Let's Do the Time-Warp

"I'll have a double decaf skim grande latte with a splash of caramel syrup, no
whip, shaken not stirred, rebuked, and then served in a stack of three cups, no
cup sleeve, light on vanilla, a dash of nutmeg, sprinkling of cinnamon and then
punch me in the stomach"

No, that wasn't today's order :P

Yesterday was exactly 2 years since I quit my job at Starbucks. How do I remember the exact day? Because it was the same day I started seeing the therapist I grew to rely on over the next few months (and who probably saved my life, on more than a few occasions).

Back track.

New Year's Eve, 2006, I was inpatient in a research hospital in New York. It was not my first inpatient admission, but it was the first time that I sought it out, determined to recover once and for all. I flew from Scotland to what I thought would be a 4-6 week admission at the end of November 2006. Fast forward to March 2007 and I was finally discharged. It was the first time in my adult life that I had reached a healthy weight, the first time I had completed a treatment program voluntarily and the first time I had ever really believed that recovery was a very real possibility.

By the time I was discharged, fully weight-restored, I was working part-time in Starbucks a few afternoons a week, was taking an evening class at NYU and things were nothing short of amazing. I remember one of the first days after I was discharged- I was walking along the street and saw this adorable puppy. Those that know me know that I am not, by any stretch of the imagination, an animal lover (they scare me!). Neither am I one for mushiness and gushing over "cute" stuff. But the sun was shining and the puppy was jumping around, and I remember laughing. Really laughing. And really meaning it.

I had lived in such a state of numbness and malnourishment, that words like "happy" and "relaxed" really had no meaning to them. Until I was healthy. I sure as hell had MAJOR ups and downs at that point. I sunk to points of depression I never thought possible- but I also LAUGHED. I joked around, I joined in conversations, I slept until reasonable hours in the morning. My mind came alive as my body did and it seemed nothing short of a miracle to me that all of a sudden, the world was full of colours I had never seen before.

The world didn't stop turning when I stopped eating- I just hadn't been paying attention.

I commented on another blog yesterday when they mentioned the "freedom" they felt at a healthier point in their recovery and it really resonated with me. I still had hang-ups about food- I distinctly remember day treatment, when one lunchtime my salad was slightly bigger than usual. My "old" reaction would be to panic and pick out some lettuce/tomatoes- but no. I asked for extra salad dressing! I still weighed myself every day, walked a little more than most people would in the same circumstances, was struggling a lot to accept my new healthy body. But it was as if by gaining weight, a weight was lifted off of my shoulders and for the first time that I could remember, I experienced true happiness amongst the lows. Everything was so bright and intense because I wasn't hiding from the world behind my body- I was THERE, taking up the space I deserve, as if to say, "I'm here world- bring it on".

The months that followed were a struggle. I'm not sure at what point things started to unravel. I look back and it's all a bit of a haze. I did have some genuine physical issues going on which led to unintentional weight loss, resulting in the numbness I had craved during some of the dips amidst my happy/free moments. Piece by piece, everything started to fall apart and I really WAS oblivious. I kept brushing things off as "no big deal" because I didn't see the life I had built for myself starting to crumble.

First I cracked a bone in my ankle and had to leave my Starbucks job. Then my class ended (98% on my final exam- woot! A nourished brain = functioning brain, fo shizzle!), then the stomach issue...then before I knew it, I'd lost a pretty significant chunk of weight, was obsessing over the size of apples and people were making noises about inpatient/residential again.

Maybe I've just blocked it out. There is a huge part of me that is SO angry at myself for letting anorexia take hold of me again, for not trying harder/doing things differently. For taking for granted that I was doing better, and forgetting that there was a hell of lot of work to be done to STAY "better. For making the same mistake of going down the 'quick-fix' route when things got hard, instead of using some of the distress tolerance skills I'd been given in treatment.

There is also this incredible sense of guilt. My family in the US had never really gotten involved with my disorder/treatment when I was in the UK. When I came to New York and they SAW me get healthier, SAW the progress and improvements, they pulled out all stops to ensure that a relapse would not happen. A lot of people invested time, energy and money in my recovery and I don't think I will ever forgive myself for "throwing it back in their faces" (it wasn't intentional, but that is how it has been perceived).

This has been one long-ass post after a long-ass day so I'm leaving it there!

But, I need to keep reminding myself of the freedom that came with health, the happiness that accompanied the lows. Coming alive again hurt like hell, but the pain had a flip-side I don't experience now. I don't know if it's worth it- to have the highs but the deepest of lows? Or to stay in this steady "not quite despair but hurting like hell" state I exist in now. But the freedom to laugh and smile and sparkle and shine...that's got to be worth it.

Today's snack- looks like a repeat (pumpkin spice trail mix w/ yogurt), but I added vanilla extract to my plain yoghurt. Wowsers. That WILL be repeated!

Edit: apologies for weird formatting. No end of trouble with blogspot this evening...

Baby Steps... Oh, Baby- Rip Off The Band-Aid and Start Striding

Tonight was the long-awaited phone call with my therapist in New York. I had emailed him a couple of weeks ago, before I had been offered a place at the supported housing project, to inquire about reapplying to do the dialectical behavioural therapy program I left prematurely in 07. The program is pretty demanding emotionally, and requires a certain level of stability with symptoms- I was starting to spiral downwards and had to leave- the recommendation was that I entered an eating disorder specific residential program, but I didn't have insurance coverage for that so was left with no option but to return to the UK.

I don't know why I have such high hopes for this program, or why I so desperately want to return to New York and complete the 6 months. I think that I am becoming increasingly frustrated with how slow my progress has been and want something more intensive to really propel me forward.

I've written about the difference between the two health care systems before- the high hopes of my team in the US for a full recovery (like ripping off a band-aid) and the s...l...o...w... way of working here. I am under the eating disorders team and I am giving my therapy sessions my all, but I find it really hard to hold onto much hope when the expectations seem so low. I want to be FREE from this completely- to suddenly be "okay" with food, health, life. To have a job, be living independently, to not be controlled by rules and rituals and compulsions. When I was receiving treatment in the US, I was really thrown in at the deep end. Quite a challenge for someone who hasn't been in full-time education since the age of 12 and pretty much grew up in hospital. I suddenly found myself being discharged from inpatient at a healthy weight, working at Starbucks, living by myself and taking college classes. It was weird. In a GOOD way. It gave me a taste of what life COULD be like. But in a lot of ways, it's made things so much harder for me- to have that all, and lose it all.

My team now want me to take this one class for 2 hours a week and not take on anything else (work, study, etc). We set small goals each week around socialising, food, etc. It's working for me- as in, it's sustainable. I'm not rushing into things, taking on too much only to have it crashing down around me. My team seem to have learned from my past history- so why is it so hard for me to do the same?

I guess I am just angry with myself for still being so stuck in this dysfunctional state when I know there is so much more out there, and having tasted it, want it more than ever.

I can't figure out why New York represents "health" so much for me. Or why I cling to the idea that I can only truly recover if I am in America. It doesn't make sense, certainly isn't based on evidence and is only further fueling my frustration. I have been working really hard at just accepting where I am right now- both with my recovery, and the more concrete facts of where I am living, the treatment I have available to me here and what that involves.

It's really hard for me to NOT compare myself to other people. I know I am not alone in my struggles with food and weight, but I feel so inadequate to others who somehow manage to go to school, work, etc. I don't know if I am just lazy? I don't know if I need to just somehow Nike-style "DO IT" or if for me, baby-steps are the only way. I should know by now that for whatever reason, just "doing it" doesn't quite work out. It's just painfully difficult for me to accept that *this* is how things are. Not that I won't keep working towards my goals, I'm just frustrated with how long and drawn out this all seems, and whether I am making things worse for myself. I feel like I can DO all these things- I can work, go to school, eat in a restaurant, deal with whatever stress life throws my way. But only for a very short space of time. Days, weeks, months- it doesn't matter. I just haven't been able to sustain things for any significant period of time without falling to pieces. Again and again.

Anyway... Back on topic. The outcome of the phone call was that the program doesn't think I am stable enough to return at this point for various reasons. This is just bizarre to me because my team here are perfectly happy with how I am doing/the way things are going. I WANT to try things here with moving into my apartment, carrying on with the small goals, and if TIME wasn't an issue, I'd be happy to do this and reapply for the program when I can stand up and say, "that was where I WAS, this is where I AM and I am ready to take it to the next level". BUT, I only have insurance in the US until October so it DOES feel like a "now or never" thing. Because it IS. I know that I am working towards that place where I can proudly say, "this is where I am NOW" but it doesn't feel like progress because I'm not there yet.

Valentine's Day, Thanksgiving.... It's All The Same To Me!

Happy Sunday- everyone ready for a new week? ;)

Today's been kind of up and down. As I've talked about before, I really want to move back to New York. I've been looking into options and trying to see if I can make it work (I've moved back and forth 3 times in the last few years). There isn't a single fibre in my body that would rather be in the UK, but there are a lot of practical things to consider so it's not straightforward.

In the spirit of Jenny's post a few days ago, I realised that I am spending a HUGE amount of my time and energy thinking about where I would rather be and what I'd rather be doing. A good thing in that it gives me some focus and inspiration, but it's taking away from the things I could be appreciating right here, right now.

Soooooooo... I decided to make a list of the things I am grateful for in this moment.

- somewhere safe and comfortable to stay
- the city I live in is beautiful- this is right in the middle of the city (Starbucks gives a great view!)



- the progress I have made in recovery (I still have a lot of work to do, but I have come a long way from the darkest moments)
- living in a relatively civilised country (apparently in some cultures, you face criminal charges if you have an eating disorder?)
- my health (yes, I have a lot of consequences of my eating disorder, but things could be a LOT worse)
- having enough food, enough heat, enough of the essentials to LIVE
- having access to doctors, dentists, medication, etc if I need it
- the amazing people I have met over the last few months/years
- the friends who have stuck by me through all of this
- my family (definitely issues there, but again, could be worse!)
- my education (I haven't been in full-time school since I was 12, but that is a lot more than lots of people ever get access to)
- luxuries like internet access, phone, etc...never mind things like clean water


I don't know. I feel like I spend a lot of time thinking about other people, what they do, how they live and being insanely jealous. There is a whole world out there and so many people never get the chance to learn to read and write, never know where there next meal is coming from, have never had freedom to even play outside... Kind of makes you think, right?

Point I am trying to make is that it's easy to fall into the trap of comparing, striving, always pushing to go that extra mile/get that bit ahead, and life isn't about reaching some kind of destination: it's about enjoying the ride. Goals are important and I am a firm-believer in continuously assessing and reassessing where you are/where you want to be, but I'm also starting to see that this way of thinking means I am missing out on the moments that I have right now before they pass me by.

Question: what are you grateful for right here, right now?

Everything's Changed (Back To What It Was?..)

I last posted over a week ago. Things haven't really changed from a physical point of view. I'm still sleeping insane amounts, still feeling horribly unwell and still no clue what is actually going on with my body right now. Different people have different theories- adrenal fatigue, food intolerance's, depression, thyroid problem. It's all being investigated.

Meanwhile, on Tuesday night I started exchanging emails with a really good friend of mine in New York. Turned out, she is moving into a new apartment this week and looking for a roommate. Within 24 hours, I had booked flights, made appointments with a psychiatrist and therapist and am all set to go.

How do you know if you are doing the right thing?..

The reasons I left New York remain pretty much unchanged. The reasons why I want to leave Edinburgh so badly are accumulating by the day. I *need* to get out of Edinburgh and New York is the "easiest" option (as in, I know the city, have somewhere to live, etc). I don't know if it's going to work out this time. I pretty much stopped caring about ANYTHING somewhere amidst my move to London, and that also remains unchanged. I don't want to go back, but honestly? I don't want to be anywhere right now. I am NOT (for the record) suicidal. Hell, I don't want to be dead anymore than I want to be alive right now.

Something in the emails sparked *something* in me, and maybe now that the initial excitement has worn off, am just overwhelmed by moving, yet again, and the increasing frustration with the situation in Edinburgh.

I don't know what to do, and I don't know what my options are right now. There are so many "pros" to moving, and far less for staying. Lots of cons on either side. Nothing feels quite right about this, and I can't think straight enough to figure it all out myself. But I don't actually have anyone in real life to talk this over with...(and yes, I am aware how pathetic this is).

Less Choice, More Choice...Whaaat?

Some of my decisions have been made for me- for now at least.

Things in London aren't going to work out. So my choices are staying in Edinburgh, or returning to the US. I have a lot to consider. This afternoon has been spent on the phone to insurance companies and programs in the US, and various organizations in the UK.

I like the attitude of providers in the US. Health care is not easily accessible, but the treatment I got, for the most part, was worth fighting for. Sure, some of it was crappy beyond belief, but they all hold the same basic idea that EVERYONE can make a full recovery. I'm looking into various types of programs. I don't know if I want to commit to a long-term program right now- I have nothing stopping me, but I guess...well, I'm scared. I don't know if 3-5 weeks of 4 hours a day is going to make much of a dent in my behaviours/mindset and may make things worse? I don't know.

IF I stay in Edinburgh, the plan is to see my therapist weekly and be monitored by my GP. I've hated the place I go for therapy since I started there. Something about it just really rubs me the wrong way- perhaps the stark contrast between the attitudes there and the attitudes of that in the US. Being written off as a lost cause/hopeless case at the ripe age of 23 when I first went didn't sit well with me.

Staying in Edinburgh means I don't have to get well. I don't have to fight my eating disorder, don't have to face up to my demons and *gasp* move on with my life. I can drift from one low-key job to another, occasionally be admitted to hospital to stabilise, maintain the bare minimum "safe" weight. Forever. And that is what my life would look like- therapy, blood tests, meaningless/boring jobs, the social isolation that anorexia brings. It's a pretty bleak prospect.

The US is somewhere I HAVE to be healthy. It's just not negotiable. And that is what has appealed from day 1- I want to be there? I have to be doing well. No "maintaining the bare minimum weight", no staying in bed for 3 days or walking for 12 hours a day. I have to be eating properly, have to be working, have to be healthy. It works for me because I have so much social support and love the lifestyle/culture/family I have there so much that I desperately WANT to be a part of LIFE. Not like here where I honestly don't give a rat's a** about anything.

I am trying to think of ways of bringing what I love about NY to the UK...it's hard. Things are different. People are different. Life is different. I know that peace/happiness/whatever starts from within, but I also believe that environment is where it breeds.

So many things to think about right now.

Meanwhile, I need to figure out how the hell I am going to add in a tablespoon of peanut butter to tomorrow's meal plan...(and yes, I am aware of the fact that eating 90 calories worth of peanut butter should be the LAST thing on a 26 year old's mind).

The differences between the US and UK health care systems

I have experienced health care on both sides of the pond, so whilst some may disagree with my opinions, I believe them to be valid.

In the UK, it's all about maximising resources, saving money, damage control/harm reduction. I've been shunted from program to program, deemed "unresponsive"/chronic and had several years of "treatment" where the primary focus was on living with my eating disorder. I was taught how to maintain a low weight in as stable a way as possible. I was taught how to minimise the damage I was doing to my body. This, to me, was great. I was tired of living in psychiatric units. I was tired of being held down and force-fed, tired of my body being controlled by others. Once I turned 21, the focus changed and in order to prevent wasting more money on treatment I wasn't making use of*, it was all about helping me to avoid medical crisis after medical crisis, and manage my condition in the community. This is fine and well. Everybody knows that eating disorders can kill people. What people don't know is that if it doesn't kill you straightaway, you live, day in and day out, within a vacuum- nothing is as important as food and weight. You think of nothing else. You have no social life because your malnourished state is causing such obsessive thinking that you cannot hold a conversation, never mind relax over drinks with friends (friends? oh- did nobody tell you that you lose them all? They have lives to live that DON'T revolve around calories/numbers). Anyway. Back to my point. I was being taught how to stay entrenched in my illness without really realising the impact this would have. It wasn't just a case of being a normal functioning human being who happens to be rather thin. It was more a case of being left to my own devices knowing that there would be some intervention only if and when I should happen to collapse in the street and somebody calls an ambulance. Fair enough. The National Health Service has spent a fortune on my treatment- money that maybe could have been better spent elsewhere. Maybe on something other than just refeeding. Or on a program better suited to an anorexic 15 year old than a juvenile detention centre (after one doctor washed his hands of me and nobody knew quite what to do with this child who would just not be normal dammit)

So, yes. I've had my fair share of NHS treatment and quite frankly, would not be alive today without it. But...there's always a but. Maybe I am being a little too 'Pollyanna'-ish about it, but I still believe that there is a better life out there for me. I don't think I have to settle for what I currently have. I don't want the life that the NHS has mapped out for me- several more years of outpatient weigh-ins/check-ins, doped up on psychiatric medications, too stuck in my own world to hold down a job/live independently/have a *gasp* life.

This train of thought was what prompted me to try a different approach. The NHS was (and remains) a closed door in terms of actual help with a true recovery for me. I looked elsewhere and was very fortunate to qualify for a research study in America. I do consider myself VERY lucky to be offered a place on this program. The treatment was free because I participated in research. From the word "go", it was clear that they KNEW recovery was possible. They weren't even going to entertain the idea that living with an eating disorder was an option. No sir-ee. This was a whole-hog "refeed/fix the brain/eat like a normal person/you can do it" program. I got to a healthy weight for the first time in about 6 years. I ate pizza and French toast. I started a part-time job, a part-time class at university, met new people...got a life. Things were starting to take on a new and exciting form for me.

I graduated from the program, and for follow-up, attended a world-renowned treatment centre's day program. Don't let the name fool you kids- you don't always get exactly what it says on the label. This was a "wham bam thank you ma'am" program. You paid a rather disgusting amount of money just to be scrutinised as you cut your sandwich into quarters, and sat in endless hours of silence as the groups were facilitated by robotic clones who seemed brainwashed into saying little more than, "that is inappropriate conversation" should we even dare to utter the slightest reference to food/weight/body image/celebrities/men/media/fashion (hence the silence- you can only talk about the weather for so long!). The first signs of struggling, you were issued a "contract"- break the contract and you go to a higher level of care (oh, and what do you know? they even OFFER a higher level of care, at...what a surprise! An even higher cost!) I didn't technically break my contract, but it came to a point where I had "saturated my time on the program". Their explanation was that I would not get more benefit from the delights they offered. The reality was that I was paying the sliding-scale fee, and after a certain length of time, they wanted to give my space to somebody paying the full cost. Fair play. Business is business.

WAIT! NO!

Business should not be *just* business when it comes to health care. What about the patient? Where do they come in? Isn't their health a priority? Nope. Not if they don't have the money or the potential to sue at some point. You have enough to pay for treatment but not for a lawyer? You're home free. You have semi-decent insurance? They'll take you, all concerned and caring, then 3 days later kick you out when insurance pulls out. All of a sudden you go from being "in desperate need of help/support/observation", to "there's no more money- pack your bags". Seriously. I've seen it happen.

Americans may read this and not bat an eyelid- it's the system they know. I was shocked. The system, in both countries, is fatally flawed. No, I am not being melodramatic here. I don't even want to imagine how many people die each year as a result of the US money-making machine that they (almost laughably) call "Health care", and the British system, whilst free, is almost as bad with the "postcode lottery" and "care in the community at any/all costs" approach they take.

Either way, it's not your illness or symptoms that determine what kind of treatment you get. Whether it's an eating disorder or something completely different (cancer, diabetes, a broken bone), in the UK it's about spending as little money as possible to stop you racking up a huge bill to the Government. In the US it's about what insurance you have and whether that person sitting at the admin desk in the insurance office decides whether or not today is your lucky day (I wonder if they use some kind of magic-8 ball system? Or a spin-the-bottle type game each time a claim comes through?..)

Don't get me wrong. There are huge benefits to both systems too. I have seen some excellent doctors in both the UK and US. I've had some superb treatment both sides of the pond. I've met genuinely caring and compassionate people who really DO want to help patients. But they sadly seem to be few and far between.

Just my $0.02. feel free to disagree.


* quite how you make use of being held down and having someone stick a tube up your nose, I don't know