Treatment Truths Take-Two: Week 1
If you're just joining us, welcome! Be sure to read about the months between admissions in The Darkest Quarter. You can also read about the first admission beginning here.
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January 24, 2017
I'm really back.I arrived yesterday at 11:30AM and somehow finished admissions before lunch. So - yay - back to eating.I met with Mrs. Gamin and the new dietician right after lunch. Then we closed, had phone time, unpacked, and had dinner.The ladies here are really kind. There's a sweet missionary here from Columbia. A lady from Canada was admitted today, too. I knew right away that both of them were Believers. There are a few other ladies. It'll be good to get to know them.After dinner, I felt like I was quickly sliding down a muddy slope of sheer exhaustion. I literally COULD NOT physically keep my eyes open.I fell asleep in the chair. I awoke to someone standing over me, rubbing my back, calling my name. The ladies around me were giggling. Apparently they'd been trying to wake me and couldn't.The rest of the evening was pretty much the same. I just went through the motions. Every time I had to move to another room, I felt like I was dragging my feet in slow motion. Or like I had taken a really strong sleeping pill.I moved to the bedroom for unpacking and fell right back to sleep on the bed before we even began.I even slept through evening group time. And I slept all night in my bed without even getting up to use the restroom.Truly, I've never felt such exhaustion.I think it had to be from the previous two weeks leading to admission. I was trying to get Valentines and anniversary gifts together. I also wanted to pack the freezer with meals and treats. I wanted to make an album with pictures of the kids and me. I had lots of miscellaneous projects I had to get done. Just trying to do anything to make this easier on everyone and assure them of my love. A couple of nights, I stayed up all night. Most nights I got between 3-4 hours of sleep.I didn't feel much better this morning. Every time I sit still, I fight sleep.It's been a little better since about 3:00 this afternoon. But I'm still very, very tired.Hopefully, another good night of sleep will take care of it.Today, I had art, group with Ms. Freeman (yay!), group with Ms. Grove, and tonight we have Mrs. Benson. They are short-staffed.Yesterday in my session with Mrs. Gamin, she asked me to tell her what happened when I got home. I explained how within just a few hours of being home, I felt COMPLETELY overwhelmed.I described the time in the car with my children with conversations about dating, seeing everyone at church, and how the tears began and wouldn't stop.Mrs. Gamin said that all made sense. I left home to come to residential treatment last August functioning within all my roles, numbed to most feelings or ignoring them. I returned home in October to the same roles with my feeling receptors wide open. I was hanging on her every word. That was exactly it.She believes that the conversations in the car were triggering for me. They brought back feelings and memories of trauma from my past.That makes sense, because anytime they are on that topic, I always feel the same way inside.But my feeling receptors were on overload, having learned to open them at treatment. I didn't know what to do with the feelings.Wow. That seems so simple. But so accurate. But I remember knowing in that moment last October 12 that I was not ready. Tonight, I am missing my family terribly. I put their pictures up in my room and in my binder. It's honestly hard to look.My heart just aches, and the weeks ahead suddenly feel overwhelming. I feel anxious and sad about that.Mercy, how am I going to do this again??One step at a time. One day at a time. I keep holding onto the glimmer of excitement I feel for being able to recover."She holds onto hope, for God is forever faithful." He is faithful. I just have to hold on.But please, Lord, help me learn quickly, and help this hurt. I don't know if I can stand it.I can smell dinner cooking, and it smells so good. But I feel guilty for looking forward to eating it. :(I know God can heal me, but it seems there's just so far to go.One sweet thing happened today. Mrs. Daugette told me she wore her exposed zipper today to welcome me back. How did she remember that I like them?!?! That made me feel good.
January 25, 2017
It was so, so good to see my family last night via FaceTime. Oh I miss them so!!And it hurt so badly to see them hurting. I feel so guilty for what I'm doing to them - again.Kevin is working hard to get the house ready. I feel so badly for not being there to help him.Their precious faces -- oh my heart.Please God, let this work!I'm really struggling with meals and snacks. I'm actually hungry (at times). I find myself getting a little spark of excitement when I smell something good or see we're having something I really like.So on top of feeling guilty for even eating at all, I also feel even worse for enjoying what I feel guilty about doing in the first place.Tonight after dinner, I was still hungry. It's been a long time since I've really eaten. I'm disgusted with myself. I feel like a selfish, lazy, gluttonous pig. And it feels awful.I had an individual session with Mrs. Daugette today, and it was so encouraging.She asked me to share with her what happened in the days I was home.Then she said she had a few things she wanted to share with me. And what she shared was so sweet and made me feel so loved.With teary eyes, she said she hoped I knew for certain how much she personally cared for me, how much she respected me, how dear I was to her heart.She said that beyond her personal feelings, she knew she could speak for the entire team. I held a very special place in all of their hearts. When it was shared with them that I was returning, they were all excited. They weren't excited about the reason I was returning. They were excited because they all so badly want recovery for me. They were happy to welcome me back.She talked about how much she admired my strength and my courage and said the only thing she was upset with me about was that it took me so long to get back here.She said she knew the day I left that it was too soon. I wasn't ready. She of course hoped for the best, but she knew from her experience what would happen.She asked very directly about my level of commitment this time. Last time, although I worked my butt off, I was very clear from the beginning that I was giving it 30 days. That was it.She wanted to know what my time limit was this time, or if I was going to be committed to the process no matter how long it takes.I told her that although it was hard and I still wanted it to take as short of time as possible, I was determined to trust and not put a time limit on it.She was very glad to hear that and was ready to jump in and work hard with me.I'm still super tired, but today was definitely easier than yesterday with the heavy fatigue. I'm just not all the way there yet. I'm hoping another night of sleep will take care of it. It's miserable to have to fight sleep during sessions.
January 27, 2017
I woke up this morning feeling a little better. I took a Trazadone last night, because there's lots of noise in our room. I was afraid that I wouldn't be exhausted enough to sleep through it.But this morning my head hurts even more than usual. It is slamming. I guess the caffeine withdrawal is at full force now.I'm also still so groggy. I want to be wide awake in sessions and groups today.I'm sitting in the doctor's office right now, missing a session with Ms. Freeman. Seriously?! Shoot!!!! Her groups are the BEST and I love her.BUT, I will trust that the Lord has gone before me and ordered my steps.I feel a little odd, physically, beyond the headache. I'm lightheaded and dizzy when I stand, which is odd considering the amount I've been eating. I felt these things at home, but they seem worse now. My blood pressure was a little low this morning (88/62), so maybe that's it? I want to take a minute to write about the road that brought me back to treatment. I always want to be able to look back and remember how God went before us and made a way.
Within a two week timeframe, I had to go to the emergency room twice for eating disordered behaviors and for the worsening of the cramping and aching in my heart/chest. The first time, I just got a referral for an endoscopy. The second time, the results were all normal. I felt like a hypochondriac and was so embarrassed. Clearly I was not unhealthy. Shame on me.
My psychologist and dietician told me there was nothing else they could do except try to support me through daily living. They knew I needed a higher level of care. I knew I needed more help but I couldn't stand the thought of leaving my family again.
When we got home after the second visit, my husband and children were really upset and not speaking. Everyone went to their rooms. I just sat on the couch downstairs in our little rental and sobbed. It all felt so hopeless. I decided that something had to give. I either needed to die now and put everyone out of their misery, or I had to get help. Because clearly, I could not do this on my own.
After much deliberation, I determined I could not kill myself, because I couldn't bear the thought of what that would do to my children. And what if they were the ones who found me? No matter how bad it seemed or how much better off I thought they'd be without me, I just couldn't do that to them.
So the alternative - I had to get help. Things just couldn't continue like this.
That was a Sunday night. The next morning, I emailed the treatment facility and begged them to consider allowing me to commute Monday-Friday for Intensive Out Patient.
I asked my home therapist if I could meet with him and told him about the email I'd sent. He seemed relieved that I was acknowledging I needed help. He suggested we call my husband and ask him to come so we could talk about it. He was relieved as well.
My therapist recommended we talk with our older children and allow them to share how they're feeling.
We called them downstairs that night, and I was not expecting to hear what they said. It was basically an intervention, although they would never have known that's what it was called. They said, in a nutshell, that I am not getting better. I'm getting worse. They knew I was trying, but it wasn't working. They were not OK with watching me die, and they felt that was what was happening. They said they didn't want me to have to leave again, but that was what they were asking me to do. I had to get help. They just were not going to watch me die. My son said he needed me to be there for him. That he was going to get married and have children and needed me to be an awesome grandma to them. It was so hard to hear all of that. But I don't know that I've ever been more proud of them. They were so respectful to me, as their mother, yet lovingly firm. They were convinced that I had to go away to get the help I needed. The biggest thing to me was that they loved me enough to ask me to go and gave their permission for me to do something that would make life harder for them. And they were so mature about all of it. I was so, so proud of them.
The next morning, I sent a new email to the team telling them what happened and that I likely would need to return to residential care.
One of the admissions coordinators called me that afternoon. We talked through insurance, me needing to be at home for the closing of our new home on January 19, power of attorney, etc.
We didn't talk again until Friday, when she shared that we had 1 of 2 of the worst insurances that work with them. Aetna was out of network, and in addition to paying the $16,000 maximum out of pocket, there would also be $400/day in charges that Aetna would not pay for which we would be responsible. So we were looking at $28,000-$30,000 for residential care. And that was just for 30 days. This is on top of the $16,000 we had to pay back in November when my husband's company switched insurance plans. Aetna was not willing to include that amount in the maximum out of pocket, because we didn't have prior authorization. I was in residential care when insurance companies were changed, so there was no way I could have had prior authorization.
I was absolutely devastated. It was a horrible feeling to come to the place where you recognize you need help and agree to it only to find you may not be able to get it!
My husband reached out to his HR rep, and the coordinator contacted her as well to give her some advice, from her experience, of the best way to get insurance personnel to respond.
A case manager was assigned to us.
My husband said we were just going to wait and trust. He knew God would work it out if that's where He wanted me to go. I knew my husband would do whatever he had to do. So it was difficult for me to trust, knowing he would pay that ridiculous amount if it came to that. Everything in me screamed against paying that amount. That just wouldn't be right. But in the end, I knew I had to leave it with the Lord and stop trying to control it. We waited on God, trusting as best we knew how.
The coordinator called late the following afternoon to say that God had worked miraculously on my behalf. She said she's never seen Aetna do this and knew it was truly an act of God. Our case manager was agreeing to a one time case agreement were they would allow the facility to be considered in-network! So that reduced our MOP to $8,000 instead of $16,000. Further, they agreed to cover any and all expenses after that, which meant the additional rate of $400/day went away. AND, because of my youngest son's surgery earlier in the month and other medical expenses, we've met all but about $2,200 of the MOP! We still have more than $2,200 in my home dietician/psychologist receipts for which we've not submitted reimbursement. So that will eventually meet the deductible, and we'll be reimbursed that amount.
When we closed on our home on the 19th, we found that the cash we had to bring to closing was $8,000 less than what we were expecting to pay. So we now had the $8,000 we'd set aside for that purpose that could help cover the expenses.
The admissions coordinator called the next day to tell us that our MOP is actually $6,000 instead of $8,000, so we only had to bring $400 to treatment at admission. And we'd be reimbursed even that amount once we filed the receipts from the dietician and psychologist.
But God wasn't finished.
The coordinator called the next day to say Aetna had called to inquire about the $16,000 we'd paid in October. They wanted to know if they were responsible for reimbursing us that amount. So she is trying to get them the information they need so that they will reimburse us for that.
AND, the treatment facility still owes us a partial refund from what we paid them for the first admission. They will reimburse us once the final payment is received from United, our former insurance company.
So in recap, we thought it was going to cost $30,000 for just the first 30 days. We knew my stay would be longer than that. But $30,000!! God took that amount down to $0 once we are reimbursed. We also had $8,000 from closing we weren't expecting to have. PLUS, we had the facility’s reimbursement plus the $2000 reimbursement for receipts, and the possibility of having $16,000 reimbursed to us from the first admission. So not only was I able to go to treatment without paying anything, we also had between $10,000 and up to $26,000 that we would get back that we didn't even know we had! HOW AMAZING IS GOD?!
God, I thank You for the miraculous way You provided for my family. You not only made it financially possible for me to return to residential care, but You are also giving us money we didn't even know we had. You moved mightily, miraculously, mercifully, generously, and graciously. None of which we deserved, but for which we will forever be thankful. This is yet another major rock of remembrance for our family when we can look back and see how You paved a beautiful way before us as a reminder of Your goodness, Your grace, and Your abundant provision. Thank You, Father, for loving me so much, despite the many ways I fail You.
The doctor was as kind as usual. I really like him. He said that my fatigue/exhaustion will subside. Losing that much sleep for a person in good health is difficult and tiring. But for someone whose body is already in a compromised state of health, losing that much sleep is detrimental and takes a while to restore.He also reminded me that most repair and renewal come from sleeping hours, and my body needs a lot of that right now. My husband had been telling me the same thing. Dr. Morse also wanted to talk to me about my dexo scan results. I have osteopenia in some parts of my spine and in one hip. I have osteoporosis in other parts of my spine and in my left hip. There's a chance that the bone loss can be stopped at this point and not progress further. There's just no way to know for sure. The only treatment necessary for now is to get rid of the eating disorder, which is what caused it.I asked if this was something to be considered of significant importance. He answered it's definitely not the end of the world. But it is something I will for certain have to deal with in the future. I'll have osteoporosis and the effects of it to deal with well before my friends of the same age.He reiterated that right now, my responsibility is to get rid of the eating disorder, because that's the sole cause. Hopefully, the bone loss will stop.As long as it doesn't interfere with future bike riding with my friend, I'm OK with it!My labs were not great but not horrible. His main concern from them as of now is my white blood cell count being low. I just had a brief meeting with Ms. Hedrick She told me that they needed to increase my meal plan tomorrow. It will be significant, so they are doing it before the weekend so there will be plenty of support.I asked why they weren't waiting the full week as is their typical protocol, and she said that my body is just at too critical of a point to allow me to stay at this level. The risks are too high. They've given my system a few days to get readjusted with food but have to step it up now. I asked if this new amount of food would be the amount of food I would need to eat after I finish weight restoration. Her reply was that it would be a step in the right direction, but it still wouldn't be enough. There's a part of me that's so hungry for more food. But goodness, I'm SO ashamed of that!! The eating disorder is telling me that's not acceptable. I need to keep things at a minimum. The part of me that feels ashamed and guilty also feels panicked, because I know that this means the weight gain is beginning. And that scares me, and makes me sad, and makes me feel unsafe.But I'm going to have to push through it and figure out what's causing those feelings. That's the main thing that's gonna get me back to my family. To recover, I have to gain weight. Period.
January 27, 2017
Today is the first meal increase day. So far, it hasn't been too bad. I'm still hiding behind the fact that I have to eat it because I'm here when it comes to the guilt. I know that has to be challenged if there's going to be lasting change. I feel really off physically again today. I'm fuzzy and tingly and off balance, standing or sitting. I'm thinking it has to be my blood pressure. If it's happening right after breakfast already, it can't be my blood sugar. Ms. Hedrick said it could be that my body is just sucking up everything as fast as it can. But my blood pressure was 83/57 this morning, so it could easily be that. Who knows. I just don't feel good. And I still have a horrible caffeine headache. I had a good session with Mrs. Gamin this morning. We went over my treatment plan. There are lots of similarities to the plan for my first admission. She added a diagnosis of PTSD and decreased bone density this time to the extreme anorexia nervosa restricting type and Hashimoto's thyroiditis. Problems/symptoms to be addressed while in care are out of control eating disorder behaviors resulting in excessive weight loss, difficulty with body size distortion and excessive fears of weight gain, extreme depression, feelings plagued by guilt and shame, and concern amongst family members as a result of the eating disorder. Ms. Hedrick told me she is going to have to increase my plan again in order for me to be able to go to church on Sunday. They don't want me going off-campus until my meal plan is at a certain level. What does that have to do with anything?? It made me cry. I know this part has to happen, I know it's a big part of the recovery process. It just really scares me. It doesn't feel safe to me. And there's this awful realization that if I'm going to recover, I can never be thin again. And that makes me anxious and sad and very uncomfortable. And afraid. The weekend is here. We're getting ready to close with Ms. Freeman, and then we enter the two days that feel like two months...I feel like God opened my eyes tonight to see part of my body for what it really was. As I was putting my PJ's on, I caught a view of the back side of my body in the mirror, and I was shocked at what I saw. It actually scared me a little bit. It was so abnormal looking. I've never seen it that way before. But I know it was God, because I already don't see it that way anymore. And I'm not sure what to think about that.
January 28, 2017
It's the first, full weekend day. Last night was OK. I read instead of watching the movie for movie night. I'm reading a great book, so that helped.Today, our field trip is to go to the theater to watch "Sing." We had French toast sticks with syrup for breakfast this morning. It tasted so delicious. But I feel so self-indulgent and gluttonous and selfish. And it's sitting really heavy and making me feel guilty.It just doesn't feel right to give that to my body.I'm supposed to have another meal increase tomorrow. Yesterday's was so slight, I barely noticed. So tomorrow's will hopefully be just as slight. I know the weight gain is coming. I so fear and dread that. We just had a group session on self-care. I got really irritated and was tempted to just shut down when she talked about weekends at treatment being designed for self-care. To expect or feel entitled to additional time is selfish and indulgent. It just lit a fire in me. When I did the self-care wheel exercise, I realized that I already do several things that could be considered self-care. So that changes my over-all perspective of self-care a little bit. But it also makes me feel really guilty and ashamed of myself that I do so much self-care.We just finished lunch and are leaving soon for the theater. I am so tempted to engage in a behavior. I've even figured out a way to cover it. I'm irritated with myself for even having those thoughts. I'm supposed to be here recovering. In the end, I'm afraid to carry it through, because I'd be breaking a rule. But now I'm ashamed of myself for missing the opportunity. I think that's what Mrs. Daugette refers to as the Double Slap. You're shamed either way you choose.The movie was super cute! I wasn't expecting it to be, but I liked it. We had Nutella for evening snack tonight. It tasted SO good. I've never had it before. But goodness I feel guilty. Shame on me for being excited about eating. I know that has to be challenged. I can enjoy food and I have to eat what's put before me. But how is this going to work when I don't have to eat it and it's not just placed in front of me anymore? Resonating thoughts from Table in the Darkness by Lee W. Blum -
The scale distorted my body into just a number, one that fueled my every action.
I kept the stomach empty, because it didn't deserve to feel full. It growled and spoke to me. I ignored its wants and desires.
The numbness helped and soothed. It provided a light emptiness in my head. I liked the lightness. I liked the empty. I liked the space where empty was left with no thoughts but a simple hum. That hum became my drug.
I pined after those feelings, the feeling of shrinking.
Too much. You are too much. So I stayed in that place where the head was light and the eyes saw stars. That would keep me safe. That would protect me and help me not to be too much.
No one wants to hear about your pain. So I didn't talk about it. The more I busied myself, the less time I had to eat. And the less I ate, the less I had to feel.
It was a weird feeling, knowing I was now too thin, yet finally feeling so comfortable. Sometimes I felt invisible but sometimes I could feel the looks and stares at my black leggings that no longer clung to my legs.
When I would try to fill up my body like I was supposed to, I felt such guilt and shame.
I wanted people to stop worrying and talking about it and about me, yet I couldn't seem to do the basic act of feeding myself.
My stomach grumbling for food, my mind telling it to quiet down...
I will disappoint you and can't give you what I should.
Because it would be weak/indulgent to enjoy sleeping or rest.
Manic-like thoughts
Why - when everything was going so well, with a great friendship, wonderful times with family, serving God, and surrounded by supportive and amazing people - would I continue to need the eating disorder?
You deserve punishment. You deserve to hurt for all you have done to people.
For the ones who did know, I despised all the worry and pain I had brought them. It was better if I played the part, acting like everything was OK.
But I know he'd be able to have someone better, someone without so many issues and so much baggage who could meet his needs.
I "should haves." My life was full of them.
It had been too long, too many people burdened by my instability. It had to end.
What a fake I was. What a failure. What a disappointment I had been to God, to everyone.
Yes, I do love God, and yes, I did want to die.
Before, when I was socializing, there was always this part of me somewhere else.
I choose life! I surrender.
Even though I hated telling on myself when I was struggling, being vulnerable with strangers, and even having to check the "depression" box on the forms at the doctor's office, I knew all of it - being vulnerable and real - was better than wearing a mask.
But he was able to love me, not the eating disorder. He was able to see me without the eating disorder and to continue loving that part of me.
Why, when my life was finally going so well and I was finally using my voice, would I harm myself? Because sometimes, somewhere deep inside, I still felt like I didn't deserve the good.
My parents did the best they could with what they had.
I'm letting go of the urges to "do," trying to listen to my body and its cries for more sleep or more rest.
January 29, 2017
We went to church today. We are currently attending a Methodist church. It was OK. Services here always remind me of how much I have to be thankful for in my church, especially with Dr. Brunson and the music. It was so dry, and the pastor missed the opportunity to share the Gospel.Last night, I read in Table in the Darknessa verse I'd never noticed before - Deut. 30:19-20. "I have set before you life and death, blessing and a curse. Oh, that you would choose LIFE, that you and your offspring may live, loving the Lord your God, obeying His voice, and holding tight to Him, for HE IS YOUR LIFE and length of days." The author went on the say "I choose life!" And in choosing life, the eating disorder is not an option.Every time she heard the voice talking to her, she would audibly state, "I choose life. The eating disorder is not an option." or "There's no longer room for the eating disorder."I love that verse, and it has stuck with me all day. I CHOOSE LIFE. THE EATING DISORDER IS NO LONGER AN OPTION. But if I take those verses a step further...
I choose life.
I will LIVE by loving the Lord my God, obeying His voice, and holding tightly to Him
serving
pursuing Him
claiming biblical truths
trusting Him/surrendering
living according to His Word (specifically, now, that would be trusting the team God's placed around me, being vulnerable, being real, and learning to trust and let go)
I was able to put that into action this morning at church. They do Communion every week, at the end of the service. I wanted to partake, but immediately began counting calories and feeling guilty for even thinking about eating something I'm not required to eat.Then I was ashamed of myself for counting calories for the Lord's Supper.But then, the Lord brought Deut. 30 to my mind, and I wanted to say out loud, "I CHOOSE LIFE," But I didn't since I was in church.I did stand up with conviction, walk down that aisle, let the Methodists bless me, and took Communion. Then I knelt at the altar and told God I wanted to choose life, and I needed His help.I stood up and walked back to my seat, really dizzy and unsteady. But over and over in my head, I continued to say, "I choose life. I choose life. I choose LIFE. And the eating disorder is no longer an option."In my mind, every "tally" on the choose life side will happen when I eat a meal or snack, when I engage in a group session, when I write in my journal, when I fully engage and allow myself to be vulnerable in an individual or family session, when I challenge automatic thoughts or disordered thinking, when I read a book on eating disorder recovery, and even when I admit I'm struggling. Because I will. And I'll ask for help. I'm sure there are lots of other "tallies," but these will get me started.And who knows if that's even what those verses mean. I think they are probably referencing eternal life and death, but regardless, they have helped me so much today, and I'm going to continue choosing life.I really can't remember clearly the days when I didn't worry about what I was eating/calories/my body shape. It was for sure before high school. Everyone keeps saying when I am fully recovered, that won't be an issue anymore.I can't even imagine, but it's really exciting to think about that possibility.I really do believe I've had an eating disorder since my sophomore year of college. I think the health aspect has ebbed and flowed through the years, and I got really good at just covering up symptoms and maintaining a healthy enough weight so as not to cause concern for anyone.But since the eating disorder in college, I do not remember eating a meal by myself. I ate lunch when I was invited to go out with someone or a group or if someone brought it in to me. But I was always mindful of what I ate and compensated for it in some way over the next day.I tried to plan the lunch days around times I would not eat dinner, like Wednesdays, Thursdays, and Sundays, or nights I would work late.When Kevin had to work late, I'd feed the kids, but I wouldn't eat. If I was home by myself for the day, I'd just grab handfuls of pretzels or animal crackers and keep going.It just hasn't felt right to feed myself other than times when I was with others. It felt wrong, and I don't know why. So I avoided it.And then, of course, when the eating disorder was fully ablaze, eating anything (and the more nourishing, the worse it was) caused me to feel guilty and disgusted and angry and ashamed of myself. This led to compensatory behaviors.So there's a lot to figure out, but I will continue to choose life. The eating disorder is no longer an option.I'm so thankful for the help I have right now at treatment that ensures the eating disorder is not an option until I'm able to make those choices myself.