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 🙂 ).

Riding The Scale: The Eating Disorder Roller Coaster

Eating disorders don’t always fit into nice little diagnostic criteria.  There are as many variations of anorexia, bulimia, binge eating disorder/compulsive overeating, and combinations of those as there are people with eating disorders.  The diagnostic criteria give guidelines for when to apply a specific diagnosis, but they are often very limited in their scope.  If someone starts out quite overweight, but loses a significant percentage of that original weight, and has the behavioral characteristics of a ‘pure’ anorexic, they are anorexic for treatment purposes. But, the diagnostic criteria is often limiting, and the person doesn’t get the proper treatment. They are viewed as not ‘sick enough’. I’ve also heard of 78 pound adults who didn’t have ‘enough’ of the behavioral characteristics to qualify for help. It’s crazy.  Restricting bulimics may have generally normal eating patterns between binges, but then starve afterwards or overexercise  and not purge by vomiting or laxatives- and they are misdiagnosed.  It’s about the overall picture, not just the individual behaviors.

From the time I was eleven years old, I was a compulsive eater when I could get to the store on my bike and buy food. My food intake at home was restricted by my mom beginning at age 7 (she didn’t want me to be fat- as she perceived me to be). I was hungry.  So, when I started babysitting (which I did for neighbors at an early age), I’d save my babysitting money to go buy fruit roll ups and a cinnamon roll at the bakery next to the grocery store.  I’d eat the cinnamon roll on the way home, and sneak the rest into my bedroom by cramming the fruit rollups into my socks.  As I got older, and had more babysitting money, I’d get more stuff. I’d also bought a bigger bike with a bag on the back that held more than my socks did.  I was sneaking food before 7th grade.

 

When the imposed food restriction began, at around age 7.... not fat !

When the imposed food restriction began, at around age 7…. not fat !

During high school, I often joined in on diet contests, where I’d lose up to 14 pounds in a couple of weeks, usually ‘winning’.  Between high school and my freshmen year at the University of Illinois, I became anorexic over the summer when I was working at a church camp.  By the time that first semester started at the U of I, I was ‘hooked’.  My life was never the same.  At that time (1981), the ‘Feighner’ criteria was used for diagnosing anorexia, and was based on a percentage of the original weight being lost, along with behavioral characteristics. Then a ‘refusal to maintain minimum weight’ was instituted, so the criteria eliminated people from  for treatment eligibility.  BMI wasn’t around yet, so  specific weight wasn’t required for diagnosis until then.  That made even more people ineligible for help.

Bulimia is generally diagnosed on a person’s self-reporting, or the observations of close friends and relatives- not weight.  Other telltale signs are the calloused fingers/knuckles, eroding teeth, weight fluctuations, presence of laxatives and/or diuretics, and compulsive exercising.  Those can also be seen in anorexics who are of the ‘bingeing’ subtype.  Compulsive overeaters are generally thought to be obese, but that isn’t always the case.  Much depends on the frequency and activity level of the compulsive overeater/binge eater.

These diagnostic criteria are used for insurance purposes- not for any true benefit for the sufferer.  The insurance forms require a code in order for the treating therapist or treatment center to be reimbursed. It’s as simple as that. Money.  It’s not known how many people die from eating disorders that aren’t correctly diagnosed, because the criteria is so narrow and often weight biased.  That seems so hypocritical when the treating staff then tells the patient that it’s not about weight  (which it’s not- but the diagnostic criteria often depends on it).  But money will always win out over what is best for the patient.

I spent years in treatment for anorexia, and after one outpatient treatment center’s rules about no diet soda or food, my weight blew up to 300 pounds. I learned nothing about portion control (their model was to eat when hungry, stop when full; when someone starts out with abnormal eating habits, like having food restricted for them, the hunger/satiety signals don’t work).  Most people who know me from my hometown never saw me like that.  At some point, I lost over 100 pounds from a combination of undiagnosed diabetes, and then a bad relapse into anorexia.  Since I was overweight, I wasn’t diagnosed as anorexic, even though I’d refuse to eat more than 300 calories per day, used laxatives,  and walked like a maniac for miles at a time.  I was sent to treatment, and even though my ‘eating disorder inventory’ was purely anorexic, the treatment center basically lied to insurance and said I was bulimic  in order to get paid (I did use laxatives, but never binged during that time).  I wasn’t ‘thin enough’. But I’d lost 50 pounds in three months, and panicked around food.

I managed to get myself out of that last relapse after that ‘treatment center from hell’ did little but give me access to a good dietician (the only staff member of any use). She did help me start eating somewhat better (nowhere to go but up at that point).  After that, I read every book I could find on eating disorder recovery (professional books), and applied the principles and techniques to myself.  It took years, but I got better.  My weight settled out still in the moderately overweight range, but considering where I’d been, I was about 90-110 pounds below my highest weight.  I could live with myself.

Life went on, and I ended up with gastro-esophageal reflux disease (GERD), which was very uncomfortable before being diagnosed, and I lost about 30 pounds unintentionally. It was ‘good’ weight loss, but it was because of a disease process, and thus ‘abnormal’.  The GERD got treated, and my weight went up a bit, but by that time, I’d gotten used to eating one average meal over the entire day.  That was my new ‘normal’, and while it wasn’t good, it wasn’t based on any eating disorder behaviors. I was even putting a tube from my nose into my stomach every night to supplement with diluted liquid nutritional drinks to get more protein and fluids into my body; I never would have done that during active eating disorder relapses.  My doctor knew what I was doing, and initially she wasn’t that thrilled with it (she also knew I was an RN and knew the safety measures to take, so didn’t ‘ban’ me from doing it- which would been pointless; I was trying to keep from relapsing, and would do whatever I had to in order to avoid another round with anorexia).

I was fairly stable for a while. Then I ended up with leukemia in 2010.  The initial induction chemo caused ‘bad’ weight loss (even though I was technically overweight), and muscle mass loss.  When I got done with that, my eating was still strange, but I gained back the weight I’d lost in the hospital. Then I started arsenic (treatment for the type of leukemia I’ve got; in remission now), and after that, a year of 3 different pills. The chemo caused weight gain; I remember that first week on arsenic when I was in the hospital, and overnight my ring didn’t fit from fluid weight gain. The pills also had weight gain listed as a side effect.  My blood sugars went nuts (I’d been diagnosed as diabetic in 1995), and I was needing MUCH larger doses of insulin to keep from requiring hospitalization for high blood sugars. Insulin causes weight gain.  Chemo ended, and even a year after the last dose, I’m still holding onto the weight even though I’ve tried to lose it.  Calorie counting, high protein, meal planning, etc.  It’s not working.  Oh, and did I mention I’m pre-menopausal?

So, I’m in a position now of needing to lose the weight I gained, but not get triggered back into unhealthy habits from the past.  I’m very limited physically now, so exercising is a major struggle.  Doing laundry hurts.  I haven’t been pain free since 1996 when I was diagnosed with fibromyalgia.  I also have dysautonomia which is made much worse by elevated temperatures (including increased activity- messing with the car battery yesterday had me getting to the point of ‘low’ symptoms; much more of that, and I would have been ‘out’ for the rest of the day). I’ve got several bone spurs on my spine, and degenerative joint disease. My right lung has scars from many, many pulmonary emboli in 2007.    It’s a major problem.  At this point in my life, I’m obese by the numbers, and when I see photos of myself, I see the face of one of those orangutans with the huge ‘chin-neck’.  Physically, losing weight is very important.  I love jewelry (rings and earrings, not so much the other stuff), and want to fit into my rings again.  I want to be healthier.

I just need to be very careful not to end up back in negative territory.  I’ve been up and down the eating disorder roller coaster repeatedly.  I’m not ‘eating disordered’ at this point- the weight had a start point during chemo- not because of overeating. My dad comments that I eat vicariously through the Food Network shows and eat ice (which is NOT how I eat- LOL), but he notices that I’m not overeating, and is a bit bummed that I don’t have better snacks around when he comes over.  Thirty-eight calorie freeze-dried apple chips aren’t his bag 🙂

I’ve been somewhat browbeaten by my oncologist about the weight loss, and I’ve explained my history of eating disorders.  I don’t think he gets it at all.  But I’ve got to protect myself from anything that leads me down that familiar, dangerous path.  I see my regular doctor, and will be seeing an endocrinologist for the crazy blood sugars. Something happened to make those crazy even before I gained the weight during the entirety of the chemo; the added pounds now make insulin work less effectively, so I need more insulin.  It’s a vicious cycle.

I’m doing what I can, emotionally and physically.  I have to focus on health, not numbers.  Medicine likes numbers.  For someone with an eating disorder past, numbers are hell.  They have hooks that snag me back into that dangerous area of seduction.  I have to be vigilant, but still get the job done.  Most of the time, I feel incredibly misunderstood.  Like I’m hanging onto this weight for the heck of it.  I’m not.  😦  I want to feel better, and not like I’m lugging around a 40 pound bag of rock salt everywhere I go.  I want to fit into my older shirts, and not look at my legs and see tree trunks.  I have motivation- to stay healthy, but still get rid of this weight.

I’m tired of explaining that I am actively trying to lose weight to my oncologist. I no longer agree to be weighed there. I won’t discuss it with him; it’s not his job to keep harping at me about it. But he keeps bringing it up, and spends the majority of the appointment talking about how much I need to lose weight.  I’m not stupid.  He’s kept me alive with the chemo for the leukemia; job done.  This has to be done carefully, and with the doctors who can really help me, not just keep telling me I’m fat (not in those words, but it means the same). I KNOW I’m fat.  I’m not blind.  And I’ve got a history that could be repeated if I’m not careful.  That is my job, and I won’t let up in efforts to lose the weight in a healthy manner.  There is nothing that is worth going back into relapse mode.  Once ‘it’ kicks in, it’s not a matter of turning it off when I hit my desired weight.  It’s insidious, and I’m not sure I’d survive another relapse. I’m not a teenager, or in my 20s anymore.  I don’t ‘bounce back’ anymore- stuff just adds up.  I have to go slowly, so I can be around to enjoy being at a more healthy weight.

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…

“Just Make Her Eat”

“Dear God, please just let me wake up in the morning.”  I weakly said that before I’d drift into a fitful sleep every night for weeks as I was deteriorating from a relapse of starving and purging.  I was getting ‘flack’ from co-workers, and even comments by waitresses on the rare occasions I’d agree to go out and ‘eat’.  I’d lost roughly fifty pounds in about three months, and a hundred pounds total over the previous year or so. And I was stuck.  I didn’t see the weight loss as others saw it, but I knew I was in trouble. Yet, the disorder refused to let me say I needed help.  A former co-worker saw me one day and asked “Are you OK? How much weight have you lost?” in the same tone someone uses when asking if someone has a visible affliction; I did have a visible problem- but I was the only one who couldn’t see it clearly.  I had no answer for her. I was confused. How could anyone notice I’d lost weight? (fifty pounds, and I couldn’t figure that out).  That was the beginning of the end of the tight control the denial had. It didn’t leave completely for years…but I had glimpses of reality after that day.

I was working at one of the top alcohol and drug treatment centers in the country, and my co-workers knew when they saw an addictive process. The denial in spite of negative consequences, the inability to change, the refusal to discuss anything logical related to my behaviors…they were all there.  I was dying.  I later asked my physician how much longer she thought I’d last, and she said less than a month.  I’d lost chunks of skin from my heels. I was crawling up my stairs in my townhouse to get to my bedroom.  My hair was thin. I was always freezing. My bones  hurt. My muscles would spasm. I was dizzy. I was in my own self-imposed hell.  A starving brain can’t process logic. I could still justify not eating- and yet, it felt like my choice in any of it was gone.

The relapse into anorexic and bulimic behaviors seemed to  have been triggered by a fast weight loss while I had pneumonia in late November 1995. I’d lost nearly 50 pounds slowly during the  nine months prior to being diagnosed with diabetes. The diabetes had been diagnosed in June 1995, and the weight loss slowed as my blood sugars improved.  In November, that bout with pneumonia kick-started something I thought had been put to rest years earlier. It turned out to be the worst go-round with eating disorders I’d ever had.

I was still very overweight, so actually categorizing me as anorexic didn’t fit the diagnostic criteria, though the behaviors were those of someone who was ‘really’ sick. My weight was my excuse to keep going. In my head, I was fine if I didn’t have bones showing.  More denial.  Had I started at a ‘normal’ weight, I wouldn’t have survived.  When my co-workers did a formal intervention and shipped me to California for treatment from the facility, I knew I was in trouble.  I just didn’t know how to tell them I knew. And I was terrified.  Each relapse gets a tighter grip much more quickly than the previous one.

I was also exhausted. Keeping up the secrets, and avoiding some odd ritual from being discovered took a lot of mental energy I didn’t have.  My thought processes were erratic as far as what I thought was ‘normal’.  When I was in my late teens/early 20s, I counted curds of cottage cheese, and I’d eat three ‘medium’ ones…three curds of cottage cheese. In 1995-early 1996, I thought I was doing so much better since I’d actually have an unknown number of curds on a fork.  I’d eat 1/4 of a potato, and be stunned that at some point in my life I’d actually consumed a whole one.  With toppings. If I had to eat in front of someone, which had become monitored and critiqued (and very unpleasant), I’d take laxatives ahead of the scheduled meal, so it would exit as quickly as possible. I never did throw up.  I guess that’s a big blessing, as it was one less thing to ‘fix’.  As it was, my gut never recovered.

In the early 80s, in the dormitory, I’d pick cheese off of pizza boxes in the trash room after as many people as possible were back ‘home’ and I felt little chance of being discovered.  Since I wasn’t doing that, I must not be so bad, right?  I wasn’t taking 40 laxatives per day like I had back then, ‘just’ 40 per week, so that was pretty good!  How could I really be sick? But how could I keep going?  I hadn’t purchased new jeans, so I had to use something to tie belt loops together so they didn’t fall off. That didn’t knock a knot in my head either.

One co-worker  (I’ll call her “C”) had a daughter who had been anorexic in college, and she watched me like a hawk. She said she’d talked to our boss about me not doing well, and my boss had talked to me.  “C” would bring food back for herself  from the cafeteria when we worked together, and put pieces of it on a plate near where I worked, and then leave it there.  She’d say something to indicate that she was done, and if I wanted anything it was fine, then return to the medication room where she did most of her work. If the pieces were small, and I wasn’t too terrified, I’d pick at what she’d left.  And the war in my head would go on and on about how pathetic it was to ‘give in’ and eat.  I should be stronger than that.  “C” would pick me up  on our off days to go shopping (she tried to get me to try on clothes that fit, but I was terrified that I’d look so much fatter) and usually out to eat… and make comments about how I was going to die, and other blunt statements about what I was doing.  I thought she was exaggerating because of what her daughter did. I wasn’t like that. Right ?  I’d met her- she was a size four if she was bloated… I didn’t look like her.

I’m not exactly sure what hit the fan, but I  got called out after about 3 1/2 months of things going downhill.  I’d worked a double shift (evenings and nights) and decided to sleep for a while on campus, then later do some dictation summaries that I did for the medical director.  “C” often had a room since she came from a couple of counties away, so she told me I could use her room to sleep while she got started on the summaries that she also did.  She came back around lunch time to get something, and told me to walk with her to the cafeteria to at least get something to drink; she knew I wouldn’t eat. She said she had to stop and drop something off at the operations director’s office, so I followed her. When I walked in, I knew what was going on. I don’t remember now who was already there, though I do remember who ended up being there. They had planned an intervention. About ten people were there, telling me I had to get help, and it had all been arranged. They had the plane tickets, and the driver was waiting.  No help meant no job. Someone had already agreed to take care of my dog, and my car would be watched at work. NO excuses.  My landlady had even been contacted about paying rent when I returned (my boss lived in the same complex).  There was an employee of the company’s Houston office that would meet me at the airport there to be sure I got on the connecting flight to Los Angeles. The treatment center in Port Hueneme, CA would have an employee waiting for me on that end.  Details done. Would I go?

Uh, yeah.  Like the choices seemed so plentiful at that point.  In one way I was so relieved. I didn’t have to fight ‘it’ anymore.  On the other hand, I was terrified of eating.  I knew what those places did. They made people eat!  My brain was so confused, but people I trusted and liked were telling me what a great idea it was. And I was exhausted (seriously, I’d had about 3 hours of sleep in a bed that wasn’t mine after working a double on a day I didn’t usually work).  I still remember thinking that if I told them I’d had a 1/2 sandwich on the night shift maybe I could get out of it, but thought maybe that wasn’t such a swell idea after all.  I felt cornered and freed, and fortunately the fatigue urged the words “I’ll go” out of my mouth.  Then the whirlwind started in ernest.  I was immediately put into the van, taken to my apartment (with “C” and the van driver in tow) to pack, and go straight to the San Antonio International Airport. From there to Houston, and then on to LA and ‘the facility”.

I stayed at that facility for 5 weeks and one day (not that I was counting). It was horrible. It was a drug and alcohol treatment center that took eating disorder patients. No actual dedicated unit.  But I knew that telling my co-workers and friends back in Texas that the place sucked wouldn’t come off as anything but the disorder talking, so I dealt with it as much as I could.  I got sick out there, and wasn’t allowed to attend any of the program activities, so they finally cut me loose. They’d sent me to the ER, and it was really something…they diagnosed me with a blood virus after doing a urine test. W.O.W.   I was better. I did eat. But I wasn’t ‘fixed’.  I had to figure that out on my own, through a very rough few years. But I wouldn’t have been able to get to that point if I would have stayed home.  That part of being shipped out there was definitely a positive, but I wasn’t ‘treated’.  I talked to my boss and some of my co-workers (my only friends) when I was in California…my boss would say “Tell them I said ‘just make her eat'”.  There was so much more than that needed to result in any sort of real recovery, but it was a start. Without the nutritional aspect being addressed, anything else was pointless. The dietician at the facility wasn’t nuts, so that helped !

After treatment with my 'before' jeans... 1996.

After treatment with my ‘before’ jeans… 1996.

But I did get something that can’t be appraised- I got another chance. For some reason, God listened.