Posts Tagged ‘IOP’

If only it were that easy. I finally have a family I believe would understand what I’m going through. My host family cares about me more than my biological family can and ever will. Friends and mental health professionals have suggested I open up to them and tell them that I struggle with eating, well that I have an eating disorder. It’s not that I’m afraid they won’t get it. It’s that I know it hits too close to home for them. My host brother (who lives away from the house with his fiance and son) had a serious girlfriend a few years back who struggled with what sounds like anorexia. When my host mom began describing the situation a few months back, I felt her heartache for her son and this girl. Things didn’t work out between them, I believe because of her eating disorder.

When I began treatment this summer a few occurrences are necessary to mention. Days before entering my first treatment facility, I had an anaphylactic reaction. At the time, I didn’t panic; it was actually a nurse at the school health center who flipped out more than I did. I calmly reassured her as I swallowed allergy pills (of course that day they didn’t have Benadryl or the like).

A few days later, I was admitted inpatient for what was supposed to be a short (2-3 day stay) to make sure I was stable before heading to a residential facility for eating disorders connected with the hospital. About three days after the anaphylactic reaction and one day into treatment, the allergy resurfaced, my leg and throat swelled yet again. In my first eating disorder treatment, I was constantly utilizing liquids to meet my nutritional needs. I was given excessive amounts. If I finished any less than 100% of my meal, I was given one Ensure Plus (I’m sure if you’re reading this, you’re a pro on calorie content, and there’s no need to trigger someone even more). If I finished less than 50% of my meal, I could look forward to having to down 2 Ensure Pluses. It was certainly not a liquid calorie for solid calorie equivalent. It was unfair and I was often noted as “not-compliant” with the meals and told I’d stay longer because of this.

Insurance company wasn’t on the same page as the treatment center. I wound up remaining inpatient for 9 days which I know isn’t long but remember I was only supposed to be there 2-3 days and then transfer to a residential facility. Upon an immediate, abrupt and unexpected discharge, (thank you insurance), I went to an extended day program not connected with the facility (since insurance refused to cover residential at that point) and began my journey there. Liquid supplements occurred every so often for me.

My body seems to always have expressed itself more than I can express my emotions. Lo and behold, I developed a bizarre condition where it felt like food was getting stuck and backing up in my throat. Like any “decent” treatment facility, a group therapist prompted our group as to if anyone else has experienced such a phenomenon and if so, raise hands. Every hand in the room was raised. It was all I could do to not scream out, “this is different, I just know it”, and so I sat silently, knowing within me that it was.

After weeks of having most meals finished with a Boost or Ensure Plus (this facility does calorie for calorie exchange so that’s a relief), the directors prompted me to seek medical advice. Not knowing where to turn, I decided if the problem’s in my throat, let me go to an ENT (Ear Nose Throat) doctor.

Upon seeing the doctor, he noted inflammation in my esophagus which he could tell by bubbling forming in the back of my throat. He sent me for a liquid swallow study. After the results came back, the doctor said there didn’t appear to be anything acutely wrong, yet referred me to the gastroenterologist. I scheduled an appointment for the following week.

Things were progressing pretty well in treatment, I was bringing up traumas and feeling them a little bit emotionally. This occurred after weeks of narcoleptic fits or “seizures” after delving into something emotional (I now can attribute this to traumatic stress release and the shaking wasn’t actually a bad aspect, it was my body’s was of discharging the negative energy). One night, after progressing to a lower level of care in IOP (Intensive Outpatient), I was having a regular conversation with other clients. I had switched mainly to liquids for the rest of the meal. This was a common occurrence and o one thought much of it at this point. As I was mid-sentence, I felt something come up my throat. At first, I thought it was something that used to occur. When I was 14/15, I would often have a clump (sorry for graphics) of what appeared to be semi-solid mucous come up my throat. I attributed this to anxiety at the time. However, as the object of this night was traveling up my throat, I quickly realized this was not the same. It was almost as if someone or something was trying to force me to vomit. Let me clarify- I have never engaged in vomit behaviors. I always knew my throat was sensitive and in this disorder, I wasn’t trying to kill myself.

I quickly got up from the table to find something to spit this into. Bathrooms are locked during meals, so I found a tissue and spit the thing out. Only later did I realize that it was undigested food. I sat weeping the rest of the meal, alone (as I was always a slow eater) and by then, people had finished their meals. My dietician happened to be sitting at the same table as me that night and said I should get an appointment with the gastro earlier than a few days from then. Long story short, after many procedures (some traumatic, some not), it was found that I have Jackhammer’s Esophagus or Hypercontractile Esophagus. Essentially, peristalsis doesn’t function as expected and succinctly for me as it does others. My esophagus contracts so frequently that it doesn’t allow food to move down as needed. The radiologist performing and evaluating one of the studies said “we don’t see this pattern of swallowing in your age group, we see it in 80 year-olds”.

I don’t feel special. I am quite certain (whether wishful thinking or not) that my physical problems are mostly related to the excessive traumas I’ve endured. It’s interesting to me that I develop a motility disorder while undergoing Eating Disorder Treatment. Rather than put my thoughts and feelings into words, my body speaks for me.

I care so much about my host family and how they’d be affected and perceive my eating disorder, that I can’t bear to let them in on this. They’ve already adjusted much on my motility disorder and buying foods I can bear with. At least, they managed that for a week or two. I feel like a burden already. I don’t want to hurt people who’ve shown me the most kindness anyone has ever shown me for extended periods of time.

So, I sit here and write this post as I hear the dishes clanking and the laughter emanating upstairs.

 

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I sit in class, amongst people, most younger than myself by at least half a decade.

What was I doing when I was their age?

Oh, yeah that’s right, I almost forgot.

I almost forgot the reason I didn’t graduate on time. Why it will be more than 10 years after high school graduation when I receive my college degree.

Almost.

I was in college at their age.

I was in college, part-time with an entire continent separating myself from the rest of my family.

My family who sent me to the first program.

I was excited at first when I heard I may be going to California.

It was two weeks after I was discharged from my first psychiatric hospital stay.

The stay that according to Conroy, the social worker who admitted me was supposed to last between 3-10 days.

I stayed 18 days.

No outdoors. No light aside from the fluorescent ones beating down on me in the halls, in the rooms, in the showers.

After discharge, no one knew where to put me. They said it would only be once that I’d be in the hospital for things like this, that I was just going through a “transition”.

I guess I have a lot of “transitions”… 8 hospitalizations, 3 residential treatment centers totaling 2 and a half years and half a dozen IOP/PHP and 3 attempts later.

I remember sitting in class half a decade ago wondering if I’d make it to college graduation.

I remember thinking that I would get in trouble if I was seen chewing gum, not by the professor but from someone also in program going to school seeing me. We weren’t allowed to chew gum in the lower levels.

I remember not being able to accept rides from friends at school, even from my professor the night that it was pouring rain, pitch black, and I was all alone at the school bus stop with nothing or no one around late on a Friday night after class finished.

I remember begging my parents to get me out of the first place, saying, “I’m sorry, I made a mistake.” They told me it was either the program or the streets.

I didn’t even do anything wrong to deserve long-term residential “treatment”.

I was severely depressed, I needed love.

Love is not what I received.

I received way more fake hugs than I’ll ever get in my life real hugs.

I saw people try to kill one another.

I saw other people struggling, constantly talking about suicide and the next attempt.

I saw people attempt.

I saw people relapse.

I got abused, mostly verbal and emotional abuse.

I thought that was in the past. I thought the abuse was done.

It was thrown in my face constantly.

My current classmates have an average age of 20.

At the age of 20, I was taking 20 prescribed pills a day.

Once, someone from the program had to call my professor prior to the school year beginning to let him know that I was heavily medicated and may fall asleep in class.

My classroom experiences at a traditional college age are skewed.

So, when I sit in class, a bit ashamed that during the working hours I’m in a classroom at a desk, I wonder what happened, I almost forget what went on.

I know others wonder why I’m in class at the ripe old age I am.

If they ask, I tell them, usually surface-level things.

Usually, I just say I did the college route backwards, went to work first after high school and now I’m in school.

If only they knew the real story, the fucked up shit that I was locked away for, years of my young adulthood taken from me, because of depression stemming from abuse, neglect, and in-affectionate beginnings.

When I sit in class, I start to think of all these things. I think about what I was doing when I was their age, what I was exposed to, what was going on in my life.

Absolute madness.

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Love this phrase, all too often someone says he or she will do something, and behind the scenes another person comes to find the inaccuracies between what one is saying and what one is doing.

I now try to avoid people who cannot or do not live a generous life face-to-face AND when no one’s watching.

Let’s face it, someone or something is always watching. No I’m not going to preach religious or spiritual beliefs, all I’m saying is, don’t you count? Aren’t you watching yourself, holding (or not) yourself responsible for actions, words, etc.?

I’m not going to tell you I abide by a vegan diet, be really picky at any restaurant we go to, and then go home at night and devour a pepperoni pizza. It’s just not going to happen. I try to live an honest life. I specifically said prior to beginning a vegan diet, I would likely have an exception, and that exception would be frozen yogurt.

Friends continually asked me well, “what about ice cream”? “You can have that can’t you, because it’s close.” Sure, I suppose I could. Will I? Nope. I have tended to hold myself to my words most of my life. I can’t imagine saying one thing and doing another. Yes, I come across unbelievably blunt at times, or emotional, or flustered. Ok, I accept that. That’s me.

So how has this vegan diet been? Hah, I feel like I’m having a one-sided conversation with you readers. Thank you by the way, as always, for taking time out of your day/night to peruse this. I appreciate it! It was an interesting decision to become vegan days before Passover.

For those who aren’t familiar with this Jewish holiday, Passover has a lot of food restrictions, particularly if one is of Ashkenazim descent.

The vegan diet: no animal products or byproducts. The Ashkenazim Passover diet (taken from judaism.about.com) relatively accurate:

“Passover Kitniot

In the Ashkenazi tradition there are additional foods that are usually forbidden during Passover. These foods are called “kitniot” (pronounced kit-neeh-oat) and include: rice, millet, corn and legumes like beans and lentils. These foods are off limits because the rabbis determined they violated the principle of ma’arit ayin. This principle means that Jews should avoid even the appearance of impropriety. In the case of Passover, kitniot can be ground up and cooked with like flour, so they should be avoided.

In Sephardic communities kitniot are eaten during Passover. It is also not uncommon for vegetarians who identify as Ashkenazi Jews to follow the Sephardic tradition during Passover – it’s tough to be a vegetarian during Passover if chametz and kitniot are off the table!”

I didn’t want to delay this diet and constantly make excuses for why I hadn’t transferred to a vegan diet after saying I would the day after returning from Alternative Spring Break and so I didn’t. I also find it interesting that in this description of diet to follow for Passover, it mentions that vegetarians can esssentially change it up. I don’t believe that makes sense. My personal belief about being vegan or vegetarian is just that, personal. No one forced me to do it. My religion which is my culture and arguably engrained in my DNA won’t change even if I convert… my roots, my biological basis as a human is rooted in Ashkenazim Jewish heritage.

So what can I eat? What have I consumed thus far? Unfortunately, my choices are limited but hey, if I think about choice thousands of years ago when my ancestors were effectively wandering in the desert, I am relieved to have as much of a selection as I do. I am grateful.

Thus far, I’ve had whole wheat matzah, fruit, vitamin water (I’m ok with consuming foods or beverages that have no ingredients needing “kosherization”), Jordan Almonds, fruit pieces. Yep, that about sums it up. I do have a plethera of further choices for the upcoming week such as seaweed, kale chips, pistachios, and some products which would require baking (less than 18 minutes of course).

I told my therapist (K) on Sunday that I switched from a vegetarian diet to a vegan diet and the first question she asked, not in a rude way, was “why?” Initially I mentioned the health benefits a vegan diet provides and the evidence showing the benefits of a plant-based diet. Towards the end of the session I told her that it made it a lot easier to merely say I’m vegan than try to explain to people that I’m restricting my intake. I guess that sort of tipped the seesaw for her. She strongly encouraged me to begin attending an evening IOP (intensive outpatient program) to facilitate ways of better dealing with my emotions and those surrounding my weight.

Admittedly, I have lost quite a bit of weight over the past two weeks. I’m not going to put numbers up because I’m not actually trying to compete with anyone (actually reading this). I added the parentheses because I realized that in fact I think I am trying to compete with someone at a subconscious level. First, it was let’s get below my brother’s weight: He’s a mere 160 and 6 feet tall (attribute this to his illness). Then, I’m trying to surpass Barbara’s (I’m her progeny) weight. She nearly 60 years old, 5’6” and 125 pounds. She intends to keep it that way. From what I’ve noticed on Facebook pictures though, she’s likely a lot less (I suppose this is an illness too…. of a different sort).

I’m well-versed in this area. I know what I need to eat, I know how losing weight fast in an instant gratification sort of effort doesn’t pay off in the long run. I know a lot regarding physical well-being. Ironically, I continue to gravitate towards unhealthy coping mechanisms.