Monday, July 31, 2017

As "Normal" As Ever and Two More Emergency Calls

Quite a lot has happened since I last wrote.  Because D had to stop flying, I had to make a trip to a remote community by myself. It ended up being a good 10-day trip where I was able to accomplish a lot with an older Aboriginal lady, editing a project we had been working on. Towards the end of the ten days, D was cleared to fly again! They said his fainting was just a vasovagal response to back pain. It was fun to go home after my trip and have a big reason to celebrate!

A few days after I got home, D had a trip of his own to make: flying people around over a long weekend. The day he got back from that trip, we had a 2 week vacation to Europe to attend the wedding of one of my best friends. We toured around 3 countries and stayed overnight in another one on the way home.

Of course, some of the joys of traveling around other countries are seeing the interesting architecture and trying new foods. The wedding was the fanciest I have ever been to. It started in a castle in the early afternoon and ended with a 6 or 7 course meal that lasted until midnight.

As soon as we got back from that trip, we were planning our next to two remote communities and we left a few days after getting back (with just enough time to start getting over the worst of the jet lag).

Our trip in to the communities was difficult with poor sleep at night in the first community which turns out to be a very noisy place.  The second community was peaceful,  but we only stayed there for 2 nights.  After almost 3 weeks total, enough work had been accomplished that we could come home.  We ended up flying a couple young guys back from a community out to town so that they couold geta flight to Sydney.  We had a couple busy days providing meals for them, helping them find a place to stay for the night, helping them purchase plane tickets and getting them back to the aiport.  They are attending a 6 month program that we are very excited about as we think it will help them be prepared to contribute more to their community.  We've seen big changes in their lives since the "revival" last October.

This past weekend, I took two healthy "sick days."  Besides going out to a garage sale briefly on Saturday and church on Sunday, I basically just stayed in bed all weekend watching Netflix and reading.  I enjoyed watching "Untold Stories of the ER" since all the stories had happy endings.  It was nice to not pressure myself to accomplish anything, but really I felt like all the reading and TV watching were serving as a distraction and weren't really restorative for me in the long run.  I felt like I was blocking out my feelings instead of dealing with them and I was hit with a wave of anxiety when the weekend was over.  I think I actually feel better about life when I get some things accomplished each day.

Changing topics, I'll share one little adventure we had a month ago, on Territory Day (between our last two trips). We were out for an evening walk and a man called out to us to call an ambulance. His wife was lying on the ground next to him. She was conscious but had chest pain. We called emergency and struggled to get them to understand where we were as we were on a funny little backroad.  When they finally came we saw that it was the same emergency technician who had come to "rescue" D on the morning he passed out.  We were able to let them know that he was fine and back to flying.

Just after we left them, we saw a firework land in long grass and a fire starting.  We called emergency again as the fire was begining to spread.  It took them a long time to come (there must have been lots of other more urgent fires to attend too).  On our way back from our walk, as we watched dozens of fireworks going off in the distance all around us, we saw that the fire had spread out in a huge ring and had burned most of the field.  It was approaching some trees and the walkway we were using.  Fortunately, a ute with a water tank arrived and slowly started to control the blaze at the most critical places.  We watched and I told D that I was keeping my sunglasses on in case someone else lit up another firework too close by (I didn't want my eye shot out).  He replied that that was unlikely.  Surely they would see this enormous grass fire and realize that this dry grassy land with all the dry trees was a bad place for fireworks.  Shortly after he said that, another firework whizzed closely overhead!  I was worried as we finished our walk home as people were shooting off fireworks everywhere, often very close to where we were walking.  Luckily we made it home without one hitting us!

Tuesday, April 25, 2017

Easter in a Hospital

Well if my life was a driverless car before, it became a runaway train on Easter.

I've struggled to want to write about this because last week, it was causing so much anxiety just to think about it, but fortunately, that's starting to wear off now.

On Easter morning, my husband, D, was just finishing breakfast, sitting at the table when I came into the kitchen.  I was talking with him and he suddenly said, "I feel like my blood pressure is really low."

I responded, "You should go lie down then," but he didn't answer.  I repeated myself, putting my hands on his shoulders but his torso just tilted to the side.  He moaned a very deep, strange, close-mouthed moan.

I yelled, "Are you okay?" And sat him up a bit so I could look at his face and see if he was choking.  His head flopped back a bit so I supported it and i looked at his hands to see if he was motioning as if choking, but I just saw his right elbow on the table with his forearm held up perpendicular to it and his contorted hand silhouetted against the sunlit window.

I thought he must be having a seizure (though he's never had one) and started screaming for a housemate to call emergency as I felt for his breath, intending to give him mouth-to-mouth.  He wasn't breathing at all, however, he let out another weird groan, so I knew he wasn't choking.  Since I knew he'd said he had low blood pressure, I wanted to get him lying down.

One of my housemates came and started calling emergency as I grabbed D from behind with my arms under his armpits, tilted the chair over to the side to get him on the floor as gently as passible and then laid him back, supporting his head.  I thought I might have to start CPR, but almost as soon as I had him lying down, he started breathing again.

I asked him if he was ok.  He answered, "Why?"

I said something like, "Do you know why you are on the floor?" And he responded saying something like it was because he hadn't felt good.  Later I found out that he wasn't even really conscious when he had said, "My blood pressure is really low."  He just remembered thinking it and not being sure if he had actually gotten the words out.

The ambulance came, and medics took his vitals while he continued to lie on the floor.  His head had been in my lap, but we put a pillow under him instead so that I could go get dressed.

When they were done, they wheeled him out on a stretcher and my housemate, E, and I joined him in the ambulance.

At the hospital, a minor abnormality in his EKG seemed to indicate pericarditis, but it turned out he didn't have that.  We still don't really know what happened, but it could have been a response to some back pain he was having that morning and maybe some dehydration.

He had to stay overnight for monitoring, but I couldn't stay with him.  They admitted him to a bed in a ward where all the beds were only separated with curtains and there was no place for a family member to stay. Plus they said they didn't let local visitors stay overnight.

He was frustrated staying there. They had him hooked up to a heart monitor and he wasn't allowed to get unhooked even to use the restroom.  E and I stayed with him for all the visiting hours.  We entertained ourselves with Snapchat and such, but I was still in an adrenaline rush and was frequently shaking and feeling keyed up and hyper.

Fortunately, the next day, they released him at about noon.

Now he can't fly for a long time.  He has to get all these tests and jump through a ton of hoops.  He is not very eager.

We had finally finished converting his US licences to Australian ones.  He had finally just started flying for work 2 months ago, and now this.

I loved flying with D as the pilot.  It was so cool to go out to remote communities with him.  I am so proud of how hard he worked, and how patiently he waited to get to where we were able to work together like that.  I loved seeing how skillfully he did everything and how focused and calm he was doing all the pre-flights and run-ups and handling the traffic and radio calls at the bigger airports.  Now we are faced with this huge set back and even more waiting.

Fortunately, I was able to focus on a project with an Aboriginal lady who was in town this past week and could get my mind off of our now (even more) dubious future.  Also, every time I remembered what had happened and how scared I had been that D was dying in front of me, I felt panicky, so it was good to have some work to distract me.  I'm starting to recover from the panic now.  I am thankful that D wasn't flying when he passed out. And obviously I'm super glad he is alive!

I don't know if his passing out had to do with dehydration.  He doens't seem to have a very responsive sense of thirst.  I'm always having to remind him to drink.  It sometimes seems like a "drinking disorder" or something, like he just doesn't have an appetite for fluids.  But it's not psychological, it's just that his body doesn't seem to remind him to drink.  In the past, he has had the occassional migraines from dehydration, but it's been years since that's happened.  I'm the complete opposite.  I drink tons of water, feel thirsty frequently.  I sweat a lot and drink a lot.  However, when I get anxious or depressed, my appetite for food diminishes.  So sometimes, I'm the one getting D to drink some more water, and he's the one getting me to eat some more food.

I wish this was the only time I had been afraid for D's life, but we had another scare shortly before we got married.

He was swimming in a pool and wanted me to time him for swimming down and back on just one breath.  As he was swimming back toward me, I saw him do a breaststroke  as he reached the shallow end and his head came above water and went back under.  I thought, "Oh he didn't make it on one breath."  Little did I realize he was already unconscious at that point and hadn't breathed in when his head came up.  He stood up suddenly and was having laryngeal spasms that sounded horrible.  His whole body was in a sort of spasm and he was starting to sink back under when I grabbed him around the waist and hauled him to the side of the pool.

I was going to try to push him out of the pool for CPR and was about to yell for help when the spasms stopped and he began breathing again.

I asked, "Do you want to get out and sit on the side for a minute?"  He said sure.

While we were sitting there, he asked, "What was my time?"

I was shocked!  "You didn't make it all the way.  Don't you remember coming out of the water for a breath?"  That's when I discovered he had been unconscious already when I first saw his head come out of water then go back under.  I had thought he only lost consciosness after he stood up.  I didn't realize that the body can have all sorts of reflexes to save itself.

Actually the first scare I had with D was before that.  We were sitting on a couch talking and he suddenly stopped being able to speak or form normal words.  I thought he was having a stroke.  It was terrifying.  About 10 minutes later, he could talk again and I found out that it was probably "just" aphasia which can be an aura for a migraine.  Sure enough, he had a terrible headache start shortly after that.  Sort of funny is that when he started to get his speech back, words still sounded really weird to him and we had a mild argument about whether Skype was actually called "Skype" or whether (he thought) it must be called something.

For as much as my husband cares for me,  I'm glad that I have the strength and fortitude to care for him, too.  I have the strength to haul him to the side of a pool  in 4 feet of water though I'm 10 inches shorter than him.  I have the strength to get his unconscious body out of his chair and lying down.  Even though it is easy for me to feel discouraged by my many weaknesses, I'm thankful to God that he has helped my body and mind to come through for me in times of need. (But may I never need to do anything like that again!)

Thursday, April 6, 2017

Unexpected Twist

In an unexpected twist of events, my husband, D, and I find ourselves back in town and back in our rented (small) house.  As always, we never know where we will end up until (at most) a day before we end up somewhere.

On Tuesday morning, I was out for a walk in the remote community and praying about our situation, something like this: "...Well, God, D is pretty restless right now and so am I.  We somehow are stuck here waiting for things to happen that might not happen since they keep getting delayed.  We don't really have much to do and we are uncomfortable in our current living situation.  D really needs to get some more flights in, too, but we don't have any current prospects for trips he needs to fly.  Can you help us? ..."

As soon as I got back to the house of the lady we were staying with, she asked, "Did D tell you the new plan?"

It turned out that the funeral of a lady who had recently passed was planned for Wednesday (the next day).  So suddenly a plan had fallen into place to leave the house in the next hour, join the funeral ceremonies in a distant community for an uncertain number of days, sleep any any one of three communities, maybe on a floor, maybe just outside, then come back.  Then we would continue to wait for people to be ready for the next project to start.  But maybe those people would then be going to another funeral for a few days, so maybe hte next project would just keep getting delayed.  D and I had been feeling ready for days at that point to get out and get some time to ourselves in town, so I felt like what we were longing for was getting delayed yet gain.

I prayed in my head, "God this isn't exactly what i had in mind: Packing for a trip we are leaving for in an hour with no certainty of where we will stay or how long or who with.  Not knowing how much food to bring or how many people will be relying on us to feed them.  Not knowing whether there will be clean water available as the pumps in that community aren't working. But I guess it's better than staying in this community with nothing to do.  I'll trust you know what you are doing!"

Just then, we got a call from an administrator in our organization.  D was needed to fly someone from our main town on Friday.  We could say "no" and stay out in the remote community for longer, or we could come in to town.  After various phone calls and negotiations, multiple changes of plans, etc., it was determined that D would fly me (in the organization airplane that we had flown out to the remote community in) to a community near the funeral community, get a ride to the funeral ceremonies, spend one night out there, then fly to town.

I felt a huge sense of relief.  I can handle absolutely anything for just one night, even having no place to sleep, no water source, and minimal food.  But having a multi-day trip of indefinite length like that had seemed overwhelming.

So that's what we did.  On Tuesday, D flew me to the community with the airstrip closest to the funeral, I'll call Airstrip Place.  We hitchhiked to the nearest house of someone we knew.  We got a ride to Funeral Community and greeted some people there.  We found out that we could spend the night in yet a different community that I'll call Sleeping Place, made our way there. Then, surprisingly, were offered a room to ourselves in a minimalist cabin!

The water system at Sleeping Place is fed by water bores and extensive pipes traveling kilometers from Funeral Community.  Unfortunately, the bores have stopped working and Funeral Community has no water.  That absolutely should mean that Sleeping Place has no water, but for some reason, water came out of the taps at high pressure for the whole time we were at Sleeping Place even with 30 people there cooking, washing dishes, drinking, and bathing!  It was like a miracle!

Still, I was very nervous that maybe the water would run out at any time.  When kids at Sleeping Place left the taps running, I would get so nervous.  I had no idea what we would all do if the water stopped as there were no places to get it for many many kilometers.  Nevertheless, we had a good time with people at Sleeping Place, including some older people whom we love dearly.

As previously agreed to, the lady who had hosted us for the past couple weeks, I'll call M, had brought enough food to share with us and a few other people.  As evening approached, it became clear that the food would be getting shared with all the people at Sleeping Place as none had brought much of their own food.

D helped M make a big pot of stew.  Just as we were serving up one bowl per person, 8 more additional people pulled up in their car and hadn't brought any food.  The stew got thinned out even further so it would spread.  I got a bowl-full but went to bed still hungry.  I tossed and turned all night.  I felt anxious and increasingly hungry and headache-y.  Somehow D didn't really seem as hungry as I was.  Maybe he had eaten more than me at lunch.  We'd had to eat lunch on the go in between packing and planning.  Also, I think my body was still trying to make up for the time I had been sick the previous week and had taken a whle to get my appetite back. Edit: In reviewing the events of the last couple days with D tonight, I discovered that whereas my stew had been mostly broth and little else, his had been far more nourishing with more meat and potatoes than broth. Haha. Better luck next time!

In the morning, I enjoyed some special times with some of the indigenous people we are close to, even though I was feeling quite bad physically at that point and still quite anxious about the water potentially running out and the minimal food supply being stretched among more people than it was meant for.  A big pot of oatmeal was made.  It had to be thrown out because the oats were old and had gone sour.  So 30+ people shared 3 loaves of bread for breakfast.  I was getting ravenous at that point even though I had been lucky enough to get one of the 15 boiled eggs that D had boiled the previous day for M, as well as some fruit along with my piece of bread. But I knew that we would probably be able to leave in the plane before too long.  Then we would be able to snack on a couple extra snacks I had brought without feeling pressured to share with 30 people.

Unfortunately, the person who was meant to drive us back to Airstrip Place had gotten wrapped up in another activity.  As the morning wore on, I began to wonder if we would even be able to leave.  The weather usually turns to storms in the afternoon around there.  We each got a chunk of damper for lunch.  My headache was continuing to worsen from the increasing heat and on-going hunger.  We were told that many more people were planning to come to Sleeping Place in the afternoon and that the main part of the funeral was delayed until the next day.  Knowing the usual way of things in that culture, I doubted they would be bringing more food.  I began to wonder if the water supply would hold out and if anyone would go get more food.  I was starting to worry that we would have to stay another night and my growling stomach was beginning to feel resentful.  Then the person giving us a ride to the plane was ready to go.

It took over half an hour to drive to Airstrip Place.  Big dark clouds began to roll in and rain began to fall as we drove.  I was bracing myself for the worst.  The radar over the area was broken, so we'd just have to try to fly and see if we could make it.

It took D a little over half an hour to pre-flight the plane on the side of the bare dirt runway.  Meanwhile, more big black clouds rolled past just south of us.  Fortunately we eventually got going.  Up in the air, we could see more storms closing in and the rain began to fall harder.  I was so worried we would have to go back, but D said he could probably manouever between the clouds.  We made it out of the worst of it.  The choppy air made me feel airsick even though I had loaded up on ginger pills before we left.  I was able to sleep a little bit which kept the nausea from reaching unbearable levels.

It's a long flight back to town.  I wondered occassionally if we would make it all the way or get closed out by storms.  Fortunately we did make it, and last night, I got to sleep in my own bed.  While we've been gone, we've acquired an additional housemate to fill the third bedroom.  Now it's kind of like living in a commune.  Not the most comfortable feeling as I would really prefer if D and I could have our own place.  But on the other hand, the location is amazing and the rent is much less this way.  Plus we are hardly ever home anyway.

We were very happy to go out for Indian food last night.  My body was more than ready to make up for the lost calories of the previous 24 hours!

Originally, the plan was for D to fly someone on a trip tomorrow coming back in an indefinite number of days.  I wasn't too excited, trying hurriedly to help him get his laundary done and supplies replenished today.  Then an hour ago, we were told he wouldn't be leaving tomorrow but the next day and would only be gone for one night!  Hooray!  (Of course I realize that there are NEVER any guarantees in our line of work!)

Well, that's all for now.  We are excited to be back where the food is plentiful and varied and we can have whatever we want.  I am excited about air-conditioning too.  I don't mean to be a princess about things, but I am really grateful for comfort and increased independence at least for a little while.  Knowing me, though, I'll probably be itching to get out of here in another week!

Sunday, April 2, 2017

Driverless Car

Sometimes my life feels like an occassionally malfunctioning driverless car, and I'm just along for the ride.  Sometimes I seem to be making headway on a road that looks logical to take, and then I'm just free-wheeling through some fields and streams and wondering when I'll next see a road.  Is this a short-cut?  A detour?  A random joyride with no major purpose?  And then sometimes, the car just parks and I don't know when it will start up again.

Though we have an apartment in a large-ish town that we are always paying mooney to rent, I've only been there for about 2 weeks out of the past 4 months.  Our travel schedule has not really gotten any less hectic or any more predictable.  Sometimes it makes sense.  Sometimes it doesn't.

A bit over two weeks ago, we left town for a remote community.  I was going to help with a couple different important projects.  The first week, I got involved in one of the projects and was able to have lots of good input on it.  It was wearying, but wonderful.  Then halfway through the week, I got sick and had to sit out for the rest of the week.  I started up again at the beginning of the second week, but then a key person had to leave early and the project was stopped.  We thought, maybe we can head back to town now.  Then we got word that the next project might start up this next week.  We decided to stay.  Now it looks like that project might be delayed.  So basically, we could have headed back tor a break, but we are "stuck" here waiting to help with a project that might start up again tomorrow, or we may be here with nothing to do for a few more days.  The project may last a few days when it does start, or a few weeks.  No idea when we will next be able to go "home."

It's not so bad, but it's just not home.  We are staying in someone else's house with them right now and I don't feel all that comfortable here. There isn't much to do in this particular community.  It's very hot, but there's no place to swim.  There is a limited variety of food available at the store.  But at least there is a store.

In general, I think that I'm pretty "normal" about food these days, though I do prefer eating healthfully.  However, staying with the person we are with presents a challenge.  She really likes fatty red meats, fried foods, white grains, and considers potatoes a vegetable.  I don't mind the occassional meal like that, but I start to feel uncomfortable (and my digestion isn't so happy) when I have really frequent meals like that.  My husband and I actually don't eat much meat when we are on our own and hardly ever have red meat or breaded fried things, so this is a big change in our usual food intake. I do my best to contribute to the cooking with vegetables and by stocking the fridge and pantry with some more healthful options.  Sometimes the pre-stocking works, but I feel pressure to stay on top of it, or the default will be food that I'm not as happy to have.  I really don't enjoy food prep and when the work projects are in full swing, I don't really have time to get home and help choose and make what's for dinner.  Fortunately, my husband does a lot of cooking and knows generally what types of foods I'm happier with, but he really likes his fatty meats and fried foods too, so he is not always that interested in finding another option.

All of this challenges me to think about if my attitude toward food is completely where I want it to be.  I find myself getting frustrated over the current lack of control for what I eat.  I have genetic high cholesterol and an eye condition that will degenerate more slowly with a high intake of vegetables, so there are legitimate reasons why I don't want tons of saturated fats and limited veggies.  I also struggle with slow digestion and really wish I could have more whole grains instead of the easier to come by white rice that is common around here.  I've been feeling particularly strongly that I want to get back to town, and I think the food situation is a part of the reason.  That's really unfortunate, since I generally have liked being out in communities in other trips, even when the projects weren't working out and there wasn't much to do.

To be clear, I am not afraid of the food affecting my weight.  I know my weight is very steady.  I more just worry that the food will affect my arteries and long-term health.  I suppose that deep down I do wonder if the lack of lean protein will affect my body composition, but in general that hasn't been a concern that has taken up much mental energy because I don't care all that much.

I stopped taking my anti-depressant, bupropion, a couple months ago.  It had been slowing my digestion so horribly that I was starting to think it might do permanent damage as I was having to take meds almost daily to counteract the side effects.  I still sometimes have digestion problems, but mostly now it is just from stress and traveling and my inability to have as much control over my diet (since I think it would be rude and I would feel weird if I always made separate special food for myself).

To get what I need for vegetables, I have to be flexible and rely on my less prefered options.  As there isn't much variety at the store, I stock up on canned green beans so even if I can't get much in the way of a veggie with my meals, I'll always have a couple servings available as a snack.  I also try to keep fresh carrots in the house.  Really the only other green vegetable that is available consistently is broccoli: frozen or fresh.  The fresh stuff sometimes is wilted so there's only frozen.  I really don't enjoy broccoli that much, but I try to prepare some to add to dinner each night (or cabbage and onions if it's available.).  Ideally, for my eye condition, I'd be having 2-3 servings of spinach daily because of the particular nutrients in dark leafy greens.  Unfortunately, we can only rarely get that out here.

I've written before about collecting traditional foods.  We haven't had the opportunity to do that on this trip so far.  My husband did catch some fish when we first arrived, which was really nice.  He just got in invitation to go fishing later this week and I hope he does.  Neither of us love fishing, but we do like fresh food.

I usually don't think about food much, but it has been on my mind more because of the minor stress of trying to eat some more healthful foods.  During my recent illness, I didn't eat much and it's taken a while to get my appetite back. Now that it's back, I guess food has been on my mind a bit more.  Along with that is the feeling that I wish there was more available of things that I enjoy and the desire to get back to a more comfortable living situation.  For now though, I'll honor my appetite as best as I can even with foods I don't much like.  I'll try to remember to check my weight whenever we do get back to town just to re-affirm that I've continued to eat intuitively during these slightly adverse circumstances.  I am aware that it is possible that I've lost weight because of the illness, but as I mentioned in my last post, I'm pretty confident that it will correct itself.

Wednesday, March 29, 2017

Keeping the Scale in its Place

In my last post, I mentioned how keeping track of my weight helped me with intuitive eating: It revealed that my "intuitive eating" was causing weight loss and setting the stage for binges.

There are some people who will not benefit from tracking their weight: Some people find that knowing their weight always leads to a relapse.  This advice is not for people in that situation.

However, for the few of us that benefit from tracking our weight, it can still be useful to have some guidelines regarding when and how to use the scale.

Now that I'm recovered, I don't weigh myself very often nor do I have to have any rules about the scale since it isn't ever distressing or triggering for me, but early in my recovery, the following were useful guidelines:

1. I never weighed myself when ill or after being ill.  Obviously, being ill can lead to short-term weight loss through fluid loss, poor appetite, increased metabolism, muscle wasting, etc.  I noticed that once I recover from illness, my appetite naturally increases and if I hold off weighing until a week or two after being sick, my weight would be what it was before getting sick.   I felt that weighing myself when sick would just be giving into morbid curiosity: "How low can my weight get?"  Of course, if one doesn't get one's appetite back after being sick, it might be important to weigh in after a few days and take measures to regain the weight, overriding appetite as needed.

2. The same ban on weighing applies for religious fasting.  Firstly, I wouldn't really recommend fasting if you've had an eating disorder, but there was a time when I felt strongly the need to pray for someone really important in my life a few years after recovering.  I fasted a little bit during that time of prayer, but certainly didn't weigh myself as weight loss was not at all a reason for the fast.  In fact, that can be a good test if you are wanting to fast for religious reasons: don't do it if you are going to be tempted to check your weight or if you are even thinking about weight loss at all.  If you are fasting for the "right" reasons, there shouldn't be any problem eating extra after it's over.  Again though, in general I would really advise against religious fasting after having had an eating disorder.

3. Don't weigh daily.  There are too many reasons for weight to fluctuate around: hormones, fluid retention from salt intaek, slow digestion, etc.  If you have reason to suspect that your weight is going to be higher than normal (having eaten a super salty meal, "that time" of month, constipation, etc)  don't bother weighing.  At this point in my recovery, I don't really care if I see a slightly higher number since I know my basic range and what to expect, but early in, I figured there was no reason to weigh myself when I knew I was bloated.

4. Only consider your monthly weight when tracking long-term change. This one doesn't apply to me as much since I don't really fluctuate a lot, but I heard some advice a couple years ago to only reaally pay attention to your weight on the same day of your monthly cycle since otherwise, too much fluid fluctuation can make you think you are gaining or losing when really you aren't.  So if you are watching changes over time, only record, say, day 7 of your cycle and observe the trend month to month instead of week to week.  For me, I'm not concerned about a couple pounds in either direction, so I just weigh in occassionally when I remember to.  I don't write it down.  I just check to see if I'm in my usual 5 pound range.  I only pay more attention if I go out of that: especially if I'm right on either edge of the 10 pound range Iwas given in treatment.  When I was figuring out intuitive eating, it helped to weigh more often than monthly so I could catch the downward trend early.

5. Don't do anything that feels sort of weird or embarassing to you personally. If you feel ashamed of how often you are weighing, it's time to cut back.  If you are weighing multiple times a day, like before and after exercise or before and after a meal, it's time to cut back.  When I was in the first part of my treatment, we weighed in a hospital gown, first thing in the morning after peeing and before breakfast.  When I moved to the second stage of treatment, we weighed in our clothes after breakfast.  I'm not really sure why that change was made, but it helped me to know that I didn't have to be regimented about how and when I weighed.  Some people weigh without clothes, but that didn't really work for me after I got married and was living in a tiny efficiency apartment.  I didn't really want to be so regimented, so when I did occassionally weighed in, I wore my pajamas.  I didn't really want the whole thing to feel too ritualistic and feel like I "had to" haul the scale into the bathroom and strip down in order to get the "right" weight.  I felt it was better for me just to be more flexible with what was an appropriate weight range and not have to see the "lowest possible number."  These days, when I get weighed to fly on small planes, I've got shoes, a hat, sunglasses, after breakfaast, etc.  It doesn't bother me that my weight isn't going to be recorded as the lowest possible weight that I could be considered to have.

6. Once you have a solid handle on intuitive eating and your weight is very stable, consider taking longer breaks from weighing.  This should happen naturally.  Weight will become a very boring topic once it's really stable.  No need to focus on it any more.

Monday, March 20, 2017

Intuitive Eating: Not the Hunger-Fullness Diet

After my 3 month stay in IP at age 18, I was given a meal plan to follow and had weekly meetings with a dietician back at home to help me stick to it.  We had read some articles and book chapters on intuitive eating during my IP stay, and had taken a few steps toward eating that way.

For example, people who were nearly weight-restored were allowed to leave a couple bites of food on our plates at meals.  We had snack challenges where we could meet individually with a dietician during a scheduled snack time and we were given a snack that was higher in calories than the one on our plan.  We were encouraged to eat it mindfully and leave behind whatever we weren't hungry for.  I remember doing this kind of snack challenge with my dietician and feeling surprised when there came a moment where I just wasn't really hungry for the treat anymore and could easily stop eating it.  She told me to keep the leftovers and either throw them away or eat them later.  This was meant to help me trust myself around the food.  I felt a sense of pride being able to throw away the rest of the snack and not feel like I really cared either way if I had kept it or not.

In the less intensive last few weeks of the program, we had restaurant challenges and also snack challenges where we ate out at ice cream places.  At these we were encouraged to follow some basic guidelines (like eating at least half of the entree and all the sides, or maybe at least half the ice cream) but beyond that, we were supposed to listen to our appetite.  I think we even had a "pot luck" group meal where we were supposed to try a little of every dish and then get more of what we liked if we were still hungry.  We were also able to shop for and pick all our snacks at the less intensive program, and we chose menus and cooked food in our housing groups which helped us decide what sorts of things we liked or didn't like.

At the time, I was ready for these challenges and they did help me learn to trust my body.  After treatment, having a combination of a meal plan and partial intuitive eating was useful even though I did eventually relapse.  However, it was clear that some of the people in treatment were not at all ready for even this fairly structured verssion of intuitive eating.  Some girls said they still weren't hungry for anything, ever and only ever ate the bare minimum requirements.

Some people, when allowed to leave 2-3 bites on their plates, could be seen to be portioning out the biggest possible bites into 3 piles, ready for inspection by the meal supervisor.  This particular behavior was kind of frustrating to watch since I thought it should be obvious to the professionals that this was definitely not intuitive eating, and yet I didn't see anyone get challenged on it.

When I stopped purging for good at age 20, my body was absolutely ravenous.  I had some weight I needed to regain at that point, and I did a lot of bingeing/reactive eating.  Sometime after that, I started to slide into bingeing followed by exercise compensation.  But at age 23, I got deadly serous about stopping all forms of ED.  I was so ashamed that, having claimed to be recovered, my eating and exercise were still so disordered.  So I decided to re-tackle intuitive eating, with a vengeance!  This time, though, I didn't have a meal plan to go along with it.

I became like a drill sargeant with myself. I wouldn't let myself eat a bite beyond what I felt hungry for.  If I did, I would analyze my behavior into the ground, picking apart the likely "triggers."  I completely stopped exercising or weighing myself.  Yet I dropped weight quickly as was obvious from the fit of my clothes.  Probably some of this was muscle lost fhat I'd gained from excessive exercise, but also, I had been over my IP-given weight range, which I saw as further proof that my bingeing was "ridiculously out of control."  I didn't give myself any mercy or think that maybe my body just needed that extra weight from years of starvation and semi-starvation.  And eventually, having lost too much weight by my self-imposed hunger/fullness diet (which I thought was the same as intuitive eating), I started occassionally bingeing again and really being angry with myself.  I didn't weigh myself so I didn't see the pattern of small wieght-loss followed by a binge, followed by more semi- "intuitve eating" and small weight-loss, followed by another binge.  I didn't really figure it out until I started weighing again.

Before I figured it out, I had become obsessed with hunger and fullness.  I could tell within a bite when I stopped being hungry and then thought I had to stop eating at that bite since I was "fulll."  I thought constantly about each bite and every sensation it created.  I thought that's what I had learned to do in IP, but didn't take into account the additional structured meal plan that had helped balance the intuitive eating.  I would find that within half an hour of eating and being "satisfied," I would feel hungry again.  But I wouldn't be sure if it was hunger or not.  Maybe it was anxiety.  If it was, I shouldn't eat more, or at least that's what I thought.  How could I tell?  I thought about it a good portion of the time.

Eventually, I did recover, but I had to stop analyzing every bite and every sensation in my stomach.  Intuitive eating is a lot more than strictly eating when hungry and stopping when "full" (or "not hungry").  When I did that, I was losing weight and setting myself up for binge after binge.  It was awful.

After time, I gained intuitions about how to eat until feeling pleasantly full (not just until "not hungry").  And I also learned that it was also normal just to eat a meal without thinking much about hunger and fullness.  I kept track of my weight just enough to use as external evidence to help me make sure I wasn't undereating because of my intuitions being off.  I didn't want to continue the accidentally restrict/then binge pattern.

These days, I don't spend much time thinking about hunger and fullness.  I definitely eat when I'm hungry, but I hardly think about how I feel after a meal.  I just get on with my day.  Sometimes I feel a little too full after a meal, but it doesn't stress me out and I no longer feel at all any need to dig into "the underlying reason" for why I ate more than I strictly "needed" (whatever that means!).  Generally, eating extra only happens when I eat too fast or the food is just really good and worth eating extra of.  My weight is very stable to the point that I don't weigh myself often since it is boring to always just see about the same weight come up each time.

I definitely wouldn't recommend intuitive eating to someone who isn't weight-restored (or nearly there).  And it's good to start with a structured plan as a minimum requirement.  It's possible to transition out of this later to more complete intuitive eating, but it's good to have someone making sure one isn't losing weight during the process.  There is potential for relapse during the transition time, so it's something to be aware of.  Also, there are different ways of eating intuitively, so really, there is nothing black and white about it, so be careful if it ever starts to feel that way.

Tuesday, March 7, 2017

An Old Friend Makes It Through In-Patient

A few posts ago, I mentioned that my husband D's old friend, I'll call K, was looking to go in-patient for his eating disorder.  He was struggling with what was probably orthorexia and with a loss of appetite from anxiety and depression.   He really wanted to gain weight, but hadn't been able to convince himself that his body could handle the foods needed to do the job.

D used to be housemates with K.  I first met K about 7 years ago.  At the time, I was staying a couple weeks with my close friend A, and D was hardly on the radar at that point in my life, but A had been looking for opportunities to set us up. She suggested we go visit D who was staying in another part of the coastal state that A was living in.  I was amenable to the idea, but warned A not to try too hard to set me up with D because I don't like drama and awkwardness nearly as much as she does.  She told me that there was plenty of other awkwardness to distract from any potential new relationship drama: She explained K's struggles with food and the marital struggles of her brother and his wife who were temporarily crashing with D and K.  Fortunately, things went smoothly and we all had fun together.  I remember feeling sorry for K when we all went out for an early surf and he was struggling and shivering in his weakened state.  He said he was trying to gain weight and I tried to encourage him to push past the physical discomfort, but didn't reveal my own history.

After returning home, I stayed in touch with D and a distance relationship slowly began.  Friend A eventually moved in with D and K in a new much bigger house where they each had a floor to themself and D and A tried to help K gain weight as best as they could.  I went for a visit a few months later and saw the meal plans they had tried to help K establish hanging on the fridge.  K had neither gained or lost since I'd last seen him.  Early in my visit, A admitted that she had told D and K about my eating disorder history in an effort to encourage K. I was kind of embarrassed.  I didn't know what D would think and we were still pretty early in our relationship.  (But it didn't much matter because a couple days later, D and I took a trip to visit one of my relatives who said in front of him how glad she was that I had overcome my eating disorder!) Anyway, knowing that both D and K already knew  about my past, I was able to try to share some practical advice with K when he asked.

Over the years since that visit and after our marriage, D and I continued to keep in touch with K.  Unfortunately, when A and D moved out of the house and were replaced with other roommates, K recommenced his downward trajectory.  We saw him occassionally in our travels and visited him in 2013 for a week and he was doing a little better, but his eating disorder might have been a factor in his later breaking up with the girlfriend he had at that time.  After the breakup, he took a downward plunge in his health.

Last year, he called letting us know that he was searching for in-patient options.  He had the extra burden of finding a place that would treat men.  He was anxious and oppressed with the feeling that he might pick the wrong place and not get better.  I told him that as long as he picked a place that ensured he would gain weight, he would be better off than not going.  He wasn't really afraid of weight gain, but had realized that he just couldn't trust himself to make it happen or to get himself to try foods he'd become afraid of. And yet, the fact that he was willing to go to treatment and gain weight made him feel that maybe he just wasn't trying hard enough.  Knowing his long history with his eating disorder, I assured him that it would be a big relief to let someone else make the food decisions for a while.  I told him what a relief it had been to me to go to treatment and take a break from the mental gymnastics of food decisions.  I encouraged him not to be afraid to try medication if they offered.  It definitely (eventually when I found the right ones) helped me take some steps forward in my recovery and I've seen the same happen in others' stories.

We talked for over an hour and I can't remember all I said (though I'm sure I didn't make that big of a difference in his final decision), but a few weeks later I was very happy to hear the K had made it through an in-patient program and was in an intensive out-patient program.  He said his attitude toward food had completely changed and he no longer feared eating like other people do.

D and I traveled back to the States for Christmas and we were able to see K quite a few times as he had come to visit his family in D and K's hometown.  We shared a few meals with him and he did seem more at ease around food.

In D's hometown, he has another friend, I'll call B, who is a former Marine and really loves food.   B has been on a medication for a few years that is known to increase appetite, and he is considering becoming a chef so he likes to talk about food a lot.  When we are in D's hometown, we spend loads of time with B and one day it just made sense to invite both K and B for a day of fun even though they basically only know each other from hanging out with D and I during previous visits.  We had a great time ice skating and then went to the mall food court for lunch.  K and I went to a place that has mostly "healthy" (meaning it has some vegetables with the food) options and D and B got food from a place that basically prides itself on the multiple layers of fried foods and non-vegetable-containing cheese-smothered options.  I felt a little conflicted about getting the "healthier" option as if as a recovered ED-sufferer, maybe I should be setting a better example.  K explained that even though he is now not so afraid of the "unhealthy" option- he trusts his body can handle it- it's still not what he prefers.  He said that even the "healthy" food he ordered wasn't something he would have been able to eat before treatment.  They had happened to have that same "healthy" restaurant near the treatment center where he had been and it had been a popular option for the out-patient group.

It was interesting hearing K explain to B where he had been for the past few months when B asked.  It was a very matter-of-fact conversation.  B asked a few questions about the program, K answered straightforwardly, seemingly unembarraassed, and then they moved on to other topics.  I wondered how the conversation might have been different between women.  I don't know if I would have been so open about where I'd been if I had been in K's position.  For now, it seems that K is on the road to recovery.  He still has more weight restoration to do, and he did admit that they didn't have a strong focus on aftercare at the treatment facility, but he was working on making some important decisions about work that could help relieve some of his stress and anxiety so that recovery will be easier.

The meal with K reminded me of a dream I'd had a couple months before.  In the dream, I was in a building that looked like an enormous high school with many floors.  I saw some people in passing that I had met in treatment when I was 18.  "Maybe you'll be in our group," they said.  I realized that this was an eating disorder treatment center and that I was an aid and was supposed to assist a group of recovering young adult women.  I sat with a few ladies at a round table in a school-style cafeteria and we each had a plate piled up with breaded fried meats, Doritos, and sausages that were so full of grease that it poured out of the middle when you cut them in half: not a vegetable or fruit in sight.  I was torn internally and a little anxious about the food. I knew there probably wasn't a problem eating a meal like that once, but it was way more than I was hungry for and I didn't know if I had to finish it all to be a good role model.  And I thought, "These ladies will only be here for a couple months eating like this, but will I have to eat like this for years since I'm working here?"

I was stressed about not wanting to trigger anyone so I didn't say anything at first, but then I asked one of the women, "Do people usually finish their meals?" wondering if maybe they were just supposed to eat intuitively and stop when they felt full.  "I usually just keep munching away at it it until it's gone," she replied solemnly.

One woman finished most of her food but left the sausages.  "Do you think you will finish those?" I asked her, feeling torn because it seemed like she had already eaten plenty of food, but unsure whether I was supposed to "make" her finish.  "I just can't eat those," she replied as she cleared her plate from the table without waiting for a reply.

Having that dream contributed to some thinking I was doing about exactly what my relationship is with food now that I've recovered and weather it is as healthy as it can be (and by who's measure?).  Hopefully I'll get a chance to blog about that sometime, but this entry is plenty long so I'll call it quits for now.

I actually had a couple different dreams about eating disorder treatment last year.  Has anyone else out there dreamed about eating disorders?