25 April 2013

The Thorn in My Flesh

“I am forever engaged in a silent battle in my head over whether or not to lift the fork to my mouth, and when I talk myself into doing so, I taste only shame. I have an eating disorder” (Jena Morrow, “Hollow: An unpolished tale).

I sit here in complete confusion, wondering how I let myself get this low again. As I look at the IV in my left forearm, feeling the intense burning of a high concentration of potassium diluted IV fluid flowing into my shriveled veins and looking at the monitor showing each beat of my overlooked and abused heart through the five leads placed on my chest, I wonder how I could do this to myself once again? My mind had forgotten the tormenting and nearly unbearable pain re-feeding requires—there’s no way around it, as hard as I may try. Extreme bloating, a desiccated stomach now stretched to its limits, stomach pains from a body so used to starvation and unsure of what to do with the now foreign food, orthostatic hypotension (blood pressure drop and subsequent heart rate increase upon standing up), constipation, and infinitely more complications overwhelm my frail body. Why would I do this to myself after knowing from previous experience the absolute torture called re-feeding? The torture doesn’t end there, as it’s not only a physical battle but also emotional. Raising the fork to eat seems far beyond my ability as I glare at the food with eyes that could pierce through the strongest tower, thoughts race through my mind reminding me I’ve failed to meet my (ED’s) goal which only increases in unrealistic expectations, forcing myself to swallow seems impossible yet I have to do it—there’s no other choice but a NG (nasogastric) tube forced down my throat directly into my stomach. Why does food—even the very thought—bring such engrossing fear to my emaciated body? Why does the sensation of piercing hunger pains and the feeling of razor sharp bones piercing through the paper thin layer of skin bring satisfaction to my twisted mind?  I see the doctors pacing the floor and the nurses pushing carts with electronic health records, reminding me I am safe—I don’t have to count every calorie, plan every meal with absolute perfection, or measure each ounce to the tiniest mill equivalent because it’s all done for me; all I have to do is eat, which seems to be the hardest part far beyond my own insufficient power. How did I get here, in this prison once called home—hooked up to innumerous cords and wires camouflaging my wasted body?

Monday morning, I awoke with excitement to turn twenty-one years old, but this excitement was superficial and short-lived after recalling I had yet to get through an exhaustive nursing exam. Days upon end had been spent studying for this comprehensive exam yet I felt as if I’d learned nothing—my malnourished mind failed to retain the information to its optimal ability since I failed to feed it for days upon end. How much more of a hypocrite could I be: instructing patients to take care of themselves, therefore promoting optimal health, while at the same time intently abandoning and even compromising my own health? Once the test was done, I could finally breathe—the crippling stress once sucking the life from within me now vanished. There was one more thing I had to do before celebrating my long-anticipated twenty-first birthday: see the doctor for a physical exam. Due to the constant stress of nursing school as well as tightly-gripped perfectionism and perpetual sickness from a compromised immune system, I have lost a significant and absolutely unhealthy amount of weight, which has consistently only kept dropping; to help me gain back the weight, which is further compromised by a history of severe anorexia nervosa, I have been seeing a primary physician and dietitian weekly but setbacks seem more prominent then progress. After my vitals were recorded and my weight confirmed, the doctor entered the room with a sense of urgent alarm encompassing her voice as well as expression: I’d lost even more weight, which seemed to be the continuous trend we’d been trying to avoid. After admitting my anorexic behaviors, I agreed to hospitalization since I so obviously needed help, for gaining weight was too much for my weak and vulnerable mind to embrace. As much as I wanted to celebrate my birthday, I knew my health was far more important and undeniably at risk. Immediately after I agreed, a room was prepared and all plans cancelled; memories of the past flooded my mind as I relived a past far too abominable for this world to ever know—a past devoted to the demon of anorexia nervosa residing within my vulnerable body. Upon entering the hospital room I’d call home for the next five days and reliving countless hospital admissions in that very room (or at least nearby, within the very same hospital), shame gripped my heart and fear overwhelmed me: I’d have to face head on the excruciating pain, both physical and emotional, of re-feeding once again and the absolute shame accompanying my condition. After being asked an illimitable amount of questions, I was admitted, for the first time in over two years, for the life-threatening disease of anorexia nervosa—the thorn in my flesh. Immediately, an IV was inserted into my truncated veins and blood was drawn to determine the exact extent of harm I’d inflicted; IV fluid was immediately hooked up and administered at a maximum pace to get some form of nutrition into my malnourished and dehydrated body. Once a steady infusion was being administered, a dietitian was sent to see me in order to promote adequate food intake by allowing me to partake in meal planning (undeniably my least favorite thing to do); the dietitian entered with a set format for each of the six meals required daily and gave me a menu to pick what I wanted to meet each requirement. My eyes, filled with adamant fear, glared straight through the menu and my mind whirled with anorexic thoughts as each food choice overwhelmed by compromised mind—why was this such torture? After managing to plan a day’s worth of meals, she decided to come back the next day since I was so obviously vanquished (mentally defeated).

Once the results of the blood test came back, I was confirmed severely hypokalemic with a serum concentration of 2.0 (the minimum range for survival is 3.5), as well as deficient of all other electrolytes. Extremely alarmed, the doctors decided to perform an EKG to evaluate my heart rhythm since it was very possible for an arrhythmia to be present, not to mention cease to beat since electrolytes are required to reside within a very small inflexible range for survival. The EKG came back positive for arrhythmia, so a Holter monitor was ordered to constantly monitor my heart rhythm, allowing for quick detection of any further abnormalities. Upon re-feeding, a dangerous heart rhythm began to appear on the screen and the doctor rushed into my room with alarm covering her face; my heart rhythm was severely abnormal, forming a nearly flat line which further indicated a compromised ability to pump blood to the rest of the body, which was also confirmed through decreased vital signs and cyanosis (blue skin color). Potassium was ordered in the highest concentration allowed in an IV (causing an intense burning/throbbing pain in my arm, where the IV was infusing) but could only be administered at a rate of 80 ml/hr. due to my malnourished condition; I was then ordered to eat 2 bananas and threatened to be directly sent to ICU had I not. After plugging my nose, I managed to get both bananas down to then avoid admission into the Intensive Care Unit but anger and fear overwhelmed me at the thought of consuming two bananas more than my planned 2200 calorie diet required. The dietitian also required me to eat at least one fun food (to an anorexic, there’s nothing fun about them) a day, so a mini birthday cake was ordered for me to enjoy, or more like antagonize over Constant medicine, obtaining vital signs every four hours, as well as frequent blood draws have been only but a glimpse of my reality these past few days: confined to a bed and enclosed within four walls of prison. The nurses here are absolutely outstanding and leave me longing to be one of them. As a student nurse, I find myself closely evaluating every aspect of my care, well on top of why each aspect is performed/included as well as alert to any mistakes. It’s strange to be the patient rather than the provider, as I’ve gotten so used to caring for patients during clinical practice, so a part of me is going stir crazy within these four walls, longing to be released.

These past few weeks have been a roller coaster ride, leaving me on stress overload due to the fast approaching nursing finals. Stress seems to bring out the worse of anorexia, as I’ve struggled to force even a crumb into my mouth without all-consuming fear overtaking me. The more weight I lose, the harder it is to think straight, so school only seems to get harder thus adding more stress—creating an overwhelming downward spiral I can’t pull myself out of; indeed, I’ve tried but things only seem to get undeniably worse since the war is far beyond my own feeble strength. The devil attacks me with relentless aggression, leaving me desperately gasping for breath within the whirlwind of his lies—why me? Ever since I’ve agreed to publish my story, he attacks me with daggers far too sharp for this world to comprehend, leaving me near nonexistence. A part of me has been angry God would allow such aggression, pain, and temptation, but I know that there is a purpose for every aspect of it and I must lose sight of the shore before I can cross the ocean. Whether I like it or not, I have to swim with all my might, upheld with the right hand of the One who holds me up. 

2 comments:

David Bertsch said...

Thanks for sharing this Chelsea. I think of your family often and just as often tell Kristin that your dad is a man I would most certainly follow because I am certain he follows Christ. You have a tremendous mother and father that would make most people jealous to have parents like them. I am glad to hear you are OK now. We cant wait to see how you are doing in the future. Besides my kids love you and want you as a babysitter again. ;)

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