Disclosure

Dietitian usually checks in with my weight every month or two, not necessarily every fortnight. It'd been relatively stable for several months, so it wasn't really needed to keep a close eye on. Since I ramped up my exercise, I've been torn between hoping she'll ask, and hoping she won't so I can lose more before she does. 

Last fortnight, I actually found myself talking more to try to fill the time, rambling about the differences in my previous yoghurt (Yoplait Zero) vs my current one (Chobani Fit), and how I feel like I'm now eating too much protein because it's more than the bare minimum ("there's no such thing as too much protein for you"), so there wouldn't be a lull in the conversation for her to ask about it.

This week, she did ask. I feel like it's not that much different to being in the 56s last time she asked, but it was enough to set off warning bells.

"We do not want you back in the 40s again! Do you hear me? We battled for so long to get you out of there."

"I'm really not happy with that. But I know it probably makes you happy that I'm not happy." 

"I'm going to be keeping a close eye on you."

All I want is to be back in the 40s. Though unfortunately I'm not delusional enough to think it'll make me happy, or ever be 'enough'.

I'm kind of relieved that it's all out in the open though. 

Psychologist has been checking in too, which still feels weird. In the past, I haven't talked to her much about it. When I started seeing her, I had already been drinking heavily for a year or two, and was back at a normal weight, and I just didn't want to talk about it. We've spoken briefly when it relates to other things going on in my life (like the bowel surgery), but for the most part, I only talk to dietitian about everything ED-related.

She asked if I've been trying the distress tolerance techniques. I laughed, and told her I kinda got stuck on the exercise part. But hey, it works. She wants me to at least try the cold therapy (cold shower, face in ice water, etc), but I guess my brain doesn't really see a need to. The exercise has scratched the itch for self-destruction, something to channel all that negative energy into, and laxatives are back to being just an occasional passing thought. She said it's not good, but better than the laxatives. I definitely see it as the lesser of two evils. It's a more passive, long-term form of self-harm (much like the ED in general), versus the laxatives having a much higher potential for emergencies in the short-term.

Last week, I had two days at 2hrs, and four days at 3hrs. I feel like I've barely had time for anything else. I think the rest days are even more important for my mind than for my body. It's nice to just sit without it hanging over my head, and to have time for other things (today, blogging), or to just relax. 

While it's going to be somewhat annoying to have both of them keeping an eye on me, I'm not ashamed to say the overwhelming feeling is that of validation. Of course, I could've just been honest about the fact I've not been doing very well for quite some time now, but it's not the same. It's like, until it's seen from the outside, it's not valid. Which is probably why I don't jump to offer this information up to them until they ask.

As I'm finishing writing this, I just got a text from my Great Aunt's phone. I'm supposed to go visit her on Friday. But one of her sons has just texted from her phone, telling me she's in hospital and will be in contact when she can. It immediately knocked the wind out of me. At almost-95, and with her medical issues, I can't help but think the worst. Of course, they haven't told me what's going on. I'd like to think they'd tell me if the situation were dire, but I don't know that they would. I can only think it can't be good if she's not texting/calling herself - this hasn't happened with any previous hospital admissions.

54.0 today.

Some days it just feels like I'm getting no where. I have to keep checking the graphs and weekly averages. It's moving about 0.5kg a week, which is better than nothing. It's been a couple of weeks without seeing a number beginning with 55, but I'm so ready to be done with the 54s.

xxBella

Spring

I've kept up with at least two hours a day on the walking pad, with one rest day a week. Some days have been up to three hours. 

When I first got it, I thought I could just use it for 30 minutes here and there. Get five minutes in when I'm waiting for a telehealth appointment, or if I have a few minutes before S gets here, or waiting for the washing machine to finish. Maybe when I've been sitting for a while, and just felt like moving. But compulsive exercise has always been an issue for me, which is one of the big reasons I've avoided getting a proper exercise machine again. I didn’t want to go back to having the constant stress. Now it's hanging over my head again, something I need to do before I can sit down and stop.

So far, I've mostly been walking between 4-5km/h, usually some 12,000ish steps across two hours, and according to my Fitbit, around 600 calories burned (more like 480, if you subtract the ‘staying alive’ calories). I know they're never going to be 100% accurate, but it's better than nothing.

Dietitian didn’t ask how much I’m walking, just that I am. I guess I'll see if she asks tomorrow. While I’ve never been one to lie to hide my eating disorder, I do tend to omit parts of the truth with professionals unless directly asked. Psychologist did ask though when she spotted the walking pad. I don’t usually talk much about the ED with her unless it comes up naturally, because it’s not her specialty, so I was surprised when she showed concern. 

She asked if I was getting enough calories for it (no intake increase), if Dietitian knows (not really), if it was triggering for the ED (that’s the point, I certainly don’t exercise for my health, I just needed to do something to get the scale moving again), and if I’m aiming for a specific number on the scale (not in particular, I’ve done this long enough to know I’ll never be satisfied).

‘Not in particular’ feels strangely accurate, if vague. It’s always just the next milestone. 51kg, 49kg, 45kg, BMI 15, 14, 13, 12… a never-ending string of goals, but none in particular. 

But at least I haven’t taken laxatives again since I started exercising so much. 

My worth today is 54.3kg. 119.5lb, BMI 16.4.

56.6 at the start of September, 56.0 when my walking pad was delivered three weeks ago. In recent months, I'd sit mostly between 55-56kg. Something had to give. ~54.5kg is what I'd only see after a laxative overdose, when I was dehydrated and drained. When I hit that, that's when I knew I was outside of 'normal fluctuation' territory, and that the scales were finally moving again.

I try to keep my focus on the bigger picture. It’s only now that I can look at the trend for the past few weeks and see a definitive loss. I weigh myself every time I use the bathroom, but only count first and last weights of the day (the latter so I can try to predict the next morning’s weight). Even then, I try not to stress out when it jumps up. Yesterday I woke up 0.6kg heavier than the morning prior, and ended up walking three hours because of it, because it’s an abnormal fluctuation to the current pattern, but of course it was back down this morning anyway. 

The warmer weather is officially here, and it's such a relief. I spend winter shuffling around in a dressing gown, hugging a heat pack, even with the heater on a reasonable temperature. It's always so nice to be able to just sit around in leggings and a tank top. I immediately feel so much lighter (metaphorically).

xxBella

Just Keep Walking

I finally took the plunge and bought a walking pad.

It's been years since I've had a full-size exercise machine. I had an elliptical for many years, which was my first love in the early days of my AN, then an exercise bike for a while. In recent years I've only had smaller items (like an aerobic step, mini exercise bike, and a mini stepper) but mostly they're more geared towards building muscle than I'd like, whereas I'd rather get rid of it.

I've always liked the idea of being able to walk inside without having to pace in endless loops, but I wasn't sure if I'd get used to the sensation of the moving belt, so I was apprehensive. It took a couple of days to adapt, but now I'm loving it. After the initial period of getting used to it - 60 minutes on the first day, 90 minutes on the second day - I've been doing a full two hours each day, broken up into three or four sessions.

I did have one rest day, and felt much better for it physically (my legs have been screaming at me), but in little over a week, I feel that all-too-familiar anxiety already taking root. I didn't think I'd be using it this much, at least not initially, but it already feels non-negotiable, an obligation to hit the numbers before I can rest. It's constantly hanging over my head. At the end of the day, I've been so tired, I haven't had energy to do much else. I was determined to get a post done today though, even though it means I've only done 40 80 minutes so far, and will have to keep going once I've posted this.

I'm hoping it'll be exactly what I need to break the plateau I've been stuck at for months now. It's far too early to tell, but I'm cautiously optimistic.

I guess it's as good a reason as any to get out of bed in the morning. Plus, I'm smashing through audiobooks.

I told Psychologist about the laxatives. I wasn't sure if I would. I could feel myself dancing around the issue, trying to avoid it, but knowing I should tell her.

Towards the end of our sessions, she always asks if there's anything else I wanted to talk to her about. Most of the time, I've usually covered the important things.

This time, I paused.

"Um..."

Pause.

Then, it all spilled out. I told her about how I've been getting fixated on self-harm, the vivid thoughts of carving myself open, knowing exactly where the blade should start and stop. I told her about the laxatives. That I crave lasting pain they give, not just momentary like other forms have been.

We spoke a bit about distress tolerance techniques, and gave me a plan to follow using a few different methods. She wants me to try it when my distress levels are like a 6/10, and see if it drops any. The idea is to do it before it gets to a 10/10, before it gets to the point where I'm DoorDashing laxatives.

1. Stop, don't act

2. Face in ice water, or ice pack, cold shower, etc

3. 60-90 seconds of movement to increase the heart rate (suggested star jumps)

4. Breathing exercises

5. Chew strong gum, peppermints, something sour, etc

I couldn't help but laugh at the star jumps. It's the one thing I have tried before. Back in 2013, trying to avoid self harm, I tried jumping up and down on the spot and shaking my arms. The first time I tried it, I sprained my arch. Once it healed, I tried the technique again, and immediately sprained the other arch. Fool me twice...

So far, I'm only really doing the exercise part (which scratches part of the 'self destruction' itch). I don't really know how to stop as the first step. A week after my last post, when the urge came, I immediately opened Amazon and ordered three bottles of laxatives, then took them as soon as they were delivered two days later (note: it still didn't feel like enough). I like the idea of the whole process, but it seems that actually starting it is the problem. I don't know how to circumvent the impulse.

She asked if I'd told the rest of the team. I said I'd told S, but still wasn't sure if I was going to tell Dietitian or GP. She said that if I did, GP knows they can call her if they have any concerns.

I laughed "I don't know that she does."

At our last appointment (when she agreed to increase the Seroquel further - still waiting to see if it helps), GP asked me if I've ever thought about linking in with psychology. I've been seeing my current psych for 9 years, in-and-out of different mental health professionals since I was 12. 

It made me realize just how little she knows about me and my overall situation. I know it's still early days, but after 6 months of fortnightly appointments, I was shocked that she didn't even know I have a psychologist. It makes me wonder what else she just doesn’t know about yet. 

xxBella

Letting Go

 When I first stopped drinking last February, I was hesitant to get rid of my alcohol. My bar remained intact, and I kept a cask of wine in the fridge - so it would already be cold, just in case.

 
8 months sober. I was getting ready to move house. I wasn’t sure what I wanted to do with my alcohol. I looked at it every day, trying to figure out whether I would keep it or not. It was one of the last things I packed; kept, but labeled to go straight to the garage. 

My first time moving house without cans of pre-mixed vodka, instead taking Thermoses filled with black coffee or cold brew iced lattes as I set up the basics and took measurements to figure out where furniture would go in the new house. 

At the new house, my bar becomes my coffee station. I kept a single bottle of Rosé on hand, stashed at the back of the fridge, behind my assortment of sugar free soft drinks. Just in case. 

14 months sober. I deep clean the fridge. When I put my soft drinks back in, I look at the bottle of wine. I think maybe it’s time. I leave it out, sitting on the table, unsure of where to put it. It no longer belongs anywhere.

It sits there for months. During a home visit, Psychologist spots it and tactfully asks “Is that a bottle of wine?”. I no longer look at it when I’m in the kitchen. I don’t even see it. It’s become invisible to me. 

18 months sober, this Wednesday. I go out to the garage, to the stack of boxes I no longer need. I go through them to check for the things I want to keep, pieces of paraphernalia I rather like. I can almost taste it; the Shiraz, the vodka, the Kahlua. 

Then, I let go.

S has a friend or two who would appreciate a large donation of drinks for their parties. Two dozen bottles of wine, plus maybe 30L in casks. A dozen bottles of spirits and liquor. What can’t be rehomed, I have asked her to dispose of. It fills the boot of her car, plus the backseat. 

I always wanted to be able to moderate, to be able to occasionally have a glass of wine with dinner. But it’s simply not possible for me. I’ve never been able to moderate my addictions. If it was there, I needed to have it all. 

I kept a small cask each of red and white wine, for cooking purposes. Though I don’t cook much these days, I do like certain dishes with alcohol in them, and I still want to be able to cook and enjoy them. Admittedly, this is something I haven’t done in the past 18 months, so I’m unsure how I’ll feel about pouring the wine. I try to think of it as: they aren’t drinks - they are ingredients. It would be like drinking soy sauce. 

(I did also keep my Absinthe, purely for aesthetic purposes.)

* * *

I haven’t had any appointments since my last post, due to things shuffling around. I know I need to tell my team about the laxatives, probably Dietitian first, as she’s easiest to talk to. New GP will find out immediately from the notes anyway. If I’m feeling particularly brave one day, I might email Psych, as it’s always easier to make confessions through text.

I did tell S. I wasn’t even really planning to. I was having a Good Fire day, and was explaining to her what I shared in my last post, how some days it feels like my brain’s on fire. Then I told her about the laxatives. I did feel better having told someone.

I haven’t taken any this week. Mostly because I feel like the amount I took didn’t hurt enough, and getting more than two bottles requires planning in advance, shopping at multiple retailers to get around the limit. Plus the idea of spending $40 on one OD is insane. It’s not a sustainable habit. 

Part of me just wants to see if it’s possible to get the kind of pain I want. Three bottles? Four? I tell myself I’m just sating my curiosity, just once, but I know that’s a lie. I’ve even been considering trying the little pills again, wondering if my body might’ve forgotten the instinct to throw them back up, even though the thought of them makes bile rise in my throat. 

One week until my next appointment with New GP. I just hope increasing the seroquel further will stop this madness. 

xxBella

Good Fire, Bad Fire

 I’d been toying with the idea for maybe a month. Occasionally I’d find myself browsing pharmacies online, catalogues of laxatives, looking for something I might be able to take without vomiting, the way those tiny pills had started to make me do last year. 

They stayed in my cart on DoorDash. A liquid, a different type of laxative to those I’d used in the past, but still a stimulant. Every now and then, I’d open the app, just to see them there. A kind of relief, a safety blanket, knowing they were there just in case I might need them. Almost subconsciously, I mentally noted the store’s closing time - no late night panic order possible. 

I don’t know what the exact trigger was that day. Only that my brain screamed “DO IT!”. And so, with 4 minutes until orders closed for the day, I did. 

That was two weeks ago. I’ve since taken them four times. 1/3 bottle, 2/3, a whole bottle, two. 

I tell myself it won’t happen again. That it’s not worth it. But within a matter of days, the idea plants itself in my head again, and it’s like I can’t concentrate on anything else until I do it. 

15 doses, all the way up to 90, and none of them gave me the level of pain I was looking for. While I never want to experience the pain of the volvulus or post-surgery again, I think it’s skewed my perception of GI pain, and I’m left underwhelmed by what laxatives themselves are capable of. 

They’re dangerously easy to take. Tasteless, though a bit tricky to empty the bottles designed for counting drops. But at 6x the price per dose compared to the little tablets, it’s not practicable for the amounts I take. 

I can’t believe I let myself do it again after what happened last year. I know it’s stupid. I haven’t told anyone yet. I know I probably should. I suppose admitting it here is the first step. I wasn’t even sure if I would share it. 

Overall, I’m not sure if the higher Seroquel dose is helping yet, self-harm urges aside. Maybe a bit? Theoretically, it should be. New GP thinks it might have to go higher still, but I want to wait a bit longer until I know for sure. It’s so hard to tell in the short-term. To quantify mental health. It’s only in looking back that I’m able to see. 

The best part of the lower dose is that sometimes it feels like my brain is on fire. It’s kind of like it lights up, but with unbound intensity, in a way I rarely felt while on the higher dose. 

When it’s good, I’ll be amazingly productive, to the point I struggle to keep up with myself. I have all these thoughts in a million different directions. I can’t move fast enough, like time moves too fast and I move too slow. I’ll write for hours because it just keeps coming and everything fits together with perfect clarity. I have all the energy in the world, and get through to-do lists and life admin, cleaning and organizing and sewing. It feels amazing. I wish I could bottle it. 

But other times, it’s the same intensity, but of stress and overwhelm, fixating on self-destruction and everything that is wrong in the world, when I’m unable to think of anything except the pain I crave. 

I wonder if the good justifies the bad. 

Apple blackcurrant sugar-free cordial. You’d never know there’s 90 doses of laxatives. 

xxBella

Unstable

In the past couple of weeks, I've come to the conclusion that I am not okay.

I feel volatile, like a container under pressure, that could completely destroy itself at any moment. It's like I can feel myself returning to the person I used to be, the person I never want to be again.

For months now, I've been growing increasingly agitated, frustrated, on edge. Reckless. So overwhelmed by absolutely everything. Unstable. Feeling strangely disconnected from people. Not dealing well with people in general. This whole time, I've been thinking "why the fuck do I hate myself and the world and everything and everyone?!"

Up until two weeks ago, I hadn't even considered that maybe reducing my seroquel dosage isn't working for me. I hadn't made the connection. My BPD had been pretty well managed for some years now, and before she retired, Old GP thought it was time to try without the meds. So I've been slowly tapering down in little steps since November. I’d been on 300mg, twice a day (and had been for 13+ years), and was down to 125mg, about to drop to 100mg. But on reflection, around the time I went below 200mg things started getting... different.

I think it's also the cause of what I describe as a lingering discomfort with life. The way I've felt desperate to hide away and avoid everything. Feeling like there's no escaping myself. I think it's been that constant feeling of overwhelm that's been causing my struggles with routine, my sleep issues.

I did wait until after I spoke to New GP last week before I increased the dose. As tempted as I was, I know from experience that tinkering with meds of my own volition is a slippery slope. But I was set on it, and told her straight up that I needed to go back to 200mg. 

Thankfully, she listened, and didn't make me justify it or suggest a different dose. She looked at the guidelines, and said it'd take two weeks to slowly increase back to 200mg. I told her I can't do that. That I'm not in a good place and I can't keep going like this (careful to avoid those magic words, "I'm not safe"). I was ready to just jump straight back to 200mg, and deal with being a zombie for a week.

To her credit, she said maybe we could do it a bit quicker. Not an immediate jump, but I'd been back to 200mg in 3-4 days. That, I could deal with. I'm just glad she actually listened, and was willing to make a plan outside of the guidelines, because if she was adamant about sticking to them, I would've just done it anyway.

Maybe I can try again at some point, be it in months or years, now that I have a better idea of the warning signs that things aren't going so well. I was starting to really looking forward to getting off it. But at this point, I feel like I could burn my whole fucking life to the ground and have to regrets. I am not okay, and I need my stability back more than anything.

I'm also willing to consider that it might be part of why I don't particularly like New GP... or my OT... or even S at times. Every little thing that doesn't usually bother me has been grating. That was what made me realize the lower dose isn't working for me. The first couple of days S was back were great. But then routine settled in, and I started feeling annoyed at stupid little things again. I knew it had only been in recent months that I'd been feeling this way, and eventually connected the dots.

Maybe it's also why I'm fantasizing vividly about slicing my body open every night, the exact cuts I would make, even though I haven't taken a blade to my skin in years. Laxatives have become a daily consideration again too, even though just thinking about those little fluoro pills is enough to make me want to vomit, like they had for the last several months I'd taken them. Today also marks one year since The Great Disembowelment, so I guess that's how long it takes for me to start seriously considering laxatives again.

Before this, there'd only been a handful of times where I’ve had a strong urge to take laxatives again. Sometimes I try to convince myself it’s okay, like if I haven’t had a BM in a couple of days, that it would be 'normal' to take them. But I know that my regular Benefiber and Osmolax will work eventually, and I may just have to tinker with the dose. Sometimes I just crave the pain, which has been the case recently.

The scar has healed very well. I’ve been diligently using Bio Oil on it. And while my bowels will never function 'normally' again, I have more or less adjusted to The New Normal.

Stay tuned for when I'm less of an insufferable bitch.

12 months

5 months

xxBella

Words that Sting & Cling

I’ve been thinking recently about how people's words can stick with us. Even little things said in passing that most people would forget about shortly after, but they stick with us, trigger us, and can deeply affect us and our eating disorders. They get inside, lodge in our brain, and become part of us.  

Going over my blood results, I talked with Dietitian about this. Among other things, my B12 has been steadily dropping. I mentioned that, when it first became an issue, Old GP immediately said

"Are you eating enough veggies?"

I have no idea why she said that. B12 mainly comes from animal products. Eggs, dairy, meat. My brain automatically made the connection of not eating enough veggies = fat. I felt deeply shamed, and although she never elaborated or mentioned it again, the comment lodged in my brain, even though it was irrelevant to the situation (or perhaps because it was irrelevant to the situation).

In general, I try to talk to Dietitian first, and she'll go over my blood results with me, because she is the one more knowledgeable in deficiencies and how to remedy them (and knows that B12 does not come from vegetables). Of course, GP will still go over them, but I try to shut down any conversation of recommendations by telling them I've already spoken to Dietitian about it. But some comments still slip through.

When she noted that New GP didn't order my HbA1c (which measures your average blood sugar over the past few months), I was relieved to not have that number.

"Old GP said I was basically on the edge of diabetes."

"But you're not! I've worked in diabetes for 35 years--"

"I know. But it stuck."

"And it doesn't matter when I tell you you're not?"

My HbA1C was completely fine. It's always been fine. I know this. Dietitian repeatedly tells me. But it doesn't sink in, blocked by Old GP's comments. 

Dietitian is (quite literally) an expert in diabetes. She was originally my mum's dietitian after she was first diagnosed with diabetes. EDs are not her specialty, and is probably not who a GP would refer me to, but this was at a point where I had no medical supervision after far too many bad experiences, sitting around BMI 12-14, and mum thought Dietitian might be someone who could help (and be kind).

The first time Old GP said this, she asked if I still had mum's glucometer. She wanted me to start checking my blood sugars, even just once a day. So I dug it out of a box, ordered new test strips and lancets. I still do it first thing every morning, before I even get out of bed. Occasionally, if it's above a certain number, I have to check again later in the day to see if it's below that number before I'll allow myself to eat. The best start to my day is when I wake up hypoglycemic.

Because I usually have appointments with Dietitian before GP, it was two weeks before I spoke to Dietitian about it. She was horrified and immediately told me to stop, but it was too late. The habit had already taken root, yet another number to determine my worth.

Logically, I know I'm not 'on the edge of diabetes'. But it still eats at me. In retrospect, I wish I'd asked why Old GP said that. I don't understand it, nor does Dietitian. Even with an abundance of caution because of family history, it doesn't make sense. But I would immediately shut down when ever she mentioned it. Again, my brain made the connection of diabetes =  fat.

Dietitian also seems to be very focused on my weight, and that I can't lose more, even though it's been frustratingly stable for the past few months. I think looking over the last year's records in April might've been a bit of a red flag for her. I always tell her my weight honestly when she asks, though I prefer not to get on her scales when I do see her in person. It's mostly been a slow and steady decline, so maybe she hadn't realized how much it'd dropped. 

As always, when she comments that I can’t afford to lose any more, I point out that I was much lower for many years (including the first 4-5 years I saw her), so I'm not particularly concerned.

"But were you well then?"

I paused for a moment "I wasn't unwell."

"... that you could recognize."

(Then, when I went to see her in person last fortnight, she chirped brightly "You're looking well!". Fucking kill me.)

But I disagree. While I was more unstable in earlier years, once I started seeing her and got a handle on harm reduction, maintenance, and (once Old GP joined the picture) regular medical monitoring, my health remained pretty decent. I mean, even while I maintained that low weight, I didn't really have emergency trips for things like hypoglycemia like I had in the past.

She doesn't seem like she's going to let it go this time though, so it's an ongoing topic of conversation between us.

At my last appointment, after my blood test, New GP restarted the supplement chat. I told her in our second appointment that it wasn't going to happen, but she still wanted to discuss it further after I had a new round of blood tests done. 

Thankfully, she seemed to understand when I explained why I can't. That it's not just about calories and weight, that my AN makes it difficult to willingly give myself nutrition in any sense.

Of course, she still tried to find practical solutions to get me to take supplements. The B12  shots are easier, firstly because I'm not the one doing it, but also because it felt more like medication than a supplement. So I'll be starting back on those every few months.

Other things are more difficult though. Always the problem solver, she tried to find ways around it. She suggested that, for vitamin D, I could take a large dose once a month rather than taking it every day, but that doesn't sit well with me either.

I should also say, I'm so happy that S is back. I’m trying to get back into my normal routine. That said, things were already pretty fucked up before she left. I’m starting to suspect I’m not doing so well with the recent changes in my meds, so this week I’m planning to talk to New GP about going back to a higher dose. 

Some bookmarks I threw together recently, to use up some random scrapbooking card I’ve had in my stash for at least 10 years (why? I don’t even scrapbook!)

xxBella