12 May 2010

I think I'll go to the moon ...

A month ago my insurance said the 30-day program at Renfrew was covered.

I filled out forms and underwent numerous medical tests. I made peace with being away from my husband for thirty days. I looked around at everything and everyone I loved and silently said good-bye.
I was ready to leave and start on the road to recovery from anorexia nervosa. I was already dreaming of my new life without the ED thoughts constantly gnawing at me 24/7. I felt a cautious hope.

On Friday the insurance denied coverage of the 30-day day treatment program at Renfrew. I had to cancel my reservation at the extended stay hotel, tell everyone I wasn't going anywhere and then cried myself to sleep. I kept thinking, but I'm supposed to be going to Florida tomorrow. My mind just didn't want to make the connection that I was not going anywhere the next day.

On Saturday I was heartbroken and doubled my dose of Ativan to keep myself from falling apart, combining it with OTC sleeping pills and one night, a glass of wine, just so I could remain numb. The few times I was awake I kept thinking, I'm supposed to be on the road to Florida. To hope. To recovery. I had invested so much of my heart and soul into this program. I was reluctant to go at first, but finally listened to my husband and doctor who continuously said I needed more extensive treatment. That I was getting sicker. That I was dying.

I barely ate anything between Friday and Monday, subsequently losing three more pounds and am now at the lowest weight I've ever been since I was in junior high school. I veered between despair and anger, and just wished the anorexia would kill me soon. Or something. A falling meteor. A caved-in roof. Anything to stop hurting and thinking.

On Monday the insurance company offered an alternative, the River Centre in Ohio. The company said its doctor was recommending IOP (which is only offered three evenings a week at the Florida program; an idea my doctor did not endorse) or partial hospitalization at the Centre. I looked the Centre up, learned that it had had some problems involving its director, but that all that had been resolved. But I was still scared - I had never heard of this place. On the other hand, ED Referral had a lot of good comments posted about the center.

On Tuesday I shook myself out of the fog I was enveloped in (thanks to everyone's kind and blunt comments!) and called the Centre. The person I spoke to sounded really nice and was very helpful, answering all my questions even though she knew the Centre was my second choice. The program sounded good, and the fact that they had a trauma-based group was a plus. The Centre also provides dorm-like housing (two to a room), so I would be around people in the evening after the program ends. Evenings and weekends are free, and some people commute and others stay there through the weekends.

On Wednesday (today) the insurance went through my second appeal; another one of their doctors talking to my doctor. He told them if I didn't get more extensive treatment, I was going to end up in the hospital.

Both my doctor and the insurance company called to tell me I was approved to go to any partial hospitalization program in the United States. I missed both calls because, ironically, I was making myself lunch - the first meal I had even tried to eat since Friday - and my cell was downstairs. I finally got angry and said I wasn't going to let any insurance company decide if I were to live or die. I finally had had enough. It wasn't much of a meal, but it was an attempt and a sign of hope and the fact that the despair was breaking up.

Now the question is - Renfrew or the River Centre? Each has its pluses and minuses. Renfrew is a seven-day, 30-day program. The River Centre is more open, but my planned stay there was going to be about 30 days. Of course, my total length of stay will be determined by the insurance. It will be reviewed every six days (something that is common, I am told). But now I am afraid, what if I get to Florida only to have to turn around and come back in a week? How hard is recovery going to be with that hanging over my head?

At Renfrew, I will have a room by myself - but I also will be alone each night, no one to talk to about how the day went. At the Centre, there will be a group of women around to talk to after the program day has ended. The housing costs are covered as part of the program at the Centre; I will have to pay about $1,300 out-of-pocket to live at the extended stay hotel while at Renfrew. I was looking forward to living alone, proving I could go through treatment and be an adult and handle all the stuff that comes with it.

I'm so confused. I was twittering at length to fellow blogger and good friend Half Shattered and she said I need to make the right decision for me. Not what will please this program or that center. Not out of guilt for putting the staff to trouble, only to say I'm going to this place instead. Putting myself first.

I need to choose the best place for me to start on the road to recovery. But my mind is such a jumble. This whole week with the insurance company makes me feel like Alice in Wonderland, where logic is turned upside down and twisted, where nothing makes sense.


Kelly J. said...

Maybe the initial denial was a blessing in disguise, and the Centre is really the right place for you. I would imagine that a place where you're surrounded 24/7 by people who know what you're facing would be better than having to constantly face strangers who have no clue.

What does your doctor say?

sarahlynn said...

I have to second Kelly, but I think you need to weigh it carefully. Think about what your doctor says, and 'think with your heart.' I think you should go whereever you feel most comfortable. Renfrew is notably pretty good. But that doesn't mean that The River Centre wouldn't be.

And keep in mind that I'm trying REALLY hard not to push with "I live a spit-shot away from Renfrew FL!" Hehe.

Whatever decision you make will WORK. The question is not what program to do. Or shouldn't be. If you want to recover - and you DO - you'll find help whereever you go. Even if you're only there a week, or two... it WILL help.


Good luck.

Anonymous said...

Sounds like it'll be your first time going into a treatment program. I can tell you from experience that in order to do partial, it's a good idea to have some recovery roots put down.

You'd be isolated a lot of the time at Renfrew. How good would that be for your start in recovery? Isolation is one of the things we ED people do best. ;)

I'd go for total recovery submersion. If you have an opportunity to go inpatient, by all means, take it and get all that you can out of it.

It's hard to predict what issues will arise and at what level of intensity. In the beginning, it's key to be in a safe environment. Being inpatient will better guard your emotional and physical safety.

Good luck to you! You can get better. It just takes time and practice, practice, practice. :)

Samantha said...

I'm so sorry things are going so terribly with your insurance. Insurances are a bitch sometimes...


I saw your blog and I just wanted to pop in and tell you about www.disorderedblogs.com . It's a blog network specifically for people who have eating disorders. It's a great community, and there's all sorts of cool stuff! Tons of themes to choose from and lots of options! Also, once you've had a blog for a month, you can apply to be part of the revenue sharing program, and a percentage of the money that the ads bring in!

Anyways, I just wanted to say hi, and tell you about it. You look like you'd fit in well with DisorderedBlogs. :)

If you ever want to talk, feel free to email me!

Anonymous said...

I have a big sigh of relief. I'm so glad that you will be getting something, even if it isn't what you were initially planning on. Wherever you decide to go, I hope you make the most of it.

Liv said...

I am so happy you got approved. I only know you through reading your blog but I was worried about you after reading the content in your blog the last few time, concerned about your mental and physical well being. I hope you are feeling better with the chance to go to a program in your hands. I wish you the most success and growth in your time at your program,

Anonymous said...


Praying for the best possible outcome for you and your decision and I believe that God will lead you to the right place. :) You have my love and prayers. I am so glad you are going forward with this!


Tiger said...

Angela, I know what I would do, if I were in your shoes, however, I'm not you--It's extremely important that you make a choice that is the best one for you.


Queen Lili'uokalani said...

I am so sorry this is happening to you. I came across this blog from a friend of a friend through FB; so truly just happened upon your blog. I knew your name and face from your previous employer's byline.

A few years ago, I remember recognizing you downtown happily visiting with a shop owner. You came across as a very confident and poised professional, fully embracing your life. I recall being envious of your self-confidence.

I wish you the best in getting back to that point in your life. Whatever it takes, it will be worth it. You have many people's best wishes.