Sunday, October 28, 2012

Don't ask if you don't want to know: I have an eating disorder

I don't really recall right now how much I've written about this subject, so feel free to ignore any of this. Or, you know, maybe you shouldn't, because chances are pretty good that if your reading this you care about me.

I have an eating disorder. You wouldn't know it from looking at me, or spending any time with me, but I do. The only real way anyone really knows about it is if they get inside my head at all - here's a big reason why it's so hard for me to let people in. I fall mostly in line with the clinical definition of bulimia, but there are some dalliances from that. I don't purge (anymore - I used to), but I do often fast for long periods of time, which lead to bingeing, which leads back to fasting because eating makes me feel like a disgusting slob. More than 50% of the time, I feel like I'm not in control when I eat, even if it's just a little bit. I suffer from anxiety and depression because of this, and it affects my self-worth by damaging my pride without ever affecting the number on the scale like it's supposed to - which makes me feel like a failure and then I fast and purge harder. 

This has been an issue since I was 12. I would intentionally skip meals because I was the girl in the health class who, when she heard about people intentionally starving themselves (or bingeing and purging) to lose weight, thought it was a suggestion. But the true root of this goes back farther to an abuse that lasted, I don't know how long, that took away my control over how I related to food. (The details don't really matter, so I won't go into it.) As I grew up, this loss of control was solidified in my mind, and the only way that I could control my food was to fast before a meal, or purge after it; I would still lose control when felt hungry, and snacking felt like weakness, and even though I would only eat a small amount it was a personal failure for me.

I continued to grow up in multiple environments that taught me to feel shame about my body and my relationship to food continued to be hostile. When I was in college, it was even more hostile because I had to be on food stamps, and this increased my shame, but certainly gave me an "out" as it were for skipping meals. What was even more of an out was alcohol. Even before I was old enough to drink, I would intentionally drink so much that I would vomit. The drinking was fun, but I knew what I was drinking had tons of calories, so I would make sure to make myself sick so that I wouldn't metabolize all of the fun I was having. There were even a few times when I made myself sick off of other substances combined with what I called at the time "over indulgence" but was really a binge. 

Around junior year of college, this all started tapering off and I became a little more okay with my body, (either that or I was still experiencing symptoms, but I decided to ignore them), and a little more okay with food, but the thoughts of needing to lose weight, watch what I ate, and control every aspect of my diet never truly went away. I relapsed a few times, purging for what I hope was the last time in the fall of 2010 after a fight with The Emperor. The continuing thread throughout all of this, though, has been skipping meals in order to feel like I'm in control, even though I don't feel that way.

When someone tells me they're on a diet, I feel inadequate because I can't diet. I fail at the exercise part of it because I lose interest, don't have money, or feel too weak to keep it up on a regular basis. Then I fail on the eating part of it because I'm apparently an all-or-nothing kind of gal in that respect. I sometimes feel resentment toward people who work to lose weight, because I can't figure out a way to control my weight, and I am obsessed with actually trying to do that. Or maybe I'm obsessed with failing at it, I don't know. 

What really gets me though, is food restrictions placed on me by others. If someone criticizes my food choices, I lose my shit. The digestive issues I've been having lately have been especially troublesome as doctors orders are to eliminate specific foods, and EAT ON A REGULAR BASIS. Even several small meals is okay, but the problem that no one seems to understand is that when someone tries to tell me that I should or shouldn't eat something I go nuts because they're taking my power from me. 

It all boils down to power and control, and it always has, because when I was a small child who had just developed sovereignty over her eating it was wrested from me by idiots who continued to abuse their station of authority over me until they no longer held such authority - but by then it was too late. Those tapes had already been recorded ("you're too fat", "eat it or else", "suck in your gut", "you should lose some weight", "all you have to do is restrict your calories", etc) and the damage was done. Up to this point, I haven't intentionally dealt with it, because I thought I could ignore it when it came up and just move through the cycles that various points in the year held. 

But then came the Celiac. Then came the need to be fastidious about one item of food. And it built back up. For a while, I felt comfortable in the control I took in eliminating gluten from my diet, but it still built. And then I had a gluten exposure that made my insides explode apart and got sick for two months. It's especially easy to fall back on old habits of fasting for control when I don't feel well; easier when the emotional turmoil of the battle between me and food is played out inside my body. There's so much guilt and shame going on in my body that I really can't handle it and I don't know anyone who can help.

My doctor is looking into a couple of options for me for therapy. The Emperor and I are talking about constructing a juice fast which will give me something to have power over (other than denial of food) while giving my insides something to repair whatever damage was done when I first got sick. I'm taking some steps on my own toward recovery, but goddamnit I wish that people would quit looking at me weird when I try to tell them what's going on.

Tuesday, October 23, 2012

Things fall apart

On Monday we got the results from my first round of blood tests. No infections; so assume that the "elevated temperature" is something else entirely, and focus on the gut issue. We also decided to do a full blood panel, and I'm going back to the vampire on Thursday. A possible culprit is the thyroid. But at least it's not lupus*. 

That was a relief, but there was a lot of talk about me and eating. Questions like "are you avoiding food because of the pain?" and "when did you eat last?" and then statements like "I don't care what you're eating at this point, as long as we can get you to eat"; then utter bewilderment when I stated that I never wake up hungry (cuz we're doing fasting blood levels). Years and years of dieting and disordered eating have caused my "hey I'm hungry" signals to turn into "omg I'm gonna hurl" signals, or just disappear all together. Turns out, that's not normal.

Then there's the anxiety that crops up because someone's giving me grief about eating. My whole life someone has been harassing me about eating too much, or again, or going back for more food, or disappearing off to the bathroom after meals, my food choices... all of the control was taken away from me in this abusive situation, and then if that wasn't enough, I had to be subject to dieting because I couldn't barf myself thin. I hid it pretty well, but then again, I don't think anyone was actually paying attention and how could I have an eating disorder? I was fat and it was always an issue. 

So, I skipped meals, and then I'd binge and get so fucked up that I'd barf. There were times when I would intentionally drink too much because I knew that I would vomit. And the fat thing was still always an issue - hell, it's an issue right now. And I knew about the health risks from bulimia and anorexia, but it was never a factor because it was more important to everyone that I wasn't fat. As it turns out, I was more unhealthy as a fat person trying to force herself to become thin than if I had just been allowed to be fat and be okay with it. 

Now I miss meals because I don't want to deal with it. Eating is a hassle. Since the gall bladder thing started, not only am I not able to eat gluten, but meat and eggs are out, AND I can't even drink (which, I suppose given my history, isn't exactly a bad thing). It's causing me a lot of anxiety. I've now had two, significantly more mild, panic attacks since the first one on Thursday last week. And while eating doesn't hurt as much as it did, I'm still really not interested in eating (unless it's something I really really enjoy like tacos or cookies), because of the emotional toll it takes. 

"You have to eat to survive," my doctor said. Well, that's nice, but you can't overcome 20-something years of programming that says that I don't have the right to eat because I am fat. Then you tell me I have to eat regularly? Actual meals? All of this conflicts with my programming, and that makes me anxious. And things start to fall apart..


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*It's never lupus**.
**Except for when it is.

Friday, October 19, 2012

Idiopathic...

I went to the doctor again on Thursday. But as we were deciding that I needed to go back in, I had a panic attack. A really bad one too. You could even say that I was hysterical, because for a little bit, I completely fit the profile of someone going absolutely out of her mind. After I stopped crying hysterically, my brain broke and I couldn't talk for about four hours. This is only the second time in my adult life (I don't know so much about panic attacks when I was a kid) when I've had an anxious episode so bad where I've lost the ability to speak. Suffice to say, the muscles in my neck and throat tensed up so badly that sound wouldn't really come out - except I said "ow" once, and that required a tremendous amount of effort.

My primary symptom are fever (hovering around 100 degrees for 15 days now - or at least, that's when I think it started; we got the new thermometer a little over two weeks ago and I don't know if I've had a fever since before that), and fatigue. As stated in previous posts, The Emperor has been doing his best to take care of me (or make sure I'm taking care of myself), but it's a little cumbersome at this moment. I pretty much can't do anything else, and I'm testing myself quite a lot by being out today instead of resting at home. (Granted, I am sitting in a Starbucks in a nice comfy chair, blogging, but there is more effort involved in being out in public than laying in bed watching reruns of Stargate.)

So, I had a fun time answering questions, and describing secondary concerns that might be related without the use of my voice. It was difficult, (and fairly disconcerting), but I found ways to communicate thanks to my smrtfone. (The Emperor kept asking "can you tell me?" or if I would just say one word to him; he didn't get it.) I was examined, palpated, and then the doc took some blood - which was an exciting experience in itself and took ALL of my my yoga training not to completely freak the fuck out and refuse the blood draw.

And that was it. "We'll talk to you on Monday, but the results might be back sooner and the doctor will take a look at it." Okay. Great. This tells me nothing. But I don't really know what else to do. I don't know what the next step is, except going over my blood panel, and I'm worried.

What if this is something that will require hospitalization? Surgery? Long term care? Is one of my internal organs failing or malfunctioning in a disastrous way? Do I have cancer or liver disease? Is there something wrong with my blood? Oh god, what if I'm pregnant? (I'm not, and quite frankly, of my list of OMGWHATIFs that's the easiest and cheapest to attend to*. Probably even easier than getting my damn wisdom teeth out.) And I know that we'd find a way, and everything would get solved and I would be okay, but still, all this open-ended stuff is really not only not making life easier, it's actively making life harder because being worried about my health is making me MORE exhausted, and LESS able to get work done. 

I had an illness like this when I was a kid (I don't know about the fever, but the gall bladder attack), and my intestines were a mess. The doctor that I went to gave me activated charcoal (for some reason, I don't even know why), and that was pretty much it. There was no follow up, there was no discussion of it being more than just angry insides. After that attack I stopped eating meat. And at some point, I remember my mom remarking at how I "had always been so healthy", so it was kind of a pain in the ass that I was suddenly not feeling well most of the time.

I don't need/intend to impugn my parents, but this commentary about me always being healthy has to be complete bullshit. Maybe it's not, but I do know that during my teen years, none of my parents knew what was going on with me and I was far from healthy LONG before my insides exploded and no one thought to actually investigate that. I don't know if my current state has anything to do with that neglect, but considering anything else, I can't help but wonder if it is. 

The other thing that bothers me from all of this is I'm wondering if I'm reporting my pain adequately. When I was a kid, every time I said I was in pain, I was ignored, yelled at, or ridiculed. At some point (some time after I began menstruating), I stopped reporting my pain. I stopped telling my parents that I was hurting, because it was pretty much constant (either bodyaches or intestinal distress), and I went around like it was all normal. This kind of conditioning leads me to, as an adult, under-report my pain to doctors, and it takes a really good doctor to be able to notice the subtleties of my reactions, range of motion, and other indicators of dis-ease. 

All I can really say now though, is that I think I'd really rather be at home with my dog.




*I don't want to hear it. I've already made the choice, and, despite the fact that it isn't actually anyone else's business, my body can't handle making a baby anyway.

Tuesday, October 16, 2012

Sick and triggered

I dropped the ball.

Rather, I had a surge of pain in my gut and the ball was knocked casually from my fingers by gravity. This has been the story of the last several weeks, where misfortune on top of misfortune have simply begun to pile up and I'm drowning in my circumstances. Now, for a while I put on my big girl pants everyday and "did it anyway" as Mary Kay would have advised, but when I got the flu and had a fever for going on 10 days, that determination kinda went away for a while; it was subsumed by the feeling that the next thing is going to be shingles followed shortly thereafter by death.

I stopped taking my temperature on Saturday. It was still hovering around 100 degrees, but I had pretty much stopped caring. I took the day and rested (cuz, Jewish), then Sunday morning jumped right into a busy day of community and family doings. I even went to yoga. Today I jumped onto my work necessities, interspersing that with teaching Fiery how to make a casserole so he can be more gluten-free with home-cooked food with less effort. By 6:30, I wanted to die, but I pressed on because people were counting on me.

When I got home, I took my temperature. 99.8. Again. Or still, I don't know. I immediately knew that I had overdone it over the last couple of days, but I don't know what else I'm supposed to do. If I don't work, I don't get paid. If I don't get paid, neither do my bills... but that's not even it. If I'm not working, I'm not happy. The week I spent on the couch was devastating, and I still haven't recovered from it emotionally. So, needless to say, being sick triggers me.

The helplessness, mostly. But even when The Emperor* was trying to take care of me, (in amidst all of the other things calling his attention, including being sick himself), I started feeling guilty about it. I pulled myself up off the couch and started cooking for myself. This is after arguing with him about whether I needed to eat, whether I was going to, and that I didn't want anything. His concern over my diet triggers me too, and not because he ever harasses me for eating: he gets on my case for NOT eating. 

Why would that flip you out? You ask. Well, because food flips me out. It does. All of these digestive issues that I have, plus my history of disordered eating, makes my relationship with food tenuous at best. My recent forced conversion** to a low-fat vegetarian diet (as if it wasn't already hard enough to feed myself with the Celiac) has devastated my appetite. My emotions on the issue makes it worse, and I haven't been eating enough to knock out whatever has my temperature up 2 degrees from normal.

The thing is, I've been ignoring the hunger signals. I feel hungry, but being faced with all of the emotionally charged decisions and limitations just sends me right back into disorder mode. It's infinitely easier to ignore the fact that I'm hungry (and then later cure the shaking and fog with a smoothie that has a subsistence amount of nutrients in it), than it is to deal with the emotional weight of the decisions I have to make about food. But, because I'm in disorder mode, I don't think "hey, it would be easier to deal with this now than it will to have an emotional breakdown in a couple of hours".

Then there's the lecture that follows. The programmed lecture is about how I'm fat, fat people are impossible to love, fat people are unattractive/gross; I'm lazy; need to make better (read: fewer) food choices; and I'm completely, 100% to blame for the "extra weight". So, because of this programming, when The Emperor is telling me that I need to eat, that he's worried about how little I'm eating, that it causes him a great amount of anxiety, that he doesn't understand... all I hear is the lectures and criticisms from my childhood bullies. He means well, wants me to be healthy (not skinny: healthy) so that I can work and so that I can be happy.

It's hard to deal with genuine love when you come from a background of abuse (I think people who are moving beyond their abuse know that, but precious few other people do); and I vacillate between utter admiration for the men who love me (specifically The Emperor, who has given me so much) and utter hatred because they trigger me without meaning to and don't understand why I get so upset about things that seem random and harmless. There's a different sort of helplessness here, but in that state my need to protect myself doesn't really see the difference between being loved and being harmed.

All this is to say, I dropped the ball. I know I did, but I didn't really have any choice. When we say "g-d first" in Mary Kay, that means taking care of g-d's instrument too. I know that I can get it back and make some amazing things happen, but the last two months just didn't go how I wanted or planned - and not for lack of working. Sometimes shit just happens and there's nothing you can do but got to the doctor. Sometimes you can't just suck it up and make phone calls while lying on you back on the floor; sometimes you can't see far enough into the future to make booking calls.

So when you can, you should.

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*I contemplate, sometimes, simply calling him Ten, but that's not necessarily fair.
**gall bladder issues; doctor's orders are no meat, eggs, onions, garlic, or booze. I'm not having surgery. Don't even think about suggesting it.