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Archive for June, 2012

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I did go see my therapist this week. She wasn’t happy. I don’t blame her, I’m not particularly happy with myself either. We discussed the medical school situation and her opinion was that being at 5 at this point in time made it slightly more likely that I would get in. She also said that choosing to let myself slip further into this is essentially choosing to not go to med school. The options she gave me were:

1. Eat and gain weight on my own

2. Get into treatment soon

3. Continue as I am but take my name off the waitlist

First, who in their right mind would choose option 3? Second, while option two is viable it would require an extreme amount of work, and finagling things, and explaining this messy situation to other people. So I said I would attempt option 1. She wouldn’t let me walk out without committing to my first step. And I got stuck. Ideally I would have committed to walking out and going to eat a semi-normal lunch but I knew that I wouldn’t follow through on that. Although I am sad that I couldn’t do that I am proud of myself for being honest about it. It would have been all too easy to tell her I would do it and then not. I told her the only thing I could commit to eating and fully follow through on was a salad. Weak, I know. I did it, but I haven’t been able to continue since then.

And now I’m stuck back where I started. Should I start looking at treatment options? If I started now it might be possible to get it worked out and still be able to return if I should get into med school. Treatment scares me to death. Obviously my insurance would cover everything if I were to come to the hospital I currently work at. However…E (my therapist) said she would want me to start with at least a couple weeks inpatient. No thanks. While I don’t work on the eating disorder unit I work often enough with the staff there and staff from my unit float there quite frequently. Additionally, I’m not a fan of the staff doctor or the general orientation of the program, and I have been in partial 3 times and wound up right back where I started. I’m beginning to think it probably won’t work for me. If I were to go somewhere else I wouldn’t have a clue where to start looking. I don’t know what my insurance would cover, I would have to talk to my parents, I would have to talk to a zillion treatment people, I would have to talk to my internship supervisor….I don’t want to do any of this. And I don’t see E until next week. A whole week of freaking out on my own. Lovely. 

And…the one other person who could help me, my doctor, is someone I work with at my internship and I’m terrified to go see her as I haven’t seen her as a patient since March and have gone significantly downhill since then. 

Why do I get myself in such messy situations?

 

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I feel like I’ve broken my brain. Seriously. Even though my eating has been extremely disordered at times my weight was never truly that low. My body (and brain) reacts very strongly to minor changes in my weight so a lot of times I thought and acted like someone at a much lower weight would. But recently I’ve gotten lower than ever before and everything I have ever done has been turned on its head.

For my whole life my goal has been to not be fat. Any weight I lost was because I overcompensated out of a fear of gaining weight. Years ago (around the age of 15 or 16) I came across an extremely outdated formula to determine ideal weights for runners. I always wanted to look like a distance runner so I latched on to this formula. It was the basic Hamwi Formula (100 lbs for 5 ft plus 5 lbs for each inch over) with a twist. Sprinters were supposed to be at IBW-8%, hurdlers at IBW-10% and distance runners were to be at IBW-12%. I calculated out the IBW-12% and have had that number stuck in my head for ages. As I said before, I never actively tried to get down to it although I was always extremely happy to be a little bit closer. But over the past 2 years my body has gradually allowed me to reach lower and lower weights with the same effort.

Last week I reached that number I had in my head. I should mention two things: 1. I calculated this when I was an inch shorter and never compensated for growth so now it’s more like IBW-15% 2. As a health professional I would never suggest this formula to a patient and would probably even identify it as dangerously low for the average person. But regardless, I considered it okay for myself and as I reached this weight a switch flipped in my brain. All of a sudden it became imperative that I not only continue to lose weight, but strive for it. I lost all interest in eating food although I could stare at pictures and recipes for ages. I had previously felt like a failed anorexic because I never seemed to have the willpower to resist things and I would eat with friends or my boyfriend and be okay with it. But now it takes no effort to resist things. In fact I’m not really resisting the allure of food because the allure is nonexistent. And I no longer can suspend judgment of myself and eat with my friends or boyfriend.

Now I don’t know what to do. Sometimes I feel perfectly normal and more than capable of handling life (which currently consists of 20 hours of work, 30 hours of internship, and 10 hours of class each week) and other times I can barely keep from breaking down in tears. I have an appointment with my therapist on Wednesday and I’m terrified to go. I know she’ll tell me that I need to gain weight and that I have the tools to do it, and there’s nothing she can do unless I do the actual work. I’m afraid she’ll think I’m just wanting attention.

And there’s so many other things to be afraid of. I have 6 1/2 more weeks of internship and class to complete before I graduate. I am 5 on the med school waitlist and even though it’s been the only thing I’ve wanted for the last 3 years I am completely terrified I will actually get it. I’m planning a trip to New York with my boyfriend in August and secretly I want to spend that week curled up alone in my bed.

To compound it all I keep getting mixed messages from people. I have people who tell me I am a little too thin. People who say that I’m so lucky to be naturally tiny. People who say I look sicker than I ever have in my life. People who tell me I “look great!” And people who tell me that although I am thin I look “really healthy.” I wonder what I would think of myself if I were healthy? Will I look back on pictures of the wedding this weekend or the video from my practicum and think that I look thin but great or will I think I look sickly? Personally, I can’t ever imagine the latter happening. I’m not sure I’ve ever looked at anyone in my life and thought they looked too thin, which is another testament to my messed up brain.

Sometimes I think I want to go to treatment just so I don’t have to deal with all this and then I immediately hate myself for having that thought. Treatment isn’t an escape, it’s more like walking directly into the flames and I’m not sure I’m ready to do that either.

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