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.

What recovery meant to me

I wanted to be free.

I wanted to be free of anorexia. Free of the thoughts. Thoughts that taunted me 24/7, telling me I didn't deserve to eat, didn't deserve food or life or happiness or love. Thoughts that told me I am worthless and useless and ugly and that I don't deserve to live.

I sit here, dreaming of what might have been . . .

I wanted to continue with graduate school, learning and writing and exploring new ideas. I wanted to continue to grow as a writer, and planned someday to use my skills to do all sorts of things: advocate for those whose voices have been silenced by society, people with eating disorders and other mental illness, the poor and those who live on the fringes; write children's books and poetry; teach and help others discover the gift of writing within themselves; and just write for the sheer joy of it.

I wanted to heal my marriage of the damage anorexia has caused it, and rediscover the happiness and love that were ours before I got sick.

I wanted to be able to be there for my family and friends; rediscover relationships that didn't always revolve around how sick or how thin I am.

I wanted to go out and eat and not be afraid, spend time going to the movies and concerts and other events without anxiety nipping at my heels.

I wanted to stop the daily weigh-ins and calorie counting. I wanted to sit down at one meal, just one meal, without being afraid of the food. I wanted to eat one piece of food without knowing or caring about how many calories were contained within it.

I wanted to be free.

I wanted to return fully to myself, not be halfway there and never fully recover. I reached out for help, called Renfrew and was ready to give my total self to the program and begin true recovery.

But recovery costs money. I sit here, fully expecting a final no from the insurance company today. I constantly check my cell phone, waiting for it to ring. It would almost have been kinder if the insurance company would have said no this morning instead of drawing out the agony all day.

Do they not realize what this means to me? That I felt this would start me on the path of recovery. I felt that it would save me.

I was supposed to be on the last leg of my journey to Renfrew today, heading toward hope and help and possible recovery. Instead, I am sitting here filled with anxiety and wonder how I will handle that final no. I'm sorry I ever called Renfrew. I'm sorry I ever gave myself that hope.

Everyone says if this doesn't work out there's something else out there? WHAT??? There are no support groups here, the hospital is only a place for stabilization and if my insurance isn't going to cover this - a 30-day day treatment program - it isn't likely it will cover anything else.

To them, I am just a number. That reality was brought home to me Friday when my doctor said not to take this personally. How in the hell am I supposed to take it?

I AM MORE THAN A NUMBER. WE ARE ALL MORE THAN JUST NUMBERS TO BE PLAYED AROUND WITH BY THE INSURANCE COMPANIES. WE ARE HUMANS.

I am a human. I had a life, and I want it back. But I can't do it by myself. I can't handle the thought of getting better, only to have the fear of another relapse haunting my days and nights.

I wanted to be free. But I guess I'm just wasting my time.

No hope

I won't be going to Renfrew after all. The insurance denied the pre-authorization today. I was supposed to leave tomorrow for the three-day trip to Florida. I was all ready; I just had to pack. We even got new tires for the car and cleaned it out.

I have no hope this will work out, although the insurance company said they would review it and call me Monday. It's just their way of appeasing my tearful pleas that this was my last chance for recovery. I just don't understand what else they need - my doctor told them on the phone today that this was "essential" for my recovery.

I doubt that I will be blogging for a while, as I am devastated by this and can't think of anything else to write or say. There is nothing else to write or say, except treatment is only for the rich, I guess.

The worst part was that I was ready mentally. It took so much to prepare myself to go, to leave my home and my husband for 30 days. It took so much to admit I needed more help than I was getting here. It took so much to accept the idea of giving up control to get better, but I worked through it and was ready.

I was ready.

Now there is no hope. And I don't want to turn this blog into a hopeless, depressing mess. Because that's what I am right now - a hopeless, depressing mess.

Halfway gone and feeling anorexic

A strange awareness came crashing through this morning.

The pale light of dawn was just appearing through the mass of green leaves. Cool air blew through the open window. I was in a land between dreams and wakening; luxuriating in that drowsy feeling where you feel safe and warm, the outside world not yet invading your mind or soul.

It is a feeling of safety. I feel this way when I'm drifting off to sleep, snuggling with my husband as I am able to slowly forget that I have anorexia, that I have any problems at all. I also feel this way when I am first leaving sleep; blessed sleep where I can rest and lay down my burdens for the night.

This feeling of safety was taken away this morning. I reached up and touched my collarbones. But this time, I really felt my bones. The protruding collarbones and the jutting clavicle. The sharp hip bones and the hard knees clicking together.

I couldn't breathe. I panicked. Where are my curves? Where is the feminine smoothness, the slight roundness of hips?

I touched my face, feeling nothing but a skull. My heart began to race. I realized I am thin. Thin. There is nothing to soften the sharpness. I felt like I could feel every bone pushing against my skin, the layers of muscle and fat eaten away by months of restricting and laxative abuse and enemas and suppositories. All the tools I used to keep the hateful food out of my body.

To deprive myself of life.

On Sunday, I went to our church for the last time in five weeks. I looked around, this group of people who have embraced me as a family and prayed for me for years. The church has a fantastic couple who provide music, and they played "Canticle of The Turning" for me. We talked about the changes coming to the church, how the Episcopal Church's rules won't allow our priest to retire there and so there will be a new person.

I felt sad and forced myself to nibble on a homemade muffin made by one of the members. Our priest will most likely be leaving about a month after my return from Renfrew, and I will miss him. I told him so, burst into tears and hugged him, then ran out in embarrassment.

I felt as if I couldn't stand one more change in my life and I choked down half my dinner. Later I proceeded to take a handful of laxatives, unable to handle the food and the feelings and the emptiness and the sadness.

I was sick all day Monday, constantly running to the bathroom with diarrhea. I had to go and get an EKG and blood and urine tests for Renfrew, and thought I really screwed up this time. Why did I do that? I knew what that many laxatives would do to me.

But my heart hurt. I couldn't stand the thought of more changes, and I was struggling with the thought of being apart from David for one month. It was the only way to cope.

Throughout the tests, I had to stop and run to the bathroom. This continued until I went to bed that night, exhausted and depleted.

Then this morning. It's not like I haven't seen myself in the mirror and realized I am too thin. But this time, I felt it. I felt every protruding bone. I was frightened I would die of anorexia, die of laxative abuse, die of a cardiac arrest.

Die at 44.

I feel as if Renfrew is my last chance. As I looked in the mirror, I saw the now-prominent veins and drained face.  I applied some makeup; a wine-color eyeliner that did nothing for my half-hooded eyes. Dead eyes from lack of nutrition.

I am halfway gone. I realize if I don't find a way to recover, I will continue to lose weight and everyone will watch as I fade away. My life will be over before I have a chance to get it back.

I decided this morning I don't want to live if I can't recover from anorexia. I'd rather be dead than continue to live with the realization of what I am doing to my husband and my family. I'd rather be dead than be anorexic.

Getting ready for anorexia rehab

Anxiety Fear Hope Desire Love Beauty Depression Panic Fragmented Life Death Heaven Christ
Emotions and words swirl through my mind like a fast-moving tornado heading dead center for its target. "Left of Center" by Suzanne Vega is playing. The watery sun is setting on the deep, dark green grasses and newly bloomed bushes. Aliena sits in the window, ready to pounce on any stray bug which crosses her path.
I am cold. I am hot. I can't think.

I leave for Renfrew in one week. I'm afraid I will fail. I'm afraid I will succeed. I'm afraid ...
Thirty days. Away from my home. Away from my husband, my friends. I will be alone each night, trying to sort out each day as I work toward recovering from anorexia. There will be memories stirred up, things I would rather forget. I will face food I am afraid of and I will need to eat it. I will need to talk about how I feel.

How do I feel? My emotions are in upheaval right now. How am I supposed to feel? Should I continue to mourn the life I lost when anorexia hit me at 41? Or do I move forward, knowing that person died years ago and it is time for the resurrection of a new me? Do I rage against the neighborhood boy who sexually abused me? The uber-conservative church of my childhood which left me feeling dirty and knowing I was hell-bound? Do I continue to be angry because alcoholism and depression made my childhood feel unstable and rocky?

How do I let go of it all?
I believe I must let go in order to recover. I must let go of everything. Anger. Secrets. Laxatives. Cutting. Enemas. Restricting. Control.
Playing at recovery.
I will have to turn my entire life over to complete strangers for thirty days, and that will require a hell of lot more trust than I've ever been able to give anyone.

But I can't take it anymore. I will not be able to live much longer with anorexia. I can't take waking up each morning crying and hating life because ... because I'm me.

Eating with my eyes

I have been eating with my eyes.

I am a stalker. I have been lurking around several blogs written by women recovered from anorexia, in which they post pics and describe the foods they are now enjoying. I feast my eyes on the pictures, drinking in the bowls of fresh oats, almond butter and bananas mixed together; the fresh bread spread with avocado and topped with crumbles of hard-boiled egg, Romaine lettuce and tomato; the long, tall smoothie blended with yogurt and cream and fresh fruit, the young woman leaning forward to take a sip; the cookies-and-cream drumstick, the ice cream slightly dripping as if it had just been delightedly slurped.

I am obsessed.

I remember when I was first diagnosed with anorexia nervosa. It was by a dietician whom my family doctor referred me to around February 2008. Of course, at the time I didn't feel anything was wrong with me. So when she said I was anorexic, I reacted first with surprise and then a little anger.

It wasn't like I didn't know anything about anorexia or other eating disorders. And I didn't have a eating disorder, in spite of the fact that I weighed about 95 pounds at the time, was very restrictive and rigid in my eating, and had an intense fear of gaining weight (and in fact, wanted to lose more.)

But I wasn't engaging in any of the bizarre anorexic food behaviors or rituals at that time. I didn't cut my food up into miniscule pieces. I wasn't afraid to eat in front of my friends or co-workers (I didn't really care if they thought two thin slices of deli turkey meat did not make a complete lunch.) I wasn't collecting recipes, reading food magazines or cooking large, elaborate meals for anyone.

So therefore, Ms. Dietician, your diagnosis is wrong wrong wrong. I am not anorexic, I do not need to see an eating disorders specialist nor go to Renfrew, Remuda, or Rogers Memorial Hospital. I do not have a problem. I am just thin and what's wrong with being thin? Even if I am depressed and anxious, even if I am yanking up my size zero jeans and fighting with my husband about food and eating and hearing from everyone that I need to gain weight and my niece's nickname for me has become "Skelator"?

I'm just fine. Other than being severely underweight, of course. There was the daily counting of calories and weighing myself. And the fact that I was becoming quite popular at the office for the weekly donuts/scones/ {insert forbidden food here} that I brought in. But I wasn't doing anything else except restricting, therefore I could not have anorexia.

My treatment with that dietician ended after she declared I wasn't making any progress, i.e. I had not gained any weight after four months of treatment. Soon after this, my psychiatrist terminated with me (I had been seeing him from depression and anxiety) because he agreed I had anorexia and he wasn't equipped to deal with it.

So I went to Rogers Memorial, only to check out AMA 24 hours later. The psychiatrist there declared I would be dead within a year if I didn't gain both insight and weight. My discharge papers were a dismal declaration of how ill I was. Prognosis: poor.

As most of you know, I did eventually agree to see an eating disorders specialist who convinced me to go into Beaumont Hospital for two weeks of refeeding. But even though I was connected to a TPN line running nutrients into my body, I remained unconvinced I had anorexia.

You see, the eating disorders patients there all did strange things like cut their food into tiny pieces and hoarded sugar and salt packets and get angry because we weren't allowed to have no-calorie sweeteners for our coffee like the other patients. One woman carried around a notebook filled with recipes and pictures of food,  another continuously chewed on ice and a third would not eat her food without loading it with salt and pepper and mustard and whatever other condiment she could get her hands on (since I didn't care what my food tasted like — the blander, the better — I was happy to give her my packet of condiments each day.)

I had read about these and other behaviors and decided there was no way I could be anorexic because I didn't do such things. I became a bit annoyed by these behaviors and seriously wanted to tell one girl to please please please stop pressing your grilled cheese sandwich between five million napkins before I lose the last shreds of sanity I have left!

But this was years ago, and I notice I have my own little food rituals. I can't eat foods that touch each other and I have to eat one food at a time. (I notice normal people eat a few bites of this and a few bites of that.) I can't tolerate foods with sauces or gravies, unless they come in a box and I know the exact calorie count. I can't pick up a sandwich and bite into it; I must either cut it up or deconstruct it. I need to eat slowly, and I actually do cut my food into tiny pieces, thus taking more than an hour to eat a meal most people can finish in twenty minutes.

Have I had these rituals for years and just didn't notice? Or did I develop these food rituals as an attempt to gain some control? Or are these behaviors the manifestation of anorexia as I have continued to recover from it.

The few times I haven't been able to adhere to these rituals? behaviors? has caused a weird sort of anxiety and strangeness, as if I didn't do it right. I usually need to take an anti-anxiety medication before I can eat out with friends. Restaurants feel like torture unless there is some type of salad I can order. I was positively thrilled when Bob Evans, my husband's favorite restaurant, came out with its light menu and listed the calories, fat grams, etc. on that menu.

Denial hangs around a long, long time. I weigh 97 pounds and have been actively restricting food since January. I feel exhausted, and yet often can't get to bed until 4 or 5 a.m. I have trouble concentrating on anything; class work, magazine articles, watching a television show, holding a conversation. I have gone through the assessment process at Renfrew and plan to be admitted in May for the 30-day day treatment program.

But despite all this, I said to my husband last night, I don't think I have anorexia. I think I am just thin and everybody is making too big a deal out of it.

Then I dreamt last night of those food blogs, the abundant richness taunting my sleep. I could almost smell the cinnamon sprinkled on the oats and taste the creamy saltiness of the almond butter. I opened my small container of yogurt, which was not mixed with granola or sprinkled with fruit, and wondered why I would ever question that I have anorexia.

I am now following a couple of these blogs; I need the images and descriptions in a way I can't describe. I want to eat with all my senses. This is my dream, and I believe full recovery will be achieved by first being able to eat without fear.

I have been eating with my eyes.

"You are so much more than your body size."

"You are so much more than your body size," my doctor said to me today.
I sat there quietly, thinking about that remark. What does he mean? Who am I? Who was I? Unwanted tears — God, I hate being weak; I used to be so strong — threatened to spill as I thought about who I might be besides my body size.

"You have so much to give to the world," he continued.
I felt confused. What do I have to give to the world? The world has demanded that I be thin and I have become very good at accomplishing that. What more does the world want from me? How thin do I need to be to be THIN ENOUGH? But I knew that's not what he was talking about.

"In spite of everything, you are still reaching out, trying to help others," he said. He mentioned my gift for writing, and how I still try to help people understand anorexia and those who suffer from it through my words.
"But what about helping Angela?" he asked
Sadness filled me, and I whispered, "I don't know."
I then confessed that I felt guilty about going to Renfrew in May; that I feel like I have failed him. Failed by not recovering.

I was supposed to be the shining example of recovery. Everyone said so when I entered Beaumont Hospital in August 2008. I had only been battling anorexia for about a year. I readily agreed to the TPN line, feeding nutrients to my heart and body. I ate everything they put in front of me, and after my first-day meltdown, I kept my mouth shut and adopted a passive-aggressive approach to treatment. I didn't know then I wasn't helping myself; I was just marking time until I could get out of the hospital and start starving again.

Several nurses and fellow eating disorders patients were very impressed by my supposed motivation, not realizing I felt as if I were dying on the inside and wanted to rip the TPN right out of my body. One nurse knew I would I would go home and continue to eat, become weight-restored and then put anorexia behind me. Ipso facto, it would be as if I never even had the illness. One patient said most anorexics don't fully recover, but that I was different because of the short duration of my illness and that I would be Dr. Sacekyfio's success story; the one who made it, the one who recovered and made all his hard work and dedication worthwhile.

No one can live up to those kind of expectations, and I started failing almost from the day I walked out of Beaumont on that sunny, warm and windy day in September 2008. I was restricting again within a week. I didn't understand why after having just spent two weeks in the hospital trying to get better, and I truly did want to get better. And yet I didn't want to get better. I wanted both — to be thin, thin as society admires; and yet recovered and back to my self. What did they want from me, anyway? I was thin, wasn't I? Thin enough? What else could I do?

I remained confused throughout that fall and winter, fighting to recover and sabotaging every effort I made. I would eat a sandwich, only to take laxatives. I would write, hoping the words would help save me. Then I would throw away my lunch.

And I would often think of what everyone said and thought that I was supposed to be the one who recovered. My mind was swirling all the time; the words recovery and anorexia and failure taunting me until one December evening, I couldn't stand it any more and cut myself in anger.

I had failed. I was under 100 pounds again. I was afraid of food, and my panic attacks were increasing every day. I couldn't even sit at the computer and write a simple news story without my heart racing and thinking I was a failure.

I did not become the shining example of recovery. Instead, I was filled with almost uncontrollable anxiety and a strange heaviness which had nothing to do with weight. I struggled each morning to get out of bed for work and I dreaded each word I had to write.

The unthinkable had happened. My refuge, the one thing I had always been able to count on, my writing, my gift, the essence of my soul ... became a hated thing. I had once thought I'd rather lose anything except being able to write, and now I was losing everything and my ability to write.

I checked into Beaumont several days after Christmas 2008, the first of five psychiatric hospitalizations between that one and February 2009, mainly triggered by anxiety and fear of food and weight. I could find no peace; no solace in writing, no connection with God. I had failed, and I knew it and I blamed myself for having anorexia and I would scream inside myself to stop, just stop, can't you quit being so freaking sick and weird for once?

I agreed to take a low-dose of Seroquel in February 2009, during the last of my five hospitalizations. It calmed my anxiety, allowed me to sleep and rest and write. I also was treated for severe anemia, returning to work after almost three months sick leave.

I weight-restored during those months of sick leave. It was the worst time of my life. I hated food, I hated feeling full, and I hated every pound I gained. But I also began to feel as if I were returning to life, and that maybe recovery was possible. I felt confident enough to leave work and go to graduate school, and even though there were some rough spots, I enjoyed learning and the new challenges. I was able to stop taking Seroquel in October 2009, and my Ativan dose was down to less than two milligrams a day.

January 2010. Everything fell spectacularly apart, recovery exploding into a million shards. I couldn't get the thought out of my head that I didn't deserve to eat, that I didn't deserve food. I immediately cut my calories down to about 300 each day. I threw away food my husband made for me, and began to engage in some really strange behaviors, such as eating one or two grains of rice at a time and ripping my lunch meat into tiny shreds. I couldn't (and still can't) pick up a whole sandwich and bite into it; I had to deconstruct it into a million pieces until much of it was inedible.

Then I discovered proana sites and joined several of them under the alias Ana Magersucht. (See "Grace and the death of Ana M" for more about this.) I started — but never wrote a word — a proana blog, and posted about my drive for thinness on several proana sites. I dived in headfirst, part of me determined to enter that black hole and never come out.

"You are more ill now than you were two years ago," my doctor said one January day this year, as he tried to convince me to go back into the hospital. He was particularly concerned about the alternative, proana Facebook personality I had created and my total immersion in all things proana and my philosophy that I should remain anorexic forever. After all, losing weight and being ill was what I was best at, right?

I went back into the hospital in February, this time connected to a NG feeding tube because my ketones were high, my potassium was low and I was literally starving. I couldn't think, and didn't care. I had failed again.

I asked him how he can tell I am restricting and struggling before I even say a word. He replied my whole demeanor changes. He is right. I become a different person, one with little hope. A person who feels drained and tired and ready to give up. But, as he always reminds me, I am not a quitter. I never completely give up, or else I wouldn't continue to make my weekly, two-hour (one-way) trips to meet with him each week and I wouldn't be planning on entering Renfrew's 30-day program in May.

It's lucky for me that I have a doctor who is even more stubborn than I am. For every argument I present stating why I can't get better, he is able to come up with ten arguments to give me hope that I can get better.

"You are so much more than your body size."

Those words continued to echo through my mind as I rode home. I looked at my too-thin face, the emaciation beginning to show. I wonder who I am besides my body size. But I am ready to find out, and I am trying not to feel like a failure. I'm trying to think of recovery not as a finite destination, but as a lifelong journey that will take me first to weight restoration, then guide me to health and self-esteem, and finally to joy.

"You are so much more than your body size."

Thank you. Someday, I will believe those words and I vow to teach that same idea to others. Because in my heart, I want to believe we all are so much more than our body sizes.