Weekend Lessons from My Body

This weekend was an eye-opener in several ways.  The main lesson was that my body and I do not do math in exactly the same way, and the equations are never as simple as I would like.

To start with, it's no accident that over-exercise is a major component of my eating disorder.  I was always an active kid, loved sports, nature, etc.  I genuinely enjoyed challenging myself physically.  Of course, once the ED set in, this took on a life of its own.  The focus shifted from sports and activities to working out, and I gradually dropped out of all of the team sports that I loved, plus rock climbing, biking, etc etc because it interfered with my gym time.  Sort of painfully ironic in hindsight, too busy working out to do fun exercise.

Breaking the workout habit is one area of recovery where I've made almost no progress.  I know it's pathological, I completely understand that, but it just doesn't seem voluntary anymore.  Especially now that I have put on some weight and am not in constant energy deficit, working out actually feels good again, which makes it even harder to quit.

H. realizes what a job it is going to be to wean me off the workouts, so on thing she suggested is that I find more real activities to do, instead of sticking to my ritual workouts at home.  Instead of slaving away on the exercise bike, get on a real one and ride someplace, enjoy the sunshine.  Instead of doing the routine on the treadmill, go for a hike, etc.  

This is a great idea, and now that 1) spring is here (woot for reaching the 80 degree mark today!) , 2) Daylight Savings Time has started, the outdoors are beckoning, and 3) I actually have a little bit of free time this semester.  I have always resented being stuck inside working out instead of outside running around like I used to.  This weekend the weather was bee-yoo-tiful, and so I planned a hike with a friend on Saturday and a bike ride on Sunday.

But remember the part about exercise not feeling voluntary?  I wasn't kidding.  It's just default at this point.  I wake up, I do X.  I walk the dog, I have breakfast, I do Y.  After lunch, I do Z. I walk the dog again, a few hours later have dinner, do X again.  This is my day: no question, no decisions, it's just programmed in.

So, as you may have guessed by now, I got up early on Saturday, did my usual workout, then went on the hike.  Then did errands (you never realize how much walking is involved in a trip to Wal-Mart until you do it in an energy deficit), came home and completed the rest of the day's routines.  Business as usual.   So in the end I did the hike plus everything else, instead of as a substitute for routines, which is what H. wanted. I rationalized this by drinking a Boost between the hike and the store.  See, see, recovery!  Replaced the calories, good Cammy!  In a way this is progress, because usually I would have just considered the extra deficit to be an accomplishment.

Needless to say, though, I was wiped out by Saturday night.  All I really wanted to do was lay on the couch and watch reruns of House, but that wasn't allowed. Getting through the pre-bedtime routine was a big challenge, and the next morning was even worse.  But I did the usual, because that's what I do.  Period.  

And I still had the bike ride on Sunday.  I just sank major money into a nice bicycle, and I haven't had the chance to use it much.  I have a busy week coming up, and Sunday was the only time I'd have to spare for a good ride.  Plus, the weather was pristine.  So I did it. I  helmeted up and went.  I didn't think it would be a big deal, because I spend a ridiculous amount of time on my stationary recumbent bike every day.  I have probably "traveled" thousands of miles on that thing.  But apparently real bikes are much, much different, I was exhausted (not out of breath, just fatigued) after just 15 minutes on the road (I am no Ai Liu yet!). But I still couldn't force myself to give up the usual workouts later in the day, and so I dragged through them.

 And today my body resented me for the weekend of overexertion.  I feel like crap, not just tired but sick-tired. My legs are lead, my head hurts, and my heart feels tight, irregular, and a little bit scary .  This isn't fair.  I have put on weight, am supposedly making progress in recovery, and yet just two days of mildly increased activity have left me feeling like a wheezing invalid.

For anyone has made it through this long-winded story, the lessons from the weekend are: 

1) We get so wrapped up in what is happening to our bodies externally (regaining weight, etc) that it's easy to forget that we have to replenish ourselves internally as well.  I look much healthier and sure as hell feel a lot bigger, but this weekend reminded me that my body is still working to repair itself after years of abuse.  Food does much more than just form fat, it also helps vital organs to strengthen and replenish themselves, which is hard when you're still constantly pushing your body to the limit.

2) Just replacing calories doesn't necessarily  make up for extra activity, it's more than just a simple numbers game.  Yes, the energy helps, but it doesn't completely solve the fact that your body needs recovery time.  You can have your cake and eat it too, but it doesn't make up for pushing your body beyond its limit.

3) The major problem here is that even in areas where my behaviors may have changed, my thinking hasn't. Regarding food, that is, the exercise obviously hasn't changed much at all. Consuming extra fuel on Saturday was a big step for me; before I would have never replaced extra spent energy.  But the mindset that calories in MUST be related to calories out hasn't changed.  Exercise still determines how much I am "allowed" to eat.  Must keep the "balance," as arbitrary as it may be. I think getting over this hurdle is a major step towards recovery, and I haven't made it that far yet.

Anorexia is My Vodka

I have almost zero time for television, beyond having CNN as background noise while I'm writing, but there are a handful of shows that I TiVo to watch when I'm doing TV-friendly workouts.  Intervention is one that I watch faithfully every week.  I have never had a problem with drinking, drugs, etc.  I've smoked a total of 2 cigarettes in my entire life, and although I do have an occasional drink (within calorie budget), I have never been drunk.  Never tried pot (the fabled Munchies are the best anti-drug campaign ever, for me at least), don't even like taking headache medicine unless I really feel incapacitated.  But I always find something to identify with in the cases on the program.  I'm a strong believer that many addictions have the similar themes and issues, and I don't think it's a stretch to classify an ED as a type of addiction, or at least that has been my personal experience with mine.

So, did anyone see last week's episode with Tiffany?  (If not you can see a preview here, it's episode 83) She was a 24 year old struggling with alcoholism, consuming unbelievable amounts of vodka and other drinks every day.  

There was one scene that hit me like a ton of bricks: her parents invite her over to visit one evening, for dinner, talk, board games, etc.  She does the bare minimum to be polite, but wants to leave as soon as she can after dinner.  She needs to go home and drink.  She loves her parents but at the same time switches into being obstinate and abusive when she's pulled out of her "safe-zone" where she can drink her pain away. They are worried about her, they want time with her, and they know what she'll do when she goes home.  But she is blind to all of that, all she knows is that she needs to get out of there and get some alcohol.

That's me.  I can't count the number of times I've cut time with my family so that I could go  exercise, or get home in time for my meager, ritualistic meal.  I only go to see my parents once or twice a year, and I can't remember the last time I stayed more than 18 hours at a time with my grandparents.  I have missed graduations, promotions, first communions, fun vacations, you name it and I have copped out so it wouldn't disrupt my disordered routines.  Even when I lived at home, I quit eating dinner with my family sometime when I was 13 and never had another evening meal with them (except for holidays) for the remaining 5 years that I lived there.

 Tiffany had issues with her parents (they were both alcoholics too) and didn't get along with them, I can't even use that excuse.  I get along great with my family and I love them with all of my being, but they still get shoved aside, without fail, when the ED beckons.  

It cuts me like a knife to think about it, but how painful must it be for them?  

Tiffany "needs" her vodka just as much as I "need" my aerobics DVD, and somewhere in there is a reluctant need to need that has been grossly displaced and distorted until it has replaced those that love us--those that we really do need--with illusions of needs that destroy us.

Frustration with Framing: Scandous Six Calories

Does anyone else find this article to be frustrating?  Title: "Exercise Campaigns May Encourage Extra Eating." Wow, so people consume an extra 6 calories of raisins after seeing an exercise poster...that means if they view 583 exercise posters, while not expending any extra energy, they will actually gain a pound, sacrilege!  Quick, ixnay on the osterspay!  While you're at it, halt public transportation that crowds people into close quarters, because I'm sure someone is taking in an extra 2-4 calories worth of Tic-Tacs before boarding the subway.  Oh, oh, also don't forget to impose strict curfews and bedtimes on the general population, because if they think they need extra energy to stay up late, they might actually consume a diet soda for the caffeine, costing them 0.4 calories for every eight ounces!  So glad the message is getting out about these insidious public health hazards.*

Really?  Isn't there some sort of more constructive dialogue we can come up with?

It really seems like there could be some more informative and helpful way to report on this study.  It is interesting for psychological reasons if we show that anticipating exercise increases our appetite, sure, but the article is framed as a warning about how promoting physical activity could be dangerous.  

How about delving into adaptive reasons for this response, it would be cool to show that just thinking about doing an activity causes appetite-related hormones to spike, makes sense from an evolutionary perspective.  Or, if we don't want to get that scientific, how about  suggesting that exercise posters and promotion are coupled with literature on healthy snacks to fuel better workouts and promote a more holistic view of health?  NY Times, could we please do something with the information besides fueling our society's collective weight phobia?

*Note: I won't deny it, at times during my eating disorder I really would have balked at an extra 6, or 4, or 2, or maybe even 0.4 calories.  I do not mean to ridicule anyone who struggles with this, because I know that thinking that way is part of a true illness.  I think my exasperation with this article stems largely from the fact that at one point I did limit my Tic-Tacs, tallied my sticks of sugar-free gum, etc.  I know how terrible it is to be caught in that cycle, and messages like the headline discussed here are just not helpful in promoting healthy thinking.  

Speaking of drugs....

Speaking of drugs . . . I teach pretty much all day on Wednesdays, but I have a break from 3-5, and it is my ritual to come back at 5 with my signature coffee from my favorite local cafe (ventidecafsugarfreeamericanowithanextrashot).  

Background: I am a total coffee addict, BUT I am totally off caffeine.  I am one of those people that yes, actually enjoys coffee outside of mochasuperfancychinos.  At one stage in my life I was a complete slave to caffeine (consuming about two pots of coffee and a few diet cokes every day), but after some heart scares I detoxed from it.  That was my senior year of high school, about 4 years ago, and although I occasionally lapse (during exams, or when I have to make a long drive), I've been good about not succumbing. 

During the Caffeine Years I was almost immune to the stuff, I always had a cup of coffee about half an hour before bed.  Now that I'm "clean," however, I am SUPER sensitive to it.  One cup of coffee in the morning will keep me jazzed all day long.  

So, we get back to today: when I ordered my drink I emphasized that it needed to be decaf, said it at least THREE times.  Got my coffee, took it to lab, consumed it...and about 20 minutes later, realized there had been a mistake.  Heart going crazy, queasy stomach, weird feeling in my head.  Yup, I had consumed a large Americano with an EXTRA shot (making that five espresso shots) at 5 PM. 

It's going to be a long night.

I have to say, though, that I'm reminded of why I was hooked on this stuff for so long.  My system stayed a little freaked out until I got home and had dinner (I'm not sure if any studies have been done on whether food can "mop up" caffeine in your system, or just get the stimulation a little stabilized? anecodotally, seems to work for me).  But despite the fact that I only slept 4.5 hours last night, I had no problem focusing on my reading, etc, and I absolutely tore through the routine with my post-dinner workout.  I didn't do anything extra, but I went through it with tons more energy than usual, felt awesome.  Power, power, power!   Screening Lady would be proud!

Except I seem to have overdone it, because now my muscles feel depleted from my overenthusiastic workout, but at the same time I still have the java jitters.  My stomach still feels a little queasy, too.  That might be because I drank tons of water when I got home, even more that usual b/c caffeine makes me especially thirsty, and I also reasoned that it would help flush the stuff out of my system.

I suppose I should go channel this nervous energy into something productive (grants, thesis, etc).  This little episode has made the day much more interesting, but I am still pretty unhappy with the barista, even considered calling to complain, but I decided against it.  Tomorrow will be a struggle.  Whenever I have caffeine I get stimulation "hangover," not only do I stay up extremely late but I find myself wide awake earlier than usual also.  I'm just glad I don't have any exams tomorrow or Friday, because I am anticipating a high degree of zombie-ness.

Regulation Madness

The NY Times has a disturbing article about the dangerous implications of the fact that the FDA has no control over dietary supplements (everything from vitamins to herbal remedies to weight-loss "drugs").  Not, of course, that FDA regulation means a product is completely safe (peanut butter, anyone?), and the FDA actually does have some oversight: it controls these products as "ingestible nonfood substances," but has much less authority and control over them than "real food" items.  I don't really see the difference, if you ingest it, it goes into your body, the same way real food does.  Seems just plain criminal.  

Part of the problem, too, is that our culture seems to have concluded that any problem can be cured with pills.* You don't have to worry about eating a variety of fresh foods, just chew a Flintstones tablet** once a day and you've got all your nutrients.  Why change your dietary habits when you can buy a drug that prevents you from absorbing fat and other nutrients (yes, fat is a nutrient, your brain is made out of it!).  For more on the issue of the de-foodification of nutrition, see Michael Pollan's In Defense of Food, I'm a big fan of all of his books. 

This is relevant to EDs, obviously, because of the unbelievable industry that has developed around marketing bogus or, worse, dangerous products to people seeking quick fixes for their waistlines. Snip from the NY Times article: 

 The F.D.A. recently published a report citing 69 brands of weight-loss supplements that illegally contained active drug ingredients that could be harmful to consumers. So far, only three of the brands have been voluntarily recalled. Such limited authority over supplements, along with inadequate allocation of F.D.A. resources, leaves consumers vulnerable, the report said.

While this seems shocking, it's not really "new news." It's not limited to weight loss drugs, either.  I have a friend that is on our university's swimming team, and she can't take daily vitamins because they are so unregulated that some hidden ingredients can produce positive results on drug the drug tests that athletes must take before competitions.  

 Even if the FDA did regulate these products, they would certainly be abused by some people, but the fact that as of now they are allowed to lure people in by making unproven or outright untruthful claims, and including potentially dangerous substances that is not listed on the label or explained to the consumer is unconscionable.  I'm glad that more attention is being paid to this issue, hopefully changes are on the horizon for the regulation of supplements and OTC remedies.

*Note, I am not criticizing people who take prescription meds for psychological diseases, I'm referring to the nutritional supplement madness that seems to have swept our society, as if people have forgotten that our ancestors apparently did quite well without ever swallowing a single tablet.

**Not bashing the Flintstones, I personally love these things, and having a purple BamBam with my breakfast always seems like a good omen for the day.  BUT I also try to get as much as possible of  my full nutritional requirements from actual food.

Health Fair Ironies

Today my university is having a health fair, with tons of screenings, healthfood giveaways, free pedometers, and enough brochures to wallpaper Versailles. I already know that I have low bone density, but I did the osteoporosis screening just out of curiosity. The results were pretty much as I expected, and the Screening Lady sat down and went over all the reasons it is low but I shouldn't be concerned. Apparently:

1) since I am under 35, I haven't reached peak density yet!
2) I appear to have a "light frame" "lucky you, hee hee"
3)I should exercise to build more bone! At least 30 minutes three times a week! [when was the last time I even let myself leave the house in the morning without doing triple that???]

My reactions:
1) Except my density is lower now than it was when I was 17, not a trend leading to a peak in middle age
2) Yeah, it's amazing how a decade of pathological austerity will sculpt that frame down real nicely. I do love it when I am supposed to be getting used to the idea of gaining weight but people still compliment my skeletal structure like it's an acheivement.
3) Ha. Is all I can really say, big fat humorless ha. Screening Lady, do you really want to hear how many sets of workout clothes I have had to throw away because of the bloodstains from the friction between my bones and the floor/soles of my shoes/exercise equipment?

After she finished rationalizing all the reasons I shouldn't be worried about my ultra low score, I mentioned
Me: "Well, I have had an eating disorder for a few years."
Her: Blink, blink. "Well, you know that could possibly be a factor."
Me: "Thanks for your time." [turn to walk away]
Her: "Have a great day and don't forget to grab a t-shirt, I think the smalls are almost gone!"

Wow, I'm so glad we're provided with access to this free health advice and insight!

Other, non-ED related ironies from the health fair:
-I walked through around 11:30, when the lunch rush was starting in the student center, and there were long lines at all of the snack machines despite the abundance of free health food being given out at all the booths, including swag bags with all kinds of samples of fresh fruit, protein bars, health drinks,e tc.
-The Center for the Deaf was giving free hearing loss screenings, but the people at the booth were having to shout the information at passers-by to be heard over their iPods.

"The Problem" According to J.

I'm not sure if any readers have noticed, but there has been less mention of J. this semester. We don't have any classes together, so I don't see as much of him, and to be honest I've purposely pulled away a little bit from our extracurricular time as well. That is a long, complicated issue, discussion of which I will save for a rainy day. Anyway, a recent conversation with him gave me something to think about. Maybe everyone will read this and think it's mundane, what's the big deal, but it struck a chord with me so I just wanted to share it.
For set-up, it was a really warm day last week, and I was wearing a t-shirt for the first time in months. J commented on the fact that I was in short sleeves, and I made some disparaging comment about the size of my arms.

J: Come on, Cammy, don't be like that.
Me: Why not? [yes, I am so ultra mature sometimes...]
J: I like your arms better now.
Me: Oh really, why might that be?
J: Because they look like real arms.
Me: I didn't think the ones that I had before were fake.
J: I know you didn't think so, that was the problem.

Kind of makes me wonder what I believe in right now that will reveal itself to also be fake or misguided at some point in the future.