Educating Myself on Osteoporosis

Osteoporosis: A medical condition in which the bones become brittle and fragile from loss of tissue.

It is one of the common effects of anorexia nervosa. I know that I have osteoporosis - in fact, I've known for a while; ever since I've had a BMD (Bone Mineral Density) Test completed back in the middle of October while I was still at the intensive station. Yet it is only know that I have become curious and have looked further into the matter as the doctors sent me to the orthopedic station at the hospital today, in hopes of figuring out whether my osteoporosis is improving and if my daily calcium tablets are sufficient. 

The orthopedist was very informative and gave me an entire lecture on the causes of osteoporosis and what needs to be done; it was almost like being back at school, hearing a teacher explain a certain topic - the only difference was that I actually paid attention. Before his disquisition, he quickly glanced at my medical history and the tests that I have done, only to inform me that I have the bones of an eighty year old grandma or so. Great, I thought - just one more thing that anorexia nervosa has given me. He reassured me that my osteoporosis can improve with the right treatment; thank goodness. Basically, according to this article - which sums up what the doctor informed me on nicely - 

Anorexia nervosa has significant physical consequences. Affected individuals can experience nutritional and hormonal problems that negatively impact bone density. Low body weight in females causes the body to stop producing estrogen, resulting in a condition known as amenorrhea, or absent menstrual periods. Low estrogen levels contribute to significant losses in bone density.

In addition, individuals with anorexia often produce excessive amounts of the adrenal hormone cortisol, which is known to trigger bone loss. Other problems – such as a decrease in the production of growth hormone and other growth factors, low body weight (apart from the estrogen loss it causes), calcium deficiency, and malnutrition – contribute to bone loss in girls and women with anorexia.

The outcome of the meeting with the orthopedist was basically that since I also suffer from amenorrhea, which is one of the causes of osteoporosis, that I should first see a doctor at the gynecology station and then come back with the test results from there.

Although it was a very informative day, I wasted three hours of my precious time today, running around the hospital or sitting, waiting patiently to be called up - and the end result? nothing.

Hopefully I will get some answers regarding my amenorrhea and osteoporosis next week; we'll see.

First Night Leave During the Week

As was discussed - and mentioned in this post earlier - with the doctor in charge of me last week, to help ease my transition back into the real world, I would be given night-leaves during the week.

Well, yesterday to today marked that first night-leave during the week - there's a first for everything! Although I had to be at the station for all my meals on both days, it's a start. I had to be back this morning at 8 am; just in time for breakfast. But that wasn't a problem for me as I am an early riser, waking up as the sun slowly ascends over the city and the first signs of movement are heard on the street - a sign that the busy day ahead has set into motion. This time, the night-leave was solely for sleeping at home and being able to enjoy a good night's sleep in my own bed during the week.

Since everything worked out great and I was here for all meals, I am hoping that for my next night-leave during the week, that I might be able to have a few meals outwards - maybe dinner and then breakfast to start with. I'm hopeful; I have to be. It's always good to remain positive.

I'm Back In Charge

Weigh-in days are never something I anticipate or look forward to in the slightest, like I would when meeting up with someone I haven't seen in a long time or Christmas Eve when you're about to open up your presents. All morning until 7.15 am, when I am weighed, I am anxious beyond belief - Was it enough? Did everything work out? Will the result be positive? These thoughts circulate in my mind consecutively until I know for sure and see the result, a definite answer. I do not need to wait for the doctors round later on in the day to figure out whether or not the weigh-in was a positive experience as I myself know whether I gained weight, stayed the same, or lost weight. 

This time, like always lately, everything was positive. Not only that, but I overshot the weight that the head doctor said I needed to reach in order to drink my supplement drinks on my own again without supervision. Finally; I couldn't have been more relieved this morning upon seeing that number. Knowing that now, after two weeks - or longer, even - I am in charge of my supplement drinks again, not the helpers. It was that sense of relief one has upon having a graded paper returned and seeing that it has been completed with excellence - pure contentment. 

Now I am finally able to be in charge again, not only of my meals but of my supplement drinks as well. For the past weeks I had to consume my supplement drinks just after finishing each meal - not only was it extremely uncomfortable for my stomach to drink them straight after my already substantial meals but having that many calories all in one go isn't the best for my mentality either - but that never stopped me. It was just harder than it had too. Now that I can decide when to have the supplement drinks, I can have them in between my meals as snacks so to say.

Everything's looking up.

Reducing my Medication

It is never good to be completely encapsulated with drugs of whatever sort - whether they be antidepressants, tranquilizers, neurolepticas, mood stabilizers, hypnotics, nootropics or anti-dementia drugs. There are endless possibilities to the type of drugs that would suit you and your current situation. Doctor's assign us drugs to make us feel better and sometimes those medications can add up and all of a sudden, you are faced with multiple drugs in the morning, at lunch, in the evening and at night. Drugs are a superb development as they really do help one.

What I'm trying to say is that initially, drugs that you are specifically prescribed for by the doctors are essential and necessary. They enable us to feel more at ease and help stabilize our mood, thoughts, and emotions. Yet sooner or later, I feel that it is important to not be dependent on drugs anymore in order to feel 'okay' and 'normal'. It should be one's goal to ultimately not need these drugs anymore to be content and in the right place mentally.

For me, I started out with a vast array of medications - ranging from antidepressants to mood stabilizers to neurolepticas. And I can't forget my Vitamin D and Calcium tablets that I receive three times daily as my body is still lacking those nutrients. Now I do not count those as medications per say, since they are something you can buy at your local drugstore and a presecription isn't necessary.

Since today, I only receive one drug - and that is to help me fall asleep. It has already been reduced to the minimal dosis which I am thankful for. It was decided at yesterday's doctors round that I would be discharged of my antidepressant, that, as a side effect, also acts as a mood stabilizer, starting tomorrow. I received this drug to help with my anxiety and to keep my thoughts in check. But lately I haven't been apprehensive nor have I had any negative thoughts - which is what I told the doctors yesterday. Upon hearing this news, the head doctor agreed with my wish to discharge my last remaining antidepressant and see how it affects me.

Well, I survived the day - no anxiety attacks and no negative thoughts about myself or thoughts about food. I'm quite proud.

Gradual Transition Back Into the Real World

It's frustrating to see people after people come and go at the station while you're the only one that remains. I've been here the longest out of everyone by far and it's still unclear of how much longer my stay here is. My longing to go back into the 'outside' world is so great, that hearing "oh we'll see about that next week" when asking about a possible date as to when I could leave is infuriating - I just want a clear answer. I hate this uncertainty. I just want someone to tell me, plain and simple, what my future at the station here entails, and for how much longer my stay is.

As the length of my stay is still out in the open, I have made arrangements with the doctor that is in charge of me to slowly ease back into natural patterns. This involves:

• Drinking the supplement drinks on my own again without supervision and then having to sit next to a nurse for half an hour while constantly being glared at, like a hawk does when hunting for prey, to ensure that I don't somehow get rid of the calories.
• Getting full night-leave from Saturday to Sunday and eating all meals outwards, except for breakfast on Saturday. I have never done this before but I talked with the doctor and we agreed that this would be the next step - to see if I can maintain, or hopefully even gain weight, when being given full control as to what I consume in two days.
• Eating more meals outwards during the week - mainly dinner. This will be done to lessen my anxiety that arises when I am faced with either having to create my dinner or order something off of a menu. It will be done to show me that eating out, or eating at home, is completely normal and does not involve panic or anxiety attacks.
• I will be given night-leaves during the week - maybe one or two per week - to slowly transition into being at home more frequently.

The meeting, as well as the results that we came up with together, are quite positive. Although I still don't know how much longer I am staying here, at least I know the next steps and that I am gaining even more freedom. I hope everything works out.

A Constant Coming and Going

Chaos - patients, doctors, and nurses rushing in and out of doors, sprinting full force through the station with papers and certificates of discharge for those lucky enough to have departed today. It felt like Times Square does at its peak hour, where everyone is dashing home after a long and stressful day at work, with people switching from one errand to the next completely frantic and in a hurry - creating disorder.

As today marks the first day after the holiday season, it entails that all stations here at the psychiatric ward are now open again and everything will be 'normal' again. The patients that came to my station, 6B, over the break because their station was closed all went back to their original station. Not only did those patients leave, but many were discharged as well; including two close friends of mine. With all these occurences happening today, it's suffice to say that the doctor's had a lot on their hands this morning; the station was in constant motion and there was never a dull moment.

It's always sad to see people leave, especially when I have grown so close with them. It seems that everyone can go home at one point or another; everyone except for me. Excluding my time at down at the intensive station, I have been here at 6B for 9 weeks already, or more - I'm not entirely sure. Out of all the remaining patients here, I have been here the longest and am one of the only people who has no idea how much longer I have to stay. Whenever I ask the doctor's what my close future holds for me, and when I might be able to go home, they simply say, "oh we'll see next week." Hearing this week after week becomes quite frustrating as it isn't a clear answer. Yet there is nothing I can do.

I just need to keep doing my thing and hope that everything works out.

It Seems Like It's Never Enough

Today is friday, which for me means it was yet a further weigh-in day. Another day where I spent the night before eating copious amounts of food to ensure that everything runs smoothly; my anxiety is sky high up until I know the results of the scale and I just don't feel good overall because of all the stress that my weight has on my therapy and 'privileges' here.

The good news is that I gained a sufficient amount of weight from wednesday to today - yay I guess; I keep telling myself that I need to gain weight, that it's good for me, because statistically, according to the BMI chart and all, I am still severly underweight even though I can't always rationalize this as I have already gained so much weight. Yet although I gained quite a lot over the last two days, my privileges were cut short. 

Why? I don't understand. I mean, it always depends on the doctor who partakes in the daily visit when we have them and what their particular standpoint is of the current situation. Today, for instance, I was informed that I would no longer be able to drink my supplement drinks on my own - I would need to take them in supervision again and then sit next to the caretakers for half an hour once the drink has been consumed. Additionally I do not have full night-leave from saturday to sunday like I did last weekend even though I weighed less then. Yes I have night-leave but I need to be in for lunch on both days. Now I don't mind having lunch at the station here, I just can't follow the thought process of the doctors as to why I don't even have the option of a full night-leave from saturday morning to sunday evening like last weekend - same for taking the supplement drinks. Up until today, for the past two weeks, I was able to drink them without supervision. 

Although I weigh more now than I have since the summer, these two 'priveleges' were taken away from me today. Someone please explain this to me as I am finding it incredibly difficult to accept.

Relief

Although the approach I tried to take towards the ultimatum that I was presented with this time as opposed to last was a lot better, it did still cause me a lot of stress. The approach was healthier, yes. But I still struggled in finding a balance between enough food and too much.

Regardless; everything worked out! I gained enough weight so I am able to spend the night at home. I am able to enjoy myself tonight. Tonight will be celebrated. Tomorrow I will write a long post about how last year was for me and the goals that I have for next - you'll all have to wait and see.

I wish everyone a HAPPY NEW YEAR! May all your wishes and goals come true. For myself, I only have one goal for the upcoming year: to gain my life back one step at a time and to ultimately be happy, because if I can achieve that, it means that everything else will have fallen into place.

Another Ultimatum, Really?

Just like for the night from Christmas Eve to Christmas Day, the doctor's have given me yet another Ultimatum for New Year's Eve.

Why? I don't understand why they do this to me. I told them how stressful it was by being given an ultimatum like that; telling me that if I don't gain x grams, I can't stay at home and spend time with the ones I love. Last time I simply stuffed everything I saw into myself to ensure that I would reach their criteria. But the stomach pains that came from eating so much; the mental battle that I faced; the disordered behaviors that surfaced - all of that, the doctor's don't care about those aspects of one's recovery it seems. All they care about is the weight gain. But to me, that's not all. An eating disorder is so much more than just the weight gain as it has a lot to do with one's mentality as well.

I told the doctor's how hard last weekend was because of the ultimatum and how much pressure I put myself under just to make certain that I could go home for Christmas. Although I informed them of the situation and how difficult it was mentally - and physically, as I had severe cramps from all the food - the doctor's did not take any of my comments into consideration. Why? I don't understand.

This time, I am approaching the whole matter differently. I will not have a repeat of last weekend; that was not normal. I will simply eat my three main meals and consume my three supplement drinks as that is hard enough as it is. It should be enough, it has to. If it isn't, then I don't know what I should do as I can't force this weight gain onto me. Weight gain is something that takes time - it doesn't happen over night. It also isn't recommended to rapidly gain weight.

If I can't get night-leave for New Year's Eve I don't know what I'll do yet. But I will make a scene at the station in front of the doctor's as it isn't fair that others get to go home and I can't. All others from the station already know whether they are allowed to stay the night at home; everyone except for me. 

I'm giving it my all, and that should count too.

Eating out of Pure Frustration

Before I begin to compile my thoughts and vent about my boring old life, may I just say Happy Fourth of Advent everyone! It's amazing how fast time flies this time of year - it just goes to show just how much there is to do before the Big Day tomorrow. I can't believe it'll be Christmas Eve!

Christmas Eve; December 24th - that's tomorrow. This is a day that you spend with loved ones. It is a day filled with joy, exuberance and festivities.

For me, it all depends on tomorrow's weigh-in. The head doctor decided on Friday, similar to an ultimatum, that if I don't gain x grams over the weekend, I will not be able to spend the night that is supposed to be so breathtaking - that I've been anticipating all year long - at home. How unfair is that? Possibly keeping me from my family on Christmas Eve. I hate how everything is so dependent on my weight and whether or not I gain y grams every time there is a weigh-in. Weight fluctuates, doctor's should know that too. Sometimes I really do not understand their reasoning.

Therefore I have been doing everything in my power to ensure that tomorrow's weigh-in goes by smoothly. Not only have I eaten my three main meals completely and consumed my three supplement drinks both yesterday and today, I ate extra - out of pure frustration at the world. I don't think I've ingested this much food in I don't know how long. I struggled with my thoughts this weekend - with my disordered behaviors - and feelings of uselessness and simply being 'fat' were not uncommon during this period. I think that it had to do with the guilt that came with eating all this extra food.

I did this all for tomorrow. If they don't let me stay at home on Christmas Eve, I don't know what I'll do - they can't keep me here. 

I really gave it my all; that's all I can do. I hope for the best

It's All Too Much At Times

Sometimes I can't handle it all -

The weight gain, the thoughts, the remarks from others here, all the appointments, the therapy sessions, the doctor's visits. 

Sometimes I just need a break and I was really, genuinely hoping, praying even, that I would be able to spend just a few days over the holiday season that's just around the corner at home with my loved ones. Yet I also know that the doctor's obviously know what they are doing and that I need the time here. I hate these conflicing concepts, but I'll have to get used to it sooner or later as it is impossible for me to influence the opinion of the doctor's. 

In a way, the hospital is my safe place - my haven that I can return to in tough times or when I feel that I am incapable of eating proper meals outside as I get too anxious, the thoughts are too loud, or whatever the reason is. That's all the positives that I can think of right now; but hey, at least I'm slowly starting to get my head around the situation of having to be in the hospital over Christmas.

Gaining Their Trust Slowly But Surely

The last three weekends, I had night-leave from Saturday to Sunday; yet I still needed to be here for a certain period of time. I was only allowed to leave Saturday after lunch as long as I was back for lunch the following day. Up until now, the doctors did not want me to have to deal with so many meals outside of the hospital just yet; as they thought it would be too overwhelming. They were right. It takes a lot of time and patience to get used to eating at home again; or better yet, not in the hospital - regardless of where I eat.

I have consecutively shown them that I can manage fine by eating meals outside as my weight has been progressively going up. Therefore, today at the doctors round, without my having to ask or argue whatsoever, the head doctor simply said that I would have a night-leave pass like everyone else this time - as it is the next step in my recovery process. I am allowed to leave tomorrow (Saturday) after breakfast and only have to return again on Sunday at 8 pm.

What I'll be doing exactly is still out in the open; I might be here for lunch, I might not. Who cares. 

All I care about is the fact that I have proven not only to myself but to the doctors as well, that everything is going uphill.

Uncertain

Uncertainty is definitely the word of the day. I'm uneasy and I don't like it; it agitates me, I get anxious and then I'm incapable of being myself as my whole thought process revolves around this sense of uneasiness regarding my stay here at the hospital.

I had a plan concerning the next two to three months of my life. I thought that I would be dismissed next Wednesday, December 19, along with half of the station, so that I could spend the holidays at home with my family - with my loved ones - and then return at the beginning of January for another few weeks before fully separating from the hospital again.

Yet after the talk I had today with my assigned doctor and mom, everything is out in the open. The doctor said that she didn't foresee this 'break' you could call it for my stay here. She believes that it would be detrimental and only hinder my progress. My mom, on the other hand, has mixed feelings - she isn't sure herself. With reference to my short 'break', my doctor reasoned that I could maybe leave for a few days over Christmas - three or so - and then return; if that is at all possible. Either way, what I can definitely have during the holidays if I stay in the hospital is daily outings from dusk till dawn - or longer, because it gets dark so early, haha, that I just have to return before night time draws upon us. 

We had a very long, deep talk; almost an hour - which, in my opinion, is an extremely tedious time frame for just one issue. We did not arrive at any conclusions, leaving me with this feeling of uncertainty that I dread. I understand her reasoning and the points that she made, yet it is difficult to completely switch my thoughts regarding the subject in such a quick interval as I had wholeheartedly believed that I would be spending the holidays at home, and not in the hospital. It's hard and I don't know what to believe anymore; I am torn between two extremes, in a way.

Tomorrow this will be discussed further with the head doctor, my assigned doctor and myself. I'm scared of the outcome; scared of the unknown. Hopefully I won't be too disappointed with the end result. We'll see.

"Monday Funday"

Normally people dread Mondays as it's the day after the perfect weekend of relaxing and not thinking about one's responsibilities and work. Like Garfield, who hates Mondays with a passion, I generally do too as I always long for the weekend to be drawn-out because it feels so nice to be at home with my mom.

But today was different, today was a good Monday. Everything worked out and was positive even though my mom left to Germany this morning. 

The day started off with amazing news - I gained weight again over the weekend! Which means that all my hard work is paying off. It also showed me that I am capable of gaining weight by myself as well as I spend the majority of my weekend outside of the hospital.

The positivite atmosphere continued all the way through ergotherapy, where I started my next acryllic piece - this time it's for the living room in our new apartment. Ergotherapy is definitely my favorite therapy session as it allows me to be creative and during the therapy, I forget about everything else - not worrying about my body, calories, and food - solely focusing on the task at hand. I eagerly await ergotherapy like a little child waiting for Santa every morning.

In the afternoon, with the help of my grandfather, I managed to accomplish every task that I set out to do - buying my little cousin's birthday present, going to the phone shop as an update didn't install itself, photocopying an article about anancastic personalities that my doctor gave me to read, as well as a quick layover at home to pick up my laundry. It was very productive to say the least, but I didn't stress myself, which is something that I've been working on as I have always been easily stressed and overwhelmed by certain situations.

Although my mom departed once again this morning, this time to fly to Germany, I managed to occupy myself again tonight as I did not have anyone visiting me, which is rarely the case. I went to starbucks by myself as it is more comfortable to read my book there, in a nice, comfy chair rather than the hard, wooden stools that we have here at the station where I need a cushion to sit because otherwise it hurts.

And now it's time for me to say goodnight, after this oh-so-productive and affirmative day, even though it was a Monday, the day I usually dread the most.

Reassurance

Today, I decided it was time to visit one of my good friends down in 4C, the intensive station. I hadn't been in a while and thought that an exchange between us was overdue - it's been six days since I had last been there; six long days where I have grown a lot mentally.

As I am still not allowed to leave the station by myself, I had to come up with a plan on how to get to 4C. Thankfully, another friend of mine from the neighboring station, who was down at 4C the same time as me, wanted to visit the station as well and decided to join me on my adventure.

On our way 'downtown', back to our old home in a sense, we encountered the leading doctor from 4C, who is responsible for saving my life and my fresh start. I owe him so much for all that he has done for me. He was overcome with happiness to see both of us. I hadn't seen him since my dismissal nearly two weeks ago and the changes that I have been through both mentally and physically were clearly visible to him.

His smile today is a symbol of his satisfaction; seeing how well we both adjusted to the new stations and how we are doing. His smile reassured me that I am doing the correct thing and that I need to keep going in this direction.

It's amazing just how much a smile can influence a person. He left me with hope, courage, perseverance and strength to fight on.

Rough Times

Today is just not my day. I lost weight from my last weigh-in on Wednesday. Shit happens. And now I need to deal with the consequences in a more positive way.

Although I've been following my meal plan, finishing each meal down to the last crumb successfully, and drinking all three high-calorie supplement drinks without hesitation because I know my body needs it, I lost weight. How did this happen? Why, I don't understand. Why me? I've been giving it my all for so long, why punish me like this? The answer is simple - I don't understand; it's not rational - it just doesn't make sense.

Yes, weight fluctuates but I don't understand why the doctor's need to punish me for this since I've been giving it my all. Maybe my drop in weight also has to do with the fact that i had a stomach virus yesterday.

Anyway, regardless of the reason behind this shit result, the consequences are unjust - or so I believe. I am no longer allowed to walk around the premises by myself, only with visitors. And I can no longer leave the premises at all. This, of course, ruined all of my plans for the weekend.

I had several talks with the doctor's today regarding this topic, but no one listened to me. They said that there is nothing I can do to change their mind for this weekend until the next weigh-in, that I'll be having on Monday. Hopefully everything will go as planned and I will not have lost any more weight, but will have gained a bit back. I need this and I hope that my body realizes this.

Sometimes are bodies function irrationally, and I need to be fine with it. Not everything always goes as planned.