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.

Windows on the World, WTC (RIP)

        I was home visitin' mi mum for Mother's Day. I went through a couple boxes of old photos and found a batch from our Mother's Day breakfast 1986, at Windows on the World restaurant on top of the North Tower of the World Trade Center, NY.

       On the morning of 9/11/01, this restaurant was the site of a business technology conference hosted by the Risk Waters group.

Don't breathe the air today

Don't speak of why you're afraid

-Sleater Kinney

Here are my distinct memories from 9/11/01, circa 8:46 am onward:

 -I was on the bus to work. Bus was still in Brooklyn, on the Expressway headed towards the tunnel to lower Manhattan. I was in my own world as usual, probably listening to music. A guy sitting in the last row (I remember this for some reason), who had been listening to a walkman radio, suddenly shouted out that a plane hit the WTC, I looked out the bus window, and had a perfect view of the towers, and the first. My first thought was that it must have been an accidental collision, like the plane that hit the Empire State Building in the 1930s (just the tippy top of it). My next thought was, "there are people dying there right now."

-After the 2nd plane hit, and it became obvious that this was no accident, I distinctly remember thinking, "What the eff kind of bumbling moronic/lazy?/Stupid?/effers do we have working in the Cee-Eye-Ey, or whoever's supposed to be preventing this from happening."

-Another guy on the bus said (again, aloud, to anyone listening) that he was supposed to inside the WTC, but he was running late to work.

-Our bus, and all traffic heading towards Manhattan, came to a complete standstill (thankfully we weren't in the tunnel yet!)- while seemingly every emergency vehicle from Bklyn zoomed through.

-A lady on the bus started having a panic attack, and was demanding that the driver to let her out on the expressway. He kind of just ignored her. He was an older man, I remember, and looked very sad and/or weary about what was happening.

-Eventually (after an hour, but before the South Tower fell), traffic was turned around back to Bklyn. A man in the window of an apartment building we passed was waving an American flag out his window.

-Papers from the towers flew all the way over to Bklyn (Park Slope, Brooklyn Heights). I was tempted to collect some for posterity, but I stopped myself because it seemed morbid and/or disrespectful.

-THE SMELL that day--- like something burnt, electrical, but like nothing I've ever smelled before or since.

-Meeting a lady I knew from my local bus stop, who, unlike me, actually left her house early and got to work (in lower Manhattan) on time (I only escaped being on a bus that travelled through lower Manhattan because my boss was in Sweden that week, so I came to work late). Anyway, so this lady was physically okay, thank God, but she described horrible things- bodies falling, body parts in the streets, etc. So did a lady at my church- a falling body missed her by mere feet.

-I didn't attempt to go in to work (in Manhattan) until Thursday the 13th. The trains were running mostly normally by then. (Speaking of trains, my next-door-neighbor at the time worked for the MTA, and was in one of the stations near the WTC when the attack happened. I don't remember all the details, but the jist of his story was that his supervisor screamed "Run for your lives!" and he and his co-workers did just that, and thankfully got out of the station in time, before it was destroyed.... maybe it was Cortlandt Street station actually; that was closed for years after 9/11).

Anyway, the hospital at which I worked and still do work is a few blocks north of Bellevue and NYU hospitals, and I used to walk by those hospitals to get to work every morning. Well, I wasn't quite prepared for what I found my first day back to the city, 9/13: every available side of a building/phone booth/pole/construction wall was plastered with hastily made "Missing" signs, with photocopied pictures of loved ones who worked in the towers. I guess the family members were hoping that hospital employees might recognize them, but sadly, from what I understand, hospitals were on the ready but never received the patients (survivors) they were expecting.

Monday

Can I go back a little, to Monday, September 10? That was the last day of normalcy; the world would change in a mere matter of hours. How did I spend the time? Doing normal/inane stuff: I was engaging in some flirty e-mails (at least flirty on my part) with one of the surgery fellows. That evening, I went to an Anatomy and Physiology lecture at NYU.

Memories of the World Trade Center

-It's such an 80s building in my mind, I guess because it was mostly in the 80s that I visited it. Also, at that point it was still pretty newish (I think it opened in the early 70s), so people still oohed and ahhed about these huge toewers.

-Besides the Mother's Day in the mid-80s, I remember going on class trips to visit the observatory at the top of (one of?) the towers. My last class trip to the WTC was in the early 90s, when I was in 8th grade. I actually shoplifted a little marble elephant from the gift shop up near the observatory. I still have it somewhere.

-One of the last times I spent any considerable time there was when I started 9th grade and my mom and I went to one of the stores therein to purchase me a school bag.

-I think that the VERY last time I was actually inside the WTC was when I was 16 and my parents, brother, and I took a trip to Liberty Science Center, which required transferring to the PATH train at the station in the WTC.

-In the summer between my junior and senior years of college, I worked as an office temp at a company in lower Manhattan. I remember taking my lunch break in that plaza between the two towers. Even though the plaza was pretty spacious and it was outdoors, it seemed dark (at least at the times I went there) due to the shadows of the buildings.

-In early 1999, I had a part-time job in Brooklyn Heights, directly across water (and Bklyn Bdge) from the towers. After work, in the evenings, I would sit on a bench on the promenade with my frappacino (I know, right?). There were always sporadic lights on in the windows of the towers, no matter how late at night, and I would sit there and picture the important financial (and other) workers burning the midnight oil. I remember thinking of them admirably, admiring their work ethic.

-In the summer of 2000, I rented a room in the village, not far from the towers. From that point and onwards, they always served as a placemarker of sorts. Yes, even tho I lived in the city my whole life, I have a terrible sense of direction, but no matter where I was in Manhattan, I could usually see the Twin Towers, and that was my marker for downtown.

New Monstrosity
Last year, May 12, 2012 to be exact, I met up with my maw and sister to visit the memorial (reflection pools) on the footprints of the towers. HORRIBLE- I hated it- what a yucky kind of memorial those pools are. I mean, black granite, deep into the ground... I see it and I just think of holes, or The Hole (which is what some people called Ground Zero in the early days). The pools are in a park-like area: carefully paved paths, and a tree hither and yon, but it the greenery looks too forced and planned and thus, artificial. The worst part is, to enter this memorial park/pools area, you have to go through airport security- seriously, you have to have your bags scanned, and go through a body scanner. Meanwhile, some genius decided to build another hideous skyscraper, the newWTC- why??? Isn't it an automatic target for another air attack??
             Anyway, the only good (or at least, thought-provoking) thing about my experience at the memorial was this weird little occurence: one of the few 911 victims I know OF (just OF; I never actually met him in person) is the brother of an acquaintance who had an office in the North Tower, right at the impact zone (his brother said that when he watched the footage, it looked like the plane flew right into his brother's office). Anyway, out of the 3000 names that were carved into the stone memorial, I didn't expect to find his name. I wasn't really looking for it-the names are organized by company I think, or something, but I remember I didn't know the details to even look him up. But I looked down at the part of the panel right in front of me, and there was this man's name staring back at me! Anyway, I recently looked up this man on the internet (there are several great sites that people have built to honor the 3000 souls with individual bios). He lived in Cobble Hill, he loved his family very much (he had very young kids), and in his "free time" (ie, time that wasn't consumed by work or fam) he started some kind of grassroots organization that went around planting trees. Most tellingly, though, was the photo of him that accompanied this bio; he had such a kind, warm smile, such kind, warm eyes.

May he, and all the others, rest in peace, and may their loved ones find healing and comfort.

Angie's Case

I have been following the case of Angie E., who, last October, wrote about her rape in an Amhurst* dorm room  (*misspelling intentional; those old private liberal arts colleges have MONEY to sue random obese internet bloggers).

http://www.huffingtonpost.com/2013/01/15/angie-epifano-amherst_n_2480070.html

She was raped by some a-hole who went on to graduate with honors, while she was understandably distraught enough to eventually drop out, and spend some time in a psych hospital. The rape by her fellow student was horrible enough, but then this poor womyn was figuratively raped by the college administration. It's sickening.

Sugar and spice and everything nice

A gift from my pal Carl, to reflect our discussions about womyn's colleges, Wellesley vs. Smith catfights, etc.

I almost broke down crying in Walgreens. People seem so OTHER and mean/uncaring. To begin with, getting on the train this morning, a guy shoved me out of the way so he could board first, though it made no diff which one of us entered the car first since it was packed with rush hour traffic. I'm sure he would have pushed me into the tracks without a thought if it meant he would get to stand in the precise spot he wanted on the platform; that was the feeling I got from him--
-dang! I was just interrupted with a question from a Cornell surgery resident (so I gathered from reading his I.D. badge). Usually I hate questions from strangers (my desk is right next to the door so they come in all the time, looking for Pathology or Plastics or Radiology, none of which is my department). Anyway, he even commented on the fact that "you probably get annoying questions all the time since your desk is next to the door." Shishkebob, this guy actually ties in perfectly with what I was just writng about subway-a**hole-from-this-morning; i mean, he, being considerate of other human beings' experiences, is a stark contrast to the effer who shoved me out of the way this morning.

Bravery

Moon, the cat we are cat-sitting. She is very sweet, and VERY timid. Even if she herself sneezes, she will be so startled that she'll run away and hide. She mainly lives under our basement tenant's bed, though in the evening hours she comes upstairs to visit. We have our little murderball cat Matilda, though, who usually scares her away. But still, Moon can be very brave at times. Like when Matilda had the audacity to go down to the basement (Moon's established territory), Moon chased her back upstairs. I'd rather not let them really get into a fight though, since Moon has been de-clawed whilst Matilda still has her talons; t'wouldn't be a fair fight!