The Waiting Game

One of the more interesting/uncomfortable parts of seeing R is the waiting room. He is almost invariably behind schedule, so I get the chance to see lots of people coming and going from the office. Several therapists, social workers, dieticians, etc. all work out of the same building, so the waiting room gets a pretty steady stream of patients.

The treatment center specializes in eating disorders so naturally, there are a fair number of teenage girls. I've seen the same two every time I go. One of them comes in with her mother and knows all the receptionists by name. The other one comes in by herself and usually looks close to tears. Although I try not to be, I am acutely aware of their weights. Neither looks anorexic in the stereotypical emaciated way; they look pretty average. Thinnish/normal. Not fat.

This week, however, there were two patients I'd never seen before and they were both SKINNY. One of them was a teenager; she came in with her parents and was bundled up in sweatpants and a sweatshirt, but you could still see her stick-thin legs through the fabric. She looked tired and sick and I couldn't not stare.

The other one was probably in her late twenties, early thirties. I didn't notice her body at first because she was sitting down, bouncing a baby on her lap. It wasn't until I sat down next to her and let the baby play with my keys that I realized how skinny the mother's legs and wrists were. Like, so thin I don't know how she'd been able to lift her baby, much less give birth to him.

I'm not sure how I feel about seeing people like this. It doesn't exactly "trigger" me - i.e. it doesn't make me want to skip my appointment, sprint home, and have lettuce for dinner - but it DOES tend to make me downplay my own ED in my mind. I'm not even close to being as thin as her, so therefore I must be fine and R and J and everyone are making a huge deal out of nothing.

Interestingly, this clinic also treats binge eating disorder. Nearly every week, besides the high school girls, there are at least a couple middle-aged morbidly obese women. Again, this doesn't really trigger me in any way; I don't binge, nor am I particularly worried about it, but it does scare me that there seem to be so many people stuck on either end of the spectrum - loss of control versus hypercontrol over eating. It makes me wonder whether anyone is normal anymore, or if food always has to be a struggle one way or the other.

Usually, I feel like my ED is not that bad, not out of control, nothing to be concerned about, etc., and I get complacent about challenging myself to push forward in recovery. R's biggest frustration lately has been motivating me to actual make changes, rather than me just agreeing to "try" without ever fully following through. When I see people so obviously stuck in their disorders, though, I find myself a bit more motivated - more out of fear than anything else. I'm not jealous of anyone I see in R's waiting room, nor do I aspire to be like them - in fact, I'm thankful that my illness is not visible to everyone. I never want to be gawked at, the degree of my sickness apparent to everyone else but not to me.

Realizations like this don't exactly help me in the moment when faced with adding X to my meal plan or drinking an extra supplement, but sometimes it helps to focus on the big picture. I do NOT want to stay stuck in the same patterns when I'm thirty or forty or fifty. I never want to be so sick that people see my sickness before they see me.

Trip Summary

I ended up having a pretty fantastic Thanksgiving weekend at home. Beforehand, I had been really nervous about the food situation and worried that my family would be hyper-attentive to my eating, but that actually wasn't the case at all. In fact, my mom was about as hands-off as she's ever been. When we visited my extended family (some of which is aware of my ED) on Thursday, I got the impression that everyone had been warned against mentioning on my eating, weight, etc. I got lots of Your hair looks so pretty! and What a nice shirt! -type comments. So I definitely appreciated their conscious efforts to make me feel comfortable.

My two best friends from high school were around, and I spent lots of time with both of them. I also got to hang out with my brother; we've gotten closer in the past few years, but haven't seen each other much with me at school and him working crazy-long hours. He took me shopping for a late birthday present on Saturday, and we had a good time walking around together and catching up.

As far as food, I think I did okay. For the actual Thanksgiving dinner, I was pretty much resigned to the fact that I would be eating more than I was comfortable with and that I wouldn't be able to calculate the calories. That being said, I tried to not get super anxious about it and just enjoy the occasion. I tried lots of different dishes (including pumpkin pie!) although my portions were a bit skimpy. And there was definitely some major guilt afterwards.

During the rest of the weekend, I had good intentions about being more adventurous and spontaneous with food, but that didn't exactly happen. My mom seemed to be making an unspoken effort to accomodate me by stocking the fridge with my staples and cooking fairly "safe" dinners, so I didn't really have to step outside my comfort zone very much. This made things much simpler and less stressful than I had anticipated, but also didn't really push me to challenge the ED very much.

So I had a wonderful time at home, but there were no huge recovery milestones either. I guess surviving a food-centric holiday with my sanity intact is sort of a victory in itself, but the rigidity remains entrenched.

Since returning to school, I've jumped back into the typical regime (minus exercise, STILL) but I seem to be harboring this vague sense of guilt about having neglected it for several days. Not sure why.

Finally, I'm getting nervous about seeing R in therapy tomorrow. I left my last appointment feeling extremely defeated and hopeless about recovery. I had cried for the first time ever in therapy that day, which embarrassed and frustrated me. Although I AM motivated to recover, I am also still a pretty sucky patient and I hate letting R down week after week.

Giving Thanks

I'm going to be highly unoriginal and use Thanksgiving as a chance to count my blessings.

What I'm thankful for this year:

- My mom and dad. Living at home with them earlier this year was not easy and our relationship really suffered, but they put up with my miserable existence throughout and made it clear that I was loved. They don't understand the ED, but always try to be supportive and have never once blamed me for my illness.

- My treatment team. In all honesty, I am a horrible patient. I'm terrible at following the meal plan, I clam up in therapy, and I've made zero progress weight-wise in ten weeks of treatment. My therapist and dietician, however, are infinitely patient and still seem to believe that I can recover. Even though they frustrate me sometimes, I trust them completely and wish that I were better at showing it.

- My friends. My social circle has narrowed drastically over the past two years - partly because of logistical reasons (I disappeared for a semester and then I moved off campus) but also because I've changed. Big groups and constant excitement don't really appeal to me anymore, but I have amazing, intense friendships with a few certain people. My roommate, for one, and my boyfriend (yup, I think it's official), for another. I am more honest and comfortable with them than I have been with anyone for a long time.

- My university. The administration and my professors were incredibly understanding when I  left unexpectedly last January. The entire situation was handled discreetly and professionally, and there was no problem whatsoever in allowing me to re-enroll this fall. I have taken amazing classes here and met the most interesting people. I shudder to think about how quickly college goes by.

- My body. No, really, hear me out. I know that I bitch incessantly about how it looks and feels, but really, my body has been pretty damn resilient. The anorexia has not caused any major physical problems that affect my day-to-day life. I've got all my senses intact. I can walk and talk. Yes, I have horrific body image, but that's hardly debilitating. Seriously, if my biggest complaints in life are appearance-related, then I must have a pretty awesome life.

I hope everyone had a happy Thanksgiving!

Back Home

I got home last night for Thanksgiving break. My parents are being wonderful and doting and everything, although I do still feel a bit under the microscope while eating.

I'm a little nervous about tomorrow - we're driving up to spend the day with my dad's side of the family. There will be a ton of relatives who we haven't seen in a while. I've given up driving myself crazy trying to figure out when I last visited them (and what my weight was then).

Jumping backwards a little bit: I was sitting next to this obnoxious jerk on the plane last night. When he first sat down,  hee leaned over with this creepy leer and held out his hand for me to shake and said: "Thanks for being thin."

I choked and almost sprayed Diet Coke everywhere. He must have thought I didn't hear him, because he repeated, "Thanks for being thin. Skinny. Have you ever sat next to some really fat person on a plane?"

Than he made a rounded gesture with his arms, like a big stomach, and started laughing.

I was floored. FLOORED. It never ceases to amaze me how some people talk so blatantly about body weight and size to complete strangers. In my mind (and maybe I'm overly sensitive), those topics are Off. Limits.

I kind of wanted to slap him, but I'm wimpy and only managed to choke out a "No problem!" But you should meet my therapist!

There is this general sense of relief about having the week at home to decompress. On the food front - I'd be lying if I said I wasn't nervous and stressed about it. But Thanksgiving is actually my favorite holiday and I'm lucky to be here with my family for it. I'm doing my best to avoid letting my irrational fears ruin things.

One Week Down

This is the longest I've gone without formal exercise in probably about three years. The inactivity is getting both harder and easier, if that makes sense. Harder because every day that goes by is another day to obsess about how fat and disgusting I must be getting. Easier because every day is another day that proves I can indeed function without exercise. The past week has been pretty rough in terms of my anxiety and grossness feeling, but I survived. I think the forced break might be easier to deal with next week, since I'm going home for Thanksgiving and my schedule will be messed up anyway.

At the risk of sounding neurotic and numbers-obsessed (who, me???), my weight has shot up about 2-3 pounds, which is not good for my mental health. I'm inclined to think it must be bloating/water retention/something to do with the Naproxen I've been on, since the gain happened instantly the day after I started taking the pills. Even though I have to convince myself of it sometimes, I DO know that weight gain doesn't happen magically and I'm trying to be rational about it. Still, it messes with my head. I do not appreciate unanticipated bodily changes. Take note, Body.

It never fails to surprise me that I still have an appetite, even when staying essentially sedentary. Yesterday and today, I literally sat with my butt glued to my desk chair ALL DAY. Not fun. I wasn't planning to restrict, but felt lazy and disgusting and couldn't imagine ever wanting to eat. Then, lo and behold, my stomach started making timid growly sounds and my head started getting that swimmy feeling and almost before I knew it, I was hungry. Huh. I guess I am alive.

Finally, for something unrelated to food or exercise: When S came to pick me up last night, I was feeling fat and crappy and not in the mood to go out. Then I opened the car door and, lying across the passenger side seat, were six pink roses. Boy done good.

Ups and Downs

Good: My Achilles is not torn, most likely just strained. The doctor at our student health center was very thorough and knowledgeable; when I mentioned my osteopenia, he immediately ordered an X-ray just to be safe. I got the impression that he suspected an ED, but he handled it very professionally and thus provided my first ever positive experience with campus health services.

Better: I went for the X-ray this morning and my foot is not fractured. Thank God. Additionally, my insurance rocks and I didn't have to pay a dime.

Best: My courses for next semester are finalized. One of them is with a professor whose class I attended for a week last January before going on medical leave. This afternoon, she sent me an e-mail saying that she was glad to see my name on her roster again and hoped I was doing well. It was the littlest thing, but it seriously made my day.

Bad: My foot isn't broken, but it still hurts like hell. I've been taking an anti-inflammatory and icing, but the pain just won't ease up. I can't exactly stay off my feet, since I probably walk at least 2-3 miles a day just getting around campus. Not sure what else I can do.

Worse: I'm unsure about the whole S situation. I don't know why. We had a great time this weekend, but sometimes it seems like he's much more interested than I am. I enjoy being around him, but I feel like I could go a week without seeing him and not even notice. Why am I so numb?

Worst: My session today with R was really hard. There were tears. I might post more about this later, but basically it boils down to me sucking at therapy and recovery and life.

And a final random: Does anyone else find it ironic that I've been bitching all week about how much my foot hurts, only for me to experience THE WORST PAIN EVER when I bit my tongue during dinner tonight?

Injury Rant

Well, this unexpected exercise challenge is proving to be much harder than I thought. It has been three days (actually eighty hours, but who's counting? Oh, just me) since I've gone to the gym and I'm getting a wee bit fed up. I guess I had told myself that I was okay with taking a few days off and seeing what happened, but only as long as my foot miraculously cured itself and I could get back on the treadmill in a timely fashion.

Unfortunately, things have not unfolded according to plan and, as per usual, I'm freaking out. My foot is NOT getting better, despite that fact that I've been a good girl and stayed off my feet pretty much all weekend, other than Saturday night. Literally, I spent all of Saturday and Sunday sitting with my foot up, icing off and on while I worked on homework.

I thought my heel was better - the swelling on my Achilles tendon had gone down and the pain had lessened. I skipped the gym again this morning, but just walking around campus this morning made it start hurting again. ARGH.

So I limped back home, stuck my foot on a bag of frozen peas, ate lunch begrudgingly, and now I'm sitting here trying to decide how a normal person who wasn't terrified about gaining weight would react.

I'm also frustrated with the amount of injuries and health issues I've had in the past year, despite making a real effort to take care of myself. My nutrition was fantastic (according to my standards, and probably most others' standards too) from about January through June or July, when it definitely began to suffer a bit, but still not horribly. I still eat very well considering the intensity of my body hatred and urges to restrict. Compared to last summer and fall (2010), my intake is vastly superior. In the past six months alone, though, I've had: hip, back, and knee injuries, major nutrition/body fat-related eye issues, horribly dry skin, and sporadic heart palpitations.

I have a weird, contradictory pattern of simultaneously overreacting to and downplaying physical problems - meaning, I always assume the worst (e.g. thinking my Achilles tendon is torn, I'll never walk again, I'm a cripple for life, etc.) but I never believe it's serious enough to warrant changing my behavior (e.g. continuing to exercise on an injured leg, not going to a doctor, cutting food when I should be maximizing nutrition to heal faster). Not smart.

But still, every day, it seems like I'm trying so hard to keep my head above water and not dip into any truly scarily unhealthy anorexic behaviors. My head is actually in a better place now than it was earlier this semester. So why does my body suddenly feel like it's falling apart?

This has devolved into a whine-fest, sorry! I'll wrap it up. This post probably sounds insanely irrational and anorexic. The forced break in exercise is messing with my head.

Just please, body, get better. I'll treat you right, I promise.

Risks

YOU GUYS I'm taking so many scary chances lately, it's almost too much. I'm half-impressed, and half-freaked out.

Exhibit A: The other night I was sitting in my class that goes until 5:30pm, planning what I would eat for dinner afterwards (the same thing I always eat afterwards) when S texted me asking if I wanted to go get dinner with him. Which I didn't, of course, because that was not in the plans. I spent the next twenty minutes crafting a lame response in my head about why I wouldn't be able to go.

But then, you know what? I just said yes. And I went. And the world did not end. We ate dinner and talked and S walked me to my meeting at nine. By the time I got home later that night, I was still grinning like a darn fool. The post-date glow, I suppose.

Exhibit B: My last attempt to complete R's assignment of filling in my roommate about my ED was a bit of a fail. The other evening, though, I opened up much more than I usually do and we had a very honest, straightforward conversation about it. I tried really hard to explain my thought processes and my fears - both the logical and illogical ones - in a way that someone with no food issues would understand. I don't know that anyone without an ED truly can understand, but it helped to articulate them. Even if she doesn't fully understand where I'm coming from, she believes me and wants to help. And guess what? I feel better, not worse.

Exhibit C: This one wasn't exactly a voluntary challenge on my part, but I'm trying to see the positive. I think I managed to injure myself again - this time, it's my Achilles. Yesterday as I was walking home from the gym (in shorts in 30 degree weather, which was stupid I KNOW) the back of my heel started killing me. I thought it was strange, but ignored it, as per usual. Throughout the rest of the day, I did a lot of walking around campus and the pain got worse and worse until I was limping and had to give up my last couple of errands to come home. I iced, stretched, and tried to stay off of my feet for the rest of the night, but my Achilles is now a bit swollen and bruised and I am so fucking frustrated by my body failing me again and again and again. I shouldn't be surprised, really, but it still sucks.

Not going to lie: I had an initial freak-out/near meltdown over the fact that I would not be able to run, which would most definitely result in me getting fat. Then, I told myself to suck it up and calm down, and accept that I would have to be rational and take care of myself. I'm going to take a few days off from the gym and then reassess. I can't think any farther into the future because it sends me into a spiral of worries (omg my Achilles is torn), so I'm trying to stay calm and in the moment and keep some perspective because at this point, what else can I do?

This was definitely not a planned recovery challenge, but I'm trying to see it as an opportunity for some steps forward. Today was my first day off from working out in a while, and it hasn't been easy. I feel antsy and gross. But a few days off won't kill me. And it won't make me fat. Right? RIGHT?

Being challenged like this is pretty tough, especially for someone as pathologically habitual and averse to spontaneity as me, but it's making me see things differently. I'm getting glimpses of what life would be like without anorexia, without panicking over the little things, and without using unexpected stress as an excuse to self-destruct.

The Boy

We've been dating for a few weeks now. (FINE I guess he gets a letter. From now on, boy shall be known as S.) He has taken me to several nice restaurants, bought me fancy chocolates and candy for my birthday, invited me to his fraternity formal, and generally behaved like a perfect gentlemen at every turn.

So...WHY am I so conflicted? Part of it is just me - I suck at relationships. The very thought of being in a relationship freaks me the hell out. I have this fear of losing my me time, which is generally spent on food/running/schoolwork-related shenanigans. I'm not spontaneous, I hate being the center of attention, and food-centric activities make me crazy - so, not exactly conducive to forming healthy romantic relationships.

Also, the friendship-to-dating transition is tricky. Since I've known S for a couple of years now, we've sort of skipped over the "getting to know each other" phase. This has created an awkward dilemma for me; namely, how much do I reveal about the anorexia? He knows a little bit, but I've implied that it isn't really an issue anymore. The more time we spend together (read: the more meals we eat together), the more it feels like I'm lying to him.

There's another sort of secret issue that I'm not sure how to articulate. It's going to sound crazy selfish and cold, but here goes. Basically, the eating disorder still takes up a HUGE portion of my brain, and there's not a whole lot of extra space in there. The calorie-counting, fat-phobic obsessions are always there, always nagging at me, and I don't know how much energy I have left for a relationship. Sometimes I feel like I'm barely keeping my head above water as is, and I can't imagine adding another person's feelings into the mix. I can't promise that I would be able to put the relationship above my disordered regimen, and I can't promise that I'd want to.

I like S a lot and, commitment issues aside, I can see myself  being with him longer-term. But if it came down to him versus the eating disorder, I'm not sure which one would win.

If Only I'd Known

There was an article in the New York Times earlier this week about how the "Freshman Fifteen" is more like the "Freshman Three" or so, which made me laugh. Not in an out-loud HAHAHAHA way, but more of an isn't-that-ironic, thanks-a-lot-NYTimes-but-too-little-too-late way.

Honestly, a fear of gaining huge amounts of weight was a big contributor to my restrictive eating habits that intensified when starting college. After my initial big weight loss during middle school, I had slowly regained and maintained a healthy weight throughout high school. Then I basically starting restricting again the summer before freshman year. The idea being that I had to prepare for and counteract the inevitable Freshman Fifteen. I dropped a bit of weight then, pretty much maintained through the school year (2009-2010), and started losing again over the summer.

Obviously, the ED was caused by a LOT of factors and manifested itself way before I was even thinking about college, but I have to believe that a fear of the stereotypical freshman weight gain definitely played a role in triggering the relapse I'm still dealing with today. That's not to say that if I'd read an article over the summer of 2009 about how my fears of the Freshman Fifteen were completely unfounded I would've never returned to the eating disorder, but still. Makes me wonder. And laugh, a little.

Unplanned Hiatus

Oops, I didn't mean to go for a week without blogging. The break was only PARTLY my fault, since my laptop has been in the Computer Hospital since Friday.

Even before the laptop fiasco though, I was being lazy about updating. I guess I'm a little worried about always rehashing the same things - therapy, food, restaurant stress, body image blahs, etc. All of the above are definitely still very relevant to my life, but I shouldn't assume that everyone always wants to hear me bitch and moan about them. Any ideas for more interesting posts?

Anyway, a quick recap of the last week: therapy was...interesting. And stressful. My dietician J showed me a graph of my weight since I started seeing her and R. Basically, it was a straight line. Meaning, obviously, my weight has not changed in the past eight or so weeks. While this wasn't surprising (I weigh myself at home), I did have mixed feelings about seeing it mapped out in black and white. The eating disordered part of me always wants to lose weight. Always. The ED part only cares about the graph - why isn't the line going down?

At the same time, though, there is so much more going on than what showed up on J's graph. I am way more happy, social, and sane than I was eight weeks ago. While I admittedly have not thrown myself wholeheartedly into weight gain, I have no plans to starve and lose any. I don't feel fat; I just don't feel thin. So, staying at the same weight doesn't necessarily feel wrong, even though I KNOW that I am underweight and should, from a medical standpoint, gain at least X pounds to get back to where I last got my period.

J and R, however, are quite concerned that I haven't put on any weight since starting treatment with them. Both tossed around the idea of IP a couple of times - more as a scare tactic than as an actual threat, I think - but they are still going to work with me as long as I am "willing." It bothers me that they see me as UNwilling, since I feel like I'm trying so hard every day just to break even and it never seems like enough.

I told R that I knew he was probably frustrated with me for making zero progress over the past couple months. It's not his fault - I've been pretty impenetrable on the food/exercise issues. I realize it sucks, as a doctor, to prescribe medicine for a patient who won't take it but still shows up every week with the same complaints. Well, no shit you're still sick!

R was nicer than that. He said: "I'm not frustrated, Kaylee. I know you're trying. But if I let things go on this way much longer, then I'm just enabling your anorexia."

Happier news: I feel myself loosening way up in some food-related areas. I've been to three restaurants this week, went out for drinks at a bar after a full day's worth of food (yes, I'm legal!) on Thursday night, and ate a few gourmet chocolates with NO warning (a present from the boy, awwwww). No, I wasn't happy about the last-minute decision to go out for dinner last night; but yes, I ended up having an awesome Girls Night Out. Progress? I think so!

The semester is flying by. Why is it that a semester at school goes by in a heartbeat, while my semester at home seemed to last for an eternity?

I'll be better about blogging this week, I promise!