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Apr 17, 2015, 01:14 AM
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Member Since: Mar 2009
Location: USA
Posts: 10,966
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So I already started a pro/con list both for getting treatment and a pro/con list for not getting treatment. I have a lot of them completed. I'll have them all the way completed by tomorrow, probably in the morning, definitely by the evening.
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I look forward to seeing these!
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Thanks for the accountability  .
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You're welcome.
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Regarding the pacing, you're definitely right, dropping that much in one day was too much. I completely screwed that one up. I managed to drop it by one hour, only 16 hrs today, but that's it. And every hour was definitely much closer to 10 min, so strike two on that one. I do need to make it a little more manageable, but at the same time, I also need to just suck it up and do what I need to do a little bit too. Tomorrow, I'm going to commit to only pacing for 8 min., out of 14 hrs in the day. It's not as much of a drop as I need to make, up at least it's a start. I'd like it to be less than 45 min total by the time I'm discharged, but that's a huge drop, so we'll see.
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I think it best to stick to a more measured pace of change. I think that today was good, actually. Progress day by day I think. I question that you can more or less arbitrarily pick a number that seems reasonable and just expect to reach that number by discharge. I see that as a path to feeling defeated.
I think that targets should be firmly connected to where you are now. So today you maybe averaged 9 minutes for 16 hours. That is better than yesterday. Maybe it is only 6 percent better (about 1/17), but 6% is a good change for one day.
I also question whether you will just be able to drop every day, day after day. I would think that allowing for some adjustment and plateauing is more sustainable. So If you are able to do 8 minutes for 14 hours today, I would stay in that area for a while, like say 5 days. That would be a substantial change as it is: from roughly 17 x 10 to 14 x 8. Allow yourself time to adjust.
When you are discharged, I expect that you will see some falling back as you might need to pace more at home. Maybe I am wrong. But I say allow for that, see if it happens, and then stabilize before trying to move forward again.
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Your understanding as to what's leading to the abnormal lab values is accurate. I'm purging. A lot. Almost everything. And I'm not eating nearly as much as I need to be, even with tube feeding. And I'm manipulating the tube feeds so I end up getting less than I'm supposed to and I'm not taking the supplements I need. All of this lead to...horrible, critical labs. On a regular basis.
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I am wondering what is the reasoning behind discharging you to home when these large problems exist.
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You're right, it's going to be very, very difficult to break this cycle while I'm overwhelmed and not getting any eating disorder specific treatment, only medical management. And it's only going to get harder once I go home, which makes me really, really nervous.
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(and more wanting to pace I suppose)
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I don't know how much "worse" my body can handle. It scares me to be honest, which I guess is an improvement, because it didn't for a long time.
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How much does feeling scared encourage change?
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The change I really NEED to make is stopping the purging, but I just don't think I can do that on my own. That, along with increasing my oral intake and decreasing the exercise are going to be the hardest habits to break. I'm already super anxious tonight because I paced like maybe 10 minutes less today than yesterday. I feel like I'm crawling out of my skin.
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Yeah. Don't try for huge drops in pacing. Aim for little by little.
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And just writing about eating more and/or stopping purging is currently making my heart rate monitor alarm because my heart rate is going through the roof. But the purging is doing the most immediate, life-threatening damage. Okay, this sucks, but I'm going to commit to a) not messing with the feeding tube pump tonight and b) keeping one snack down tomorrow afternoon. And I'm really going to try to stick to this.
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Good.
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If I'm successful tomorrow, I'll try to improve upon that the day after. I only have a few more days in an environment where I at least have some support. That is until I enter an IP ED program. And I'd like to stay alive long enough to do so.
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You mentioned staying alive and you speak below about often not caring about that. What are your reasons to die, and what are your reasons to live?
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That being said, I'd kind of like your opinion on that. I'm really, really ambivalent right now regarding IP treatment. Honestly, I don't want to go, and I'm coming up with any and every excuse in the book to avoid going. I know I need to go...but I don't know if just plain don't want to or are scared of the work involved or what. I do know I don't want to miss anymore family/friend events or work.
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You'll recall from that article that ambivalence about change is a hallmark of people entering an ED program. It comes with the territory. And as to family/friends and work: well it sounds like right now those will be limited anyways, due to your health. Recovery, though, gives you a shot at having them for a long time.
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I also know I'm scared of some issues from my past that probably need to be dealt with if I'm ever going to get over this. Additionally, I'm afraid I'm going to completely lose it if I do face these issues. What I don't know is how to confront these issues
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I am wondering whether now is the time to speak about confronting issues from the past. I agree that you will need to do that eventually, but right now it seems to me that the main thing is to work on staying alive if that is or can be a goal and I hope that it is.
Suppose a person is (re)starting to study math. She could say to herself Ah, this is too daunting, how could i ever (re)learn calculus? and consider giving up. But of course, in due time, she could work her way up to calculus.
I think that when you are stronger and further along in recovery you will be in a position to look at these issues from the past. They would be rough to look at now, I imagine, but you don't have to do that.
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or how to convince myself to go regardless of how I feel about it or how to motivate myself to do the work required in order to reach recovery when a lot of times I really don't think I care one way or another if I live or die. Any bright ideas? I'd really love your input here.
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Well I saw you post in the ED update thread (btw I suggest starting a new thread there with your question).
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Theoretically, am going to go to Johns Hopkins inpatient program within the next week or so, but I'm dreading the idea so much. I don't even know if I can handle the idea of being back in the hospital AGAIN, this time, likely for longer.
I feel like all I'd get out of it right now is some weight gain and I wouldn't purge or overexercise for however long I was there.
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This sounds useful for giving yourself a chance to live.
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I just don't know if I'm ready to give all those behaviors up and I feel like I might just go right back to where I started....If I don't do something, I'm going to die. I get told that on a daily basis, multiple times a day, but I'm just so tired of it all and I just don't know if I have the strength I'll need to do this whole treatment thing right now.
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I go back to my question about reasons to dies versus reasons to live. What are reasons to die? Right now you are essentially making death the default option: if nothing changes, people are telling you that you will die. Is that what you actually want, or is it just what you might accept by default, rather than attempt to change?
I think that reasons to live can help you summon the strength you need for treatment. So what might be some reasons to live? You seem to enjoy and take satisfaction in supporting others here with your professional knowledge and you do so in a caring manner. You seem to have a good "bedside manner" here, as they say. Are there reasons to live underlying what you do here for others?
You've mentioned family and friends, being apart from them and wanting to connect via facebook, email, etc. (Did you do any of that today?) Could they provide reasons to live? You've mentioned journaling (which would be a good outlet for frustration and other feelings arising from reducing pacing). To what extent could self-expression provide a reason to live?
Think about times in your past where things went well, even if not completely well.
Think deeply and tell me: what are reasons for living?
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Thanks for your reply. Looking forward to your response.
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Thank you for your kind words, again. I am always happy when i see that you have posted.
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