Monday, July 9, 2012

Longest post maybe ever. Injury, benzos, and life

I write this as flat on my back as I can be an still see the computer screen. While engaging in perhaps my current favourite activity – squash – I incurred a back injury. The doctor says it's just a pulled muscle and fingers crossed that he is right. This is day 3 spent mainly horizontal and I'm getting rather restless.

However, there is an abundance of lessons to be learned from this situation and it has given me much to write about.

I have focused as of late on writing mostly about concepts and thoughts and thought patterns and steered clear of very specific personal experiences but today, I'm going to share some specifics. They will all come together but let's start with some background...

About a week ago, I had my first panic attack in a long time. It seemed to come out of the blue on that particular day and instead of reaching out to those I have available – as effective as I know that is! - I reached in my purse and sought out my small stash of Xanax. I sat in the sun and let it dissolve under my tongue and said to hell with trying to figure out why I was panicking, to hell with talking it out, I wanted to escape it. It took the edge off. I attended my scheduled lunch with a smile on my face and a spring in my step. By evening, I was more depressed than I've been in about 5 months. When I thought about it, the last time I was that depressed was after I took Xanax to ease flight anxiety. I thought to take another because that would numb the depression or at least put me to sleep as I am much more sensitive to these drugs since I detoxed and came completely off them. I didn't take another. I weathered the low mood and slept naturally. The next day, I panicked again and chose to call someone and got through it. The rebound depression and anxiety have finally reached a point of not being worth the temporary escape of benzos because without regular use, those medications hurt my mood (and me!) more than help.

As I usually do, I needed to learn that lesson the hard way again.

This will all tie into my back injury....bear with me.

Later in the week, I came to the conclusion that I needed to hand over my small supply of benzos. I needed to have them out of the house so that not even in a moment of “weakness” (read: desperation) would I resort to those to numb out and escape my feelings. And I did just that. I felt a bit sick to my stomach as I slid the bag across the table to my counsellor. She said she was proud of me but I wasn't proud of me. I was scared. As that day went on, I developed pride in myself and realized, that I would be okay. More than okay!! It was my first time in years not having “something” on me. Even if I didn't take what I had, I always felt I had an escape if I needed it. As someone said to me that day, “You don't have 'nothing' now, you gave 'nothing' away. Now, you've really got 'something'” And isn't that so true...

Insert song: “I've got the Power”

Written out, it seems like a bigger event than it really was. I went on with my week and didn't think much about it at all.

Come Saturday, I had all but completely forgotten this event. I headed to my squash game eager as always. Within 10 minutes, I made one wrong move and suddenly couldn't stand quite erect. We called off our game and I hobbled home. I spent the day on my back but about 6 hours later I had to call someone and ask what I should do as my Tylenol and Advil were not touching the pain. I went to the hospital and spent some hours in emergency. They gave me numerous medications by mouth and IV. Nothing helped there either but I became impatient (the bane of my existence), clenched my teeth and moved around with a smile and said I was fine. The very kind (and young and good-looking) doctor handed me some prescriptions and sent me on my way. Three drugs to pick up. The third on the list: Valium.

I think I actually laughed out loud when I read that. Was this really happening? Had I not just handed over my benzos two days earlier so that I would NOT have access to them??

Granted, diazepam is a muscle relaxant and I understood why he was prescribing it. I had a choice: fill it, don't fill it. I filled it. The pain needed to be controlled and I was willing to try anything. I had to do a quick check with myself prior to going to the pharmacy: was I really safe to have this? Would I use it appropriately and only as long as needed? The answer was a sure yes.

I made it through the rest of Saturday alright, flat out on the couch and eventually my bed. Awoke Sunday in worse shape. As the day wore on, the pain was not so much the issue.

Enter: familiar negative thoughts.

I need to adjust my caloric intake because I am laid up completely.
Maybe I just shouldn't eat at all.
I should walk at least. Walking is good for back injuries isn't it? You need to move somehow. You've going to gain a lot of weight if you stay like this for very long.

On the flip side, my logic and true side fought a good fight:

You need to not only honour your hunger cues at this time because they may be skewed or impeded by the medication and distraction from the pain. You need to continue eating on a schedule if need be for the next while.
You need food to heal. Healing takes energy, you need to fuel your body so that it can heal in the most efficient way.
Walking will be good when you are past the acute stage of this injury. For now, the degree of discomfort is telling you to rest. It is okay to rest.

And so on. The battle waged in my head all day but I fought for the good and right. I treated myself as I deserve to be treated. But it caused me so much doubt:

Had I only been okay with eating how I do because I was exercising?
Do “normal” people adjust their intake based on their activity?

I know the answer to the second question. Of course, people who have never had an eating disorder eat according to activity level but I would say most often they eat more on days where they have been very active and otherwise maintain a consistent intake. It has been a wonderfully “normal” thing to happen to me where my appetite rages on days when I expend a lot of energy and it makes sense. It is a blessing because I believe it indicates that my body is working much better than it has in a very long time, if not ever. This hasn't worried me up until this point.

I had to look objectively at my exercise. I am not a maniac and I only do what I enjoy. So no, my eating has not been justified or made to be okay in my head only because of my level of activity.

When I look at my history, my major relapse, the one that really took me down as an adult occurred after sustaining a patella fracture and sprained ankle. I remember the anxiety of being so immobile. It took that one event to send me into a spiral. I have spoken about this in my sessions: what if that happens again? Maybe not specifically an injury but some other event that compromises something that keeps me okay? What then? Is that why people relapse? Will I relapse?

Until now, I felt solid in my ability to fight anything negative even in these hypothetical situations. I thought, of course I won't relapse, I am stronger than that and I know what I need to do to take care of myself and engaging in the eating disorder will not help me in any situation.

So here comes the silver lining of all this: I am having an experience right now, however uncomfortable, of a challenge that I may face in the future when I am completely away from any sort of program, when I am deemed well and recovered. I have the support here that I can reach out to and ask “what do I do now? How do I take this on? How can I expedite my recovery and maintain my emotional progress”. I have the wise people very accessible to me now to help me help myself get through this.

The reality is, I actually do not necessarily know how to take care of myself. This extends from this simple injury with which I have no experience to the rest of life. I have been absent from real life for a very long time and prior to completely escaping most of life (ie. Work, relationships, etc.) I was very irresponsible, reckless even, and did not treat myself with the respect and kindness I deserve and that will ultimately keep me well.

I struggle with the fact that much of the world sees people with eating disorders, when finally behaviourally well, as having all the abilities to carry on with life. Like it was merely a hiccup and one can just get on with things. Not entirely true! When one has been sick with an ED, not only those deemed “chronic” but anyone who has kept their emotional selves “protected” by engaging in eating disordered behaviours, despite how much of their lives appear(ed) intact, there are some major skills that are missing.

I could hypothesize about dealing with an injury but until it actually happened, I couldn't possibly actually know how I might react and how I did has been a big wake up call. It indicates to me that there is still a little jerk in my head that is waiting to bring me down and I have work to do to really get rid of it.

The same goes for wanting to go to school, go back to work, have a relationship, etc. Of course I and many people working towards and entering recovery want these things. We may have even engaged in them prior to becoming acutely ill or receiving treatment. After treatment, particularly after being active in treatment and making the painful changes one does, one is a very different person and despite having held down a job or been in school or been in a relationship, the experience of these things changes as much as we do.

Perhaps I should switch back to “I statements” and stop speaking for everyone. I have more than my own experience to base these thoughts on but I will keep it personal.
I had a great job. People were wowed that I was 21, living on my own in Vancouver, working at a giant hospital, and eventually doing all that and being in school and working towards a degree. Let us think for a moment: I had/did all those things and eventually broke. It didn't happen overnight. It wasn't just the broken knee that caused me to relapse. I wasn't “coping” throughout those years that I appeared to have it all together. Is it not only natural to have some fear of entering into these things again?

Consider falling off a horse. They say to get back on as soon as possible. When I fell off the metaphorical horse of life, my illness made it impossible for me to get right back on. Completely literally, after I fell off a horse when I was around 9, I didn't get back on for about 4 years and certainly not with any confidence until just last year! When I fell out of life, had my life torn from me and become 100% eating disorder (my job, my leisure, my relationship), my health made it impossible to get back into work or school or have a meaningful relationship.

Here I am more than four years of being full time anorexic/bulimic (with the 5 adult years of “functioning” after adolescent treatment) and I am nearing the time to re-enter life. Time to consider work and school and being an active participant in friendships and family life. I have never done any of those things AND taken care of me. It might seem inconsequential to a well person who has always considered themselves and held themselves in high enough esteem to have this be natural. For me, real life nearly killed me – literally. I cannot expect to be completely fear-free regarding returning to the real world. Yup, it makes me a little nervous!

So yes, I panic about it sometimes. I cry and I get scared. Does that mean I'm going to relapse? Absolutely not.

And back to the injury and what I am learning from it. I had a familiar negative war in my head for two days. That scared me because I thought I was over that. I thought the ED as related to food and activity was gone and that I just had to practice my skills of living and facing what I believed I was afraid of and treating myself with respect. Apparently that is not it just yet.

I am so grateful that this happened now. Not that I am laid up on my couch for an indefinite while but that I have this opportunity in this still somewhat protected environment to access the second opinion or reassurance I need. And, to have that all the while seeking out that same support in my real life people...that is a challenge mostly because of the distance between us.

I guess ultimately, I do know what I need to do practically, I just need some external soldiers to help me fight for what's right. And don't we all? I don't think there is one person who takes on life completely on their own. We all need people to bounce ideas, fears, concerns, off of. I realize my task in the near future is finding those people in my “real life”. I know they are there and I guess a consequence of being more active in my relationships will be asking for those people's support and input also. Not only asking, but listening. And that takes courage and humility on all parts. I'm eager to give that of myself and my bigger job is allowing myself that need.

The injury is also an exercise for me in patience with myself. I recently heard a quote: Patience is not the ability to wait, but the ability to have a good attitude while waiting.

Isn't that just the case and certainly a pressing task at hand for me.

So, with that, my back is requesting a change of position so I will sign off with a commitment to being patient with me; to suspending judgement for not being 100% “there” yet in my head; to letting go of the fear that I am destined to have these thoughts and doubts forever; and allowing myself the knowledge that a little fear at this point is completely normal and understandable and that in time, it will fade. And most importantly, that all things that I feel are okay.

I want to extend that ever present hope to anyone reading this. It takes effort but it gets better and I'll tell you what it's like when I'm there.

With love.

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