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.

Now is now (The fallout of anorexia nervosa)

Dialysis
Even the word scares me. The thought that I might need dialysis in the future scares me even more. But the functioning level of my kidneys has significantly declined in the past few months. My blatant mistreatment of my body through anorexia and laxative abuse has taken its toll.

The first hint something might going wrong came up several months ago. I was badly relapsing and using multiple dosages of different kinds of laxatives to purge myself of even minute quantities of food. I craved emptiness and felt so clean after all food was cleared from my body. (Or so I thought. I've since learned it does not work that way and some of the food stays in your body. That was very clever of God to design our bodies to work that way, and it probably has saved me from worse problems.)

That was in February. I was hospitalized for a week with a NG feeding tube and this should have been my wake-up call. I thought I had hit rock bottom with my eating disorder, but I soon learned I was wrong.

Tests results showed minor problems with my kidneys just before I left for the PHP at River Centre Clinic. My doctor thought the problem would correct itself once I was eating properly again. No worries. The rest of my tests were fine and I was medically cleared to go to RCC.

I am tested weekly for all sorts of things via my blood and urine. I resumed both treatment with Dr. Sackeyfio and his tests after I left PHP. (I didn't receive any physical tests, except blood pressure and temperature checks, while at RCC.)

Then two weeks ago I went to see Dr. Sackeyfio. He pulled out the test results the minute I walked in — NOT a good sign — and told me my kidneys' functioning had "significantly declined" since the last tests two months prior. It really is a puzzle. RCC had me eating almost 3,000 calories daily for weight restoration and I have not once used laxatives in almost three months.

The bad news got worse this week. The damage is starting to show in my blood as my potassium levels have dropped. Low potassium levels can put me at risk of cardiac arrest, a leading cause of death amongst anorexics.

What's going on?

Damage from anorexia and laxative abuse. Damage that might not be reversible through conventional means, i.e. eating healthy. Damage which I feel I caused.

I am scared. Right now we are going to see if eating properly will reverse it. But ... I looked at Dr. Sackeyfio on Friday and asked if I could need dialysis in the future. He said yes.

Then there is food ... I have struggled with eating since leaving RCC. Eat well. Eat but not too much. Eat but avoid fattening foods. Eat but restrict a little. Eat but restrict a lot. Eat as little as possible.

Lose weight. Gain weight. Stay at the same weight. Fat. Not fat. Fat stomach and thighs. Not really hearing people when they say I am still too thin. Not seeing it myself. Nope. Nothing wrong with me. I'm just fine.

Looking at my gaunt face in the mirror. Feeling some days as if I have no future. Then becoming angry and declaring that anorexia WILL NOT WIN. Not this time. Then I plot how to eat less food each day ... Back and forth it goes.

My mind continues to swirl and I wonder why this doesn't shock me out of my complacency. I mean, dialysis for God's sake! Even the fact that it is just a possibility frightens me. And yet ... This should be rock bottom for me. What am I waiting for? Dialysis to fail and then need a transplant? Being rejected for a transplant? What then?

I feel as if I have squandered my future. I have so many dreams, and anorexia seems bent on killing them one way or another.

I try to tell myself that anorexia is an illness and I did not chose to have it. Something in my brain snapped about four years ago. I keep waiting for it to snap back, for something to click back into place and finally, finally give me the strength to let go of this and LIVE.

Many mornings, I wake up just as dawn is rising. I see the hint of the still blue-black sky and hear the small noises of birds readying for the morning. I look over at my husband, sleeping peacefully. I think about how much he loves me and how much he has believed in me through the past fourteen years.

I think about the friends and family who love and support me and the times we have spent together and the things we have shared. I think about graduate school and everything I have discovered there, from a love of children's literature to the pride I feel by finally understanding just a little about literary theory and criticism.

Sometimes I remember my days as a journalist. I remember when I flew in a hot air balloon and felt as if I could touch the clouds, that I could just leave the balloon and fly all alone. I remember the dips and shakes as I rode in a four-seater airplane, feeling scared and excited at the same time on that cold winter day. I remember the grief on the faces of family members who laid to rest a young soldier who lost his life in this inexplicable war in Iraq.

During these brief moments, my heart often races and I wonder if this time it will happen ... I lie still and try to calm my mind, but often my last thought before going back to sleep is that real life is behind me. I feel as if I am lost, lost in a demented fairy tale in which there is no cure from the evil witch's curse and I will forever be under her spell.

I wonder if I ever really appreciate how full and wonderful my life was before anorexia? Did I ever have even a hint of what was to come? Did I ever stop to think of the beauty in the ordinary? Did I know what was coming in the recesses in my mind? Or was I oblivious to the fact that the life I was living was soon going to fly off its tracks?

Did I ever tell the people in my life what they meant to me, what they still mean to me to this day? Do the people in my life really know how much I love them and that the thought of maybe not seeing their faces someday ... Why did it take anorexia to realize how important love and friendship and everyday, ordinary life is?

Each night, I lean against the back of my husband as I struggle to sleep. He already is sleeping; the peaceful look on his face makes me happy. I think of the future, in which anorexia is just a bad dream and recovery is so strong nothing can break it. The darkness begins to falls and I struggle not to let it ensnare me. I drift off thinking about possibilities ...

Then dialysis floats in my mind. But I try to let it go for the night, and bring myself back to the present. Now is now. I have no control over the past nor the future.

I tell myself I can still turn this around. That it isn't too late. I can return to health and life. That I have a future. I lean further into David's warmth, wrap my fingers through his thick wavy hair and then drift off.

(Postscript - Today I received word my mammogram showed "several abnormalities" in the right breast. I go see the radiologist tomorrow (July 13). I feel as if God is trying to teach me something ... Hopefully I will hear Him and follow His will.)

Lessons from anorexia rehab

It has been several weeks since I left the River Centre Clinic. I immediately dropped into a deep depression and started restricting the day I returned home. I still struggle to write about it, and I'm not completely sure why. But I know I need to get all the verbiage out of my head and then move on in order to heal.

It will be the last time I will allow anyone to have that much control over my body and soul. I now realize that all the answers and healing are ultimately within myself. I will never again deny that inner voice; sometimes stifled by the roaring of anorexia and anxiety, but always there if I am still and just listen ...

What I learned in anorexia rehab:
Being lonely aches more than I ever could imagine.
The bed is cold and empty without my husband next to me.
A hug can heal pain and a smile can make the day easier.
Eating disorders and the people who have them are sometimes misunderstood even by those trained to treat them.
I would never have chosen to have anorexia nervosa, but my struggles with it have made me a better and more compassionate person.
Kindness means everything when you are away from everyone and everything you know.
The sun does shine in Toledo once in a while after all. :)
I am stronger than I ever thought; you might bend me, but you can't break me.
My core values - love, kindness, compassion, and the passion to write - remain within me and can never be destroyed.

Recovery is still difficult to understand and harder to obtain. I still struggle to eat and the idea of eating for pleasure remains a foreign concept to me. One day I was sitting in the center's common room, watching someone prepare her breakfast when I thought, "I am afraid to enjoy food."

Once I did enjoy food. I liked stadium hot dogs from the Pontiac Silverdome and chocolate bars from the ice cream truck. I used to dip Oreos in cold skim milk, the mixture of chocolate and cream a delight. My mother's cornbread, slathered with butter, tasted great with a bowl of bean soup on a cold winter's evening.

But as anorexia moved in, pleasure moved out. Pleasure in anything. Reading. Embroidery. Making love. Taking a walk. Creating snow angels while looking up at a crisp winter sky. Swimming. Walking in my bare feet, the summer's sweet grass tickling between my toes.

Anorexia sucked me dry; counting calories and fat grams and worrying about how much food I consumed took so much energy.

But the worst thing anorexia has done is try and steal people and relationships away from me. I still have the love of my wonderful husband and family. I still have many caring friends whose support and prayers have sustained me through the years. But often anorexia colors my mood and thus my relationships and I have had to fight against this.

So this is what I learned in anorexia rehab: people matter most.

Free falling

Free falling into

The abyss,

I am a bird beating its wings against a golden cage.

Trapped and clipped

Unable to fly

Knowing my life is

A crumbled leaf

Brown in the fading

fall.

Silver light

gently caresses it,

Until the wind screams.

The leaf ...

swirling upward

Lands on soft dead grass,

dreaming of spring.

But it is hidden

underneath the snow,

Its true worth buried

Forever.

Reclaiming my voice

How do I distinguish between that inner voice which guides each one of us through life and the eating disorder voice which attempts to lead me down the path of self-destruction and death?

The two voices are warring within me right now. For four years, I have battled anorexia nervosa and its voice. My fingertips have touched recovery only to have it slip out of grasp and spiral downward, dead as a withered brown leaf in the fall. Hope would rise and fall, and the rollercoaster ride of anorexia would continue even as I screamed at God and Heaven to let me off.

I recently completed about six weeks of treatment at the adult partial hospitalization program at the River Centre Clinic in Sylvania, Ohio. The above verbiage is the result of both my continued confusion about what led me to need more intensive treatment (will I ever know why I developed anorexia) and how to move forward in recovery.

It wasn't the most positive of discharges. My therapist there privately told me she had concerns about my ability to continue in recovery, particularly in the area of meal planning and eating. And frankly, I had concerns about that too. I am still concerned how to transfer RCC program eating into real life. My official discharge papers also said I was leaving AMA - even though I had said before entering the program I had to leave for school by a certain date. Leaving AMA (against medical advice) could hinder any future treatment options.

Several fellow RCC patients had kind and encouraging words to say during the graduation ceremony held on my last day. I was grateful to hear that I had helped several people and that others had enjoyed getting to know me as a person. There had been a lot of drama for several weeks in our small living space and I was led to believe much of it was my fault (was I too difficult? too opinionated? did I say the wrong things?)

I know I struggled with wanting recovery, and I'm sure my ambivalence was not helpful to others who were struggling.) I know each one of us made mistakes and was gratified that for the most part, we were able to move past the problems and support each other. Hearing others speak about me so kindly helped me see the truth through their eyes.

Still, I drove back home in silence. No singing along to the radio and rejoicing in the fact that I did stick with it. No happiness that I ate everything (except one snack) and gained ten pounds. Just confusion about the future and the fear I would never escape anorexia.

I met with Dr. Sackeyfio (my outpatient doctor/therapist) the day after I was discharged from RCC. I was unusually quiet. He kept asking me about my treatment there; the things that happened and how I felt about it.

I felt weighed down and oppressed, unable to talk. He gently confronted me, asking why was I afraid to express my opinion. I started to cry. It felt like it had been a long time since my opinion really mattered and didn't seem to cause trouble. It felt like it had been a long time since I was more than just a set of symptoms and urges to be fixed.

I opened up and my fears began to ease. He asked me to consider what I learned during the past six weeks and write about it. (What I learned and what my inner voice taught me through that time will be in a future blog post.) Our session ran over because he wanted to make sure I heard something before I left: "You have the right to your opinions. You have the right to your voice."

Immediately I felt the crushing weight lift, my spirit already feeling more free. I felt relief.

I am reclaiming my voice. It is separate from the voice of anorexia, and it doesn't always agree with everything I learned in treatment nor from my doctor. It is my voice.