29 March 2010

Fighting anorexia

Dreams of recovery and freedom continue to haunt me. I see a life without anorexia just within grasp. My fingers brush against it and I try to grab hold tight, only to have this shadow dream life spirit itself away. It hides from me, glancing back mockingly while tears flow and I beg to be release,  God please release me from anorexia; I am so tired.

Ana ... ED ... The Evil One ... The enemy has many names. And it has many tricks, tricks thrown at me each time I try to move toward recovery. This journey started out as simple restricting. I didn't eat and I lost weight. End of story.

Then the illness grew and new manifestations entered my life. First Ana whispered that I should purge my food, and helpfully suggested laxatives. I didn't do it every day; just when I needed to assuage the guilt of indulging in too much food. What was too much food? Anything that resembled what a normal person would eat. Ana said I wasn't to be normal; I was to be light and delicate, beyond mere human needs of eating normal meals and the companionship that often comes with that.

Christmas 2008. It was a few months since I left a two-week IP stay at Beaumont Hospital. This stay was meant to nourish my depleted, 92-pound via a tube (called a TPN) running through my vein and set just above my heart. For ten days, I often thought about those nutrients feeding my heart, taking care of it when I wasn't able to. It was a comforting image.

But I struggled after leaving Beaumont that first time. I didn't know it then, but I would return to IP six more times between September 2008 and February 2010. I hadn't gained any weight during the months after my discharge; I was still hovering under the 100-pound mark. I was struggling and beginning to think anorexia would be with me longer than I had originally expected. ED had become a persona, and I created this blog to vent some of my feelings.

One night, I was looking at the Christmas tree with its lights of blues and greens and purples and reds. The angel ornaments hung serenely, gold and silver intermixing and glinting upon the lights. Suddenly I became very angry, so angry at myself. I decided I hated myself for having anorexia. I felt I was spoiling yet another Christmas for myself and my husband, David. I got off the couch, went to the bathroom and took a small razor, slashing it against my skin several times until I finally felt the anger leave me.

It wasn't a suicide attempt. It wasn't even an attempt to hurt myself. To this day, all I know is I felt angry at myself, I despised myself and I needed to release that anger. Why cutting? I do not know.

It never has become a regular practice, and I didn't really cut myself except once or twice throughout the years after that first incident. Then my husband left for a two-week trip to Florida in February. The trip was less than a week after I got out of my seventh stay in IP, this time for refeeding via a NG tube.

Dr. Sacekyfio told us the trip was a bad idea, but we did not to listen. Ana was overcome and dancing with glee; the freedom to restrict and indulge in all sorts of harmful behaviors was an opportunity too rich to pass up. I told him to go, that he needed a break. I felt like such a virtuous wife; so selfless and giving, when in reality I wanted him to go because I couldn't wait to stop eating again.

But that's not all I did. Ana thought of all kinds of new ideas, and no, I am not going to list them here because of the fear it could be too triggering and dangerous for some people. The only thing I will write about — and that's because cutting is so common among anorexics; another manifestation of our hatred of our bodies? — is that one night, I found myself carving, "Hate me," in my upper right arm.

As I watched the blood seep to the surface, I couldn't believe I did that. I felt faint. It seemed like it was someone else's my arm; that couldn't be my arm, I couldn't have done that. I still can't believe I did that, although the marks are still there and I am still too embarrassed to wear short-sleeve shirts.

I thought to myself, I started out restricting food and now it comes down to this? What was happening to me?

When I started treatment with Dr. Sackeyfio in August 2008, I promised him two things — I would never lie to him and I would always be upfront about what I did. I would always be honest; otherwise, I thought I would be wasting his time and mine and what would be the point in going to a therapist only to lie to him?

I have sometimes regretted that promise, but I'm proud to say I have kept it. Sometimes I have spent a 45-minute session dancing around what I know I have to say, then blurting it out with two minutes to finish up. Sometimes I have had to write down what I needed to admit I had done to myself, or about what was too painful to talk about. There have been times I have had to shut my eyes and block out everything as I talk, particularly recently as we delve into the likely causes of my anorexia.

Each trick Ana has thrown at me has been exposed and tonight I had to rip the lid off another one. 

I was at a small party to welcome home my nephew, and I just wanted to be a normal person, just like anyone else who went to a party and grazed a bit and maybe became somewhat stuffed. I also ate because I was hungry; I still eat so little, I've been restricting for days and I'm not sure why.

But for the first time since I've developed anorexia, I tried to make myself throw up my food. This wasn't just a fleeting thought or a quick, halfway attempt. This was 25-minutes bent over the toilet sticking my fingers down my throat as far down as I could. I was desperate; I felt so full, I was so angry with myself for drinking four glasses of wine and eating chips and salsa and homemade brownies made by my sister-in-law.

I couldn't get the food up. No matter how hard I tried, I couldn't make myself throw up. I got up, disgusted with myself and immediately called my doctor and left him a message about what I tried to do. I didn't wait until our appointment on Wednesday. I'm sure he was thrilled to get a drunken message from me on a Sunday night, but I knew I would dance around it and I knew I had to expose this latest trick as soon as possible.

To quote my husband, "This is bad." (I told him during what I tried to do during the drive home; no bathroom stops for me and he made sure every laxative I had thrown away this morning - in an attempt to renew my promise to God; another story - was mixed in with the garbage so I couldn't get to the pills.) My husband sounded frightened of this latest manifestation of my illness. He reminded me that throwing up had been taboo; I hated to throw up and this attempt spoke of increasing desperation.

But this also is recovery. I step forward, filled with hope. I step backward, frightened and filled with anxiety. And I continue to dream and hope and work toward recovery, making sure the steps forward are more than those taken backward. Ana ... ED ... The Evil One ... can throw every trick possible at me. I remind myself I have weapons to fight, too. I have my friends, my doctor, my husband and my family.

Above all, I have my God.

This is the start of Holy Week, when we remember the Passion of Christ and the ultimate sacrifice He made for us out of the love the Lord holds for us. For me. As I move forward to Good Friday and reflect on those horrific hours of His dying and death, His descent into hell and freeing of souls; I pray that He can free me from anorexia. I remember that Easter morning is coming, and He will rise, reminding us of God's power and love.

And when he had entered, He said to them, "Why do you make a tumult and weep? "The child is not dead but sleeping. . . .Taking her by the hand he said to her, "Tal'itha cu'mi"; which means, "Little girl, I say to you, arise. Mark 39, 40-41

I am not dead, and I too shall arise to life.

                                     "Breaking With Midnight" Photo courtesy of Nasa.gov

26 March 2010

Of fireflies and recovery

Thousands of fireflies would dance through the deepening night; golden luminescence darting back and forth. Damp smells rose from the deep blue-green grass, and my toes curled against the dirt underneath my feet as I would run and play.

Summertime in Kentucky meant hot days and humid nights. The very air felt like velvet, and the western sky would darken from deep yellows to rich-reds, finally melting into angry hues of dark blue.

Then the sky would literally explode with millions of stars, and I would stretch out on that carpet of grass and gazed upward, my mind swirling into the vision above.

My step-grandmother, Dean, would cook meals large enough for ten families, the table groaning with fried chicken, mashed potatoes and macaroni and cheese. The centerpiece of these feasts was fresh cornbread made the old-fashioned way, in a black cast iron skillet. This skillet was carefully seasoned throughout the years, and each baking added its own unique flavor. It was never washed, only carefully wiped off. The skillet stayed in the family for more than fifty years, then it suddenly disappeared, taking its secrets and memories with it.

The skillet, along with Granny's handmade block quilts and Mamaw's collection of six husbands, represents one Southern family's life. The memories are there, but the only way to retrieve them would be by scraping off each layer of seasoning; an unthinkable desecration.

I crave the beautiful parts of my childhood, the dances with fireflies and the velvet nights of mystery. I have been inexplicably drawn to Avatar and its luminescent world. I want to walk through its gossamer strings of the palest of whites, baby blues and royal purples.

I was moved by this fictitious people's connection with their world and each other. Our bond with the natural world largely has been broken; the fireflies of my childhood are gone and the grass no longer touches my feet. We struggle to come together when our world is threatened; we are more likely to believe in the strength of the individual and admire people who solve their problems without help.

I long to run through its woods, to perhaps be briefly touched by its gently floating, fluttering creatures representing Eywa and reminding me of soft blossoms of cotton. I want to fly through the air with the wings of a bird and shoot an arrow with razor precision. I want to gather in a circle of people and collectively pray, to reach out to both God and each other.

I want to be free.

I will have to scrap off each layer in order to heal from anorexia. I will have to commit desecration, unveil secrets that shouldn't be told. There really isn't any other way. But I realize for true healing, I need a circle to surround and support me. I absolutely cannot do it on my own.

I dream of healing, of recovery, of freedom from fear of food and weight and numbers on the scale and what all that represents. Since I first saw Avatar, I have been dreaming of possibilities. Of life without anorexia. Of freedom.

My dreams and thoughts sometimes threaten to smother me; it all seems so unreal and impossible. I take a step forward, such as spending time with friends and enjoying the simple pleasure of eating with them. Then I take a step backward, and purge the food in a moment of panic. My body is empty of the food that makes me feel dirty, and I see the joy of the moment swirl downward into the sewage; life denied and fear placated.

But I still believe in my dreams and refuse to let them go. Several weeks ago, I started thinking about more aggressive treatment options, and found myself calling The Renfrew Center one afternoon. I knew it was a long shot; my insurance told me in 2008 it doesn't pay for residential treatment.

The people at Renfrew are a bit smarter about these things than I am, though, and found a way. I can go through the center's intensive 30-day day treatment program (100 percent covered by my insurance) and live in transitional housing, basically creating a residential treatment experience for me. The one hitch is we would have to come up with about $3,000 to $4,000 to pay for housing. We haven't figured out that part yet; I'm hoping with prayer and some creative thinking, we will be able to swing it.

I had been feeling fairly hopeless before I made that call. My thought was I am going to die of anorexia. I felt I might overcome this relapse, but then what about the next? And then the next? I have an incredible doctor who has worked with me hard through these past years; I would not be alive without him. But a 24/7 program for one month just might give me the skills I need to prevent the next inevitable relapse and could make my work with my doctor so much more productive.

I felt the first stirrings of hope, hope I haven't felt in a long time, since I made that call. I'm still too scared to completely hope, because part of me think this just won't happen, that it's an impossible dream.

But I've been dancing with anorexia for years, and I'm ready to bow to this partner and exit stage left. I'm ready to leave this behind and build a new life with my husband, family and friends. I want a life of laughter and love, books and learning, good conversations and opportunities to help others. I want to fill my eyes with the sight of the night sky and its stars; I want to gaze upon Stonehenge and think about the people and why they might have built it. I want to return to Haiti, and this time give the people all of myself, not just what was left after starving myself and could barely think. I want the ability to take every part of life and embrace it, learn from it and grow.

I want to dance with the fireflies.

17 March 2010

Bargaining with recovery

I have to decide whether I want recovery or death from anorexia. As I wrote earlier, I have been bargaining with recovery. I want to be healthy and live a full life, one filled with love and learning and joy and laughter, and one without fear.

But I also want to be thin; to be the thinnest one around, the one who is pointed to and whispered about, the one people wonder, "How did she get so thin?" I asked my husband the other day if I looked "anorexic" and he answered (honestly) that I do. I was secretly pleased. I also was angry. For me, it's about being thin and then again, it's not about being thin. Being thin is the outward manifestation of my inner pain.

It's like the morning ritual of the scale — the number is never right. If it's lower than the day before, I'm pleased for just a moment (then - what about tomorrow? why isn't it lower by two pounds? three pounds? am I not a good enough anorexic? anybody else would have lost more, damn it!). If the number is higher, the war within starts (should I be glad? upset? I know I need to gain weight. But what if ... what if I ate too much, the wrong thing? what am I supposed to feel?) And if the number is static, I just shake my head, thinking the number will be better tomorrow.

There are moments that should have shocked me into recovery. Times at the store when I start to see black, the ground rising up to meet me, my knees shaking as I sink to the ground, sitting and pretending that I am fascinated by what is on the floor. Days when I have read a page three, four times; finally realizing I didn't understand one word because my brain didn't have the fuel it needed to process the words on the page. I ask myself — since when did it start taking me two hours to read fifty pages? Moments recently when I couldn't pull myself out of bed before noon, all because I remember, hey, I'm still anorexic today and that changes everything.

Then there was Saturday. I had my usual breakfast of yogurt; my heart broken by recent events and unable to eat more. I went to take my morning shower; the hot water always feels like a refuge from my world as long as I don't look at my body closely. Looking is a no-win situation since my relapse. Sometimes my eyes are open like Eve's, and I see the protruding hip bones and prominent clavicle; other times, I see the huge thighs and enormous stomach.

Muscles weakened, dizziness hit me, heart raced. I sank to the ground, shampoo still in my hair. A rare thought — I need more food — crossed my mind, and my husband fed me pieces of a cereal bar as I sat in the bathtub with the water running over me.

Not enough. I stood up, rinsed the shampoo out and quickly rubbed in the conditioner. I continued to feel weak and again sank to the bathtub floor. As I rubbed soap over my body, I reflected that I had to take a shower sitting down at the age of forty-four. Shaking all over, I tried my best to finish my shower as the hot water began to fade and I began to grow cold. The simple joy of the shower was gone, and my hair was damp with conditioner I didn't have the energy to rinse out.

I crawled out of the shower, wrapped a towel around my head and sank to the floor. And for the next hour, I couldn't move without my husband holding my arm. I felt old, older than the oldest person. I felt ashamed. And I felt scared.

I can't continue to bargain with recovery. As I wrote after a recent post, "Recovery isn't failure," on ED Bites, I am becoming more and more tired of anorexia being part of my life. I will fail either way. I can fail at recovery and win at anorexia. I could become the thinnest, but I will lose my soul and my life in the end.

Or I can fail at anorexia and win at recovery. The possibilities both frighten and thrill me. The thought of finally being free of Ana, to be able to eat and breathe and live without fear ... My mind swirls with thoughts of two very different futures ahead of me.

I step forward.

It will take more courage to embrace recovery than anything else I have done in my life. But ... no matter how many times I panic, no matter how many times I rage that recovery is a lie (at least for me), that a return to normal life is an impossible dream painted by my doctor ... no matter what I tell myself, I still believe in dreams.

I step forward ...

(A poem)

 Or the twisted path of Anorexia"

I wake up
Remembering who I was
Knowing who I am

I throw the label
At myself like a dirty bomb
A well-aimed hit

The fallout destroys
Reader, writer, wife
Lover, sister, friend

Human being
No more

I trace the steps
The path through this

Turning in circles
Dazed, confused
Wasted body

Not human


Meaning lost
Not by familiarity
But by contempt

I want to take
My wasted body
Apologize for 
Its pain

Outer pain
Shown through
Fine lines
Dead eyes

Stroke the fine
Blue veins
Protect the
Fragility I have
Both desired

And hated

Soothe the inner
Remembering food
Thrown away

To say
'I'm sorry'
I know others
Hurt you

And then
I did too.

14 March 2010

Anorexia, assisted-suicide and injustice

The Netherlands, late 1990s: A 48-year-old woman with a history of anorexia nervosa and depression approaches her doctor and tells him she wishes to die. Her anorexia is in remission; however, she continues to struggle with depression after both her mother and husband die. She says she fears her anorexia will return and asks for help under that country's assisted suicide laws. She is evaluated and months later a psychiatrist helps her kill herself.

In spite of the fact that neither anorexia nor depression are considered incurable illnesses.

In spite of the fact that most likely her depression was situational; i.e. she was grieving the recent loss of two loved ones.

In spite of the fact that mental health professionals consistently state that depression is one of the most treatable of all mental illnesses, and that there is a wide variety of treatment options ranging from medication to cognitive behavioral therapy to ECT available.

In spite of the fact specialists treating eating disorders — including my own doctor — stress that full recovery is possible.

The Dutch woman was four years older than me.

This case chills me to the bone. It speaks of the stigma of mental illness and the lack of understanding of eating disorders. It tells me that it is easier to kill people than to make an effort to treat them.

It makes me believe that perhaps I am expendable.

This case is an extreme example of injustice toward someone with anorexia. But what about the many other cases of injustice and stigma directed toward those with eating disorders?

Recently, I found out that I did not get a position because of my illness. I was told through a third-party there was concern because of my recent relapse and hospitalization, and questions about my stability in relation to that. It was hinted that some people didn't like the fact that I am "too open" about my illness.

As the facts unfold, I am convinced that I was not denied the position due to a lack of qualifications. I was denied the position because I have anorexia nervosa.

I will continue to believe my doctor that I can achieve full recovery from anorexia and create a life that includes my wonderful, loving husband, supportive friends, complete involvement in life and the fulfillment of my long-time dream of obtaining my master's degree in English.

I will not deny being afraid. I often fear I will not achieve full recovery from anorexia, that I will die of this illness. I still struggle every day to eat and create a life of healing and health for myself. I wake up some mornings wishing it would all go away, and that the pre-anorexic Angela would come back from wherever she might be hiding.

But I will not live my life filled with fear, and I will not hide behind anonymity. I will not become a 48-year-old woman who asks for help in killing myself because of my anorexia and depression, perhaps thinking it would be easier for others.

I have anorexia, and I will continue to look for the best possible ways to achieve full recovery. But I also am much more than my illness.  I will not believe I am — or anyone — is expendable.

(Footnote: "Physician-Assisted Suicide in Psychiatry: Developments in the Netherlands" includes the case study about the 48-year-old woman with anorexia and depression. The case itself received little attention in the Dutch press and the psychiatrist was not prosecuted for his role in the woman's death.)

04 March 2010


I am paralyzed by fear. Fear of failure? Fear of success? Or am I just dead inside?

Graduate school started out rough for me, but I soon learned to love the learning and interplay of ideas and discussions that take place both within and outside the classroom. I am specializing in Children's Literature, and I particularly enjoyed studying what children read and analyzing the meaning behind the texts.

Last semester, we started with Robert Fagles' translation of "The Odyssey." (Although not specifically for children, literature for children often draws inspiration and meaning from this epic poem." I was entranced by the language, the description of dawn with its "rose-red fingers" and the journey Odysseus undertook - battling evil gods and goddesses and his own nature along the way - to return to the love of his life, Penelope. I was shocked by the violent ending in which the suitors are slaughtered, and yet moved by the loving reunion between Odysseus and Penelope.

I couldn't wait to read the other books, to go to class, to take part in the discussions and to write my term paper on female heros. I fell in love with Sara and "A Little Princess," her stoicism and kindness shining through. I was amazed by realistic portrayal by a male author of the female protagonist, Lyra Belacqua in "The Golden Compass," and was both enchanted and drawn into the world created by Philip Pullman so much I immediately went out and bought the sequels, even though neither book was required reading for class.

This semester started out well. I wrote a creative non-fiction piece about life with anorexia — the onset of this illness at age 41, my struggles to recovery and my decline into relapse — that was well-received and has the possibility of being developed into a larger piece for publication. In my other class, I enjoyed learning about the early texts used to teach children, from the Catechism to hornbooks to Puritan pieces that assumed the basic evil of nature even while teaching them the alphabet.

Now it all feels like ashes and dust. My moods swing so violently from anger at anorexia to hopefulness that recovery is possible. I feel like I am on the world's fastest roller coaster, careening from this turn and that turn; here there is a fun house mirror that shows me as fat and ugly, there is another that reflects a drawn, skeletal woman who looks as she will drop at any moment.

I sit down with one of my books or at the computer, and I become completely paralyzed because this roller coaster in my head won't stop and I am getting dizzy. I hated roller coasters pre-anorexia; the rides always made me nauseated at best and sick at worst, and now I'm on a roller coaster I can't find the exit to.

I am beginning to feel desperate as I enter my fourth year battling anorexia. I know many people have battled their eating disorders for decades, and some friends with EDs say that I should be able to overcome this because of the short length of time I've had it. But I am 44 and my body and soul can't take much more.

I constantly feel as if the pre-anorexic Angela has been snatched away forever. She will never return; there will be no "happily ever after." I want off this roller coaster; I am too dizzy and sick. And I'm increasingly beginning to feel the only way off this horror ride is if anorexia kills me and that this will be the year it does. Then so be it . . .

01 March 2010

Leaving Ana

Leaving Ana

Snarls wrap around me
Tentacles clutching for the kill
I struggle to free myself
The more I try to escape,
The more Ana will not let me go.

Smooth, concave stomachs
The jutting of hip bones
Breasts of a young girl
Empty doll eyes staring at nothing
The promise of perfection

Ah, but the price!
Starve yourself
Deny your hunger
I am beyond mere human needs
Ana says
I am becoming a higher being
And no one else really understands, right?

Increasing blackness
The feeling of lightness
Means progress
Friends fade
Family becomes nothing
Dreams are just wispy puffs
Is all I need

Ana feeds me,
I live on air
As the pain grows
The first cut is the deepest,
And Ana cackles in the background

Trying to extract myself,
I enter a horror-house maze with no exit
The snarls choking me,
At every turn
Ana is a very jealous lover,
You see

The fight has begun
Anger begins to turn outward,
I slash out at the tentacles,
Cutting deep into the lies
Desperate not to drown in Ana

Piece by piece,
I am freeing myself
Untangling the web
Drowning out Ana’s voice saying
That I am nothing without her
Ana is winning the battles
But in the end, I shall
Win the war