Speaking of Normalcy...

 

I couldn't resist taking a cheeky snap of this mug when I saw it in a shop window.
I'm on holiday in Cornwall; land of smugglers and sea shanties and shipwrecks and ancient tales of hidden pirates' plunder. It's now home to thousands of artists (on account of the beautiful, flat light and the sheer sense of SPACE). 

Cobbled streets, winding lanes, laid back locals and sun soaked flora. The essence of Cornwall. Pints of real ale, Cornish pasties, and fish and chips fresher than any you'd ever find. The streets here are lined with gift shops galore; the type that you bump around, stroking pretty wooden shapes, painted in low tone shades - willow green, dusky pink, dirt track yellow...
It's as far South West as you get in the UK, and the sun sets here last. Days feel long and it's endlessly beautiful. 

I'm on a family holiday. The first for years.

I think we're past thinking we're a nice normal family. With two anorexics, an anxiety disordered mother, a control freak dad and another sister who, believe me, has her own scarring, we're hardly 'normal'. I'm glad we can (sort of) admit it (bar my mother). I'm glad we can (sometimes) laugh about it (almost). But, I remember a time when we couldn't. 

Many years ago, when the values were set differently, when the pride was stronger and the pain - rawer; we were  bound and gagged for fear that someone might see we weren't the "nice, normal family" that popped up, smiling and glossy and beautifully 'normal'.

You might ask the question, 'what is normal?'in an attempt to deny that there's any such thing. 

In my experience, those who deny 'normal' (mother), are either defending their hidden non-normalcy, or, they're just not weird enough. 
If the family is a piece of wood, pain is a plane, relentless at task with which it's charged. And the shape we're in now comes from years of scraping and turning and sanding and smoothing. And we're still very much a rough hewn hunk of wood, but at least we're not still in the denial phase of 'normal'. 
To attempt comparison is ridiculous... yet in some strange way, it's more painful to be at that end of the process. I still bear scars from smothering hands that insisted that we were 'normal'.

Facts and Figures. It's All or Nothing

Three Months - One Stone (6.3kg)  = Slow Downward Trend

Based on current rate

BMI 16.1
- 1 Stone  (3 months)

 = BMI  13.6 by end of August

I'm trying so hard to keep fighting but I'm doing a really intensive teaching course (English as a foreign language) and I'm finding it very hard to focus on both the input sessions, assignments, lesson planning and teaching, and the battle against Anorexia. 

I must write here more. The intention is there but I find the drive towards perfection kills my ability to even begin. 
This is so typical of somebody who has 'all or nothing' thinking. 

Side Effects of Anorexia

I haven't really written about the effects of Anorexia, and to begin doing so is a little bit like looking at a sheer cliff face, wondering how on earth it can be scaled.

However, partly in an attempt to promote understanding and awareness of the effects of this illness, and partly as an exercise to remind myself of the horrors that lie just a few degrees beneath the point where I now stand, I am going to attempt to climb the scarp.

Let's make a start at the base of this mountain.

When you first start losing weight, your body feels great and your mind may even feel sharper, clearer. You may go so far as to feel on top of the world because you have some sense of control or achievement. 

The problems begin as soon as your BMI drops too low. For those who don't know, your BMI is your Body Mass Index which is a measure of body shape used by the medics. Although it is not an exact science, it provides a guide to a healthy body weight based on the ratio of your weight to height. This is regarded as being anywhere between 18.5 (though some argue 20) and 25. 

The effects of being underweight are fairly well documented and a quick Google search will inform you of the main risks. However, I'm going to write about the things I won't miss about being at a stupidly low weight.

HAIR

I'll start with this. (Always a good place to start, if you're lucky enough to have it!) 

It's an odd thing with extreme weight loss; sort of a 'ya win some, ya lose some' scenario.

Every time I washed my hair, I'd have to be really careful of it's devilish attempts to block the plughole, because it would just come out in big, tangled clumps. I molted like a cat in springtime.
The hair I did have lacked life. It became dull, brittle and dry, resisting the conditioners that I sometimes used.
When I sank to a much lower weight, the reverse happened. I stopped molting and began to develop soft, fine, downy hair on my face, my arms and my legs. This is known as 'lanugo' and is your body's desperate attempt to keep warm.Clever really.

Which brings me nicely to something else I won't miss. COLD.
Unless you're one for subjecting yourself to ice baths or Arctic wanderings, I think it would be difficult to imagine just how cold an anorexic can be. I recall putting on layers of thermal socks, leg warmers, tights, anything to warm my freezing feet. Nothing worked. My hands were chapped and peeling, my core, constantly numb with cold. And I'm not even talking about winter.

Speaking of my hands and feet, it almost hurts to remember the ELECTRIC SHOCK SENSATIONS I got as I expended energy. I would feel electric pulses throughout my body, culminating in bizarre sensations in my fingers, cheeks and feet.
I know now that this was due to severe electrolyte imbalance, which occurs when you don't have sufficient nutrition. Binging and purging is also one of the causes, as is excessive exercise. All of these of course, also put undue strain on the heart.

I won't go into the mortality rates.
In fact, I feel emotionally exhausted. I'll continue in another post. 

Breaking ...

Silence, for all it's mystical, whimsical and wise properties, is keeping me prisoner. With the passing of each silent day, another bar goes into the cage and I, half crazy for the want of words, pace endlessly up and down the concrete floor.

Inside me, thoughts, ideas, agonies scratch to be given a voice, nails on a blackboard, wet fingers on cotton wool.

Today it has become unbearable and so I sit here, trying to break this silence.

I have ideas swilling round inside and yet it almost hurts to entertain them. 

I have hopes that this post will loosen the odd bar, enough at least for a piece of me to slip through.

"Absolute silence leads to sadness. It is the image of death."

Jean Jacques Rousseau (1712-1778) Swiss political philosopher and essayist"
.

Redundant - A reflection

re·dun·dant  

/riˈdəndənt/

Adjective No longer needed or useful; superfluous. (of words or data) Able to be omitted without loss of meaning or function.

Synonyms superfluous - unnecessary - needless - excessive - spare

It's Bad News I'm Afraid

You've been made 

REdunDANT

a haze

empty space

where words were

Of Course You'll be Paid

... sentences fade

REdundant

RE - DUN-dnt

rephrase 

News

new

phase

new 

ways

So Sorry

she says.

Later I thought
outside the daze
I'm out of a job

but I haven't fought 
this long
this hard
to be 
redundant.

I'll leave dun
and duh nt
take the re
thanks

re start
    re view
        re fresh
           re new

Thank you.

Eating Disorders Awareness - One Truth About Anorexia

I'm conscious that it's National Eating Disorders Week. 
I'm also conscious that much of my writing here has borne witness to my own, very personal, struggle with Anorexia and that, whilst there are many apparent similarities between sufferers, each and every person has their own 'strain' of the illness. 
I recently watched a BBC documentary by a now recovered minor celeb who, having suffered from Anorexia in her youth, embarked upon a quest to find out 'The Truth about Anorexia'. I watched with a  degree of cynicism, (typical of me) because the results of this exploration were pretty obvious from the outset. 

(Aside) As it happened, I was more intrigued the next day, by the widespread and vicious backlash on various discussion forums, where anorexics ripped the programme, and its celebrity 'investigator', to shreds, claiming that she obviously hadn't been a 'proper' anorexic! 
That would be another topic!

One thing that I've learned from the large number of patients in the treatment centres I've been in, is that there IS no single 'cause' of anorexia. There can be no 'getting to the bottom of it' because it's as shape shifting as the virus for the common cold.  

You think you can spot an anorexic? It's the legs that give it away right? The two pins that, by some miracle, are holding them up. And the face. The way their eyes sink into the skull, dark skin sagging at the ridge of bone which runs from the top of their cheek to the deep line around the mouth.
The clothes that hang baggy off their shoulders. Tired, tiny arms, narrowed, fleshless at the tops. 
Yep. Definitely.
As I type, I sit in Cafe Nero. Couples sit sipping valentines coffee. A barrista sweeps conscientiously, moving the easel with the 'Hot Soup' ad, concentrating on each swish across the tiled floor. A young man sits at his laptop, looking over dark glasses at intervals. 
I'm drinking a one shot Americano with skimmed milk, hot. My make up is immaculate (last time I checked anyway). Subtle grey eyeshadow, a touch of mascara, a little blush. I'm about seven stone; that's forty five kilos to the metric crowd. My clothes are an eight. I've just eaten a Kit Kat. 
Nobody knows I'm anorexic. 
Nobody can see that beneath the recently acquired flesh, a cold skeleton howls, like a forgotten child. Nobody can hear the whispers, the taunting desire to have one of the brownies that the rosy-glow girl to my right is enjoying. Nobody can see the rapid calculations, the figures flicking up and down as I add, divide, add, multiply; 107 calories = my biscuit, 100ml of skimmed milk =  43Kcals x 2 plus a bite of cereal bar. It's too much. How can I compensate at dinner? 
Nobody sees the anorexic who knocks around in a body too large.
I may be sitting near another at this very moment.

I think I've digressed somewhere. 
I set out to illustrate the fact that the one truth about Anorexia I know is that everyone's illness is different.

During inpatient treatment people presented with dangerously low BMIs. But how they got to that point varied. 
Okay, we all have an issue with food. But some anorexics are calorie obsessed, whilst others are more preoccupied with the fat content in foods. 
Some are addicted to exercise (myself included) and can hardly sit down for more than ten minutes without having to get up and do press ups or squats; others can happily lie on a sofa for hours and sleep. 
Some patients have buggered up their system by taking laxatives and/or making themselves sick. Others won't take a tablet, even for a migraine.
Some quake at the sight of a potato because carbs are sworn enemies, others are too afraid to eat a carrot because it has somehow become a 'fear food'. Still more are terrified of dairy products, not touching milk or cheese for years.
I met patients who will 'water load' to throw their weight (water loading is a common but dangerous behaviour practised by eating disordered patients who consume vast quantities of water in order to fake weight gain). Then again, some people are so obsessed with knowing their actual weight that they will wear exactly the same clothes to be weighed. 
Some anorexics are so scared that their body will absorb fat that they won't use cream shower gels or moisturiser on their skin. 
I've met anorexics who drink copious amounts of alcohol, whilst others won't even sniff it.
When I was at my worst, I couldn't drink coffee for fear that it contained hidden calories. I couldn't trust the calorie content on certain labels and so I ruled out anything which I deemed to have 'too few calories to be believed'.
Some people can't watch food programmes, others read cookbooks obsessively and liked nothing better than to cook a three course meal that they could never eat.

Eating Disorders may present similarly, but no one sufferer has the illness in quite the same way, which may be why they are so difficult to treat and why they are still so widely misunderstood.

The writer of this blog...

... has been in hell for the past two months...

perhaps more.

My silence here has been down to the simple fact that my head is mostly a jumble of sounds which don't seem to translate into anything as neat and orderly as WORDS.

It even sounds far fetched to me, but it's one of those 'you just had to be there' things. 

Unless you've been in my shoes (and stomped round and around the same hospital building three times a day for twenty minutes 'fresh air') my ridiculously dramatic sounding excuse for silence just won't wash. 

(Cue Persil ad...)

No really. 

Prompted by a friend to describe what it's like to be restoring weight, I wrote that it's like...

...having your skin peeled off in long strips, and then your body being rolled around on a grater, with pressure being applied in varying degrees in different places

and sometimes

it makes you bleed purple rivers in hidden places

or mouth short 

breathless 

cat-screams

and other times

anger-fear juices inwardly curdle

with an inverted agony

that leaves me folded on the floor

pressing cold fists into my eyes

to stem the red pain seeping out of my sockets

and in me, a mighty snake twists

my colon, a strangled tree trunk 

and the more I eat

the more it turns and thrashes 

against the raw muscle tubing 

 ***

Okay. So every word is wringing with pubescent angst and perhaps the silence, if not golden, is at least preferable to the torture - jargon. 

But this is the truth of it.

This is how it feels for my anorexic head to be growing a body.

And no amount of Seroquel or Pregabalin or Duloxetine is going to make it okay. 

It's not supposed to be a joyride, this recovery lark... but six months in... it hasn't got easier... just...
... different. 

New Year's Resolutions?

No rest... for the Anorexic.

BMI 16.8
42 kg

This is hard.
I'm growing. More, I've GROWN. 
(Groan.    I do.)

It's getting easier to eat the food on the unit.
I'm not feeling the intensity of the agony I was. I rarely end a meal and feel like hanging myself from the shower rail (which, incidentally, is magnetic for just that reason).

Now it's OFF the unit that the problems occur.

I have weekend home leave fortnightly. 
It would be weekly if I didn't lose weight every time.
I TRY. I really do. But I panic and I walk around a lot and eat fairly 'light' meals and feel triumphant if I manage to keep my head so busy that my body 'forgets' that it has missed a snack.

Exercise remains a HUGE issue for me.

I NEED to get past this.

As I was on one of my walks the other day (I'm allowed three twenty minute walks nowadays) it occurred to me that I can restore my weight to a BMI of 20 - 25 and still be a slave to exercise, a slave to the thoughts which perpetually torment me the minute I have to sit down for a second longer than 'rest' is enforced for. 
I can restore my weight without ever challenging myself to eat pizza or drink wine or eat ice cream or pasta or ciabatta or gnocchi or avocado or any of those things that terrify me.

I could well walk out of this hospital, a picture of health; the epitome of 'normal'; cheeks glowing, hair shiny, eyes sparkling; vitamin B, C and D radiating from every pore... and still be utterly horrified at anything more than a sprinkling of carbs across my week, and COMPLETELY unable to even contemplate something like takeaway.

I HAVE to challenge myself with these foods or I will never overcome the fears I have.

And yet.

I feel helpless when it comes to even sitting in the hairdressers for a couple of hours. 
Today it nearly made me cry that I had to sit down for so long.

If I could kill this illness, I'd want to torture it first.
Torture it like it tortures me and all the girls here.

Distortion - The Extent To Which Anorexia Lies

I sit in the shabby hotel conference room, anxious for the guy whose innocent gesture has landed him a bidding price that is far, far higher than anything he can afford. 

Nobody else is bidding and my fingers are twisting themselves into tight, three dimensional infinity symbols. 
"Any advances on..." 
A grey suited, old man, wearing a felt Trilby, half rose and then collapsed in the middle of the room.

"Time... Time..." 

Time for what? 

A melodic voice in the distance

"... that time again..."

I lurch and my breath is caught and it's sudden: The realisation that I'm here, not there. I'm awake. 

Six am, in the half light of Weigh Day, and the Support Worker stands cooing at my door. 

I know I must leave the bathroom door ajar so she can hear me as I pee.

It's a long time since this felt like an indignity. 

I stumble down the corridor into the glare of the clinic room. Somehow I manage to keep shading my eyes as I peel off my nightwear.

The scales confirm weight gain.

I fight my way through a cloud of sleep - laden mist to calculate just how much.

I do, and I am not devastated. 

Perhaps I'm getting better. 

Perhaps I'm just too tired.

I pretend I'm still asleep as I crawl back into bed.

Miraculously it works. Until 7.45 when the alarm pips me back into reality.

Even as I write the word 'reality' here, I debate whether to use inverted commas, because actually, within minutes, the distortions conjured by this illness can transform your mind from a Ferris wheel, to a drop spindle for your thoughts. 

At six o'clock in the morning, I knew exactly how much weight I'd put on in the three days since my last weigh in. Approximately one and a half hours later, during which time I had done nothing but sleep, I awoke convinced that at least three days worth of weight had suddenly piled on and, were I to stand on the scales again, they would read quite differently. 

Just to make it clear: in this moment, I was utterly convinced that my body had withheld weight until one minute AFTER I stood on the scales, at which point, it suddenly and spontaneously added the pounds / kilograms that it had been hiding. 

Yes. 
These are the lengths that Anorexia will go to in order to keep its victim ensnared.  

And this is only one of the many distortions its capable of.

The fact that the mind can do this in a period of time when there has been no food intake, perhaps you can imagine the outstanding strength of some of the convictions that an Anorexic has after eating, the sheer havoc wrecked by having food in the body.

Although everyone has a different experience, I am often overwhelmed by the physical sensation of fat layering itself onto the backs of my legs and my thighs. At any given point in the day, I will suddenly be aware of this thickening of my body. I swear, I can FEEL it. I've been told this isn't possible, and yet, it's always someone who hasn't HAD the experience that tells me. Perhaps you have to have experienced feeding your skeleton, putting flesh onto bone, to feel it. 
Or perhaps it really is another of the distortion of reality... which is a frightening thought because, how will I ever know what's real and what is, in essence, a figment of the imagination. Like a phantom limb, the fat clumps on my body. I feel it and, I SEE it. 

And yet, as I do my calculations, I briefly think of the previous nights' anxiety; the conviction that I must have put on a least a kilogram (that's two point two pounds). 
I hadn't.

Can I really feel POINT three of a kilogram? 
Really?

The ugly truth is that part of my reality is almost certainly distorted.
My truth is not THE truth. 

Every Picture...

... tells a story, right?

Right.

Seeing as I am having great difficulty in communicating some of the ways in which my head is dealing with the treatment here in the unit, I figured that perhaps I could use some pictures. 
Cop out?
Perhaps. But at least it's something; and something is better than nothing. 



When I came into this treatment centre, my sister (the anorexic one) sent me this bracelet. If you look closely, you'll see that the simple piece of thread is tied to a charm depicting a little bird. 
I haven't taken it off since I put it on. For me, the bird is representative of hope and freedom.

I think one of the hardest things in recovery is holding on to hope. Right now, despite my weight being up to 40.1 kilograms, I can't ever imagine being about to shake this illness off. 

But I have to hope.
I need it in my spinal fluid. I literally need it to strengthen my backbone. 
I need it to give me the strength to keep going. 
I need it like the world needs a horizon. My world needs a horizon. I think it's a need that every human being has. 
Trouble begins when the horizon isn't visible.

Hope Is A Thing With Feathers

If life is a ragged nail, chipped and broken by the most menial of tasks, poetry is a glass file, reshaping and smoothing... 

American poet, Emily Dickinson is one of the most well known writers of the nineteenth century. 

All too familiar with the alternating pain and numbness of depression, and the paradoxical feelings of safety and loneliness which come from isolation, she poured her thoughts into poem after poem and, famously, a vast number of letters.

In what I consider to be one of her most beautiful verses, she uses a bird as a metaphor for hope. The poem reflects the simple innocence of hope, making the point that whilst it may appear as fragile as filigree, hope can endure extremes, harsh storms and the most bitter winds.

I made this poster for my room here in the unit. 

I look at it morning and night, every time I feel that hope may have perished...

I pray for Dickinson's words to be true for me.

“Hope” is the thing with feathers 

BY EMILY DICKINSON

“Hope” is the thing with feathers -

That perches in the soul -

And sings the tune without the words -

And never stops - at all -

And sweetest - in the Gale - is heard -

And sore must be the storm -

That could abash the little Bird

That kept so many warm -

I’ve heard it in the chillest land -

And on the strangest Sea -

Yet - never - in Extremity,

It asked a crumb - of me.

Hope?

I'm Still Here...

... Still in the hospital.
... Still battling.
...Still wanting recovery
and...
Still finding communication very, very difficult.

However...
I am currently weighing in at 38.8kgs and my BMI is now above 15.
Although I am finding weight restoration almost unbearable, I am finding that eating the food itself is less frightening.
I even enjoy it.

I want to begin writing about the recovery process and I want to use my experiences to benefit others in some way and yet, I still have so, so far to go.

Tomorrow I get to go home for one night after twelve long weeks... Or is that thirteen?

I think it will feel like heaven, and yet, I am scared I'm gonna mess it up.

If you're still reading here, 

you are more faithful than I am deserving, and show more loyalty than this blog warrants!

It's an Inpatient's Life

I began the following post on Day 10 of treatment.
I am completing it on Day... Thirty five..?
What am I still doing here?
I wish I knew.

Day 10

Ten Days after admission and I am just getting past the numbed haze of the first few days as an inpatient in an Eating Disorders Unit. I want to be positive and strong and cheerful but in reality, there are few words to describe the abject misery of the long, closely monitored, periods of 'enforced rest', that characterise the treatment of undernourished patients.

As a newbie, I have been placed on 'Level One Obs', a nursing term meaning a patient must be 'checked on' every fifteen minutes.

Words fail to describe the torture that accompanies the lack of sleep these 'checks' entail.

Prone to insomnia, I think I managed two hours last night. Sleeping medication has been prescribed but I am loathed to use it every night, meaning that I am cultivating an unhealthy dread of long, 'every other night,' shifts. Tossing and turning, I sweat on a rubberised, wipeclean hospital mattress, under a rubberised, wipeclean, hospital duvet, tortured by unspent energy and the cruel whisperings of the relentless Anorexic voice.

I get up and shower in the wet room, cursing the ever growing pool of lather which collects around the plastic drain. I hope to be on time for the discretionary extra glass of water that is allowed in a narrow, fifteen minute window, in the mornings.

Outside the clinic room door, a queue of barely rested, skeletal patients in varying states of undress, forms. A small plastic punnet of pills is pushed across the trolley. I swallow the seven tablets in two gulps. At least this is the chance for a bit more water. (Restricted fluids is part of the treatment and they swear that what we are allocated is 'enough').

Thankfully, this is as close to One Flew Over The Cuckoos Nest as this place gets.

Breakfast is at 8.30 and comes with juice, but if you complete your meal within the allocated half hour, you are allowed an 'extra' water, tea or coffee.

Two minutes over and you're fucked.

At the table, I cast my eyes around, looking to smile encouragingly at my comrades who sit, eyes cast down, pushing tiny forkfulls of fattening foods into fear filled mouths.

Cheek bones clench painfully, accentuating the grooves around their mouths as they chew on branflakes and then toast.

I haven't eaten toast for about three years.

As a carbohydrate, it terrifies me.

Day 35

I was thought I'd be here for four weeks.

Come Thursday, it'll be five.

Last thursday I reached a BMI of 14.1 and weighed five stone 8 pounds. It feels like such a lot.

I've had time to get to know the ropes a little, although, it doesn't make them any less painful to climb.

I won't continue with a blow by blow account of the days here... Suffice to say that, when you are assessed and deemed  'cognitively well enough', you are allowed to join certain 'groups' which take place twice a day, both an hour long.

Days are structured around the three meals and three snacks. Each of these is followed by a period of 'enforced rest', during which time we have pulse rates, blood pressure, temperature and sats done.

I can't fault the care here. The team are outstanding, though there are many times when I would gladly escape their attentive listening and their constant presense.

The worst thing about this place (aside from the obvious and the ensuing weight gain) is the complete lack of privacy.

The doors to the bedrooms have little windows and staff patrol the corridor at regular intervals, day and night.

I am currently allowed out for two, 'unaccompanied' 5 minute walks.

You can imagine the pace of these.

Twice a week we are woken at six for weigh in. I'm usually the first because I've been awake for hours, sweating on the rubberised hospital matress, which still makes me boil in my own skin despite the fact I have a blanket and two sheets seperating the rubber and my body.

We're spared little dignity as a member of staff stands outside the slightly opened bathroom door, waiting to listen to us pee so they know that the figure on the scales is a reflection of our 'true' weight.

No room for stagefright.

No room for cheating either, as we strip down to bras and knickers to stand on the scales.

Mondays also entail enduring one of an assortment of unhelpfully similar acronyms; a CPM.

Daunting to even the most seasoned of inmates, this requires that you sit before a selection of senior team members who feedback on your progress, sanction (or not) each of the three requests you are allowed to submit for consideration, and discuss the efficacy of your mealplan.

Mondays are rarely dryeyed days for the majority of patients.

I have all that to look forward to in the morning.

My stomach churns as I type, unable to digest the huge portion of ice cream and rhubarb crumble, unable to face the numerical realisation of my inevitable weight gain, and unable to face the impending bowl of bran flakes that lies in wait for me at nine thirty this evening.