A Week With Me: Day Patient Edition

I’ve done a couple of these before and they’ve been well received, and since my life is pretty different since I’ve been in my anorexia Day Support Programme I thought I’d do an updated version so you guys can see what a week in treatment is like!

Today is the first day it’s been agreed that I’m allowed to walk to the Eating Disorders Clinic to attend DSP (Day Support Programme). Monday is weigh day which is always hard. We also get weighed on a Thursday but it’s our Monday weight that they use as a marker, so it’s more significant. I arrived on time and after putting my belongings down, went to get weighed. The staff do everything to make it as comfortable and dignified as possible but it is awkward having to strip to your underwear in front of someone in a tiny room. Today it was just one person, but sometimes it can be two if there is someone new. We’ve just had a new student start so I expect it won’t be long before there’s three of us squeezed in the clinic room. Some people find more staff worse, but I kind of feel that if I’m basically naked in front of one person then it doesn’t really make a difference if it’s two.

After getting weighed we went for breakfast. We have three cereal days and one ‘other’ day a week, which is usually crumpets, pancakes or pastry of some sort. Today was a cereal day. There are always two cereals on offer but we don’t know which ones until we go in, and we don’t know where we will be sat for each meal as our place cards are laid out in a different place every time. We have to measure our cereal out into a coffee mug so that it’s level with the top, and pour milk into a measuring jug which gets checked before we pour it on. We have half an hour to complete main meals, followed by a half an hour observation period in which we have to sit still in the lounge and can’t leave. These times are reduced to 15 minutes for snacks.

Our first group on Monday’s is called ‘Open Group’ which is basically a bit of a free for all where we can choose an activity we’d like to do. We have a weekly review every Monday morning at the same time as Open Group so people dip in and out – today we played Exploding Kittens. I was last for my review today. It usually consists of me, my Case Manager, the Dietician, the lead DSP Nurse and the therapist who oversees the programme. It’s basically a time to just reflect on the week and check progress. Despite a big weight jump last week, this week I didn’t meet the requirements, which means I may have to take reflective leave if it continues. I wasn’t surprised I didn’t as I struggled a lot with my meal plan last week, but they’ve given me another week on the same plan to catch up which I was pleased about. The whole team are incredibly supportive.

After my review we went for snack. I had ice cream which I find a bit bizarre still – I don’t think it’s normal to eat ice cream at 11am in January but then I guess nothing about this process is overly normal. After snack we have a short window called ‘Me Time’ which is basically half an hour of self occupying. I’ve been working on an embroidery for the lounge over the last few days so I did a little more of that. I’ve struggled to read there as my concentration still isn’t brilliant and it can be quite distracting with the telly on and people chatting, but I find embroidery very therapeutic. After Me Time we had Peer Support, which is a session in which we talk about how we are and how our weekend has been and offer each other advice and support. It can be quite useful when people contribute and everyone has something different to offer. It’s nice to hear from people who get what you’re going through rather than professionals all the time – though the staff are amazing too!

Lunch time! Today was a difficult lunch for me. Because a lot of vegetarian food is less calorific than meat versions, it sometimes means I have to have a bigger quantity compared to other people. I had what looked like twice as much for the main part, salad, fruit and a dessert which was a big fear food of mine and the first time I’ve eaten anything like it in well over a year, possibly longer. After lunch was the final group of the day: Relaxation/Mindfulness. I love it when they do the relaxation sessions but I don’t like Mindfulness, it’s just not for me. Today we had a presentation about what it is and how to do it but I just find it frustrating. At the end of the day the staff check in with everyone in something called R.E.S.T (Reflective Emotional Support Time). We go around the room saying a good thing about the day, a challenge, and what we are going to do later to help manage our difficulties.

When I got home I went and met my mum at Costa and had my first proper hot chocolate for a long long time! It was scary but I’m proud of myself. When I got home I made my dinner, and also had another recovery win. I’m on 2/3 of a portion for dinner still and I had a ready meal that I knew had the right amount of calories in the whole thing. So instead of letting anorexia trick me into having 2/3 of it, I made the whole meal and finished it! Cara – 1, Anorexia – 0. I really struggled to settle tonight so took a couple of sleeping tablets which helped.

I got to DSP at the usual time today. Today was our ‘other’ breakfast day (the one day in the week that we don’t have cereal), so I had crumpets. I was allowed to roast them and spread them myself for the first time, although the butter and jam is already portioned out which relieves some of the anxiety. After breakfast and obs I had a session with my dietician about ‘free pouring’ (not measuring) my cereal and milk in the mornings. I practiced a lot of times pouring out the correct amount of cereal and milk without measuring it first and what I thought would be easy was actually far more anxiety provoking than I’d anticipated it being. I am worried that I am pouring myself too much of both, and letting go of that control is hard. But ‘normal’ people don’t measure out their cereal and milk every morning, so I need to get used to doing it if I want some freedom and independence back.

After snack (ice cream again!) I did some reading – I’ve currently got Louis Theroux’s autobiography on the go and I’m enjoying it a lot! I met briefly with my keyworker to go through the rest of my care plans, check in my progress and discuss the plans for the week. Tomorrow we agreed that we are going out on my first community leave to Costa to get a hot chocolate. Even though I did this yesterday, it’s still a huge challenge, and this time I have to order it with a higher calorie milk than I would usually get which is scary. Weirdly, doing something once is often less scary than doing it a second or third time.

Our next group is called ‘Motivation Group’. Today I had a choice of letter writing activities. One of them was writing a letter to my body, and a second one from my body to me. The thought of that made me feel quite upset so I chose the option of writing a letter to anorexia, which was still hard but felt manageable. It was difficult reflecting back all the things it’s taken from me, but it’s all the more motivation to continue onwards and upwards. We had lunch together then in the afternoon played Bananagrams and did R.E.S.T.

I went and did my food shop after DSP which is always quite stressful but I got everything I needed, came home for dinner and then did some of my bullet journal.

I woke up on the right side of the bed today. I’m not sure why exactly, but I felt in a good mood and super motivated. In breakfast I poured my milk straight into the glass like I practiced with the dietician yesterday, which was scary but I did it! I didn’t feel ready to not measure my cereal because it was one I didn’t practice with yesterday, but hopefully next time I’ll be able to. After breakfast I had my first community leave. They don’t happen very often due to staffing but the client group is really small at the moment and there are a couple of students so there were enough people to take me out to Costa. We agreed that although having whole milk would meet the calories requirements for my snack, it didn’t feel manageable, so the staff agreed that I could have semi-skimmed milk because being a little bit down on calories was okay as it still meant I was going out and challenging myself. I really struggle with ordering things for myself because it makes me feel greedy, so the staff did that for me. I’m meeting my friends in a cafe this weekend so having two Costa trips has helped me prepare for that. When I got back we had WRAP (Wellness Recovery Action Planning), and I brought my journal in to show my key worker.

Today, as well as all the other challenges, I was allowed to prepare my own lunch. It’s all proportioned but I put the sandwich together and cut up my own salad, which I’ve not been able to do up until now. I actually felt okay about it because it helped me to feel more in control. I was the only patient there by the end of the day so R.E.S.T just ended up being a chat with me and my key worker. I got all my care plans finalised and was allowed to go home a little bit early.

I cleaned my rabbit, Luna, out when I got in then had dinner, a bath, and bed.

We get weighed on Thursday mornings and despite feeling like I’ve done really well this week I didn’t meet the requirements which has made me super anxious. It means that I have A LOT to make up over the weekend. After getting weighed we had breakfast and I made my cereal without measuring either the cereal or milk for the first time which I was really proud of. We had Anxiety Management group this morning where we covered sleep hygiene, then had snack.

In the afternoon I met with my dietician and we went through my food diaries. Overall she said she’s really pleased with how I’ve done over the week and we both identified areas where I can improve. I explained to her how anxious I felt about my weight and she said that by keeping me on the same meal plan for two weeks they knew that I might not gain, but understood that psychologically it was important. I do feel like I’ve made a bit of a mental breakthrough because it’s helped me realise that my weight isn’t just going to continue shooting up at an unmanageable rate, and that my body is starting to trust me again. We discussed increasing my meal plan on Monday but I felt ready to do it from today. I had a couple of 1:1 chats with some of the staff and then left to do a bit of food shopping.

I followed my meal plan to the letter this evening and even added extra in to make up for what I’ve missed out on over the week. I’m still feeling very motivated and I’ve been so incredibly well supported by all the staff this week, they’ve been amazing.

We aren’t in DSP on Fridays, so this morning I got up and made my own breakfast without measuring any of it again.

I think I might be starting to experience something called ‘hypermetabolism’ which I always thought was a bit of a myth to be honest. I’m probably not doing it much justice as an explanation because I’m not sure of all the science behind it but essentially it’s quite common in anorexia recovery for people’s metabolism to go into overdrive and end up requiring a much higher amount of calories to maintain, let alone gain, weight. I’m struggling to work out if that’s what’s going on or if it’s just that I’ve been cutting corners that I’ve not realised which is a real head fuck and is filling me with anxiety.

I had a blood test this morning then went to a Dr’s appointment – she was much better than the last one I saw and has agreed to refer me for a DEXA scan finally (thanks to the persistence of my dietician!) which is good news but brings its own anxieties. I really, really hope any damage I might have to my bones is reversible. I spoke to my dietician earlier to tell her that I’m almost certain I won’t meet the weight gain requirements by Monday and ask her if it’s safe for me to go over my meal plan – her advice was that yes I can go over it if I feel able to but not to sacrifice my mental health in the process.

This afternoon I visited my best friend and her two girls – I always refer to them as my nieces though we’re not blood related! The oldest one is two and a half and is just at the age where she is starting to get really chatty – it melts my heart when she says my name now. On the way home I picked up an amazing recovery ring that I got from Etsy from the Post Office – it certainly got me through a tricky dinner.

One of the most fun benefits of recovery and weight restoration so far is that my nails are growing back! I painted them mermaid style this evening before washing my hair and having an early night.

I had a bit of a terrible sleep last night and was up and down a lot so I feel pretty tired this morning. I’ve done a little bit of house admin then went shopping for food for the next few days. I realised with my dietician that I’ve been automatically buying the low fat/sugar free/diet versions of things when I’ve been going to the shop so I got rid of those today and replaced them with ‘normal’ items. I spent what is an embarrassing length of time in the Sainsbury’s bakery section but finally came away with a regular loaf of bread – to put that into perspective I’ve not bought ‘normal’ bread in over three years.

This afternoon I met up with my work friends for the first time since I went off sick. The version of me that they spoke about feels like a different person: grey, lifeless, irritable, snappy and miserable. Today they told me it was the first time they’ve seen me genuinely smile in months, and that there is life to me that there wasn’t before. These are the moments that in my dark days I need to cling onto – that I am becoming myself again. I ordered, and enjoyed, a hot chocolate and their wonderful company. It’s so heartwarming to hear that other people are seeing the real me returning.

After two years of having a broken one we also finally got a new dishwasher today which is exciting! After it was installed I did my usual routine of dinner, bath and relaxing in front of the telly.

I was up pretty early this morning. I was due to go to the Anti Diet Riot Fest today and I was SO excited about it but my energy has been through the floor this week – I’ve been asleep by 8pm every night – and it would be such a long day including travel that I just didn’t think my body could handle it this early on into recovery. I’ve kept myself pretty busy all day though making lots of stock for my shop, getting some orders ready and making a couple of jumpers for myself which I might end up listing at some point.

There is a treatment for anorexia called MANTRA (Maudsley Model of Anorexia Nervosa Treatment for Adults) which is relatively new and is a manual usually delivered by a therapist, but I bought myself the workbook and started going through it today. One of the first exercises is to write two letters to anorexia, one as though it is your friend and one as though it is your enemy. It was emotionally very difficult to do this and I actually found the first one harder which surprised me. I guess it’s difficult admitting that there are positives about something that is so destructive, but everyone’s eating disorder serves a purpose for them. I’ve decided that instead of opting for MANTRA, because I can do a lot of the work by myself, I am going to try CBT again when my 1:1 therapy starts up. I really like my Case Manager and hopefully it will be him delivering it, and sometimes the relationship is the most important part of therapy.

I feel really, really anxious about tomorrow because I’m not sure I’ve gained enough weight over the week and it’s weigh in in the morning. I’ve tried SO hard this weekend so I’m keeping everything crossed.

Wish me luck!


Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s