Intervention and Treatment Memories

I gained a lot of weight during the time I was on chemo for leukemia.  It’s been very hard to get rid of it, as I’m also perimenopausal, and limited physically as far as what activity I can safely do.  Add a history of eating disorders, and the idea of losing weight is actually rather frightening at times.  I guess in some ways that’s good, since I don’t take for granted how bad things got the last time I relapsed in 1995-1996.  It took years to put my life back together so I could eat normally, and longer than that before I could accept my body without being disgusted by it.  My oncologist told me just to be thankful I’m alive (which I am), and don’t focus so much on the weight.   Easier said than done.

The last time I started to relapse coincided with being diagnosed as diabetic, and suddenly having to account for everything that passed by my lips. I lost about 50 pounds over several months prior to, and after being diagnosed (not noticeably abnormal ), and was holding my own without any eating disorder behaviors (purging- laxatives were my vice, restricting, excessive exercise, etc).  I ended up with pneumonia later that year (November 1995), and lost quite a bit of weight in a few days, and the sensation of being ’empty’ and seeing the scale numbers drop was enough to trigger the old eating disorder stuff that started when I was in my late teens and twenties (early 80s).  I’d been free of the anorexic end of things for many, many years.  It didn’t take long for being around food to cause anxiety, and for numbers on the scale, calorie books, and blood sugar meters to drive my entire life.  I lost another 50 pounds in about three months.  Other people noticed.

I worked at a drug and alcohol treatment center as a detox RN (and weekend charge nurse of sorts- if anything was wacky on campus, I had the last word if it was OK or not, though with serious stuff, I had plenty of folks to call for feedback and input) , so my coworkers were very aware of what addictive behavior looked like.  And denial.  And refusal to listen to rational feedback.  I coasted for a bit, but by the time a formal intervention was done, I was in bad shape.  Eating anything was excruciating.  Every night, I was asking God to just let me wake up in the morning.  And I literally crawled up the stairs to and inside my apartment.  Chunks of skin fell off of my heels.  Things weren’t good.

The day of the intervention was on the day after having worked a double shift.  I got off at 7 a.m. and went to rest for a while in one of the cabins my coworker had (she lived a few counties away and stayed on campus when she worked- we worked weekends and Mondays) while she went to do some discharge summaries, which I planned to do as well once I got some rest.  She came and got me at around noon, and asked me to come with her to get something to drink, and also drop off something in the Operations Director’s office.

I never saw it coming.  Inside the Operations Director’s office were my boss, her husband (who also worked there with the clinical staff), the medical director, day charge nurse, and several other people, including clinical staff who I worked with as well. There were 8-10 people there.  When I saw them all in the office, I knew what was going on.  I was terrified, but also wanted to stop fighting the wars in my head over something as ‘stupid’ as food.  It’s never about food, but that was what was going on mentally.  I was told of the plan to take me directly to my apartment to pack (supervised), then driven to the San Antonio International Airport to be put on a plane.  Someone would take care of my dog (that’s a whole different story), and my car could stay on campus where it could be monitored.  I’d fly to Houston, where an outreach employee would meet me, and be sure I got on the flight to Los Angeles.  That was the only way I’d be allowed to come back to work. What I hadn’t told them was that my primary doc had told me that I probably wouldn’t last a month, tops, if I continued as I was.  Their timing was perfect.  I wouldn’t have been ready before then.

So, off to Los Angeles I went.  Scared to death… I knew they made people EAT in eating disorder treatment.   But, I figured the sooner I got with the program, the sooner I’d get out of there.  So, in a feeble way, I’d begun to surrender on the plane.  By the time I got there, I was so exhausted from the double shift, then the intervention, traveling, etc, that the guy who picked me up thought I’d OD’d on something that made me semi-coherent.   I was just flat-out tired, and told him I was there for not eating (I never looked like I was starving as much as I was- curds of cottage cheese were something I worried about).  I was also exhausted from the battle fatigue from what had been going on in my head for months.  I’d been ‘confronted’ a couple of weeks earlier by a former coworker from another place I worked, about my weight (she was dropping off her child for treatment), and she asked if there was anything wrong with me.  I didn’t know how to answer.  It didn’t register that losing fifty pounds would be visible to anyone.  Seriously.  That jarred me a bit, but the intervention had the biggest impact.

I went to the treatment center in California (they no longer ‘do’  eating disorder treatment, thank God), and it was horrible.  The facilities were pleasant, and the food was really good (which amazed me, since I didn’t like much of anything, but all of the fresh produce ALL THE TIME was great) !  A few of the staff were decent, but eating disorder treatment it was not.  And the primary ‘assigned’ therapist I had was bad news… I was not allowed to speak about some things that seemed therapy-worthy to me. The ED patients had a table segregated from other patients in the dining room (and we were often like an exhibit in a zoo for the other patients who wanted to see if we ate), and one OA meeting a week (otherwise we went to AA).  That was the ED program. They may have been great for chemical dependency and/or dual diagnosis, but I was a generic eating disorder NOS (not otherwise specified) patient.  They didn’t get that right either.

When I first got there, I was so weak that when I went on the ‘beach walk’, I could barely make it.  Walking in the sand was exhausting, and I was having a lot of trouble even keeping a visual on the rest of the bunch who opted to do that activity.  My jeans were falling off, so they gave me a trash bag to tie two belt loops together, then trimmed the excess so it didn’t violate the safety rules about plastic bags.

The day before I was sent there, I’d packed up a detox patient to go there for more dual diagnosis issues than we generally dealt with at our facility, and then I showed up as a patient. Surprised her !   We sort of stuck like glue together, trying to make sense of the place.  Then another patient, AND person who worked where I worked showed up… They were both dumbfounded about the detox and treatment  process (so had a lot of questions), but come to find out one hadn’t told them all of the things she’d been taking. I told her she needed to fess up for her own safety.  They’d come to me (their former nurse) before talking to the staff there.  I wasn’t licensed in CA, and I was off the clock out there- but I was glad to be of some support.  We all needed each other out there.

There were a few of us ED patients, and we stuck together between groups, wondering where the ED services in the brochure were.  But, I managed to survive 36 days out there. The last 10 days, I had a virus of some sort, and wasn’t allowed to participate in any groups or meetings (but wasn’t sent home). They’d taken me to an ER, where they had me pee in a cup, and then decided I had a BLOOD virus- from a pee test…  The group would literally come to my room at the end of the session to say hello.  I could go outside and sit in the sun (or smoke), but no activities anyone else was doing. I could go to the dining room with everyone else, so it wasn’t like they were worried about me giving bugs to someone… but whatever.   I had a few roommates, some ED and one alcoholic,  (at different times) who were nice enough.  But I left there feeling totally unprepared for going home and making it OK.  I had no aftercare.  I was more scared leaving than when I got there.  But it was a great motivator to not want to ever end up in another situation like that was.

One really funny thing happened one evening, during my ‘banishment’ from groups, when I was outside  smoking.   One of the techs (fondly called the ‘clipboard jockeys’) came running around the corner asking if I’d seen the REST OF THE PATIENTS.  All of them !  😮  I told him no, and he was sure I must know something, even though I wasn’t allowed in groups. I really didn’t know. Come to find out that the rest of the patients were doing the evening community group, and after the tech checked everybody off of his clipboard, they went to another room to mess with him, and hide.  Eventually, all showed up, and the tech laughed, but I can imagine the thoughts going through his head about how he’d lost the entire lot of patients, except the puny one not allowed to go to groups.   That would have been a serious pile of incident reports and phone calls.

In the meantime I’d been told that I would NOT be allowed back to work where I’d been working at the time of the intervention until the director of nurses OK’d it (she had some serious boundary issues, and was also a neighbor of mine who had been in contact with my therapist in the treatment center- acting like some sort of information verifier.  The treatment center wouldn’t let me talk about being raped until my boss had reported to them that it had actually happened when she found the info and news clippings in my apartment when I was gone). Anyway,   I really liked that job, so that was a huge loss until I showed I was doing well enough to come back.   Eventually, I did get to go back, and stayed another couple of years until things started feeling unsafe with a huge increase in census, and no changes in detox/nursing staffing for several months.    But I’ll always be incredibly thankful that I got to work in that facility.  I learned a lot, and am a better nurse for my experiences there.  I still am in contact with several people I worked with there.

The intervention likely saved my butt, even though I had a lot of work to do ON MY OWN when I got back.  I got every professional book on EDs I could find, and did an ‘as if’ thing.   I looked at what I needed to do ‘as if’ I were carrying out orders for one of my patients.  I had to detach for a while.  Eventually, I was able to make it about me, and feel like I was doing OK. (The one OA meeting/group in town was ‘lead’ by someone who brought specific diets to show to the group- nothing 12-step about it, so I passed).  Whenever I see the show ‘Intervention’ or someone getting nailed on Dr. Phil, it brings back a lot.  Interventions are terrifying, but there was also a huge sense of relief at not having to go it alone any longer.

For those who think it might happen to them, just go with it.  Let everybody talk, and then be thankful that you don’t have to get well by yourself, and it doesn’t have to be perfect.  One step at a time, even if they’re baby steps.  A slip doesn’t have to become a relapse.  It beats being tied to an addiction that wants to kill you !  Things can get better, IF you are willing to let someone nudge you on your way (feels like an emotional sledge hammer, but in retrospect, it’s more of a send-off to the rest of your life 🙂 ).

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Tis The Season…..

….to have all sorts of things churned up.  I don’t really get ”depressed’ over the holiday season, but more a vague sense of being overwhelmed since there are a lot of ‘anniversaries’ around this time.  This year added a new one with the death of my amazing, crazy companion- my miniature schnauzer Mandy, who died on December 27, 2012.

I’m still crying pretty much every day when I think about her, and especially about that last day.  I’m very thankful that that ‘end’ part was pretty fast.  And she was in my arms.  At first, she whimpered enough to alarm me, and from that point until she was actually gone, no more than 15 minutes went by.  After she  peed, and then froze in her tracks, she seemed confused, and not sure what to do, so I just held her and told her how wonderful she’d been.  Her breathing slowly stopped as I held her on my lap.  The ‘new normal’ of not hearing her come running when I mess with the dishwasher or clothes dryer (she had a thing for appliances), of her not leaving the room when I sneeze (or even said the word ‘sneeze’), or escorting me to the door when I got my keys to get the mail.  I didn’t have to say anything; she just knew.  I miss her more than words really can describe.  She was my only companion here in this city, for the past 10 years.  I talk to my dad every day; I saw my dog 24/7- especially since being on disability since April 2004.

Then there is the whole issue of being disabled.  It is somewhat worse in the winter months since everybody has the heat on. I don’t tolerate heat- to the point I shaved my head again (well, I had a professional do it; I wanted to avoid slicing my ears off).  With my ‘normal’ hair (mine is really, really thick), I can’t tolerate the heat it retains. Think dead animal on my scalp.  I also have to see a surgeon this next week about some (more) cysts on my scalp that are painful.  They need to go, so the poor doc has to be able to see my head.  The other issues with disability include being in more pain when it’s cold outside, and my joints just not liking getting in and out of the car.  Sounds wimpy.  Maybe it is.  All I know is that I have to manage it the best I can- so whatever I can get delivered to my door (Schwann’s frozen foods, Walmart for laundry and paper goods, Amazon for miscellaneous stuff, etc), I do.   It’s still very painful just grocery shopping for the dairy/fresh items, but it definitely helps to get stuff delivered when possible.  I’m thankful that those things are available.

Early January is rough for anniversaries.  January 7, 1978 my figure skating coach’s six kids were murdered by her then husband.  I was 14 years old, and it rocked me to the core. I can’t imagine how she has done.  I think about her often, and have always prayed that somehow she’s managed to have a life after that.  January 10, 1987, I was raped and ‘tortured’ (word the newspaper used- don’t want to sound overly dramatic on my own) for 6 hours when the uncle of a baby I took care of regularly lied his way into my apartment… he did things to me I’d never heard of, being very naive…and a virgin.  I’ve never let anybody get close to me since then.  I’d always thought I’d have a family of my own.  That day changed a lot- but I survived.  And I’m thankful for that.

In 1982, the semester that started in late January was a bad one.  I was in the midst of some serious eating disorder stuff, and the depression I only get when I’m starving and purging.  I ended up getting sent to a psych hospital (no eating disorder ‘treatment centers’ back then) for several months.  That was a bad year. I ended up attempting suicide the next semester when I returned to the university.  I was in a coma, and then shipped back to the psych hospital for many more months, once I woke up and was medically cleared.  Things weren’t done in a week to 10 days back then.  I spent about 8 months altogether at Forest Hospital (Des Plaines, IL) in 1982.  They were good to me; I did do better, but the eating disorders were on-again/off-again for decades.

This is the first winter since early 2010 (when I was diagnosed with acute promyelocytic leukemia) that I haven’t been on chemotherapy or waiting for the built up amounts of toxins to leave my body.  I’m still dealing with the weight gain and changes in my blood sugars and insulin doses, as chemo messed that all up.  The diabetes is getting better faster (great endocrinologist with a Joslin Diabetes Center affiliate here in town). I wasn’t on steroids long enough for that to be an issue- it’s ‘just’ the arsenic, tretinoin (ATRA), methotrexate, and M6Mercaptopurine.  They rearranged my chromosomes (literally…. they ‘re-translocated’ the arms of 15 and 17). I guess it will take some time to get my body back to ‘normal’.  I hate the weight.  I’ve had a long history of eating disorders, so can’t just do some crash diet and hope for the best- it could easily trigger a relapse that I just can’t afford.  But I’m going to turn 50 in late 2013; I don’t want to  look like this when I turn 50.  I didn’t want to look like this at all… but it was chemo or die.

And yet, I have a lot to be thankful for. I’m alive- that’s the big one; people with APL sometimes aren’t diagnosed until autopsy (and I know of 2 people just a few months ago who only had one and two days from the time they were told the diagnosis and the time they died; one was 11 years old).  I’ve survived being raped, and other stuff. And, with my health, I am glad to just have a day when I can get the basics done around here.  I’d like to be around people more, and am hoping to get to that Bible Study I’d mentioned in another post; last week (the first meeting of this topic- Ephesians) I wasn’t feeling well- that doesn’t mix well with indoor heat, even with my ice vest.  A childhood friend who I’ve reconnected with on FB came over one Saturday, and helped me with some generalized clutter (result of not being able to unpack after the last time I’d packed to move BACK to Texas), and is coming again- that has been a huge help.  I want to get this place puppy-proofed for the new puppy I hope to get this spring.  That helps, too.  I can’t imagine not having that hope for a new little companion to fill the dog-shaped hole in my heart.

2013 isn’t starting badly… just ‘complicated’ by past and present stuff mixing together.   There is still more good than bad.  I still have a lot of interests, and while I can’t physically do a lot, I do find things to keep me happy and make me laugh, especially online.  Blogging has been a great way to blow off steam, and some days that makes  a big difference.  🙂

The Designated Nut At Age Eighteen

As a result of anorexia and the depression I only experienced during periods of starvation, the university I was attending decided I wasn’t safe staying on campus. I was to be sent to a psychiatric hospital near Chicago.  It no longer exists, but my memories sure do.

It was February 1982, and I was falling apart.  The eating disorder and coinciding mood swings were making university life and class attendance nearly impossible.  I was horrified that I couldn’t just make it work.  I had some suicidal thoughts, and the means to carry them out , as I’d discussed with the therapist I’d been seeing as a condition of staying at the University of Illinois (they found out about the anorexia very early in the first semester in the fall of 1981). She didn’t want to take any chances.  I’m sure that the fact that I was talking more had to be somewhat alarming, since I’d said little besides “I don’t know” to anything she’d asked since first meeting me in September of 1981.  I didn’t have much choice- either voluntarily admit myself to a psychiatric hospital, or be committed.  I was horrified and ashamed, which wasn’t helping anything.   I agreed to go to the hospital near Chicago, but only if my parents were NOT the ones who drove me there.  Arrangements were to be made, but in the meantime, I was taken to the university health center and kept for observation.  Nifty way of saying they didn’t trust me, and weren’t sure I wasn’t going to kill myself.  The therapist had the university fire department drive me over there.  Subtle.

I didn’t really want to die. I just wanted the pain to stop and I hadn’t found any way to make that happen.  I was 18 years old, and didn’t have the life skills to know that the bad times don’t last forever, and the eating disorder that made most anything ‘logical’ impossible was driving a lot of my thinking.  So I was to stay at the inpatient clinic until the plans were arranged.  I’d asked for a specific family friend to drive the 200 miles to come and get me, and then take  me the 170 miles or so to the hospital.  That’s a lot to ask, but she agreed.  Then it got complicated.

In February 1982, central Illinois got hit with a blizzard, and the arrangements to pick me up had to be postponed until the roads were cleared, and it was safe to travel.  If I remember right, it took about 3-4 days.  During that time, my dorm friends came to say goodbye.  It was sort of surreal.  My brain was so starved that not much really sank in.  I knew what was happening, but at the same time,  I had no idea about what  type of place I was going to be admitted .   The only type of psych hospitals I’d seen were those on TV, and the accuracy of those was questionable.  Finally, the weather cleared enough for me to be picked up by my friend and her daughter (who I also know and like- I still know them), and I was taken to the hospital.

I was mortified to see my parents in the lobby. I was so ashamed that I’d failed to just pull it together. They had to be there to sign the insurance forms and admissions papers for billing, but I also had to sign myself in since I was ‘of age’.  I was the youngest person on the adult unit.  And in for a real education.

My psychiatrist (assigned at random) ‘banned’ my parents from contacting me for at least a month. He let them know if I was doing OK.  He wanted to get to know me, and find out why I didn’t want them to pick me up in Urbana (shame). He also wanted me to learn to let loose a little bit; I was too restrained and worried about what other people thought.  He asked my folks to send $100 (worth a lot more in 1982 than it is now- though still a nice chunk of change) so I could go to K-Mart and get some overalls (something my mom refused to let me wear) and have some fun shopping with one of the psych techs who monitored us nuts on the unit.  My mom never let me go to K-Mart (it hadn’t spiffed itself up at that point; afterwards, she didn’t mind it).  I was to be dressed in name brand clothing (preferably stuff that made The Preppy Handbook… I’m not kidding). Marshall Field’s & Co. was HER preferred place to get my clothes. I hated that store when I was growing up.  Too much foo foo.

I was the designated ‘nut’ in the family, but no member of any family gets to the point of needing psychiatric hospitalization for eating disorders (or anything else) in a vacuum. In the early 80s, eating disorder treatment was in its infancy.  Nearly all ED patients were put on general psych wards, and the stigma went with that.  I didn’t find out how bad that stigma was until much later when I found out that my folks never told anybody where I was.  I just ‘wasn’t’ at the U of I.  Enter a void in time and place regarding my existence. My mom’s ‘baby’ brother came to see me, so he’d found out.  I’m still not sure how.  It doesn’t mean that my immediate family was some raging psycho farm, but something wasn’t OK.  Sometimes it’s perceived, and sometimes it’s actual dysfunction- but the end result is actual dysfunction for somebody. When I got older and worked as an RN in a psych hospital with adolescents, I saw it all the time.  The family needed someone to direct their troubles at.  The kids are easy targets- and often are acting out in some way because of the dysfunction.

My mom was not a warm type of mom.  Even the social worker caught on to that during the one  interview with my folks.  My mom wasn’t ‘evil’ or ‘bad’-she just had her own stuff.  She and my dad had both lost newborn sons about two years apart from the same disease, before they were 25 and 29 years old (roughly).  That’s pretty young to deal with such loss. Dad turned to work, and mom just shut down.  Now, they’d be offered counseling without that being seen as ‘weak’ or ‘defective’ (as therapy often was up until, and through, my treatment for anorexia).  It just wasn’t done by ‘normal’ families.  So a lot of hurting people were stuck in their pain, alone.  My mom wasn’t in a place to be nurturing a baby when she was terrified something would happen to me, and she stayed at a distance to protect herself. It wasn’t about me.  She was in pain.

Anyway, I was at the hospital for about 3 1/2 months that first admission.  I did better, but eating disorder treatment didn’t address the core issues of self-worthlessness and overall loathing of taking up space on the planet.  That wasn’t about dying either.  It was about feeling like  I just shouldn’t ‘be’.  It took many years to get to the core reasons I was so self-destructive via the eating disorders.  It made me the designated family crackpot.  That seemed handy, and it was a big secret to anybody outside of our home and very close family; I’m still not sure most of them ‘know’.  I’m not proud of it, but keeping things secret just perpetuates disorder.   NO family gets through this life without something dysfunctional going on.   Everybody has stuff.  It hurts less when it doesn’t seem to be so shameful.

Diabetes After Chemo

I woke up this morning with a blood sugar of 205mg/dl.  Very NOT OK.  Before chemo it was between 65-85 mg/dl nearly every day, and rarely over 100 mg/dl (where it’s still tolerable).  After getting off of all chemo, it’s been around 140; sometimes lower.  I don’t know what’s going on this morning.

Ever since being on chemo, my blood sugar control has been totally nuts. There has been no control, but oddly, my A1C in February was 6.7, or around there. I was amazed. I expected it to be over 7 for sure. Usually it’s well below 6.  I’ve had great control, with a fair amount of effort.  My body is still figuring out it’s new normal since the leukemia.  The blood sugars (and need for more insulin) don’t help the weight loss issue.  Insulin stores fat. I need to lose the forty pounds I gained while on chemo.

I have to admit, my carb counting has been ‘fair’.  I know the carb counts of most things, and do look at labels, but I’m not doing the extensive counting that I did before. I need to get back to doing that.   I don’t want to go blind, lose a leg, or have kidney failure.  Nope.  Don’t want those on top of what’s already wrong with me; I’d end up in assisted living before I’m 50 years old.

I took the usual amount of NovoLog insulin this morning, and added a bit because of the psycho fasting blood sugar.  Now (2 hours later), my blood sugar is 135mg/dl.  I’m glad it’s going down, but not sure I’d planned for it to drop that fast.  It still needs to get considerably lower before it’s a problem.  I’ll be sticking my fingers a lot today.  It’s sort of a ‘sick day’, except I can’t figure out what is ‘sick’…

Chemo changed a lot of what had been controlled: my weight, my blood sugars, and my insulin dose.  I’ve been off of chemo for nearly a year (11 months).  I’m going to have to go back to the rigid counting and figure out the new insulin:carb ratios.  My I:C ratios had been so steady before.   It’s been nearly 2 1/2 years since the initial diagnosis.  I have to remember my ‘old normal’ way of dealing with the diabetes, and apply it again to this ‘new normal’… which isn’t normal at all.  It’s a lot like starting from square one.

My physical situation is such that sitting exercises are all I can do.  If I walk more than the distances inside my apartment, I have to use a walker. Or shopping cart.  My balance gets iffy. So exercising is a problem.  I’d love to walk around the neighborhood on cooler days.   That IS my ‘old normal’ and ‘usual decrepit’ – LOL.  That is back to ‘normal’, which hasn’t been ‘normal’ for a long time.  I’d torn my left ACL and meniscus (mildly) the summer before the leukemia diagnosis, and because of beginning to feel lousy (thinking I was just being a slug) I postponed the knee replacement that was recommended.  When those big ball players roll around whimpering or screaming on the field after their knees go out, they aren’t being weenies- that HURTS. I’d been using a walker in my apartment up until the morning I was admitted to the hospital when I was diagnosed with leukemia.  Being physically limited is nothing new.  Anyway, I’d like to exercise more, but it isn’t generally safe.

So, I’ve got to buckle down and get these blood sugars under control.   I’ve got to lose weight. And I’ve got to get it done without triggering old eating disorder habits.  Sometimes it seems overwhelming.  Sigh.  But I’ve got to do something.

Starving At 35,000 Feet

I’d been put on a plane in San Antonio en route to Los Angeles, via Houston (ascend x 2 and descend x 2…no direct flight).  I don’t like to fly, and had taken a Benadryl to get me past the jitters. I’d flown many times with no problems, aside from that time coming back from Hawaii when the plane dropped a few thousand feet and blew out windows in buildings below- but I was 9 years old, and clueless. Otherwise, I’d never had any mayhem with flights other than delays. I was already in bad shape physically, and every time the pressure changed in the plane, it felt like the plane was nosediving. Nice. Just great.  I was already ambivalent about going to eating disorder treatment, and now the plane was going to crash.  It had been a great day all around. Oy… someone just shoot me now, but please pick out a slenderizing casket.

While I knew I needed help, I was scared to death.  Looking back at the photo taken on admission to the treatment center, I looked like I’d already died, but hadn’t had the sense to go lie down.  I was very pale, and my eyes were barely open (though I remember I’d tried to look perky. Fail. ).  Now I was on a plane, alone, and thinking I’d made a huge mistake. I’d been given an ultimatum at a formal intervention: no help means no job.  Maybe I should just figure out a way to get back home, and get a different job. I was a registered nurse; it took about 12 minutes to get a job on a bad day where I lived.  But, maybe I should get some help. I knew I was falling apart.  I’d been diagnosed with anorexia in my late teens ( the criteria used at the time based it on many things including a percentage of weight lost from original weight- which I prefer, as waiting until someone is skeletal delays help for a lot of people who are still clinically very ill, but not skinny ‘enough’; they die anyway).  I was still overweight, but had lost around one hundred pounds in about a year and a half; fifty of that in the previous three months.  I was confused. But I knew deep down that I was in trouble.  I was still scared.

In between the episodes of thinking the plane was going down, I tried to keep calm.  Since I was half dead anyway, that wasn’t really that hard, but I was still in a minor panic.  I knew that any eating disorder treatment included eating…big bummer.  I was 32 years old.  I’d been in some sort of eating disorder treatment on and off for 14 years.  I’d had some sort of eating abnormalities from the time I was six years old, and had food restricted unnecessarily. That led to hoarding food in my room that I’d get with babysitting money, because I was hungry.  I wasn’t a fat kid. I was told I needed to lose weight by my mom all the time. Looking back at old photos, there was nothing wrong with my weight.

I knew how this treatment stuff worked, and while strapped to that doomed airplane seat, I decided I had to eat in order to get home if I didn’t die in a fireball when the plane crashed. That’s how it works.  Once I got home, I could do what I wanted to do, but in the meantime, I had no way to get home (no cash for another ticket). I knew that the plan wasn’t for me to do a round trip in one day, and not get help.  I was stuck.

The ‘nosediving’ feeling happened about every 20 minutes or so, from what I recall.  It was often enough to be disturbing.  Nobody around me seemed to be writing out their last wills and testaments, sooooo….. it must be me. That helped a little bit. My blood pressure was probably sub-viable, so that didn’t help, and the Benadryl would have made that worse, but there was no way I was getting on a plane to have my life turned upside-down without something to chill me out.  I was a mess.  I’d also come off of working a 16-hour double shift with only about 3 hours of sleep since the morning before.  I was exhausted, mentally and physically.

But, I knew that when I got to that treatment center (where I’d sent a patient from the facility I worked at just 24 hours earlier- great, I’d be seeing one of my patients…. more joy…) I’d have to eat. When the perky flight attendant started handing out box lunches, I panicked (per usual), and then looked into the box.  There was a sandwich (OK- maybe I could pick that apart), some chips (not a snowball’s chance in a volcano for those), and a mini Snicker’s bar (I wanted that SO badly…but that was a really ‘bad’ food).  *sigh*  I had to make an effort.

The sandwich seemed the least horrifying. It didn’t have any sloppy dressings or spreads on it, and it was easy enough to peel off the cheese. That little packet of mayonnaise could go spread itself; no way I was eating that.  But I didn’t want to appear totally deranged to the complete strangers I’d never see again, so I left the thing intact. I figured out the calorie and fat content, and figured that in the past 36 hours, I’d had little more than that, so may survive it.  And, I told myself just to try acting normal for one stupid sandwich…pretty soon, I’d have someone setting a tray of stuff in front of me, and I’d be expected to finish it. Gotta get my teeth wet, and just do it.  So, I took a bite.  That was already kinda gross, since I didn’t like food touching my lips- it felt weird, and I preferred to extract things with my teeth from a fork. No utensils in sight, so I had to buck up and just get on with it.

Now, ‘normal’ people will think this is all completely nuts. (So did my co-workers, and that’s why I was fighting with a sandwich 5+ miles above the earth’s surface).  To someone with an eating disorder, I was making huge steps even before I  had to !  Nobody on that plane cared if I ate the sandwich, chips, or even the box (well, OK- maybe gnawing on thin cardboard would have drawn some stares).  It was just me and the sandwich.  And, the beginning of getting better.

My brain had been living on fumes for months, and it showed to those around me. In hindsight, I can see where I was really bonkers when it came to food.  I could still do my job, and pay the bills, but in regards to food, I was more than a little goofy.  ‘Fumes’ don’t make someone all that insightful. ‘Fumes’ make nutty stuff sound reasonable.  ‘Fumes’ keep the disordered thinking going strong, and any glimpses of reality really hard to grasp.  I knew I’d have to eat.  In some way, I think I felt some sense of control in taking those first few bites of ‘random’ food on my own with nobody breathing down my neck, or checking to see what I’d eaten.  I needed to get my head in the game of getting better.  At least I still had that much clicking in my noggin.

It probably took about 45 minutes to eat that 4 inch sandwich (on some sort of sub-roll). Bite-chew-gag-swallow-repeat.   It wasn’t anything I would have picked out by a long shot, but I got through it and it didn’t kill me. It was the first ‘whole’ anything I’d eaten for weeks, especially without my trusty laxatives to zip it on through my guts.

The plane also didn’t go down in flames.  Life went on.  I ate the little Snickers…