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.
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.
Apparently blogging is my most recent study procrastination strategy
So many things to think about in the past week.
1. I passed my human organ systems exam. Despite feeling excessively prepared I came through with an 81% overall. Primarily missing histology questions. I didn’t study histology at all and got 93% on the non-histology portion. Note to self: study more histology.
2. I am totally freaking out about my immunology exam. Seriously don’t know what I’m even supposed to know for it. It’s all random letters (C1q binds the activated IgG, then activates C4b which activates C2a then the C4bC2a complex activates C5b which leads to formation of the C5bC6C7C8C9 MAC and C5a runs off to stimulate TNF-a etc etc)
3. The Biggest Loser. All I have to say is wow. It’s a strange experience though. She is approximately my height and weighs exactly what I do right now. I look at her and can sort of see what people are freaking out about, but I look at myself and swear to god that I definitely look 10-15 lbs heavier than I am. So I’m in this strange place where I actually almost understand why people are worried about me because I do think Rachel doesn’t look all that good. But then my brain goes in to overdrive to tell me that I definitely don’t look like that and could still lose more weight without looking any different.
4. And speaking of weight….I’m on a short rope right now (surprise surprise!). This seems to happen every time I’m in therapy and lose weight and yet every single time I don’t understand why people make such a big deal of it. My therapist told me I had 2 weeks to stop losing weight (I’m pretty sure he would have preferred one, but he doesn’t believe that’s a completely fair measurement). He said that he had seen a significant change in just the short time I had been back to see him. Now I am totally paranoid that everyone is looking at me and thinking I’ve lost too much weight and the worst part is I don’t even know what I look like to them! And then there’s the whole I have to stop losing weight thing too. We discussed the 3 main factors: eating, purging, and running. I had a minor outburst at his suggestion that reducing exercise might be good for me (ok, he said it was a major outburst). And I’ve been trying to stop purging for well over a year and haven’t succeeded, so surprisingly food appears to be the variable most easily modified here. And it’s not easy at all. I also spent a good half hour trying to convince W that my exercise was not a problem at all and that I was not obsessed with it. Apparently arguing about running when he didn’t even say I had to stop running does not give the impression that I am not obsessed with exercise. He didn’t really say much about what happens at 2 weeks if I can’t maintain my weight, he just said we would have to discuss other options. I then told him as long as I was passing tests I wasn’t leaving school. We both have concerns about my ability to do this on my own.
5. My car died today. I was just starting on a ~35 min drive to a clinic to shadow a doctor for one of my classes and 5 minutes in my car stopped responding to the gas pedal (while I was on the interstate). I was just going on an entrance ramp to another interstate and stopped to see if I could get it to work again. But alas, it only got worse. Fortunately, if my car had to die it chose a very good moment and place to do so. I was still very close to home and on the entrance ramp there were 2 tow trucks winching a car out of the ditch (from the snow/icy roads we had this morning). As I fiddled with my car, called my physician mentor, emailed school, and called my parents they finished up and came over to check on me. I then paid a ton of money to have my car towed to a repair shop. The shop was about done for the day so I don’t know what is wrong with my car. I’m hoping it’s nothing serious. My trust cav has come through a lot with me and I’m not ready to giver her up yet.
6. School has been hectic recently. But it should start to get better. As I looked through the next month my schedule is much more free than it has been the past 4 weeks. That is good because this month has been just as bad as first semester. I have been in class essentially 8:30-4:30 every single day. From here on out I primarily get done at 2:30 and even have some days where I’m done at 12:30. Can’t wait.
7. Cold. I hate it. It will be the death of me. In related thoughts, I realized today that every winter for 4 (I think?) winters my weight has been low. This led me to wonder how different winter would be without starvation induced coldness on top of my already somewhat low cold tolerance.
8. There’s probably more, but I have about another 20 minutes of immunology studying and a neuroscience lab video to watch yet tonight.
I’m in a Thursday night motivation slump and am struggling to continue to study for my exam tomorrow. First exam of the semester: Human Organ Systems–covering epithelium, skin, muscle tissue, nervous tissue, connective tissue, and pretty much whatever doesn’t fit in to the “real” organ systems. I think part of my lack of motivation is that I’m still not fully back in to the school routine. I haven’t had an exam yet and the reality of exams every Friday has yet to hit me. The other part is probably related to my brain struggling through the eating disorder fog.
But the stuff we are learning is definitely more interesting.
Ok. Honestly, I can’t even think straight enough to write a coherent blog post right now so the rest will just be random thoughts.
Neuro is cool. At least the playing with brains part. I was enjoyed neuro lab today and was like “ooooh! that’s awesome!” and one of my lab partners responded “it’s neuro, it’s not awesome.” And he was somewhat serious. I thought that was strange because I’m holding a real human brain! how on earth is that not cool?! He then suggested that perhaps I should be a neurologist. I will almost certainly not be a neurologist, but I will continue to think brains are cool.
Wound healing is awesome. Ok, so I did once time in junior high document the phases of a random largish cut I had, so this shouldn’t be all that surprising that I like wound healing. Sadly, with my low weight I struggle to get extremely excited about things, so although normally I would be over the moon about learning how wounds actually heal I’m more like “meh, that’s interesting. I’ve always wondered how that worked.”
Immunology….uhhh I’m somewhat lost there right now. I should probably get unlost before the exam in it next Friday. It’s not that I don’t understand it…ok so I don’t understand some of it. It’s primarily that I don’t have a clue what I should or shouldn’t even be trying to learn.
I was looking forward to learning the neurological exam and then I went to learn it and had a quiz on the musculoskeletal exam right before that and the standardized patient gave me 50% for stupid nit-picky reasons and it ruined my mood for the neurological exam. It did however, make it somewhat more satisfying to gag her and prick her with a pin as part of the neuro exam (don’t worry, I didn’t do it too hard).
I really hope I don’t fail my exam tomorrow. If I did fail tomorrow though, it would make me consider taking time off for more intensive treatment slightly more than I currently am. I think I would probably have longer-lasting success if I could get back up on my own. But most nights I feel so stuck and in such a deep deep hole that I’m not sure it is possible to get out on my own.
A text from a friend regarding recovery from an eating disorder. I saved it because it’s so poignant. And sadly, many days I share the same sentiments.
It’s a losing battle, always. There is not a single person that I have met through all of my treatment that is better, or even doing well. Maybe they were for 2 months, maybe even a year, but everyone ends up sick again, in treatment, over and over again.
We’re a hopeless bunch yet so caught on the hope that we might get better, so we put in the energy and the huge sum of money, and the time. It never seems to truly get anywhere, except maybe a short reprise where we can function for a short time, at least well enough to fool everyone else. But we don’t fool ourselves.
I returned to therapy.
It all somewhat started the week before Thanksgiving. I was having an exceptionally rough week in school and my anxiety and depression were utterly out of control. I broke down crying every night, I couldn’t focus in class, etc etc. So I went in to the medical student counseling center and talked to someone. And of course my past history came up and although I wasn’t intending on telling anyone at school about it, I mentioned to the counselor that in previous times of stress I had turned to restriction and purging. And one thing led to another and my current purging came out. Clearly she was worried because she wanted to see me relatively soon after that, but fortunately she also recognized my reluctance to returning to any sort of treatment and didn’t push too hard for me to see a psychiatrist or therapist. Eventually I came around and scheduled an appointment with a psychiatrist. And from that eventually scheduled one with a therapist.
It is a different therapist than I was previously seeing although I know him (W) because he is the primary therapist for the partial and inpatient eating disorder programs. The psychiatrist is completely new (though we had briefly met when I worked at the hospital) and of course the medical school counselor is new. I haven’t had to get to know a new provider for 3 1/2 years. I have trouble opening up to new people, especially when combined with the fact that I was really hesitant about returning to treatment in the first place. It’s a little strange that a year ago weekly therapy and routine psych visits were part of my routine and life felt off-kilter without them and now it is completely the opposite. I feel uncomfortable checking in at the clinic and sitting and talking to someone. I suppose with time though this will change.
Anyway, the reason I started this post is that I saw my therapist this morning and his question to me was, “What do you want?” And I didn’t really know at the time. (other than to stop purging because that really sucks) But now I do know.
I want to eat. I want to eat good, healthy food and not feel guilty about it. I want to wake up in the morning have a nutritious breakfast and not spend all morning obsessing about how to compensate for those calories at lunch or through exercise. I want to embrace my love of cooking and experimenting with food and not fear it because cooking leads to eating. I want to feel strong when I run because I have not starved or dehydrated myself. I want to spend my free time pursuing the things I love, not hunting for ways to cut calories out of food and add calories in to physical activity. I want to do amazing things with my brain and my body. I want to be free.
The semester has flown by. I last blogged 2 months ago. How has time gone so quickly?
Blogging crosses my mind sometimes but every time I sit down to write my mind goes blank. I’m never quite sure what to write. Every week is essentially the same. Go to class, study, take an exam, repeat. The last few weeks have felt a little different, primarily because I’m doing “lasts.” Last cell bio exam, last patient interview (for the semester), last dissection. It feels good. I have officially passed 4 classes in medical school. The hardest 2 are left (anatomy and biochem) but I don’t need fantastic scores on the final to pass either class (34 and 37% respectively). I think the most difficult thing will be motivating myself to study for the next 7 days.
Most days I continue to ask the same question. How have I done it? How have I gone from someone who failed (almost) every exam in the summer prep course to someone who has very little chance of actually failing any class? I still don’t feel like I’m smart enough to be here.
On the personal side, things have been difficult. I’m struggling a lot with purging, consumed with the thought that I am excessively fat, and just been in a lower mood overall. I’ve been going to the med student counseling center briefly every week and this week am meeting with a psychiatrist though I’m not sure I want to start medications now. Mostly I’m afraid of getting back into the never-ending cycle of mental health appointments though I am also afraid of continuing to purge and jeopardizing my relationship. Perhaps things will get better over break without the massive stress of finals.