Photo: mine
It’s been nearly a year since things with my former eating disorder ‘therapist’ went far enough down the tubes to feel like therapy, such as it was, was over. Nobody had asked about my intake for a couple of years, so it seemed like it didn’t really matter if I ate or not. I knew I’d have to make myself get in enough fluids and food to make sure that my kidneys had enough on board not to get worse. It’s been hard, and there are a lot of days when I think about just going back to what was less physically uncomfortable. The emotional end of things has been much harder considering all that has gone on with my former non-therapy.
I’ve tried multiple times over nearly 4 years to get rid of the nasogastric tube that gets enough fluids in for adequate kidney function, as well as blood pressure support. The tube is back in after another try at not having it last month. I made it a few days, with lower volume food intake (tried to eat higher density foods, but I don’t like a lot of them), but then struggled for 3 days, and that’s my self-imposed limit. I can’t risk going longer since I’ve been in acute renal failure twice in the past 4 1/2 years. But I am still maintaining fluids, even if I need the tube to do so.
Food is still a problem. “Normal” eating is still something I don’t feel I deserve, and it’s physically unpleasant with bloating and feeling too full. I’m not a purger, so once it’s in, I have to put up with the side effects. I’m not as ‘avoidant’ with the types of food I will eat, but am still consumed with not eating over X number of calories per day. Tracking food is something I tried to get away from, but I have to know carbs for insulin dosing, and protein for my kidneys. It’s very difficult to get in enough protein when I have to restrict the options because of gout.
I’ve been trying to do the opposite of what my head says, and at times I can do that, but only with some types of food (single serving sizes are helpful). I’ve wanted to let myself have one meal a week or month when I just have what I want, but that hasn’t gone well for several reasons. The medical restrictions on food, only getting X amount of insulin per month, etc are hard to deal with when attempting to break some ‘head rules’ about food. The current “never restrict” goals of eating disorder recovery are hard for someone who has literally always been restricted (when I was a child) or my own active and passive restriction… For me, active restriction is when I relapse and passive restriction is eating how I did for my entire life, eating about one meal stretched over the day. For me, that was ‘normal’. And what I see in the mirror still doesn’t look like it deserves food, even though I’d give more to someone else, whether they were larger or smaller than I am.
I am starting to understand that like dogs, birds, fish, or whatever family of animals, humans have different sizes and shapes that ‘just are’. There’s no ‘defect’, just natural differences. I’m not sure what my set-point weight is (natural weight without restriction) because I’ve never NOT restricted in some way (or been externally restricted). I’ve read or heard (YouTube) that it takes time and an extended period of not restricting to get to that place, so I’m nowhere near that since I’m still restricting to some degree with the fear of going over X number of calories that are below what the dietician I saw told me is ‘normal’ for my age, activity level, and body type. I will never be a greyhound. I’m more of a Labrador retriever. And I still have the urge to be a greyhound.
I understand that repairing the damage I’ve done to myself over decades takes time and food. I know that I’ve gained muscle in my arms and legs, and that there is a difference in swelling if I don’t eat enough protein (hardest thing to get in with medical limitations). Some of that muscle gain is starting to atrophy a bit. I’m tired of most ‘safe’ protein sources, so there is a lot of forcing in of stuff just to get to the minimum, and honestly, I miss that mark many times a week. But I’m still trying. My heart rate is still wonky, and my blood pressure stays low normal unless I’ve taken trash out to the dumpster; then it goes to high normal for about 10 minutes. The higher blood pressure is probably better for my kidneys since poor perfusion is why they are damaged.
Most days I don’t feel like anything will really work to get me rid of the restricting. I still feel worth less than I did 5 years ago when I relapsed, after 3 1/2 years with my former ‘therapist’. It’s hard to feel worth anything when I’ve felt worthless for decades, and I felt kicked to the curb by someone who had no interest in me getting well even though that was the sole purpose of that relationship. I also know it had nothing to do with me personally, I was just another failed patient because I was too broke to be worth the time to get well. I’m not alone there… lots of examples online, which helps in knowing it’s not about me, but also sad that so many have been left suffering more because of that relationship that fizzled out without the decency to finish what was started. I’m working on getting past that, which is hard, but it’s not like this is the first person to be a disappointment and something to recover from. I generally land on my feet, and thankfully am as independent as I can be within physical limitations. There is no limit to my emotional independence since that’s pretty much all I’ve known. So, while I’m broken, I’m not destroyed.
Tag: intuitive eating
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Have I Gotten Anything Right Yet?
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Grieving Hope of Recovery With Ex-Therapist
Photo- mine
It might sound weird to grieve for something that never happened. But I’d dreamed of getting well with someone who seemed to have figured out how to get the eating disorder voice to go quiet for good. She has helped a lot of people, but it seems that she loses interest quickly when the money runs out- even though she said she’d still keep me (after paying $32,700K USD- the agreed monthly amount before she accepted me). The calls petered out, and there was always an excuse. But what hurt the most is basically being blown off while I was still paying. I know that sounds stupid. I’m skeptical of a LOT normally. I’m not one to believe most people after so many violations of trust in my life, or taking advantage/targeting me because I want to be helpful or ‘good’ to others. But I felt I could trust her. I was very, very wrong.
The ongoing and lengthy absences with no warning, constant excuses (I don’t even know what things to believe are true or not), telling me other patients’ private information, and calls that never came just reinforced the feeling of worthlessness, with no acknowledgment of that whatsoever from her. When other patients did something she didn’t like, I was told by her that they were difficult or were somehow worth more of her time, when I did what I could not to cause problems. And that was a huge mistake. I needed squeaky wheels to be acknowledged- like she needed the patients to swarm to her for contact. I don’t do that 4th grade crap. This whole thing has been traumatic and painful. It’s hard when hope gets blown off by a person who is supposed to be a ‘last resort’. Her promises meant nothing.
I wanted the freedom to not think about food and losing weight that has haunted me since I was 6 years old. I wanted to be able to have something just because I like it- not because it’s specifically to fit into the macro numbers. I wanted my head to be ‘rewired’ so that I had a healthier relationship with food, so I could be more social with friends, and get my body repaired. It’s been through a lot.
But those dreams aren’t dead (they are with that therapist), and I still hope to get well via YouTube eating disorder recovery videos that all promote basically the same thing. Don’t restrict food. Period. Weight will even out when the body knows it’s going to get consistent food, and doesn’t have to hang on to calories for fear of not getting enough. I still have trouble with that because I’m not thin- but I have to try something, and with the numbers of people who have recovered with this method (intuitive eating and feast v famine mentality and body response), there has to be something to it. And aside from buying the books that Tabitha Farrar and Elisa Oras have written, it’s free. I also have my IRL dietician, who is very helpful, and knows I’m struggling. She also always responds to questions via email. If she’s out of the office, I get a notification that she’ll contact me when she’s back.I am hoping I have the nerve to have a piece of birthday cake this year- kind of a celebration of being free from the psychological manipulation and control by someone who isn’t worthy of such power, as well as not doing what my head says about being too ‘bad’ to deserve a bit of cake. Little goals.
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Doing The Opposite Of What My ‘Head’ Says
Photo: Mine, lychees
This is so hard. I’ve never known “normal” eating, and now have the Ex-T’s “food rules” to undo as well. The entire idea of restrictive eating disorder therapy to undo the restrictive eating disorder is NOT to have food rules (other than those I have to deal with for medical issues- diabetes, kidney disease, and gout). I just want my head to settle down, and not dictate what I eat, how much, when, etc. I’ve had periods of time when it was all less intense, but for the last 4 1/2 years, it’s been pretty constant- the longest continuous time in my life when I’ve been so controlled by ‘my head’ to this degree. I’ve been in acute renal failure/acute kidney injury twice because of not eating enough in those 4 1/2 years. I have to get this sorted out. I do have a dietician, and I’m thankful for her.
Every time I make a day’s food plan, it’s all about ‘the numbers’. I don’t eat things I like UNLESS they also fit into the days ‘numbers’. Macros (protein, carbs, fats), as well as sodium (can’t go too low or my BP drops which puts my kidneys at risk, and muscle cramping is horrific). If I spontaneously eat something different during the day that messes with those numbers, I have to redo the rest of the day so the ‘numbers’ are OK again. I’m trying to figure out how to just eat stuff without focusing on the stupid numbers as much, but it’s all I’ve known for 5+ decades.
My hunger cues have been messed up for a long time. For many years, I didn’t feel physical hunger, even though I thought about food constantly and still do. I am starting to feel physical hunger again, and it’s terrifying. I have images of me eating what I want until I feel full and ending up gaining even more unneeded weight. In reality, it doesn’t take much for me to feel full. But the fear is very real. I view myself as already grotesquely overweight, even though when I see TV shows about extremely obese peoples’ weight loss journeys I don’t judge them. I just wonder what hurt them so badly that they are hurting themselves so much. I know that sounds hypocritical. I KNOW all of this is bonkers. And, I can’t just flip a switch.
I want to set up a day when my blood sugars are more stable (parathyroid hormone is wonky right now, so insulin resistance is increased), and then just try and – for one day only (to minimize panic in my head)- eat what sounds good when I’m hungry, and not worry so much about anything that isn’t focused on getting me stronger. If I make it for only one day, I don’t have the pressure to do it for longer while giving myself the chance to see that it is possible. Then, I can do 2 days, etc. In the meantime, I’m trying to have one thing every day- even if it’s just 15 grams more of something, that is against what my head wants, which is eating close to nothing, although I’m eating ‘enough’ to keep kidney function stable at this point. I do get some reprieve because of the kidney situation, but it’s not all-encompassing. I HOPE that if I can get my eating more ‘normally’ that my kidneys will do better. I am not someone who would do dialysis if it came to that.
I have found that I do better if I can avoid sweet foods in the morning. I just don’t like them, so the past 3 1/2 years of being strongly encouraged to eat yogurt and berries, kefir, or oatmeal/porridge, and the horrible sweetness of those, have been miserable. I couldn’t find a savory oatmeal recipe that sounded edible. Scrambled eggs were/are allowed, but when my blood pressure isn’t stable, or I’m in a lot of pain, it’s hard to do a lot of stuff that requires prep and/or cooking. I much prefer something like cheese and crackers, and maybe some fruit that has a bit of tang, or even leftovers from another savory meal. Many countries have soups as ‘normal’ breakfasts, and that might also be a good thing to try.
Single serving items are also helpful, though I have to be careful with prices. For frozen entrees, I have several that are budget friendly and taste good, and only require being popped into the oven or microwave. Lean Cuisine has a lot of flavor options, and for a substantial treat, I’ll get Amy’s Kitchen or MichaelAngelo’s frozen single serve entrees. With some products, I can count out the portion size-and that’s doable. I do like the flavor of a lot of different ethnic foods, so that helps as well. I do have very specific dislikes, but those are easy enough to avoid.
It’s been good to be having more fresh fruits and vegetables, though with the prices in the US, most are a luxury. It helps to incorporate them into chickpea salads, or other food ‘stretching’ meals, and keep the frozen and some canned items for more ‘bulky’ vegetable servings. Lettuce is too expensive for what it provides, so most of my salads are what I’d put on a bed of greens. It cuts down on the volume without cutting down on the nutrition that comes from the chickpeas, peppers, onion, olives, cheese, and croutons. Doing seasonal grocery lists has been useful, as have some frozen options. I could have fruit and veg with Ex-T, but with the other stuff she wanted me to get in, volume tolerance was a problem. Now, I prefer to prioritize fruit and veggies more, and ‘fill in’ with protein, starches, and fats with an emphasis on nuts, olives, and the occasional avocado or premade single serving of guacamole. It’s still a challenge not to feel too full, but I’m making little steps.
Mostly, I need to quit freaking out about the numbers at the end of the day. I don’t let myself get to a calorie level that is too scary, and that’s still a problem. Calories should only be an issue in that I get enough to fuel my body for continued healing. Not that are restricted because it’s what the eating disorder wants.