Radical Will Eating Disorders Therapy Session part 6

So I got up  at the maniac’s hours to write my abstract on Radical Will. I was super excited, it had been quite awhile since I had done anything but blog. I really missed school. I couldn’t wait to return. Hopefully by the Summer semester. I prayed for three classes. I went to the store with Julia Bleu in tow. We got the coffee and we came back home.

I took my Adderall right away. wanted the good golden elixir working through me. I spent a little time the day before outlining the specifics I wanted to cover. I didn’t give much thought to page range, I knew it was only a detailed abstract. I thought to myself I would share this with  Pam but would only let her borrow a copy with signing a confidentiality statement. This whole idea, my medical care, was all my own very idea. I had no input from nobody else, I probably could have use some if I had thought about it. I began to write the abstract. It felt so good to be writing and producing work. The next four hours flew by. I was just about through when Stephanie surprised me. It was still 3 hours early for her to be getting up. She woke up because she knew I was writing my Radical Will abstract. She was pretty excited too. I kept on writing and did talk to her as Julia Bleu sought Stephanie’s affections. It was overwhelming for Stephanie. She asked me how I felt and how was the scale today? Oh my I had forgotten about the scale I was just about finished so I would wait to weigh myself for a few more minutes. However, now it was gnawing at my brain. Finally my abstract was finished, and Stephanie could proof read it for me.

I went into the bathroom and took off my clothes, I had had a pretty good day yesterday. I wasn’t sure what to expect, I wanted the best but knew it probably wouldn’t be the case. Sure as hell the scale was now down five pounds. I panicked I didn’t know what to do. I knew that  Pam would weigh me again today. I threw on my clothes and I came out to see Stephanie. She was smiling from ear to ear. She told me my abstract was written like it was taken out of a medical journal. She handed me the corrections, and I didn’t say anything. I really was lost for words. She finally asked me about the scale. I stopped what I was doing and turned to face her. I looked directly in the eyes as I began to cry, I said, “It’s down over five pounds and Pam is going to weigh me today. I then asked Stephanie if she would make me my smoothie now. Sure she said surprised but went off to make it. I was going to have to really dig deep today. I finished my edits and printed it again. I re-read it and made some more corrections. I fixed those too and printed out one last copy. I read through it slowly and aloud. I printed off two more copies and then found a confidentiality form for Pam to fill out. I even stipulated it had to be kept separate from my own folder. This was my intellectual property. In fact I would give copies to all my provides and have them sign confidentiality agreements. I thought it articulated my position and my stance on Radical Will. I really started building steam for this approach. Not because it was mine, but because I thought it had a really great chance of working for me.

Stephanie came back with my big smoothie. I was very grateful and gave her the last version of the abstract to read. She thought this was my best I ever explained the entire concept, and my rationale for using it in the first place. I asked if she would make me some pancakes and veggie sausages for breakfast. I was going to drink at least two bottles of soda on the way. Anything to get away from the five pound mark. Stephanie of course said she would be happy to make me breakfast. She said she was also excited now that I had a true working abstract. I got up and went to turn on the shower. The last thing I wanted was to jump in, but I knew I needed to take one. I was in and out in no time. I was dressed and still had soaking hair, my breakfast was ready so I did like I like to do and threw on a ski cap to cover my head. We sat down to breakfast and  I said a small Grace. I ate as much as I could eat, and worked on my smoothie at that the same time. I had horrible stomach pains that were only going to get worse. I could have cried but knew it would do nothing except stress me more out. I was stuffed, my smoothie was less than have drunk, I had eaten 3/4 of a pancake and a  veggie sausage. I had a ways to go and my appointment was at 11 am with Pam. Stephanie asked how I was doing. She usually only asked if I didn’t look well. I said, “I am stuffed, my stomach is a land mine field, and I HAVE to eat and drink as much as possible. I can’t get admitted by my primary care today for the weight loss. I googled pro-anna sites for information on quick weight  gains. I honestly don’t go on them anymore I know all the tricks at losing weight, it is the gaining part I don’t know. I remembered that people  salted even their fruit at Walden because the sodium made them retain water. I got the salt and salted my shake, and my breakfast. Stephanie laughed nervously at me. “Another Walden Trick?” “Yep I said , “Desperate times desperate measures.”

I was feeling so crappy and was scared about the hospital in a deep inexplicable way. I felt rather doomed. I finished my pancake, and sucked down to about have of my smoothie. I asked Stephanie how she was doing? I invited her to come in for my entire appointment with Pam. “Really? ” she said. “Yes, you are the person I am closest to and I think you might learn, plus  then we can talk about the appointment instead of me telling you about the appointment. Stephanie came over to me and put her hands on my shoulders. “I feel so lucky Corey that we are the friends we are. You don’t have any idea do you?” “I feel the same way probably 100 times more.  I would seriously be dead if it wasn’t for your love and care.”

We stayed like that for a minute but my stomach was killing me,  I had to finish my shake and I had to drink soda. I felt like I could actually throw up. I was so bloated and uncomfortable. I needed to get ready as we needed to leave in a  half an hour. I brought the smoothie with me and dropped my plate and things into the sink. Stephanie went upstairs to get ready and I finished getting ready in the bathroom on the first floor. I was leaving the ski cap on for the day so my hair was not an issue. I finished getting ready and was really starting to crawl out of my skin. I was not okay. I found my smoothie and choked down some more. I was basically ready to go and almost forgot my abstract. I put three copies in a folder, and threw in my smoothie recipe and my weekly eating log. Stephanie came down the stairs and wow she looked fabulous. I never looked at her that way but she was It Girl today! I started the car, as I loved the remote car starter, nothing like getting into a warm car. Stephanie threw on her gear and asked if she could carry anything. I asked her to grab the folder. I had my knapsack and my smoothie. I was dying at the moment from my stomach and death was near or so it fucking felt. Oh how I hated myself and the body I blew to  tiny bits and pieces. We headed out to the car, I asked Stephanie to grab 4 heating pads.

We got in the car, it was warm and we always leave the seat warmers on. I got situated with the heating pads in my underwear, and Stephanie drove us to Pam’s office. I was so nervous. Not about Pam really, but my primary care doctor. I choked more of the shake down and I opened a diet sprite. My pants and stomach were going to implode. I honestly couldn’t get a full breath because of my stomach was so filled. I hope I would actually be able to really puke some of this later. I couldn’t stand myself. We got to Pam’s office and Stephanie dropped me at the front door. I waited for her to park and actually drank the last bit of my smoothie. I was so ill I hoped I made it through the session. Stephanie came in and we headed to Pam’s suite together. We sat in the waiting room and honestly I was about to bust and needed the bathroom. I felt so bloated I couldn’t get a deep breath.

Pam came out and greeted us. I explained to her that I had invited Stephanie to come in for  the session if it was alright with her. Pam was more than happy to have Stephanie join us. We went into the office and before I sat Pam handed me a johnnie and had me get ready to be weighed. Okay here we go I thought. This could be heaven or hell. I got into the bathroom and my belly was super descended and killing me. I came out and walked over to the scale. I got on it and held my breath. It read, just under a 5 pound loss. All the eating and drinking hadn’t even added a pound. “Okay we are not stable with your weight.” Pam said. I went into the bathroom and now didn’t know if I had to worry about her too.

I walked into the office and Pam and Stephanie were mid-sentence. I sat down and tried to ignore my severe  pain and my difficulty breathing. Pam asked if I had had the time to work on the abstract. I grabbed the folder and handed a couple to both Pam and Stephanie. Pam asked for a few minutes to read through it. I read it again, and was happy with it really. I could definitely right a research protocol for this abstract. Pam looked at me and smiled. “This is the hard work of a person who is NOT staying sick.” I instantly started crying and it was from a place I never knew existed. I would  later come to realize it was a new place within reserved for my painful recovery and my frustration with my recovery.

Pam started talking,” Corey I am honestly impressed with this concept and it challenges a lot of what is current in the world of therapeutic alliance in anorexia. I think you make some  compelling arguments for particular patients in terms of their recoveries. I think the area you need to develop for this protocol is the weight restoration which is clearly your problem as well.”

“Yes Pam I am very frustrated. I have brought my eating history and I brought my smoothie recipe to  share with you from Amber, my nutritionist.”  I handed Pam the papers and I asked her the question I had been dying to talk to her about: refeeding.

“Pam I was hoping we could talk about refeeding and how I think I am stuck in it. When I was at Walden they thought I got stuck in it. Is that possible. I am eating, drinking my prescription Ensures and now I have had a smoothie every day. I have really limited my activity as well. The scale goes down almost everyday a little bit. My mind is not as bad as my weight restoration is, and weighing myself everyday because I need to know how bad or good it is causes great stress and then there is my worry and anxiety about being admitted into the hospital.”

“Well Corey, I don’t really use the term refeeding, I think it is like being hyper-metabolized, and I have seen to some degree, not as bad as you, but patients who really struggled with hyper-metabolism and I have read extensively on the topic. I would agree that you are eating some, not enough and we will get to that, but I don’t think your mind is as sick as I thought it would be.. There is a fine line between hospitalization and not hospitalization. You are in the murky zone and I feel and sense your frustration. You can obviously only lose so much before we have to think about an NG tube for feeding. I know your primary care is giving you some leeway but you are continuing to drop. That said I would like  to talk about my idea of what an eating plan would look like for you. I don’t want to step on Amber’s toes I will call her myself today.” I didn’t know if this was good or not. I sat up my stomach was still in fire mood and I had to pee and knew I couldn’t.

Pam handed out three sheets of paper. “This will be it for us today once we get through this,” I was relieved it didn’t seem like the hospital today was going to happen. Pam explained the sheets. One was recipes for the crockpot that met all my nutritional needs in one meal. The second was a sheet with a list of the different food groups accompanied with weeks. The third was another food history that Pam also wanted me to fill out.

“Obviously these sheets are pretty straight forward. I know you are recording your intake for Amber but I would like you to do it for me as well. The sheet we need to discuss is food groups with the numbers and  the weeks. You are not even eating at week one level. So that is our goal. I would imagine including your smoothie you will work on reaching week one levels  for two weeks. Does that seem acceptable to you?” “Yes, two weeks to get to eating at week one levels.” I answered. On top of that I have one more sheet you will need to make lots of copies of. It is a food attitude/ED thought sheet that you need  to fill out everyday. Pam asked if everything was clear. I said it was. I asked her about the hospital and any advice she could give me.

“Corey you are going to recover. If you need the hospital we will do it because the goal is complete recovery. “I would also like you to work on a paper now of Radical Will. I know I am throwing a lot at you but I already know you are ready and willing. That will make the difference Corey!” Stephanie asked Pam about getting more recipes for nutritional value. Pam was more than happy to indulge Stephanie with recipes.  “Okay well I think this was an excellent session. Having Stephanie join you Corey is a big step. I will see you at our standing time next week.”

“Thank you Pam we said in unison.” We walked out and I ran for the bathroom. I felt really emotional. We got to the car and I started to cry. Doubts of failing danced all over my soul.




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