Posts Tagged ‘eating disorder’

Yep. My therapist “strongly suggested” we take a month hiatus.

And not because I’m doing so well.

It’s because I’ve made absolutely no progress in the last 1 1/2 years.

So now I have a month alone. And I’m not sure how to deal with it.

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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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…in partial that is.

It was a hard day. Hard because I was back. There are a couple people there that have been through the program but for them it’s been years and years. I’m the only recent readmission.

Hard because I was in the same hospital where I go to school and work every day.

Hard because I don’t know if I care about the why of it anymore. I kind of feel like that is beating a dead horse and has really become irrelevant. All I want to know is the how. How do I get out of this? How do I keep from falling back in?

And I’ll admit it, there’s still hesitation. If I could get better without gaining the weight I would do it. If I could gain the weight and never have to think about it again I could live with that. But I know it’s going to be a never ending struggle. I pray that it isn’t my solution for everything (med school too hard? lose weight. Difficulties at work? Lose weight.) although I know that for a long time it will be at the front of my mind.

But I’m so scared. I’m scared of getting fat. I’m scared that my fellow public health students will think I’m huge when I get back. I’m scared that I’ll be the fattest person in my med school class.

But I’m not brave enough to talk about these yet. Instead I sat all day in group, on the verge of tears.

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I’ve mostly stopped fighting it now. After last week when I worked so hard at eating and I still lost weight. And this week where I can’t make myself eat.

And last night when I nearly started crying in class. We were working in groups on a needs assessment and intervention planning. The assigned topic: healthy eating. It started out with a couple people going on a rant about how muffins are really just cake and people fool themselves into thinking muffins are healthy. These are the people I see in class every single day as I eat my (extra-large) muffin and drink a frappe. Can you say calories and sugar? An idea for the needs assessment was to give people a list of foods and have them make lists of the healthy/unhealthy ones. (The ED treatment mantra is “there are no bad foods.”) Then it went on to designing an intervention. They chose to focus on college students with a meal plan. One suggestion was to place calorie counts next to “unhealthy” items along with something saying how many minutes/hours/miles you would have to exercise to burn it off. I was screaming inside and it was nearly 15 minutes later when someone was like “maybe we shouldn’t do that with concern for eating disorders on college campuses.”

I went home and sobbed. Sobbed about all the damn healthy eating/obesity/physical exercise interventions I’ve had to design. Sobbed about how I couldn’t even finish my muffin and coffee. Sobbed about how full and fat I felt when I only had 600 calories yesterday. Sobbed about going back to partial.

And yet it was a bit of a relief. Knowing I probably would go back to partial, but also knowing that would give me a respite from all the health behavior lectures I struggle through every week.

I talked to S—-, the director of partial, yesterday. She did help me realize that it would be okay. I could still make school and work fit in, though probably not on the schedule I have been doing.

Random funny story about S–. She is one of my favorite people and last time I was in partial I (only half-jokingly) said “I want to grow up to be just like you” Her response was “Honey, I don’t think you’ll ever be as tall as me.” And she was very serious. Haha.

Anyway, I’m looking forward to maybe getting some more help. That I’ll be able to take on food in a more supportive environment. And that I’ll get a short break from obesity iterventions.

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…I’m safe.

I won’t mention how I managed it, but I’ve skeeked by until Saturday.

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Once again I stand at the edge of it.

I was told last week that I had to gain x lbs this week or I would be going back to partial. It was so hard, but I ate. I ate because I knew I had to and then I freaked out about gaining weight and eating too much. I’m afraid it didn’t make much of a difference though because for the last three weeks I have been stuck at precisely the same weight regardless of what I ate.

The only reason I’m resisting partial is my job. Working on a psych unit. But it’s not necessarily that, I don’t want to have to tell my boss or coworkers why I need time off. And from time to time I work (as a colleague) with some of the people who work in partial. I don’t want to be in the large percentage of eating disorder patients who relapse. I want to present the image of being strong and capable of everything I take on.

Apparently I am not. And that makes me feel like a failure.

I see E— at 1 today. Crunch time has arrived.

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