Back Together

Wow, I can't believe it has been almost a month since I last posted.  Please accept my apologies.

As you may remember, at the end of April I was not in a good space.  And after I wrote that last post things only got worse.  I just felt extremely depressed.  My eating habits were extremely unhealthy.  I slept only a few hours each night and ended up doing nothing during the day.  Every day I woke up hating myself even more even though I thought that wasn't possible.

In the beginning of May it was the 7 year anniversary of my friend JB's suicide.

I'm in a better space now, but I'm not "better."  I am coping, which is good.  My eating has been more regular, but I have not put on any weight and on two occasions I abused laxatives.

I've also been trying to find a new psychiatrist for when I move for graduate school, but I've been having trouble with that (more at a later date).

I'm trying to put my life back together, but it's a slow process.

Cheeseburger?

Apologies for not having posted in a few days and for not having visited your blogs too.  I'm not sure what my excuse is, but the following factors probably played into it: fatigue, insomnia, inability to make myself do the things I should be doing, confusion, depression, and fear.

No, not fear of writing, but fear of catastrophe.  Fear isn't really the right adjective, but I will explain.  Over the past several days at random points I will suddenly feel like I am going to die that day.  Not that I will kill myself, but that there's an overwhelming sense of doom and my time is up.  At first this was somewhat distressing, so I tried to reach out to my friend SS but she didn't respond (and when she did respond the next day we talked about her life, not mine).  So I haven't really spoken about it to anyone.

Today I had an appointment with my surgeon from two weeks ago.  He said everything looked great.  Then he said I had an assignment: to read The Beauty Myth by Naomi Watts, a book that argues that as women have made strides in gaining rights society has devised a new tactic of keeping women from living to their potentials: honoring a very narrow definition of beauty to which all women want to strive, and because women become preoccupied by this concept by buying makeup, getting plastic surgery, and developing eating disorders they can't achieve anything significant.  Then he said that he wished he had brought me a cheeseburger.  Then he left.  (The appointment lasted all of two minutes.)

I left the office on the verge of tears.  It's difficult to articulate why, but I'll give it a shot.  For one thing, I don't believe I look underweight, so hearing that kind of thing from my doctor confuses me and produces a lot of cognitive dissonance.  And the cheeseburger thing-- he made it sound like my life will be solved if I just get fat.  Then he left, never really expressing concern directly, but instead making these covert statements and suggestions.  The appointment was supposed to last for twenty minutes, so he had the opportunity to express genuine concern and offer genuine help.  But he was running an hour behind, which I guess was more important than my life, so I got two minutes of his time and odd doctoring strategy.

I want this thing to kill me.

Shame On Swedish Model Scouts

Now I don't know what to think.

On Friday I posted about... a lot of things, one of which was how not very many people I know have commented on my body, leading me to question whether I actually look unhealthy or not.  It turns out, Friday afternoon I saw my neighbor who said "You've lost weight!"  "Oh, really?"  "Yes, and it's good!  It's good to lose weight!"  And this, readers, is why we need more awareness about eating disorders.  The mixed messages that people suffering from eating disorders get-- no wonder it's so hard for people to recognize they have a problem, decide they want to recover, recover, and maintain recovery.

Speaking of mixed messages, have you heard about this?  Model scouts in Stockholm are literally standing outside the Stockholm Eating Disorders Clinic and recruiting newly discharged patients to become models.  WHAT?!?  It's very hard for me to think of anything more despicable.  People who were just brought back to life from a disease that very well could have killed them (and probably did kill a part of them) take a breath of fresh air and enter back into a world where it is hard enough trying to recover with the mixed messages like the one I got on Friday and are offered money, glamour, admiration, and fame to abandon all of the progress they made and return to killing themselves.

"But NOS," you say, "modeling does not mean having an eating disorder!  There are plenty of models who don't harm their bodies!"  True.  But there are plenty of models who do.  Place anyone who is questioning whether or not recovery is right for them in an environment where people are literally throwing up next to them and see how they do.

I just can't with this.  Eating disorders are not diets gone awry.  They are killers.  I've seen them kill people dead-- teenagers who have no business dying, women and men who definitely had more life to live.  I've seen them kill people spiritually.  I've seen them kill people psychologically.  I've seen them make life so awful for people that they resort to ending it (or trying to end it) themselves.  I've seen these things firsthand.  I myself have experienced some of these things.  When people relapse they don't just lose weight, they lose their lives in more ways than one.

So, to that person who is standing outside of the Stockholm Clinic handing their business card to patients: These people are on the verge of life.  And you are literally handing them a ticket with money and other perks attached, inviting them to die.  How can you live with yourselves?

Seeking Meta-Therapist

On Wednesday afternoon I had a therapy appointment with D.  At the end I jokingly told him that I needed another therapist in order to process the therapy I have with him.  A meta-therapist?  I was only half kidding.

When I stepped in his office, he asked me to tell him about my surgery and recovery experience like I expected he would.  Then he immediately brought up eating like I somewhat expected he would.  I told him that there was basically a day and a half last week where I couldn't eat because of a mixture of pain and required fasting before going under anesthesia, then it took a while for my tummy to be able to handle non-liquid(ish) food (I could eat things like yogurt and pudding and drink calories, but I couldn't handle solid food for a day or so).  I told him that I had probably lost some weight unintentionally during the ordeal, which he said he agreed with.

Then I told him about the bed weighing (see the third to last paragraph of this post for the full story).  I didn't realize until after I wrote that post, but the weight that the (probably inaccurate) bed scale recorded would put me in the "Anorexic BMI" category.

[However, BMI is a very controversial measurement, as it is not an accurate measurement of body type because it does not differentiate between weight from muscle and weight from fat.]

I'm confused.  I know I am not at a healthy weight because I have had experience being at both healthy and unhealthy weights and I definitely appear to fall in the latter category.  But besides D, my mom, and my friend SS no one has said anything or expressed any concern.  No one in my eating disorder therapy group has said anything and none of my coworkers have said anything.  RU hasn't said anything, and always tells me that I have a "sexy body," which is especially confusing because does that mean I'm not underweight or that he finds underweight attractive or is he just trying to make me feel better about myself?  I just don't know.

So D thinks I need to gain weight.  He keeps telling me that it's very hard for "an anorexic" (that's... an odd phrasing) to gain weight outside of a hospital and that a lot of his ED clients are in the hospital because they couldn't do it.  Which, of course, I interpret as "THIS IS A THREAT THAT I AM GOING TO SEND YOU TO THE HOSPITAL AND TAKE AWAY GRADUATE SCHOOL FROM YOU," which makes me even more scared of this whole thing.

Here's a breakdown of some thoughts I had at the end of the session:

• I think I might not be at a healthy weight.
• I think I might not be at not a healthy weight.
• I think I might not look healthy.
• I think I might not not look healthy.
• I need to gain weight.
• I am terrified of gaining weight.
• I'm terrified of not losing weight.
• I'm terrified of going to the hospital because... hospital.
• If I don't gain weight I won't go to grad school.
• If I gain weight I will be fat in grad school and no one will want to be my friend and I will be ashamed.
• My appearance is not troubling to my friends.
• My friends don't care about me.
• My friends might be troubled but are afraid to express concern.
• My friends will notice if I gain weight.
• I will be less liked if I gain weight.
• My boyfriend will notice if I gain weight.
• My boyfriend will love me less if I gain weight.
• I should step on a scale to see what the truth is.
• I should never step on a scale again.
• I have no damn clue what I am thinking.

Which is why I need a meta-therapist.

Not Much Feeling Happening

Today I realized that I haven't been feeling much in the past week.

Today marks the one week anniversary of my (second) trip to the ER, and I'm feeling a lot better, physically.  I have been taking walks outside with my mom and dog ever since the weekend, but last night for the first time since this whole mishegas began I actually "went out."  RU took me to Cosi-- a restaurant that has its menu's nutrition information on the website so I could look up the fat content-- and it was great!  I felt like a real person (although I was not wearing my usual clothing because of the inflated belly), like I have a life.

But then I came home and... nothing.

It's interesting.  Although last week I experienced the most intense physical pain I have ever experienced in my life, I didn't shed a tear until they were wheeling me off to surgery and my parents and boyfriend said "I love you"-- something my parents never say to me.

[It's been about 15 minutes since I wrote that last sentence and I am still staring at my screen unable to come up with a next one.]

RIP Gallbladder 1988-2013

My New Bellybutton

Apologies for not having written in a while but, yes, you guessed it: I had my gallbladder removed.

Do you remember on Monday when I went to the ER because of what they discovered was gallstones?  And do you remember when the doctor told me to go home and wait until I was in excruciating pain and then go to the ER again?  Well, that happened at approximately 2:30pm on Wednesday.

I had actually just finished up commenting on some of your blogs, and I was closing up my computer to prepare to drive to my psychiatrist's (Dr. K's) office for our appointment when suddenly I felt the most pain I have ever felt in my entire life.  The worst pain.  I figured it would go away in a few minutes, but about 2 minutes later it was only getting worse and I was doubled over on the floor, rolling around, trying to find a position where it didn't hurt (there was no such position).  My mom, also a psychiatrist whose office is in the basement of our house, was with a patient so instead of disturbing her I called 911.  The operator told me to grab my meds and unlock the door and wait for help to arrive, which I did.  A minute or two later a police officer showed up and just stood there.  I apologized for looking ridiculous while rolling around on the ground, and he said "Sorry I can't do anything.  But if you die I can defibrillate you back to life."  Thanks.

Finally the medics arrived.  They took my vitals and told me they were taking me to the ER.  Just as they were setting up the chair to take me to the ambulance my mom came rushing upstairs-- her patient had apparently left her office and saw the police car and ambulance and went back inside and told my mom about them.  So instead of taking the ambulance to a very busy, not so great hospital, my mom drove me to her preferred hospital.

By the time we arrived in the ER it was 3pm.  I was triaged and registered immediately, but they were so busy that I wasn't taken into the ER until 5:15pm.  (And actually, I was never taken into a room.  I had a stretcher in the hallway because all the rooms had been filled.)  They gave me morphine at 5:30pm (which was great because it took away the mind-numbing pain I had been experiencing for three hours, but it also made me nauseous and dizzy) and then took me for an ultrasound.  After laying in the hallway for another few hours, a surgical resident came over and said that my options were to have the surgery ASAP, go home and schedule the surgery, or go home and wait until my gallbladder ruptures or gets infected which would then warrant more invasive and dangerous surgery.  So I chose surgery ASAP because there was no way I was going to experience the pain I had felt earlier that day again.

I should probably mention that when my mom took me to the ER, I called my dad and RU and they both came and met us in the ER.  I texted my therapist, D, that I wouldn't be there on Thursday for my session, and he came and visited too, which was nice but uncomfortable.

I finally got a room at 1am on Thursday, and RU ended up staying the night with me.  I had the surgery a little bit before noon.  I was discharged on Thursday night, and I've been home ever since.  I've been mostly immobile, but I've been trying to go on little walks here and there (although I typically don't get very far).  The surgery was laparoscopic, so they pumped tons of air into my belly which makes me look pregnant and feel very uncomfortable.  Also, I have not pooped since Tuesday or Wednesday (I can't remember which), so my abdomen is even more swollen.  I know it isn't "real" weight gain, but it's driving me crazy and I'm having trouble coping with it.  But I don't have much of a choice at this point.

I've been trying to eat enough, but it's just plain difficult when any amount of stomach distention hurts.  To make matters more complicated, I have to be on a "low-fat diet" which, when I asked the nurse what exactly she meant she said, "You can look it up online," which is probably the worst advice anyone has ever given anyone ever.  She elaborated a little and said "No greasy food, no fried food..." which I don't eat anyway (being a vegetarian with an eating disorder), but I've now had to look at all the fat content in my food, which is triggering.  The only thing that I have been unable to eat that I usually eat is peanut butter, but boy do I miss my peanut butter and apple jelly sandwiches.  Luckily this diet is only temporary, but for the time being it's making eating scarier than it usually is.

One final anecdote: When I was taken into my hospital room late Wednesday night (or technically very early Thursday morning) the nurse asked for my weight.  I said I didn't know, but that I could ballpark it at about X lbs.  She said, "Oh, no worries!  Your bed is a scale!" and then proceeded to take my weight from the bed.  I asked her not to tell me, which was a challenge, but she didn't tell me.  Unfortunately, they wrote my weight all over my discharge papers (ALL OVER my discharge papers), but in kilograms.  Now, I know the rough conversion from kilograms to pounds, so I can pretty much estimate what my weight is.  I haven't looked it up online though.  But now thoughts are running through my head: Is the weight she took accurate?  Am I really that weight?  Should I check?  The bed had linens and blankets on it and I was wearing jeans and a gown-- does that mean I'm lighter than what it said?  Did she even write down the right weight?  It's driving me nuts.

So, that has been my week.  I've been feeling incrementally better each day, but I'm still in pain.  They sent me home with oxycodone, so I've taken a few of those, but mostly I've been taking Tylenol and Ibuprofen.  I'm going to try and catch up on your blogs when I get the chance and energy.  I would just like to take this moment to remind you to thank your gallbladder for everything it does for you.  Eat a peanut butter sandwich today.

[By the way, that picture is my bellybutton, where they made the incision, taken on Thursday a few hours after the surgery.  It didn't used to look gross.  But hopefully it will heal nicely.]

Warning: Real Poop Talk

Sorry I haven't written in a few days, but boy do I have a story to tell!

On Sunday I realized that I hadn't pooped since the previous Saturday (eight days before) and started to freak out.  Also, it was very uncomfortable.  So I needed to get rid of whatever was in my body, but I couldn't use a laxative because of my tendency to abuse them.  So I drove to a pharmacy and bought an enema, which I tried to use but was unsuccessful.  Apparently there was so much... blockage... that the fluid wouldn't even go in.  So, although that endeavor was a failure, I did manage to have a small bowel movement later in the day.

Yesterday (Monday) morning I woke up experiencing excruciating pain in my upper right abdomen.  I thought that maybe my attempt at the enema had ruptured something so I was scared.  I asked my mom (a doctor) for advice and she said that if I get up, eat something, and start moving around that the pain would go away.  Didn't happen.

Then at around lunchtime my mom finds me curled up in pain and says "You know this is probably related to your eating disorder.  You're skeletal.  You need to get a handle on it before it finishes you off; and it will finish you off."  Then she told me that I need to gain weight, completely ignoring the acute pain I was in at the moment.  That's when I realized that I was not going to get sympathy from her because she believes I brought this pain on myself.

So I took matters into my own hands.  I called my insurance company to ask which Emergency Department they would cover and then went there.  They had me pee in a cup and take blood, then hooked me up to an IV for fluids.  The doctor came in and asked some questions and felt around, but he was not the friendliest guy in the world.  Nonetheless, he gave me this vile lavender-colored thick fluid to drink to "put my stomach to sleep."  It was disgusting, but it did make the pain less severe.  Then he ordered an ultrasound of my upper right quadrant and an abdominal x-ray for me.

I was at the ER for about 5 hours, and probably 4 of those hours were spent lying down, reading.  But at around 6:15pm the doctor came in and told me that I have a "huge packet of gallstones."  I asked him what causes gallstones and he said "a lousy diet."  He told me that if one days I experience crippling pain, brown urine, vomiting, and bloody vomiting or stool I should go straight to the ER to have surgery to remove my gallbladder.  I asked him what the likelihood of this happening in the near future was, to which he replied, "Pretty good.  You have a nice bag of pearls in there."

So now I'm very scared and ashamed.  I'm scared because I feel like a walking timebomb; any minute my gallbladder could rupture.  I'm also ashamed because gallstones are usually a symptom of over-eating fatty foods, so now I feel like my meal plan is unhealthy and that's scary too.  Now I'm afraid to eat my normal foods because I'm afraid they will either make me fat or will kill me.

I have gallstones, and it is very unfair.  I don't know what is going to happen.