The ol' bathroom on M4

 Today I was feeling nostalgic. I was also feel very very very sad and very full of self-loathing. These feelings came together in a productive way: I sought out and found the nice, out-of-the-way (and thus, rarely used and comparatively clean) bathroom that I often puked in back in the early 2000s, when I worked my first job. Back then I was so effin thin and young and full of hope (well, not consciously, but looking back, I should have been). Now I am nothing but an old wreck, a vacant dilapidated void of a person (who, ironically, is being suffocated in fat).

 I had a darn good hurling session. I hurled the requisite 8 times. The hurling activity did not yield a particularly copious amount of fluid as I hadn't ingested much, but I still left with that delightful dizzy feeling. 

"The dizzy dancing way you feel/When every fairy tale comes real" (Hole? JoniM?)

"....so many things I should have done but clouds got in the way"

Sometimes

 I just cannot.

art?

Dr Happy and the busted kidney

I have been experiencing lower back pain since the beginning of May. I figured my years of poor posture had finally caught up with me, and the fact that I sit in a chair for 8 hours a day 5 days a week does not help. But the pain had been manageable. I was still able to do my morning crunches and to go about my day. However, over Memorial Day weekend, the pain got much much worse...like, curl-up-on-the-floor-in-a-fetal-position worse. That Sunday in church, it was exceptionally painful for me to sit and stand (anyone familiar with Lutheran church service will know that you can get a good workout during a typical service, what with all the sit-stand-kneel-stand-sitting that goes on). I took a nap when I got home. When I awoke, I was in even more pain than before. In addition to the back pain, I also felt a sharp piercing pain that moved from the umbilicus to the xiphoid area. I assumed that my belly button ring had snapped open and pierced through my layers and layers of gut flab, resulting in peritonitis. I tried to remain calm and breathe in and out, and wait for death as peacefully as I could.

After a good 30 minutes, realizing death was not imminent, I decided to try to stand. I had to slide off my bed and sort of crawl up the wall to a standing position. We were having some neighbors over for a bbq that afternoon, and I had to go downstairs and help my hubby with the preparations, or at least be sociable. But I could not completely mask my pain (back AND front pain now), especially since it caused me to contort into some odd positions. The neighbor ladies- all in their 50s and up- quickly came to the consensus that it was gas (the ventral pain at least). Once they decided this, the conversation proceeded to take a disturbingly scatological turn (I mean, we were gathered around a table about to eat); it started with their recommended remedies for my gaseous situation (peppermint tea), and branched out to descriptions of their colonoscopies, the pros and cons of various bowels preps, and a slew of other digestive system topics. Fortunately I found a not-too-long-past-the-expiration-date box of gassex in the medicine cabinet and popped a few of those babies, and eventually the sharp umbilical-to-xiphoid pain subsided, thank God. But the back and left flank discomfort were still present. A few hours later, I popped some Motrin, but it did not help.

The next morning, my back/flank pain was even worse. It was so bad that I was actually in tears. I couldn’t bend, nor could I stand. Once again, I had to slide out of bed and crawl up the wall to stand. [Ever try crawling up a wall? I felt like the kooky chick in that Charlotte Perkins Gilman Story.] My morning was spent twisting and contorting, moving from the couch to the living room floor and back again, desperately trying to find a position that would relieve the pain. Since it was Memorial Day, I knew no doctor's office would be open and I would just get a recording. And, oh yeah, I didn't even know what kind of doctor to call- chiropractor? osteopath? Sports Medicine dude? I did a perfunctory google search for a “back pain doctor” in Manhattan. One such place had all-positive (4 or 5 stars) Yelp reviews. To my utter shock, when I called the office an actual living breathing person answered the phone. I spoke to this nice lady, and she took my info and said the secretary would call me the next day to schedule an appt. Before 9am the following day, the secretary called (she was a nice gal named Melody).

 

I originally scheduled an appointment for the following week, but fortunately there was a cancellation and I was able to see the doctor* the following afternoon [*chiropractor, but he refers to himself as "Dr. ___"]. So that afternoon I showed up at the fancy pants office at the appointed time, and was seen promptly. ChiroDoc brought me into his office, which was decorated with photos of his lovely children and stock photos of ballerinas. I explained my symptoms. I was in just as much pain as I'd been all weekend (ie, A WHOLE EFFIN LOT). I was twisted and hunched at the same time, and had my arms pressed firmly against my sides to sort of brace myself against the pain. “Are you in pain now, dear?” the savvy doctor asked, and I replied yeaahh-uh-huh. We reviewed my medical history quickly. I did not have any significant illnesses to report, nor had I ever been hospitalized (he seemed surprised at this latter point; he said, "Never?!"- no, sorry dude, not all obese old people have been hospitalized yet).

Next came the dreaded physical exam. Let me just say that IT IS NO FUN FOR FATTIES TO UNDERGO PHYSICAL EXAMS. He gave me a robe to change into. I kept my pants and bra on. I don’t know if that’s protocol, but I didn’t care. Revealing my rolls and rolls of back fat was exposure enough for a day.

The chiropractor/doctor had a male assistant in the office with him. I guess he was there just to protect the doctor from rape accusations (and maybe from actual rape too…hey, you never know) because this assistant didn’t actually do anything during the exam. The doc snapped on some latex (gloves) and went to work giving me a perfunctory back poke and prod and neck twist. Oh, and he even tested my patellar reflex with a little hammer which was so cute!- I had NEVER had that done before. I thought those hammers just came in Fisher Price doctor kits. Anyway, the leg on my affected side failed to twitch when tapped. I said, “Why isn’t this leg moving?” but the doctor kind of glossed over it. Then he asked me to put my chin all the way against my chest and try to lift each leg straight. It hurt like an em-effer when I tried to lift the leg on the affected side.

He kept asking why I looked so nervous. I said that this is just how I always look. I also let slip that  "I hate doctors"- but quickly apologized. I really meant that I hate being on the receiving end of medical exams, particularly ones that involve removal of any article of clothing.

 After the perfunctory poking and prodding and tapping, he drew some blood. Yes, the doctor (or whatever he is) drew blood himself!- that had only ever happened to me back when I saw my internist for the first time in 2000. After that day (9/28/00), only bimbolina dingbat phlebotomists have drawn my blood in the doctor's office. (Phlebotomists I’ve had in blood donor settings and in Quest labs have all been professional, but my internist’s office only seems to employ dingbats.) Anyway, the doctor said, “Let’s see those lovely arms!” (hairy fat pale scar-covered appendages are considered “lovely” I guess). I held out my arms and he looked from one to the other, trying to decide which one to puncture. Finally he went for the one fewer scars. Maybe he thought the scarred arm had been through enough, but I would think the opposite would be true: an arm with scars is a SURVIVOR, it has experienced the cold piercing pain caused by an angerly-wielded exacto knife; a dinky little butterfly needle is nothing in comparison). So then the doctor had to consider which vein to use- median cubital or […I forget what the other commonly-used vein is called- lateral cubital?]. I said, “My veins are pretty easy to find” (it's true; my skin is see-through), and he said, “Don’t jinx me now!” har har. Anyway, he got some blood. Several vacutainers of blood, actually. Then I was instructed to pee in a cup, and escorted to the crapper. There was a medical scale in the bathroom (a convenience for bulimics?), and I stupidly decided that I wasn't in nearly enough pain, and I should weigh myself and thus add psychic agony to my general state of misery. I don’t know what I expected my weight to be... well, I expected it to be bad, but not THAT bad. So depressing. I should  have stabbed myself in the carotid with a broken shard of pee-cup right then and there. But alas, I went back outside and handed the (still-intact) cup to the nice medical assistant guy. By the way, the pee-in-a-cup experience brought back fond memories of last summer's Maternity Nursing class; after witnessing one C-section and one vag birth, I volunteered to hang out in the Admissions department for the remainder of the rotation; I took vitals and prepared venous puncture kits, but spent the majority of my time holed away in a tiny closet doing ketone urine dips. 

After my sample was handed over, the appt with the chiropractor was concluded. But not before the avuncular (though really he was too young for that description) doctor dude said, "J___, I want you to do one thing for me: breathe!" I said, "It hurts to inhale." He replied, "Yes, but not breathing will make it worse." Whatever.

After forking over my co-pay, I walked 21 blocks to Lennox Hill Radiology Associates to get the X-rays he had prescribed. The x-ray experience was not without incident. Since it was my first time ever having an x-ray (or any type of scan, for that matter), I did not know what to expect. I changed into the (really nice, blue and white seersucker) gown they handed me.  [This gown was so nice that I was seriously tempted to take it, but I chickened out at the last minute; I was afraid the changing room had hidden cameras, like changing rooms in clothing stores.] The radiology tech lady told me to keep on my underwear but to take off my bra. So when it was time for the scan, I assumed that I had to be totally nude from the top up (it was a thoracic-to-upper lumbar scan), and I pulled my gown open when the poor x-ray tech gal was mere inches from me. She said quickly, “No no! You can keep your gown closed!” (shock & horror were probably overcoming her; to her credit though, she managed to not throw up, even though my gelatinous rolls of flesh were mere inches from her face).

That night, I experienced another episode of severe pain that caused me to roll around on the floor trying to find a position that alleviated it. The fetal position was momentarily helpful, but not totally. My hubbie and I watched old episodes of Da Ali G show, but nothing could make me laugh, not even Borat Visits the South. The chiropractor had prescribed Klonnie (he is also a nurse practitioner so he has a DEA number), ostensibly for the spasms. The Klonnie just knocked me out, which was fine actually because being unconscious is one sure way to alleviate pain.

I experienced pain off and on between last Wednesday and yesterday. Monday night was pretty bad, but not AS bad as the previous episodes, and yesterday and today I feel fine, thank God!



Maybe mah renal cells look like dis!

I saw the chiropractor again on Tuesday. He led me into his office, turned his computer screenso I could see it, and said enthusiastically, “Congratulations! You have a kidney infection!” Just like that, for real. I guess his point was, you don’t have a tumor wrapped around your spine, so you should be glad. I AM glad for that of course, thank God! I wish I had been quicker on my feet and mustered a reaction that had matched his in alacrity: I would have jumped out of my chair and said “YES!!” with fists pumped. But instead I just responded like my usual confused/dazed self. I was actually pretty stumped, because I thought that kidney infections started as UTIs, and I had never experienced any UTI symptoms. Maybe I did have one though, well, I guess I did, I dunno. The chiropractor said that the pyelonephritis was probably the cause of my side/back (flank) pain. He gave me a two-week supply of some hardcore broad spectrums, and told me to come back when I was done with those so I could pee in a cup again. It was kind of funny when he was explaining how to collect a urine sample; he rolled his chair back from the desk and started to open his legs a little- it looked like he was about to demonstrate how a woman would pee into a cup, which would have been horrifying in the moment, but pretty f*ckin funny later. Unfortunately he stopped himself, and just used words to explain.

He also showed me the Radiologist’s report from Lennox Hill. "Also good news!" Even though the 

Picture this gal with many more
layers of flab and ya got me!

report listed diagnoses of levoscoliosis and posterior thoracic spondylosis. There was an ‘m’ word before each of those- minor/minimal, I forget which went with which, but when he handed me the report he said “Key words are minimal/minor!” So upbeat, this guy! He did say that I have the spine of someone 7 years older though. He recommended Physical Therapy. I was pretty hesitant, but he said it would help, and told me that “You’re worth it!” (what is this, a Pantene commercial?). He said the scoliosis had probably been present since I reached my full height. And he said the PT exercises would help me prevent further spine deterioration. He is even having his daughter do these stretches now, and she is 12. He said she is going to be pretty tall too. He gestured to a shelf of photos of his beautiful kids. (No pics of his former-model wife though.) He asked me how tall I was and I told him (6'1), and he asked when I’d reached that height.

Dr Happy also pointed out that my labs show that I have very low Vitamin D. I have been taking some Vitamin D pills that my mom gave me last time I saw her. But he said some people- like me, apparently- just do not absorb Vitamin D well, no matter how much of it they consume, or how many hours they sit in the sun. So he gave (sold) me some high-dose Vitamin D sublingual drops. Meanwhile, I was reviewing the other lab results. I had low MCH but normal hemoglobin, and elevated creat- wtf?? Have my looney drugs and Unisom pills finally started eating away at my kidneys, or is it the result of the infection? Also, I noticed that I had “trace ketones”- another indication that I am diabetic (along with my blood sugar of 95 and my mounds of abdominal fat). Heck, I certainly don’t have ketones due to starvation.

 

So here’s where it (okay, I) got a little crazy. I finally got to the bottom of the lab results page, where the thyroid function test results were listed; they were all normal. I burst*into*tears. You see, I had been hoping that the tests would show me to have hypothyroidism (which my mom has), and that would be my excuse for this weight I have gained since 2012. And then I would just start popping a lil Synth' and hopefully shed the poundage. But that was not the case, thus proving to my fat ungrateful self that my obesity is no one’s (that is, no gland’s) fault, but rather the result of me being unable to stop shoveling foodstuffs into my gaping feedhole. 

When I started crying, Dr Happy was like wtf, and I explained to him why I was crying (cause why not? what do I even care anymore?). He said somewhat sternly that the thyroid has many functions and I really do not want a forked up thyroid, and that his wife has thyroid issues and it is really difficult. So of course then I felt like a total b*tch, but I couldn’t stop crying anyway. The medical assistant guy from the first visit came back in to deliver a prescription, glancing at me in horror (I look even uglier than usual when I am actively sobbing). Dr Happy must have motioned to him while I wasn’t looking, because he left and came back a moment later with a box of tissues. (Side note: why do doctors' offices always have the sh*ttiest, single-ply tissues? Even fancy pants offices with leather upholstery....they can't spend a few more bucks a month on tissues? I used up like half the box of these cheap rags in just a few minutes; then again, I was a particularly hysterical mess.)

Dr Happy was not content to let me lament my fatness in peace. He proceeded to inform me that he also offers medical weight loss treatment with the HCG deit. He explained the diet to me (500 calories a day plus daily shots to the gut). Of course, desperate, I was interested and asked questions. He e-mailed me a link to the book he recommends about the diet. He said that if I seriously want to try this diet, I would have to read the book first, and he would quiz me. As a testament to the diet's effectiveness, he told me that he and his wife lost weight on the HCG diet. And that Dr Oz recommends it. Yippy for them. Beautiful kiddies, and a wife who is a former model and now is some makeover/find-your-beauty-guru who appears on Rachel Ray (I googled them, of course). Even if I shoot myself full of whatever-the-eff HCG is (I just know that preggos produce it, and also that it masks ovarian cancer…and that it has not been shown in any scientific, peer-reviewed studies to contribute to significant weight loss)….yeah, even if I do that, I am still not going to be a glamorous former-model type. So maybe I should just enjoy my peanuts and dried cranberries and forget about it. The end.

Ode to the ruin of Julie

 

Here be a lil collage I made in honor of Kathleen Hanna, one of my favorite artists of all time. She was in Bikini Kill, Le Tigre, and, currently, the latest incarnation of The Julie Ruin. The words are from a Julie Ruin song.

 

12 Things I Hate About Bulimia

I found a really interesting tumblr called "Things Bulimics Hate" and decided to try to make my own list. So here is what I came up with right off the bat. (Doesn't sound like a very glamorous/movie-of-the-week disease, does it kids?)

1. The smell. Even if I scrub my hands and face, the smell of vomit lingers for a long while—maybe it's vomit that got up the nose?)
2. The tons and tons of mucus that flows out of my nose while hurling.
3. Splashback! Especially when vomit (and/or terlet water) splashes right in the eyeball.
4. The TMJ and jaw pain from keeping my mouth open that wide for so long.
5. Having co-workers who overheard me puking ask if I'm pregnant.
6. Fear of rupturing esophagus/aspirating vomit/otherwise having hurling session result in a medical emergency that will involve someone finding me in a very embarrassing position in a public restroom, dead or near dead, and covered in my own puke. Like someone who died of a drug o.d., only fat. Maybe I will have passed out and smashed my fat head against the terlet, so there will also be lots of blood.
7. This fear is especially prominent when I don't drink enough water before and during ingestion- (that is, if I unintentionally binge, and drink a few glasses of water AFTER already eating, which doesn't really help). I try to drink a lot of H2O or seltzer during an ingestion because it makes the E-gestion process much smoother. If I try to hurl without drinking lotsa water beforehand, it is just too difficult- the food feels like it is about to get caught in my throat. If I do the "catchup" method (ie, drinking several glasses of water AFTER eating), I just end up hurling up all that water right way, and then still having all that food to try to get up; this involves lots of painful and scary (see above) retching. Thankfully I haven't had anything get stuck yet, but I have come close- especially with bread products (which is why I usually don't try to hurl up bread anymore, unless I've also ingested a bunch of other easier-to-get-up foods along with it).
8. I almost exclusively hurl in shared, public restrooms, and there's no telling what surprises await when I lift the toilet seat. I'm not talking about stuff left behind in the actual bowl- that's easily flushable- but splatter (blood, pee, crap) on the underside of the terlet seat.
9. Some bathrooms, especially in small restaurants, have a cheap/old-fashioned (ie, non-industrial strength) flushing mechanism that results in pieces of food still floating in the bowl after flushing. Then I have to stand there and wait for the tank to refill before flushing again. If the pieces of food are really big, I'll just pick them out, but usually that's not the case; there are too many, or they are too small to pluck out. This is especially sucky when there is only one toilet in the place and you know there is a line of people waiting right outside, wondering what is wrong with me (diarrhea is probably what they're all picturing- gross!).
10. Worrying that I'll leave a vomit smell in the bathroom. My mom could always detect the vomit smell when I used to hurl at home, even though I cleaned the toilet (and other splattered areas), and opened the window for a few minutes. No one else ever said anything to indicate detecting a vomit smell, but I'm still paranoid about it.
11. Having to clean up around the toilet after. As neat (ie, as direct an aimer) as I try to be, and despite the fact that I get as close to the toilet (with my face) as I can bear to, there is inevitable splashback that requires cleaning up. This wouldn't be so bad in my own home, but in public restrooms it is gross, because who knows what else you are wiping up from the sides of the toilet.
12. Developing 7 cavities in a little over a year, and having teeth so disintegrated that pieces crumble off. Oh, and then having to go to a dentist who will say, "Is there something you'd like to tell me?"

Nice online LD, etc.

     Last night I left a rambling, tearful message on my looney doctor's voicemail. I said that i didn't want to see him anymore because the last 2 times I saw him he brought up LIPOSUCTION. The first time, we somehow got on the topic of plastic surgery (it was during one of those general chatty sessions when we discussed non-me related things). He asked if I had ever considered plastic surgery for myself, particularly liposuction. I was a bit flabbergasted at the time, but didn't make a big deal of it and the session continued (mainly I didn't let it sink in immediately). But for the next week I was consumed with the uneasy/disturbing realization that my psychiatrist had brought up liposuction with me. He is not an E.D.-focused psychiatrist, and in fact once made that comment that E.D.s are just the modern means for young women to express their misery, as they did with "hysteria" and fainting back in Freud's time. So I try not to discuss E.Ds. too often, but sometimes I mention that I struggled a lot that particular week. He is a really great guy, who is sincerely trying to be helpful, and he's very kind. But since I started seeing him last year, every time I bring up how I feel fat and disgusting, he suggests that I diet, and that suggestion, coming from him, breaks my (fatty) heart.
         The week before he made the first lipo comment, he had recommended I try some kooky-sounding diet where you eat 500 calories for a few days a week, and eat whatever else for the rest of the week. And a few weeks ago, he said, "There's no medical reason why you cannot lose weight." 
        Anyway, last night I was so upset about this on the way home. I walked over the bridge as usual, then sat numbly in the park in Long Island City for a while. At first I was thinking of calling him from there, but I there was so much train noise that I couldn't hear myself think. So I took the train home, and called him as I was walking from the train station to the house. I remember telling him that I was so upset at our last session because he suggested liposuction, and he has also been suggesting diets to me every time I start to tell him how fat I feel(am?). I started crying as I was saying this, which was really surprising. He called back about an hour later and left me a message, which I'm too chicken to listen to. I'm so chicken. But I don't regret saying what I did; actually, as soon as I left the message, I felt FREE and light- like a great weight had been taken off my shoulders (now if only I could take a great weight off my abdominal region!).
      

 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

 UPDATED: About the time that the above drama was happening in my mind and heart and body, I reached out in desperation to a LD who runs a brilliant blog on ED treatment. I have been reading his blog for years. I even had an appt with him once, circa 2008. He just happened to have  had a cancelation that day, but he did not have any regular treatment times available and offered to refer me. He said that I had "never been treated" (based on what I told him about my treatment up to that point). But after that one meeting in 2008, I continued to follow his blog, which is brilliant- if there is any one in the world who understands EDs, and possibly can cure them, it is this man. So in desperation last June, I wrote him (anonymously of course), and he was kind enough to reply. Here is the exchange.

 

Dear Dr ____,

I am an avid reader of your blog- I think your understanding of eating disorders far surpasses anything else I've ever read on the subject. For the past year I have been in therapy with a psychiatrist for the treatment of depression. I have a long history of bulimia (or ednos- I haven't checked the dsm v yet so I'm not sure which if any ed I meet criteria for). I have told this doc about my ED, but he seems kind of not too interested in hearing about it; he really just focuses on mood disorders. That's better than nothing tho- it's not easy to find a psychiatrist who treats eds. I like him a lot generally- he's young, kind, very smart and he trained at some great institutions. But every time I bring up the fact that I feel fat, and that these thoughts are all-consuming and drive me to despair, his response is to give me weight loss advice. I am much heavier than I'd like to be, but I'm still within normal bmi. But he says things like I would feel better if I lost 10 pounds, that I should try that new diet where u eat 500 cals two days a week...  And the last time I saw him he suggested liposuction. Anyway, I guess my question to you us, is there any reason that you can think of that a well-trained smart psychiatrist would say these things to a pt with an Ed?  I mean, I'm trying to figure this out. Is there a tx protocol that I just don't know about? It seems wrong, well, at least, it makes me feel even worse. Are ppl supposed to feel really bad like this before feeling better? I just am trying so hard to understand this. Thank you for reading this!

HIS RESPONSE:

Thank you so much for your kind words.  I am very happy to hear some of what I wrote has been helpful for you.  Your psychiatrist sounds like a kind, well-trained doctor with a good pedigree.  However, most psychiatrists get no formal training in treating people with eating disorders.  The likely reasons your doctor is avoiding the topic or mentioning things like weight loss or various diets comes from a lack of knowledge more than anything else.  No, people don't just get better in treatment like this.  Even though your doctor is nice, I suggest looking for a therapist who has expertise in treating people with eating disorders.

 

Hi Dr _____,

Thank you so much for writing back and giving me your opinion- I greatly appreciate it. Originally I was just going to not make any further appointments with this therapist, but last week I ended up leaving very honest and tearful (ok, hysterical) voicemail for him, because honestly this was just bothering me so much. He responded with a lengthy voicemail in which he explained that he didn't really think I was fat or needed lipo; he had mentioned fad diets and liposuction as an attempt at "absurd rhetoric" which clearly wasn't effective. So the upshot is, I am going to talk to him at least once more, mainly because I am curious about what the heck he meant (some kind of reverse psychology?). **I know it would be best to find someone who specializes in treating eds (or at least acknowledges them), but unfortunately, that's easier said than done. Anyway, thank you again for responding to my question. And thank you for writing your blog; your insights are tremendously helpful- more so than anything else at this point!

 

HIS RESPONSE:

I do hope the appt with your doctor goes well. It does appear he had some thoughts about moving forward.  If you would like to, you could tell me where you live and I could see if I have any referrals there or ask colleagues if they do.