Archive for January, 2011

Breaking Out


I got my hair chopped off yesterday! It hasn’t been this short since I was a little kid. I like i,t but it’s scary. I always used my hair as a curtain of sorts and now I feel really exposed. But I think it’s a good sort of exposed, one that will push me out of my comfort zone, hopefully.

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This week I came down with a terrible sickness. I lost every ounce of fluid in my body and I couldn’t eat for 2 whole days. I felt horrible and I am still recovering from it.

In the thick of it, I was scared by the weight loss I experienced. I knew that I hadn’t been properly eating in the week(s) up to it and that losing so much fluid in such a short time could wreak havoc on my electrolytes. I missed the strict eating routine I had gotten into. I thought that this fear would continue.

But it hasn’t. I’m getting over it, but now I’m more obsessed than ever at staying at this weight. I want to continue without eating, but at the same time, I can’t physically do it. And every time I eat something, I regret it. I think about the calories in it, about all the other food I’ve had today, about how I haven’t gone running since Monday, about how much my stomach hurts with even the smallest amounts of food now (it shrunk a bit). At least when I was sick it was easy to forgo food, I had an excuse for not eating, I had a reason for feeling awful.

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What if…

I’m playing the what if game again. Except this time I have a legitimate reason. I’m considering my options in the event that I don’t get into medical school again. Obviously, it’s not a situation I want, but I want to be prepared. I know from experience that having a plan in place before the news comes makes it much easier to continue moving forward.
So what have I been considering?
Since I am already in the MPH program I would continue with that full degree (if I get into medical I’ll join the combined MD/MPH program which uses come crossover credits). And I would put in another application to medical school. This year I only applied to Iowa since I wanted to stay here, but if I have to apply again next year I would try some more places because I would again be at the end of a degree and relocating wouldn’t be terribly difficult.
But I would also consider putting in applications to other degree programs. I definitely want to continue working with people and particularly in psych. I thought about applying to psychology programs, but that would require a few more classes (which would be doable if I have another year here). Obviously I’m not making the decision right now.

This could be so much easier if they would just get back to me. (My interview was just shy of 3 months ago….sigh)

The “what if” I’m trying to avoid is the “what if I get this other job I have an interview for.” After being rejected from 18 research jobs (including several I had interviews with), I’ve found it’s pretty hard on me to plan what I would do if I got the job only to not get it. I guess I’ll just wait. BTW, the interview is this Wednesday….wish me luck.

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Losing It All

I was telling E– how scared I was about my ability to handle school. It only came to me later that this isn’t new.

I’ve been scared since the second semester of my freshman year in college. At the time I realized that I had many outstanding music accomplishments and grades, but that I hadn’t tried very hard. I was afraid that people would discover how little effort I put into it and that I didn’t deserve any of them. I always thought it was a fluke–I played extra well one day, someone else had a bad day, the professor had easy tests. I’ve always thought that someday the whole world would see me as I see myself–inadequate and a failure.

I don’t remember having these doubts in high school. I don’t remember having them before my first semester of college. But, it has only grown as time has passed. Maybe that’s why I took the med school rejection so hard. Maybe that’s why I have such high anxiety about my current application. I believe people will use it as a piece of evidence for my failings and not see it for the common occurrence that it is.

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Yesterday was the first day of a six-day stretch at work. Doing a one-to-one. As a general rule, I am not a fan of 1:1s. I have trouble sitting for eight hours and I find them to be more mentally exhausting than working the floor. When I work the floor I have brief minutes of downtime when I step behind the nurse’s station. Working a 1:1 I don’t have that option. 8 1/2 hours, with a 30 minute break. I constantly have to be mentally alert.

Yesterday’s’s 1:1 started out ok. My patient wandered up and down the unit so I wasn’t sitting for long stretches. I had to be closely watching that tubes didn’t get pulled, but that’s not all bad. What did bother me was having another patient dumped on me that continually untied his restraints and spent several hours cursing at me because I wouldn’t let him get up (he wasn’t able to walk on his own). Both patients were incredibly confused and, in their ramblings, increased the other’s agitation. While dealing with one, the other pulled out a tube. Yes I was frustrated. I felt like a huge failure. The whole reason I was there was to keep that from happening. All my coworkers were very understanding and didn’t call me a failure at all. They understood that it only takes a second to pull something out and there’s very little someone can do once the patients is intent on that. But I continued to blame myself.

And another thing that wasn’t okay? Not getting a break. I managed to slip to the bathroom twice while the nurse was giving meds, but that was it. The only thing I had eaten all day was an english muffin. I grabbed coffee and diet coke on my bathroom breaks. But I had nothing else. I was absolutely starving. I was surprised by that, but even though I don’t eat very much I spread it out so I’m never that hungry. I felt physically ill. My stomach was upset, I was irritable, I had a headache, and I was exhausted–physically and mentally. I picked up some cold-case chinese food from hy-vee, but I felt so sick that I couldn’t bring myself to eat it. It’s still in my fridge…unopened.

Know what else is irritating? I have less than 3 hours left on my shift and I still haven’t had a break (I’m sitting on another 1:1). All I ate this morning was some yogurt. I’ve had my coffee, but I haven’t even been able to get my diet coke yet. I came in today with a fresh outlook, trying to not let last night hinder tonight. But I’m starting to get upset. I really hope the whole weekend doesn’t go this way.

But I keep trying to have a good mindset. Someone will remember me, someone will respond to my request for a break…

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1 to 5

E—‘s (my therapist) assignment for this week was to come up with challenges for myself and rank their difficulty on a scale from 1-5. Then each week I tackle one of them, starting with the least difficult and moving up each week.

I’ve started, but I haven’t come up with anything that’s just a 1. It all seems so much harder. In fact I have some difficulty coming up with things at all.

I’m not entirely sure what my fears are. I have added meat back into my diet. I will eat a bit of pasta. I will even, on occasion, have a cookie or dessert. So it’s not like there are any foods that are off-limit 100% of the time.  I guess the bigger difficulty is not compensating for those additions. I will not have a second carb with pasta. I cut back in exchange for having a cookie. I have difficulty having meals with more than 1 item (which I realize, hardly even counts as a meal). I hesitate to eat more than a particular calorie limit at one time (although that limit has been raised a little).

And it’s particularly hard now. I keep losing. And although a part of me likes it, I am also incredibly terrified by it. I don’t want to disappoint E—. I don’t want to drop out of school or take time off work for treatment. I’m not as scared by that prospect as I have been because I’ve been feeling pretty good still. Maybe it’s the Prozac, or maybe it’s just that I haven’t been in school for nearly 4 weeks, but I’m not as depressed and exhausted as I have been at this weight in the past. I’m more excited to tackle school.

Last week E— and I talked about the guilt I experience all the time. This includes guilt about letting down my treatment team. But I’m still scared to talk to her about some of this because I’m scared to admit that I’m not getting along as well as I put on. I know it’s her job, but that doesn’t make it any easier. And I’m scared that opening up will result in me losing more control (e.g. being sent into treatment, more restrictions on my exercise, less trust of what I tell her). And I dread seeing that look on her face when she’s disappointed. I dread seeing that look on anyone’s face.

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As I wrote in my last post, I don’t typically use new years as a starting point for goals or reflections. But since the rest of the world uses it as a new beginning there are quite a few posts and suggestions this time of year that are perfect for writing about. The one I have been following in the Reverb10 project. I like a lot of their prompts and I think I might use some of them and tweak them a bit, focusing on the past year, whether it’s January or September.

One idea that has popped up in a lot of blogs (more than just reverb10) is to sum up the past year in a single word. I thought about this one for a while. I think my word of 2010 would be apathy. I feel like this year I just followed the waves of life, simply dealing with what was thrown at me rather than taking charge of my destiny.

I spent most of the year waiting on med schools and none of them accepted me. I have tried to get a better job, but I still think that I could have put more effort into that as well (though that could be my perfectionism speaking). I didn’t try all that hard in this fall semester of school. There are a lot of times when I don’t care about getting over the whole eating disorder crap anymore. Many days I don’t want to move off the couch for any reason; I just want to curl up and sleep forever.

Obviously, it wasn’t that enjoyable or enviable, so what word would I like to define 2011? I don’t want to sit here next December or January and realize that I had another apathetic year. I want to go after my goals; I don’t want to meekly accept other people’s decisions about my life. I want to grow as a person. I want to grow as a professional.

I want 2011 to be defined by the word dynamic. I want to learn, grow, and change. To not be bowled over by disappointments, but to rebound back from them with new strength and strategies for the next round.

I want to return to living. And enjoying living.

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