Managing The Basics

Operation Recovery is underway.

I saw Elise on Monday and we made a meal plan for the week, but that was under the erroneous assumption that everything would be “back to normal” on Tuesday. Today is Thursday, and it is my first day back to work since the accident. I’m getting over whatever bug I picked up at the hospital and I actually had an appetite this morning. I guess today is my first “back to normal” day, if I’ll ever have a “normal” day again.

No more saltine crackers and Gatorade for this woman. This is where the rubber hits the road and I start following the meal plan that Elise and I made for this week.

I am already terrified. I have eaten more calories by 1:00pm today than I usually eat in a 24 hour period when I’m restricting. I need to remind myself that the whole point of eating like this is so that I don’t feel the “need” to binge/purge and that I will most likely lose some weight if I can stick to the plan.

After the last two weeks I cannot possibly deny the fact that life is too short to live without actively fighting for recovery. When I die, I don’t want people to say, “Poor Anna, she was a victim of depression and eating disorders and was never able to have a sense of peace about her life.” Instead, I want people to say, “That Anna really struggled with mental illness, but she fought against it every day of her life with all that she had.”

For now, fighting against my mental illness means that I:

1) take my meds, as prescribed, every day, without fail

2) keep my appointments with Dr. Shemo and Elise, every week, without fail

3) follow the meal plan that Elise and I agreed upon as written (or, if substitutions are made, they are of equal or greater caloric value)

4) NO alcohol (nipping this is the bud – I’m starting to get a little too “friendly” with the bottle again)

Following the meal plan is the hardest of all these goals. I always make and keep my appointments with my treatment team, even when I’m doing really bad and am ashamed to have to go in and tell them how I’ve been engaging in ED behaviors. I always take my medications, accept when I’ve been drinking, because I know that heavy duty psychotropic meds and alcohol do not get along well. I had let alcohol slowly creep back into my life, but I just don’t think that is a safe idea. No more cheap, sweet Virginia red wine for me.

We’re going to the farm tonight, so I’ll have to make a decision about dinner. Do I risk it and wait until we get there and see what’s left from the deluge? Or do I eat before we go so that I can control exactly what it is I eat? The “normal” thing to do is probably to just wait and eat there, but I’m not sure if I’m up to that yet.

I have been physically sick for the last 48 hours. Headache, sore throat, nausea, chills, dizziness, exhaustion. I have been living off of crackers and Gatorade.

Chris, Jessica’s husband, returned to the hospital this afternoon and took over “nursing duties” so that I could come home. I got home a few hours ago and immediately fell asleep. I napped for awhile and when I woke up I felt better. Not great, but better. I’m going back to work tomorrow and my plan is to get back on my meal plan then, if I’m feeling well enough. For the rest of tonight I’m going to keep pushing crackers and Gatorade, but hopefully tomorrow I’ll be up to eating full meals.

Jessica is obviously upholding her end of the bargain to get better, so I need to work like hell to uphold my end. I can’t keep going through life in this state of suspended animation, waiting to get better. I need to take the steps to get better, not just wait around and hope that “better” somehow finds me.

This whole situation has made me think about the brevity of life and what I want to get out of my time here on earth. Right now I am where I need to be given my physical and mental health. That said, I really don’t like where I am. Solution: improve my health so I can move on with life.

Move on where? This time last year I was going back to get two more BS degrees in nursing and dietetics. Dietetics still interests me and is a possibility (assuming I can get my own nutritional status stable), but I am leaning more and more towards med school. When I told my professors in the Chemistry and Geology departments I was back at JMU for nursing and dietetics, they all looked at me like I was nuts and said, “Anna, get your butt into med school now.”

If I do go the med school route, it will be at UVA. Emergency medicine or endocrinology.

Obviously I cannot be an orthopedist at UVA because I am 1) not male, 2) not African American, 3) not bald, and 4) not ridiculously good looking.

I. Am. FINALLY. Home. From. Charlottesville.

Sorry for the blogging hiatus. Time has run together for me, I know today is Wednesday but I have no idea of the date, and I can’t remember the last time I was home for more than two hours. Sunday? Monday? I have no clue.

Amazing news! Jess is walking! Ok, “walking” may be a slightly generous term, but she’s moving her body. With the help of a walker and one person supporting most of her weight and another person acting as a “spotter,” she has made not one, but TWO trips from her bed to the bathroom. Pretty freaking amazing when you consider that last week I was sitting by her bed in ICU reminding her to breath when the alarm on the CPAP machine went off.

Each trip to the bathroom took close to an hour, and she was basically carried back to bed, but she is trying so hard. The pain she is in is unbelievable and indescribable. I honestly don’t see how she can make herself get out of the bed and try to walk when she knows the incredible pain it is going to cause her.

I haven’t seen Falon and Aubree for days. I’ve heard from Gabe that they are doing as well as can be expected, and now that Falon has been reunited with Aubree full-time, they are both in better spirits. Gabe is still only going into work for about half of each day. He spends the rest of his days doing his “therapy”: fishing, sleeping, hanging out with Barry, on the tractor, talking to friends, and going for drives. I may spend a million dollars an hour to meet with Dr. Shemo once a week in Charlottesville, but what Gabe is doing with his time is just as much therapy as I do with Dr. Shemo.

Thank you all for your prayers and support. Specific prayer request: Jessica’s pain needs to be better managed.

I met with Elise today for the first time since the , and since she’s been home from her vacation. I told her about the deal I made with Jess: she works like hell to get better, and so do I. We came up with the following meal plan:

Breakfast — 2 tbs peanut butter, bagel, mandarin orange pieces, yogurt

Lunch — frozen vegetarian dinner, Amy’s brand, any type and yogurt

Snack — granola bar and apple slices

Dinner — 2 tbs peanut butter, bagel, carrotts

Snack — mandarins, cottage cheese

I basically have none of the above at my house because we just haven’t been home to eat, and when we are home people are bringing us food. So, if you want to do something that would really help out, feel free to drop any of those foods by our house.

Help keep me accountable, ok? Ask me if I’m on track.

(And yes, I am planning on eating the same meals for a week in a row. Sometimes that is just easier than dealing with choices.)

I can’t believe that the was a week ago at 11:30pm tonight. In some ways it seems as if it can’t possibly have been a week ago that our world fell apart, but in other ways it feels like the last seven days have lasted a life time.

Jess continues to do well. I’m at UVA as I write this and today alone she has had major surgery on her face, ultrasounds of both legs, a visit with the chaplian, and a consultation with a dietitian. Jess really can’t eat anything right now because her mouth and jaw are so sore, so the dietitan asked Jess if she would consider being supplemented with Ensure. Jess jumped at the opportunity to get the nutrients she needs to get out of the hospital.

That was the first time I’ve ever seen a patient get happily excited about Ensure. I’ve seen lots of patients get aggitated about the idea of being supplemented, but I’ve never seen one be happy about it

I’m trying to encourage Jess to take it one moment at a time. She is worrying about what is going to happen to Chris. We found out today that his BAC was 0.11 when they did his draw almost an hour after the crash. He is meeting with the State Police tomorrow. I have no idea what is going to come of that.

Back to Jess: her surgery went well this morning. Her entire face was reconstructed and it looks wonderful. She looks like Jess again. There is swelling, and they re-set her jaw, so she really can’t open her mouth very well, but she is in good spirits. Tomorrow she is scheduled for more surgery on her legs.

I’m going back to work tomorrow for the first time since the . I’m going to try to get out an hour early and head back over here. I’m torn because I know that Gabe needs me at home, but I know that Jess needs me, too. I’m going to do the best job I can with this balancing act. I may end up having to take a week off without pay, but we will cross that bridge when we get to it. I’ve used sick leave up until this point, but I’m not sure if I can do that for two weeks in a row, since tecnhincally I’m not the sick one. Gabe is going to go to work for half the day tomorrow and then take it a day at a time from there.

Thank you all for your love and support. Keep praying for us.

Quick update:

Jess was extubated yesterday and is actually talking now!

She’s doing so well that she was moved from ICU to the step-down unit. This was at least a week sooner that anticipated.

She is having additional surgery tomorrow to reconstruct her eye socket. Her doctor’s may attempt to work on her knee at the same time, but there isn’t much to work with.

She may end up back on ICU after her surgery as a precaution, but that should only be for a day or two. I’ll keep you posted as to her whereabouts.

I’m going back to work on Tuesday. I’m going to be coming to UVA everyday for a while, though, after work, so if you want to get a note to Jessica, just give it to me or to Gabe. We’ll get it to her.

Grandmom Ruth is fine after her scare yesterday. She’s mad at me because I told her she had to eat or go to the hospital. She ate a good meal and felt better, but she’s still mad at me. I think I can take it.

Chris has to go speak to the State Police on Tuesday. This may result in his arrest.

Clay’s viewing and funeral were both moving tributes to his life. Thank you to all how were able to come and to all who could not attend in person, but were able to lift us up in prayer.

Falon is doing as well as can be expected. She is trying to figure out where she and Aubree are going to live for the time being. She wants to be with Bev and Barry, but that are so many memories of Clay at the house that it is hard for her to be there. She is staying with her mother some, and Mallory and Val have done a wonderful job being there for her.

Bev and Barry would never ask for help, so please just give it to them. We have enough food to get through the middle of this week, but then anything you could bring them would be appreciated. Child care for Joe and Cyrus would be wonderful because Bev wants to be here with Jess as much as she can, and Barry has chickens going out this week. (Talk about incredibly bad timing.)

We have a long road and a heavy burden ahead, but your love and support help lighten the load. Thank you for everthing. We love you.

During times of stress, some people drink. Some people smoke. Some people sleep all the time.

I binge and purge.

And right now I couldn’t care less that I have lost count how many times I’ve engaged in eating disorder behavior since the accident.

I cannot take care of myself when Jess, Gabe, Bev, and Barry need to be taken care of first. I am going to get them through this and will then deal with getting my life back on track.

Falon and Barry have been smoking up a storm and no one has said a word to them about the health risks of cigarette use. People actually seem to understand that it is, for them, a necessary coping mechanism. So I don’t want to hear one word about my coping mechanism just because it isn’t as socially acceptable as smoking or drinking . I’ll deal with it when I have time to deal with it.

Stop asking.

Jess is doing so so so well!!!!!!!!!!!! Praise God, the Healer and Physician.

I was with her yesterday until I had to leave to go to Family Night. (UVA is about a two hour drive from Franklin.) They had stopped all of her sedation medications so she was more “with it” than she had been since the accident. The swelling in her face had gone down considerably, so she could open and close both eyes for the first time.

While I was with her, her nurse needed to suction her vent tube. Apparently this is an unpleasant procedure for the patient – she basically couldn’t breath for 15 seconds while the suctioning is taking place. While the patient is in no danger, is must be a scary feeling. The nurse started the suctioning, and Jess grabbed my hand so hard it hurt. She sat up as much as she could and started shaking her head back and forth, as if to say, “Cut this crap out right now!” It was WONDERFUL to see her pissed off. Our spunky Jessica is coming back.

Her husband, Chis, stayed with her after I left to get back for family night, and while he was still there she was extubated!!! She is trying to talk and asked about the accident. She knows that Clay died, but I don’t think the reality has hit her yet, which is probably a good thing. She’s upset that she’s immobile and has no patience to sit still. I don’t think she’s being the most pleasant of patients, so her doctor may wish he hadn’t take the tub out when he did

I had planned on going back to UVA this evening, after the dinner at the church, but Bev and Gabe forbid me from driving. I was upset, but they were right. We got back to our house around 4:30 and I fell asleep immediately. I’m going back to the hospital tomorrow – leaving Franklin at 7:00am sharp.

Surgery to reconstruct part of Jessica’s face is scheduled for Monday. Her knee has been obliterated, so I’m not sure what will be done with it, but that is low on the priority list right now. Joe and Cyrus want their mommy NOW, and are starting to have a hard time being away from her. At first it was a grand adventure to get to have a bunch of sleep overs with Grandpap Rick and Grandma Angie, but they are so ready to be back home with mom and dad. As soon as Jessica gets moved to the step down unit we’re going to take Joe to see her.

Right now what we need most is prayer. We’ve got food coming out the gills, and none of us have gone to work this week, so child care just hasn’t been an issue. However, next week we are going to have to go back to work and try to regain some semblance for normalcy, at least for the sake of the kids. If you would like to do something for us, please consider bringing a meal next week or the week after, or offering to take the boys to the park or the pool for a day then.

Every little thing you do for us a blessing.

While we as Clay’s family must carry our grief ourselves, it is reassuring to know that our friends and family are rallying around us and cheering us on. I’ve been told that one day we will get to a place where the boulder of grief and sadness will become stones that are easier to carry, but that will always be with us. We appreciate more than words can say that fact that you are walking with us in our journey.

Family Night at the funeral home went well. Initially Bev had been set against not having a family night, but Dave told her that many mothers feel that way, but that in his experience, every family that does have a family night draws incredible strength from it. He was right. Gabe and I stayed in the chapel greeting friends and family as they filed by the casket, and Bev and Barry stayed in the lobby greeting people as they left. Bev and Barry were so touched by the number of people who came and the fond stories you were able to share with them.

The funeral could not have been more touching or appropriate. Randy Ours, the family pastor, did a wonderful job keeping the service respectful, but also light hearted, as Clay would have wanted. There was an opportunity for family and friends to stand and speak about their memories of Clay, and I told the story of how he spilled a bottle of beer all over my calculus notebook my freshman year at JMU. At the time, it was anything but funny, but now I can’t help but laugh about it.

The enternment was hard, but he is now at peace on the hill overlooking the Keiter family farm.

By this weekend I will return to blogging about mental health issues in general and my mental health issues in particular.

As great as my blog has been as a way to disseminate information about Jessica’s condition and Clay’s services, I need to get back to writing about other things and processing my reactions and behaviors.

If I don’t take care of myself I can’t take care of anyone else.

Writing is the best way I know how to take care of myself and I need to take care of myself now. I’m beginning to fray around the edges.