Managing The Basics

It is really hard to eat when you stomach hurts so much you want to cry.

My stomach pain woke me up this morning it was so bad. I got up and walked around a bit and the pain subsided. It didn’t go away, but it was tolerable. While I was driving to Charlottesville it came back with a vengeance. I felt like someone had tied my stomach in a knot and was pulling the ends tighter and tighter. I almost had to pull over on the interstate.

I’m sure it’s no coincidence that I feel like this on the day I have to see Dr. S and E. The anxiety really gets to me. Usually I have a killer headache all day, but I guess I’ve psycosomatically moved the pain to my belly. How appropriate.

I did eat breakfast today and I did manage to get my lunch down. Every bite of food made my stomach hurt worse, so it was a real test of will. It is nice to know that I didn’t have to eat it if I really couldn’t handle the pain. On 2East you have to finish your meal no matter what. Psychologically this is a high hurdle to jump, but physically it made me and the other patients cry on occasion, more so when I was anorexic. Re-feeding hurts. Your stomach gets hard and distended, you have really bad reflux, and you stomach muscles have likely atrophied from un-use. None of that matters, though. You have to eat through the pain. Sometimes it gets so bad that the patients will actually request that Ensure be substituted for some of their calories because it is generally less painful to drink than eat.

My appointment with E is in 45 minutes. I would not be surprised at all if my stomach ache magically disappears as I walk out her office door.

I had my ultrasound today. On one hand it was very cool. On the other hand it was a major bummer.

Cool hand first: I couldn’t see much when the tech did the pelvic ultrasound. I could kinda make out the structures, but only if I squinted and looked really hard. The trans-vaginal ultra sound totally rocked! I got to see all my reproductive features in 3D! It was so clear it was like looking at a text book. I saw my cervix, my uterus, both ovaries, my endometrium, and my bladder. The tech was great, too. She was friendly and explained everything she was doing. I LOVE my midwife’s office. If you live anywhere near Harrisonburg, call me and I’ll refer you. They are absolutely amazing.

Bummer hand second: my ultrasound was totally normal. No pathologies at all. Everything looked good and healthy: all the structures were where they were supposed to be, they were all the right sizes, and basically I’m text book normal. The reason this is a bummer is because I wanted something to be wrong, so that we would know what is going on with me and could come up with a treatment plan to fix it. No such luck.

I hate to admit it, but it is very likely that my lack of periods is a direct result of my eating disorder. A person’s body will only take so much abuse before systems start shutting down. There is still the possibility that my thyroid is whacked, but that too would most likely a result of my eating disorder. It’s hard for me to come to terms with the fact that something I’ve done to my body may haunt me for the rest of my life.

If you’re flirting with disordered eating behaviors, seek help or stop now while you still have some control. It is totally not worth the toll it takes on your body.

I really want to purge right now.

It’s late. G’s not home. I’m by myself. I’m tired. I’m depressed. The perfect storm for wanting to engage.

I feel so gross and fat. Yes, fat is a feeling – I don’t care what anyone else says.

I haven’t even binged today. Actually, it’s almost two weeks since I last binged and purged. But I really want to purge right this very second.

Instead of purging I’m going to take a hot shower and go to bed. On second thought, maybe I shouldn’t be in the bathroom right now. That would probably be flirting with temptation.

I’m going to sit with the feeling for 15 minutes. I can handle 15 minutes. I’m going to remember that G is so proud of refraining from binging/purging. I’m going to remember how yucky it makes me feel when I do it. I’m going to remember that I have to go to Dr. S tomorrow and let him know how I did this week.

What I wouldn’t give for 10 cc’s of Valium right now.

Why being at home is better than being on 2East:

1. My access to my husband is not limited to afternoon and evening phone times.

2. No teenage drama queens.

3. I can use the bathroom without an audience.

4. I decide when to wake up and when to go to bed.

5. I don’t have to listen to listen to Linda Chow (sp?) after each meal.

6. I have unfettered access to razors and can shave my legs.

7. I can eat what I want to, when I want to.

8. No Vera.

9. No code greens.

10. I’m not a test case for medical students.

11. I can wear clothes with drawstrings and under wire bras.

12. No meal process sheets.

13. I don’t have to be supplemented with Ensure.

14. No morning weights.

15. No blood draws.

Don’t get me wrong, I am so grateful for my time on 2East and thankful that it was a resource I could use. The vast majority of the staff are completely committed to their patients and go out of their way each and every day to make living on a locked ward as bearable as possible. I wrote this list because I need to remember why life on the outside is better than life on the inside. I hurt so much and my life is such a battle right now that I want to retreat back to the safety of 2East. I can’t do that now. I need to learn to manage my behaviors at home, where I live. Where I can build a life.

(I do, however, really miss Kate’s shoes and Chris’ weird sense of humor.)

According to Dr. S, the vast majority of eating disorder patients are unmarried. Of those that are married, their prognosis for long term recovery is poor.

I am married. Not only am I married, I’m married to the most compassionate, fair, friendly, sexy, loving, understanding, patient, devoted, strong, consistent, trust worthy, stable, and peaceful man that has ever walked the face of the earth short of Jesus himself.

Granted it would be much easier for me if I wasn’t married. On a purely practical level, I would never have gone without health insurance because my income would have been so low as to qualify me for Medicaid. I wouldn’t have to lie to the person I love the most in the world about whether or not I had binging/purged or restricted that day. I wouldn’t have to feel guilty about hurting the person I love most in the world. I wouldn’t have to put some much effort into recovery because I would not have any motivation to recover.

It doesn’t surprise me that on the whole women with eating disorders are less likely to successfully recover if they are married. From my experience, these women have very low opinions of themselves, and as such they seek out men who reinforce this belief. This includes everything from emotional, physical, or psychological abuse to multiple infidelities. I could never relate to these women, because when the talked about thier husbands in group therapy, it was apparent that their husbands were part of their problem. On more than one occasion I actually felt uncomfortable talking about G and how he treated me because I did not want to make the rest of the women, with unsupportive and destructive marriages, uncomfortable.

It is impossible to know for sure where I would be today if it wasn’t for G’s unfailing love, support, and commitment, but I am sure that without him I would be in a much worse place, both physically and emotionally. The amazing thing is that he has never once complained or made me feel like a burden (I just feel like I’m a burden because I think I must be). He has been unwavering in his devotion to me and our love grows deeper as time passes.

If G’s love could make me well, I would never be sick a day in my life.

Thank you, Lord God, for the incredible gift you have given me that is my husband, best friend, and biggest fan. I’m so incredibly thankful that we are not given what we deserve in life, because if that were the case I would never have been blessed to be his wife.

It’s Saturday. Blah. Gross.

Most people look forward to the weekend: two days of freedom from work, time to hang out with family and friends, short road trips, time to devote to favorite hobbies and past times, and other such things that the responsibility of the work week lives little time for.

The freedom that Saturday brings terrifies me. I need the structure of the week to stay on track and refrain from binging/purging. It doesn’t help that G works on Saturdays, so not am I only facing unstructured time, I’m also facing that unstructured time alone. In the past this has translated to a day of sleeping in, binging/purging, going back to bed, binging/purging, going back to bed…. and on and on and on….

David Sedaris moved to from Paris to Tokyo for six months to help kick his cigarette habit. Not only do I have no desire to  move to Japan, I lack both the resources and language skills to do so. Harrisonburg has become my Tokyo. (This is probably the first and only time in human history that these cities will be used in the same sentence.)

I started the day off on the wrong foot. G woke me up when he left for work and told me get my butt out of bed, take a shower, and head over the mountain to the ‘Burg. After he left, I promptly got overwhelmed at the idea of getting out of bed, rolled over, and went back to sleep. He called me about two hours later to see how I was doing. Needless to say he was less than trilled to discover I was in the same place where he had left me.

He came home, dragged me out of bed, put me in the shower, and stuck around until I was dressed and ready to go. He walked me to my car and told me to get going and to stay in Harrisonburg until he’d be home from work around dinner time. Sometimes I don’t know whether to kiss that man or slap him.

I’m writing this from Carrier Library at JMU. I hung out at Panera’s reading the Daily News Record (which Dr. A, my freshman year history Prof deemed only good for training puppies and wrapping fish) and eating half of a veggie sandwich. I’m proud to say I managed this feat in a little under an hour. I’m not sure how I’ll spend the rest of my time here in the “city” but I am determined to refrain from eating disordered activities while I’m over here. What’s the point in spending $15 in gas to drive to the Valley and then engage in destructive behaviors I could have done just as easily at home?

The Health Insurance Digest has linked to my blog. You can find them at:

http://healthinsurance.titeblog.com/?p=618#comment-2

It’s nice, but weird, to know that people actually read what I write.

Feel free to link to me if you want to. While initially the point of this blog was to be a therapeutic tool for me, a way to get my thoughts out of my head, I think it has evolved into something bigger: a means of bringing a personal face to the craziness that is the current American health care system, and hopefully bringing awareness about eating disorders and mental illness to people who would not otherwise have any knowledge about them.

So link away!

I may still be on a roll and refraining from binging/purging and while this is an accomplishment, in the interests of full disclosure (also known as honesty and integrity to you ABBHH folks), I need to come clean about my other “wacky behaviors.”

(Note to readers: this post is going to contain “numbers.” If there is even the slightest chance that this may be triggering to you, please make the healthy choice to stop reading now.)

1. I the know the exact caloric content of every food I eat.

2. I keep a log of everything I eat, the time I eat it, and how many calories it has.

3. My goal is to eat 1,000 calories a day. I figure this should be enough to keep me from wanting to binge, but also low enough that I don’t feel too guilty. Some days I eat 900 calories, and other days I eat 1,150 calories. The important thing is that it all averages out by the end of the week.

4. I eat slooooooooooowly. Very sloooooooowly. It takes me an hour to eat my breakfast and drink a cup of coffee. Dinner is even worse.

5. I’m “liquid loading” with water, coffee, diet soda pop, and iced tea.

6. I’m abusing caffeine (see #5).

7. I eat the same thing for breakfast every day: no-fat cottage cheese (100 calories) and a small can of mandarin oranges (70 calories).

8. I eat the same thing for dinner every night: canned pumpkin, Cool Whip Free, and fat free/sugar free Jello brand cheesecake flavored pudding mix all mixed together in a bowl. (Weird, but good. Really. Try it sometime before you judge me.)

9. I will not look at myself naked in a mirror. It is too revolting for me to see that I’m as big as a house.

10. I change clothes a couple hundred times each morning trying to find the outfit that makes me look least fat.

11. I compare myself to every other female I see each and every day. I am always bigger than each of them.

12. I think it would be less traumatic for me to be water-boarded by the CIA than to go into a grocery store.

13. When I do muster up the courage to go the grocery store I buy food that I think I “should” eat, even though I know I never will eat it.

14. I have no brand loyalty and I do not buy food based on how good it tastes. I buy the variety of a certain food — be it bread, yogurt, popcorn — that has the fewest calories, even if it means buying a product that is more expensive and less appetizing.

15. I would rather suffer arsenic poisoning than have to drink anything with calories.

Ok, I could go on and on and on…. but the point that I’m trying to make is this: for me to claim victory over the nightmare that is my eating disorder, I will have to do much more than simply refrain from binging/purging. My whole relationship to food/weight/appearance will have to undergo a radical shift. Obviously it’s better to refrain from binging/purging than it is to engage in binging/purging, but refraining in and of itself is insufficient. There is so much more work that needs to be done.

Appointment with midwife: drew TSH level at office, will start charting my cycle at home; pelvic ultrasound scheduled for Monday to investigate the possibility of PCOS. The only PCOS symptom I have is irregular periods, so it’s a long shot, but worth investigating.

Eating Disorder Behavior: still not binging/purging. Even though gas is crazy expensive I’m still planning on spending Saturday in Harrisonburg again. I think it really was what I needed to keep from engaging.

NEDA 2008 Confrence in Austin: for sure going.

Our fence: now has a big hole in it where Gabe got it tangled up in the tractor. Ya gotta watch those damn fences — they’ll jump right out at you into the path of on coming farm equipment

University status: started the process of retroactively withdrawing from the Fall 2007 semester. This is the first step in getting my transcript straightened out. Next step is to get my field camp credits transferred.

A week and two days without binging/purging.

It’s even harder than I thought it would be, because even though I’m putting so much effort into it, I’m not getting anything tangible in return. I still feel like crap. I still hate myself. Sometimes I wonder what the point is of investing so much effort into refraining from bulimic behaviors if doing so doesn’t make me feel better.

But it will make me feel better eventually, according to the all wise and knowing Dr. S and E.

So every day I put forth the effort and energy that it takes to not engage in eating disorder behavior. I can’t describe how much energy this is. By the time I work a ten hour day and get through it without binging/purging, I’m done. That is it. Technically I could do more. I could tell myself I have to fix G a hot dinner every night, that I have to go visit his family with him, that I have to stay on top of the laundry, that all the dishes must be washed before I go to bed… but doing those things would drain me of what precious energy I do have. Energy that must now be spent of focusing on and fighting for recovery.

All the hot dinners, family visits, folded laundry, and clean dishes in the world mean nothing to G if I’m not well. So I put myself first and reserve my energy for what matters: continuing to make healthy choices. I replenish my energy reserve by nurturing myself, by praying, by getting the appropriate amount of sleep, by devoting time to reading and journaling (this blog is my journal).

This is not being selfish. It is just one more healthy choice I make so that I can maintain the physical, emotional, and spiritual stamina needed to worship God and be a productive, responsible human being.