Perspective

So, from my perspective, I have been doing pretty well for the last month or so. New relationship, have regained the weight I lost during the move and initial few weeks here. Between spending time with Match and being crazybusy with grad school, I am slowly (ever so glacially slowly) loosening up on a few bits of the exercise stuff. I am working on making sleep more of a priority, although this is difficult when I have the neighbors playing the rock band from hell underneath me every night.

So, positives, good news. It's interesting, though, to contrast how I see the situation with how my new therapist sees it. Last week she said that she thought should look into IP treatment. I guess I can see where she's coming from: she sees me at point X, and it's harder for her to picture that point X is part of a positive trajectory up from where I was two years ago. I'm still not to that magic 85% of IBW that seems to gain you more trust from treatment providers. The exercise really has her concerned, and rightly so. I'm aware that it's still majorly excessive, and eats up ridiculous parts of my day. I still have a lot of disordered rules about food and meals.

I'm not claiming to be out of the woods, and I think that having a fresh perspective from a new therapist has been an eye-opener for me (although I still miss H so much it hurts), helping me to see myself more objectively. But sometimes I wonder whose perspective and/or interpretation is more accurate. Do I use being on the "upslope" as an excuse for complacency, or is she just not listening to me? Probably a little of both. My weight gain has been glacial, from the perspective of my treatment team, at least. I reached my peak weight for this recovery about six months ago and have trended down and then back up towards it, but haven't had a net gain since then. Also, that weight was the "first step" goal (meaning a landmark but not The End) that H originally set for me to achieve by July 2008. I have been working quite a bit on loosening up on thoughts behaviors, though, and sometimes I feel like my new T is not listening to me about that progress.

I guess it is a little awkward to get on the same page when you start seeing someone midway through this whole process. Sometimes I feel like she's treating me like a new client that she has to convince about recovery and scare into action, instead of someone who is open to committing to this, even if I blunder around on the path at times. I do really value having fresh perspective, don't get me wrong, but I don't feel like we're entirely on the same page yet.

Ironically, the fact that no healthcare company has yet agreed to insure me is the only reason I'm still able to afford therapy. I have an application in the underwriting stage right now, and if it is approved I will be paying a shit ton in premiums every month. My T is aware of this, and told me she will "work with" me on the insurance thing, but I'm not sure what she has planned for that.

I have been SUCH a bad blogger, and do have more things to talk about, life is just crazy right now. I miss you guys!

Promise Kept

Last year I made a "promise for next year" that I would not spend my birthday feeling terrible and stressed and depriving myself. I actually make promises to myself all the time, although I know that I will do pretty much nil to keep myself accountable for them.

But I actually did keep that promise this year. Yesterday was the first birthday in many years on which I have not ended up in tears of frustration at some point during the day. I didn't have a big fantastic celebration, but I did feel worlds calmer and more centered than I had in years past.

I don't think it had anything to do with my birthday, actually, I think we just tend to be more aware of ourselves on milestone days. I am still definitely a work in progress with recovery, but yesterday was really an eye-opener for me, as I contrasted the State of Cammy with previous years and contemplated how truly miserable and stressed I used to keep myself, day in and day out, for years and years.

So, kind of a low key birthday, but that was fine. Match works on Fridays, so he took me out to dinner on Thursday night. He also wished me a happy birthday through about 5 different media on Friday (woot for modern technology). I got lots of calls/messages on my birthday, my adviser treated me to Starbucks, I attended a fascinating talk on campus and then had a couple of drinks with my new crew of friends down here. Again, not a rockstar scale party, but I am not that type of person, so the low key day suited me just fine.

I guess I just wanted to report on that, milestones like birthdays are good times to reflect on where we've been or where we're going. I got some nice presents, but I think the best one was the one I gave myself: just spending the day feeling alive.

Follow-Up on Image Labeling

Just wanted to point you towards a very well-thought follow-up to Randy Cohen's blog post about the ethics and image manipulation, which I linked to earlier this week.

Preview:

I agree that it is incumbent on us all to be informed and skeptical, and not just in response to advertising. But it is futile to rely on the critical thinking of even the most astute and determined consumer. Such a suggestion erroneously assumes that simply knowing that an image is falsified immunizes you from its effect. Not so. Advertisers realize that images also affect us subconsciously. Nor can you escape such images: they are ubiquitous. Even if you never open a fashion magazine, you still interact with and are affected by those who do. We are social creatures, profoundly influenced by the people and ideas of our community.

Read the whole thing.

Ethics of Image Labeling

Today the NYT blog "Moral of the Story" has a very well-thought out post, regarding the ethical case for requiring that advertising agencies give disclosure about electronically-manipulated images. One section particularly interested me, so I thought I'd post it in case anyone had thoughts on it:

It could also be argued that a labeling law, equitably applied, would require warnings on nearly all ads, including those that alter reality in other ways. For example, few roads are as serenely traffic-free as those in car commercials (and indeed some automobile ads on TV already note that they were photographed on a closed course). But here’s the distinction: Although that open road deliberately conveys a bogus sense of driving delight, the road itself is not the product. The car is the product. In fashion ads, however, whether for clothes or makeup or shampoo, the model’s beauty is the product, or at least the direct result the product is meant to achieve. Because that beauty cannot be obtained via the proffered merchandise but only through a tricked-out photo, this is a case of false advertising.

I sometimes hesitate to post direct questions, for fear that no one will answer and I'll be a lonely blogdorg, but: What do you think about the fact that beauty is the product, not the bra, lotion, etc? In what cases is this more or less true than others?

Anywho, I highly encourage you to read the whole post. I subscribe to the blog, love the way this guy cogently breaks down such a wide variety of issues.

Opening Up, but Not Pouring Out

So, long time no blog. I guess I just haven't felt like I had much of signficance to say. I am so incredibly behind on blogs and e-mails, sorry. School load has definitely picked up. Also, Match is starting to become involved in more and more of my time every week, but I am definitely not complaining. We had a talk about "us" and it appears I done got myself an official relationship. I have a teensy bit of mixed feelings: I like him, enjoy him, enjoy him enjoying me, etc, but then there is always that part that resists being so vulnerable, you know?

Anyway, lots of challenges to food routines and daily schedules. I think I am doing fair with that so far. I have definitely had to loosen up on the routines, and I am actually making progress with being less rigid about missing a workout. I still do my best to make it up, but it does not consume my thoughts, and I'm more likely to let 10 minutes slide here or there. I am not trying to use Match as a crutch, but I can't deny that it is a hell of a lot easier to spend the evening on the couch with him than it would be to try and keep myself still and non-exercising if I were alone.

I may have mentioned that Match is a psych major. I did tell him that I am "in the process of recovering from AN," and we kind of left the issue alone for quite a while. Now we are getting to the stage where we're starting to share deeper things with each other, though, and he seems to be very interested in the "story" of my ED (how it developed, etc). He said he had not learned much about thesubject in his psych classes, but did do quite a bit of research after he learned that I have dealt/am dealing with it.

I trust him, and I know he cares about me, but I still feel a little weird telling him about what a dark and pathetic history I have when it comes to this. I guess I still carry a good deal of shame, for what I have put my family and even myself through. I made it clear to him that I do NOT expect any kind of help or built-in therapy from our relationship, the fact that he wants to be a therapist and I am currently in therapy is just an ironic coincidence. He said he understands that, and just wants to be supportive however he can.

Ok, there isn't much of a point to all of that, except that the background information is much easier to organize in my head than my actual feelings about it. Now that we are getting to know one another well and fill in info about our histories, leaving out the ED factors does tend to leave gaping holes and missing links in many of the details about my life for the past 10 years.

I often wonder what he wonders. He hasn't shied away from inviting me out to eat, and most of the time I go along with that relatively well. I still have some hang-ups about eating out, but it is entirely based on control over the prep of my food, not about eating in public.

I guess I will just take a stepwise approach, not dumping everything on him but giving him more basic facts and filling him in as it seems appropriate. I think there is a line between opening up information and completely pouring everything out. Advice from anyone that has been in this situation?

Because You Have to Laugh

Today's dose of "you have to laugh" Black Humor awkwardness: the nurse asking the anorexic if she thinks she can handle not eating for X hours before a blood test.

My therapist wants me to have one last thorough exam (bloodwork, EKG, etc) before my insurance runs out later this month, so I called to make an appointment today. The staff has worked with me quite a bit over the last couple of months, getting the referral for therapy worked out, so they are very aware of my "issues." They are actually way more knowledgeable and concerned about ED issues than any other physician's office I have dealt with. I talked to several knowledgeable people today, and I do still have some options for health care, but it is going to cost me much more per month than the plan I was originally hoping for, which will take away all the money I could have possibly spared for therapy, and then some.

I actually didn't intend to let this post devolve into whining, sorry. To end on a positive note:

-Things are progressing VERY nicely with Match.

-I finally got the courage to complain to management about my neighbors, after multiple attempts to resolve the problem with them personally. I am so nervous because I really hate the thought of people being mad at me, but in reality I have zero relationship with these people, and really have nothing to lose. The management was very understanding and assured me that if they try to "get back" at me in some way there will be consequences for them. I hate hate HATE feeling like a tattle, I have lived in apartments/duplexes for 5 years now and have never had this issue with anyone, but I did try my best to address it without getting anyone higher involved, and the neighbors just escalated. So, shaky woot for having guts today.

-I am in love with the new show Modern Family.

Ok, off to go get some work done. I'm going to be with Match most of the day tomorrow and helping my labmate with work for most of Sunday, so I don't get too many nerd points for staying in to research on a Friday night, I think. And honestly, I kind of like my nerd points anyway. ;p

Modest Proposal Takes on Health Care

One of my all-time favorite pieces of literature from high school is Jonathan Swift's 'A Modest Proposal.' I have always appreciated facetious wit, and I was thrilled to discover that even way back in the 1700's, political commentators could be smartasses. The Modest Proposal format has been copied, parodied, and adapted many times (I even did a few version of my own in high school) to deal with a variety of social issues.

So check out today's Kristof op-ed in the New York Times, in which he presents an updated "Modest Proposal" for dealing with Congress's criminal fumbling of health care legislation. Snip:

We accept that life is unfair, that some people will live in cramped apartments and others in sprawling mansions. But our existing insurance system is not simply inequitable but also lethal: a very recent, peer-reviewed article in the American Journal of Public Health finds that nearly 45,000 uninsured people die annually as a consequence of not having insurance. That’s one needless death every 12 minutes.

When nearly 3,000 people were killed on 9/11, we began wars and were willing to devote more than $1 trillion in additional expenses. Yet about the same number of Americans die from our failed insurance system every three weeks.

Anyway, health care stuff has been on my mind a lot recently, and I know many of my readers have had issues with it as well, so just wanted to share.

And by the way, my application for insurance was indeed officially declined.

Application Dilemma

So, I officially age out of my parents' health insurance plan this month, and am in the process of applying for my own policy. I am in a bit of a moral quagmire over how honest to be about the ED stuff, this is hard. I don't have a choice but to mention the anorexia, it is all over my medical records. But I am honestly not sure how to answer the specific questions about it.

"Description"

What do they want to know? Weights, etiology, behaviors? Would it be to my benefit to tell them that the disorder has most recently been skewed to overexercise instead of severe food restriction (although the two remain inextricably linked)?

"Date of onset"

Hmm, this will be the 10 year anniversery. Thus far Hallmark doesn't appear to make cards for that.

"Treatment"

That one is easy, outpatient therapy. But do I also mention the cardiologist, endocrinologist, and orthopedist visits I have made, if those did not result in medications or specific "treatments"?

"Was recovery complete?"

Hell no. But I actually haven't decided if I'm going to stay in therapy once I'm on my own policy, because all of the plans I can afford pay nothing for mental health services until you meet your deductible, and only 50% after that. I cannot shell out these outrageous premiums for basic insurance in addition to monthly therapy bills. So if I'm not being treated for it anymore, is it safe to just tell them I'm recovered? How do they check these things, anyway?

I really do consider myself to be an honest person, and I get incredibly uncomfortable when I am not sure the best way to answer things, and when I have to do cost-benefit analysis to fudging the truth. I'm not sure how checkable these things are, how much these people know about EDs, or how all of this will weigh on me getting coverage. If they deny me, I can't very well go back and reapply with no mention of the ED.

Argh, does anyone out there have advice/comments from their own experiences with these types of applications? If you don't want to comment here, please feel free to email me privately.

Rewards

I took a road trip this weekend to attend a family get-together with my grandparents and various aunts/uncles/cousins (same location as this trip back in August). G. got to go, and the weather was absolutely gorgeous. That part of the country really feels like home to me, everything from the landscape to the local social customs, so I was looking forward to it. Also, I've been working on doing better with my eating lately, so although I've actually lost weight since that trip back in August, my energy has been improving and I felt much more stable, both physically and emotionally.

Accomplishments:

-Sitting up until way too late having beer and discussing the world with my cousin.

-Allowing myself a snack that was always my standard for road trips as a kid, but that I haven't had in a while.

-Not overcompensating for missed exercise sessions.

-Having extra energy to help my grandparents out. We went to an event on Saturday that was mostly outside, with performers underneath big tents. There was one that my grandmother really had her heart set on, but she moves very slowly and by the time we got there every.single.seat. in sight was taken. I roamed around, up and down, for about 10 minutes, and there was not a chair to be had. So I ran down to the next tent, two blocks over, grabbed three chairs for us, hauled them back, and wheedled my way up front to plant them in the very first row, so that my grandfather could hear and my grandmother could see (their senses, or lackthereof, are complementary at least). All they could talk about for the rest of the day was how happy they were to see me barging down the street with those chairs in tow, and it was probably the best I have felt about myself in a very, very long time. There are not many times when I actually feel proud of myself, you know. I can think of almost no examples. My grandparents and I are extremely close, and lately they have started looking older and older every time I see them. They helped to raise me, after my mom and I had to run away from my biological father, and I always knew they would do anything and everything they could for me. Now the roles are reversed, and I have to say that being able to take care of them, and to have the energy to put forth when they need something, makes me very, very proud.

I have attended this event with them almost every year since I was a kid, and I can remember so many times, starting in middle school, when it took every scrap of energy and willpower that I had just to make it through the day without collapsing. All I could do was muddle through the day in a hypoglycemic haze, mostly tuned out to the performers because my mind was alternating between calculating calories and counting minutes until I could get back into the car for a rest. This weekend was such a refreshing contrast, it really gave me a lot to think about and was a motivation-booster for staying on track and not letting myself slip back into such a disconnected, miserable state.

I tend to stress over quantitative things, even in recovery: grams, pounds, calories, BMI, minutes of exercise, etc. This weekend was a reminder that although the metrics may be a means to an end, the end in itself has got to be about regaining the qualitative things that make it all worthwhile.