistic/certain it would help a few times. J, basically everything about CFD, and now L.

When we first met, she confirmed that it would be best to continue the meal plan I had been used to. Insert HUGE sigh of relief by me. How I had been eating wasn’t great. I skipped meals and restricted. The first goal was have 3 meals per day. That was scary but felt attainable at the same time. I didn’t quite make it there that first week. I felt pretty guilty as I headed into her office. She wasn’t pessimistic like I thought. She was happy that I accomplished 3 meals nearly every day. There wasn’t any expectation for me to be perfect from the beginning. This week’s goal is eat 3 meals again and hit slightly more than half of the mealplan I left CFD with. Again, she made this in a way that wasn’t too large a step from where I was but also not stagnate.

The two sessions I’ve had with her go very much like a therapy session. I never thought I needed or wanted this but it is a game changer. She really wants to know my thought processes. It isn’t just “how much did you eat? what did you eat? behaviors?”etc. Last week she instead presented a deeper conversation. L isn’t just concerned about the food. I shared my fears, what has triggered ED thoughts, significant events that happened, my treatment experiences, what helps/doesn’t help me, and anything else relevent to the struggles I am having with food. I can tell how much she values getting to know me and my eating disorder inside and out.

I’ve gotten some good suggestions and challenges so far. A huge surprise was her giving other options for supplementation than Ensure. She wasn’t saying Boost or one of the many other nasty, chemical tasting options used in the ED treatment world. Her goal is to find something I can use if I need that doesn’t taste like liquid punishment. I am a little weirded out by the freedom, actually. I’m not sure what exactly I’ll go with (or whether I’ll switch at all). I do only have 6 Ensure left, so the time to switch can be now. Two challenges came hand-in-hand: doing a comprehensive thought-tracking with my meal plan tracking and writing letters to “Ed.” I was 100% on board with the first part the second she said it. Letters to Ed, on the other hand, was a little flashback to FV (sidenote: she actually worked there as lunch support on Saturdays AND I met her during my inpatient stay!). I sat there not buying into it at first. I convinced myself she was wrong and this was a stupid idea, but decided to give it a try to prove how little it would help. As of now I really enjoy my thought logs and actually think the letters to Ed are helpful too.

Overall, I am very hopeful that this will bring growth and change. L is already becoming a vital support in my recovery. I am thankful that I made the decision to push past fear and see a dietitian again.

Giving Thanks – Nov 3

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Today I am thankful for: MY DIETITIAN.

I met with my new dietitian, L, for the second time today. It makes the ED part of me want to run, but that’s the point. She is exactly what I need, what the healthy me needs.

There is so much I can and will share about this experience so far. For now, 3 reasons I already feel blessed beyond measure:

  1. Two parter: she came in today specifically for me and had our session go for and hour and 15 minutes. This is only our second session yet she cares enough to give me the time and scheduling I need.
  2. She is beyond willing to work with where I am. She doesn’t expect change overnight and listens to me fully. The goals we have set are what both of us feel comfortable with. Also, I still get to use my CFD meal plan which is comforting and familiar.
  3. She will push and give new ideas. A good chunk of our meeting today was spent with her asking me the hard questions and digging deeper into why I have been doing poorly. A goal for this week is a technique I haven’t used in almost two years, but I feel like this is a good chance for a second go around.

God put L in my life right now for a reason. I cried out for help and He answered. She is a part of my recovery now and I am already grateful for it.

Planning for success at college.

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I thought I would take some time to explain all of the resources/plans I have at college to keep me on track in recovery. By no means do I feel it will easily, but I feel very confident that I have the most care and best care available. My opinion on that may change after meeting my new therapist and dietitian. Even if they aren’t the right fit I will work to find someone who is. Anyways, here’s my list:

Therapy 1x per week. This is so essential for me. I honestly wouldn’t have gotten through last year without talking with J each week. Individual therapy is important and allows me to talk through whatever thoughts I have, whether it be ED, depression, anxiety, or even a random SH urge. I also get to check in and if my therapist sees a downward trend she can help me get out of it. I’m also a huge fan of therapy homework. S is my new therapist here on campus and she seems wonderful. I’m hoping she will be a great fit and I love that I get the perks of academic assistance (ie taking a test in a room with less people because 90 kids in a class makes me anxious or even if I need a break from class one day)

Dietitian with weight tracking. Yes, I am seeing a dietitian. I was the girl a year ago who claimed I was above having a meal plan, hated the dietitian I met with, made excuses to never go again, etc. Forest View this time around convinced me to change my thinking. That was actually a big part of why VH let me go so soon. He wanted me on a meal plan and being weighed often so that a relapse could be detected early. It makes sense. I’m open to it and glad to be going. I think since she’s also at the school I’ll have more help with meal planning. Plus I can hopefully resolve my lactose issue or confirm that I am intolerant and plan accordingly. I hope to see her weekly or at the very least be weighed weekly. I’m not sure how that will go but I see her this week.

Following my meal plan (yes for real this time!). I could technically say I folowed my meal plan for about a week last time, but even that’s a streth. Obviously, that needs to change this time around. I’ve had success for the most part so ar. I know it’s not going to be easy, espeically with my lactose resttriction, but I am willing to make it work. I’m hoping that with my dietitian I will hit 90% each week. That’s the goal for now because I know I will screw up sometimes or the dining hall might not have something. I’m going to try my best regardless.

Daily recovery devotional/work in recovery books. Faith and ED recovery go hand in hand. I really can’t tell you all the ways being in God’s word fights the ED thoughts and puts me in better spirits period. It’s wonderful. My goal is to start each mornign in the ED devo book J gave me and work in my recovery workbook daily as well. If I focus on that it will give less time for the ED to take over.

Coping skills. I have so many coping skills this time around. I bought lots of markers and pens and coloring books. I find that to be so helpful. I love listening to oworship music while doing so. Yoga will be a regular part of my day as soon as I pick up my mat from home. Crosswords and other logic puzzles are always engaging. Anything on my computer from netflix to playing sims to just browsing. I have made sure there never will be a time I don’t have something to distract me. This means distraction when I have meals alone as well.

Accountability. I will fill out my meal plan record every week and show my mom, therapist, dietitian. My mom texts me a few times daily to see if I’m on track/having a  hard time, which is wonderful. I’ll have my dietitian and therapist to be honest with. I would love to have someone at Calvin know what’s going on. I’m waiting on that for now but hope to tell someone part of this soon.

Outside support. For now, at least, I’m going to be relying the most on outside support in my mom, Livvy, Lily. It’s hard, but I want to do my best to stay on track and reach out if need be, even though they can’t be physically here.

I have infinitely more resources and options for treatment her. My hope for this year is tgat I get unto a good, healthy groove and use all the help I’m given. As J said at our last session, God put me here at Calvin for a reason. He knew I needed more help and the fact that everything is so close and there are therapists and a dietitian here is amazing. I don’t want to follow the ED’s plan of slipping below the radar into relapse anymore. I have hope that however hard, recovery is still worth it. Here’s to a fresh start and an amazing, healthy, reviving year!