Something had to Change

There's so much to process, so much to say. This post might be a little messy, so bear with me. I had my monthly appointment with the GP this morning, and the dietician yesterday. Let's start with the GP.

It's no secret that I've been struggling lately. Yes, I'm managing to hit my calorie goals, but that's about it. It's become a real battle to make it through each day, and something had to change. In sheer desperation, not knowing what else to do, I asked my GP if she could change my anti-depressants. 

I've been on mirtazapine for nearly three years now. A few months ago, for whatever reason, it stopped helping. She raised my dose from 45mg to 60mg, but it didn't help. She said she has to think on what to prescribe me, but she'll write me a new script tomorrow. As frightening as it is to change medications, something has to change. I still don't understand why it stopped working after so long; there was no trigger, but I guess it doesn't really matter why. I'll have a new script to pick up tomorrow, and while I know it won't fix anything, hopefully it'll make things more tolerable again. 

She checked the bruise on my arch, which is still spreading two weeks after the injury. She actually asked if I'd done it again, which I haven't. We discussed my self-harm habits, and gave me advice on which methods are less dangerous. She checked my injuries from head to toe, and said she'll be checking each time I see her from now on. I have three scripts; antibiotics for the infected wounds, a gel to help with healing, and an ointment to prevent further infections. 

As for the dietician, well... It was one of those days. The kind where I only brushed my hair two minutes before walking out the door in my slippers. 

I sat down and she asked "How've things been this week?"

I was stumped "I... I don't know."

Silence. 

"Not a good day? Was it hard to get here?"

"Yeah."

We talked about the picnic in the You Yangs, about the few dinners I've cooked. My intake last week was between 1,211 and 1,230; accuracy and consistency seems to be kinda my thing lately. My weight stayed the same, though she again expressed concern over the 'trend'. For now, I'm relieved that I'm not gaining, she's relieved that I'm not losing.

At the moment, I'm brain-drained. I just want to hide in my blanket cocoon. Tomorrow, I'll have new meds, and hopefully things will start becoming more tolerable again. 

xxBella

A Picnic in the Mountains

I stepped out into the world again today, for the second time in nearly a year. 

There's a mountain range that I see from my house everyday, the You Yangs. A few weeks ago, mum and I went for a drive there. It was nice and quiet, and I thought it'd be a good place to go out one day. I was feeling particularly brave this morning, and the weather was gorgeous, so we decided to go for a little picnic. 

It's only a half hour drive to the You Yangs, but it feels so remote. We stopped for coffee and Subway on the way. There's several picnic grounds, and we drove around all of them until we found a quiet area without anyone else around. 

We sat for a while with our coffees and cigarettes, taking in the scenery. I have a horrible fear of heights, so I stayed far back from the cliff's edge. It was lovely to be out in nature, anxiety aside. We even saw four kangaroos hopping across the road. 

We ate our sandwiches when the clock struck 12. I had part of a 6" chicken, lettuce & carrot on wholemeal, even though it was more than I'd normally have for lunch (216 cal). Shortly after I finished, the fear and discomfort of being out became overwhelming, so we packed up and headed off. 

I live in a beautiful area, really. We're only minutes from the beach, on a great part of the coast. On the other side, we're only a few kilometers away from farmland and bush. There's a lot of beautiful little places around, and it's a shame to miss out on.

To say it was scary would be an understatement, but it was refreshing to get out for a while. I felt physically sick with anxiety, and I started crying as soon as I got back to the safety of the car. It was just completely overwhelming. I don't have many words, and I'm exhausted in every way, but I took a few pictures so I'll leave you with those.

Yesterday was my first full day off the crutches. I still can't put my foot flat without feeling like it's about to snap in half, so I'm walking on the side of my foot, but at least I'm walking. I'm seeing the GP on Wednesday, so I'll get her to check it then. 

xxBella

Missing Links

I saw the dietician yesterday. Usual Tuesday routine. It was my third week on 1,200 calories, and the scales showed a loss. Nothing drastic, but a loss nonetheless. Is my metabolism kicking in? The extra energy burn from being on crutches all week? Either way, I'll take it. 

I was actually 100% prepared for the potential of a temporary gain this week, as my tummy hasn't felt quite right. Tuesday through Thursday, I was having awful cramps, to the point where I could barely move. I only had one (*ahem*) 'movement' all week since, which is highly unusual for me. So, in any light, the loss was an unexpected bonus.

Again, my intake was between 1,140-1,180 calories each day; 600-900 of those being food, the rest Ensure. 

"No 1,200? What happened to 1,200?"

I shrug "I just see it as being close enough."

"It is... but it'd be great if we could try to get to 1,240, 1,260, that sort of range. It's just as close."

I still have the mentality that a calorie goal is to be strictly stayed under. It's a maximum, not a minimum. So, this week I'll be aiming for 1,200-1,250, which just means a little extra powder in my Ensure, so I should be able to manage. 

I've been completely useless and unproductive all week, unable to do much without assistance. Mum's been helping out in the kitchen. I accepted I couldn't do it all on crutches. I still have to weigh everything myself, but I've started asking mum if she can get things out for me or watch what's cooking, while I sit at the bench. I've only had soup for dinner twice this past week; I'm cooking and eating family dinners unless mum's already planned something I flat-out won't or can't eat, so that's something.

The crutches have knocked every ounce of strength out of me. It wasn't this difficult last time. My body aches from head to toe, and I dread having to move. I'm completely exhausted in every way. 

Yesterday, I tried doing short stints without the crutches. Just around the kitchen, rejoicing in being able to carry things. I still can't wiggle my toes and the arch still touches the ground, but I enjoyed having some form of independence back. I could actually make a coffee and carry it outside, opposed to just tucking cans of Coke Zero in my pockets. It's the little things.

Today, I'm back on them. By last night it felt like my foot was going to completely give out again, and it's aching like mad this morning. I think I actually made the swelling worse. Maybe I pushed it a little too hard. I'm off the anti-inflammatories, and had to stop taking the stronger painkillers a couple of days ago, which sucks, but I'll deal.

Mood-wise, nothing's changed. I still feel like I'm trapped in a fog. Being immobile certainly isn't helping. I know I should be sewing, I know I have things to do in the kitchen, I know I have a to-do list as long as my arm. I just can't do it, even when I'm physically able. I can't get from A to B. It's like there's some missing link. Mum says that's a part of depression. I just sit, blank, still as a statue, feeling utterly lost. 

And wow, it's October already?! That's come around quickly. Time just goes by quicker and quicker. 

xxBella

Guess who's back on crutches?

Yep. I've sprained my arch again. This time, in my left foot.

I should explain, as I was never crystal clear on how-why-what happened last time. Sometimes, when I feel the urge to hurt myself, I try not to. So (and this has happened twice), I decided jumping up and down on the spot would be a good alternative to try. Not a bad idea, until the third or fourth jump, when my foot gives out and I topple over in agony. Basically, when I landed, my arch was forced flat. Yes, that is as painful as it sounds.

I was certain it was a sprained arch, though my family wanted me to get it checked out just in case. So, yesterday I saw my GP. She came to get me, saw the crutches, and just said "Oh dear... Looks like you've got another story to tell me."

She checked over my foot, and I told her it felt exactly the same as the last sprain. My arch is bruised, and touches the floor when I rest my foot flat. I can't put weight on it, nor wiggle my toes, and it aches like mad. She strapped it and gave me anti-inflammatories, plus a script for stronger painkillers. She didn't do an x-ray, because it's such a similar injury to last time, though it reminded me that I still need to book my bone density scan. 

She also mentioned that she wants to start keeping a closer eye on my blood pressure since there's growing concern over my weight, so she'll be popping in to my dietician appointments on Tuesday mornings to check it. The dietician mentioned it this week, and asked if my GP could come in to check it, but I said I felt fine and we left it for next week.

She did say it was a good idea to try jumping up and down as a self-harm alternative, but evidently it's not an alternative, just a different method. She suggested I try a rubber band around my wrist instead (how cliché). We don't really talk about self-harm unless I have an injury like this that needs tending to; she doesn't know about methods or frequency or anything. The thing that irritates me the most is that I was really trying not to hurt myself, but did anyway.

It's ridiculous, these injuries I'm ending up with, and it's no one's fault but my own. And so I'm back on crutches, which is incredibly frustrating, not to mention exhausting and painful. The bruise from my last sprained arch only faded a few weeks ago. My first thought was that I'm obviously heavy enough to cause such an injury. Why does everything come back to weight?

So, my plans of sewing and leaving the house have been slightly skewed. There's not a chance I'm going out on crutches. With any luck, I'll be off them within a week. I can sew with my good foot, but everything just became 10x more exhausting, and I still have the motivation of a sloth. Everything feels foggy, blurred, like I can't think clearly enough to do anything. 

Thank you all for your comments on my hair. I forgot to mention: even though it's so long, it only needed one pack of dye because it's thinned out so much. I used to need two once it got past my shoulders. There's always a silver lining, I guess. 

xxBella

Stuck in a Rut

My self-image's been in the gutter lately, mostly because A) I feel like a fat lard, and B) I've been covered in unsightly self-injuries. Both are starting to really knock down my confidence. So on Friday I dyed my hair, in the hopes it'll make me feel a little better about myself (so far, it hasn't).

It's been almost a week since I last posted. I just don't have much positive to say at the moment. The days have been spent crying and waiting for time to pass. Mum asks me if I want to talk, but there's so little to say anymore. If I say anything, it's depression's word vomit (I just want to die, I'm worthless, all I do is hurt people, etc.), which isn't helpful at all. She holds my hand and offers words of encouragement, and I just cry.

As always, Tuesday is dietician day. It's becoming a lot of effort to drag myself out to appointments. My intake's been between 1,153-1,181 calories, much the same as last week, and my weight stayed exactly the same. 

The dietician mentioned "1,400", and I panicked. Not happening. I'm not comfortable adding that much more Ensure, and I don't want to actually eat more than I already am. I don't see any room to build on what I'm eating. I'm eating 'appropriate' meals at all the right times, and that's more than enough. Besides, if I'm already maintaining, there's no reason to eat more. She wants me to work towards slowly gaining, I don't. She's giving me a few more weeks on 1,200, but she wants me to aim for 1,200-1,250, instead of 1,150-1,200.

When I think about it, I don't think I could stop seeing the dietician if I wanted to. Over the last 15 months she's become such a big part of my life, my routine. I'd be lost without her appointments.

I didn't sew at all this week, except for a half hour on Saturday. So my goals for this week are to finish sewing this skirt, and maybe try to get out of the house again. I'm thinking of either going to a quiet cafe in the middle of nowhere for a cuppa with my mum, or somewhere out in nature; whichever seems least daunting at the time. Maybe. We'll see. 

xxBella

Venturing out

Dietician yesterday. In the waiting room there was a new poster that caught my eye immediately. "Start the conversation on eating disorders", some sort of an information night at the hospital. "Finger food provided", I had to chuckle.

It was another appointment where I didn't talk much. She tries to give me prompts and asks lots of questions, and mum fills in the blanks if she can. I just can't seem to hold a conversation. I either choke on my words or vomit them up.

On Friday I ventured out into the world briefly, which the dietician was excited to hear. She asked how it went, and I said "not well". Mum and I drove two hours down the coast, to a cheese factory that we've been to a few times before. They make the best cheddar. So we browsed the gift shop and picked up a few kilos of their vintage cheddar; five and a half kilograms to be precise. It's crazy, I know, but it lasts forever and it's cheap in bulk. The best thing about it is that you only need the tiniest shaving, it's such a strong flavor.

Anyway, we were in the gift shop and I ended up having a panic attack, grabbing the keys from mum and running out to the car in tears. When mum came out, I'd been scratching at myself and started rambling about how I wasn't going out again, that it was too much and I couldn't do it. So it didn't go great, but it's something.

Back to the dietician. She asked if my mood had improved any, how I was doing with sewing, cooking, smoking, motivation in general. I just shrugged and mumbled; mum shook her head. I didn't sew or cook much this week. I just didn't want to, didn't have the energy to. One night I made a beef malabar curry with Thai rice, another night I made a long-grain chicken risotto. Both were because the days had been totally awful, and it was my way of apologizing to mum for being such a negative little shit. 

Calorie-wise, I was actually 'good' this week. Ensure every day. Each day came out between 1,120-1,160, which I'm calling 1,200. And what did the scales say? My first week meeting 1,200, and my weight stayed the same, thank god. If I keep having lower days, I'm just going to suppress my metabolism, and keep gaining-losing-gaining-losing.

Last night I skipped the Ensure, and opted for a few glasses of Shiraz instead. A temporary band-aid for feeling dead inside. Calories are calories. Who needs complete, balanced nutrition anyway?

xxBella

Meal Plan

I wake up in the morning, and I stay on the couch for an hour before actually getting up, dreading the day ahead. After I get up, it's all about waiting for the day to pass, trying to make it speed by as quickly as possible. I curl up in my armchair on the porch, pull my knees up and my blankets over me. I just want to sleep all the time, but I never do. 

I have so little to say, I do so little, it's not even funny. I prepare food, I spend a lot of time on Blogger, sometimes I sew. I cry, ramble and hurt myself, breaking down over the smallest things. Mum takes me out for a drive each day, not that I ever get out of the car. We'll spend an hour driving around the outer suburbs, in a desperate attempt to make my time pass quicker. It's all quite pathetic, honestly. 

Enough moaning and groaning. I'm trying not to let depression's word-vomit run rampant. So I've got something a little different today, for a change of pace. I talk sometimes about changes to my meal plan, or breaks in routine, but I haven't actually posted my meal plan here for quite a while. So, here it is, what I suppose you'd call an 'average day' of food.

Breakfast (88-99 cal)

20-25g (one slice) wholemeal bread with 6g Vegemite and 80g nonfat strawberry yoghurt

Lunch (148-184 cal)

A sandwich, with an average 45g of wholemeal bread (105). I alternate between two fillings. 

Either: 6g Vegemite and 20g 97% fat free cheddar (148)

Or: 2g canola spread, 40g mashed egg, 23g carrot and 24g iceberg lettuce (184)

Snack (78-105 cal)

Either a 95-100g pot of custard (100-105)

Or 150-200g (two small) golden delicious apples (78-104)

Dinner (125-300 cal)

Either: 200-250g soup (lamb, lentils, barley, peas, carrot, potato & onion) with 10-20g wholemeal bread (125-174)

Or: 200-250g stew (beef, carrot, potato, tomato, onion, flour) with 10-20g wholemeal bread (141-194)

If I cook a 'family dinner', my serve comes out around 300 calories.

Supper (183-215 cal)

22-25g mini bag of Outback Animal Cookies (88-100) and an 80-90g Skinny Cow Sundae (95-115)

Total = 622 - 903 calories

I also drink 4-6 cups of black coffee (12-18 cal) and 6-8 cans/2-3L of Coke Zero (7-9 cal) throughout the day (I'm a caffeine junkie, shoot me).

Ensure makes up the extra 300-600 calories. I'm apprehensive to go any higher than 1,200 until my meals change, but I don't want to change my meals that much either. At the moment I'm working towards eating family dinners most nights, and saving soup for a 'sometimes' dinner.

As I've said before, stir-fries are my 'safe' family dinner, though sometimes I cook things like bolognese, curries, risotto. And I don't think I've mentioned this, but currently I won't use two pieces of cutlery, like a knife and fork (it's too confusing), which limits my options. Once I get past that barrier, which will hopefully be soon, I'll be enjoying fish and salads and baked potatoes.

That's about all from me for now. I hope you're all enjoying the weekend, whatever it may hold. 

xxBella