Climb on?

I went into my appointment with Dr. C yesterday with just one objective: get approval to start rock climbing.

I was first introduced to climbing last fall via my roommate. We are blessed with a huge rock wall and bouldering area here at Calvin. Around one night a week, all year long, I went climbing. I grew stronger and fell more in love with it. The huge sense of strength and power continued to bring me back. I was able to challenge myself with the continually changing routes. It certainly isn’t easy, especially with Ehlers-Danlos, but I made it work. The minor (and one majorish) injuries were worth it.

Unfortunately, I didn’t get to the wall much this last semester. My eating disorder played a huge part in this. When I wasn’t isolating, I usually felt too weak to climb. I still pushed myself when I probably shouldn’t have. This leached some of the fun away from an activity I enjoyed so much.

I’m not in a perfect or great place now, but I am more than mentally ready to tackle climbing again. I crave another way that I can appreciate my body and have fun with friends. I was relatively optimistic heading into my appointment. Honestly, I shouldn’t have been, not at all. I am better than the end of less fall. I am off medical leave. I am handling the semester thus far. I am not, however, at a healthy enough place to take on such a physically demanding task.

I grew the courage to ask for Dr. C’s approval towards the end of my appointment, to which she answered, “Absolutely not,” in a solemn tone. I immediately questioned why and hoped for a compromise. Her concern is my heart. I am not allowed to belay (hold the hope taught as your partner climbs) because she is afraid I will pass out and put someone else’s life on the line. While not ideal, I could technically still climb but need to have one other person belay my partner. That idea lasted for about two seconds before she gave her reasons why I cannot climb. One is that I would pass out at some point during my climb. Assuming I had an experienced and focused belayer, I would be okay. More serious than this, she believes there is a chance that I could collapse or even have a heart attack. If that were the case there isn’t any guarantee someone would be able to help  or even resuscitate me in time to prevent serious damage. Minor issues with climbing include broken bones (due to possible osteoporosis/penia with my ED), dislocations/subluxations (thanks EDS), and in general injuries related to the way I am inadequately nourishing my body.

I’ll admit, I do understand some of her worries. It isn’t a great idea for me to try this without following my meal plan. If I was restricting that much I probably would be too weak to even hoist myself up the wall. It’s happened before. I don’t agree with most of the heart stuff. I frequently get dizzy and sometimes feel like I’ll pass out. This mainly occurs if I’m going from sitting or lying to standing too fast, or when I am not hydrated. I could easily be careful enough to prevent this. There is no way my heart is “bad” enough to cause me to collapse or worse. I have no special restrictions otherwise for the abnormality. Mainly I just need to ensure I hydrate and feed my body. Easier said than done, but something I would work on the days I climb.

Part of the reason she is so worried about my heart is because she believes I may have Marfan Syndrome. I am missing nearly all of the markers minus my PE, hypermobility, and vision (eg: not tall, no long and skinny limbs/feet/fingers/etc, no mitral valve prolapse or aortic root dilation, none of the facial features, lack of family history). If I did have it there would be an increased risk for multiple heart conditions much more severe than what I am dealing with currently. I still need to wait until I see my pediatric surgeon in a few weeks (more on that soon), but I can almost guarantee he will rule it out. Once that happens I may be able to negotiate with Dr. C again. Side note: I’m looking forward to picking his brain on EDS and hopefully, maybe getting referred to someone who actually gets it.

As much as I disagree and discount her concerns, I will listen and resist rock climbing for now. The tone she used scared me. We have spent two months now talking about my heart and how imperative it is that I start nourishing my body to prevent damage in the future. I can’t easily forget or play my symptoms off as absolutely nothing no matter how hard I try. It isn’t normal for your heart rate to increase 30 bpm when standing and as much or more practicing gentle yoga. I shouldn’t, at 21, be plagued with symptoms, an abnormal echo, and worry. And yet, here I am.

This conversation we had is about far more than just rock climbing. Her goal isn’t for me to increase my food intake so I can have her blessing to get back on the wall. This is about taking care of myself. If for nothing else, I need to repair any of the damage I’ve caused before it gets any worse.

I didn’t get the answer I had hoped for. I don’t agree with some of Dr. C’s reasoning. I am still resistant, making excuses, and defying her (and everyone else’s) requests. I have started to realize the bigger picture here. That’s a step in the right direction, one I don’t want to take, but a step nevertheless. One conversation at a time, I am getting there, even if it means getting motivated about renewing my rock wall privileges.

 

Oh, my heart.

I had expectations going into my appointment with Dr. C last Friday. She would go over the DEXA scan and tell me it was normal. The echo would also be normal. She too anticipated those results and had no worries that it would be different. It was.

“Your bone density turned out within normal. I would like to see it a bit higher, but we’ll keep an eye on it. I wasn’t expecting any abnormalities with your heart.. but I was wrong.”

Cue shock, disbelief, and finally numb/lots of fear. She certainly isn’t a BSer, so I actually had to trust her word.

I’m not going to get into exactly what the echo found, but I’ll give her analogy. If you picture my heart muscle as a trampoline, a larger person will produce a larger bounce with more force for the trampoline to return to shape. If you take a smaller person, it only is pushed in a little and doesn’t require as much effort to get back to shape. My heart is looking like the second instance. It isn’t being forced to give a strong response. Over time, this would weaken and then calcify my heart. *this is very paraphrased

This abnormality is something that just isn’t seen in a young person. She fully believes that my malnutrition is the cause. The starved heart isn’t a healthy one. Adding dehydration to the mix doesn’t bode well either.

For now, this doesn’t have to be permanent. I can work hard in my recovery to nourish my body. If I continue down this road and the heart begins to calcify it will never get back to normal. Currently, I am using hydration to help. Restriction is back full force and it can be hard to get water down too. If I want to give myself the best chance of reversal I will need to eat. That’s pretty terrifying.

I began bawling before I even got out of the building. This can’t be true. I am still so much larger than I had been in other periods of my eating disorder. How could I have done this to myself? While the real Emily has these concerns, Ed’s view is the opposite. He says it isn’t that bad and I don’t truly need to eat or listen to her. My heart is going to be just fine. On the other hand, this also proves that I am sick and doing well in anorexia. (side note that I found interesting: this reminds me of how the serpent tested Eve in the garden way back in genesis)

This whole situation is a mixture of thoughts and emotions. Almost a week later I still can’t decide what to believe or think or feel. I’ve gone through shock, denial, sadness, etc, but not acceptance. Honestly, I probably need to see Dr. C again before any of this will really sink in. For now, I pray that I won’t randomly pass out or anything (as Dr. C warned there is a small chance it could happen) and eat/drink enough..