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God

This is why people believe in God. I want so badly to believe that there’s something on the other side of this life. That I’ll get another chance to see him loping towards me with a tennis ball in his mouth. Another chance to be the owner he really deserved. A chance to get answers about all of it.

My heart is broken right now. It feels like someone reached into my chest, grabbed a piece and won’t give it back. It went exactly as I’d imagined. I threw him some tennis balls and his frisbee for a few minutes when we got to the farm. My mom anesthetized him first. The anesthesia she used typically causes hallucinations and often they look terrifying but even Zef’s hallucinations were happy. First he rolled around on the floor like he was doing the happy dance he did when I gave him a bone, then he lay on his side and was running somewhere. For the actual euthanasia I cradled his head on the table and held his leg so my mom could find the vein like I had done for so many dogs so many times before. He took his last breath in my arms. That was the only time I was silent and without tears. And then I broke down again. And so did M. I don’t think he expected it to be as hard as it was.

I cried all day. I cried all evening. I woke up now in the middle of the night crying again. I’m sitting in the living room because M finally fell asleep and I don’t want to wake him up with my sobs. But even this feels wrong. Zef is supposed to come out from under the bed, give me that What-the-hell-are-you-doing-up-at-this-time-of-night look, and flop on the living room floor to sleep near me.

He showed me how to truly love every moment of life. He was my buddy when I lived in lonely apartments by myself. When I was depressed he would drop a tennis ball in my lap and give me that goofy grin of his and I would be motivated to finally move. He did so much for me and I just gave up on him.

Home

I’ve been home for a week now and have hit every emotion from ecstasy to despair in that week.

I was so excited to be coming home and yet sad to be leaving everyone in Denver behind. And then so happy to be back in Iowa and see everyone there. Being home was more challenging than I expected. Life here isn’t structured and regimented like it was in treatment. I’m responsible for choosing and making my own meals. Our lives are hectic and chaotic and dinner might happen at 6 pm one day and 9:30 pm the next and who knows when lunch might be, if it happens at all.

And then today I made the hardest decision of my entire life. Zephyr (my dog) is the love of my life. I have loved him more than I ever thought possible to love any living thing. Up to about the age of 3 1/2 or 4 he was happy and loved all people and all dogs even if he was a spastic ball of energy. But then his personality started changing. He started becoming more aggressive to other dogs. I took him to classes and then had a trainer come work with us 1:1 at home, but it didn’t seem to help and his behavior has only gotten worse. He still goes up to people wanting to be petted and then will turn and out of the blue try to bite them. 6 months ago he bit M’s little sister. At that time I had my mom do a full medical evaluation and we started him on Prozac for aggression. She couldn’t find any medical issues. The only possible explanation is that about the time his personality changed I witnessed his first (rather long) seizure and he had another fairly long one again this spring. But his behavior has continued to get worse. He has bitten/tried to bite several friends who came to the house. He’s become a liability, I’m out of ideas for what to do for him, I’m afraid to walk him because I worry some person (or kid) will come up and try to pet him, and I don’t know that it’s much of a life not being able to be petted. So I decided to have him euthanized.

I’m so sad I can barely function right now. I feel terrible. He’s in the prime of his life and still seemingly healthy and I feel like a terrible person doing this. I feel so guilty. I feel like I failed him in some way. And I feel like I don’t deserve to own another dog.

Last week I felt like I had really hit a turning point in this whole recovery thing. I was feeling great and things were getting easier and life was amazing. This week has been almost the exact opposite. I have had so many eating disorder thoughts and urges. I had an all-day pass on Sunday during which I missed some exchanges and had more exercise than my team had wanted me to. Coming back I was honest with my team about it (a new thing for me compared to previous treatments). When my psychiatrist even grazed the idea of pushing back my discharge date because of my struggles Sunday I made a goal of getting through the next 2 weeks with no behaviors. Easier said than done. Especially as the eating disorder thoughts are coming back with a vengeance (extinction burst?).

Today we had a lunch outing to a pizza/pasta restaurant plus we had challenge snack in the afternoon. At the beginning of community meeting I was thinking that there was no way I could keep pushing through this until my discharge date. Community is a twice weekly meeting where everyone in my treatment group (18 patients) plus all the staff (milieu coordinators, therapists, dietitians) get together and discuss things. The primary activity is where we go around the room and all the patients have to say (1) something they are accountable for, e.g. an eating disorder behavior, restriction, exercise; (2) a committed action for how they will do things differently to change that behavior; (3) gratitude for someone; and (4) a success. This was the first community meeting in a while where I was able to say that I had no accountabilities. Saying it aloud to a room full of people along with my success that I did it despite raging eating disorder thoughts/urges made me realize that even though this week has been really hard, I have been doing it. I have been succeeding. And that has made the rest of the day easier. I don’t know that it will last through tomorrow but after being disheartened by my difficult week it has given me hope.

I suppose it’s time I could sit down and write a quick update. I’ve been at ERC for 7 1/2 weeks now. The days take forever to get through but the weeks seem to have flown by. Probably because all the days are the same and I have no external events (i.e. exams) to mark the time. I finally reached maintenance weight this week so now I get to start decreasing my meal plan. I had a decrease on Friday and will have another on Tuesday and then after that can discuss an “exercise contract.” Pretty sure their definition of exercise is not quite the same as mine, but still it will be nice to not get scolded every time I decide to walk somewhere.

This week I have felt more like myself than I have in years. My mood is up, I enjoy socializing and hanging out with people. It’s been amazing and so much fun. I’m looking forward to enjoying family and friends back home with my new (old) self. And that will be happening soonish…I fly home May 14th. Can. Not. Wait!!!

Week 2

It’s hard to believe another whole week has gone by. I started week 2 by getting moved up to “level 2.” A somewhat arbitrary designation–basically it means you are completing all your meals and get to eat with other level 2 people. They aren’t struggling as much so it makes it easier to get through meals too. Because I’m in residential, it also means I can go on passes for meals/snacks off the unit on my own. I went on my first pass on Tuesday just for morning snack….meaning I went to Starbucks!!! We only get one cup of mediocre coffee in the mornings and I have been struggling with that. While I sort of wished I had found a local coffee shop, the Starbucks across the street (that taunts me day and night with its glowing sign) hit the spot. This weekend though with everyone visiting me I have more passes! Hopefully involving more coffee and possibly a diet coke….

Here’s how my days go

5:55 am: wake up, go wait in line outside the bathroom

6:20 am: bathrooms finally open, stand in the line for vital signs, pee in a cup, put on a see through gown, get weighed, hope I did all that quickly enough that I don’t have to wait in line for one of the 5 showers that 20 girls have to share

7:15 am: get meds, waste some time

7:30 am: breakfast

8:30 am: morning goals/intentions group

9:15 am: waste some more time, bathroom

9:45 am: snack

10 am: waste some more time

10:15 am: fresh air/outside time!!

10:30 am: some sort of therapy group (ACT, DBT, values, menu planning)

11:15 am: stand in med line, bathroom

11:45 am: lunch

12:15 am: waste some more time

12:30 pm: group

1:30 pm: waste some more time

1:40 pm: fresh air/outside time again!!!

2:00 pm: waste some more time, bathroom

2:15 pm: snack

2:30 pm: stand in line to get my electronics/free time

3:30 pm: turn electronics in (sad face), afternoon group

4:30 pm: waste more time

4:40 pm: another fresh air time!

5 pm: waste some more time, stand in med line again, bathroom again

5:30 pm: more f#$$ food (aka dinner)

6 pm: wrap-up group

6:30 pm: stand in line for my electronics again

6:40 pm: last fresh air time

7 pm: free time

8:15 pm: why the hell do we eat so often??? (aka night snack/tea time)

8:35 pm: more free time

9:15 pm: turn in electronics, stand in med line one more time, bathrooms open for an hour to get ready for bed hope there is an open sink to spit my toothpaste in

10 pm: sleep

Repeat, repeat, repeat, repeat

Speaking of which….it’s 9:13 meaning I have to turn in my electronics in 2 minutes…

Week 1

I feel like I should write something to update people but I don’t know what. I’m tired. My stomach/GI system are very unhappy right now. I’m somewhat depressed. But I guess I’m in the right place to move forward. Hopefully the physical stuff will begin to improve and with some more weight my brain will come back.

The past 2 days

Thursday Feb 20th

1:30 pm: appointment with my psychiatrist (Dr. H). I’m assuming that it will just be a regular appointment. I have been struggling and I have been considering more intensive treatment, but my psychiatrist visits are more of a formality and she doesn’t do much with me. My therapist and the counselor at the med school are the people I really talk with about this stuff.

1:45 pm: Dr. H wants me to go to the ER and get a “medical” evaluation. I am adamant that I will not do that. It’s not that I’m against being medically evaluated I just think it’s a waste of healthcare dollars to send me to the ER to do it. Why can’t I do outpatient tests and if they come back abnormal I’ll come back? I beg her to call my therapist, W, thinking he would side with me that I don’t need to go to the ER. I am wrong and he agrees with her. Shit. Apparently I am a little too adamant about not going, Dr. H sends off a page and suddenly there are 2 people at her door to escort me to the ER.

2 pm: ER. Awkward chief complaint: my psychiatrist wants me to be medically evaluated for an eating disorder? EKG, blood draws, hang out, chat with the on-call psychiatrist, wait for the test results to come back normal so I can leave. His response: “you don’t know then?” Clearly, I don’t know. Turns out Dr. H. got a legal hold and they are admitting me to one of the inpatient psych units. It is not the general eating disorder floor fortunately.

2-3 pm: ER. I frantically start calling and texting people. The staff physician on the admitting floor comes to talk to me. I am so fortunate that currently the staff physician is my favorite psychiatrist in the whole facility (Dr. F). He is down to earth, normal, listens to patients, and gets stuff down. He tells me that he has already arranged to work privately with me with absolutely no resident or medical student involvement. He then does all my admission stuff in the ER while we are waiting so once I get to the floor I should have things set. He asks me what he can do to help and lobbies to allow me to eat a vegetarian diet, remain off the strict eating disorder protocol, and have my laptop. He must be a good persuader because I am allowed these privileges–dependent upon my not abusing them.

4 pm: M is taking this surprising well. He is going to take care of my dog and bring me some stuff tonight. We are both pissed at Dr. H.

On the unit: Matt brings me stuff. Dr. F stops by to talk to me again. He says that W is already working with facilities to get me admitted to a different eating disorder treatment program as soon as possible. Basically I am here to stay “safe” until I can be admitted. I am a ball of anxiety and spend most of the evening pacing the hall. The staff here know nothing about the typical eating disorder protocol (basically zero movement) and while I am not on the protocol I know I probably shouldn’t be walking as much as I am and am terrified someone is going to call me out on it. They let me order a safe meal and pace the night away. I’m not sure if ordering a safe meal is abusing my privileges or not. If I didn’t order something safe I would very likely purge it so I err on the side of what I think I can eat and not purge and if someone gets angry then I will deal with it.

Friday Feb 21

I am awake half the night. Nothing unusual. This has been happening more frequently the past couple weeks. I fall asleep and an hour later I am wide awake for another 3-4 hours. I am pissed that they won’t let me hang out in the day room and color so I sit in my bed and read a magazine by the faint hall light until 3 am. I wake up at 5:50 when my alarm usually goes off. They won’t let me take a shower until 7:30 am. WTF.

A friend comes to visit, the medical school counselor comes to see me with forms to sign, the staff dr comes to see me, a medical school dean comes to see me. I pace the halls. Even with the safe meals I can’t seem to finish them but I am committed to not purging so I do what I can. I pace the halls some more. Dr. F comes back and drops the legal hold and lets me sign in voluntarily. M and my mother come to visit. Dr. F comes to talk to me briefly with them when they are there. It is somewhat awkward because while he doesn’t bring up purging (thank god) he brings up depressive symptoms and sleep that I haven’t really let on. Throughout the visit Matt gives me some strange looks. I choose to not elaborate on why I am here. Apparently my dad is angry too. Dinner is the hardest meal yet. I’m not sure how much I will be able to do on my own over the weekend. I guess I’ll tackle those meals when they come.

And here I am Friday night. It has been confirmed that I will be admitted to a treatment center in Denver the only question is when. So I am almost certainly stuck here for the weekend. My roommate wasn’t too bad yesterday but today she is driving me nuts. At least the staff basically ignores me.

I’m mad that W hasn’t come to see me. I’m thankful that Dr. H hasn’t come to see me because I’m not sure I could be civil.

I want to cry. I can’t cry. I alternate between wanting to sprint the halls and curl up in a ball in a dark corner. Neither of those is acceptable so I compromise by pacing the halls at a moderate speed.

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