Why is it that my therapist only ever calls WHILE I'm puking? Twice yesterday she called me, two different times of day, and I was puking both times. Yesterday was a major purge-fest, but it's happened other times too. "Yeah, hold on, lemme wipe the puke off my chin. You need to reschedule our session? All right, shiny."

No, self, do not answer your phone like that when you see her number on caller ID. That will get your ass shoved into residential treatment, not keep you out.

Well, my doctor's visit yesterday was a complete and total waste of two hours and a $20 co-pay.

The last time R. ordered me to go to the doctor, my regular GP was out of town, so I saw another guy in his practice who seemed at least semi-knowledgeable about eating disorders, in that he asked about specific behaviors. My regular GP made it clear he has no clue about them. I told him I was in treatment for an eating disorder, and he asked which one. I told him restrictive bulimia, and then I had to explain that to him. Fair enough, since it's not your classic presentation of either anorexia or bulimia. But he didn't ask ANY questions about my ED symptoms, not even when the last time I'd eaten was--which is odd, considering that I told him I was having severe lightheadedness whenever I stand up. He said several times that he doesn't "really know anything about eating disorders," and he asked ME what tests he should run. Um, last time I checked, Doc, you're the one who went to med school, not me.

My sodium, potassium, and glucose were low, and my ketones were up. This is typical of someone with an eating disorder. Low electrolytes tend to be a characteristic of bulimia (you lose them when you purge), and elevated ketones are a sign of inadequate caloric intake as the body breaks down its own tissues. This is not new information to me; I'm reasonably well-informed about the medical consequences of eating disorders, thanks to R. having gone to nursing school and liking to lecture me at great length about this stuff.

"So what was your doctor's brilliant medical advice?" I hear you all asking. I'll tell you.

Are you ready for this?

Here it comes.

"You should probably try and eat more."

Yeah. That's it. Try and eat more. Brilliant and inspired advice from Alabama's medical elect, folks. Tell the bulimic to eat more. Okay, sure, I got no problems with that, so long as I can barf it all up. Yum yum.

I think I need a new doctor.

Current Mood: frustrated

I'm down to 97.5 lbs, and I have no bloody idea how. My only explanation is that whoever said you retain 50% of the calories of anything you purge was wrong. See, yesterday I was 98.5, and it was a major binge day.

( Food )

The downside is, I have to get on the scale today at my appointment with my dietitian, and after that I have to go see my doctor--all by order of my therapist. Apparently they're all "extremely concerned" about me because, well, the only thing I've been living on recently is whatever bits of food don't come up when I purge. Friday, R. said she would be "beyond thrilled" if I would do one protein smoothie a day, but I haven't. Well, I tried Friday, but part of the damn thing came up on its own, so then I just thought, "Well, what the fuck is the point of even trying to keep it down?" So then there was a big b/p session because I decided it didn't matter, since I now apparently purge without even trying to.



I don't know what I'm doing anymore. I want to be better, but I don't want to go through the process of getting better.

Well, I'm not getting sent to residential quite yet. My therapists want to try creating their own intensive outpatient program for me, since they don't like the ones available here. It would mean working with R. (ED therapist) 5 or 6 days a week and M. (primary therapist) and S. (dietitian) once a week each, and R. was also mentioning bring in an art therapist too.

But first they're demanding that I get medical clearance. Apparently they're not happy with my weight being down in the double digits--Friday I got told I'm playing with fire. Like I don't know that. I went to my GP about 5 weeks ago, and since then I've been to the cardiologist twice. I tried to use that excuse to get out of seeing the doctor, but R. said no, my weight's dropped too much since then. So I'm going to have to take off work on Monday because my doctor only works afternoons, same as me. I also have to find the money to pay for the co-pay, which I really don't have right now. I tried to figure out some way to get out of it, but R. not only wants copies of the paperwork and whatnot, she also wants me to have the doctor call her. She didn't leave me any wiggle room.

Monday I also have another appointment with S., and R. said I have to get on the scale. Ugh, I don't know how I'm going to manage that--I've been putting it off for a month or so, but R. says she can't work with me unless my weight is being monitored. So I'm anticipating that Monday's going to be a major meltdown day.

Today I haven't eaten anything, after b/p'ing majorly yesterday. I'm talking like half a box of cereal, several sandwiches, a box of macaroni and cheese, and half a package of cheese hot dogs, plus some other random stuff I can't remember. I really want to go b/p because I'm so anxious, but I'll be damned if I'm going to gain any weight. If I have to get on the scale, I'm going to make damn sure I weigh as little as possible.

I'm not planning on eating tomorrow, which should actually be pretty easy. My church is having this 50th anniversary party right after the service tomorrow, so I'll make an appearance but stay away from the refreshments table. I can't stay long because I'm going to a play in Montgomery at the Alabama Shakespeare Festival with my grandparents, and that's an hour and a half drive. We're going to see Winnie-the-Pooh, and I'm excited. I'm such a child. :-) Anyway, I'll just tell my grandparents I ate a ton at church, so I can get out of eating with them. Dinner is going to be harder to get out of, but if I totally can't get out of it, I guess I can just purge. But that's only a last resort because I don't want the extra weight from water retention.

I just want to run away from all of this. I'd go somewhere tropical with good scuba diving, but not Aruba. I might end up as shark bait like Natalee Holloway.

I am so completely drained and exhausted. I can barely hold my head up, can barely type. I have to get through the day. I have to go to work. Have to keep putting one foot in front of the other, no matter how hard it is.

The answer is so easy: Just eat something, just a little bit to keep yourself going. I wish I could do that. I wish I could eat just a little something, but I can't. If I eat one thing, it'll turn into a binge. Then I'll have to purge to get it out. Then I'll have to take laxatives. Then I'll have to starve for a day or two to compensate. Better not to eat anything in the first place.

Tomorrow. Tomorrow's going to be bad. Tomorrow I'm probably going to be told I'm getting sent to residential treatment. They're not happy about my being under 100 lbs. Honestly, neither am I, anymore. It used to make me happy when the numbers would go down, but now it's just not enough. I have this irresistible compulsion to make the numbers keep going lower and lower, but it doesn't make me happy anymore. It controls me, shoves me down on the ground, and kicks the crap out of me.

I want it gone, but if I let go of this, I'll have nothing else to hold onto, and I'll go spinning out into the ether and never come back.

Everyone on my treatment team is talking residential treatment now. S. mentioned it when I saw her Monday, and M. brought it up when I saw her yesterday. Friday is my standing appointment with R., but M. said she was going to be there "just in case R. wanted to do a joint session." (R. and M. work out of the same building.) That statement is BS, I know, because M. doesn't usually work Fridays, so it's not like she was going to be in the office anyway.

I was right in my suspicion that M. rescheduled because she found out I've not been eating. After I saw S. on Monday and basically told her (albeit more nicely than this) that she could take her meal plan and shove it, S. called R. R. has been sick with the flu, so she called M., and M. called me.

I'm sure Friday's going to be shiny happy fun. (Note to self: must not throw things at therapists. This is apparently Rude and considered to be In Bad Form.) I'm pretty certain they're going to tell me they've discussed it and decided I'm going to residential treatment. I don't know where--a couple months ago, I know M. was looking up some places "just in case," and she mentioned one in California somewhere. Of course, R. is the expert on eating disorder treatment programs, so she'll probably have some ideas.

I'd still like to know how they think I'm going to finance this. Those places cost upwards of $1000 PER DAY for treatment, and I make $500-$600 PER MONTH. Thanks to my ED, my math skills have improved substantially, so I'm figuring it would take me two months of work to pay for one day of treatment. Most places want a substantial deposit first and at least a 30-day commitment. Yeah, I'm foreseeing some mathematical issues here. Next some moron's going to divide by cucumber.

Also, it's snowing. WTF, Alabama? Yesterday it was 71, no joke.

I am in so much trouble right now, it's not even slightly amusing.

I haven't kept food down in two weeks or so. I've dropped 10 lbs, meaning I'm now at a lower weight than I've ever been at before.

And this is while I'm supposedly in treatment. Yeah, I'm doing great with this whole recovery thing.

I saw S., my dietitian, today. I flat-out told her I wasn't planning on eating anything and keeping it down. Binges and purges happen, but I puke and take lots of laxatives to compensate, so I actually lose weight instead of gaining. Probably helps that I don't have massive binges like a lot of bulimics do. Anyway, S. was worried, and I signed a release for her to talk to R., my eating disorders therapist. She even mentioned getting R. on the phone right then, but I told her no, I was fine. (We won't mention the fact that I haven't eaten in 3 days and have cuts all over my arms and legs....) S. mentioned hospitalization. Great--I've seen her 4 times, and she's already talking inpatient. This does not bode well.

I probably would've gotten a phone call from R. today, were it not that she has the flu. She actually had to cancel our appointment for Friday, which was actually good for me because I keep worrying she's going to stick me in the psych unit. She threatened that the second or third time I saw her. (Are we noticing somewhat of a theme going on here?) I was 112 when she threatened that, and I'm right at 100 now. We have a standing appointment on Friday mornings, but if I'm really lucky, she won't make this appointment either. That way I can keep losing weight without the imminent threat of hospitalization.

I know, I'm a horrible person for wanting my therapist to stay sick so I can continue to kill myself without intervention. I'm going to hell, I'm sure.

M., my primary therapist, did call me today while I was at work and left a message for me to call her. I was terrified that S. had called R. and R. had called M. and I was in deep doggie doo-doo, but it turns out M. just needed to reschedule from Thursday to tomorrow. Mmkay. She won't be happy with me for not eating, but she doesn't threaten me with the hospital, and she doesn't spend the entire hour harping on food and eating like S. and R. tend to do. So that should be okay, I guess.

Anywho, I took some crappy cell-phone pictures this morning because it's picture day at purgatorium, and it struck me that you actually can see the weight loss in my face. I didn't think you could because my face is naturally kind of chubby, so it surprised me.

My icon is from September, and I was at about 135-138 lbs then. Also, ( Another September face shot. )
( Today's pictures )

Cardiologist appointment tomorrow at the ass-crack of dawn. Wish me luck. I'm nervous.

My therapists demanded yesterday that I go see a doctor. I know they're concerned for my health and all that jazz, but I hate doctors. The last time I went to one was when I ruptured an eardrum in a karate accident. He told me "This will be a little uncomfortable" and, without any explanation of what he was doing, dropped acid on my eardrum. I promptly passed out from the pain, and I'm not a wimp. You can't see it in my pictures, but I have scars in my right eyebrow and across the bridge of my nose from where I busted my face on a marble coffee table 3 years ago. I cussed a lot, but I didn't cry. Acid on your eardrum when you're not prepared for it, however, hurts like a bitch and made me pass out. Just one of many reasons I don't trust doctors.

So I'm busy freaking the hell out and wondering what on earth I'm going to say when I go in. I mean, you always have to tell the nurse what's wrong before you see the doctor, and I really don't feel like announcing that I have an eating disorder. And I have no idea what the frack the doctor's going to ask or what kinds of tests/exams he's going to want to do. Also, in my infinite wisdom, I cut up my legs earlier in the week. It's not deep, severe, infected, etc...but it's definitely not accidental, especially since I carved the word "FAT" into my leg. It's gonna be fun trying to explain *that* to the doctor.

I'm supposed to go in tomorrow, to the doc-in-a-box clinic. Ick. I don't feel skinny enough to walk in and tell the doctor I have an ED. I'm 5'3.5" and 102 lbs, right on the borderline BMI for anorexia. I don't think I look sick, and I don't feel sick. Okay, I'm dizzy a lot, short of breath, and my heart does funny things, but I'm still standing.

I'm afraid of being told there's nothing wrong, and I'm afraid of being told there's something wrong. I don't want to go.

Also, in unrelated but also sucky news, I think my phone is dead. This makes me a very unhappy person.

Work got canceled on account of tornadoes. Or, I'm assuming work got canceled, because when I went to pick the kid up from school (I'm a part-time tutor/nanny for a special needs kid), there was no one there, and his mom didn't answer her phone, and they weren't at the house.

What I should do: go see a doctor like my therapists are demanding. The doc-in-a-box is open till 8:00. The doctor I usually see isn't there, but I don't really care.

What I want to do: b/p like mad.

What I'm doing at the moment: sitting in front of the computer to distract myself and waiting to see if my ED therapist is going to call me back.

In other news, I'm starting intensive outpatient next week. Hooray, or something. I still don't think I'm skinny enough--my BMI is right around 17.5-17.8, and I want it lower. I don't want them to make me gain weight. I know I'm being stupid and childish and superficial, but I want to weigh less. I want to weigh 95.

Renee (the ED therapist) told me today that anorexia will kill you, and bulimia will kill you, and both of them together will kill you the quickest of all. Great. Here's me, anorexic and bulimic and not really thrilled about this recovery thing. I mean, I'd really like to be able to eat like a normal person and not freak out about food (and every other damn thing), but I'm absurdly terrified of gaining weight or even maintaining my weight instead of continuing to lose.

I feel crazy.

Current Mood: blah