a tangle of incandescent talent and ingrained character flaws that can only lead to one end: self-annihilation. diary!blog graphic and triggering in content
for self injury, depression/suicide,
eating disorders, etc.
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i have purged a salad and eaten an orange total in the past three days and just have no mental interest in eating or drinking (and poor understanding of physical signals)
but i keep trying to buy and hoard food like normal so it’s piling up and i’m getting anxious over how i’m not wanting to eat it and it’s going to go bad and i don’t have the money for it to go to waste
i’m so cognizant of how it’s always just temporary, though, that i don’t want to fight it, can’t try to push food or fluids despite having to brace myself every time i stand because other than my surgery, this is the first time in like five years i’ve gone more than 24h without purging, down from an average of 5/day to <1 this week? how can i not try to stretch this as long as it will go?
thanks to this new insurance (and my hitting my out of pocket max in one go with that hypokalemia faint thing this week), generic meds for me are literally zero dollars. (thanks, obama)
which means i’m actually filling prescriptions and taking things i had previously ignored because i didn’t care about myself even five or ten dollars worth.
so two days of prozac and topamax (and potassium supplement and heavy duty proton pump inhibitor) and i’m spaced the fuck out, briefly dissociated so badly in the car during a weird instrumental classic rock piece that i literally should not have been driving because i could not feel my body, but i also just went an entire pizza shift with minimal food hoarding and no binging, even after i got home.
this is a first in probably years, and it’s so revelatory how much of this disease is fucking biochemical and compulsive. like, i still want to eat the pizza i brought home (because i still grabbed a bunch, i’m not fixed), but i’m able to not, whereas three days ago i wouldn’t resist at all because it’s like what if i was never able to eat again? or something. weird subconsciously catastrophic thinking that undoubtedly stems from famine training of ye olde restriction days.
I’ve had episodes of bad wooziness while at work before, because I am a trash human with trash behaviors including things like puking right before I go in and have to stand for prolonged periods.
But lmao tonight I managed to completely pass out in a patient’s room, have to be flopped into a wheelchair and then flopped onto a bed, only coming back after they Trendeleberg’d me for a bit.
Which would be fine if that had been all, I’m better within 5 minutes and maybe should sit down to work the rest of the day but we can make that happen, but nooooooo apparently making a fool of yourself in front of the entire ER means you get checked in as a patient and aren’t allowed to come back to work even after they run in fluids and check labs.
This is super shitty already, because I’d made a point to everyone that if something happens to me, I want to go to the other ER [so I don’t have people I work with looking for veins on my scarry arms or seeing my weight/diagnoses/psych history in the computer].
I picked an insurance with a low out of pocket max (Thanks, Obama), so I’m responsible for just the first $600 of the $3000 initial bill (which will go up because that just accounts for walking in the door, not labs or supplies or the physician fee), but how great is it that I made -$600 at work today? ugh
[[Also, my potassium was like 2.6 apparently, so I’m now psychosomatically feeling funny again. And really hungry, but afraid to eat anything until later in the morning when I can pick up the K script, since I am basically incapable of not-binging/keeping food down. I have actually had a Quest bar and two apples though which is a World Record for me not purging (oops too uncomfortable with gd fruit why do i suck) Medical scares often smack me into shape for a bit I guess.]]
subsuming your self-harm urges into destructive b/p behavior since that’s the only thing you have energy for amidst this depression bout
to the point where you get so fed up and physically in pain and angry at how the binges + sloth have caused a 7lb weight gain in 3 weeks that you swallow an inadvisably supratherapeutic dose of three different sedating medications just to make it fucking stop
(leading to literally 23 hours of sleep without moving, which is apparently my body’s threshold to wake me up having completely locked my hips and back like the 90 year old skeleton i am. holy shit, you should see the way i’m writhing like a birthing mother unable to find a comfortable position; it’s hilarious.)
probably the plan again today, tbh, since apparently i can’t be trusted for an hour awake without binging right now for some reason, and doing so is just triggering this anger at myself that i don’t usually get and can’t really deal with right now because that’s way too activating/motivating of an emotion when in a mdd slump ugetme
i think the SADs attacked real hard because i have been non-functional the past two and a half or so weeks.
sleeping 12-16 hours a day and not enough energy to even get out my laptop when i am awake, just lying in bed half watching something on my phone until it shorts out (because it likes to randomly die and then get caught in a restart loop?) and then shrugging and going to sleep more, punctuated by four or five middle of the night b/p sessions because there’s nothing else to do/nothing else i have the motivation or energy for. plus, really having to work hard to not do self-harm things (basically there by the grace of no energy don’t go i).
i was attributing it to scheduled PMDD time, but looks like we’re 0 for two-more-like-three months on that now. i remember saying this the past two months too, though, so it’s weird that maybe i’m still having enough hormonal swings to induce mood worsening without actual menstruation?
also had to go back to work this past week which probably didn’t help just in terms of it being an energysuck. i still feel stuck in pizzajob, trapped by it being decent money + bingefuel, but also hate having to go most of the time because the availability of food makes my anxiety so bad, like the world is fucking ending if i don’t b/p when i have the chance because what if i don’t have that chance again. i have called in sick before because i was up all night and didn’t want to go to work where i would have to b/p all day too, what kind of sense does that make? (honestly, if i had to attribute this mood to anything, it would be this, and the resultant major worsening of body image that comes with these more compulsive binges + additional weight from the pizza)
and the hospital is just unfulfilling and i try way too hard. while there’s more that i could learn from just being there of course, i’m basically 2039842308 eons beyond my job requirements (judging by some of the shit i have seen that is apparently acceptable charting recently, i mean holy gd) and that’s frustrating.
i just want to not be tired
i have had so many things i needed to write about over the past two weeks, but everything just seems so impossible right now
you know, it is really goddamned horrifying that i can walk out of a doctor’s office with a piece of paper in my hand saying “your BMI today is X” and nobody has a word to say about that.
like, is this just how diet-culture and thin-ideal fucked up we are now, that 40lbs under ibw looks as normal to other people as it feels uncomfortable to me? is my body image actually distorted at all from what other people see? i previously kind of operated on the assumption that i was objectively thin even if i couldn’t see it, but now i can’t tell; thanks guys.
my therapist basically validated me staying at this weight????
numbers are double obscured but still tw
i was talking about how there’s this obviously-biological mindset snap. i don’t know how to describe it without romanticizing it, but that no longer focused on food stage of ~starvation mode. (there’s the meal planning and grocery list browsing i do as a restrictor, but that’s different [less intrusive?] from the constant hunger and obsessiveness over when to eat and where to get food and when i’ll be alone next of a binger in my experience.)
it occurs as a gradual thing associated with caloric restriction, which ebbs and flows when i’m in bulimic-mode and not actively restricting, but is not usually present except for short periods where i’m more-than-usually undernourished for whatever reason. but then there’s the variant that seems to kick in anytime my BMI hits [[hover]], no matter what my behavior patterns were. i’m suddenly not interested in binge/purging at all short of almost obligatory to get some nutrition in, my weight drops like a rock [[down]], i’m able to do other activities and be interested in things like social engagements that otherwise would just have been treated as an opportunity for b/p, etc. (i’d wonder if the social stuff is because i’m more comfortable in my body at this weight, but 99% is just with roommate, who sees me without teeth now for fuck’s sake, so we’re beyond that lmao.)
anyway, therapist said that the goal now is to increase nutrition in a non-threatening way, even if i purge it (since part of my pathology is b/p on junk/cheap foods because worthlessness and low self-esteem and not wanting to waste healthful stuff on myself), and maybe just stabilize right here for a little bit. i may have accidentally verbalized a little more of my currently-severe passive suicidiality this appointment than i usually let slip, so i guess it makes sense that she’s on team-let’s-do-whatever-to-shore-up-some-emotional-defenses-for-a-bit
though she still keeps pushing for IP every appointment. obviously my eating disorder is in the “this is 10000% egosyntonic” stage once again, so.
lmao another round of completely normal labs (except for the chronic low wbc and high creatinine [which tbh are probably ED related but have been like that for years and nobody seems to care] and magnesium borderline high because I’d used epsom salt lax the day before)
it almost feels more than usual like being betrayed by my body, like these numbers are lying and not really reflecting the maelstrom of fuckery happening inside and continuing to present this “everything’s fine” facade when i’m really gd desperate for something to show that “hey no its not” to back up my sort of non-chalant saying so
because the day i got them drawn was the first i felt well enough to get out of bed after about four days of chest pain/tachycardia/dyspnea/orthostatic intolerance/two actual faints, telling myself daily that if it didn’t get better i would go to the ER for a PE workup (but then not going because i can’t ask for help especially from people who know me and might judge me). like, i’m doing better right now ~ish, but i have not bounced back from the surgery still because i’m not trying to exercise or do anything, and so i’m weak and basically atrophying down to flab and puke and infection and sometimes don’t even feel okay sitting up.
i needed something to be terrible so i would go to treatment because i’m not going to make the choice on my own. but i keep getting reinforced that i’m medically fine, despite being like 10lb from my lw and WAY more unhealthy than when i was there before due to aforementioned deconditioning.
I'm still very treatment-apathetic. My motivation to go right now is just feelings of obligation, because I took the time off work and because (thanks to fuckface president over here) there is a substantial chance I won't have insurance at all next year, and definitely won't have a policy where I can hit the deductible without going bankrupt. Despite even originally wanting only to treat my binge/purging, very disinterested in any weight restoration, and even hoarding a special stash of restrictive safe foods for after, I've now caught myself thinking: well, you don't have to keep up this frantic "get it out of your system, soon will be the last time" b/p pace, because you could always do it again or use up your leftover binge foods when you get back. That's clearly just an attempt to combat my very strong scarcity-trigger drive, but with that attitude, it really seems like there's zero point in the expense, even though going now would cost <1/10 than it would if I had to go next year.
I'm still just not thinking long-term at all. My roof is still broken, my teeth are constantly stressing me out (especially the cracked and loose one I'm just waiting to swallow in the middle of the night), my stove exploded and died yesterday, both my jobs want answers to when I'm coming back by tomorrow (which I could not give if I have any intention of now leaving for treatment), etc etc. I want that motivation to change back, but my anxiety is at a solid 9 right now.
Got a letter from my ~community support specialist that was all "we haven't gotten ahold of you in several weeks; HMU or you're dropped".
Well, you knew that I was going out of town for medical treatment #1, so if I was IP somewhere as planned instead of just recovering from jaw surgery, I wouldn't have gotten this at all?
Also, seems real fucking unfair that after my last CSS quit, I went the entire summer without one and nobody cared, but I don't call back for 1/4 of that amount of time and I'm being threatened with dropping.
Probably will be dropped, though, because last week they sent me notice officially that they don't have funding for anyone not on Medicaid/care and if I don't get it by Jan, I'm out. Now today's letter says one month from now, so idk wtf they are playing at.
Idgaf about losing the CSS because both I have had have been totally unhelpful (even when I have specific tasks they could help with and ask for it, like making appointments or returning calls for me; they seem only willing to do through things like going with you to dr/therapy appointments in person, probably so it's easier for them to bill), but it's my way into the only ED therapist in town -- she's out of network on my insurance but covered through this program.
So, went to Mexico, got some work done on my mouth, but nothing like what I'd hoped for because my mouth is so fucked it's going to take a bunch of visits and probably a year. With how much extra travel and missed work expense I'm looking at, it's probably going to only be fractionally cheaper than getting it done here :/
Stayed at my parents' for about a week to start healing up, because I couldn't wear the partial to cover all the holes in my mouth yet (still can't really -- stitches are out and it's hurting less to wear, but there's a spot of wound dehiscence right over one of the implants I'm trying to baby), but finally got fed up with my piece of shit brother and all the verbal abuse he hurls at everyone all the time and snapped back. Per usual, he tattled to mommy who instantly defended and excused all of his behavior -- I don't understand how she literally does not see that giving him everything and never holding the line has created this monster with whom both siblings and very nearly his father have had to go no-contact. So, fucked out of there on very bad terms.
Back at home now, still having to hide inside the house both because I'm ~out of town for medical treatment~ and more because my mouth is not fixed and I need more work done imminently to fix or replace the tooth that was knocked loose by its treatment and hurts.
Still supposed to go to treatment maybe while I have a few more weeks off, but I don't really have any desire to do that anymore. Which sucks, because the best idea was to go right after getting my mouth worked on so that I would have that support to not b/p and fuck things up. Nope, lasted about three days (two of which I didn't eat anything at all, and spent my plane ride home trying not to puke because I was floating around a sugar of 40). I make a good argument that it's just logistically unfeasible when I can't eat with my faketeeths in yet (possibly for several months), and keep requiring massive amounts of pain meds for the wiggly infected tooth, and being in a situation where I can't just grab a handful of naproxen or run off to the bathroom to fuck with my teeth right after meals is untenable.
But I think more I'm kind of depressed right now (probably lots of tooth shame, disappointment that things are not more fixed in my mouth after ANOTHER round of time and omg so much money, being in pain all the time, fight with family, side effect of Tramadol?, not taking my Topamax which has a good mood stabilizing effect for me, moderate weight gain from several weeks of binging and shitty purging due to having to be more discrete than usual both in Mexico and at parents' house) and haven't been thinking about the future at all. I'm only interested in treatment when I'm able to think big-picture and able to actually see a future where I go to medical school and stop being a piece of shit. Otherwise, I'm in the place I find myself now, pretty content just puking myself likely to death.
So here's a fun story about what it's like to travel to a country where you speak about 40 words of the language to have oral surgery:
It's all fun and games until they split your jaw open and you literally cannot eat anymore, which is my only recreational activity. Compound that with the constant stress over being also now mostly toothless on that jaw, forced to remain that way for unknown how long until the swelling totally resolves (and under threat that wearing your partial at all before it's totally healed in 10+ weeks could fuck everything up and waste your $thousands and result in killing another chunk of jawbone), it looking like it's going to heal funny because the guy put the stitches in too tightly which would ruin the ability to wear the fake teeths anyway, AND now not being able to b/p to cope with your feelings, and I would prefer to die.
Idk, I'm overall pretty accepting that this dentist knew what he was doing, but it doesn't change that I'm really upset about how it's not a one or two appointment thing (because the reason I lost teeth in the first place was because I have a weirdly set-up mouth/jaw that resulted in major bone loss from tissue ties, they have to fix the bone and put in implants really tentatively). $4000 + $350 in travel expenses just for this first appointment, in the setting of me being off work 6wk (originally because I was supposed to go to ED treatment, but then I had another chunk of bone fuck up and decided I needed to do this urgently + while I had the time off, and now it's not like I can go and do meaningful work because I'd basically have to be entirely on supplements, which would not treat my binging) is very not good. If I don't have teeth I can wear, I can't (won't) go back to work at all, because I'm too shamey about my mouth, so tbh I'd rather just quit and then also be able to mb still go to treatment, but while I could get another pizza job, I don't think it'd be as easy to go back to hospital.
I feel like I'm almost getting a taste of what treatment would be like in terms of bulimia detox. After not eating at all for several days, and now being really strict to avoid having to purge (but still binging on stuff like cookie dough and jars of dip and meatloaf because I'm fucked), I'm constantly hungry and angry about how I can't eat and in pain and have tonight moved on to crying. (I also have no idea what my weight is because I got off the plane in parents' town and am still at their house; I'm sure I'll be horrified no matter what, as either I've dropped 8lbs or haven't despite the weird restrictive eating.)
this coming monday was basically when i was supposed to admit somewhere, but that is totally all fucked now because my life went to shit
two weeks ago, a tree fell through my roof, and insurance is being a fuckwit about dealing with that. i mean, admittedly, there is a bit of weather happening in other places right now, but there’s been nothing but blue skies here and it’s been two weeks and i have a tarp over six holes in my ceiling.
and then i (you know, with the best intentions) killed my cat, which sucked a lot. insert instant mdd flare punctuated by two day episode of probably justifiable moderate substance abuse (i mean, if you benzo yourself to sleep for two days with ill intent but don’t actually take more than the bottle says, you’re fine, right?). that plus the below pain issues are still really fucking me up in a compounded way; there’s a lot more impotent anger (which as per usual i take out on myself by doing things like huffing off to bed and not eating for 48 hours like anyone would notice but).
so as if that wasn’t enough reason that leaving home wouldn’t be the greatest rn, i’ve suddenly got four different spots in my mouth that need teeth pulled, two of which Cannot Happen because they are crucial to other dental work in my mouth and one of those i suspect was knocked loose during my EGD last week. But i’ve been in pretty near constant pain averaging a solid “i am considering pulling these myself right now” for at least the past week (half the time tooth and half the time the fact that it’s easier to count non-headache hours over the past week, which has never happened in my life), so i hope that if i can just figure out which ones are flaring the worst and get that under control, the others might calm down (like the one that might only be angry because it just got a large filling and doesn’t need to die).
also i think one of them might be infected because it was just dental pain, then + maxillary and radiation to ear, then + tensiony headache, and then the past few days it’s been all that + subjective fever. but still no teeth specifically have that characteristic “make you scream when tapped on” of an abscess that would make me go “yup, can’t be saved, gotta yank it” so i’m hesitant because dnw lose teeth....
but that’s terrible and like all pain it’s made worse by stress, and the fact that i have such fucking terrible bad-tooth shame, and the fact that i’m perpetually at a loss for how to fix the issue because i don’t really have a dentist right now (i keep going to this walk-in low income place that only can do like one filling or extraction because my other low-income place is months out on appointments), and the fact that low-income people are not offered the appropriate treatment for their condition (like the bone grafts i needed after my mouth infection so i could eventually get that to heal right)
i just can’t think about anything else right now. i can’t go somewhere and be expected to eat like this when i literally cannot function. i cannot go somewhere and be expected to eat after having four teeth pulled without having some kind of something to replace them. i took off work already, i mean fuck, but my timeline is just wooooooosh until i can get this taken care of.
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