A Purchase: Some Thoughts

I went out to buy diet soda–again.  This time, as last time, I chose not to go to Tedeschi’s, as they know me, but to CVS, where I can be more anonymous.  There is another convenience store closer by, but they charge $2 a bottle, and CVS has diet soda on sale for $1.25 right now.  That plus at the other convenience store, which is family owned, they are always giving me looks.  I think they give everyone looks.  Maybe not, though.

So I went to CVS, a longer walk to save 70 cents.  As I approached the soda aisle, I saw some kids with their parent blocking the corner.  Annoyed, I walked around an entire aisle to avoid them, then came up the next aisle, and all the way around to the soda.  I don’t want to be seen.

There it was.  Still on sale.  Four for five dollars.  I grabbed a bottle.  Diet Wild Cherry Pepsi.  I checked ten times to make sure it was “diet.”  I snuck around the back way to the registers.  No wait.  Good.  I approached the cashier, a gentleman, maybe 60.  Never seen him before.  Sweet.  I used my debit card, so that I could get a $10 bill for the cab to my primary care doctor’s on Tuesday for weigh-in (I take a cab there and bus home as it is a complicated commute).  He handed me $30.

“Huh?”

“That’s what it said.  Thirty.”

“Okay.”  I looked at the sales slip.  Looked again.  “Nope.  I put in ten, and it says ten on here.  You just owe me ten.”

“Well, thanks for your honesty.”

I hand him back the $20 bill.

It isn’t until I eft the store that I realized that he never asked me for my CVS card, and I didn’t get the 75 cent discount.  They are supposed to ask for the card so customers can get the discount.  Was I supposed to remember the card myself?  Probably.  But I didn’t.  I expected the discount without it.

Was the guy new?  Probably not.  That particular CVS isn’t doing well enough to be hiring new people, as far as I know.  Maybe he isn’t accustomed to working the registers.  Maybe he normally works “out back.”  I can only speculate.  Maybe he just didn’t know the complexities of cash register work.

What I know he didn’t know was that I, his customer, was going to go home and fill up on diet soda so that I would feel full enough so that I wouldn’t eat anything, because I hadn’t eaten dinner.  What he didn’t know was that I starve myself.  What he didn’t know is that I am a lot skinnier than I appeared to him in the store tonight.

Or maybe I didn’t fool him.  Maybe he knew. Maybe he has a daughter, a niece, a friend, a wife, a lover, a son, who is anorexic.  Maybe he himself has an eating disorder.  Maybe he is going to leave work, stop at Tedeschi’s, buy a couple of cheesecakes and three bags of chips,  go home, gorge himself, and then puke his guts out.

We don’t know.  Eating disorders are for the most part invisible.  There are an incredible amount of people out there with eating disorders who are doing ED behaviors in secret.  Even people who are unusually heavy or thin can hide their eating disorders–or the severity of their disorders–from everyone, professionals included.

When I first developed anorexia in 1980, no one suspected–not even me!  I had never heard of anorexia, and I’ll bet half of the people around me hadn’t heard of it, either.  Some noticed that I had lost weight, others did not.  One person–one–remarked that I may have lost a bit too much weight, and showed concern on her face.  This was someone on the music faculty at my college.

I’d like to talk to her now.  I’d like to tell her that I wish I’d spoken up.  I’d like to tell her that I wish I’d cried out for help just then, and told her about the obsession, the restricting, the fact that I ate so little, and wanted to lose more and more, and how deeply unhappy I was.  I wish I’d asked her what my problem was called.  Maybe she would have told me it was called “Anorexia Nervosa.”  Maybe she would have told me there was such thing as eating disorders, and that I was not alone.  Maybe she would have known where I could have gone to get help for it.

Actually, I don’t really know for certain that she knew. I can only guess.  But chances are, she did.

But the subject was dropped.  We went our separate ways.  Nothing more was said of the subject.  When we saw each other again, we talked about music.

Music.  I swear everyone else at the college was clueless.  Totally.  Myself included.

Maybe I still am.

***********************************

My wonderful new book, This Hunger Is Secret: My Journeys Through Mental Illness and Wellness is now available in e-book form from Chipmunkapublishing.  Click here to download the .pdf file.  To read excerpts at my home site, click here.  The book will be available in paperback form in May 2011.

My visit to Dr. P

…which was yesterday.

Dr. P and my primary care physician, Dr. K, are in agreement.  I need a “higher level of care” than what I have now.  Dr. P suggested the ED hospital, and I refused to go, saying that the ED hospital constituted “inhumane treatment.” She replied, “It is not inhumane.”

“Dr. P,” I wanted to reply, “you have not been there.”  But I didn’t.

She then suggested various treatment programs.  I did not play the “wild card” that I mentioned in my previous post.  I just quietly refused.

All the emphasis was on weight.  Weight weight weight.  A number.  “You are not gaining weight on you own.  Therefore, you need to go to some ‘higher level of care’ so that you will be forced to gain weight.”  That was the gist of it.  And, “You obviously aren’t eating on your own, therefore, you must have supervision in a program.”

I argued what I have stated here, that “treatment” isn’t the answer.

“Well, what is the answer, then?”

“I don’t know.  But ‘treatment’ isn’t working.  It’s got to be something else.”

“What?”

At this point, we were talking in circles.  I said, “I am trying desperately to figure this out.”

Meanwhile, she was typing out everything I said into her computer.  Word for word.  I hate that.  She does that sometimes, so that she can argue with me more effectively.

“You know, people in the waiting room have remarked on your weight loss, how extremely thin you are.”

“Many people comment on my weight.  It is rude of them to do so.”

“That is a lame comeback, Julie.  People wouldn’t comment if your weight was normal.”

I wanted to tell Dr. P that her remark about people in the waiting room was kind of rude, crossing boundaries, I think.

Wait, let me back up.  I came in there with a list.  I had written it on a 4×6 piece of note paper that I had neatly folded and put in my wallet.  I read the list to her at the beginning of the session.  Actually, I read the list real fast because she tends to interrupt, and since we only have 20 minutes, if she interrupts, I won’t get through the entire list.  I’ve had sessions where I’ve only gotten to the first item, and have neglected to mention all the others.   So I zoomed through the list.

I won’t tell you all the things right here right now, except to say that much of what I mentioned was positive.  Less depression.  No mood swings.  My meds are working.  The latest increases and decreases seem to have been good decisions.   I did, however, say that I felt extremely hopeless.  And I mentioned that I had lost a huge chunk of my friends.

Eating wasn’t on the list. Nothing whatsoever about it at all.   Of course, this was deliberate.

It’s all a game, Dr. P, all a game.

Manuscript sent to Chipmunkapublishing

Hi everyone, I sent off the final version of my manuscript just now.  It is like letting go of a helium balloon and letting it go wherever it wants to go.  Or at least that’s how it feels right now.

I’m kinda scared.  But relieved, too.  Now I don’t have the pressure of getting it done, of worrying that the publisher might get impatient with me, feeling that I can’t get on with any other projects (except writing to you, of course).

Now, I pretty much answer whatever questions they might have, and sit back and wait and see what happens.  And hope there are no snags.

Snags…my whole life has been a one big snag since I turned 22.

I dealt with it.  I do have two degrees after all.  I have a book on the way.  I met a wonderful man, fell in love with him, and dated him for many years.  I survived his sudden passing.  I have a wonderful dog.  Doesn’t that count for something?

This Hunger Is Secret: My Journeys Through Mental Illness and Wellness is about what happens when you find out you have a mental illness.  It’s about living with mental illness.  It’s about dealing with it.  It’s about surviving it.

You know, this is weird: Proofreading the book, I can’t help but weep when I read some of the chapters.  It surprises me which ones make me cry.  Some of them make me tear up every time I read through them.  I can’t help it.  I think these chapters are happy–and sad–and I don’t know why.  Some of them are about me being skinny, or at least I’m skinny when the events take place, and these chapters are hard to take.  Some of them I can’t imagine reading aloud.  Not now.  Not now, maybe not ever.

So I’ve let it go.  If I can touch one person, if one person reads it and can relate, or if one person reads it and and is moved in some way, then I’ve done my job.

Proofreading of This Hunger Is Secret is Finished

I have finished proofreading This Hunger Is Secret: My Journeys Through Mental Illness and Wellness. Finally.

What should have taken about two weeks took about three months, because I have been in a state of starvation.

Every time I go through certain points in the manuscript, I change something minuscule, then I go over it again, and change it back, just for the sake of changing something.  It’s time to let it go.  I plan to send it in to the publisher first thing tomorrow, or maybe later tonight if I get some food into me.  It takes a bit of energy to click on SEND.

Thoughts after this week’s weigh-in

I step off the scale.  Another stupid, meaningless number.  I “passed” this week.  That means no hospital. At least not this week.

Dr. K says to me as she’s gathering my chart and getting ready to leave the room, “Dr. P tells me you’ve been water-loading.  We discussed this….”

Then she says something and I haven’t a clue what she is talking about.  Maybe I don’t want to understand.  Maybe I don’t want to listen.

Then she clarifies and says it’s okay if I water-load so long as it’s the same amount each week.

Later, I step off the hospital shuttle and thank the driver.  The #73 bus is already here, but the door is shut while the driver is having his break.  He is discussing some bit about his work conditions with another transit employee.

Wow, another world.

I hop onto the bus, thinking, how much longer can I continue to lie and cheat?  Who am I really lying to?  Who am I deceiving?

Myself, obviously.  But here’s a question rattling around in my mind:  Is it the eating disorder that’s deceiving me, or has it gone beyond that, and is it now me that’s the liar and cheater?  Have I become my eating disorder?  Am I nothing but a living, breathing ED?  Am I nothing else now?

These are very stupid, stupid questions.  Maybe the hospital gown I was wearing actually weighed three and a half pounds.  But a number is only a number.

I desperately want to tell my therapist that therapy isn’t helping.  But at the same time, I want to tell her that therapy is one of the things that is keeping me alive.  Without my twice-a-week therapy sessions, which I never miss, I would descend rapidly into Anorexia Hell.  Yeah, life seems to get better, get worse, get better, and there’s this downward trend, but therapy is keeping me above water.  I may be moving further from shore, but I am not drowning.

Yeah, therapy isn’t making me improve.  No “treatment” is making me better.  I don’t think “treatment” is the answer.  Something else is the answer, and I’m not sure what.

I do have a life outside of these three-times-a-week appointments (twice-a-week therapy and weekly weigh-ins, plus monthly check-ins with Dr. P).  These appointments take up…let’s see…about two hours a week, plus another two hours and 15 minutes in waiting rooms (I come early).  That’s four hours 15 minutes.  There’s a lot more time in the week than that for “non-treatment.”  At least I don’t go to a day program, which is 30 hours a week.

Some people center their lives around treatment.   At this point, with the threat of hospitalization looming, it is hard for me to avoid constant worry about my treatment fate.  But it is time to stop worrying and start living.

How do I quit this worrying?  Well, eat, obviously, and get them off my back.

I step off the #73 bus.  The $71 bus comes immediately.  I still haven’t taken off my fleece jacket.  It is 85 degrees out.  Jeez.  What the heck am I wearing a fleece jacket for in this heat?  Is it because the bus is so friggin’ cold and I have no meat on my bones to keep me warm?  Is it because I want to hide my body?

The $71 bus leaves me off across the street from the CVS, where I buy toilet paper and dental floss.  Neutral items, not food related.  Relieved, I pay for these items.  I do not remove my fleece jacket until after getting out of the store, because I’m afraid of running into a former neighbor in there.  If I do, she’s bound to make some rude  “comment” about my body.  Why do people do this?  Am I supposed to answer, “Wow, you’re so fat!”?

I cut through a parking lot, through the park, and down a walkway in the woods and a dead-end street, coming out across the street from my home.  I look both ways before crossing the street–several times, back and forth, back and forth.

Why do I look both ways so many times?  Why do I stand as far away as possible from the train on the subway platform?  Let me tell you something:  Anyone who has ever thought of jumping–I know this–does not stand on the edge.  They stand as far away from the edge as possible, for fear of accidentally/on purpose falling off.  I always look both ways over and over, because carelessness/purposefulness can strike anytime.  And Puzzle desperately needs an intact mama.

After looking both ways, cars stop for me, on both sides.  I wave–happily–thanking both of them, and cross to the other side.  I ask myself if I should put my jacket back on before venturing into my building, to hide myself, but–now this is wicked stupid–what if someone saw me doing this?  Wow, is this paranoia?  What is it?

I enter the building, and peek into the dining room.  Nope, there are people there.  Not safe.  So I go up the elevator instead.  Quickly, I turn right, rush down the hall, arrive at my apartment, put the key in the lock, open the door, and I am safely home with Puzzle.

Safe.  For now.

Yet another trip to Tedeschi’s

I went to Tedeschi’s again to buy a 2-liter bottle of diet cola–their brand–99 cents plus five cents MA deposit–total $1.04.  I brought with me–that’s right–a dollar bill and four pennies.  I didn’t intend to buy anything else.

This embarrasses me.  I go in there frequently, too frequently, to buy a 2-liter bottle of diet cola and nothing else.  Well, why the heck does this skinny girl buy diet cola and nothing else?  Does she drink diet cola instead of eating?  What’s the scoop here?  And why doesn’t she buy root beer, something with calories in it, for godsakes?

Yeah, I’m embarrassed.  I try to hide my body.  I calculate: If x employee was working at 11am today, will he still be working at 7pm, and see me buying yet another 2-liter bottle?  Or will the shift have changed?  I calculate: what is the likelihood of my running into a former neighbor at this hour?  Once, former neighbors caught me hurriedly stashing not one but two 2-liter bottles of diet cola into my knapsack.  I ask myself what they thought of me.  Probably, nothing, my logical mind responds.  But my ED mind is all over the place.

Yeah, this heavily reminds me of something: Binge Eating Disorder.  BED, the days past, when I went to stores and bought cakes–Entenmanns, frequently, cookies, M&M’s, candy bars, cheesecakes, pies, everything, came home, and devoured it all at once.  Sometimes, I had no choice, being a desperate pedestrian, to go to the same store several days in a row, and yes, I suspect the employees did indeed wonder what I was doing.  At the city drug stores, and places where I didn’t go frequently, or at supermarkets, where I could be anonymous, no, they didn’t know, though always I worried that everybody–customers, cashiers, baggers, passers-by, everyone–knew my vile habit.  But at the tiny convenience stores–yes, in hindsight, they knew.  They knew exactly who I was.

As I sit here today and look back on that hell I went through, I wonder how I survived it all.  I wonder how I made it from day to day, trying nonstop to avoid the next binge, the next trip to the store to buy foods I gorged myself on, the next nightmare stuffing the food into my mouth until my stomach was full and my throat would accept no more.  I remember the shock I felt afterward at what I had done, the sheer horror of it, the shame and guilt and knowledge that I was Evil and that I had done and felt and seen and known something Evil and had been to Hell and deserved to stay right where I was.

Compared to this, my guilt over buying a 2-liter bottle of diet cola, and having people witness me doing this, seems minuscule.  Yet the obsession I have about my weight, and about food and calories, and my drive to starve myself–these are powerful indeed.  Someday, I hope, I will look back on this and either laugh or cry.  Or maybe I’ll be relieved.  Relieved that I don’t have to cross Main Street to stop at Tedeschi’s anymore for anything–junk food or diet cola–nothing at all.

Sometime in 2008 I crossed over an ED Main Street, and haven’t returned.  I suspect I won’t cross back, because crossing the ED street is too scary, but maybe there’s a bridge somewhere, and I can somehow find it, or someone will show me the way.  Maybe the bridge is a gentler, softer walk, back to the other side, back home again, back to the way I was before, back to me.

Is there a bridge?  Will you show me the way?  Will you guide me, take my hand, lead me to the entrance, up the incline, and down the other side?  Will you help me be strong and brave and steady as I walk across?  Is there such a bridge?  Maybe not.  But maybe, just maybe, there is.

Regarding Eating Disorders “Treatment”: Today’s Reflections

There are many kinds of ED treatment available today.  People who develop ED’s in this decade are indeed fortunate that the knowledge and experience of professionals is much greater than it was when I first developed anorexia and subsequently binge eating disorder in 1980.

Those of you old enough may recall that Karen Carpenter died in 1983 of anorexia nervosa.  Some of you are young enough that you don’t even know who Karen Carpenter was.  She was one of the best-known singers of the 1960’s and 1970’s.  She had an angel’s voice.  All the money and fame she had did nothing to help her.  Her friends were desperate and didn’t know what to do, as nothing was known about the disorder.  She kept it hidden from the public throughout her career.  Her solo album was released posthumously.  I was in the hospital (for my mental disorder, not the ED, which doctors ignored) at the time, and was deeply affected by her death.  The nurses didn’t understand how I could be so devastated over some celebrity I didn’t even know personally.  But in a way, I did very much know her.

But I digress.  There are many treatments available today.  There are hospitals and various treatment centers that specialize in ED.  You can see a nutrition specialist.  There are therapists and psychiatrists that specialize in ED.  You can go to various levels of “step down” programs for ED, which include “residential,” which is like an ED halfway house, where you go to live.  There are ED evening programs, where you bring your dinner, and have groups.  These generally meet 6-9 at night several nights a week, and are designed for people fairly along in their recovery who work during the day or go to school.   These can be fairly long term.  There are “partial” programs, that get people back on their feet again after the hospital, which meet 9-3 generally.  You still have to take time off of work because six hours of the day are taken up by this program.  These have a “supervised” snack and lunch.  The rest of the time is taken up by groups.  It is short-term, just a few weeks.  Another form of ED treatment includes various types of independent outpatient groups that you can go to, generally run by a specialist.  There are also self-help groups and support groups that don’t have leaders, including 12-step groups.  I don’t think there’s such thing as ED long-term (over three weeks) day treatment in my area, and I don’t know if it exists anywhere as a treatment option as ED alone, but a general mental health day program, such as the one I tried to get into as an alternative to hospitalization…because, as I said before, I was desperate to avoid hospitalization.  But I have been successful at avoiding hospitalization…for now, anyway.  But I have told you this before, so enough of that.

Correct me if I’m wrong about all the details on treatments, also if I’ve left one type out, please let me know.

What is available to me: Therapy, with my therapist, twice a week, who has a lot of knowledge and training in ED but is not an ED specialist.  My psychiatrist, who is an ED specialist, and once headed up an ED program at a top hospital in the area.  I can see an ED specialist, but I don’t.  I saw a nutritionist and it didn’t work out.  I see my primary care doctor once a week.  I don’t go to a group, but I could, and in fact I saw one–an expressive therapy one (art therapy, etc) for ED–that interested me.  I tried to get into another group and got turned away because they said I was too sick for it and not “recovery-oriented.”  Imagine that.  Psychiatric day treatment–I was turned away.  I was reasonably certain it wouldn’t help anyway.  An ED partial is available to me, and I haven’t even bothered to tell my T that they take my insurance because I know it won’t help me.  Again, group programs have never helped.  They make me worse, generally.  Plus, what good will just a couple of weeks do me?  I heard from five or six sources–people that have been there–that the program is terrible, just not a very good program, and not really worth going to.  I’ll play this “wild card” only if I desperately need to–if I need yet another alternative to hospitalization.

What about these evening programs, and the halfway house?  Can’t do.  None in my area take Medicaid and Medicare.

Do I really want “treatment”?  Do I really want to get better, to rid myself of my anorexia?  Or do I want to stay in this hole I’ve dug for myself that everyone steps over, where no one sees me?  People walk around it sometimes, or try desperately to pull me out, and cannot.  The hole usually feels like a safe, warm place.  Often, though, it feels like my grave.

But do I bank on the knowledge that treatment, right now, isn’t helping?  Nothing is working, and that’s a fact.  Therapy isn’t making me eat.  Meds aren’t making me eat.  I am getting turned down left and right from other types of treatment that won’t work anyway.  No amount of statistics and physical symptoms I have seem to scare me into eating.  Do I like this?  Or do I desperately want help?

You know something?  I think I want help.  And as I write these words, I weep.  I want to be helped, gently, out of the hole.  I want to be invited, not pulled, out of the hole.  I don’t know what it’ll take.  Maybe it’ll be the faithfulness of my friends and all the love and caring they are giving me, and the way they listen to me, and I listen and share with them, and how we quietly spend time together.  Maybe it’s the satisfaction I get from making progress on yet another sweater for my beloved Puzzle, knowing I’ll keep her warm this winter.  Maybe it’s writing here, communicating, which I do with such desperation these days, knowing that people are actually reading my words and hearing me.

And maybe it’s the look in Puzzle’s quizzical eyes, when she tilts her head and wags her tail, and I remember, “Puzzle needs a mama!” and know that I must, must plod on, if only for one more day, and then maybe for another.   And  I am suspecting, believe it or not, that my faith in God, which was eradicated when my anorexia returned in 2008, may finally be peeking from behind the clouds, just a wee bit, and although I cannot catch it, and it may disappear again before I can grasp it, this hint of something–anything–gives me a sense that maybe, just maybe, something is going to happen.

Lamb’s Pride Braided Dog Sweater for Female Dog–Pattern edited–again….

I found another small error in the pattern, and fixed it.  Here’s the URL, once more….

http://juliemadblogger.wordpress.com/2010/02/20/new-dog-sweater-pattern-free/

Go take a look at this free dog sweater pattern!

As it turned out

As it turned out, I was not admitted to the day program.

Get this: they don’t want me until I’m more “stable.”  A lotta sense that makes.  Don’t people go to programs to get stable?  Well, when I do get stable, I sure won’t need or want day treatment, that’s for sure!

For a change, my therapist agreed with me.

Thankfully, nor do I have to go to the hospital.  This issue seems to be resolved.

My therapist is still encouraging me to voluntarily agree to get locked up, have my rights taken away, get force-fed, and forced to gain weight at an inhumane rate in a “hospital.”  She wants me to do this so that I will “gain weight faster.”  IMHO, rapid weight gain alone is not only unnatural and taxing on the body, it is cruel and unusual punishment.  So I told her, “Maybe some other time.”

No, I’m only kidding.  I told her, “No way!”

She said, “Well, then, you have to eat.”

I said, “I suppose I do.”