Wednesday, September 28, 2011

Doubts

Today in therapy, I was trying to articulate why I have so much trouble following the meal plan. I wanted to be able to say: "I don't know if I can make dinner that big because I'd hate myself afterwards" or "It's too hard to eat when I'm not hungry so the extra snack might not happen."

I wanted to be honest about what's hard for me and what I see myself realistically accomplishing on a daily basis. At the same time, though, I was afraid that my honesty would make R think I had no motivation to eat better and gain weight, and that we were all just wasting our time.

Then he said:

"Kaylee, I have no doubts about your willingness to put effort into this."

So now my own doubts are lessened considerably.

Tuesday, September 27, 2011

Body Image Crisis

Why is it that increasing my meal plan not only makes me feel worse about my weight - but it also makes me feel worse about my hair, my skin, my nails, my feet, my eyebrows, and my teeth? Why does everything suddenly feel so wrong?

I've really been making an effort to do better with eating this week, and as a reward my mind has decided to mutiny by throwing every terrible thought about myself front and center. Now I'm not just fat, but ugly in every way. I never had a problem with my teeth before, but now they're crooked and yellow and nasty. My hair is too frizzy and refuses to lie right. My eyes are a gross color.

This makes me sound like I'm appearance obsessed, which I'm not. I hate that these new anxieties about my body make me want to hide from the world. For the most part I couldn't care less about fashion, but it still takes me forever to get dressed in the morning because everything I put on looks wrong. I worry that everyone will be disgusted by the zit on my cheek, and I would rather walk around wearing a ski mask than subject the world to that ickiness.

I wouldn't judge someone else for having flaws, but with myself everything seems so much worse.

Tomorrow I'm seeing R and J again. I'm super nervous about getting weighed, even though I weigh myself every day anyway. What is it about these Official Weigh-Ins that freaks me out so much? I usually have a general idea about what the scale will say before I even step on. I know weight fluctuates, but I still get hung up on minute changes. So I don't want to gain weight tomorrow because it will confirm that all the yucky pudginess I feel in my body is real.

But if I lose weight, I'll be disappointed in myself. R will be disappointed. He will probably give me a Very Serious Talk about motivation and goals and follow-through. The eating disordered part of me, though, will be ecstatic. And that's still a big part of me.

I don't want to end on that terrible note. Some good things:
- My exam today was easy. Whew!
- The weather was perfect - sunny, breezy, perfect temperature.
- My dad sent me a sweet e-mail last night that nearly made me cry (in a good way!).
- I have all my limbs, my eyesight, my hearing, and my mind.

Sunday, September 25, 2011

New Dietician

I had my first appointment with the dietician in R's office this week. The verdict: I like her, I think. She, J, is younger than my old dietician and has a much different personality, but is friendly and nonjudgmental and nice and didn't make me feel too awkward. So that's all good.

J spent the first half of the appointment asking questions about my history, current intake, habits, etc. Then she gave me a mini Nutrition 101 lesson, which was semi-interesting but not really necessary. I'm pretty much a nutrition expert - in theory if not practice. She looked over my food records from last week and said - I quote - "Oh good, I can work with this." Her official opinion is that I'm good about eating regularly and not skipping meals or snacks, but that my portions are just too small and my choices are too limited. Which I sort of already knew, but it's helpful to hear it from a professional.

So that was the good part. The bad: she wants to reset my ultimate goal weight to a significantly higher number. Like, SIGNIFICANTLY higher. I think she could tell how freaked out I got because she immediately added that this was a "longterm goal." Which confused me even more - longterm meaning in six months? A year? Five years? Ten? What if I get pregnant? It just seemed like the number J came up with was super high - definitely higher than anything I've ever weighed before. If I gained XX pounds over the next few months to get back to my original goal, why should I have to gain ANOTHER X pounds just to get into the new range?

It all seemed kind of moot at the time anyway, since I was feeling somewhat ambivalent about gaining any weight, much less the XX pounds J wants "longterm."

Anyway, we spent some time going over my food records and beefing up my meal plan. I was reluctant about it for obvious reasons, so J launched into an explanation of BMR and how I'd need a certain number of calories just to stay alive - a concept that I know is true, but that my brain still can't quite grasp. Metabolism scares me because I don't know enough of the science behind it, plus I don't think anyone's metabolism behaves exactly according to a scientific formula. So I don't understand how it works and that freaks me out.

Anyway, my go-to method of increasing calories is usually just adding protein bars. I asked J if she minded me eating multiple bars a day, despite my new commitment to variety. She said something interesting:

"When a patient is underweight, I tell her she can eat McDonald's every day to gain the weight back. The health risks associated with eating fast food all the time are less dangerous than the risks associated with staying underweight."

So...a fast food binge wasn't exactly the recommendation I was expecting from a dietician. Not sure I totally believe her, but she made her point. When you're underweight, it doesn't matter how careful you are to get in your fruits and veggies and whole grains - anything less than a weight-gain diet is not healthy for you.

Friday, September 23, 2011

Pointless PMS

Is it possible to be "on the cusp" of a period? Like, hovering on some menstrual threshold? I think I'm there, and it kind of sucks. After no periods for almost two years, I had one this past April around the time I hit my highest post-re-feeding weight.  In May, I had a super light period that only lasted about a day. Then none since then as my weight has dropped to its current range.

HOWEVER - every month around the same time (third-ish week), I swear I still get PMS. First of all, my appetite goes through the roof; I am insanely, insatiable hungry for about three or four days. I also get hit with this incredible exhaustion and I walk around in a state of chronic fatigue, even if I've slept well. My face breaks out like it hasn't since middle school. I bloat, gain a couple pounds, and freak out until I pee it all away.

Is this normal? I guess my hormones must be totally out of whack, but I do not appreciate having all the miserable side effects of a period without getting an actual period. When I got the April period, I was almost exactly the same weight as when I lost it back in the summer of 2009 so I have to assume that's where my body wants to be. But what's with all the crazy hormonal action? It seems like I'm straddling some crucial boundary between Healthy and Not Healthy.

I don't exactly miss getting periods, but still kind of wish I could be normal and eat chocolate and bitch about tampons and cramps

Wednesday, September 21, 2011

Trying for Variety

Variety eludes me. For the most part, I eat the same things at the same times every day. I hate choosing foods and creating meals because I'm afraid of eating the wrong thing. I never know how to pick foods - do I base it on calories? Taste? Size? What looks good? What sounds good? I could spend an hour standing in front of the refrigerator trying to figure out the perfect thing to eat.

I go through phases of eating the same foods multiple times a day, and phases when I am super picky about not repeating meals, but I always stick to the same relatively small array of acceptable choices. Even when I'm eating plenty of calories, I get stuck in ruts where I have peanut butter sandwiches twice a day, just to avoid having to make any real decisions.

I guess I never really think about it much beyond this is what I eat because this is what I eat. For the past week, however, I've been keeping food records to bring to my first appointment with the new dietician tomorrow. I am suddenly very aware of how limited my repertoire of meals and snacks really is. Sometimes I make vague attempts to be balanced, like adjusting a snack to include an apple because I haven't had much fruit that day, but calories are still always the first consideration in any food-related decision. Basically, I eat to fill a certain calorie quota and don't really worry too much about the ratios of proteins to carbs to fats. Definitely not the healthiest way to go. I KNOW.

My dietician from home, B, tried hard to get me to expand my list of acceptable foods over the summer. She said something in one of our last appointments that stuck with me:

"Variety is important so you get all of the nutrients in foods - the nutrients we know about and the ones we don't."

Normally I hate uncertainties - I want to know exactly what's in my food, dammit - but B's comment helped me reframe the variety issue. It's not just about checking off boxes on my meal plan. It's about exploring and experimenting. Letting my body learn and adjust. Not living in a vacuum.

Easier said than done, obviously, since I haven't really expanded my menu much. I don't consciously cut foods out of my diet, but I tend to gravitate towards the same few "safe" foods because I know that I like them, they'll fill me up, and nothing bad will happen from consuming them. If presented with a new meal option containing the same amount of calories, I would still choose my safe meal every time. I don't really know why, other than the comfort of familiarity.

But now I'm trying to think in terms of what I'm missing. Yes, I could eat sufficient calories on my limited meal rotation, but what if that meant I would never consume any trace of some unknown nutrient? What if I never gave myself a chance to benefit from it because I was too busy being safe?

Goal of the week: try something new. Anything.

Monday, September 19, 2011

Daily Observations

I've got over a hundred pages to read in an obscure novel so obviously, it's time to blog.

Some things I've noticed:

- It's much too early to be needing sweatshirts and jackets. What gives, Mother Nature? Isn't it technically still summer?

- College City public transportation sucks. Today I waited 45 minutes for Bus A, which was scheduled to come every 20. When it finally arrived, I asked the driver to confirm that it was stopping on the road I needed. She said no, that I had to wait for the next bus, which would be coming "three or four minutes" later. Twenty minutes after that, I hopped on Bus B and rode it to the end of the line, at which point the driver asked where I was trying to go. When I said "L____ Street," he told me that Bus B doesn't go there, and I should have gotten on Bus A. So I rode Bus B all the way back to where I started and had to wait 15 more minutes for Bus A to come back. When I got on, the driver asked, "What are you still doing here?"

- Walking counts as exercise. REALLY. So does stressing and hyperventilating and tapping your foot off in the back of a bus.

- My best friend/roommate eats like a champ and I kind of want to be her someday. She just took a break from studying to bake cookies and then she.....................ate one.

- Drunk boys are a different breed. Last night I was awoken abruptly around 2am to the sound of hooting and hollering and exploding firecrackers in the alley behind my apartment.

- Even though I'm a total introvert, I got nuts without some human contact. This afternoon (after the Bus Fiasco of 2011), a five minute conversation with a friend from freshman year radically changed my entire mood.

- I'm not in college to lose weight. I'm in college for a million other better reasons.

- A hungry brain doesn't work very well.

Sunday, September 18, 2011

The Rundown

So sorry for the lack of updates. There's not much going on beyond what I've already talked about. I'm hanging in there with eating, trying to stay on track as much as possible. I think my weight is pretty stable but I haven't really been keeping close tabs on it. You would think this is a good sign - that I'm less obsessive about weighing myself at EXACTLY the same time every morning like I usually do - but I historically get less rigid about the weighing ritual as my eating deteriorates. When the anorexia was at its worst last year, I barely ever weighed myself, even though we had a scale sitting right there in the bathroom. I was vaguely aware of my weight, as in I would hop on the scale every once in a while and register the number with a brief huh, that's lower than last time, and go on with my day. It's sort of similar now, except that my eating is way better than it was then and I'm still as nervous as ever for my weekly weigh-in with R. So, I'm not sure what to make of that observation.

In other news, I'm having a really good time with my friends and getting wrapped up in classes and schoolwork again. For the sake of my sanity, I HAVE to stay fairly busy, but it's a fine line between healthy-productive-busy and stressful-panic-self-destructing-busy. Lately I've been toeing that line, trying to figure out exactly where it lies. Schoolwork is starting to pick up, as are various club/research/work activities, and I'm trying to resist the urge to take on a million projects and throw myself into everything headfirst without first consulting my responsible, moderate, reasonable side.

I really hope my last post didn't come across as all doom and gloom, because I really am happy to be here and trying so hard to make it work. I don't think I was ever under any illusions that this would be easy, but the reality of it has still taken some getting used to.

Things I'm happy about:
1) My wonderful, compassionate, brilliant, endlessly supportive and understanding roommate.
2) My mom. We've been talking on the phone almost every day. I know she's super worried about me, and she is doing an amazing job of being available without prying.
3) Therapy. I really like R a lot, and I'm almost looking forward to seeing him this week. I feel like he is very purposeful during our sessions and sets a clear agenda and goal, whereas my old therapist W just sort of asked questions and listened to me ramble before moving on. So I'm thinking R is definitely an improvement and I could make some real progress with him. If only I didn't have to get weighed.
4) The delicious sushi I just ate for dinner. I was feeling fat and gross and really wasn't up to facing a restaurant, but my friends wanted to go and we ended up having a great time. Why don't I learn from these experiences?

Things I'm worried/stressed about
1) Schoolwork, exams, too much reading, blah blah blah.
2) The paper-thin walls of my apartment. Seriously, I can hear my neighbor snoring from the next unit.
3) Therapy. Like I said, I really like R a lot, but I HATE getting weighed. Last time he gave me to option of having blind weights, which I'm still undecided on. I have my own scale so I could theoretically check my weight anytime I wanted, but maybe having the blind weights with R will reduce some anxiety about my appointments so I can focus on the therapy part and not the weighing part.
4) Not having time to get to a grocery store. My food supply is majorly depleted. There are places on campus where I could eat, but not everything is Kaylee-friendly.

I think that's all for now!

Tuesday, September 13, 2011

When the Going Gets Rough

I hate using this blog as a whine fest but things have been a teeeeeeeeensy bit rough lately. I guess I started restricting during the chaotic travel/move-in/general transition period with the mindset that it was "just temporary" and "just to be safe" from all the unpredictability and that I would "go back to normal" once I settled into a routine.

Well, basically I kinda sorta maybe just settled into the routine of restricting. Not horribly, but some. I'm not starving and I'm not dying. Just teetering a little. It's hard to keep perspective about it because the last time I was in this environment, I was so much worse. If the Kaylee of 2010 could see what the Kaylee of 2011 eats, she'd have a heart attack. Not from malnourishment - from shock. (Maybe a little bit from malnourishment.)

I guess I just thought that being back in college would make everything easier and it's not.  I think I expected that the excitement of having a life again would carry me and I'd sail through recovery. Oh hey Friend, you wanna go out to eat? No problem! I can do that now! Food rocks!  Now I can almost see how staying on track at home was way simpler because I was so isolated. I mean, it sucked, but I could mope and moan and groan my way through weight gain without having to participate in real life too. Real life is complicated.

When I saw R for my second appointment yesterday, he said again that he definitely wants me to gain at least another XX pounds. Last time he told me this, I said okay. This time - well, I didn't outright refuse, but I left R's office with absolutely zero intention whatsoever of following through.

I had a hard time articulating my thinking to R when we were talking. My weight was down a little from where it was last Wednesday, but the difference was small enough that I assumed he would attribute it to normal fluctuations. Instead, he made a really big deal about it and said: "I think we can safely assume that you're losing weight." Basically, I told him the truth: that I'm not trying to lose weight, but I'm not doing much to keep it on either, much less gain any. He asked me to keep food records this week, but I'm scared to. I don't want him to tell me to eat more because I feel like I'm eating just fine, dammit. Or maybe it's not totally fine, but I don't care because I don't want to eat more and I don't want to gain weight.

The biggest problem is that none of this feels like a problem. I'm not dead on my feet from exhaustion. I'm not at a dangerous weight. I'm not even skinny. I'm fine. I don't know how to express to anyone that the issue is not that I don't know how to gain weight. I do. Gaining weight is very simple. The issue is that my mind is not okay with gaining weight. R can tell me to pack my extra Clif bar, but if I've already decided that I'm not okay with eating it, well, then, I'm not going to eat it.

I hope this doesn't sound like I'm being purposely stubborn and difficult. Nothing bugs me more than feeling like an obstinate brat around the people who are trying to help me, but this really is how my mind works. Once I've decided something (e.g. I can only eat X calories today) then that is what I do. Period. If you offer me a bite of your cookie, I will say no. If the store is out of bananas, I will go to another store. I am not flexible and I do not adapt.

My motivation is still there, but it's shifting. I'm definitely motivated to stay in school,  which is contingent on me being healthy. So I'm motivated to being healthy, but I'm also motivated to not hate myself, and I don't always have healthy ways to accomplish that. And I can't help it that when I go into the student center bathroom and catch sight of myself in the full length mirror (that was NOT there last year!), I get so disgusted with myself that all I want to do is throw out my lunch and run for hours.

Friday, September 9, 2011

The Calorie Tally

Sometimes I think that if I could get over my obsession with numbers, my eating disorder would be cured. This is what occupies 90% of my mind at all times: numbers. All numbers, really, but calories in particular. I've had phases of counting fat and protein grams too, but calories is the one that has always stuck.

I started counting calories when I was about twelve. I have no idea what possessed me to start, other than despising my body. I have no recollection of how many calories I was eating at the time - but I'd be willing to bet that it wasn't enough if I were already sufficiently aware of my weight to be counting calories.

I've gone through periods of counting less obsessively - just estimating, really. But when my anorexia has been at its worst, I count and recount every bite that goes into my mouth. And then some, since I have a problem with overestimating my intake. I adjust my meals based on the calories, and not necessarily to lower them.  It's more that I like "neat" numbers, so I combine certain foods because their caloric contents add up nicely. I would be more likely to choose a certain type of cereal with more calories than another type with fewer calories if Cereal #1 + yogurt together contained a "neater" (round, even) total number of calories. Get it?

Currently, I'm stuck in an extremely rigid calorie-counting rut. This most recent trend has been in place for the past two years at least, and definitely got worse about eight months ago when I started regaining weight. Part of it was probably just that I suddenly had bigger numbers to work with on a daily basis, and wanted to be extra vigilant about not losing track or mixing anything up. Part of it was probably also an intensified fear of gaining weight since I was, you know, gaining weight.

Now, my body is a million times healthier than it was eight months ago, but my mind is still stuck in this awful counting cycle. My daily intake is much bigger than it used to be so changes of XXX calories one way or  the other aren't really very significant anymore, but they still seem HUGE in my mind. I still perform these crazy mathematical gymnastics in my head to get the "right" number of calories for each meal and each day. Then I perform them again just to make sure. Then again to keep myself calm.

There has definitely been progress in that I'm now okay with a much larger number of calories each day than I used to be, but I have no flexibility. I measure everything so I can be sure exactly how much I'm getting. I still save up calories instinctually and eat the majority of my daily intake in the last third of the day. Sometimes my biggest impediment to eating is not that I want to restrict and lose weight, but just not knowing how many calories are in something. Most of the time I could probably guess pretty accurately, but the unknown factor freaks me out. Almost every day, I eat the same default set of meals and snacks simply because I know exactly how many calories are in them and it's easier than trying to concoct something new that would fit neatly into my elaborate guidelines.

The most frustrating part is that I recognize all of this and I know that it's messed up and disordered, but I literally have no clue how to stop counting calories. There's a continuous tally running through my head all the fucking time and I can't turn it off. Correction: I know that I could throw off my tally by not measuring my food, by mixing new foods, and by eating different combinations of foods - but I also know this would only lead me to grossly overestimate and cut back the rest of the day to make up for it. So I'm being stubborn and staying stuck.

Wednesday, September 7, 2011

New Therapist

Today I had my first appointment with the new therapist.  I didn't realize I was so anxious about it until yesterday/this morning when my stomach started doing these nervous rumblings and I couldn't sit still for more than two minutes at a time.  Homework did not get done.

I think I was just uneasy about jumping back into treatment after being able to sort of pretend to forget about it for a couple of weeks.  Like I got a little honeymoon period without all the therapy and weigh-ins and meal plans, which made recovery - and the ED - seem less real.

I was worried about the therapist being male, and that it would just be too weird to talk to him.  Was I supposed to bring up my period?  Would he bring it up?  Ew.  I was worried about getting weighed - I wasn't sure it would happed, but figured it was a distinct possibility.  So I worried that my weight would be too low and the therapist would think I was restricting.  And I worried that my weight would be too high and he would think I didn't need treatment.  I also worried about having to explain my ED history - how the hell do you condense something like that?  And how do you phrase it without sounding stupid and dramatic? Worryworryworry.

Long story short, I survived and the therapist - let's call him R - was super nice.  I was uncomfortable at the beginning, but I really think it had more to do with me being uncomfortable about therapy in general than it did with R being male.  He was really easy to talk to, even though he made a me squirm a couple of times.  But the squirming was because he was challenging me and trying to make me articulate my recovery goals and some disordered patterns I still have.  So I think it was good for me.

Basically I felt like he understood me without too much trouble, and was able to recognize pretty quickly where I am in recovery.  I signed a release for him to talk to W, my therapist from home, which will hopefully save us some rehashing of stuff I've already gone over in therapy before.

He did weigh me.  At first he wanted to do it backwards, which caught me off-guard because B never did blind weights.  After hearing that I'd known my weight all along, R left it up to me.  So I said that I would rather see my weight, and that I probably already knew what it would be anyway.  Then he asked what I thought my weight was, and my guess was correct within a pound (i.e. I weighed one pound less on his scale than I had predicted).

I was pretty (irrationally) self-conscious about my weight, and nervous that R would say I was too fat for therapy and he wouldn't want to waste his time on me.  Obviously this did not happen.  He started off by saying, "I don't think you need to lose weight."  Okay, well, duh.  I guess I didn't really expect him to tell the anorexic to lose weight.  But then he said he would like me to regain some of the weight I'd lost over the summer, and asked whether I would be willing to do that.  This was one of the points at which I squirmed.  But never fear - I did agree to gain the weight.  Still squirming though.

As for seeing a dietician - R said it probably wouldn't be completely necessary every single week, which is fine with me.  Been there, done that.  And I'm already kind of an expert on calories.  However, R and I both agreed it would be helpful to at least check in with the RD there at least every few weeks.  I tend to lose perspective on what "normal" eating and "normal" calorie amounts are, so hopefully an RD will be able to keep me on track.

So I think this was a positive development.  I'm not thrilled about being back in therapy and I wish it weren't necessary, but I'm open to it.  And at least the guy's nice.

Monday, September 5, 2011

Back to Life

Suddenly, I have a life again.  I am taking classes, going to restaurants, highlighting textbooks, and staying out late.  The transition back to college has definitely been hard, but I think I'm finally making it.  I feel so much more connected and real and alive.  Today when I was walking back from the gym in the most fantastic sunshine I've ever seen, I thought: I might actually be happy right now.

My classes are amazing.  I love them all.  I'm so thrilled to be back in an academic setting, to be engaged and stimulated and excited.  Every morning, I am genuinely happy to get out of bed and start my day.  I will never take this feeling for granted again.

That's not to say everything has been perfect.  I spent much of last weekend feeling hugely insecure and fat and gross and lonely.  What if no one even remembered me?  What if everyone hated me for disappearing last semester without warning?  How would I explain myself?  Pushing myself to reach out to my old friends and initiate social contact involved a lot of freaking out and anxiety and omgwhatifIhavenofriends? But then, you know what?  I just did it.  And it has been so worth it.  On Friday night, one of my best friends since freshman year gave me a huge hug and said, "Kaylee, I'm so happy you're back!"  I wish I could express to her how freaking amazing that made me feel.

Eating has been so-so.  Honestly, I'm really busy, and food isn't on my mind 24/7 anymore.  It just isn't.  I'm not trying to lose weight, but I'm not really trying to not lose weight either, if that makes sense.  I'm finding myself eating less by accident, realizing it after the fact, but then still lacking the healthy perspective to add a snack and make up the difference.  Part of me is screaming I'm fine!  I ate less yesterday and I was fine!  I don't NEED all that food.  It's also hard to put my calories in context, because I've been working out much less here than I did all spring and summer at home, but now I am walking constantly, climbing stairs, and lugging a backpack full of books all over campus.  So, do I need more or less food?  The same?  Different food?  The thought of trying to quantify calories in/out makes my head spin.  I find myself cutting corners here and there, just to "be safe."

The results: I'm down a couple of pounds, totally unintentionally, but I can't say I'm upset about it.  This worries me a bit, but my weight really isn't forefront in my mind at the moment.  I just feel like...I don't know, like I can't be bothered.  I'm not actively trying to eat less, but I find that to be my default setting and I'm getting lazy about challenging it.

This isn't a very cohesive or exciting update, but I've got lots of reading to do and a paper (already!) to write.  Have I mentioned that I LOVE being back at school?  I know the stress will hit soon, but for now I'm working to stay balanced, calm, and really make the most of getting another chance without running myself into the ground.  I've stayed out super late for three of the past four nights, so I'm aiming to make tonight an early one.