Just Keep Swimming.... (Part III in a Series)

"Very slowly and carefully, you let go of the log and practice floating. When you start to sink, you grab back on. Then you let go of the log and practice treading water, and when you get tired, hold on once again. After awhile, you practice swimming around the log once, twice, ten times, twenty times, a hundred times, until you gain the strength and confidence you need to swim to shore. Only then do you completely let go of the log."-From Eating in the Light of the Moon by Anita Johnson

This is the third in a three-part series of "A Day in the Life".  You can read Part I, which depicts a day in the life when my Eating Disorder was at its worst HERE  and Part II as things got better and when I was admitted to  Mercy Hospital's New England Eating Disorders Program for the second time in 7 months HERE.

In this last part, I wish to illustrate what a day in my life is like now, 9 months into my recovery journey, which included 2 ICU hospitalizations and 2 additional  Emergency room visits.

Recovery isn't a place.  It isn't a destination where I will arrive, unpack my bags and announce, "I'm here!".

Or, maybe it will be.

That's the trouble with recovery.  It is difficult to define and therefore quantify as each of our experiences, while etiologically similar, have varying manifestations of behavioral idiosyncrasies.

Recovery is messy.  It isn't linear or predictable.

There isn't a specific medical definition or even a "recipe for success" that professionals agree upon except interrupting the starvation cycle, stabilizing medical issues, and normalizing eating.  That is precisely what (most) treatment programs do, period.

It is the focus of treatment because it is medically proven that recovery cannot happen until nutrition (and therefore, proper brain functioning) is restored.

And that is where most insurance companies declare an Anorexia patient, "cured" (and where they stop paying for treatment).

If you have had an eating disorder or care about someone who does, you know that discharge from the treatment facility is where recovery actually begins.

So, we get discharged to do the long and difficult work of recovery, with very little professional support, back into the environments where our eating disorders thrived.  And if you do not have a strong support system, who understands the nature of and warning signs for relapse (this is most of us, because our support people are almost universally left out of the treatment process) its little wonder that the statistics for full recovery are so grim.

Anorexia is a disease.  People with diseases are not told things like,  "find the motivation to heal"  or, "choose recovery over your illness".  Imagine if that was our new course of treatment for people diagnosed with Diabetes instead of insulin and medical monitoring.

Remember, it wasn't that long ago that the Medical Community espoused that the cause of Autism was "Refrigerator Mothers".

Now you see maybe why it is true that people diagnosed with Anorexia have the  highest mortality rates of any psychological disorder, due in part to medical complications such as brain shrinkage and heart attacks.  

But there is something even more sinister at play.

Studies cited by the American Association of Suicidology (Holm-Denoma et al, 2008; Kaye, 2008; Keel et al., 2003) indicate that the suicide mortality rate of people with anorexia is one of the highest of all psychiatric illnesses including Depression.   It was noted in this same series of studies that people with Anorexia who are at the point of attempting suicide are not simply crying out for help.  They use the most lethal methods to seal the deal.

They jump in front of moving trains.

They injest toxic chemicals (and large amounts of prescription medications).

They just want the noise to stop.

All of that said, (and this may sound contradictory) there is an important component of recovery that is up to the individual.

Dr. Sarah Ravin calls it, "Insight".  

She puts forth that when one has the physical components of recovery in place (weight restoration and medical stability), it is then the work of the individual to recognize and subscribe to the factors that will keep recovery moving forward, and eventually, make it a reality:

1.) Acknowledging and accepting that you have (or had) an eating disorder, which is a biologically-based brain illness that you did not choose to have and your parents (or partners ) did not cause

2.) Acknowledging and accepting the possibility of relapse

3.) Ability to recognize eating disordered thoughts, feelings, and behaviors in yourself

4.) Understanding the necessity of maintaining full nutrition, every day, for life

5.) Accepting the necessity of maintaining your ideal body weight in order to reduce the risk of relapse

These are my five commandments.  I live by them because I know that in order to continue enjoying a life free of Olivia's nonsense, I have to move away from the log (Olivia)...swim out further each day...until I can let go of it completely, and swim to shore (life).  

Let me share with you then.  A day in MY life of recovery: (Beginning with last night, July 7, 2015)

8:30PM~ Sit down to a delicious dinner made by my oldest daughter, along with my youngest daughter and one of her friends.  (Sweet potato "Nachos" made with Sweets and Beets chips, chicken sautéed in Siracha and BBQ Sauce, peppers and onions, covered with cheese and baked in the oven with a side of home-made guacamole.  I had seconds.  We laughed genuine laughter, enjoyed each others' company and I did not notice any thoughts of restricting or purging.

9:00PM-11:00PM~ Get out the checkbook I have been needing to balance because my computer crashed last week with all of my savings data wiped out.  Gone.  

Oh, and right before that happened, all the cash I had left in my wallet for groceries and gas was stolen while I was at work.

If you know me, you know what kind of stress this causes a perfectionist, meticulous budgeter, who is living on the tightest budget I ever have.  

Olivia would usually convince me in this situation, that tonight is not a good night to attempt this because of the stress caused by the computer crash and the theft.  "You deserve some wine... you have been abstaining for weeks now.  Go ahead and have some so you can sleep tonight.  Hanford is open until 10PM now"

Tonight though, I notice that she is still quiet.  

I work through the bills and the budget, $42 short of what I needed to cover, due to my recent hospitalizations and lack of income during that time. 

Olivia is still quiet.  

Or, I can't hear her.  

Or maybe I choose not to hear her.

Louder than Olivia is my determination to get through this rough financial patch without loans or having to dip too much into my savings.  And free of eating-disorder coping behaviors.

Louder than Olivia is my commitment to being the best mother I can be to my girls, who are sitting close by, trusting my ability to take care of them.  

And because I have eaten enough calories to both sustain my weight in a healthy range and for brain function, I am able to handle these small stresses that each alone, would have tipped me over at my sickest.  

11:30PM~Get into bed and work a crossword puzzle to help clear my head of distracting thoughts and worries of my future, to keep me grounded in the present, so I can sleep easily.

11:45-4:45AM~Sleep soundly, only to be awakened by my intentionally-set alarm, to meet my running partners for the first time since last Friday, to do a cardio run.  

No push-ups.  

Eat a banana while I am waiting (with coffee of course....I'm not perfect!)

Check my phone and in spite of some occasional sadness that it reminds me of in the morning, place it down and lace up my shoes to wait, wondering how late my friend will be this morning (Hi Erin!)

                                               <A Short Moment to Celebrate a Small Victory>
Today is now Wednesday, July 8th.  It is a special day in my recovery journey.  It marks the longest time  since I began recovery in November, that I have gone without both an incident requiring medical intervention and COMPLETELY FREE of all eating disorder behaviors, including abstaining from alcohol.  

 You see, after my first round of hospitalization at Mercy, I didn't understand that I needed to, nor did I want to (subconsciously) let go of ALL of the disease.  I was still coping. I wasn't recovering.  

I needed Olivia.

I wanted to keep exercising and did so without asking anyone's thoughts or opinions about it.  I got a job that has many possible triggers that I had to face on a daily basis, without asking anyone's thoughts or opinions about it.  I slowly re-introduced alcohol back into my life, even though my body weight was going down and I knew I was restricting.  I left the loop-holes open that gave Olivia just enough of a foot-hold to take me down...again...and again... and again... until I finally hit a bottom that was lower than I ever dreamed I was capable of.

This time, I have closed the loop holes.  I hardly make a move without confiding with my therapist and/or friends who know me and have been with me through all of the ugliness this disease has caused in my life.  Some of them took the brunt of it.  And they are still here, walking beside me.   Now I reach out to them and not Olivia.  She can't help me.  

So, the reason why today is significant and that it is possible, is because I have the most number of solid days of true and actual healing of my body/mind/soul than I have ever managed since beginning treatment.  And THAT is what makes it possible to wake up tomorrow, in spite of the trials I have had over these last few months, and choose recovery again.  

I swim further from the log each day...

                                                     <gratuitous back-patting over now>

6:30AM~ Return home from our run, make a recovery shake with a powder containing 500 calories all by itself, that I add almond milk, frozen berries and a banana to, and drink it while I get ready for work.  This replaces the calories I burned in our run.  The point is for me NOT to exercise to lose weight, but to have fun and be strong.  

Olivia wants me to skip it.  She berates me for even adding to it.  

My healthy self remembers how good it feels to work out the next day when I have had enough calories to avoid Negative Energy Balance.  I drink it and imagine the cells in my body, which I have deprived for so long, repairing and getting stronger.  Rewarding me with strength, and endurance, and my dignity re-emerging. 

7:30AM~ Because I have to be in court, I eat breakfast at home so there is no excuse to mess with the timing or skip it all together, blaming it on the court schedule.  (Two poached eggs over two slices of Canadian Bacon, on top of an english muffin, topped with melted cheese and a fresh fruit cup with strawberries, blueberries and cantaloupe on the side).  

9:30AM~(So far, Olivia is fairly quiet... but I  know that she has been turning up the heat over the past few days because of the significance of today to me.   I expect her to get loud at some point today.)  

I eat my mid-morning snack at my desk because court is over.  (white chocolate macadamia nut Cliff Bar and another banana).

11:30AM~

Enter Olivia

I planned to go to the cafe across the street to get a sandwich (major fear food!) because I didn't have anything at home that appealed to me this morning to pack for lunch.  While backing out of my parking space, I heard that sound every auto insurance agent dreams of.  

My car is the Element with the fender folded
over.

Of all of the things over the past couple of weeks that could have upset me to the point of that familiar panic attack where I find it difficult to breathe and then cry with emotion, a fender-bender with Willy Nelson (my car's name....don't ask...) brings it on.  Usually, when that feeling would come over me, I would want to make it stop.  As soon as possible.  

Olivia didn't disappoint.  

"Skip lunch.  You will feel better, it will stop this terrible anxiety about the bills you are going to have to pay.  You will be able to think better and feel less stressed about this if you just skip lunch."

Sitting at my desk, breathing like I learned how to and that is becoming my first reaction to stress now as I get more traction in the process, I  shout (out loud), "shut the FUCK up!".  

(It's a good thing I was working alone today).

I kept breathing.  I stayed present and I waited as the anxiety first climbed to its crescendo, then felt the newly-familiar release of its grip on me, as I continued to breathe, and it faded as quickly as it came.  

I went back outside, talked with the owner of the vehicle I hit, and we sorted it out amicably.  

When we were finished, I went back inside my office to take a moment to try and understand what triggered the flood of emotion over vehicle damage, of all things.  What I realized, was the sadness stemmed from the grief of not having my partner anymore to call for support in that moment.  To lean on and ultimately, give me advice or take over the problem for me.

I acknowledged the thought without judgement, and let it pass for what it was.  

Then, I used another skill learned in treatment which is essentially an antidote thought.  Replace the thought that caused me grief with a thought that is closely opposite.

So, I thought to myself,  "I am alone now because I am healing and it is necessary to my process.  Because I was alone today, I handled this situation without self-destructive actions or letting someone else fix things for me.  I am capable.  I am lovable.  And I when I am whole again, I won't always be alone. " 

It probably sounds hoakey to those of you who do this with ease.  It would have to me 6 years ago.  But this process allows me to slow down each process.  Look at what is REALLY happening and prevent Olivia from using stressful situations to entice me back into her grip.  Further, when I can expand a negative thought and sort out what is truly underneath it, It allows me to change how I feel about a situation.  

That's right.  Thoughts are not facts.  But they do cause feelings.  If the thoughts are faulty, the feelings are too.  This tiny nugget of realization just might save my life.  

I can change my thoughts.  I can change how I feel.  

You all probably knew that.  Somewhere along the line, I missed that (along with a sense of direction, but I digress...)

12:30PM~ I employ a little Yankee Ingenuity and get on with my lunch excursion.

1:00PM~ Eat lunch at my desk.  

Turkey, avocado, tomato, lettuce and mayo (yep!) on ciabatta bread with a side of German Potato Salad and (REAL, not diet) lemonade.  

Healthy Self - 5, Olivia-zero.

1:30-3:30PM~  It is quiet in my office so I sit at my desk and work on a project that I often put off because it is tedious.  (Data entry from Hotline calls).  I notice during this time, my ability to focus on the task.  To be present in what I am doing.  I don't hear Olivia's voice, I am not starving or counting the calories I've eaten today.  I enter the names and the numbers and demographic information of each victim I worked with in the month of June, this time, remembering each of them and their stories.

This makes me smile.  I notice that I am feeling real joy.  I acknowledge it and stay present with it, because it is important not to let it pass by without notice.  Because it's beautiful.

3:30PM~ Midday Snacktime. 

 Peppermint Luna bar and fresh cherries

3:30PM-5:30PM~  I finish my data entry and drive home, calling my mother as I often do on the way, telling her of my triumphs of the day.  She has become my biggest cheerleader.  My solid-as-a-rock support.  I feel proud to tell her of my successes today because she knows of the dark place I was not too far back in the rear view mirror.

5:30PM-9:00PM~ Spend some time at the park, in the sun with my blanket and a book then get home in time to see both girls before they leave me for the evening.  

Olivia doesn't miss a chance to try one last time.

"Everyone is gone for the night. You are alone until morning.  You deserve some wine.  C'mon, you should celebrate.  You deserve it! Nothing bad is going to happen.  Just one night, no one will know if you skip dinner and have wine instead.  I promise I won't bug you to do it again tomorrow.  You can go right back to recovery tomorrow."

I made my dinner, (shredded chicken I cooked in the crockpot all day, mixed with mayo and curry/cumin, mixed with pumpkin seeds and raisins spread on toasted multigrain bread.  I also had guacamole and carrots and some weird popcorn crackers my mother sent home with me (Thanks, Mom!)

Then I sat down to write this entry.  

And celebrated the small accomplishment of the past few months with a dish of Ben and Jerry's Salted Caramel Core.  Which is a gift from Heaven.

In the words of a very dear friend, tomorrow I have to get up and "...just keep swimming..." (for the shore.  For my life).

Rinse. Lather. Repeat.  

Trading One Hell for Another (Part II in a series of III)

This is Part II of a three part series which depicts a "Day in the Life" of my own personal journey from the most active time in my eating disorder to the road which I am presently on to recovery.  You can read Part I HERE.

In Part II, I wish to share what a typical day in Mercy Hospital's New England Eating Disorder Program was like when I began to take recovery seriously.  I was hospitalized twice in this setting, once in November, 2014 and then again in May, 2015.  The two experiences were similar in structure but worlds apart in substance.  That's a story for a different day.

Here I am trying to depict what a day in the middle of my treatment was like, when it was still difficult but not as trying as the first two weeks.  I have gained a little traction by now and have started feeling the positive effects of proper and regular nourishment.

4:30AM~Wake up and fight immediately with Olivia about exercise.  While in the program, I am prohibited from all exercise.  I am not even allowed to walk up the stairs to the 6th floor of the hospital.  I am required to take the elevator.  No caffein allowed.  This works against Olivia and she chides me to break this rule each morning.

5:30AM~Drive to Portland to make it to Mercy by 7:00AM.

Every morning on the way to the hospital, like a movie reel which only plays an unsatisfying, repeating preview clip that never gets to the happy ending,  I re-live all of the ugly moments that caused so much pain in my life and which threaten my ability to stay in recovery.

By the time I arrive, I am filled with anxiety from the negative thoughts Olivia has managed to berate me with in an hour's drive.

"You can't eat today."

"They are making you eat bread AND butter AND sugar AND meat.  There are way too many calories in that and they are just trying to make you fat."

"You HAVE to resist it or else you are going to leave this place so out of control you will never be able to re-gain control."  

"Everyone will see what a failure you are, even at Anorexia."

"If you eat all that food, no one is ever going to think you are pretty or strong."

"Being thin is what makes you special.  If you lose that you have nothing else and you will be alone your whole life."

7:00AM~ We are required each day when we arrive to submit to a battery of tests (vital signs, etc.) and to answer questions about pain, bathroom habits, etc.  Then we are summonsed by the nurse to go into the office, strip down and put on a johnny.  Next we have to stand on the scale backwards, so we cannot see the result.  Olivia always pesters me to look.

I don't look but I do try and encourage the nurses to tell me at least if I gained.  "Yes" says the nurse.  Inside I am filled with anxiety.  To fake my not-yet-solidified commitment to recovery, I say, "good".

Olivia turns up the noise even louder. "You failure!"

It is the start of a new day in treatment.  8.5 hours each day, five days each week, devoted to the job of recovery.

7:30AM~ We move as a group, dutifully to the "dining room" when the nurse announces, "time for breakfast!" in her best effort to inspire motivation into a group of people who would rather have slow, unmedicated root canals than eat this meal.

Once in the room, we circle the table in what must look like a crude attempt at musical chairs... previewing the meals, hoping that the one with our name on it has nothing under the ominous plate cover that will provoke our Eating Disorder voices into their ruthless torments.  They move us around the table each meal...often to put those of us who might be struggling, closest to the supervising nurses at each end.  (i.e. hiding butter in our pockets or intentionally dropping food to the floor).

They have been around a long time.  They know all of our tricks.

There are strict meal-time rules:

1). We must eat 100% of what is on our tray.  Each butter pat must be completely scooped out, dressing packets must be squeezed empty, if you don't slurp your juice through the straw at the end, you didn't drink it all.  Any missed/dropped/hidden or otherwise uneaten food is "replaced" before we leave the table with a calorically-equal ration of Ensure which must be consumed before the allotted 40 minutes for the meal is over.  

2).  We are not allowed to "deconstruct" our meals.  In other words, if a sandwich is on your tray, you may not take it all apart and eat the bread first, then the veggies, then the meat, etc.  We must eat foods as they are intended to be eaten (Most of us have rituals and rules that they are trying to help us move away from).  

3).  We are not allowed to talk negatively about our (or anyone else's) bodies, foods that we don't like, overeating, undereating, tricks for eating a little, tricks for eating a lot, (you get the picture...)

4).  We are given a mood-monitoring sheet at each meal where we are required to log our present feelings about the meal and whether or not these feelings contribute to or hinder our recovery.  At the morning meal, we are to write (and announce) our goal for the day in treatment. 

This morning, the breakfast with my name on it consists of two scrambled eggs, two slices of french toast with two packets of butter that must be used and one tub of maple syrup.  I also have two links of turkey sausage, a banana and two 4 ounce orange juice cups staring up at me, threatening to bring on the familiar rapid breathing, tears and self-doubt about my ability to recover.

Olivia is incensed.  This is more food than I would eat over a week.  To say that it is difficult to eat 100% of this breakfast is like saying that the Pope is a little bit religious.

Filling out my log, I note that I am feeling determined and provoked.  Many of my "fear" foods are here on this plate in front of me (our personal nutritionists get to know us very well) and it is a struggle to eat with all of the noise of Olivia in my head...trepidation to commit to recovery...pain in my heart that I am still dealing with from both ancient and recent history.  It almost seems to be too much but my goal today was to "choose recovery over my eating disorder" and I would use the coping skills, "4-4-8" (breathe in slowly for 4 counts, hold it for 4 counts then breathe out slowly for 8 counts) to achieve it.

Noticing that my pace is slowing down and I am tearful and frustrated at this meal, another patient who is half my age (yet full of empathy and compassion) reaches out to me and pats my arm in an effort to let me know she is there and fully understands.  Much like the words of encouragement my readers have offered me since beginning this blog, it is a small gesture at the right moment, that lends me the strength to complete the seemingly monumental task in front of me.  Through tears, I grit through the last bites, fighting the anxiety and nausea that threatens to reverse what I have just done, Olivia's handiwork.  

From the second day of treatment (the first day is hell, even when you know what to expect the second time through treatment), I ate 100% often reminding the staff that something was MISSING from my plate.  With each day, my determination and confidence begins to accumulate as I own my recovery for the first time.

8:30AM-11:00AM~ Since it is Monday, we have multi-family group where all of the patients have their support people join us for the morning daily check-in.  Here, we discuss how the weekend went, struggles, victories, emotions, etc. with the lead Social Worker.  at 9:30AM our snack is delivered and we are to eat 100% of it in 20 minutes, while in this group.  Still full from breakfast, I now have to choke down an apple with peanut butter and a strawberry greek yogurt cup.

11:30AM~ Lunchtime.  Same dance as breakfast.  Same daily berating from Olivia for disobeying her demands to quit, same colossal pile of food in front of me.

My lunch today consists of home-made macaroni and cheese with breadcrumbs and butter on top, cooked carrots with a pat of butter, garden salad with Italian dressing, dinner roll with butter, a carton of low fat milk and a piece of lemon meringue pie.  All to be eaten, 100% in 40 minutes....

Olivia takes aim where it hurts because this gets more and more difficult as the day progresses, feeling full and uncomfortable because early recovery does NOT feel good.

"Just STOP this right now.  If you don't stop eating  you never will be able to and you are going to lose control of your life again."

"You are so weak."

"Remember how you feel? You don't deserve to eat.  You made everyone in your life hate you.  You are never going to be able to feel love again if you eat this meal and take up more space than you deserve to."

"If you think people rejected you before, wait until you get fat.  It's bad enough to be weak but you are going to be weak, fat AND rejected.  Stop listening to these people.  You KNOW you will feel better when you start running, stop eating like a pig and lose that weight they made you gain."

It gets louder and more cruel as my healthy self stands up to Olivia.  This is the place where my recovery is most vulnerable.  Two parts of my self, given life by me, in a desperate battle for my soul.  One wants me to live.  One wants me to die.

Today, I choose recovery and let my healthy self win.  It isn't without cost however, as Olivia sensing that she is going to lose, turns up the heat and causes real and brutal nausea that increases with each bite.   I  remember that I can breathe through this moment.  Stay present.  Fight.  Breathe in for 4, hold it for 4, breathe out for 8.  Over and over and over again, until the last bite.

100% eaten.

One more victory in my corner.  The confidence that I can survive eating normally continues to accumulate.

12:30PM~Bathroom visits are not allowed during meal times for obvious reasons.  When we do need to use the restroom, it is always with staff supervision.  Yes, they come in WITH us...backs turned, trying to balance preserving our dignity with making sure that we don't attempt to purge.

Anorexia is not a choice.  Who would choose this??

12:30-1:30PM~ This is group therapy time and is usually run by the head of the program or the staff Psychiatrist.  I am tuned in, trying desperately to learn how to overcome this hell.  Sometimes literally lying flat on the floor, trying to get the food to stay in.  Looking for ways I can maybe keep a piece of Olivia alive, in case I am not really ready yet...so conflicted.  It is so confusing and frustrating all at the same time.

This is the point.

The discomfort that is associated with the changes that must be made to overcome Anorexia is real.  They are the exact emotions/physical pains/memories of past traumas and hurts that we are trying to avoid with our eating disorder behavior in the first place.

It's an evil truth.

In order to overcome this disease, I have to bring the demons into the light that I have worked so hard to bury over the years.  I have to feel all of the feelings head-on, without my familiar and faithful remedies to soften their jabs, so I can stand up to them one by one, then lay them in their graves outside of my body for good.

I force myself to discuss, out loud with this group of strangers who now know things about me that my own loved-ones and past partners never did, the painful hurt that is haunting me the most.  It's uncomfortable.  It's frightening.  It's necessary.

One more nail in Olivia's coffin...

1:30-2:30PM~This time is spent with the Recreation Therapist who has disclosed to us that she too, has overcome an eating disorder.  She is pivotal in my recovery.  She gets it.  She gets me.  Failing miserably at finding things to distract me during this hour where we are supposed to learn self-care and relaxation (this comes later for me) like nail-care, massage (NOO thank you!) and arts and crafts, she finally loans me a book she thinks will change my life.

It did.

8 Keys to Recovery from an Eating Disorder: Effective Strategies from Therapeutic Practice and Personal Experience by Carolyn Costin

If you have an eating disorder, please read this book.

If you love someone who has an eating disorder and you want to understand how to help them, please read this book.

If you know how to read.  Please read this book.

2:30-3:30PM~ Back to the dining room for the last snack of the day.  Mine is always the same.  6 graham crackers and two packets of peanut butter.  All to be eaten in 20 minutes.  Still full from the earlier victories.

We process our day over snack.  Declare whether we met our daily goal (I did this day) and share something new that we learned.  Some of the new girls don't take this part seriously.  I didn't when I was here the first time.  I didn't want to heal.  Some of them don't either.  I don't care.  Their behavior has no bearing on my recovery.

I need to participate because I am starting to find during treatment this time around, that the more I talk honestly and openly about this disease, socially exposing my own jugular for the sake of healing, the more I stuff a figurative sock into Olivia's relentless mouth.

3:30PM~I take the elevator back down to the first floor, walk to my car emotionally and physically exhausted from the work of the day.  Carrying a lighter load of "weight" in my heart with each passing day of treatment, that adds weight to my body I am overwhelmed always at this point.

Each day, I cry the entire drive home.  Drained, conflicted, saddened by the memories that I can now access of things I have done to the people I love the most.

I give in to the process fully, eventually.  Trusting the process because I haven't yet before and so far, this hell is starting to improve, unlike than the hell I have been living the past 4.5 years.

Tonight, after dinner with my daughter (prepared without gulping poison to try and kill the demons and not purged so as to continue to choose recovery, one meal literally, at a time)  I sleep soundly.

Rinse, lather, repeat....

                                                               
Someone told me the other day that I have "Fortitude".  I had to look it up.  Yeah, I think he's right :)          

A Day in the Life (First of a Three Part Series)

This is the first of a 3 part series.  If you are in early recovery and you are reading this blog, I wish to warn you that there may be some triggering language in this series such as numbers and behaviors.  Please proceed with that in mind.

If you are lucky enough not to be in recovery (because you do not have an eating disorder) My purpose in writing this series is two-fold.  First, I wish to illustrate for myself, the leaps and bounds I have achieved towards my new reality of a life without Anorexia.

Second, I wish to help answer the question often asked of me, "how do I support you (or my spouse/friend/significant other) in their recovery efforts?"  I feel that though it leaves me more vulnerable and exposed than I ever care to be publicly, this exercise will help others to perhaps empathize with their loved ones who might be suffering from an eating disorder, so that when the time comes to lend support, you might have a better understanding of what we are recovering from.

 The three parts will illustrate "A Day in the Life" when Anorexia was in charge of me and was at its worst, when I was in the hospital treatment setting and finally, as it is on my recovery journey:

                                                     Part I (When Olivia Called the Shots)

2:00AM~ wake up even though I didn't get to sleep until 11pm, because I am starving, dizzy with a headache from the lasting effects of alcohol on my food-deprived body, and my mind is racing...trying to remember..."how many calories did I eat today?" having obsessively counted them on paper and in my head all the previous day long, just in case I missed something.  Always rounding up.

2:45AM~finally drift back to sleep

3:30AM~wake from a startling nightmare.  This is the 4th night this week that this plays out. Unresolved trauma which haunts me when I give in to sleep, unable to drown it out or purge the feelings with the conscious action I take when I am awake, to keep it pressed in the corner where I wish to keep it.

Sleep will not come again for me at this hour.  Olivia is telling me, "if you get up now, you can get 100 pushups, sit-ups and dips in  before it's time to run (and before you get on the scale)."  I cannot resist taking advantage of this thought.  Like the itch on your back that you can never quite reach to relieve the discomfort it causes, I can never do enough exercise to satisfy Olivia's persistent desire for more.  I set my timer and execute my first round of self-destruction.

4:15AM~use the restroom one last time in hopes that the scale will reveal the truth I wish to see.  It's the same ritual every morning now since I bought this scale, ostensibly to ensure my continued weight-gain.  No coffee or water before the scale.  Exercise as much as possible before stepping on the scale.  Strip off all clothing.  Close my eyes until I can't stand the torture of looking/not looking/looking/not looking any longer.  Then ultimately, always look.

You see, it really doesn't matter what the scale says.  If the number is too high, it would send me into even more self-punishing restricting/over exercising/purging and self-loathing because Olivia would be at her loudest and most cruel.  If the number was lower, I am elated because my efforts have been rewarded, and I continue the path of destruction because it is working and shuts Olivia the fuck up.

4:30AM~drink coffee for energy so I can run with my running partners and keep up with their pace.  They begin to notice and comment that I am losing weight/stamina. I outwardly acknowledge that I need to eat more to placate their concerns, while on the inside, I am high-fiving Olivia for the success that even others are beginning to notice.

5:15AM~run 6-8 miles, depending on how much time we have and how late my friend (Hi Erin!) is getting here.

7:30AM~more coffee on the way to work after fighting a loud and daily morning battle with Olivia about eating/not eating breakfast.  Like most mornings for the past 4 and a half years, Olivia wins today.  "You can't eat anything now and undo all the work you have done this morning.  Are you really that stupid and weak? You are losing weight and people are noticing and that is why they love you.  Everyone will love you more when you are thinner.  You will show them how disciplined and strong you are.  It's who you are.  It's your identity.  It's all you have.  Don't give in now you loser.  Everyone will see how weak you really are if you get fat and then you will be alone again." (Or some daily variation of this theme)...

I ignore my familiar growling stomach, white and cold fingers even though it is 70 degrees outside, and my shaking body by distracting myself with a news story from the radio (that I can't even begin to comprehend or remember because I am really only thinking about my growling stomach and my freezing and shaking hands)

8:00AM~get to work and collect the things I need for a morning of court hearings for the clients I work with.  I put my "lunch" (4 carrots and 2 TBS of hummus... because it is the easiest thing to bring back up and the colors are bright enough so I can tell that I am being successful) into the refrigerator so I am not tempted to eat any of it before I am allowed by Olivia.

8:30AM-12:00PM~ court proceedings which occupy my time but where I miss important return dates and sentencing conditions because my mind is wandering "you have to put off eating today because you have to eat a normal dinner with your daughter tonight and you might not be able to purge it".  "Don't be such a weak person! If you give in to this hunger you are going to lose control and gain weight and no one will ever love you because you are going to be fat and weak." I even begin to nod off a little, a cumulative effect of the inability to sleep night after night.

12:30PM~ having successfully put off eating for this long now, the reward for my efforts begins to emerge.  My anxiety over finances, past hurts and guilt, a future that feels out of my control, finally begins to wane.

I have a quick conversation with my co-worker, making sure to confirm that she will be out of the office later this afternoon (so I can purge if I actually eat my lunch).  Dash to an hour-long meeting not remembering driving there or what was discussed.  Mechanically going through the motions.  A robot.  A slave to Olivia's ever-present deriding.

2:30PM~I return to my office and see that my co-worker is indeed gone now.  I am alone.  It's the perfect time to eat my lunch.  In the first moments, my healthy self (who does still reside inside of my head and who's voice sometimes finds a crack in the space occupied largely by Olivia) promises me that I deserve this nourishment and that purging it in my place of work is not an option.

By the third carrot, Olivia has elbowed any positive thoughts from my head, "Hurry and eat the rest, and down some water so you can purge this.  You don't deserve this food.  What are you thinking?! You are hopeless, giving in to hunger.  You KNOW you are going to have to eat tonight with your daughter...what a pig you are...you have no self-control and don't even deserve to live"

As though I am watching myself in a movie, and I have no idea of the plot or the ending, I dutifully do what I know is the only way to shut Olivia the hell up at this point.  Hastily, I shove the remaining carrots and hummus into my mouth, a snack for most people, hardly chewing.  I follow with a large glass of water and run (literally) to the restroom, frantically reach for the toothbrush I stashed in the drawer, which assures I will be able to undo the damage I have done by giving in to my hunger.

It's the only way I know of to quiet the noise.

Not caring that vomit has splashed onto the floor and my shoes, that I am now sweaty and my eye-makeup is streaming down my face, eyes red and watery, Olivia implores me to get in another 100 pushups.  Right here, right now.  Dropping to the slippery floor, I comply, then wash away all of the evidence of the hell I am trapped in, never truly able to wipe away its stains.

<I wish I was making this up.  I wish that I could say I am embellishing this to make it a good read.  If you really know me, you know that if anything, I am probably softening it a little to protect my dignity>

3:00-5:00PM~having (literally) purged the anxiety that taunted me all day, hunger quiet from the exertion of what recently transpired, I am at my most productive, Olivia quiet for a blessed couple of hours until it's time to go home and face dinner.

5:30PM~with my daughter at practice for another two hours, I quickly drop my bags, change out of my work clothes and lace up my still-sweat-soaked-from-the-morning's-workout running shoes and I am off for another hour of punishment.  Not because I am a "runner".  Not because I enjoy this, but because it is a mandatory component of Olivia's program.  "Just Do It" says she.  "Of course, I say".  And as a result, dinner will have to wait until almost 8pm.  I must sacrifice all for the sake of Olivia.  All values, all relationships, my body, all of my dignity.

7:00PM~I begin to prepare dinner, gulping wine to both numb the sharp pangs of hunger and to turn down the volume of Olivia's relentless emotional beatings for what I am trying to do (have a normal dinner with my daughter).

Like most evenings, this dinner goes as usual. We discuss the day, and what is happening tomorrow, talk about everyday teenage-girl drama and eat in less than 15 minutes.  My daughter announces that she is going to take her evening shower now ("finally!" says Olivia)

What ensues is basically "Lunchtime, Part II".  Minus the push-ups because even Olivia concedes that I don't have the energy to pull that off.

I come downstairs, once again calm with the knowledge that I have won the battle against food, pour more wine and clean the kitchen.

8:00PM-10:00PM~I sit with my daughter, sneaking wine in a coffee cup, until the pangs of hunger, along with the anxiety of my life are numb enough so I can try and sleep.  Counting the calories I ate today and most assuredly accumulated to expand my un-deserving body.  Making me visible and vulnerable to everyone.

10:00PM-2:00AM ~after my daughter goes to bed, I will once more purge (the wine and the anxiety of the day), crawl into bed, shaky, weak and full of guilt, shame and self-loathing, praying for peace and normalcy and quiet in my head.

Rinse.Lather.Repeat.

I'm a "Crack" Addict

CAUTION:  Nerdy, scientific blog post follows...

I'll try and weave in the word boobies though, to keep you interested.

My "crack" is Negative Energy Balance (expending more energy (calories) than you take in).
For me, and for most people who are afflicted with the disease of Anorexia Nervosa (AN), the scientific, biological state of Negative Energy Balance is anxiolytic (anxiety-calming) rather than unsettling or uncomfortable like it is for people who are not pre-disposed to Anorexia.   Going on a diet will often trigger this biological state, causing irritability, hunger, and anxiety for most people (our body's natural response to consuming too few calories).  It prompts one who is not prone to Anorexia to go "off" the diet and begin eating enough calories again to avoid the discomfort.  We've all been there (including me, before the onset of AN).

Negative Energy Balance is primarily the biological explanation for why the disease led me to restrict calories, to purge any small amount of food intake (bingeing is not my issue, but I have Anorexia-Purging Type and would purge even small amounts of food eaten)  and to excessively exercise, ever-pursuing this calming state which numbs pain (and joy) like nothing else ever did in my life.  It's a vicious cycle because the more one restricts/purges/excessively exercises, the more our body begins to release cortisol,  causing more stress, inciting the Anorexic mind to restrict/purge/excessively exercise more to reach the anxiolytic effects.   Please, if you read no further, understand that this is why Anorexia is not  a choice or a life-style or solely a quest for the ultimate vanity.  It is a biological trap.

On the first day of my first go-around in treatment at Mercy,  I had to fill out a questionnaire which calculated the number of times (on average) that I "purged" (defined as vomiting after eating,  excessively exercising to compensate for food intake,  abuse of laxatives, and restricting food intake).  My score was 29 times per week (on average).  Hey, it was a test... if you know me, you know I like to get the highest score possible!  In all seriousness, this is precisely why for me to stay in recovery, it's all about the food.

Today, I am proud to report, marks the longest period of time that the number has been ZERO.ZILCH.NADA  (51 days), and as a result, I am at my target weight which quite literally, insulates me against falling into the trap set by a Negative Energy Balance.  (The number is the same for days abstaining from alcohol, because I made the personal decision to continue this mandatory condition while in treatment at Mercy as I recover. )

Last Day of Partial Hospitalization at Mercy
(during my second stay)
Here I had gained 7 pounds back already

This was taken last week
just a pound  or two from my goal weight :)

In order for me to maintain the health that is in its new and fragile state, one of the fundamental elements of my personal recovery (as I discovered one time   two times  ten times finally figured out) is that I can never, ever again, dance anywhere near a negative energy balance. It is like crack to an addict.  It happens by not only skipping a meal or a snack, or over-exercising, but even by messing with the timing of my meals (going longer than 2-3 hours between meals and snacks).  I can't yet just fly by the seat of my (bigger now) pants and eat "intuitively" like most people.  I need to stay on a prescribed, structured schedule for eating until it no longer is dangerous for me to be more flexible.  This is one of the major reasons I have relapsed in the past.  I start to think that I can do it "my way".  Until this time around, I was not willing to take this part seriously.  What I know now, is that it is a matter of life or death for me.  One whiff of that calm and relaxed state that effectively quiets the noise in my head and the anxiety I feel in decided and familiar situations that can tip me over, and I am like the Walking Dead without rational thought, programmed to chase the elixir for their souls.

Is Olivia still in there?  Oh yes! Now, when I am stressed or anxious though, I use coping skills I have learned in treatment and in reading as much as I can about Anorexia.  I breathe, I walk (slowly) and I have mantras I use when faced with a struggle to eat ("why does this matter?" and "what am I afraid of"?).  The more I use healthy coping skills, the more I develop new thinking patterns in my brain that override the old, self-destructive ones.  The more I start to recognize my own strength and develop a confidence a few months ago, I could only dream of.  Today, I have a new mantra too, "why would I ever go back?"

Oh, and you should see my boobies now!

I'll Show You Mine if You Show Me Yours!

What? you were expecting something else??

In treatment, I learned that my body needs at least 1300 calories each day just to lay in bed all day long and lift nothing heavier than the remote control.  For my more scientific readers, this is called our Basal Metabolic Rate or BMR.  It is the minimum amount of caloric intake needed just for basic biological functioning such as breathing, blood flow, brain and nerve support, (you know, nothing really important) in a 24 hour period.  It is a formula based on factors such as weight, height, age, etc.  If you are interested in calculating your own BMR, you can calculate it here.

When I was active in my eating disorder, I didn't even come close to 1300 calories per 24 hour period. In addition, because I also exercised compulsively and to the extreme, I would easily burn through the calories I did eat (If I didn't purge them before my body had a chance to absorb them).   Often, I wouldn't even take in 1300 calories stretched over a 48 hour period.  Little wonder that my blood pressure plummeted, and as I was bragging to my paramedic friend (Hi Ken!) about how low my pulse rate was (before I told him that I had an eating disorder) he said, "we give IV fluids to people with rates that low".  

One of Costin's 8 Keys to Recovery relates to the notion that "It's all about the food".  Essentially, most anorexics (myself included) have rigid rules that get more and more restrictive as the disease progresses, including a list of "fear foods" or "bad foods" never to grace our lips.  My rules included such insightful wisdom such as:
~Never eat before exercise (I am a morning exerciser)
~Wait as long as possible to eat after exercise (sometimes 3 or 4 pm)
~Exercise every day (often twice a day) through injury and illness, because I have to burn any  calories I was so weak to eat
~Any food eaten before coming home from work must be purged (so I can "eat" dinner in front of my daughters and they would think I was perfectly normal...only to purge it when they left the table for a shower or to go to their rooms after dinner).
~No fat (EVER)
~No flour, sugar or simple carbohydrates
~Count every calorie (obsessively...over and over and over...in case you missed one) to make sure that the number never, ever exceeded 800 for the day.  Always rounding up just in case..... (I didn't subtract for what I purged either by compensatory exercise or actual purging).

There are a lot of reasons why I was able to adhere to such rigidity.  That is a post for another day.  Today, it's all about the food! 

Often people ask me, "what can I do to support your recovery?".  It's a question I used to reply with, "nothing...I'm good".  I wasn't.  Clearly as you can see above.    You see, even in my strong and determined pursuit of recovery, I can get caught up sometimes in eating foods that are "safe".  I am eating enough calories to support the weight gain I still need to accomplish but I notice that I gravitate towards foods that feel "safe" to me (and away from more varied and "challenging" foods).  This is not a means to the end of FULL recovery that I am gunning for.  It is a loop-hole that I need to make sure stays closed, tightly.  The photo you see above is exactly that (except that I have replaced fat-free yogurt with full-fat yogurt).  This is what I ate for breakfast today (and so far, every day this week) except for the Kashi bar and cherries, that is my mid-morning snack.  What isn't pictured is the pre-workout smoothie I consumed before a kettle-bell work-out this morning. 

So, I am reaching out and asking for help from all of you who might be reading (Hi Mom!), to  "Show me Yours!" It helps me to see what others, who do not have disordered eating patterns eat for daily meals.  If you have the time, it would be a tremendous boost to my recovery, to see what you ate for breakfast (or lunch or dinner if you are reading this later in the day!)  Post your list to the comments below or to face book.  And if you can include a photo~ even better!

One last thought.  During our monitored breakfast one day at Mercy, the director of the program came into the room and shouted (he's loud) to us, "Hey! What's the most important meal of the day?" to which we all mechanically and dutifully replied, "Breakfast!".  He shook his head and retorted, "NO! The meal in front of you!".  Every meal, every snack counts for me...everyday.

Motivation, Patience, Hope

This photo is my bathroom mirror in my home.  Stuck to my mirror is the first definition of “Recovered” I have ever read.  Beneath it are the 8 Keys to Recovery.  Both are from a book by Carolyn Costin that changed the way I approach recovery, recommended to me by one of my favorite counselors (who is herself, recovered from an eating disorder) from the Mercy Hospital Eating Disorder program.  This book saved my life and I read all of the words  you see each morning before I do anything else.

The definition of recovery card reads:
"Being recovered is when a person can accept his or her natural body size and shape and no longer has a self-destructive relationship with food or exercise. When you are recovered, food and weight take a proper perspective in your life, and what you weigh is not more important than who you are; in fact, actual numbers are of little or no importance at all. When recovered, you will not compromise your health or betray your soul to look a certain way, wear a certain size, or reach a certain number on a scale. When you are recovered you do not use eating disorder behaviors to deal with, distract from, or cope with other problems." 

After having it up on the mirror for a few days, I asked my youngest daughter if it embarrassed her to have it there, in case her friends might see it.  She said, “Mom, leave it there, I think it’s cool”. 

The Keys to recovery are not necessarily to be taken in order, but they are all-important elements to lasting recovery.  The first key, “Motivation, Patience, Hope” is truly the cornerstone to my tenacious determination to have all of the components of “RecoverED” (emphasis intentional) put forth by Costin. 

Motivation :  (without it, recovery has no backbone.  Without my own internal motivation, there is no reason for me to choose recovery every morning when I wake):
~To be the best ME I can be.
~To stand on my own two feet and love the woman I am.
~I am a damned good mom.  I want to be a great mom.
~To be present and ready for the day when I might need to take care of my mom and dad.
~To be the most loving friend to those in my life whom I adore.
~To learn from my past mistakes of choosing eating disorder behavior instead of recovery when it mattered, and to honor those I hurt because of it, with my commitment to recovery.
~To one day be someone a man could love and trust.  To one day trust the love of a man who loves me.

Patience:   (I have the same measure of patience to fill a cup as I have boobies! Just ask my daughters...)
Here is what I have learned about patience:
~Sometimes being patient means shutting my mouth and trusting the process.
~Sometimes being patient means rather than trying to DO something to make the pain stop, I need to do nothing.
~Patience requires me to slow down and stop trying to recover yesterday.  A prolonged process ensures that I get it right.  Far more important than getting it fast.
~Patience requires that I feel what I am feeling rather than impulsively taking action to numb it. ~Patience begets patience and with practice, I am getting pretty damned good at it.
~Patience requires me to stop trying to control everything around me and to accept what is,   without judgement.  Without being attached to the outcome.
~Patience allows me to walk each evening...without an ipod...reflecting on the day and what I did well...what I can do better...and to cry for my pain and losses without self-destructing.  Patience is knowing that sadness and pain are temporary and will pass, if I just ride the wave.
~Patience requires that rather than wishing for those whom I love to trust me again,  I have to simply earn it by living each day, choosing recovery. 

Hope: For the first time in years, I am filled with hope. 
~I hope to be accepted into the Masters of Social Work program this Fall so I can be the best advocate for families’ of loved-ones afflicted with an eating disorder that I can be.
~I am so filled with hope that someone is reading this blog and my words are touching their soul.
~I am hopeful that the journey before me will afford me the wisdom and knowledge to be the agent of change in the lives of those who suffer with Anorexia.
~I am hopeful that once healed,  I will find the one true love of my life.
~ I hope for many more of these in my life:  (They have nothing to do with recovery! They just bring me such joy!)

Bright Eyes, Bangs and Boobies

“Get off the scale! I have yet to see a scale that can tell you how enchanting your eyes are. I have yet to see a scale that can show you how wonderful your hair looks when the sun shines its glorious rays on it. I have yet to see a scale that can thank you for your compassion, sense of humor, and contagious smile. Get off the scale because I have yet to see one that can admire you for your perseverance when challenged in life." ~Steve Maraboli

Yup, they’re all mostly almost all coming back.

Bright Eyes
I was looking through old photos the other day and started to notice how over the past four and a half years, during times when I was most active in my eating disorder, my eyes had no life in them.  This picture haunted me by how the blank, still look in my eyes reflected the emptiness I felt in my life during that Spring following my divorce.  I was heavily restricting during this time and exercising to the extreme. I remember that day in May of 2013 in the photo so vividly~ it was Prom in Boothbay and we were taking photos at Barrett’s Park.  It took every ounce of energy and strength I had, to summons the energy to be out in public, facing all of the other parents who were most assuredly (said Olivia)  judging me, the newly-single mother.   Olivia threw the barbs inside my head for them,  “How dare you be here thinking you fit in with all the other families?”, “I bet they think you are a terrible mother”  "If you were smaller, they would all like you better" ....  As always, in public atmospheres, I was a bull's eye target for the thoughts being hurled at me by Olivia, like bullets from a gun with a crooked barrel.  I tried desperately to smile when summonsed by my daughter to “look happy” as she snapped a photo:

Bangs
 Friends who know me well, know that I am most uncomfortable dressed up, done up and accentuating my body in such a way that might draw attention.  I have, for most of my life, steered clear of dresses and skirts, heels and form-fitting clothing, opting for more sporty-type items and loose, boxy pants my friend Julie (Hi Julie!) affectionately refers to as “man jeans”.   I would have my hair cut once a year, making the excuse that I cannot afford it, when really, I never dared to do anything different, even though I longed to be confident enough to try out a new style.  It was always more comfortable to hide (literally) beneath ill-fitting clothing and unassuming style.

You see, Olivia convinced me that I didn’t have the right to try and look pretty or attractive because I had not yet achieved the double-digit weight we were gunning for and until that happened, I was weak and “fat” and undeserving of any compliments or affirmations that might (out of pity for sure) come my way.  Comparing myself to all of the other women in the room became an obsession that always left me in dead-last and full of self-hatred and regret for not devising a plan that would have excused me altogether from having to attend in the first place. 

Having to dress up for events that included eating were the most dreaded and often ended in a quiet, internal hell that I swallowed instead of the dinner being offered. Later, as my disease progressed, I would almost always have enough to drink to try and quiet the noise in my head causing my food-deprived body to quickly absorb the poison, stymieing any possibility of leaving with my dignity intact. 

Fast forward to today... I am almost completely weight restored and doing things deliberately that are outside of my comfort zone because if nothing changes...nothing will change.   I choose to wear skirts and heels to work and do plenty of self-affirmations in the mirror before I enter the courtroom or a meeting, feeding my healthy-self rather than fighting Olivia’s familiar derision.  I am gentle with myself if I make a mistake, avoiding negative self-talk and being as kind to myself as I would be to my daughters.  And today, I followed through with the decision to try a hair-style I have been wanting to, including color (taking deep breaths with every snip!) veering away from the idea that I don’t deserve to take care of myself, to try and look pretty.  You know, I kind of like it...and I think I notice that my eyes are full of life... and change... and hope.

Boobies
OK, well.  Two out of three ain’t bad!  ;) 
(Just checking to see if anyone actually reads these...)