Friday, April 2, 2010

Jane's Rules

Ok, just to be clear..... 1) I am not medically unstable. 2) I do not need to gain weight

Despite that, these are the results of my conversation/dinner with Jane last night:

She thinks I don't quite grasp how serious this slip is. She wants me to stop overthinking and just start eating better. And these are the steps, or interventions, that she is taking + my reaction to them:

1. She is calling my MD today + calling another MD who she knows specializes in EDs to tell them I'm eating too little. Then she wants me to have an appointment with them early next week. She wants them to take my vitals etc. to check if I am medically stable because, as Jane puts it, "You never know, and if you're not, you need to be in the hospital." My reaction to this: This is crazy. I AM DEFINITELY medically stable. I know it. I do know it. This is a HUGE overreaction. At the same time, I understand why Jane suggests this. It's her job to make sure I'm safe. So she has to request that I'm checked out medically. Still, I KNOW FOR SURE that I am fine physically. Also, I KNOW FOR SURE I would not have to go to the hopsital. I am SO SO SO FAR FROM THAT. That would NEVER happen. And, if a doctor did suggest that, I would IMMEDIATELY resume normal eating. So, Jane just called me again this morning to enlighten me to the fact that she is about to call the MD. I'm not stopping her, but I also have no intention of setting up and appointment to go. No intention.

2. Jane wants me to drink 2 - 3 ensures every day ON TOP of food. I was supposed to drink one last night before bed and call her to tell her I drank it. I did not drink it. I took a sip and spit it out. I just don't understand why I have to drink it. Seriously though. There are two purposes to drinking ensure as far as I can tell: 1) Get nutrients you are lacking. 2) Gain weight. In response to the former, my body is not failing. True, I probably do not get all the nutrients I need, but it's not a dire situation. In response to the latter, I don't need to gain weight, so why should I drink the ensure?

3) But, if I don't drink the ensures today + eat 3 meals, then she wants to see me on the weekend. But I don't want to drink the ensures!!!!!!!!!!!!!!!!!!! So this is a dilemma

4. She said we are going to talk on the phone every single day for a week. That's fine with me.

5. She wants me to e-mail her my food diary. That's fine with me.

6. She wants to call my parents asap and have them come up here. I WILL NOT allow this. This is not THAT big of a deal.

7. She is giving me one week, (of talking with her every day), to turn this slip around. She told me I don't even have to go back to being totally normal, I have to go from "seriously slipping" to "a little bit regressed."

8. If, in one week, I do not turn it around, then she's going to recommend I take a "medical leave" from work, see her 3x a week, talk to tracy 2x a week and do some IOP thing on top of all of that.

I'm a little worried here. These are my worries:
1) I won't drink the ensure becuase I do not see the point.
2) What if I don't eat better?
3) What if it doesn't turn around?
4) What if it actually gets to the point of her recommending "medical leave"?
5) What if I don't do it and everyone's mad?
6) What if I don't do it and everyone's sad?
7) Why am I the only person who realizes this isn't THAAAAT big of a deal? yes, I know it's a problem... but it is not at "intervention status."

**I do have extra thoughts about why I am continuing to not turn this around, but I don't feel like writing them right now.

**I feel like everyone needs to chill and just give me some space to think.

**I know I haven't been eating well, but it is not THIS big of a deal. It's REALLY not!


12 comments:

  1. Okay - I have to respond to this. I found myself in a situation very similar to this not too long ago, and I understand your immediate retraction from the whole situation ... but do you really think this is not that big of a deal or is it your ED and nutrient deprived mind speaking?

    I have been reading for a while and I think this is the worst slip I have seen ... even more so then back before summer. I don't mean to be harsh, but it is true. Something needs to be done.

    My tx team gave me a contract that I had to comply with or I could not longer see them because they were not helping me get out of the situation. I was PISSED - but looking back, they were completely right. I did quit tx for a week, then put my tail between my legs and crawled back and signed the contract. I went to the doctor, my parents came to therapy (and believe me, I only wish I had your parents - mine still think I am making it all up and will not help at all), I have increased my intake on a VERY structured MP, and I have done a lot of other hard work. I did not want to do any of it, but I did because deep down I knew my team was right.
    It is now one month later and I have been re-evaluated ... they no longer think I need inpatient, but they still believe I need more support. We are talking about medical leave and IOP right now as well. And you know what - it is not convenient, it is embarrassing, I don;t want to do it - but I am considering and we are talking through the logistical and emotional issues.
    I think I will end up doing it because none of those things will matter if I am not around anymore. I was never medically unstable either and I do not need to gain weight - but I wasn't making progress, and that is a definite reason for IP that is pretty common. So don't think you don't qualify.

    And as for the ensure --- I am drinking a boost a day (used to be more), and I am in the same boat as you. THe thought is that they are easier than food, and easily replaceable once food is not as difficult. Only the ones that say PLUS mean weight gain (and even then that is not always the case).
    And the doctor - I was never medically unstable, but I did have low iron levels and a really low resting heart rate - and some other things I was not really aware of. You could be surprised.

    I don't mean to be harsh, but I think you need some reality.
    Do what they are saying. Drink the boost, see the doctor, let her call your parents, and cry and moan and scream throughout it all - but do it. You think you are so far from hospitalization, but being of average weight has very little to do with it. Be careful and take care of yourself.

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  2. You NEED to listen to your therapist. She knows what is best for you. You are very very sick right now as much as you refuse to admit it. Jane would NOT recommend any of this if she didn't think you need it. Please just listen to her and do what she says. You are in a very very bad place and need help.

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  3. I'm inclined to agree with the other commenters. Jane would not have suggested this if she didn't feel it was necessary, and sometimes we need a shock like this to jolt us into taking action.

    Your entries have indicated to me that you are struggling, and I have been worried, because you can have serious issues with an eating disorder whilst still at a normal weight. People die from eating disorders at normal weights. You can so easily fall backwards further from this point, and it's important to catch yourself before you get so trapped in the disorder that you cannot escape.

    I wish I could be more help....

    Sarah x

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  4. Yesterday you were all gung-ho to eat and you knew why you needed it. Now you are very resistant. Whats up? And remember you can look normal but still have problems.

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  5. HUG. Sorry if I was mean. I just worry about you. And those that can SEE you are worring too. That makes me believe them. Your boss, your friend, your T and RD other workers... too many people are saying something is wrong here.

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  6. I want to just say that I'm reading all your comments. I'm at work so I can't respond thoroughly, but I thank you for your comments. I really do. Maybe I do need a reality check. Thanks for sharing your thoughts. I mean that.

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  7. I agree with what sarah said. You dont have to like it, but just do it. As far as seeing the doctors goes, if you dont think you are medically unstable then you dont have anything to lose. Either you will go in and they will confirm that you are fine (which will make jane feel better), OR they might find something wrong and then you will be glad you went in.
    As for the boost on top of meals, I guess I am going to say "just do it". Although I admit, i'm not sure it would be easy for me in the same situation. I'm like you. I need a rational, scientific explainatin of why I need the boost if I am eating 3 meals already. Yeah, thats a toughie.

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  8. Listen to Jane. She cares and wants you to be healthy. Take care of yourself!

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  9. Laura,

    I feel you, I really do! Im on a mp, which I hate and am on some days TOLD I must drink several boost's ABOVE my mp...even if I had eaten my mp...NOPE it doesnt feel fair but honestly hun, when we are in our Eating Disorders we cant see reality...we just cant, whether its because our brains are starved (which is probably true) or we are just in out right denial...it doesnt matter WE DONT KNOW BEST! If we did we wouldnt be in these situations. It blows it truly does but there are worse options like NOT being here. Which my dear friend is a very real possibility. 2 years ago I literally almost died and I was completely unaware there was anything wrong...my wieght was okay...my body was not, if i hadnt gone to the doctor that day, The ER doc told me I had maybe 2 days until my heart gave out...sobering thought. Just do as they say. If not for any other then because you respect Jane and she is wise. i know its scary laura, but you are stronger then you think, but right now you are not the best judge of your own health...i hope i wasnt to harsh...i just dont want anything to happen to you...

    big hugs

    Tara

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  10. Oh, yuck!

    Damn.

    My mom made me do the "ensure" thing for a while... Only with boosts, though - same thing (same cals, even, +/- 10 cals).

    I HATE nutritional supplements unless they are REPLACING meals, not being added to them! My therapist said the funniest thing the other day, and I had a hard time not laughing because I was afraid of how she might take it. She asked, "When you fast, do you still drink boosts or not?" What the HELL do you think? That's not 'fasting'!

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