After spilling my (rearranged) guts at the intake interview and leaving feeling like they wouldn't take me, like I was "too crazy" for just an ED program, the director called to let me know that my insurance had approved without any hassle and that my carrier mandated that I start within two days of approval. Yikes! At this point, I was freaking out and trying to back pedal. "Oh, it's not that bad. I'm totally overreacting and exaggerating. I don't have a "real" problem." Um...yeah right.
They had me start in a "partial hospitalization" outpatient program that ran from 8:00 am to 2:00 pm. It was a real stretch to be away from my daughter for that amount of time, not to mention the stress it put on us as a family in terms of running around, juggling schedules, childcare, etc. Plus, it seemed to be mostly patients who needed the structure and intense supervision to be able to eat real regular meals, whereas I had the opposite problem. I needed supervision to keep me from eating, lol.
But, as I spent a few more days in the program, I began to realize just how disordered my eating and thinking really are. I say "are" because I am in no way "cured". I am in a much, much better place than I was before treatment, but I still have such a long way to go. I slip up. I slip up too often. I had a really bad "slip up" on Friday and I felt horrible, but I reminded myself that it's OK, that it's not the end of the world. A few weeks ago, I found the most amazing quote in a fortune cookie and had to tape it to my refrigerator to use as a personal mantra:
One. Day. At. A. Time. It's all I can do. I have to remind myself of this over and over...and over and over.
Even though I wasn't the sort of patient they typically saw, they were absolutely wonderful and worked around my dietary needs, scheduling needs, and emotional needs to figure out what would be the best fit for me. We finally decided that their intensive outpatient night program would be the best place for me. I came to enjoy it and look forward to my nights there, with people who "got it". While they may not have been able to relate to the issues that bypass presents, we were joined by the feelings, the underlying issues, the negative beliefs, the lack of self-esteem, the self-hatred, the never-ending barrage of the ED voice. Because when you really break it down, no matter the eating disorder diagnosis, aren't we're all the same at heart? Broken-hearted, sad, desperate, shamed, angry, scared...
I'll delve deeper into the nitty gritty of my time in treatment as we go along and I'll share a lot of what we worked on in group, as well as the some of the more private writing I've done over the past few months. There will be positive, but there will be a lot of negative, too. I'm tired of sugar-coating and pretending to be OK. I've done it for so long that I'm not sure if I even know the "real me". Admitting that I needed help to battle my ED is but one piece of the puzzle, yet it's one that has really made me so much more self-aware and I know that this realization is going to be key to my long-term success after bypass. I want to keep this weight off so desperately. I cannot go back to where I was. The fear of failure is a strong driving force, both in terms of recovery and staying healthy and also in favor of retaining the ED behaviors. I go back and forth between needing to be rid of my ED and desperately trying to hold on to my habits for fear of regaining any weight. Such a double-edged sword, but that's definitely a topic that deserves its own post.
I "knew" I needed help roughly 15 years ago, but knowing and doing something with that knowledge in an active way are two completely different things.
My daughter has a progressive neurometabolic disease and we had decided to begin counseling to help her deal with all she goes through. During the intake interview, the psychologist asked me how I was doing. Hmm...how was I doing? That was something I had to really ponder. Honestly, until I had gastric bypass in November 2011, I had pretty much given up on myself completely: my health, my mental health, my sense of self, my goals and dreams, my body, my weight. I guess it was pretty obvious that I was far from OK after discussing a bit of both my history and my current dysfunction, lol. I wasn't seeing anyone for therapy at the time, so she had me schedule an intake for myself. I will admit that I have many, many things I could/should work on, but we don't have time to list all my neuroses/diagnoses/etc. right now. That list will take a long time to explore, but we'll get there.
I've dealt with severe depression and anxiety all my life and currently have a diagnosis of "mood disorder NOS" while they attempt to rule out bipolar. In the course of a few meetings with the new therapist, I had revealed my long struggle with ED and it made me infinitely more aware of just what I was doing to myself and how badly I could damage not only my newly rearranged anatomy, but everything else, too. I was absolutely terrified that I was doing irreparable harm inside: stretching the pouch that was my new stomach, causing ulcers, weakening the lines of staples in my "old" stomach, weakening the sites where my intestines were rerouted and joined back together. I had vivid visions of internal bleeding, emergency surgery, and not being able to care for my daughter. But, I couldn't stop the bingeing or the purging. Stress relief, but in a horribly self-destructive form.
The therapist had me start journaling daily, basically just reflecting on the day and my feelings. Being open and honest and actually facing everything I had pushed down and used food to keep down was incredibly difficult and emotionally exhausting. I really started to feel like I was hitting the bottom, but it felt good...in a way. I knew that it was time to actually do something and opening up (again) in therapy was the catalyst I needed to force me into action. I had an appointment set with a doctor in my surgeon's office for a check-in the next week and I decided to go in and just be brutally honest.
So, I did it.
It was nerve-wracking and embarrassing. I was mortified, but I just went in and told the truth. What a novel concept, huh? I was sure that they were going to be disappointed, even mad at me. I felt like a little kid in trouble. Adding insult to injury, she even had an intern with her that day and I know he got way more than he had planned out of that patient visit.
To my surprise, she wasn't mad. She was amazed that I was brave enough to admit what was going on and actually ask for help. I can assure you that "brave" was not an adjective that I would use to describe my feelings in any way that day. She had a powwow with my therapist and they found a treatment program close to my home that focused on ED in all its ugly forms: anorexia, bulimia, bulimarexia, binge eating, EDNOS, night eating syndrome, bigorexia (muscle dysmorphia/"reverse anorexia"), etc.
Because my life is one never-ending extenuating circumstance, it wasn't feasible for me to do any sort of inpatient program and I didn't feel that that was what I truly needed. I was worried that when I had the intake interview with the program's director that she would think I was "too crazy" for outpatient and would try to admit me. I was really afraid that someone would think I was somehow "unfit" to care for my daughter. But again, like my doctor, she didn't judge me or make me feel bad. I was more honest than I had probably ever been in my life and I'm so, so glad that I was. I needed this opportunity. Desperately.
Tune in next time to see where I ended up and the treatment plan we formed.
