Posts Tagged ‘eating disorder treatment’

I feel like I just posted yesterday, but it’s been over 3 weeks. In those 3 weeks I have watched my brother run in the state track meet, drove to Denver and back, spent time at my parents, went to graduation parties for my brother, cousin, and a few others, worked, and even managed to fit in a few alone days at home. I also have gone back to see E—.

I have now seen her 3 times. The first time I went I was terrified. Maybe terrified isn’t the right word. Ashamed is probably more accurate. Really I am ashamed every time I see her. Probably 90% of the emotions I experience are some form on shame. I am ashamed of what I eat. I am ashamed of what I weigh. I am ashamed of when I eat. I am ashamed of not exercising enough. I am ashamed of being fat. I am ashamed of having a huge stomach. I am ashamed of my fat fingers and thighs and arms.

But the difference this time is that even with all this shame I am fighting. I’m not always moving forward, but I’m fighting to not move backward. I would say that although I’m not jumping in to the work of recovery, I am dipping my toe in.

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Still a student…although not the type I want to be right now. ¬†I didn’t get into medical school off the waitlist. In fact, I never moved from 5. Instead I’m still an MPH student because I managed to screw up my graduation.

In my last post I was given relatively few options. Four days after that I was at student health for an follow-up appointment for my IUD. I hadn’t been there for an appointment in a long time and my weight was significantly down. The nurse (who sees me much too frequently) noticed the weight and mentioned it to the doctor. Who freaked out and, because my regular eating disorder doctor was out of town, took bloodwork and contacted my doctor the next day. I went to see my doctor the next day (Tuesday) who told me I needed treatment. Then on Wednesday I went to see E and she told me that I would be going inpatient–no questions, no excuses, no delays. I cried all evening and spent all of Thursday trying to figure out how to get out of it. Unfortunately, the only treatment program my insurance would cover is at the hospital I work at. Friday I took a genetics exam in the morning and was admitted on the inpatient unit that afternoon.

On the unit with people I work with. My resident doctor had worked with me when she rotated through my unit. My nurses had floated through my unit. The aides either floated through my unit or went to “violent patient” incidents with me when called. I had taken care of several other patients. This hospital has a very strict eating disorder program. My days were nearly all the same and went something like this:

6:30 a.m.–get woken up for daily weights

7:30 a.m.–breakfast in the dining room

9 a.m.–activity

10:30 a.m.–psych ed group with a nurse

11:30 a.m.–lunch

1:30 p.m.–activity

2:45 p.m.–afternoon snack

3 p.m.–group with a therapist

5:30 p.m.–supper

8 p.m.–evening snack

10 p.m.–bedtime

As part of the eating disorder protocol we are required to be supervised continually from 7:30 a.m. to 10 p.m. This means when we aren’t at activity or in groups we have to stay in the dayroom with a staff member dedicated solely to watching us (up to 8 patients, although no more than 5 when I was there). We are not allowed to go to the bathroom on our own. We have to show the toilet to a staff member before flushing. We are “redirected” for standing, walking, crossing our legs, or jiggling our feet. We are not to discuss food, calories, weight, exercise, or other potentially triggering topics. Because it is a general psychiatry unit with non-eating disorder patients we cannot have anything with metal and our makeup/personal care items must be checked out from the nurse’s station. We cannot have cell phones or laptops.

26 days and too many pounds later, I discharged to the partial program. Where I’ve been for the past 4 weeks. Gaining more weight. Weight that makes me sick at the sight of my own body. Weight I can feel every night when I walk my dog.

But I’m done with the partial next Friday. Done whether I’m at target or not (and I am fervently hoping that I will not be there yet). I haven’t set up any follow-up therapy appointments. I’m hoping that no one will notice and I can go through the rest of my life without people bothering me about my weight and wielding the threat of inpatient or partial over my head.

The only requirements I have to finish for my MPH degree are 60 hours of work on my practicum, a paper on what I did, and a poster presentation. The work will in less than 3 weeks. The paper and presentation can’t be done until December, unfortunately so I cannot get my diploma until then.

However, student health has offered me a part-time (20 hours/week) position to do one-on-one counseling with students who are at risk for problems with alcohol. I will begin that the week after I finish partial and continue working my 20 hour weekend job at the hospital.

And because I didn’t get into medical school I have to begin forcing myself through that laborious process yet again and now I am also considering PhD programs in clinical psychology.

I don’t know how many more rejections I can take.

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I know I was supposed to/going to stay at partial until I was at target this time round, but that really didn’t work out. Once again I left before anyone really wanted me to, but I had a different reason this time.

Because it’s a large hospital the staff doctors rotate through different services. The assignments are made by the head of each department. The eating disorder program is under the psych department. My unit (med-psych) is under the psych department. Until now I haven’t had to deal with staff doctors from my unit being on partial; I’ve only had to worry about all the coworkers I run into while I’m at partial (just two floors above, in the same part of the hospital). But on July 1 a new staff doctor came on eating disorder rotation….and she has worked 4-5 months of the past year on med-psych. Some staff doctors would handle this transition well, but I was concerned about this particular doctor. And unfortunately my concerns came true and it was not a good switch from coworker to patient…in fact it wasn’t really a switch, I was still a coworker. I didn’t get anything out of it and I was embarrassed to be there.

So I left. And like every other time I’ve left before I reach target I dropped weight immediately. I’m not entirely sure how it comes off so quickly because I swear I’m not attempting to lose weight I’m just not attempting to gain it anymore.

So I’m back in the cycle. I lost 3.5% of my bone density in the last 1 1/2 years. I know I’m not helping myself with this and I’m not sure I care anymore. I want to quit going to appointments. I want to quit seeing doctors. I’m not sure they can help me anyway.

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I’ve been in partial 3 weeks now. It hasn’t been terrible. I wanted to run the first week, but that urge has weakened since then. I finally started restoring weight (it was slow to come) and that has freaked me out. It’s not necessarily the number that scares me; it’ the direction. When I saw the same number on the way down it was great. Seeing it on the way up is terrifying. I’m afraid it won’t stop. I’ve also begun getting the “night sweats” that come with restoration. Not particularly pleasant.

I am uncomfortably full. I feel my body changing and as a result of both of those I feel horribly fat.

And apparently in the past year I developed a lactose intolerance. They give me so much milk at partial. The first two weeks were hell with bloating, and gas, and nausea until I figured out what was going on. I don’t touch milk at home because I don’t particularly like it. I used to have a latte every single day. In the past few months they have increasingly made me nauseated. I thought at the time that it was simply the restriction making my stomach more sensitive to strong foods like coffee (which does happen) and I naturally cut back on them. Looking back now, though, I wonder if it wasn’t the lactose that bothered me. Regardless, I use Lactaid at partial and avoid milk at home. Thankfully, yogurt doesn’t seem to bother me. I think I would die without my Chobani.

On the medical school front: I am currently on the in-state waiting list for my University’s medical school. I am low on the list, #46. It’s been a rough week (really two weeks since my letter got lost in the mail and after waiting a week I had to personally go in to find out). It will be more accurate in another week or so as people respond¬†about whether or not they want to remain on the list.

Last year I told myself and everyone else that the rejection was ok, that I was glad for the extra year. But even as I said that my weight dropped. So clearly, there was some sort of disconnect within me. I found myself doing that again this year, but now I have been saying what I actually feel. I sobbed for the entire first day (I never cried once last year). I am sad. I am angry. I am pissed off at the admissions committee, the director of admissions (who told me I would have “no problem” getting in this year), at the entire medical school system, and at myself for even allowing my hopes to get up.

And you know what? Just acknowledging those emotions has made it easier.

I am moving forward for my backup plan. I have accepted the evening clerk job on my unit (can you say regular hours, no floating, no weekends, and a better salary?). I am working on cover letters for graduate assistantships. I am researching other graduate programs to apply to in addition to one final round of med school apps. And I am starting to look more into what I could do if I just used my MPH as a terminal degree.

We’ll see what comes. Time will tell, both on the weight front and the medical school front.

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