Lizzie's Diary 23rd March 2009

So many times over the last few weeks I have logged on to write a new post and so many times I have logged off after not knowing what to say. But the latest comment has made me realise that I have to write something - if only to reassure everyone that I am still in the land of the living. So yes, I am alive and, if not exactly well, then definitely kicking. I must be honest though, I am struggling and am constantly aware of the temptation to restrict.
There, I have written something at least. Now all I need to do is click on publish post...

Lizzie's diary 2nd August 2008

This week I have handed over even more control. As I hadn't gained sufficient weight, they were encouraging me to reconsider inpatient care, but the thought of shared bathrooms and not sleeping in my own bed was just too awful. So as a compromise, I have decided to go in every day (as opposed to 4 days a week) and to stay for all meals (rather than leave after afternoon snack).

The days are quite well organised - more CBT than basket-weaving thank the lord. I get there for breakfast (8.15) which started off as a cup of cereal (mealplan "B") with 150ml milk and has progressed to a mug of cereal with 200ml milk plus 2 pieces of toast. Then we have a group - something like self-esteem, nutrition or body-image followed by mid-morning snack (which might be a couple of chocolate digestives, a chocolate bar, cereal bar, banana, piece of cake and a drink - they are quite restrictive on fluid intake and I spend half my time absolutely gasping). Then before lunch there is time for us to meet with our individual therapists or with the dietician. Lunch is at 12.30 and is pretty standard institutionalised stuff but not too bad. I have really struggled with the quantities and did a runner the first day I was presented with a full portion so am now back to half-portions and make up the deficit at other times. Each meal is followed by a rest-period during which we have to sit around and try not to expend any energy - no mean feat when most of us are used to being on the go all the time. Another group - either art, gardening, creative writing or yoga - takes us up to the next feeding time (15.30 snack - along the same lines as the morning one). Dinner is at 18.00 and is generally lighter than lunch. Then it is home sweet home, night-time snack and straight into the land of nod. So there you go, my week in a nutshell.

Lizzie's diary 27th July 2008

I know, I know. It's been ages - I'm crap. But at least there is a good reason for it. I started on the day-patient programme at Cotswold House 3 weeks ago (God is it really that long?) and to be quite honest, at the end of a day there thinking about me me me, the last thing I want to do when I get home is update my blog.

But I have to say, it is not half as bad as I had feared. Yes, it is hard and much of it is not pleasant at all, but the staff and other inmates make it a whole lot easier. The difference between this place and the Priory is incredible. I really feel they know what they are doing and feel that I can trust them even when everything inside me is fighting doing it.

I go for 4 days a week from 8am to 4pm and the aim is to gain a pound a week. So far I have put on 0.4kg but it is weigh-day tomorrow so watch this space...

Lizzie's diary 17th June 2008

I seem to have come to a grinding halt. That is 2 weeks without a gain and I am in breach of my contract. I don't know what to do. I was making such progress and feeling so much better and now I am in fear of slipping again. Why couldn't I keep the impetus up on my own?

But at least my BMI is now 14 which is a level at which the hospital would accept me on to the day-patient programme so perhaps that is the way forward.

Lizzie's diary 4th June 2008

Another small advance this week - a further 0.3 kilos - to 40.3 kilos. Not quite the pound of flesh I had promised my husband, but that means I am now a fraction short of 6stone 5lbs.

Slowly but surely......

Lizzie's diary, 27th May 2008

Diary entry: 27th May

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40 kg. Again. Well I suppose it is a nice round figure so its not surprising I've plumped for it.

Sometimes I pray to Cod for the veal-power to stop playing with my words but I fear it is too bread into me. For all I know, the wurst may be yet to come.

I am disappointed though - even the practice nurse had written in my notes that I was "chuffed to bits" last time I put on a pound. I guess it will go in fits and starts, but it is a bit demoralising, especially as I've just announced how well I am doing.

So it is a case of back to the drawing board or rather the mealplan, to identify the areas that had started to slip. And if all else fails I'll just down another Clinutren.

26th May - Note from Lizzie

Present weight 6 stone 4lbs, starting weight 5 stone 11lbs.
Weight gain so far - 7lbs!

Note from Barry

"Those of you who are sponsoring Lizzie by the pound need to get your cheque books out and go to www.justgiving.com/lizziegrimaldi because this weight has been maintained since the 6th of May."

Lizzie's diary, 25th May 2008

Diary entry: 25th May

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It's about time I wrote something but it has been so long, and so much has happened that I don't really know where to start. It feels really weird writing anything at all.
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First and foremost though, I need to say a huge thankyou to Hannah. But like all good things, her involvement in this had to come to an end and she has moved on to bigger and better things. So goodbye and good luck. Cheese sandwiches will never taste the same again. I would never have had the courage or strength to embark on this without her and we went through a lot together. But end it has so I shall have to build on what I have achieved which, thinking about it, is a hell of a lot.
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Shortly after the last diary entry we went on holiday - well I say on holiday, what I really mean is we were transported to another world. And for that time I got back a taste for living. It made me remember what I was missing. And when we got back and I got on the scales, I was genuinely thrilled to find that I had managed to gain enough to secure a stay of execution. Even better than that, the following week I had gained a further pound. I thought I was coming out of the woods and probably got a bit complacent because I haven't gained any more since then. Bugger.
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Having stuck so rigidly to the terms of the contract, I can feel myself slipping again and I'm scared. But having had that taste of how much better I felt (and I can't believe it was only due to the sun, sea, sand, personal chef..... well, maybe it was) I am not going to let myself go again.

Note from Hannah

Hello again all,

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Feels like ages since I last wrote this blog. So much has been going on in the last month or two - some good, some hideously ugly!

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To cut a long story short (and I know Lizzie won't mind me for being honest) things weren't really working out as they were. Sadly I have too much work on to provide Lizzie with the regular and guaranteed support that she needs. As she said in her blog, the 'duties' I'd taken on for this challenge had increased one by one over the last few months in order to try and get things off the ground and it wasn't feasible to continue with the same amount of responsibility considering that I am unqualified. What's more, I couldn't justify continuing when there wasn't a significant enough weight gain each week.

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So... things became a little tetchy for a while, and in the end we both agreed that perhaps the whole challenge needed a shake up, or just plain change. Only Lizzie could decide how that shake up was going to come about since I was taking a step back, and it appears that this new contract idea may do the trick. For one thing, it leaves no room to blame other people or situations that may arise. The daily meal plan is laid out and if it isn't stuck to then it's hospital, like it or lump it.

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Some people will have seen this coming from a mile off but hey, whether or not Lizzie did or not, I certainly thought it might work... and to a certain extent it has. At the end of the day she's gone from eating probably less than 500 calories per day to eating nearly 2000, purely as a result of constant nagging, guilt tripping and kicks up the proverbial, not to mention will-power and determination on both parts. Maybe, just maybe, she's got the tools now to work at it herself (with moral support from me, Barry, her friends, her sponsors and her carers) and make those final steps towards actually putting weight on?! Watch this space!

Lizzie's diary, 1st April 2008

Diary entry: 1st April

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A slightly better increase than last week (0.2kg) - more of a toddler step perhaps? but still pretty insignificant. I think we could have all done with a giant stride this week, but hey, at least it is still heading in the right direction. And we are only 2 days into the new contract.

Lizzie's diary, 31st March 2008

Diary entry: 31st March

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Well, I'm sticking to it. Signing on the dotted line seems to have made a difference. Minor clocks going forward-related misunderstanding at lunchtime yesterday threatened to throw the whole thing into disarray but by walking away, taking several deep breaths (and several swigs of rescue remedy) and locating a new frame of mind, the situation was diffused. And the afternoon snack was a breeze (well, tea and biscuits actually). But the only true indication of whether this is working will be on the scales. So lets just keep fingers, toes, eyes crossed for tomorrow. It may not be the whole pound of flesh which is demanded of me but it'll certainly be more than the paltry 100g of the past few weeks.

Lizzie's diary, 26th March 2008

Diary entry: 26th March

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I think a slight change of tactic is called for. At probably the same time, Hannah realised she had bitten off more than she could chew and I realised I was expecting too much of her. So I am relieving her of her food-related duties and instead have drawn up my own meal plan in tandem with a signed contract drawn up by the dreaded husband which basically states that I agree to gain a pound a week (or I go into hospital), that I address my food-associated behaviours (or I go into hospital), that I stick to my mealplan (or I go into hospital), that I stop blaming everyone (including myself) and accept that this is an illness (or I go...) etc etc. My terms, my decisions. And so far, so good. Watch this (ever increasing) space.

Lizzie's diary, 25th March 2008

Diary entry: 25th March

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Another minor increase. This is proving too difficult to sustain on my own. Perhaps hospital is the solution. I just cannot face it. I can't make that decision. There needs to be another way - this way. I have to take a deep breath and remind myself of why I am doing this, what I need to do, how I have to do it and then just get on with it. Without thinking too much. I tend to overthink everything and blow it all out of proportion. It's not that hard so don't make it. I have to sign a mental contract to adhere to the programme and constantly remind myself of it. Or hospital it is.

Lizzie's diary, 23rd March 2008

Diary entry: 23rd March

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This is just awful. I don’t know what I’m doing and don’t know how to (not) do it. I should be feeling better. Getting better. But I don’t. I feel worse. Physically, mentally, psychologically, emotionally. I don’t know how to feel, I think I’ve forgotten. I’m on edge. Jittery, unsettled. Detached and scared. Is this payback time? Have I done too little too late – “baby-steps” as someone commented.

Lizzie's diary, 22nd March 2008

Diary entry: 22nd March
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I am finding it really hard to write anything much – too much stuff going on. The only thing I can say is that I am concentrating on what I have to do in terms of meals, and then at least I can say that something positive has come out of this difficult time. It would be too obvious to use this as a tailor-made excuse not to eat, but I’ve never been the one to take the easy option.
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And the bed-time drink doesn’t half make you sleep well, for it is better to sleep on things beforehand than lie awake about them afterwards.

Lizzie's diary, 18th March 2008

Diary entry: 18th March

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Luckily the fiasco that was this weekend has not had too much of a detrimental effect on my weight (up by 0.1kg). But on reflection, I actually managed to adhere to my meal quite well despite all the upsets. I think I only missed out on 2 desserts and a snack or two. It is just such a shame that it happened, I really was making headway. I have to be extra diligent and vigilant while Hannah and Barry are away and prove I can do this. All my own work.

Lizzie's diary, 17th March 2008

Diary entry: 17th March
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So Hannah has gone to Dubai and Barry has left. Alone again.
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But I cannot and will not let this beat me, however may excuses I may have. I have proved to myself that I can eat even when the odds are stacked against me. I have to remind myself that I am doing this for me and no-one else. And I will be the one that suffers the most if I don’t.

Lizzie's diary, 15th March 2008

Diary entry: 15th March
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Tears are the symbol of the inability of the soul to restrain its emotion and retain its self command (Henri Frederic Amiel)
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My moods and emotions have gone completely haywire. Why is this happening? Surely I should be more stable now my nutritional status is improving, not less. I seem to have spent the last few days dissolved in floods of tears.
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I have managed to make up for Fridays blip and just hope it has not an adverse effect on my weight. I cannot afford to mess up, time is running out.
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I had another outpouring of emotion at lunchtime. Unquiet meals make ill digestions.

Lizzie's diary, 14th March 2008

Diary entry: 14th March
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One of the biggest problems with this diary is that the times about which you need to write most are precisely those about which you feel you cannot write. I don’t know what has happened, why I feel like I do. Is it being under constant threat, pressure, stress (whatever) of hospital, splitting up, doing what I cannot do? I can’t think straight, I’m not making sense. Everything should be so clear, so easy and straightforward but I have so many conflicting extrinsic and intrinsic messages. Why, when I need something so fundamental is it denied me. I need help but cannot provide it. If I have to ask it is already too late. I am dead set on this and am determined to make it work but I need support – even if it does come to incarceration, until such time we need to have given it our best shot. Maybe I won’t like it, but that is irrelevant. I’ve lost the luxury of preference.
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I was doing so well this week, no cutting corners, finishing everything that was on my plate (cobwebs included), deciding to have a snack instead of pretending (primarily to myself) that I would have it later. Then the proverbial hit the fan. I don’t know what I said or did or didn’t say or didn’t do, but it was wrong, wrong, wrong. And at the end of shall we say a slightly emotional day as a result of Hannah trying to tackle some of my pre-prandial behaviours, I didn’t have it in me to behave rationally. Things spiraled out of control and I am thoroughly ashamed to admit I gave in to it and let the anorexia win. Why? Why did I protest by clamping my jaw shut? Just stupid. What a waste of an evening – sent to bed with no dessert, no night-time snack and no Clinutren.

Lizzie's diary, 13th March 2008

Diary entry: 13th March
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Nicky gave me a summary the Keys paper which documents the Minnesota study of the 40s and 50s in which the effects of starvation on the behaviour of 36 young healthy men with no prior history of psychological disorders were observed. They were studied during a period of normal eating, during a longer period of severe restriction and after restriction was lifted. The findings are fascinating - bearing in mind the effects were a direct result of starvation - the men were not anorexic per se. Which begs the question, if you are genetically predisposed to it, can severe restriction actually induce anorexia or at least anorexic behaviour? Although the individual responses varied enormously, they all suffered dramatic physical, psychological and social changes.
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So many of the changes are just too familiar for comfort. Or perhaps I should be reassured - perhaps I am not a total nutter after all. Just starving.
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One of the most profound changes observed was in the men's attitude to food and eating - not only did they find themselves unable to concentrate on normal things (being plagued, as they were, by thoughts of food) but they started to adopt wheat could be called "behaviours" such as eating very slowly (guilty your honour), making unusual concoctions (not unless you count Chorlicks) and general bad table manners (licking my knife? picking crumbs? mea culpa) A few of them binged, and although the majority eventually went back to eating normally, some found it hard to assess exactly what normal was.
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Nearly all of them were depressed.
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Their previous tolerance was replaced by irritability and angry outbursts. They were anxious and many started biting their nails and/or smoking. They were apathetic (tick) and worryingly began to neglect areas of personal hygiene (does my breath smell?)
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Another aspect of the starvation was the shift in their social behaviour - they became progressively withdrawn and isolated which is something I feel myself drawn to when I'm down.
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Their concentration, alertness, comprehension and judgement were also......
Oh yes, also impaired.
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And so it goes on. I can tick so many boxes - decreased strength, hypersensitivity to noise and light, parasthesia, decrease in metabolism. one man said he felt his body was burning on the lowest flame possible to conserve precious fuel and still maintain life processes. Luckily, in rehab, their metabolism speeded up again. Phew.
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Unsurprisingly they were physically feak and weeble, however one or two went into Duracell bunny mode. Been there, done that.
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Take home message? That many of the symptoms I have are a direct result of the starvation rather than a manifestation of the AN; and that the most important thing at the moment is to restore my weight to a more normal level.
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But worryingly, those men's relationship with food did not return to normal even after the period of restriction ceased - in the short term they felt out of control and couldn't assess when they were hungry or full, symptoms which persisted even after normal weight was restored and in some cases took years to normalise.
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Very, very interesting though.
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Buoyed up by my conversation with the unbelievably divine Huge, I developed another snack tactic. Last weekend I had really questioned why I felt such guilt at playing the free-with-The-Times Scrabble CD-ROM. So to assuage the guilt I accompanied it with a cup of tea and a flapjack.
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I lost the game but won the battle.