On All Accounts

There is something to be said for going out to eat by yourself. It is one of the hardest things I’ve had to do yet. Its the test of accountability taken to the height of the eating disorder. Sure, on our passes we write down meal plans, where exactly we will go and what dish we will be consuming, but that doesn’t mean that the staff will know if we actually did it or not. To go out on a pass meal with someone is to work with that person and keep each other in check with the agenda. Without that it is almost unbelievably easy to find yourself with your butt in the dirt and the wagon rolling away without you.

On the unit my eating disorder knows full well that it can find no balance. I checked it at the door when I entered this treatment center only two short months ago. Unfortunately, each time I go out though, its still right there waiting and wanting to know where we are off to today. So I go, trying to ignore it, trying to leave it behind, hoping that it will realize that its really just not wanted and I have had success with that many times now. Most of those times though have been when out with other people.

So far I have done two meals out completely by myself. The first of them wasn’t a total disaster per se, I just came out of it relatively disheartened. The main point was that I should have followed the plan I had written. Instead I got out there and got overwhelmed, second-guessing the original choices I had made, and just had a lot of trouble coming to a decision. It was a frustrating venture but a learning experience at the same time. My mini-shmorgashboard included an egg salad sandwich with tomato on wheat, a bag of sea-salt multi-grain chips, a banana, and a triple berry yogurt muffin with a water and a soda.

I wound up eating about half of each item and calling it lunch. Its hard because we are supposed to get about 900 calories per meal but its gets really difficult to estimate the amounts for items without labels. I know its not supposed to be a strict science but in the beginning nerves get wracked because we haven’t yet learned the flexibility, intuitive eating, and general friendliness of food that should be the end result of all this.

Today was dinner. It was a  dark, rain-soaked, two-block walk to Reme’s up the street. This was the first time I had been there and the little restaurant with the red awning was the exact opposite of its foretold crowdedness. It could have been the dreary weather or the early meal time but, whatever the reason, I had my pick of tables and chose a booth in the corner. The pass meal was written for a Hawaiian ham steak with sides but the price on the menu was a good $3 over what the unit menu said so the plan changed. I wound up getting a hot open brisket sandwich with fries and a dish of green beans. Not so keen on the sandwich bread I ate all the meat and beans. I gave the fries a fair shot too but they were very much lacking in the flavor department, even with catsup, so I gave up.

Out int the rain again I rounded the corner to University Deli for a dessert. It had to be enough to make up for the uneaten fries. I stood in the little carry-out eatery deliberating over the sweets until I was uncomfortable with my own actions. In frustration I made a grab for whatever and wandered back to the atrium with my goodies. I have to say that, although delayed, my final decision was a pleasing one. I munched down a good-sized chocolate chip cookie and half a peanut butter Twix which turned out to be just as amazing as I had dreamed each time I ogled it at the store.

All in all the practice of a second time wasn’t perfect but it was just the tiniest bit easier. I’m learning to be accountable to myself. It does help to have someone there with me but, in life, thats not going to be the case all the time. I realize that the harder something is the more I need to do it. Its taking on the challenge thats key and thats the whole reason I’m here.

I’ll Pass

Its another weekend and I am so close to getting 4a and passes I can practically taste it. What happens is that you have to hit your 90% two times, for me that would be Monday and Wednesday, and then at team meeting on Thursday I will get the official “go ahead”. I already have this coming weekend booked as far as places I want to go and I can barely contain the anxious excitement that makes me jittery at the thought of exploring. The city is laid out before me and all I have left is the green light of health.

The deal with passes is that you write one out on a formatted sheet of paper and drop it in the request box so the staff can review it at one of the 2 team meetings held during the week. The yellow sheet of paper that gets filled out is very specific, especially when it comes to eating meals out. You have to not only be exact about what you are going to go do while out but also how you will get there. They need specific departure and return times and, most importantly, where we plan on eating. All passes span across the time of at least one of the daily meals and sometimes, at the end, two meals  and/or an overnight out. Many people live or have family in the area and the “practice” of returning home can be very beneficial.

The most important part of a written pass is the part of the meal. On the unit we have a thick alphabetized binder of menus from around the city. For a pass we not only have to write down where we are eating but also what we plan on ordering down to drinks and sauces used. Beyond that we even have to write down a backup plan in case what we want to order isn’t available. One of the biggest inspections a pass gets in the review process is Sally, the unit’s dietitian, approving of our meal construction. As of late I have been perusing the menus and just jotting down some combinations that work, trying to model a plate of food out based off the components that come on our tray here. Tomorrow I will be going over my choices with Sally because she actually won’t be here for my first 2 weeks on passes.

I can feel the excitement for this taste of newly acquired recovery strength building as I write. My plans for this coming Saturday start off around 1 pm. Just after lunch on the unit I’ll be off to navigate the subway down to Sullivan Street where I have a 2:00 hair appointment scheduled at Mudhoney. Heather recommended the place and, after checking it out online, it looks like its right up my alley. After that is a bit of window shopping in the area and then dinner and an evening movie with actual movie popcorn. I can only imagine how tired I’ll be returning back by 8 pm for snack.

Then, on Sunday, is the Bust magazine Renegade craft fair in Queens. Handmade goodies with quirky personality? Yes, please! Count me in! So that day I’ll be eating lunch out and I’m pretty sure I will be joined by Benji and Amy.

At this point I’ve got my fingers and toes crossed that everything goes smoothly. If all of it pans out it will be just what I have been waiting for.

Moving on to the next step!

Yes, Stomach, I hear you

Score one point for getting through things that I didn’t want to do. My tally must be pretty high right now but this time I think I will count double points for the added factor of having to do it 2 days in a row. These back to back trials of perseverance that I refer to are the long-awaited research meal days. I was too anxiety-ridden to write about it while in the midst of the experiment but, now that I can breathe with the assuredness of it being over, hindsight has again set my thoughts in motion. part of me, the forgiving part, wants to shrug and chalk it up to just having been an experience. The other part, however, would love to riddle the telling of the last 2 days with some very colorful language. I think I’ll try to find a happy medium.

The anticipation on Tuesday, the morning of reasearch meal #1, was quickly dropping like a fog over my world. When I sat down to breakfast I knew what to expect on my measly tray – two 4 oz. apple juices, a yogurt and an apple. Everyone else got the pancakes we had been asking for fervently through the last two months. Balls. I missed out on that one. I was told that they were really good though. After that I was okay until about 9:30 or so…until the hunger started to claw its way into my consciousness. Then it was all over. I couldn’t think about anything else except the pending lunch. The others did their best to help distract me but the anxiety grew to an all-consuming high. Its strange to think that I used to eat so little when my body craves so desperately now. At this point there is no denying what it wants. No confusion.

Finally, just before noon, one of the research assistants came up to get me. I followed her, in her white lab coat, downstairs and back to the same tiny room I had done both the exercise study and the sweetener test in. Everything was the same except this time there was a little round table with a plastic tablecloth ala “Lady and the Tramp” in the middle of the room. She sat on the bed while I sat at the table and in front of me was placed a sheet with a 1-10 scale and varying degrees of anxiety provoking situations listed throughout as a guide. We sat in silence for a full 3 minutes while I was instructed to think about the upcoming meal. At every one minute interval she asked me to rate my anxiety level on the scale.

Before the meal came I was repeatedly scoring quite high. I was anxious because I just wanted to eat. There were no guidelines as to how much had to be eaten. It was just whatever I wanted to do while the video camera in the corner taped my actions and her voice buzzed in over the monitor to periodically rate my levels. The tray that was finally placed in front of me had only a few items on it but they were large. I was suddenly staring at a large bowl of regular potato chips, an 8 oz. bottle of water, a family-size tube of real mayo, and a footlong turkey and swiss Subway sandwich on wheat. Other than the meat and cheese there was only lettuce and tomato on the sandwich.

That was it. Once I got the go-ahead I dug in. That first day it was excellent but I think I would have eaten just about anything they had put in front of me. I only ate 2 or 3 chips but I got through almost all of the sub, eating all of it’s insides and leaving about 1/3 of the bread; all the while my anxiety slowly decreasing. It felt great to just get some substance. After that they had some paperwork for me to fill out, some questions to answer, and then I could go about the rest of my afternoon as usual. That didn’t stop me, though, from dreading to have to do it all again the next day.

When I awoke the next morning I was calmer. The exact same test two days in a row so I knew what to expect. I was armed with knowledge. Then they threw a wrench in my gears. I was hungry going into breakfast and actually looking forward to the small amount of bulk I would get from the meal. Something, anything, to fill me up just a little. When I got in the dining room and saw my tray my jaw dropped. Apparently all I was to consume today was one lowly toasted English muffin and a 4 oz. container of apple juice. I grudgingly ate, trying to make it last as long as possible, and then spent the remaining time at the table not only hungry and anxious but pissed off as well. No one else who had done the same study before had gotten the English muffin version of research breakfast.

I got through it though. Lunch and a twin meal to the previous day was placed in front of me. I ate, with less anxiety this second go-round. I’m going to have to ask at research group next week what exactly they are looking for in this study but, for now, I’m okay. For now I can go back to enjoying my normal size expected meals.

At least until I have the third research meal day just before I head home.

Volumes of Issues

Walking alone, half a lap ahead of my peers, I watch the quiet surroundings of the fresh air park rotate in their slow carousel around me. I’m in a more contemplative mood although part of what I’m to work out in my head is whether or not I should be talking to my friends instead of thinking about things that have the potential to bring my mood down. Its just that between last night and so far today there has been enough drama around here to suffocate any amount of good intentions. I’m trying to not let it get to me. I’m trying to stay positive but its hard.

People that have been here longer than me are starting to have problems stemming from the prospect of going home. Some are having extreme family issues that peak into screaming matches both over the phone and in person when people come to visit. Some of the newer people are just having problems with the meals in general and there have been a lot of tears shed at the table recently. Some are also having food issues due to being scared of going above the goal weight that they have already met while here. Reaching “maintainance weight” and still trying to restrict your eating, still accepting that you can more or less eat whatever you want is harder than can be represented in words. I can admit, too, that seeing my peers, my friends, have their own questions and doubts does scare me. I have to admit it because, if denied, it has the potential to sneak up and just floor me.

I care about these people because I see at least some aspect of myself in each and every one of them. Its difficult to just stand by and know that I can’t really help them with their issues. I want to. Badly. Its in my nature. If I choose to do that though I know it would jeopardize my own recovery. I just can’t go back there in any part of my head right now without the potential of losing what I have worked so hard for. Some encouraging words and just letting them know that I understand is about as far as I can safely go. I have been both stunned by my positivity and in love with it in such a way that I’m terrified of losing it.

This is why I hang back. They walk and I hang back just absorbing my surroundings, absorbing my thoughts. There will be a right way to do this. This is just one in a line of speed bumps that will unfailingly be along my road to recovery. I hate to get so cliché with the terminology but is just what best describes it in this case. It is a road we are each traveling, a journey we are each individually on. And, in the end, it is each of us who decides just how big the obstacles along the way will be.

100% backfire

There was jelly, peanut butter, humus, and chicken, 2 slices of wheat bread, a pita pocket, sun chips, melon, 2 juices, and 4 chocolate chip cookies. All of this was what my haphazard conglomeration of a lunch consisted of as it spanned the course of the afternoon. It had not been planned that way by any means. The make-up of the chaotic mess was fueled by circumstance and unforseen events but proved, in the end, to just reinforce my idea that everything happens for a reason. Now that I am back, safe and comfortable, at my pseudo “home”, I can safely look back on the whole event and consider it a challenge rather than a setback. I will explain…

Today was the day of the NBC studio tour. We set off for the subway at 11:30 and rode the express train to Rockefeller Center. This time our group consisted of eight patients and two staff members. The one with the plan, the directions, the agenda and the hook-up at NBC was Talia and, when we deboarded the train she led us through the acclaimed plaza.

We had our bag lunches with us and the idea had been that we would find a food court or a lobby with some tables to eat at before we had to be at NBC at 1 pm. The only problem was that there weren’t any areas to sit in that didn’t belong to specific restaurants. The train had dropped us off at the time we should have been starting lunch and, by the time we realized we were wandering in circles and actually found a place to settle down, we only had about 15 minutes to eat. Rockefeller Center is a pretty clean place, for being in the middle of the city, and I would have happily made myself comfortable for lunch sitting on the stone mosaic off to the side.

One of my big issues, along with keeping a schedule, is not having to stuff my face because I’m trying to eat in a hurry. Each lunch bag contained the PB & J sandwich, a bowl of cut melon, the 4 cookies, 2 juices, and bag of sun chips. Its quite a bit to eat in the time we were left with and, for the first time since my arrival at Columbia, I went into the meal with an obstinately bad mood. My anxiety was already heightened by starting the meal late and the confusion about where to eat only added to that. I live by a schedule which is part of how the eating disorder took hold in the first place. Now, I know I am going to have to challenge that rigidness and need for construction, but I just wasn’t ready for what today’s winds blew my way.

I wound up eating sulkily, quietly stewing in my anxiety-ridden annoyance, until Talia declared it time to go. I just left what I didn’t get to in the bag. Talia said I could finish as we walked but my frustration and anger with the situation superseded rationality as I handed her the lunch bag with a firm “no”. As soon as we started making our way to the studio my anger flipped, though, and directed itself at me and my own actions. For the very first time I had not done 100% eating my meal. That status I was so proud of had been broken in just a few minutes time and for that I was furious. The entire time on the rather short NBC tour was spent beneath a fog of failure. I knew I could have done better if I had only tried harder and my mind seemed to not want to let my heart live that fact down.

(I swear this has a happy ending…to be continued…)

Earning the goods

I elevator down with Clara in her stiff white lab coat for the next research study on the agenda. We floor-hop for a minute, letting others on and off, before deboarding to head to the same room that the sweetener study was held in. Mostly the room hadn’t changed still housing the same little bed, same cameras on the walls, same desk with the same laptop computer on it, except this time there was a large black treadmill in one corner. I had to stop myself from scanning the paneled ceiling for a water bottle drip within the confines of the human hamster cage.

I sat down at the desk and was given a two page questionnaire to help pinpoint different levels of emotion I might be feeling at the moment. Before shutting the door behind her as she exited the room Clara placed the same little call button as last time to my right so I could notify her when I was finished. Not being particularly angry, depressed, excited or overly emotional in any other way I flew through the paperwork and started my stint on the laptop. This study also involved the repeated pressing of buttons in order to earn rewards but the incentive was different this time. This one was called the “work for exercise” study.

I couldn’t help thinking in the back of my mind that it was silly for a person to be willing to sit and push a button for upwards of 40 minutes, switching hands until both wrists hurt, just for a maximum of 30 minutes of slow walking on a treadmill. I understand how this would be a totally fine reward for a person who has an exercise addiction, which many people with eating disorders do have. However, I couldn’t keep my mind from ruminating on the absurdity of that reward anyways. If we didn’t have fresh air time that we were able to walk around during, and had to remain sedentary on a constant basis like I did at Remuda, that tiny bit of movement may have been seen as much more desirable. Heck, who knows, I may have even worked the full 40 minutes for the half hour trade.

Apparently I wasn’t the only one who saw the treadmill time as something not worth working for. They had added in a second reward of cash that I could press the button to earn. The maximum of that was $30 and it was received at the end of the session. As the exercise minutes accumulated 3 at a time, the money built $3 at a time as well and at the end of each earning I could decide which of those two things I wanted to work for during the next session.

I picked the cash. Of course I picked to work for the cash. If the treadmill had been the only reward the test to see how hard I would work for it’s company would have been over before I laid one finger on the button. I clicked away for about 12 minutes, switching hands, switching fingers, and eventually stopped when my wrists started getting sore. My need to do artwork pain-free outweighed my desire for more money. If I had kept it up, going for the whole $30, I doubt I would have been able to draw anything for the rest of the afternoon, or even write this entry now, without feeling the repercussions.

In the end I wound up with $15 which i figured would buy me about 3 weeks worth of morning coffee from the upstairs cafe. All in all it was a satisfying experience. I filled out one more short questionnaire about my moods and anxiety levels at that particular moment, rang my little buzzer, and sat back to wait for Clara’s escort to go upstairs again.

A scheduled shift

I’ve got some weird anxiety going on right now about breakfast tomorrow morning. It started out that I thought I was worried about the Sunday push-back of meals because I didn’t want to be hungry in the morning and have to wait even longer to eat. The more I think about it though the more it seems like it has to do with the schedule and what I am used to.

On Sundays, to accommodate those who opt to attend a morning service that held in the building, breakfast is maneuvered from 8 am to 9. Waking up so early, naturally being hungriest in the mornings and the routine of getting meals at the same time every day causes this little fluctuation to not sit very well with me. I’m not, by any means, annoyed or angry about any of this. I know that the situation and the schedule blip are somehow making me anxious but mostly I’m curious about why it is exactly that I’m getting this anxiety.

Finding a routine to structure each day by was not something I set out to do. Yet i have lived by one set schedule or another of my own making for years and years. I know, too, that a good portion of this eating disorder has to do with following a schedule, self-discipline, and being strict with certain things. Ever since falling down the rabbit hole of anorexia my food and meal times have been what everything else gets scheduled around. Everything is laid out perfectly here too, meals and groups at the same times every day of the week. Even a large dry erase board in the hallway with it all laid out for us to navigate. Then along comes Sunday and its extra hour.

I know in my rational mind that everything will turn out just fine. I’m not even sure what I am worried about. Its only one hour. The day will seem like any other out of the week once breakfast is over since the rest of the schedule is spaced out between the other meals like normal.

As I lay in bed, letting sleep seep slowly in, I ponder these things. Something inside me has the drive to really understand the reasoning behind my own emotions. I don’t know if this sort of self analization is the right thing to be doing or not and I guess it couldn’t really hurt anything but, regardless, I will be bringing up these new ponderings with Annie, my therapist, the next time we meet.

Stuffin’ stuff

The amount of energy that digestion of this quantity of food takes is astounding. After each meal I feel like I have just run a five-miler that I forgot to stretch for before hand. It’s definitely a different kind of tired than the one caffeine withdrawal had induced though. This kind is easier to deal with and almost more comforting in a strange way. I’m sleepy and full but it’s because I’m doing something that I know is good for me. Something I know I need to be doing. I also know that it won’t be like this forever, and that is the thought that most often covers me like a snuggly afghan to keep the anxiety shivers away.

I am up to 2600 today and this, plus my one daily Ensure, is the level I will hover at through the weekend. Its Friday and the rain they have been calling for these past few days has finally broken free of the overcast cloud bellies above the city. The gray day outside is persistent but I find it comforting; it just seems to fit in so nicely with the fullness, tiredness, and generally contemplative mood around here. The sweet vanilla scent of sugar cookies is still lingering in the atmosphere from when we made a fruit pizza in baking group this morning. The things we bake on Friday mornings in the tiny kitchen are later the challenge snack presented at Coffee Klatch.

Mostly Coffee Klatch is to experience conversation, fun, and social behavior where there is optional food present. Generally a game of some sort is played as we sip our cups and chatter. Its a good end of the week afternoon activity and good practice. Isolation and resistance to social settings is a common eating disorder side effect and some of us have given into that so much that we aren’t really sure anymore how to act in public. Its something that you don’t realize you have forgotten until the time you need those basic skills comes up. You have to reassess how to act, what to say, appropriate behaviors, how to eat around others. It’s definitely a strange thing to realize you have let go but it does happen.

The fruit pizza is cooling now and it looks, and smells, delicious. I don’t know if I am gong to have any or not in group because I am already so so full. I don’t have to make that decision for another hour or so though and I know I will at least consider it, which is all they ask of us.

Eve of construction

It’s the first night of the rest of my life and the city slowly grows dark. I am in my closet of a hotel room at the YMCA with my minimally channeled TV, lack of enough light sockets to even plug-in my alarm clock, listening to horns out in the street and waiting for the new episode of Intervention to come on. Don’t think I’m complaining though – not at all! I see this as nothing less than an adventure. It’s honestly exhilarating in this minimalist environment whose hollow halls echo with more foreign languages than I can identify. This must be what my brother, Andy, felt like in his various youth hostels as he backpacked across Europe a few years ago as I looked on with a loving envy. This is my little taste. Alone in NY, nervous, anxious, excited, and eager to see what tomorrow will bring.

I have to be at Columbia University’s Psych Inst bright and early at 9 am tomorrow morning. It’s an oddly shaped building right on the Hudson river near the George Washington bridge. 1051 Riverside Drive will be my home for approximately the next 3 months. For the first night or two I will be bedding down in what is commonly known as the “quiet room” next to the nurses station in our skinny girls wing of the 2nd floor until a real bedroom complete with a real roommate opens up. It wont be long though, I’m promised.

First thing on the agenda when I deboarded the train was to catch a cab and haul myself, with my heavy bags in tow, out to the Inst for a brief tour and meeting with the women in charge of my intake process. I feel like I know them even before we meet face to face due to the lengthy screening that has been my main priority for the last few weeks.

The Inst is what it is. It’s a hospital essentially, not glamorous, not like Remuda, but it looks assuredly as though it will serve the purpose I am here for. It looks like its going to take things seriously and I know that is what I need. Time will tell and I am planning on taking as much from this experience as I can manage. It wont be easy but it will be right and, for that, I am excited.