31 July 2010

Here we go again . . . (anorexia or me - one of us has to go!)

How many times can I screw this up???

I've been in Beaumont Hospital seven times (gee, have they named a wing after me yet???), have had a TPN and a NG feeding tube and left the River Centre Clinic in June after six weeks of treatment for anorexia nervosa.

How many times can I screw this up???

My doctor wants me to go into the hospital. AGAIN. I was just there in February. That was supposed to turn things around.

It didn't.

Then I went to the River Centre Clinic for treatment. That was supposed to be the start of my "journey of recovery."

It wasn't.

How many chances do I have left, anyway???

I told him I would think about it. That I felt just fine. That I wasn't sick enough to need the hospital. That I didn't want to go. I have too much to do. I hate giving up my freedom.

Then my real fear — it won't do any good, anyway.

I know what I have to do. I have to eat. And I have to eat a lot to gain at least ten pounds. I had to eat 2,900 calories while at the RCC to gain about one pound per week.

So why am I so afraid of food?

I have to eat real foods with fats and carbohydrates and calories. I have to drink at least two Ensures daily because I've never been able to sustain eating that many calories. (I am still feel full from today's intake - about 500 calories.)

I'm doing it all over again. Counting calories. Cutting back. Rejoicing with each pound lost.  Planning to lose more.

The only thing different is that I am angry at myself for doing this. Angry that this has controlled me yet again. Angry that I feel trapped by anorexia.

Is the key inside me?
Will I be the person who saves my own life?
And what are my reasons for living?

That is what it comes down to. I need to find reasons to live. This can't go on indefinitely. Eventually something in my body or mind will break, destroyed by anorexia.

I have asked myself many times lately ...

What needs does anorexia serve?
Why is it so hard to let go of this illness?
How do I find my way out?

There will be no brave knight on a fast horse, scooping me up and taking me away to The Land of No Anorexia. There isn't a fairy princess who can wave a magic wand and instantly cure me. There are no spells or potions or secrets that will take it away.

I will have to eat. Eat when it hurts. Eat when it is uncomfortable. Eat many times a day. Eat until I'm sick of food.

I will feel bloated. And fat. My face will probably break out. I will have night sweats from refeeding. I will hate my body as the pounds come back on. And I probably won't always be a very nice person during the process. I will complain to my husband and fight with myself in my head a million times a day.

I will want to stop after the one millionth diet ad that comes across my Facebook page or in my e-mail. I will feel like a freak because everyone else seems to be working on eating healthy and losing weight.

It will be last year all over again.
I cried each day.
Many times I wanted to die.
Sometimes I thought about killing myself.
Then I drank another Ensure.
I knew it was the only way out . . .

I can do it at home or jump-start it at the hospital. No one else is going to be able to do it for me. I will have to make a decision.

Save myself or else live with anorexia until ...

I will lose everything before anorexia actually kills me. That's what will happen. This will drag on for twenty or more years. I will be 65 and getting ready to go to yet another treatment center. Alone.

Is this what I really want for my life?

NO! I want the life I have dreamed of for so long — a loving relationship with my husband, good friends and a meaningful career and life. I don't want anorexia to be my defining trait.

I do not want this on my gravestone or in my obituary:
She died of complications from anorexia.
But hey, she was thin.
The end.


flaweddesign said...

i so relate...my dr's pushing to go back to hosp too. but admission after admission, clinic after clinic, and then..relapse. it's sooooo frudtrating. i think you're right, the key IS within us...and we must do what you said, "eat when we're not hungry. eat when we're sad. eat when we're angry" and so on. but i don't think it's so simple. my OT said to me yesterday that i have control over my actions and that i can eat if i choose to even if it makes me feel 'badly'. what an inadequate word for what it makes me feel. like minimlaizing it to a 'normal person' being like, 'oh i feel badly for having that last piece of pizza. i was actually full' i've been there, i've felt that sort of regret but anorexia and eating is an entirely different realm for me. to eat is torture.

sure, i haven't lost my physical abilitis to chew and swallow but it is in the nourishment where the feelings and thoughts come up and i want to avoid that state sooooo much.

you you're right, it's anorexia or life. one has to go. we do, ultimately have to pick. some people live 'chronically'. well, they survive 'chroniclaly'. that's not for me and doesn't sound like it is for you either.

i don't have any answers....just....i feel ya. keep strong. 2 ensures a day is great. maybe the next step will be 2 1/4 ensures. maybe it will be a jumpstart in hosp, i'm not sure. but i'm focussing on my 'lunch' that i continue to down each day at xxxcals (yes, i ruminate about it for a long time following) but i keep doing it. and it's xxx more cals than i would have been having 2 weeks ago independantly.

one day, something will witch for us both, i hope.

keep fighting the best you can.


lisalisa said...

I'm trying to think of a good comment but I dont know what to say. You are right about everything. It will be hard. It will be uncomfortable. When I try to describe the proccess of gaining weight and facing my feelings, the Biblical phrase "weeping and gnashing of teeth" comes to mind.

But it is SO WORTH IT. Imagine having a life not controlled my thoughts of numbers and food and the fear of death. It IS possible. It just might not happen overnight.

I have been hospitalised, at last count, 21 times, but I still say that the most lasting progress has come from deciding to do it (eat and gain weight) on my own (wich was about a year and a half ago). Not that you shouldnt go IP if you are in medical danger. But it is easy to justify eating when you are in a hospital, sometimes the ED even says "its ok, you can eat here, because its their rules, but as soon as we get home its back to business". Many times I have gained weight in a program while in the back of my mind I was planning to lose it when I got out. For me, to really fight the ED, I had to do it at home, because I CHOSE to, with no one telling me I had to.
I run the risk of babbling on, and ANnie is begging me for a cuddle. I hope this week brings you some peace and my prayers are with you Angela!

Sensory Overload said...

Do what you can do Angela. Give yourself the credit that you have been applying yourself to this journey of finding a balance. It doesn't have to look one way and only that way.

Acknowledge the steps you've taken. Allow what is good to be present and find a way that will work for you to get to a future.

I appreciate all that you are willing to share. I am sending warm thoughts and hopes that you will see that you are such a valuable soul. The source of light is within the very essence of who you are. Go there.

With prayers you will find and hold onto the strength you do have.


Silly Girl said...

Thank you for sharing your struggle. There is a choice to be make--your ED or your life. I think you have so much to give. I don't want ED to win. In some of my darkest times, you have always given me great advice and warmth. Stay strong and continue the fight for recovery. I'll keep you in my prayers and thoughts.

Pen said...

I hear myself in you. Our thinking seems to be a lot alike. I too, always say "I am not sick enough yet I feel just fine" but I think we need to be Honest with ourselves ALL the time. We are definitely sick - seriously sick - not matter what we look like on the outside. Can I ask how tall you are? When I was inpatient and partial my meal plan/+ensures sounds about the same as yours, so I'm wondering. I am starting to believe that all these little trips to Inpatient/hospital/etc although helpful are not really enough. I have been told to do Residental and perhaps something longer like that is the key. We have to change out minds/thoughts that have been ingrained for some of us, since childhood, so obviously that will take a long time. Keep up the fight!!!

Anonymous said...

the thing is for me....."why" do they want you to go into hospital? Are you medically compromised? If so, then yes, go in. It sounds like you may want to try to get some intake at home? I know what you mean when you say you do ok in, then as soon as you are out you lose and restrict again, done that SO many times. If you are truly ready to adhere to what they want you to do then go, otherwise make a contract with someone that you trust for home and stick to it, it is a start and sometimes easier to have your own terms (that still have to include challenging yourself) good luck to you and I hope that you are able to work towards recovery, I also, struggle like you and am "Chronic" as they say, been fighting the battle for 24 years, its truly disgusting and I am ashamed but still trying. I don;t wish it for anyone so get well while you can.
good luck

Anonymous said...

I actually think going into the hospital will just feed, maintain and fuel for the future anorexia as an identity, a life structure, a place-holder for everything you don't know or don't want to feel. A place-holder for the next achievement/goal; a place-holder for grief; a distraction from a life in transition; and escape to something that requires little more of you than stepping through the revolving doors of treatment.

It's easy to get stuck in that cycle, especially is you set yourself up for relapse and then admissions in the spirit of being a compliant patient. See, the self-perpetuating pseudo-life you can set up that way? Pursue ED behaviors and conditions such as to feel sufficiently "eligible" to consider a higher level of care. Spend lots of mental energy fretting the ins/outs, the should-I's/should-I-nots of accepting "help"; the little, temporary "high" of deciding to accept help/turn responsibility over to someone else; realize, "Oh, shit ... this isn't any different from the last time or the last place or the time before that. It's all about weight gain, and there's no emotional epiphany in that."

Your reprieve from your real life, real problems and real issues continues a bit as you play the compliant patient (or you fight for awhile, THEN get the good-girl kudos for turning it around and eventually complying). You leave the hospital at about the height of warm-fuzzies from the professionals and your loved ones (good job; atta girl; we're proud of you) ... but, then, damn! You didn't really want to just gain weight, sit on it, go live your life and get on in the world! Nothing is different ... you just weigh more!

You have no more direction or emotional/psychological center than you did before admission, and in fact, are now primed to dive back into weight loss and obsessionality ... a relief, actually, because just going on while still feeling as shitty, discontented, what-have-you as before is just NO GOOD. So, you have a purpose again, at least for now ... dump the weight, get your anxiety back in check, buy yourself some time in limbo-land; work toward compromise significant enough to attract the attention of the caregivers, repeat the pseudo-struggle with "what to do" again, then consent to hospitalization where you can hide out for a while longer under the guise of "treatment"/eating ... which will really only fuel your ability to continue the cycle vs. stopping and moving on.

(Cont'd in next comment ... it was too long!)

Anonymous said...

(Cont'd from previous comment)

It's easier to just keep walking through those physical and emotional revolving doors than it is to acknowledge the voids and hurts in your life and to sit with the idea "this is all there is?" "This is it?"

For someone who needs validation but already has blown through some career achievements and educational goals, what now? I personally think you need a goal, a purpose, missing, something else big enough/bigger than the "satisfaction" and "safety" sitting with an ED brings. What that might be for you, I don't know.

Anorexia has a way of luring you to think you must ride it out to "the end." Whatever the end is ... and you never know for sure, and when you decide a particular time is "it" and you're gonna give it up/get over it, the anorexia counters back: "No, this isn't over. You can't give up. This is one of those deals that's never really over. You give up, and you lose, and then what do you have? You're going to just have to play this out until you die or magically don't care anymore."

It can seem like a black-and-white situation that way. It isn't, of course, the the areas of gray just suck so bad for the person treading water there that the impulse is great to grab for the eating disorder, which is infinitely easier than doggedly plodding through the motions of recovery behaviors. Boring. Hard. No goodies in return ... just health and supposed well-being, even though it feels worse than being worse-off.

The hospital won't change any of that. The doc needs to try to offer the best standard of care, and if you're decompensating in mind, body or symptoms ... what else does he have to offer? It gives you another chance to take the intervention opportunity in a way you haven't before. It gives you the chance to decide this time will be different. But if you decide that, it has to be that. I know from personal experience that things won't go differently if you wait for them to settle, easily, in a better, unexpected place.

It's just really hard, and if you're not ready to go there, don't just sign in because it's the next thing to do. If you can stay at home, challenge yourself to do that and come up with whatever plan you think might help (then tweak it repeatedly with trial and error) ... take the hospital off the table and see if maybe you can't do better, knowing that you can't just fall back on a psych unit to catch you if you fail. That sets you up to fail.

Whatever you decide, I wish you the best and hope you find whatever spaces and places inside you that might lead to change, acceptance and peace.

Anonymous said...

Sorry about the double-post of the first half of the very-long-comment ... please delete. Take care, and good luck with everything :)

Cat said...

I'm sorry you are struggling so much. I know how it feels. I hope you kick AN to the curb and not your life. Recovering is THE HARDEST THING EVER (almost), second only to being sick!

Recovering from my ed has been harder than grad school, working in Guatemala with very poor communities, or pretty much anything else. It's also been singlehandedly the most rewarding thing I've ever done for myself.

Yeah my ass is bigger, but so is my life. The amount my body grew is so much less than the benefits I've gotten from being free of this. And, as time goes on and I get more solidly into recovery I'm realizing:

my body is not the problem, the way I think about it it.

Your body is not the problem either.