Hello again

It’s been a while.

I don’t honestly know what’s all been getting in the way of blogging. I’m busy and tired and there’s school, etc, but it’s not like I have never experienced any of this before. I think I can come up with one main barrier: perfectionism.

This isn’t new for me at all, yet it feels different now for whatever reason. I feel like I have a million and one things to catch up on and that I am a “bad” blogger if I don’t write about xyz first (in a timely fashion.) I’ve made promises before to talk about my treatment last summer, for example, and I continue to push it aside. I have plenty of negative/self-defeating thoughts swirling around about this. My perceived failure as a blogger is certainly feeding into that.

I love blogging and it hurts not being able to do so. I wish there was a way to take away the anxiety and obsession with writing. I think if I actually allowed myself to write in the moment without the perfectionist critic I might not just create posts but enjoy doing it.

I am ready to face my road blocks. I’m not going to promise anything at all in regards to a timeline or types of posts. That just opens up the door for more self-criticism. Instead, I will limit my editing to a minimum and only write about what I need. Here’s to being here more often!

Small update – one week out!

I can come up with a million and two reasons why I haven’t written, miss writing, “should” have written 22 posts by now, etc, BUT for now I want to talk about this.

As the title says, today marks one week post-discharge from PHP. Yes, that is just 7 days, not the 14/21+ I had assumed I would have by now. I’m not really okay with that, but I am going to be. It truly wasn’t the worst possible way to end my summer.

Here is a snippet from my post last Wednesday: “4 weeks, 19 days, 130 hours of programming, 93 meals and snacks, 3600 miles and 38+hrs driven. 
Countless tears shed. Feeling lost, overwhelmed, anxious, challenged, excited, shameful. Difficult conversations, meal plan increases, wanting to give up. Packets, lectures, assignments, and groups. 
All of the above? Totally worth it because I am now on my way to recovery. This semester isn’t going to start the same way last spring ended. PHP wasn’t at all how I envisioned my last month of summer, but I’m grateful for how things turned out and the lovely people I’ve gotten to know along the way.”

I mean those words, deeply and truly. What I needed was a program that would push me hard and make sure to fight ED even when I didn’t want to. I needed to be watched as I ate four times a day (and even the damn tray checks because I am not always that trustworthy..) I needed people who wouldn’t give up as I sat there stubborn and willful. Despite all the hardness, I also needed compassionate people surrounding me (staff and fellow patients!). IOP was too little, residential or inpatient would have been too much, and PHP was just right.

I’ve been back in the dorms since Friday and today was our second day of class. I am back here, but in so many ways I’m not where I left off last spring. My dietitian messaged me yesterday about the growth she sees in just the week I’ve been using Recovery Record again. I completely discount my positives all day long, but I want to end this post with some changes I do believe in.

  • I have eaten in the dining hall basically every meal I’ve agreed to (vs maybe twice a week prior!?!?)
  • I try to reach for a snack when I feel hunger cues
  • I’m trying to find small ways to make recovery a priority
  • I survived some seriously limited options in the dining halls – think 1-2 proteins/sides plus a salad bar
  • I’ve eaten some scary things (mostly out of necessity due to the above issue)
  • I am being honest on RR even when it sucks
  • I think I may have more energy?

This is most definitely a work in progress, and I won’t get into the hard part now because what matters is that I am trying. I am doing the recovery things and that matters.

Whirlwind

Holy cow, it has been crazy. I mean to update last Tuesday, and then Wednesday, Thursday, and so on until we get to tonight. I’ve been busy and exhausted, because I started PHP a week ago. I remember the beginning of this year. One of my top goals/intentions was to avoid treatment at all costs. Ironically, this quest to avoid has actually harmed my recovery. I have been so, so adamant against treatment that it took me a month (and the IOP team forcing it) for my to agree. I know hindsight is 20/20 and all that, but I actually wish I had listened, dangit.

I guess I may as well start off where I left off. Rather than make a separate post, I’m going to insert what I wrote and didn’t publish last Tuesday.


 

July 31st is a significant day in my life. It is my person’s day of birth (love you Livvy!) and also when I first went into eating disorder treatment.

4 years ago today, I was pushed into this huge world of what eating disorder treatment looked like. It was terrifying, confusing, frustrating, with some understanding mixed in.

If you had asked me 4 years ago where I would be now, I’m not sure that recovered would be the answer. Later on it definitely became the ideal future, but at that moment I was just so stuck into the ED. Treatment wasn’t optional and I was angry that I had to change.

Today I was back at the same hospital I started at 4 years ago. I’m not in clinicals anymore and there wasn’t support group. I had an intake assessment and tomorrow I will head back for my first day of PHP.

I cried the entire way there. It’s really hard to see that I’m in this spot again. I do feel a little hopeless and discouraged. How could I not, given how much I’ve wanted to stay strong/avoid treatment?

My disordered thoughts are very present right now, and one of the most pressing is “I am just in the same place as 4 years ago and that makes me a failure.” Yes, I am struggling enough to go to PHP. I am not in the same place, though. I can never go backwards in that way. I’ve grown, a TON. No amount of relapse can change that fact.


 

The past 6 days of PHP haven’t really gone quite as expected. I had plenty of expectations going in: irrational (I’m going to weigh 50 pounds more than everyone, I’ll have to eat a full meal plan right away, they’ll put me inpatient) and more realistic (it will be hard, I’ll have the same annoying nutrition groups, the adult PHP is terrible/dramatic). I also had an incredible amount of worries that didn’t stop at one full sheet of paper. I realized that probably wasn’t helping any and attempted to distract instead. Some things I didn’t count on happening:

  • Having a treatment center reunion since there are 3 of us from IOP there currently
  • A huge group, between 10-13! I know this is tiny compared to some treatment programs, but we barely fit in the one room and need to eat lunch in the huge room.
  • Being semi-terrified walking through certain units. The first day I recognized 5ish staff members from when I was in clinicals. For some reason, that freaked me right out and I’ve been ducking my head each time we go in the unit where I spent the most time.
  • The whole adult PHP room full. We actually didn’t have enough chairs today, so my friend and I sat on the floor. It’s pretty intimidating/annoying to have that many people staring at us as we come in and leave approximately 75 times every day. Luckily, we’re only there for 2-2.5 hours per day, which is more than enough.
  • Eating every 2 hours (sometimes less!!!). So I completely forgot about this part, or maybe blocked it out. We have breakfast at 8, morning snack at 10, lunch at noon, and snack at 2. Typically lunch and breakfast will both run late and that means even less time between meals. I knew volume would be hard, but I think eating this close together is harder even. I just get full by morning snack, then have to down even more. I haven’t been eating dinner until at least 6 because I’m still full/uncomfortable. I wish I could have started on an even smaller meal plan to try to reduce this, but I know that wasn’t going to happen. I really hope I/my body eventually gets used to it.
  • Not knowing a discharge date (or even a vague idea). My main psychiatrist did leave for vacation Friday, which was just day 3, so it is understandable. What bothers me is that there is no time frame whatsoever. My case manager yesterday said she had set up appts with my dietitian, therapist, and psychiatrist when she can’t tell me when I could be done. I’ve learned now that I have to avoid thinking about it for now, and just hear from my psychiatrist next Monday.
  • My defiant side coming out. Okay maybe I shouldn’t be all that surprised, but the ED is not taking any of this treatment BS. I have had urges to throw out food when no one was looking, nearly cried when the AT remembered to give us snack, secretly rejoiced as I saw my breakfast tray was lacking one exchange. I don’t do all I need for dinner. I’m not always doing “the work” part either. I don’t know, I guess I just thought it would magically be fine if I just took the leap to PHP. In reality, I am feeling quite a lot like 2014 PHP Emily.
  • The other patients are not too triggering!!!!!! That deserves all the excitement since it was one of my many excuses not to do partial. I was prepared for the worse and just haven’t seen it. Yes, there are others way thinner than I am, but I’ve found that I don’t necessarily want to be more like them. Behaviors are used unbeknownst to the staff, but I’ve kinda come to the conclusion that I cannot base my recovery off that. We are supportive of each other. Some don’t finish meals/finish Ensures and that doesn’t bother me too much either. Overall, it’s a pretty fun environment. We have some hilarious conversations and plenty of inappropriate ones too (also, all the swear words aha). That is so very needed in a setting like this.
  • I get to work with a psych resident one on one!! I saved the best for last. She and I have a 10-15 minute meeting each morning. I don’t get to see my case manager pretty much ever, so this has been a great time to process and really be open about progress and struggles. She’s been challenging me everyday and actually holds me accountable for those goals. I just feel very grateful I am one of the patients who get to work with her because I totally expected to maybe have 2 individual meetings a week.

PHP isn’t as bad as I expected it to be. I spend plenty of time wanting to run away and never come back. I think that’s pretty normal, though. I have come back each day to do the hard things anyways.

After all of the fighting and whining and complaining and driving my treatment team bonkers (I’m sure), I can semi/kinda/mostly admit it: I needed a higher level of care. I haven’t eaten this amount of food in a day for at minimum 6 months. That alone was never going to happen with IOP. 5x a week 8-3 means my world is invaded by treatment, but I can see this as a good thing. It means spending more time on recovery. I can’t ignore that need forever. So, while I can think of a million and one other activities I would enjoy more than PHP, I am here. I am going to be in a healthier place for school. Quoting one of my favorite dietitians: “I can guarantee you’ll find more happiness without the eating disorder, BUT THERE’S WORK.”


To finish this off, a few treatment goals that go beyond the very generic “improve healthy eating” or “learn coping skills” that we check off on our sheets.

  • Be able to tolerate the meal plan when I’m not in treatment
  • Get into the recovery mindset where I can put that first.
  • Push through the hard days because eventually they do get better.
  • Journal and make goals each day.
  • Do the little things, too – gratitude, worksheets, assignments, etc.
  • Come to a point where I am working for my recovery and not kicking and screaming every step of the way
  • Feel confident going into this next year
  • Don’t limit my exercise to compensatory only

Those are some pretty lofty, open-ended goals, but for a reason (of course I do have all the SMART goals on a small scale, though). Recovery is not black and white. I’m trying to be flexible here because I know how much feeling like a failure can harm me. I aiming for growth and not just perfection

Sorry for how long this has become, oops. It feels nice to have this all out here now. I hope to document this journey as I go. Processing it here is always helpful and something to look back on later.

I made it! – a little update

As a rule, I genuinely dislike taking breaks from blogging. I love to write. I love how this allows me to get my thoughts out. I love that I can reach other people. I love being vulnerable and sharing bits of my story. Sometimes, though, all of  that needs to be put to the side. The past couple weeks have been one of those times (for good reason).

The last post I made was on May 7. That was the start of one of the craziest weeks of my life. It consisted of: finishing a 6 page research paper in around 24 hours, writing and rewriting our last big journal for clinicals, attending IOP, shadowing a lactation consultant, packing up and cleaning my entire dorm (all last-minute, of course!), still making it to support group, studying, and trying not to lose my mind. I took my exams the next Monday and Tuesday, aced my maternal newborn ATI, and finally left campus at 6 on Tuesday.

I thought I would have time and energy to blog right away, but it wasn’t the case. I have napped more days than not since being home. I hate it but know my body is probably trying to tell me something. My brain feels like absolute mush, which definitely doesn’t help. I have all the ideas in the world, but without energy or focus I end up sitting at a blank screen most of the time. That’s finally changing because of work. I’ve always been able to think about different ideas/posts when I’m otherwise preoccupied. Driving is a top offender for this. I’ll have some brilliant idea but it slowly fades out by the time I have access to a means of jotting it down. Luckily, I have found time to type a note on my phone or even write all over my arm to remember bits and pieces of what I want to say.

Although I’ve found some inspiration while working, being there so much since coming home has left me exhausted. It’s been all kinds of crazy and stressful – from difficult requests to long hours and staying late more nights than not (I was officially scheduled 3 hours last week and worked 5 days/20 some hours). I come home and immediately sink into the recliner/my hammock. Naps and staying home are a big part of my life currently.

In the short almost two weeks since school ended, I’ve learned more and more that recovery is going to be the true full time job this summer. My team has already been on me about increasing exchanges, a meal plan change (that I’m expected to give a try..), weight gain protocol, and generally making strides away from the ED. They also share the beautiful future I could have without Ed. It’s nice to be reminded of the end goal because I can know what I’m fighting for. I don’t often see what could be when I’m in a struggling place.

I am so, so ready to be back in this space. I have lots more to share soon, but I just wanted to give a quick update to start off!

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 🙂

Treatment update – IOP round 3

I have a whole ton to update on and a couple posts I’ve drafted, but first I want to touch on a difficult subject that came up yesterday. I’m still trying to accept my new normal for the first few weeks of the semester.

I had an absolutely wonderful day at clinical orientation in the children’s hospital. I’m very pumped for it all. I left in a great mood and just felt positive, but then I looked at my phone. I got an email from R that was a little shocking and very upsetting:

K and I talked and we would like you to be at x exchanges before you stop coming to IOP.  We will extend your time in IOP to 2/15.  If you haven’t been able to reach x exchanges by then we will need to look at having you go to a higher level of care like PHP to stabilize. So,  work hard this week to keep moving forward!

Now I want to back up a little bit. In the beginning of January I stepped up care, attending more groups and eating lunch at treatment. I didn’t consider it IOP because I had other appointments while I was there. I quickly realized that being there the whole time IOP is going on still means I’m in IOP. I think it’s been good for me to get out of my dorm and try to work through some of this. The one thing that hasn’t truly improved (okay, I did have half an exchange increase from 2 weeks ago to last week) is my eating and subsequent weight loss. I don’t know that I’ve had this much trouble getting out of restriction before.

IOP is going relatively well. I’ve had a ton of challenges and mostly stepped up to the plate. Last week Monday ended up being the most exchanges I’ve had in months, thanks to increasing for both my meal and snack at IOP. Even though I do love the therapists and some of the activities, I don’t want to be there any longer than I already have been. I’m ready to focus on school instead.

Originally I was supposed to attend full IOP this Thursday and R would let me know on Monday what the plan would be. Unfortunately, that wasn’t what I wanted to hear. I’m not at all happy with this arrangement. I cried and felt generally terrible upon hearing the news.

I decided that yesterday I would allow myself to wallow. I felt all of the negative emotions that came up – guilt/shame, frustration, fear, hopelessness, a little anger, sadness. I didn’t try to push them down. At some points I felt genuinely sorry for myself. It honestly was a bit miserable. As hard as that was, I believe it definitely benefited me. I got out those feelings in a more healthy way. I didn’t focus on acceptance, which may seem a little counterproductive.

Today, I will attempt to end the wallowing, rationalizing, and planning about how I will get myself out of IOP for the next 2.5 weeks. As my best friend said, arguing against it may result in my team feeling I’m not in a good enough place to continue in this level of care. I really can’t have that happen. (side note: any other form of treatment absolutely will not work with my schedule)

Today, I will work on acceptance. I want to go into tomorrow with the best possible attitude. If I’m going to be forced into IOP, I want to actually gain something from the experience. We’ll see how that goes considering how stubborn I can be (and how loud Ed is now).

I am not where I wanted to be by the time spring semester started. I am not where my team wants me. I am (probably) not in a stable enough place to handle everything. I need to change this so I can be in the best possible place to thrive and not just survive.

This is obviously not the update I wanted to make, but it’s where I am. This won’t be where I am going to stay.

Treading water – recovery update

*Note: this does not mention specific ED behaviors, numbers, etc etc etc. I know how not-helpful that would be to anyone, including myself. It is, however, pretty negative. I think you can tell where my mindset is and that is more in the eating disorder. Proceed with caution if you think this is something that may be triggering, although I’ve tried my best to not make that an issue here

Honesty time: things haven’t been the greatest. I’ve had some slips and am more stuck in eating disorder ways than I was a few months ago.

Right now it feels like I’ve been thrown in the deep end of the pool and can’t swim. I’m able to tread water and stay stable, but I can’t remember how to swim and get myself to safety. It isn’t that I’m sinking or don’t know how to swim at all; it’s a lack of immediate knowledge of how to get from point A to point B. I’m also not really motivated to get to point B anyways, because point A seems like a good place to be. Another important thing to note is that I’m not drowning. I am not in immediate danger, but treading water for too long isn’t good either. I’ll get tired and eventually not be able to keep myself afloat. I may need someone to rescue me and throw in a life preserver.

This metaphor is about as close as you can get to how I’m feeling. I’m not in relapse. I am in the warning stage. On the scale from green to red, I am sitting at around an orange, so about a step above true relapse. The ED is trying to convince me that I can lose a few pounds. I can live off this amount of food. I can continue to use exercise in a negative way. Deep down I don’t believe that as much. K and R always remind me that it’s a slippery slope. What starts as some ED coming into the picture can snowball. It’s not really possible to believe the lie that you can get a little thinner, a little more into Ed’s rules.

My appointments with K and R have gotten.. interesting? Not as tolerable? More serious? Honestly just a mixture of many things. Today I met with both of them and as time goes on they seem more concerned.

K (dietitian)

  • I have a minimum that if I don’t reach I’m *supposed* to drink an Ensure (hahaha yeah not happening), but naturally I haven’t met that and am not forcing myself to drink a nasty bottle of chemicals. Now my maximum has been going down little by little. I stayed relatively stable this week, but it is lower to a point that my new goal doesn’t even include the minimum I’m supposed to follow. Basically it’s not realistic anymore because there’s no way I’ll do that when I haven’t hit it in maybe a month?
  • My other goal is to have more afternoon snacks. As always, my ED means cutting down on eating and morning and afternoon snacks are typically the hardest.
  • As per usual, I’m having a hard time with negativity. I tend to get in a place where I just feel like a complete failure. She had me try to list 2 positives from this week and it was honestly one of the most difficult things I’ve had to do in the past week. (Is that sad? Perhaps.)
  • I’ll admit, I have been using yoga in an unhealthy way more and more. This isn’t new to me and I’ve been here before. Actually, the last few times I’ve relapsed with exercising it has consisted at least half the time of yoga. Anything can become maladaptive with an eating disorder, apparently. Given this, K wants me to spend one day doing completely “normal” and gentle yoga. I may or may not be too happy about this.
  • For the first time in a long while, she told me that weight is not even the most important factor at this point. It’s something I’m pretty heavily focused on, but she has other markers. For example: physical symptoms like dizziness, amount of restriction, amount of exercise, type of exercise, level of Ed thoughts, etc. For some reason this surprised me a bit because I tend to judge myself by weight or size.

R (therapist)

  • I am convinced that a certain weight I want to get to is healthy, because BMI-wise it definitely is. I feel like that is reasonable and would make body image better than it is currently. R went back through my weight history since I began coming there a year ago and told me that when I get into x range, I have ended up in treatment. I don’t want to accept that my body would be more comfortable at this higher weight. Note: I don’t actually know my weight (minus when I saw it a couple of weeks ago at the Dr) so all I really am aware of is if I’m losing.
  • I have a ton of distrust in my body and it’s somewhat carried over into not trusting my team. I feel like they could be lying to me and how would I ever know that?
  • She has seen quite a bit of downslide in the last month or so. It hasn’t been super severe and is generally slow, but it’s there. If it continues… (fill in the blank with options I am not too fond of)
  • I may not be able to continue EMDR much longer if… I continue restricting and/or lose weight, since it would lead to a state where I cannot concentrate enough or have the mental energy to work through things. As much as I have a love-hate (mostly hate) relationship with EMDR, I know that it needs to happen. I can’t be held back by this any longer. It’s frustrating already to feel pretty stuck on this target, but knowing I could be forced to put it all on hold is scary. It feels like I would be giving up entirely.
  • We talked about my goal once school ends (in 10 days!?!?!), which is to maintain how I’m eating and exercising. I don’t really want to challenge everything too much, even if I will be away from much of my stressors. Stability is safer. She is concerned about this, given how my body is reacting, but I think it’s better than alternatives like just giving up the recovery piece.
  • I may be closer to relapse than I really think. Last week she mentioned I may be in the orange, so this past week I wanted to prove that wrong. I checked off every symptom I have currently from each grouping (green, yellow-green, yellow, orange, red, rusty-red aka needs treatment). I have way less in the green and much more in yellow, orange, and even red. I am a little shocked. I get into the mentality of I’m not that bad and just ignore the signs.
  • Every single time I see her (and K somewhat), I end up convincing her and myself (one of us doesn’t quite buy it) that this isn’t anything to worry about. How do I master this? Comparison! I can look back at 2014, 2015 x2, 2016, and 2017 to compare now and when I’ve previously entered treatment. I am not doing as poorly with my mealplan/eating in general, still managing school, at a healthy weight, and not currently slipping at a fast rate (actually I’m relatively stable for the last week or so). No matter how many times I hear differently from them I just can’t buy it for whatever reason. I think the Ed voice is just so strong and convincing that I have a hard time considering the other side of this.

Although I haven’t done so in this long, jumbled mess, I have been making it a point to separate out the Ed voice vs my voice. I figured it may be a tad confusing for it to happen here. I can recognize the unhealthy side, although that’s getting harder. Once of my assignments I find helpful is putting Ed thoughts or rules and reframing them. That starts to give me a new perspective.

Reading this back now, I can tell that things aren’t all great and unicorny and whatnot. I am struggling; I’ll admit it. Treading water has not been a fun thing. When it goes on for over a month, nearing 2, exhaustion sets it. I have slipped some, with the most change coming in the past month (according to R and K). I’m finding it harder to stay afloat at this point. I think I know what happens if I actually begin to sink. I don’t want that at all. I can’t do that again. My goal, then, is to stay enough afloat and manage everything. I’m not truly aiming to get better, but if I at least maintain we won’t have so much to worry about.


That’s a wrap for now (and a long one, holy cow 1500 words). I wanted to get this all off my chest and continue to practice authenticity here. I can’t just sugar coat things. This is a true experience of my struggles. It would be a disservice to myself and anyone who reads my blog if I pretended recovery is always wonderful and the easy decision. It’s messy and that’s okay. Today my version of recovery isn’t where I or my team may hope, but that can all change. I want to document that no matter which way it goes.