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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Racer on November 28, 2004, at 11:56:53
Well, now that we have a board for problems or issues around eating, I guess I can whinge about my issues, huh?
Let's see, I'm finally getting treatment for my eating disorder, and it's pretty intense. I'm finding all sorts of issues I didn't even know I had! Not only the obvious issues, like feeling as if I've tripled in size over the past few weeks, but some things unrelated to food.
The newest came up around the nutritional counseling. The RD recommended that I see her once a week, to start, but I said, "Naw, how about seeing you just once or twice -- that should be enough for me..." Of course, by the following week, I knew that I should have scheduled that next appointment for one week, because I really needed the support and the information she could have offered. (My next appointment is tomorrow, so not a long wait.) The real issue, though, is WHY I didn't feel as if I should be seen once a week? Why I couldn't accept her advice, when she is the expert in treatment, and I'm only the expert on starving myself? She knows something I don't know, she's got experience in treating people with this problem, she knows what works, because she's been involved in treatment that works. I, on the other hand, have never been treated for this before -- someone has handed over pills to make me fat, and they've worked. That's the extent of my "treatment" for this eating disorder. Yet, somehow, I feel as if I have to do this all myself, without adequate resources. Why?
I guess that's got a lot to do with the roots of my problem, but it's still bothering me. Why can't I accept help when it's offered to me?
On top of that, there's the issue about my scale. I won't give it up, especially since it's telling me that things aren't nearly as bad as I think they are. I *feel* as if I've gained a dozen pounds -- or more -- in the past week, and I'm afraid to get on the scale. When I do get on the scale, though, it shows that I've only gained six or seven pounds all together, and only two of those in the past two weeks. But I still feel humongously fat. And my mood is sinking, as I eat more and more. I feel so out of control!
OK, that's a good enough start for today.
And thank you, Dr Bob, for creating this board. I look forward to the support and information I'll find here.
Posted by Noa on November 28, 2004, at 13:02:57
In reply to My story, and I'm sticking to it, posted by Racer on November 28, 2004, at 11:56:53
Racer, I'm glad you are finally getting the tx for the eating/body image problems. It sounds like you do need the frequent support. It sounds like it will involve accepting the experience of loss in terms of giving up the need to stay underweight or the need to deprive yourself of food. Plus your body has gotten used to the patterns you've been into for a long time.
You are brave. You called it right a long time ago and I'm so glad someone finally listened to you.
Posted by Racer on November 28, 2004, at 14:52:51
In reply to Re: My story, and I'm sticking to it » Racer, posted by Noa on November 28, 2004, at 13:02:57
You have, as well as everyone at 2000.
(This is actually an off topic post, dear. I just want to say thank you, and to send you my warmest affection.)
And by the way, I'm not feeling well today, so I'm gonna go lie down, and maybe have some hot cocoa, since I understand chocolate has almost supernatural healing properties. Or maybe chocolate doesn't, but you don't care so much because it tastes good?
Posted by CareBear04 on November 28, 2004, at 16:35:49
In reply to My story, and I'm sticking to it, posted by Racer on November 28, 2004, at 11:56:53
hey racer,
i hear where you're coming from, and i'm glad you're getting help and that someone is being aggressive about wanting to help you.i've lost about 15 pounds in two months, some due to adderall appetite suppression, some due to frequent lithium toxicity, and a lot due to a throat laceration from an endoscopy that made it really painful to swallow. with all this, my GI motility has really slowed down, so when i do eat, i get bad stomach cramps. since increasing my intake significantly, this has gotten better, but i still can't handle very rich or flavorful foods, even ice cream which has always been my staple food.
during a hospital stay a few weeks ago, they diagnosed me as having anorexia as my primary disorder. my family and my present and previous doctors told them that i've never had disordered eating habits, that i've always been small, and that i've never binged or purged. still, i did fit the profile of an anorexic-- very low prealbumin (though albumin was normal), body weight much under 85% of ideal, excreting large amounts of ketones (i guess showing that my body is burning up fat because of starvation), and hypoglycemia, and body fat percentage of 10% or less. there are a few criteria that don't fit-- i'm still having periods, though they've always been really irregular and sometimes infrequent, and i'm not intensely afraid of gaining weight. starting in late september when my appetite shut down and i started losing weight, i talked to my doctors-- my primary care dr, my GI dr, and my psychiatrist-- and with the exception of my psychiatrist who gave some practical advice (flaxseed oil, odwalla juices, smoothies with boost, etc), they told me to just eat whatever i can and not to worry. i tried to see a nutritionist, but my insurance doesn't cover anything relating to nutrition (which also makes me mad because nutrition is central to health), so i was more or less on my own. that's why i think it's great that you at least have access to a nutritionist, and she wants to help enough to see your once a week. i'm upset that i asked my doctors for help early on, and they let it go this far to a dangerous point. in the hospital, they told me stuff like that my brain and heart are shrinking and that i would become infertile and break bones and such. i don't know if those were scare tactics or whether they're true. my psychiatrist said that they're risks of long-term malnutrition, but that since my problem is recent onset, i should be okay.
i'm pretty sure that i don't have an eating disorder, but there's some doubt in my mind. when they suggested restarting zyprexa (which caused me to gain about three pounds a week), it scared me. it could be that i don't want to be that sedated and zombie-like again, but even though i want to gain weight, it's really disconcerting to gain weight that fast and for reasons not explained by appetite increase. i think it also affects metabolism. does that qualify as intensive fear of gaining weight? also, what i know about anorexia is that it's usually a long-term disorder. i've never had it before, and the labs indicated recent onset and dramatic weight loss in a short period of time. does anorexia ever come on suddenly, or does it develop and get worse over time? it made me mad, too, that if the doctors really thought i was anorexic, then they should have taken the opportunity to treat it aggressively early on before it became ingrained. instead, they discharged me without plans for nutritional followup and despite the fact that i lost lots more weight in the hospital even though my intake increased a lot. when they took me off IV fluids and dextrose, i lost about five pounds in two days. after leaving the hospital, i kept losing weight even though i was eating and hydrating as much as i could. then, after i reached the lowest point, i gained several pounds in just a few days. but since then, i've hit a wall, and i'm not gaining any more and am slowly losing some back. i think my body has adjusted to more food and my metabolism has sped up, but my appetite hasn't increased as much and my digestion hasn't improved by enough either. my biggest worries right now are heart arrythmias and cognitive problems and also constant bone and joint pain. i don't want to develop osteoporosis so early in life. do you have any suggestions for any of these things?
i'm so glad you posted with your situation and experiences, and i hope you'll keep posting with updates. would you mind sharing what your history with the disorder has been like and how your doctors have responded? if not, i understand that it's very personal. thanks again! cb
Posted by tryingtobewise on November 28, 2004, at 22:43:46
In reply to My story, and I'm sticking to it, posted by Racer on November 28, 2004, at 11:56:53
Hi Racer, Noa & Carebear ~
Racer & Carebear, thanks for sharing your stories. It is good you are getting help & I can understand the resistance to accept adequate & abundant help. In my case it is a basic resistence to the idea that I need help.
My story is this:
Diagnosis of cyclothymia & ED NOS (which I guess is Eating Disorder Not Otherwise Specified). I take Celexa & Lamictal. My weight is slightly above normal. My ed issues are that I a) have great difficulty eating meals. They make me feel too fat & "heavy" even though I definitely consume way more calories eating small amounts of sugary stuff all day long. b) I can't eat anything that tastes salty -- makes me worry too much about water retention. Even though I've never actually had much of a problem with water retention other than years ago when I was on the b.c. pill. c) I easily get obsessed with the scale and will weigh myself 20+ times a day. d) my fear of things that taste salty result in a desire to consume only "sweet" things.So yes, totally illogical & strange but because I don't starve or purge, it is difficult for me to view this as a disorder & not simply accumulated bad habits.
Thank you for sharing your stories & taking time to read this.
Kim
Posted by Bobby on November 29, 2004, at 8:02:00
In reply to My story, and I'm sticking to it, posted by Racer on November 28, 2004, at 11:56:53
Periactin(cyproheptadine sp.?) It's great for increasing appetite and it's not a psych drug--Ben and Jerry beware!
Posted by Racer on November 29, 2004, at 9:21:49
In reply to Ask your Dr. about, posted by Bobby on November 29, 2004, at 8:02:00
Believe me, I'm very familiar with cyproheptidine.
The problem is, anorexia is not about lack of appetite -- I know I'm hungry all the time, and obsessed with food. Right now, I'm increasing my intake, which is very frightening, and it's difficult because I get overstuffed and nauseous when I eat more than two or three ounces of food. The dietitian is working with me on this, and on increasing my intake sensibly.
The psychological side is the problem, despite the food being the most obvious sign of it. Thank you for the suggestion, which is a good one for non-psychological lack of appetite.
Posted by Bobby on November 29, 2004, at 9:34:30
In reply to Re: Ask your Dr. about, posted by Racer on November 29, 2004, at 9:21:49
Sorry, i didn't think of the Psychological aspect--duh? I'll tell you what worked with me---a bowl of Haagen das vanilla ice cream with chocolate milk stirred in with it. you don't need to eat alot at one time. Of course my cholesterol went through the roof--but I gained just enough. Hope this helps but then again I'm not a professional. Good luck!
Posted by shrinking violet on December 2, 2004, at 10:56:51
In reply to My story, and I'm sticking to it, posted by Racer on November 28, 2004, at 11:56:53
>> Why can't I accept help when it's offered to me?
--That's the question of the century, isn't it? I have the obligatory "treatment team" of a nutritionist, medical doc(s), and a therapist. All of whom are extremely personable and caring people, especially my T; she has gone above and beyond what she should with me. But I fight them all the time. I don't want to, I don't want to be "difficult" or resistant, but I'm not sure why I am. I get angry very quickly, I get defensive. And I put my ED first, always. I don't try like I should. My nut. gives me a meal plan and emails me and tries to battle some of my thoughts, but, I get home, toss the paper on my desk and don't even try to look at it again. I give into the fear and the thoughts all of the time, and I'm not sure how to do it any differently.Sorry, I wish I had some concrete advice for you. You sound like you do want help though and that you are realizing that you can't do it alone, and that your choices may not be the best ones as you'd probably choose for your ED first and not yourself. Try to trust your nutritionist and let her help you. Good luck.
SV
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