A “fun” dietitian appt

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.

Dear Ed 12/29/16

Dear Ed,

You have been my best friend and worst enemy for a very long time now. These last few months I’ve believe you to be my friend. After all, I am losing this weight that needs to go. My body is smaller and more toned. I also have this high that is so addictive… restriction and exercise. There isn’t much like it. That part has been wonderful. It’s so good that I’ve been able to ignore the negatives you’ve caused.

While you have masqueraded as my best friend, the effects on my life and the lives of others around me have been great. I was able to ignore them for a very long time, but I can’t anymore.

I told myself that my slipping grades weren’t that bad. I told myself that I was invincible and could never end up with health problems from restriction. I told myself none of this could hurt my future. I told myself skinny meant the world to me. I told myself this was the only way to gain control over my life. I told myself this was my ticket to better self-worth. I told myself this was all coming from me when it’s really you.

Now I sit here in IOP, just as I will 3 days a week for the next month or so. I side with you that I shouldn’t be here, but my treatment team says otherwise. I have to sit for the whole interim period when I should be enjoying fluorescence. I will eat, sleep, go to treatment, eat a shit ton more, and exist while doing nothing productive at all. The worst part is that I’m actually on medical leave, meaning I couldn’t get out of this if I tried. Even today, Rebecca warned me that at this point I may not be able to do next semester unless I get some motivation to work hard against you.

I’m angry it has come to this. I hate needing treatment and wasting all of this money. You are to blame. I can’t take all of that out on you even though you’ve acted as such a terrible friend, though.

I absolutely cannot miss out on next semester. I don’t have any more time before nursing school (if I even get in…). These classes are all required for graduation. I also have to get decent grades at the very least. If I can’t, I may as well give up all hope for the future. Most of me realizes I can’t continue exactly as I have been. This amount of restriction is a little too much to be able to achieve the grades I need: A’s and B’s at least. At the same time, I’m not sure if recovery is good either. I cannot be fat again like before. My weight and eating are the only things I do have control over.

With full restriction and full recovery both out, I desire to find a happy medium. You are 110% certain it can happen. I would stay at a preferred healthy weight where my medical status, comprehension, emotions, and living status are all just fine. I want to believe you, because who knows if R, L, and Dr C. are actually right (along with family and friends)? I don’t want to trust them without trying a plan I am more comfortable with.

I pray things will work out. I don’t want these things you tell me to turn out as lies, but maybe they are too good to be true… I will put my trust in you, or at least try. I need you to be my best friend I can lean on this semester while still doing well in my classes. If not, I will be done with you and work towards a future that you will not have a part in. Please just show your true colors because this is so very confusing.

Emily

*taken exactly from my journal activity we did in IOP

IOP: a fate more difficult than residential

By Thursday, I still hadn’t connected with my emotions, broken down, or processed the fact that I am on medical leave with mandatory (if I want to stay out of further treatment and continue school) IOP. I had so much on my mind that I couldn’t handle it. The time came when I was meeting with the new dietitian. I was randomly called out in the middle of AT/process after lunch. Being under the impression that I was able to continue with L made it a surprise, one that I never wanted. I finally broke over the change and lack of control in my life now. It was then that new L (to make things more confusing of course, ha) confirmed what I had already been thinking about, “this is going to be harder than residential.” We talked about how much of an uphill battle I’ll be facing these next few months. I cried from being so completely overwhelmed. This is a harsh reality to face.

This may seem odd to anyone who has never experienced multiple forms of treatment. Residential means being stripped of your freedoms, weeks or months away from home, and a complete overhaul of your behaviors. It certainly is hard to make an abrupt change and carve out the time to do so, however, one that’s just as cushy as it is drastic. You are stuck in this place that has all of the support you could possibly need, 24/7 to be exact. It’s actually pretty difficult NOT to experience at least some growth, even if that may be forced.

IOP is a 180 from residential. In my case, I will got 3 times a week (M, T, R) from noon until 5-5:30. We have 3 groups plus lunch/snack each day, along with weekly individual therapy and dietitian appointments. The entire rest of the week we are solely responsible for following meal plans, avoiding behaviors, and applying all we’ve learned. There is no one to check in on us multiple times a day or monitor our meals. If I didn’t finish a meal in residential I would only get a supplement. On the other hand, not adhering to my meal plan or otherwise slipping backwards now can lead to forced inpatient or residential and medical leave. I have major work to do and much to lose.

I always assumed my time at CFD would be the most challenging thing I have ever done treatment-wise. How could it not? I traveled across the country and gave up school. Adjusting to the new life that is residential was unlike anything else I’ve experienced. As much of a struggle this all was, it really was the best environment for recovery. In no way is recovery ever easy, but the amount of support in residential makes it significantly more attainable and manageable.

I can fully see how different IOP is. The effort to show up for my recovery is substantial. I have just 15 hours a week in treatment with 3 meals and 3 snacks. I need to make every single second count. The work doesn’t stop there. I cannot go home and just return fully to the ED. Motivation is key and if I fail to find it I am looking at IP or residential in the very near future. No one can make me recover now.

Where do I go from here? I could become consumed by fear and hopelessness, knowing of what’s to come. Giving up is absolutely the easiest option; however, it is not the one I choose to make. I am going to fight. I’ve been through years of struggle – times where I never believed I could make it through, but I did. IOP seems impossible right now and this may be my hardest battle yet. Even so, I will hold on to hope for a healthier future.

 

When treatment (and ED) multiplied

Two months ago, I only had therapy every other week.

Just over one month ago, I saw a dietitian weekly and therapy biweekly.

One month ago, I added a doctor to the mix. Around that same time, I switched therapists and began attending one group per week.

Two weeks ago, I attended a couple more groups.

Last week, I had activity therapy, R’s group with snack, art therapy, nutrition and yoga, and another therapy group with R over Monday and Tuesday.

This week, I was placed on medical leave, attended my first two days of IOP, and had to switch dietitians without any prior knowledge or choice.


It has been an absolute whirlwind. I remember thinking at so many points that I didn’t need this next step, I wasn’t sick enough. I argued, deflected, begged, hid the truth, ignored, and did everything to fight hard against any extra treatment.

I can’t fight this anymore. In fact, if I do fight it will end with me being forced to leave school and in residential or inpatient. This is serious. If I continue to follow my eating disorder it’s going to do a lot more than send me to a higher level of care.

Where I’m at now is a crossroad. I know what will happen if I continue with the eating disorder. It’s safe and familiar and easier. I’ll have the control I crave, watch my body shrink down to an “acceptable” size, and be able to cope with everything in a my life (albeit in a rather unhealthy way). On the other hand, recovery is the unknown. I’ve had some glimpses, but going full in is scary. It could mean a full life where I can become the best me: a nurse, wife, friend, mother, and person, all without Ed. The question now is this: do I stay in the familiarity of my eating disorder and fight all forms of treatment or trust in recovery by fighting my eating disorder? I think I need to at least try option #2, because I can always go back to the ED (as I have now) while recovery will only become less attainable as time goes on.

It’s over (!!) and will be for a while

As of this past Monday, I am officially done with school for the semester. I doubted the entire last 2 months that I would even finish it. I wanted to give up. Sometimes, I wish I would have. No matter what ended up happening, I did make it and I didn’t fail any classes or do bad enough for it impossible for me to make it into the nursing program.

This was my hardest semester. It isn’t easy to complete homework, study, or take tests when your body is malnourished and brain lacking the carbohydrates it needs. No matter how much I know logically, Ed still won a majority of the time. I spent more time taking naps and thinking about food than all of my schoolwork combined.

My whole treatment team has told me the same thing: you have to be stronger in your recovery if you want to successfully complete nursing school. Dr. C talked about how I can’t be so used to lying and cutting corners as I enter into the program. It isn’t okay to hide my struggles and carry it over to my schoolwork then eventually my job.

I will go into this in a future post with my thoughts on everything, but as of Tuesday I will be on a forced medical leave for the interim (J term) semester. I honestly was pretty shocked when Dr. C told me this. She was very close to forcing me inpatient or residential. For now she is agreeing on IOP, assuming I can make progress . This next 5 weeks or so are going to be spent in treatment 3 days a week. I will be able to stay on campus still (which isn’t typically allowed but Dr. C set that up right away).

I have to work my butt off if I want to start classes again for spring semester. It’s scary and hard and I’m not sure I can do it, but I am going to try. Goodbye fun interim class; hello, all of the groups, appointments, challenges, and (hopefully) growth.