Thanks But No Thanks

A small sterile, windowless room reeking of bleach and plastic. Draped in a faded hospital gown, days spent pacing the room; the long lonely hours interrupted only by a bossy, stern nurse bringing in meals. Trays piled with unrecognizable globs of noodle casseroles, fried chicken and chocolate pudding plopped down for consumption while nurse Stern watched over, making sure every bite is eaten. Then left in the little prison, with no way to exercise, the food sitting like a lump of uncooked dough. Belly painfully distended. With absolutely no control over food, schedule, or body.  

I’ve been asked why I so adamantly resisted inpatient. Although the scene described above is how I remembered treatment depicted in an after school special, a quick Google search can find treatment options to be just the opposite. Oceanside programs with private rooms, farm to table meals, and yoga that could make even the healthiest of women to say “sign me up!” But you could have thrown in massage and a pool boy, and inpatient treatment would have still been a terrifying thought to me. Of course I did not want to be away from my family. Sure, I was concerned about what other people would think. The OMG she was sent away kind of gossip I was sure would ensue, bringing embarrassment to my kids and myself. But in reality those were excuses to cover the real reason I did not want go into an inpatient program, I was afraid of losing control. Relenquishing the power I had fought so long and hard to obtain over my life. Using food, and exercise to control my body in efforts to find peace, balance, and security. I was in no way ready to turn my only means of control over to anyone, leaving me feel powerless.

It became evident in that first session with Kirsten that if I did not pull my shit together and eat, that is where I would end up. In treatment and out of control. And I was still convinced, that because I did such a fantastic job getting myself into an eating disorder, I could get myself out.

But that ship had sailed. 

As harmful as not eating was to my body, the more significant danger was in the actual consumption of food. Refeeding Syndrome is what Kirsten called it. A term that sounded relevant for sick, weak, dying individuals. Cancer patients or people just out of a coma. Not people like me who could still run, cycle, and play tennis. But Kirsten made it very clear that even if I had it in me to eat more food, I was so undernourished that the hamburgers, pizza, and cake I promised to eat could prove to be fatal. Eating the necessary amount of food could send my body into shock, causing heart failure, renal failure, and seizures. Medical oversight, she said, was critical to my survival. The illusion that my health was just mind over matter was fading with every word Kirsten uttered and after years of trying to get my attention through heart palpitations, amenorrhea, and aching joints, my body was now using Kirsten’s words. It was screaming, “do you hear me now!”

 Yes, I heard. And if I were sitting next to my best friend being told this information, I’d say, “don’t be an idiot, you have no choice. I’ll help you pack your bags, sister.” 

But I wasn’t willing to be so direct with myself, and even though I heard, I was still not ready to listen.

Refeeding? That is for sick people, not me. Right?

Skin Deep

Why did you agree to work with me?  

I asked this of Kirsten and my dietician Gretchen recently via email. During treatment I never thought to ask why, despite their initial reluctance,they agreed to take me on.  

"I was skeptical that outpatient was going to give you the support you needed to do the difficult work of recovering," Gretchen responded. "I would still recommend inpatient for someone as undernourished as you were, but we agreed to give you a shot."

"We did agree to give you a chance," Kirsten added, "because of your family situation and you being the sole driver. But that was with the understanding that if you didn't make steady, incremental change, we would have to pull the plug and again recommend residential."

During that first session with Kirsten, I believed her neutral reaction to my body and my story was a sign that I was "not so bad". I took it as an assurance that she had seen women and men much worse off than I. But in reality, she knew what she was looking at, a woman who needed to be in residential treatment, under the care and supervision of trained medical professionals. And that is what she recommended for me. Strongly.  

I didn't realize when I walked into Kirsten's office that day that I was in life-threatening danger in more ways than one. I sat there numb as she patiently laid out the cold hard facts, my heart pounding as I tried to grasp that it was ME she was talking about. With compassionate directness she explained that continuing to live the way I was, undernourishing my body, meant I would continue to break my muscles down for fuel, including my heart muscle. My already low blood pressure would continue to drop as my heart had less fuel to keep it pumping. My electrolyte balance would lead to irregular heartbeats (which I already experienced often), ultimately leading to heart failure.

As Kirsten talked she maintained direct eye contact with me, as if she was willing me to understand her words. I saw, despite not even knowing me, the concern in her eyes and heard the worry in her voice. For the first time, I began to absorb the seriousness of my situation, and it far exceeded the obvious. Until that session, I was only aware of what my body was telling me from the outside. I was focused on how my hair fell out in clumps as I gingerly washed it in the morning. Tentatively looking at my hands, afraid to see the fallen strands tangled between my fingers. Or how my teeth cracked and crowns popped off so frequently, requiring steaming my vegetables to soften them before eating. And the way my wedding ring twisted loosely on my finger, until I had to stop wearing it for fear it would fall off without notice. With Kirsten's words, I began to understand the sacrifices my body was making internally to keep me alive.   

"Okay I get it, "I remember desperately saying to Kirsten when she was done talking. "I'll eat, I promise, I will do it." And at the moment, I meant those words more than any others I had uttered.  Ever.    

Kirsten took a deep breathe, as if she were trying to gather the courage to to respond. And when she did, her words left me feeling hopeless. Trapped in a body I no longer wanted and scared I may never get out.

Over the years, I obsessed about how I looked on the outside, but had no idea the sacrifices my body was making on the inside just to keep me alive.

Wandering

Amanda. That was the name of my favorite doll when I was young. Dressed in a pink ruffly dress, she had a mass of curly brown hair, big green eyes, and pale skin that made the freckles stand out on her nose. She and I would hang out in my room, listening to Tammy Wynette records and playing Malibu Barbies for hours. She knew all my deepest, darkest nine-year-old secrets.

I spent all week looking for my Amanda doll and I could not find her. But who didn’t have one of these!?

Imagine my surprise. When I finally got my butt off the bench and walked across the street to Kirsten’s office for our first scheduled appointment, and a tall, beautiful real-life Amanda opened the door. Although she wasn’t wearing a pink dress, she wore a pale pink blouse that perfectly offset her dark wavy hair and freckled skin.

"Sherri, it’s nice to meet you,” Kirsten said as she greeted me. She had a broad smile and a relaxed manner that exuded a quiet confidence. I felt immediately comfortable with her.

I had taken special care with my appearance on the day of my appointment with Kirsten. Applied more blush to disguise my pale skin, adding rarely worn mascara to make my eyes look less sunken. Although it was a very warm day, I covered my arms and protruding collarbone with my favorite long sleeve yellow shirt. Attempting to look more “normal.”

I watched Kirsten’s eyes as we made initial small talk and took our seats in her ninth floor office.overlooking downtown. I was searching for signs she was assessing my appearance. It was second nature to me. Having lived a decade with everything from glances to overt stares by others upon first seeing me, I couldn’t help but hop on the alert when in a new situation. And for this meeting, I was especially attuned to Kirsten’s reaction, because I had done my research.

Kirsten, I had discovered through my extensive Google search, is to the world of anorexia what Sigmund Freud is to psychotherapy. Her training and experience are vast and undeniably impressive. If anyone would see right through my facade, I figured it would be this woman. But she showed no sign of shock. She gave no assessing glances up and down my body, just her genuine smile, which reassured me that I was still in control of the situation. I could take or leave what Kirsten had to offer, no pressure.

Marc and I financed a small independent film. As part of the deal we could be extras . I resisted the idea, as I was too self conscious of how I looked. (Here with actor, Kyle Vahan, 2016)

For months, I had been telling myself I wanted help. I no longer wanted to feel trapped in my sore, achy body, afraid to leave the house for fear of how others might look at me or what they might say. I wanted to stop feeling as if I were on the outside of life looking in, stuck perpetually in junior high, feeling like the weird outcast alone in the cafeteria. It had worn not just me, but my whole family down.

But talking about help and getting help is as different as Candyland and Call of Duty. Sitting face-to-face with the woman who could save me, I realized I was still wandering through Lollipop Woods. I suddenly wasn’t so sure I wanted help.

But then again, Kirsten wasn’t precisely offering it either.