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