01 August 2013

Once Again Captive

“Relapse is inevitable. It will happen. It is a normal and necessary part of recovery. I made it a point to learn something from each relapse, and I grew stronger and stronger. I had many relapses and I am still not perfect. Ed will not let you walk away easily. But no matter how hard he fights, you can walk away. When he blocks you, step around him and keep moving” (Jenni Shaeffer, Life Without Ed).

As much as I want to deny it, or run away in absolute shame, I know that I must embrace reality, no matter how painful, in order to move forward. This gruesome battle between good and evil seems to increase in intensity within the realms of my overlooked and abused mind, convincing me I will never walk in true freedom, no matter how relentlessly I fight against the hater of my soul. As previously mentioned, I was admitted to the hospital on my twenty-first birthday for severe symptoms related to anorexia nervosa, including but not limited to severe dehydration, dangerously low serum potassium and other electrolyte levels, heart rate in the forties rather than the minimal standard of sixties, etc. Five days of stabilization, requiring close monitoring during the adamantly tormenting process of refeeding, as well as frequent drug administration and IV therapy to achieve hydration became “the norm”.
Weight gain was inevitable, no matter how hard my determined and stubborn self fought against it. As horrific as each hospital stay was, a part of me longed for its very presence because I was no longer the one in charge—the one fighting against ED. Each calorie didn’t have to be counted, meal plan manipulated, or meal cooked because that was all done for me; all I had to do was eat. Another perk was the constant attention, care, and pampering of the nurses who reminded me I am worthy of being cared for, no matter how doggedly I believe elsewise. The constant attention was something I craved, as in my eating disorder I’d become invisible, and only longed to become more nonexistent as each pound rolled off my skeleton-like physique; the constant assessments of the doctors and nurses reminded me of how sick I truly had become, even though ED tried to convince me I was in perfect health & they were only exaggerating. The pain of an IV filtrating into my veins was only but a reminder of the exhaustive thirst I’d endured up to this point, as well as the unrestricted hunger I’d become accustomed to as well as longed for. How could my mind be so twisted yet make sense all at the same time? Anorexia nervosa is a disease which still mystifies professionals, as it truly does make no sense to the human mind; once a person becomes entangled in its deadly web, it becomes nearly impossible to break free—especially on your own, as I’ve come to experience. As shameful as this is for me to admit, I must unveil my most hidden secrets in order to walk in freedom; two weeks ago, after neglecting my body’s vital needs for far too long, I was hospitalized yet again at my lowest weight since Remuda Ranch, of which I was nearly dead. 

During the heat advisory, I’d failed yet again to listen to the expert’s advice and refused even a sip of water because I was determined to lose weight, even though my body was already shutting down and literally eating itself. Lanugo (fine hair) covered my nearly nonexistent frame in order to keep my emaciated body warm during the scorching hundred-degree weather, and goose-bumps camouflaged the paper-thin layer of skin covering each bone. Why would someone so severely malnourished and obviously compromised want to lose even more weight; this is the confounding mystery anorexia nervosa presents—the mystery of why no weight loss is ever enough. Part of this may be because one entrenched within its grips can no longer see themselves accurately but instead sees an entirely distorted image staring back. Another reason is due to the undernourishment, the mind can no longer think straight but rather becomes chaotic and the urges nearly impossible to silence; the more one gives in to the urges, the harder it is to break free.
After staying out in the scorching heat for far too long, without even but a sip of water or single crumb to eat, my body went a-wire & extreme nausea, lightheadedness as well as other symptoms overtook me; I could no longer walk without darkness veiling my eyes nor stand up without extreme nausea gripping my vacant stomach. After seeing my primary physician, she merely had to open the door to see how miserable I felt; afraid to move me, she ordered for a wheelchair to be brought and a room prepared as soon as possible, before I passed out or even worse, suffered a heart attack. As I limply lay on the exam table, anxiety gripped my heart at the thought of the upcoming horror story that’d now become my life: hospitalization and loss of control. Yes, a part of me was relieved to be stripped of control, but the other part was going crazy at the thought of the rapidly approaching weight gain I couldn’t escape. Once the nurse brought the wheelchair into the room, I was hauled up to the sixth floor to what would become my home for the next five or six days; as I rode along the halls, familiar faces greeted me and I only wanted to fade away into the atmosphere, as absolute shame overtook me. My presence had become familiar, as the nurses now knew me by name and I’m sure knew my story by heart through the countless hospital admissions I’d endured. After changing into the “designer” hospital gown, I crawled into the bed, which had never felt so good to my lethargic self; countless questions were asked in order for a history to be completed, even though the majority was already in the computer system due to past hospitalizations. Once a physical was performed, an IV was strategically manipulated into my withered veins and a blood sample obtained to determine the exact extent of harm I’d so mercilessly inflicted upon myself. 
Normal saline was given at the maximum rate my gaunt body would allow, and a dietitian requested to monitor and increase my nutrition. Once the lab results came back, potassium was administered into my diminished veins, as well as countless oral medications administered to begin to resolve the highly concentrated serum osmolarity resulting from dehydration and malnutrition. Calories became mandatory, no matter how much fear each thought brought to my ravaged mind—the battlefield of this disease; each day called for a slight increase in calories in order to slowly reefed my impoverished body and avoid refeeding syndrome—a potentially lethal occurrence. The dietitian then entered with a set meal plan for me to complete, but no matter how long I glared at the menu, nothing sounded desirable but instead entirely repulsive. A psychiatrist was consulted to evaluate and prescribe medications to aid in the thought distortions and urge severity, since those I’d currently been taking were no longer effective due to being underweight; while evaluating me, the psychiatrist informed me I possessed the makings of “the perfect anorexic as well as the perfect nurse” since those two were somehow intertwined through the extreme perfectionism I’d retained.

Once my body reached homeostasis, around five days later, and eating somewhat normalized, I was released to do the work on my own, in the luxury of my very own home, which was anything but easy; two days after being released, I was given a checkup which would later become my breaking point. After being congratulated by my treatment team for my hard work and weight maintenance, I caught a glimpse of the anxiety-provoking and worth-determining number: my weight; once the horror of such a rapid weight gain somewhat faded, the all-consuming cycle of weight loss and manipulation began. A week later, after doing everything within my power to lose this weight plus more, I stepped backwards on the scale only to do so a second time to make sure the number was indeed correct. The dietitian, formidably alarmed, ordered for vitals to be taken ASAP while she attempted to solve this seemingly impossible mystery of drastic weight loss. Suddenly, all of my hard work turned into regret, as I embraced the possibility of yet another hospitalization and unadulterated embarrassment; razor sharp bones protruding through the paper-thin layer of skin no longer sounded appealing but rather shameful and demoralizing. Somehow, I managed to avoid hospitalization, which leaves me where I am now: stuck. I want so badly to recover, but the weight gain required and meal plan designed seem insurmountable; food has once again become my enemy and the feeling of razor sharp bones my pride and joy. Surrender is the only way for this disease to be reversed and freedom possible; I must surround myself with God’s truth and demon-fleeing presence of which holds the key to freedom. In order to complete nursing school, I must first take care of myself, which seems to be the hardest part; I’ve been struggling on my own to figure out how, but have come to realize that I was made for accountability and am praying for a consistent therapist to encourage me with truth on a weekly basis. We need each other in this battle against good and evil, and I am certainly no exception. So now, risking rejection, I have shown but a glimpse into the deepest hidden parts of my soul, consumed by shame; I pray that through my vulnerability and brokenness God would bring freedom and grace rather than punishment and captivity. “Perhaps strength doesn’t reside in never having been broken, but in the courage required to grow strong in the broken places” (Unknown).
On the bright side, maybe this brokenness and pain will be used to make me into the best nurse possible-- a kind, compassionate, empathetic and selfless nurse who sees life through the eyes of a grateful and awe-inspired child. "The flower that blooms in adversity is the rarest and most beautiful of all" (Walt Disney Company).