5-5-13

Today I took on the task of trying to create a Tumblr. I have no idea why it’s so hard for me to figure out, but after an hour of fooling around I am giving it a break. I am pretty content here at blogspot.com anyway. In my last entry I talked mostly about my relapse with anorexia in 10^th grade. That was the sickest I had been since my first time at Johns Hopkins in 2006. Like I said previously, I had started to accept that I would be ill with anorexia for the rest of my life. At this point in time I had also stopped seeing my psychiatrist at Johns Hopkins, and I started seeing a local psychiatrist for the first time in my life. It is amazing the difference between psychiatrists that obviously specialize in the treatment of severe eating disorders, and the average Joe psychiatrist I was about to see. It was my mom and I who to tell this psychiatrist that I was sick and needed to go to treatment yet again. This psychiatrist asked if I thought I needed it, and she asked if I thought it would help me. I was not used to this logic. I was used to a provider ordering me around and throwing me into a hospital without care of what I thought or not. I was at the point where I was feeling so sick and god awful crazy that I wanted to go away, and I was pleased beyond reason to be going to Sheppard Pratt instead of Johns Hopkins. I was 3 years older than I had been my first time. I had been educated about my disorder beyond recollection, and I knew what I needed to do. Yet I still dug my feet into the ground, and protested when I arrived at Sheppard Pratt for the second time.

 

My year up unto this point consisted of me staying at school unto 4:30pm; I would stay late at school and take the late bus home. I had a strange compulsion in which I wanted to stay out of the house as long as possible. These were only on the days I did not work. On the days I worked I would arrive at the retirement home at 4:30pm or 5:15pm depending on the day. I arrived starving, dizzy, and depressed. Working around the rich food for 2 ½ hours was unbearable. Even worse was that I was on my feet the entire time. Every time I walked from the kitchen to the dining room where the “residents” sat I hit the unlocked door with my hip as it swished open. I was so boney, that I ended up getting a massive bruise on my protruding hip bone from hitting that door so many times. I had a love hate relationship with that job. I love talking to the people that lived in the retirement home, but I hated it because I always felt sick and exhausted while I was there.  It was definitely apparent to the residents that I was not well. Lots of them asked if I was okay, I looked “Washed out, tired, etc.” I always came up with something to say. They were smart old people though; even under all the big baggy clothes and aprons I had to wear they saw that I was not well. My face said it as well. The day came where I had to tell the managers of the retirement home that I had to leave, and I did tell them the truth. I said I had an eating disorder, that I was not well, and that I had to go to a hospital for a while. I did not lose the job. In fact on my last night the manager gave me a hug and said “Wow you really do feel like a sack of bones”. Nice. Whatever, I didn’t expect anything different. When I got home from work every night I followed my ritual and ate my “dinner”, which at the end was cabbage and lettuce. My mom had become so afraid she had tried to get me to drink carnation instant breakfast packs. I drank some if it but protested at every change I got.

I believe it was a Thursday afternoon and my parents got the call from my insurance and from Sheppard Pratt, that it had been approved for me to go to Sheppard Pratt. The following morning I got up and my mom set a thing of cottage cheese in front of me and told me to eat before we started driving. I played with it for a few minutes and said that dairy made my stomach hurt. It probably did because I wasn’t used to eating anything. I was going to find out soon enough that it didn’t matter if my stomach hurt, I was going to eat or be forced to. I was very anxious because I had not been to Sheppard Pratt in 3 years, and I was unfamiliar with it. We arrived at the Pavilion for my admission around noon. The director of the program at Sheppard Pratt was doing my admission. I remember very vaguely our conversation. I remember he said I was very sick and I thought no kidding. He looked at my arm that I had been cutting for the last 9 months. “Can you promise not to do that while on the unit”? I thought if I didn’t say yes he was going to send me to a general psychiatry unit, a real crazy unit so I promised I wouldn’t do it. After my admission with the nurse and the Psychiatrist it was time to drive over to that familiar 250 year old red brick gothic like traditional building. My mom and I walked into the room separating the inpatient unit from outside world of wonders. The “Elopement Precaution” sign still on the door from 3 years earlier. The smell of the unit immediately triggered a flow of memories from 3 years earlier. Everything was the same. My mom was crying (as usual). She said she didn’t like leaving me there, but I was fine with it, I had become familiar with these types of places within only 3 years.

 

I got to the unit unpacked, stripped searched (as is the entire Sheppard Pratt policy). As I was taking my sweater off I almost fell over because I got all dizzy. Good thing a nurse was right there. I did not recognize many of the nurses or mental health workers from 2006. It was about 4pm I believe, by the time everything was done and I went to the last group of the day. I walked into the group of adolescents and they all introduced themselves to me. I said hello, but I was too pre occupied with feeling cold and anxious. As I have said early Sheppard Pratt is much bigger than the program at Johns Hopkins. I actually like this much better now. I walked out of group and the milieu and hall was full of inpatient and partial hospital patients. Some said hello, some just looked at me and walked off. I do not blame them I was quite a site. Again here is the image – a severely malnourished 16 year old dressed in shorts with leggings, sneakers with fluorescent green laces, short red hair, and heavy makeup. That was me. As the old familiar chant of “double layers!!” which meant take off your sweater/sweatshirt and go to the dining room because it is time to eat, was called, I was taken back to get an EKG. I was told I could not wear my sweater, and I was immediately hostile because I had cuts all up and down my forearm. My sweater had been my security blanket for a long time. The nurse said she could put a bandage on it. I made the mistake of not asking for a bandage because I thought that would draw even further unwanted attention.

As I sat at that long wooden plastered table I looked at all the faces of my fellow eating discorded patients. These were the people I would be living with for the next 3 months. We went through the good and the bad, and we talked of past, present, and future concerns. Something was new this time; there were no patients with nasogastric tubes on the unit. Back in 2006 this was customary I assume, but they stopped that thankfully. My first meal was never a problem. It is always a small meal and on this day in particular I had not had anything to eat so I was eating without an issue. I do not think I realized how ill I truly was. I never had a heart attack, I never had kidney damage, and I never even truly passed out. That’s probably just because my body worked in overdrive to keep me in balance. I did hear from a fellow patient later on that they were worried I would “not make it through the first night”. That was kind of a wakeup call. I just figured I was just another anorexic on the eating disorder unit. I did not warrant any extra worry than anyone else. I was extremely sick however. This is the one and only time I will ever use reference to a number but I am just doing so to show those who don’t know or believe that their eating disorder is truly life threatening. My BMI at that admission was 13.7. A BMI below 18.5 is considered underweight. I was well underweight, and that I knew, but what I didn’t know is that I was sicker than I ever first thought I was. Something else that I will say is a lot of the people with eating disorders who go on talk shows, who write books and what not, they talk of their near death weight; well most people don’t make it to that point. Most people die before getting that sick. Someone in particular stands out to me and that is the brilliant novelist Marya Hornbacher. I read her book “Wasted”, and most people don’t make it out alive as sick as she was. It is not something to play with.  I don’t think I was getting ready to die, but I do know I was sick. I had osteoporosis in my lumbar spine and hips, I had hypoglycemia, my liver functions were off, my white blood cell count was low, I had iron deficiency anemia, and above all I was suffering from a severe and persistent eating disorder.

I was assigned a different psychiatrist this time. I was okay with it. I initially really like her, but she turned out to be really tough which is what I needed, but our personalities definitely butted heads. My therapist was great. Having individual therapy in the hospital was foreign to me because at Johns Hopkins there is absolutely no individual therapy. My therapist was great. Also, the groups are Sheppard Pratt are great. Days at Sheppard Pratt were much busier. My eating disorder was beginning to revolt within just a few days of being there however. I was eating breakfast on the second day and I had toast with butter. Butter had always been the hardest thing for me to eat because I felt like it was nothing but detrimental to me. The nursing supervisor was watching me little did I know (and for my SP friends I am sure you know who I am talking about) while I was trying to wipe butter from my hands to my napkin. This nurse had the eyes of a hawk, because she immediately gave me a new butter! I couldn’t do this, and I told her I couldn’t. She said I would have to sit at the table until lunch with a supplement. I did not want to go right back to that on my second day. I started crying; broken and helpless; I was a crying little child at that moment. This strict nurse was just taking care of her patients like an ICU nurse would inject her patient with an antibiotic. She gave me the option of eating the butter straight up or eating it on a cracker. I did not want the extra calories of a cracker so I just at the teaspoon of butter. Blehh.

Even after that episode I continued to manipulate the program and nurses. I ate my food for the most part but I did the small things like wiping butter on my hands that was just something I couldn’t stop. I got a really rude awakening a few weeks later, and I did stop after that.

The psychiatrist I saw 5 days a week was harsh on me. For about the first 10 days I was at Sheppard Pratt I was severely constipated. A few weeks before being admitted to Sheppard Pratt I had started playing around with chocolate exlax. I hardly used any because I had heard horror stories of horrible abdominal pain. My psychiatrist did not give me any laxatives though. Just a few stool softeners, and eventually I started to go. For those of you who don’t think my constipation is an integral part of my story, I disagree. Constipation is something most eating disorder patients face when they enter treatment/the hospital. So I thought I would share it. Soon after my arrival at Sheppard Pratt I started to fall into the daily pattern of inpatient eating disorder life. I remember when the nurse took a picture of my face for my chart, and I looked at it, I actually thought it looked bloated. On my last day of treatment 3 months later I saw it and I absolutely did not think it was bloated. It was a sad recollection of an eating disordered 16 year old.

Adjusting to life with 40+ other anorexic/bulimic/binge eaters took a little while. It became a very comforting way of life in a twisted fashion though. Before, I had exerted all my control among myself and spun myself out of control. Now I was being pupated in this mad house with 40 other people in my same position. We all had all our control taken away. I had no choice but to go to bed at 10pm (bedtime for minors), I had no choice but to get weighed every day, I did have a choice of whether to eat or not, but not eating meant sitting with 2 supplements for hours upon end, and if you didn’t drink those you could carry on for a total of a couple days and then you would be forcibly tube fed at the medical hospital next door. I never got to that point, few people did. I knew that once I got admitted I was not going to leave until they were satisfied with my weight (and thoughts).  For the first couple of weeks I diligently continued my warped tactics of trying to lose a few calories here and there on my napkin and maybe on the floor. To be quite honest this is immature and is mostly only performed by younger eating disorder patients (like I was at the time). Most of the adults realize how blatantly stupid it is to do such things. It was a Friday and we were in Community Meeting. Community Meeting is huge. All inpatients partial hospital patients are there, plus nurses and therapists. My ass was about to get kicked. A couple of the patients who sat at my table started saying how there is a patient who is “engaging in eating disorder behaviors”. They started off in a nice way, but then it turned into an all-out bash session of this “anonymous” person. I had had it. I said “It is quite obvious you guys are talking about me, you assholes could have just said it to my face”. Well that was the beginning of the end. What seemed like half a room of angry eating disordered patients started jumping all over me. In jail they make shanks. On the eating disorder unit people say hurtful things. People said some hurtful things to me and I said some hurtful things to them. I was mostly upset because I did not know these people had figured me out. I thought my little tricks were all my own. Nope, that was not the case by any means. Looking back today I am glad they pointed it out to me because I would have been mad too. Community meeting was over, and Marissa the Great was crying her eyes out. The Director of Psychology was in the room and just started talking to me. I love this therapist to the day. She is a lovely person. She told me to breathe in and out slowly, because I was all choked up. She said it was not too late to start over. After that day, I sat at those damned meals, fork and knife in hand, almost like a robot. I was not going to eat like the cracked little fool I was. I started eating “Normal”.