food challenges

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I read a really interesting article* the other day from the Journal of the American Dietetic Association:

Food Choice and Diet Variety in Weight-Restored Patients with Anorexia Nervosa

(sorry this is the abstract only)**

The study found that weight-restored (as opposed to recovered) anorexic patients who maintained a diet which included both a wide variety of foods and also highly palatable foods, were significantly less likey to relapse than those who ate only limited number of less palatable foods.

Huh? Well, I basically interpret this as: if you can break out of that anorexic mind-set of
"I mustn't eat very much and I must make sure that what I eat is boring to stop me over-eating" then you are going to have a far better chance of preventing relapse - and fully recovering!!

So I'm going to add this to my recovery checklist:
1. nutrition
2. support
3. eat a wide variety of tasty foods

And I'm also going to add to that, the challenge of trying new foods - even those which make me feel sick. Because at the moment that's pretty much everything I can think of, so I can't trust my own judgement.

...this should be fun...


*thanks ViR for the article link via twitter

** thanks to my big brother for sending me the full text version :)

listening to the dietician

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My first degree was in science - I majored in human anatomy and biochemistry - so when I started on this adventure I assumed the dietician would be the one I would relate to most easily. I refused flat out for some months to see the councellor...that was way too touchy-feely-talky for me. But the dietician I agreed to go and see *fairly* soon after my gp suggested it.

So I really was surprised when the dietician turned out to be the most challenging one in my team. Not because of her - she is extremely kind, generous, patient and cheerful - but simply because there is nothing much else to do at her place than sit around and talk about food (hello...challenging much!!).

But if there's one constant in recovery, it's that everything takes time. Nothing is a quick fix.

And being able to talk to M is no exception.Today was maybe the 6th or 7th time I have been to see her and definitely the first time I've been able to listen to her.

So what did I hear?

Firstly that I don't eat enough. This was actually really reassuring. It means that my worst fear, that if I start eating again I will suddenly gain 20kg, will not happen when I choose to add a little more to my eating plan.

Secondly the fact that I am not eating enough yet is not a criticism of me personally. She recognises the big changes I have made and I am not a failure who needs to do better.

Thirdly that I should acknowledge the shift in my focus. Previously I saw my challenge as eating as little as possible, but now I am trying really hard to challenge myself to put food on my plate and sit down and eat it.

And lastly that every meal is not the most important meal ever. It is not a reflection on my personality if I just can't manage everything I set out to eat every time I sit down to try to eat it.

I wasn't going to post anything tonight because I am going back to work tomorrow and I thought worrying about that would take up all my headspace - but I'm feeling so good about this session with M that I wanted to come straight home and write it all down so I don't forget!!

And since my gp visit yesterday was not a huge success, it is nice to feel a little proud of myself for a change :)

nervous nelly

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Had my weigh-in with the gp this morning…

It went well in that I got onto the scales. However I was hoping to be given ‘permission’ to go running again. But unfortunately (as apparently happens at this stage in recovery) my weight had dropped off a little – so she said “no” (and she gave me ‘the face’ when I asked her too).

So there goes plan A on stress relief.

I am conscious that my anxiety levels are over the top at the moment. It’s quite surreal to be sitting on the floor reading Mem Fox books to your toddler with part of your brain, while the rest of your brain is worrying that your heart could quite literally explode if it doesn’t stop beating so hard. The anxiety has been quite relentless. K says it is to be expected as I have so suddenly cut off all my other means of stress-management (hello ED…I’m talking about you!), and now I need to find other ways of diffusing…you know, before the panic attack takes hold (preferably).

So I've been  re-reading this post, which has a whole list of great tips. I’ve also been listening to Yo-Yo Ma very loudly on my ipod whenever I get the chance. And naturally Carrie (edbites) has wisdom on this topic too (see this post).

But at the end of the day, I know part of my problem is returning to work on Friday. I think until I’ve met that challenge I won’t be able to relax…

the times they are a-changin'

Come gather 'round people
Wherever you roam
And admit that the waters
Around you have grown
And accept it that soon
You'll be drenched to the bone.
If your time to you
Is worth savin'
Then you better start swimmin'
Or you'll sink like a stone
For the times they are a-changin'.

I recently gave my gp a list of my options as I saw them. What is to follow, wasn’t the list, but rather the thinking behind the list:

1. continue on doing what I want (restrict and over-exercise)

2. find a middle ground where I can continue on as I am but without doing myself as much harm

3. change what I am doing

this was the actual list of options:

1. die

2. exist

3. live

Pretty confronting. But it made my decision so much easier. And yet so much harder.

I chose ‘live’. But by doing so I also chose ‘change’.

So how to change? Am I afraid of change? Yes. But what if I reframe change and view it as challenge? Does that make it less intimidating? Well, I’m not afraid of any challenge – I have three children after all. I have three degrees and work two jobs. I welcome challenge as the daily excitement of living. I am constantly inspired by those who embody challenge; scientists, adventurers, astronauts, athletes, engineers, artists…

…no one ever wrote a song about how great it is to stay exactly the same.

So I have started where I feel most at home – education. By reading and listening and asking questions I have been equipping myself with as much knowledge as I can to formulate my plan. I like a plan.

So what have I learned so far?

Firstly that change will not happen without nutrition. No amount of introspection will compensate for starvation.

And secondly I will need help - this is a huge change for me. Never before in my life have I ever uttered the words “I can’t do this alone, I need your help”. But I do.

So, big deep breath…it’s time to embrace my change. I’m not promising I’m going to like it. But change happens regardless of how hard we try to stop it – and this is my chance to direct and drive that change…

 

…and my time to me is worth saving – and I’m a strong swimmer.


 
this post was inspired by medicinal marzipan and her word by word series

relapse and choice

Those who know me know that I have just had one of the worst relapses ever. It came off the back of a problem at work and resulted in me very nearly requiring a hospital admission (you know, *not* the voluntary kind). Once I managed to pick myself up and resume eating, however, I decided to add some more tools to my recovery tool-kit. I read a book last week called A Girl Called Tim by June Alexander – I read a review here a little while ago, and since June’s a fellow Melbournian I thought I would have a lookie.

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*Really* interesting read. At first I was worried – she makes constant reference to weights, something I know I find triggering. But to be truthful it didn’t affect me the way I expected. So relentless was her obsession with her weight – she hung so much on the numbers (her happiness, her success, literally everything hung on achieving a particular weight) that it had the opposite effect on me. I could actually see the futility in her constant weighing and obsessing. Me! Seeing logic? Hallelujah! 

So thank you June for a terrific, honest, frightening and cautionary story.

But thank you more because by sharing your story you have provided me with the motivation to make a choice I never thought I could. I have not weighed myself since last Friday. At all.

That’s 8 days

And I was a get-up-in-the-middle-of-the-night-to-weigh-myself kinda gal. Yes I find it terrifying – I described it to my gp the other day as ‘worrying that there was something terribly wrong with me but not being able to check’. But I’m hoping that by simply not weighing myself day after day after day it will become more habit and less forced.

Not sure I really trust myself long-term though, I think I might have to chuck out the scales completely, just to be on the safe side!

are you sitting comfortably?

yes? well then, let's begin...

Since this is the first post I should probably start at the beginning – especially now that I know when that was (so bear with me – I don’t usually talk this much!). About 20 years ago, after a family holiday I decided that everything would be so much better - I would be a happier, smarter, more confident and more popular person - if I lost weight (you know, a *lot* of weight).

I weighed 57kg* at the time.

Fast forward 20 years. I now present at my mothercraft nurse appointment with my third bub in tow. She has known me for 8 years, takes one look at me in my clothes I bought from the kids section of my local Target, and wants to know what has been going on. I calmly explain that everything is okay. I’m only doing this because it makes noise in my head and stops me worrying about all the bad things that might happen to my baby while she is so small and vulnerable. Mothercraft nurse is not happy. ‘No’ she says, ‘I’d like you to go and see your gp’…

So I do. This is so silly. So I explain to my gp that I only restrict what I eat and compulsively exercise because it helps me to control what I think about. It makes perfect sense. I don’t want to think about all the bad things that might happen to my baby, so I fill the silence with thoughts that I control. ‘No’ she says, ‘You have an eating disorder.’

Blimey, what was that noise? Oh right, that was just the rug being pulled out from under me.

ED: she’s wrong anyway. You don’t have an eating disorder. What a load of rubbish. You’re just really clever and you’re doing this for a really good reason.

PJ: but what if this is what’s been going on for the last 20 years.

ED: it doesn’t matter, it’s working so well.

PJ: but back in my teens and early twenties I got so thin I couldn’t get out of bed in the morning. I had heart palpitations and would cry all the time. What if that happens again?

ED: it won’t. You’re in control this time. You know why you’re doing it and it is important. And besides, there’s nothing wrong with you anyway. And you need me…

PJ: yep, you’re right, I can’t let the gp take you away from me. I need you. You fix everything.

ED: yay!!!!

Okay that little conversation happened last July. I’ve now had two half-hearted stabs at recovery, each time knowing that I didn’t really want it, mostly because I really didn't believe I needed it; and all the while just hoping that somewhere along the line something would click and I’d realise Dr C (my lovely gp) was right. Because she is lovely and she really knows what she’s talking about. And I really like her, even though most of the time I really hate her.

But a recent relapse has shown me just how real this all is, and just how dangerous it can be...
 
So now it’s try #3. Only this time it’s different. This time I have support. Mr PJ knows now. Dr C is on my side. I also now have a counsellor (K) and a dietician (M). And just yesterday I made contact with a support officer at a local ED association. I’ve also been steadily arming myself with information from a number of fantastic blogs (like this one, this one, this one and this one).

I’ve also found that now that this thing in my head has a name I have soooo much to say about it. Hence this new blog. I’m probably going to blather on quite a bit. And I’ll probably whinge and complain. But hopefully I’ll have some insights along the way. And I’d really love you to share your insights with me – especially if you, like me, are a *teensy* bit older than the average. But having said that I know for a fact that there are a lot of hugely insightful people out there who are far younger than me – so all helpful comments will be gratefully appreciated**

Because this time I’m going to recover. Come hell, high water and relapses, I’m going to fix this mess…watch me!

*this will be the only time I mention an actual weight. I mention it here to underline my belief that eating disorders are largely genetic in nature. No amount of exposure to glossy mags  and barbie dolls could make a slim and fit 17 year old believe that every aspect of her world would be better and more under control if she was thinner.

** bear in mind this is *my* blog and I will edit and rewrite all unhelpful comments (especially anonymous ones) until they amuse me!