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.