I skipped Monday’s therapy appointment and e-mailed my T, saying I was “vacationing.” I will show up tomorrow. Instead of explaining myself and my “vacation” out loud, I will hand her this letter and ask her to read it. Here it is:
Written Monday 5/2/11 and also Tuesday 5/3/11
A LETTER TO MY T REGARDING MY BRIEF VACATION…FROM THERAPY…THAT WOULD HAVE BEEN LONGER EXCEPT THAT I STARTED TO FEEL GUILTY ABOUT FIBBING
As of the time I am writing this to you, I am on a vacation from therapy. That’s where my vacation was. I didn’t go to Hawaii (which would of course have been my first choice), rather, I stayed at my home and didn’t come to therapy and told you I was “vacationing,” which is the truth. I am doing this vacation because I needed a break to mull things over and try to figure out exactly how I felt about what was going on with my body and with what you expected of me. I am also on vacation from my weight check appointments with Dr. K, for the same reason.
Sometime after April 12 and until April 30, I experienced unexplained rapid weight gain. During the last week of this 18-day period, my weight showed a 5-1/2 pound increase in a single week between weight-checks with Dr. K. In addition to weight gain, I noticed many other changes. These included the following:
Ankle, calf, foot, and leg swelling
Abdominal (stomach area) swelling
Food staying in my stomach for many hours, even overnight, instead of going into my intestines after a short while
Constipation despite vigorous exercise (running)
Sluggishness, especially in legs
Difficulty walking due to pain from what were now ill-fitting shoes
Difficulty tying shoes properly due to enlarged feet
Decreased physical stamina
Slowed running, difficulty running, and finally inability to run at all
Extremely lowered energy level
Loss of “bounce in step”
Feeling cold all the time
Loss of motivation
Insomnia every night
Feeling ashamed of my enlarged body
Feeling hopeless about my body
On Thursday, April 28, I finally experienced severe depression due to my hopelessness over my weight. I knew something was drastically wrong. I had counted how many calories I was consuming and how many calories I was burning. I had watched my scale read a half pound a day gain for days. I cried all day long over my weight and could think of nothing else. Our session that day was only a quick fix. I went home and cried some more.
The following day, April 29, I went to see Dr. K and showed her my swollen ankles. She explained that I had refeeding edema. I wasn’t familiar with this term, so I looked it up when I got home.
You know, if you Google refeeding edema, refeeding syndrome, which is fatal, comes up on the very same page. I clicked on both. I clicked on a lot of things. I read some scholarly information, as well as some posts on message boards from people who were experiencing refeeding edema. I learned that swollen ankles is a sign of refeeding syndrome. Dr. K’s reassurance that the refeeding edema was temporary was also only a quick fix. Even when she explained that this was the reason for the weight gain, I was not satisfied, because at this point, I was beginning to distrust both of you.
I awoke April 30 to a 2-1/2 pound weight increase. Water weight, huh? I went to tie back my hair in the mirror. I did something at that point that I rarely do. Normally, I use the mirror to look at my hair only, just to tie it back. But I felt my face with my hands. It felt fleshy and less angular than it had been. I felt round cheeks, like a doll’s. Slowly, I tilted my head up and looked at my face.
I didn’t even recognize the woman I saw in the mirror. What I saw was a soft, round, chubby face, like the moon. It was a sad face. It had a pasty, white, stretched look, and no life in its darkened eyes.
I haven’t looked at that face in the mirror since. I just tie back my hair and ignore what’s underneath. But seeing what I saw then was the breaking point for me.
Was my body really playing this trick on me? Who was tricking whom? No, T and Dr. K, it is you two that are playing the trick on me and on my body. Why? Because you expect me to sit back and watch this happen to myself. You expect me to accept this rapid weight gain, extremely high fluid level in my body, and subsequent sudden larger weight and size as my fate. You expect me to live with a myriad of other symptoms as I described above.
No, no no no no no. I will not let this dangerous, cruel, thing happen to my body. I am taking back my body. I own this body–you do not–and I am going to care for my body right here right now.
I went running and did a lot of thinking. I noticed that I was very, very sluggish on my run. In fact, my pace was so slow that a walker in good shape could have passed me! Whereas I normally run three to five miles, my legs were so filled with fluid that I was only able to run for seven laps, less than two miles. My stamina was very low as well. I gave up and came home, and did some more thinking.
After lengthy consideration, I decided to do the sensible thing: I cut back on my food to rid myself of the edema, get my digestion back in order, and bring my weight to a number that I can accept as okay for me right now, not some out-of-control and rapidly rising number that I am not ready for. I knew that I was specifically not following your and Dr. K’s wishes by doing this. However, I am following what is stated in my contract, that is, to take care of my body lovingly and with respect. If I saw Puzzle puffed up and swollen, I’d be so alarmed that I would think that she was going to die. I’m sure the vet would be extremely worried as well, and would respond appropriately and not tell Puzzle to “sit with the fear” and continue to allow Puzzle to remain an ill and bloated dog.
I chose to cut down on my food quite a bit. After one day of reduced caloric intake, I felt much, much better. Already, the swelling had gone down considerably. On the second day, I noticed some body changes happening quickly. Although I am now eating less, I actually have more energy because there is much less bloat in my legs and the rest of my body, and the stomach fullness has almost completely come back to normal, though my digestion was still very slow. After three days, my sleep quality was better than it had been in over a month! My depression has been alleviated due to the fact that I no longer see out-of-control weight gain in the future. I have taken back my body, and intend to keep it. It is mine.
I have kept a careful log of everything that has been happening to me since I have cut back on food starting Saturday. It is all good stuff, except for minor pain in one foot to walking in ill-fitting shoes (same shoes, expanded feet). The foot is on the mend. I also took photos of my ankles every day to illustrate the progressive lessening of my edema. I may print out these photos and bring them in to show you. I have posted these progress photos daily on the Internet, and have intentions of posting a warning to people with anorexia about refeeding. Boy do I ever hate the term “refeeding.” I intend to say that you shouldn’t suddenly start eating “normally” because of this horrible thing that can happen to you that happened to me, that plus the chance of developing refeeding syndrome is high if you’ve been starving yourself for a while and then suddenly change your regime, with a note that refeeding syndrome is indeed fatal. Let it be a warning. I will not do this again to my body.
I hope you understand.