Continued from Part 1 here!
In the summer of 2009 I started outpatient therapy for me eating disorder. I attended counselling, weekly support groups, weekly Cognitive Behavioural Therapy (CBT) groups, dietitian appointments and bi-weekly weigh-ins and medical check-ups with a nurse. In October of 2009 the nurse had the doctor in charge of the program refer me to an intensive treatment program at a hospital an hour away from my home. I had made no progress with outpatient therapy and needed more help than they could offer.
The first time I met Dr. S I knew that this was the real deal. He asked a lot of questions about my behaviours and thoughts, I did my best to answer them honestly. He put me on the 5 month waiting list for the Intensive Day Patient Program, there was more proof that I wasn’t that sick – if I was sick, I would be an inpatient. I drove the hour to the hospital weekly for 8 weeks in preparation for my treatment admission and as much as I tried to prepare myself for the treatment program, my symptoms continued to get worse.
In January of 2010 I was at work and I got “the call”, it was time. I had to go in for a meeting with Dr. S later that week and start on Monday of the next week. When the call came, I was terrified and when asked if I was going to accept my place in the program I almost said no, my every instinct was to say no but for some reason the word “yes” came out. Later that week I went to see Dr. S, we talked about the expectations of the program as well as the format of treatment. I was going to attend the program for 8 weeks and then I had the option of attending a transition program.
For those 8 weeks I would attend the program from 9am to 6pm from Monday to Friday. I would attend a number of therapy groups and weekly individual check-ins. I would be weighed first thing every Monday and was expected to look at the number on the scale. I would have weekly meal plan adjustments if they were needed depending on what my weight had done that week. Each week I would choose my lunches, dinners and snacks for the week. I would have breakfast and evening snack on my own every day, as well as all weekend meals. During the week, I would eat whatever I had chosen right down to the last crumb.
I worked very hard during those 8 weeks and did everything that was expected of me. I made great relationships and faced a lot of my fears around food, weight and shape. Still, I felt as if I was just going through the motions, trying my best until it was time to go home. I wanted everyone to believe that I was trying to get better, to see the hard work I was putting into this. I wanted them to know that I tried so that when I got sick again, they could say “well, at least she tried”.
I was able to keep up recovery for about a month after I left the program. Then, slowly and ever so slightly, the symptoms began to return. It started with long walks and progressed to missed snacks, meals and sneaking off to purge. Quickly I returned to my pre-treatment weight and symptom frequency. I continued to see Dr. S every 8 weeks as a check-in and he knew what I was doing.
That summer (2010) I decided to apply for a teaching job in England, because the teaching jobs in my area were few and far between. I dusted off my boots and started doing really well in recovery again, I even started attending a group back at the hospital to help prepare me for life by myself over there and got a tattoo to remind me to keep fighting no matter what. I had everyone convinced that I would be fine, I almost convinced myself.
I landed in England around 10am on a Friday and someone from the teaching agency picked me up and drove me to my hotel. I had some appointments to see some apartments and then went shopping for some basic things I needed. The first 3 things I bought in England were a cell phone, a scale and a travel adapter – this was the first sign that something was going to go very badly. Already on the first day I was restricting heavily, I was homesick for the first time in my life and exhausted from an all-night flight. For the next few days I would eat my hotel provided breakfast and little else despite the vast amounts of walking I was doing as I tried to navigate my new city. On the Wednesday afternoon I was sitting on the steps of my new apartment building waiting to give my first and last month’s rent to the landlord, he would be there any minute. I sat there on the steps crying because something about this all felt so incredibly wrong. The teaching agency had changed my contract just before I landed and a few things were making the experience much harder than it should have been – this was not what I had originally agreed to. This was making me feel very uneasy about being there for the next 6-10 months but the thing that changed my mind and sent me on the first plane home was a familiar feeling deep in my gut, the same feeling I got when I was graduating University. Here I was, on my own in a country where I literally know nobody. I had been there for less than a week, already lost a significant amount of weight, had been restricting, weighing myself multiple times per day and chose an apartment that was close to a 24-hour gym – I knew deep down that if I didn’t get out of there the trip might literally kill me. I took the rent money and caught a cab, train and the first plane I could get back home.
The next few months were awful, I was able to recover from my nose dive but was still holding a very precarious position in my disorder. I was still purging multiple times daily and restricting heavily in an attempt to keep my weight suppressed. I was creeping towards the invisible barrier between “normal weight” and “underweight”, maybe when I got there it would be enough, maybe then I could stop. Well, big surprise, when I got there, I couldn’t stop. I needed to go further to create a buffer in case I gained any weight, I wanted to make sure I stayed at a low weight.
Everything changed after I got a call from Dr. S after a routine ECG, there was evidence of a recent cardiac event and I needed to see a doctor right away, I was to tell them that I needed weekly ECGs and to be monitored very closely – I was terrified. There is something about the way Dr. S speaks, you know you can trust him, you know he’s telling you the truth and you know how serious what he’s telling you is. A cardiac event, like a heart attack? I didn’t even know what that really meant and even if it did mean what I thought it might (that I almost died) it couldn’t be real and it couldn’t happen to me… right? Wrong. Dead wrong.
I went to my doctor who referred me to a cardiologist. I had a holter monitor that watched my heart 24/7 for a week. I had stress tests, an echo and more ECGs. When I saw the cardiologist, it was bad news. I had experienced something called a myocardial infarction, probably in my sleep. The wall between the chambers of my heart was thinning and the blood wasn’t flowing through my heart as it should. This coupled with my newly diagnosed hypotension (low blood pressure) and bradycardia (low pulse) caused my heart to give up for a second. I was terrified, I didn’t know how to tell my loved ones what I had done to myself or what to do about it, all I knew was that I had to get back into treatment at the hospital.
A month later I found myself back in the day patient program at the hospital but this time it was going to be different. This time I was going to do the work, challenge my thoughts, live on my own nearby instead of at my aunt’s house and take advantage of the transition program – this time it was going to work. I spent 7 months in the program and I did pretty well! I worked my butt off but there were things that I just wasn’t willing to budge on. I kept suppressing my weight by skipping snacks and walking more then I should have but I didn’t want to tell anyone, I didn’t want them to think that I wasn’t doing well when I was getting so much benefit out of the program! My mind felt like it was recovering but I just couldn’t let go of the behaviours, again I found myself going through the motions of treatment.
In February of 2012 I left the program and headed back home. My symptoms were drastically reduced but I was soon restricting again and purging 3-4 times a week. I started seeing a therapist from the program who has a private practice, Dr. L. She was the psychologist who did my intake interview back in 2009 when I first entered the hospital’s programs, she had seen me through 2 treatment terms and I trusted her. I had to drive for an hour to see her, but given the dismal support where I live, my boyfriend (yes, still Carson) and I felt it was worth it. I got engaged to my wonderful boyfriend Carson 3 months after I left treatment. I was fairly stable and things were going well, I was back to maintaining a weight just in the “normal” range again even though I was still using behaviours to control my weight, it wasn’t “dangerous” or “too bad”.
As the year went on, my condition deteriorated. I started losing weight again, slowly but surely and my behaviours were getting more and more persistent. My mind was a battlefield and I was completely unable to cope with the thoughts, not to mention being able to keep up with my meal plan – I buried myself in wedding planning and lived in it’s perfect little world. In March of 2013 things were starting to get desperate, I was once again at the same weight I was when I found out about my heart attack, I was purging multiple times a day and restricting very heavily. The hardest part I think is that I could have had another cardiac event and I didn’t even care. I found myself glued to heart monitor watches and blood pressure machines watching for any sign that my heart might be giving out again. For some reason, I didn’t even really care that I had already cheated death once and was flirting with it again, I just wanted to be thinner and thinner and thinner, as close as I could get without dying.
Check out Part 3 here!