Last I wrote, I had resolved to do whatever it took to stay in the Partial Hospitalization program. And guess what happened? I left the program. 😬
Part of it is that my insurance only approved a certain number of days. I could have fought for more. However, the more I thought about the whole program, the more I began to realize why it was time to go home.
Going in, all of us were aware that an eating disorder treatment center wasn’t necessarily the best place for me, but we knew there weren’t any other options. The program I needed simply didn’t exist, and this was the closest thing that we could find.
What I needed was somewhere where I would be fed consistently every two hours and retaught how to properly fuel myself. Due to gastroparesis, I’ve lost a significant amount of weight in the last few months to a point that became dangerous. I did not have an eating disorder. I did, however, have issues with eating.
What I didn’t need were hours and hours of therapy focusing on body image and emotional regulation—I’ve been working on these for a long time already. I didn’t need the early mornings, the tiring schedule, and the restrictive rules about the bathroom. And yet there’s nowhere you can go to focus on proper nutrition in a supervised, controlled environment that is not an eating disorder program with those other attributes.
What made me decide to leave?
It wasn’t just insurance or boredom with the hours and hours of therapy. My body made it very clear when the program completely sapped my energy. And I don’t mean I felt tired at the end of the day. I mean I was so exhausted that I slept in until 1 PM on the weekend and still had swollen glands and other flu-like symptoms—aka, a flare of my M.E. symptoms. During the week, all I could do was lie down the rest of the evening and not get anything done for my at-home desk job.
At a certain point, the resulting exhaustion from the long hours of PHP was going to completely backfire and hamstring my ability to stick to a meal plan at home. I realized that this was becoming the case due to the excessive need for sleep.
And then there were all of my food sensitivities to deal with. They did accommodate gluten-free food because of my gluten-triggered migraines, but I re-discovered that not even gluten-free grains are okay for me. I was hoping to eat all the gluten-free whole grains they gave me and discover I wasn’t actually sensitive to them, but my severely swollen hands and wrists belied my wishes.
Let’s just say I know I would carry a diagnosis of Seronegative Rheumatoid Arthritis if I ate grains daily on an ongoing basis (as a kid, doctors looked at my slightly swollen joints and predicted I’d have full-blown RA as an adult). My hands became so stiff the other week that typing was difficult, and the pain was a constant nuisance. I run the gluten-free grains experiment at least a couple of times per year and always get the same results with my joints. Every single time, within a couple of weeks of no grains, the inflammation is at least 95% gone. And this time, I also noticed my IBS symptoms abated after cutting out the grains.
So between the inflammatory reactions from not eating paleo and the energy crashes from all-day therapy, my body made it clear I needed to go home. It was time to go back to my dietician and create a meal plan with foods that I know work for my body. It was time to find a therapist that had a clue about the intersection of chronic illness and food struggles of all sorts. And that’s what I’ve done, with great success.
All of this being said, I’m glad I did Partial Hospitalization.
Although there were aspects of being in a PHP that were harmful in the short-term, on the whole it was a positive. It forced me to eat a wider variety of foods than I was so that now I’m actually eating a diverse enough diet within the constraints of my sensitivities. It jump-started the re-feeding process so that I can do the rest at home.
Two weeks after leaving, I’m in a much better place physically and mentally. I’m still not permitted to know my weight because of my history with eating disorders, but I’ve gained some back. Honestly, I can see that I look better than when I was skeletal a month ago. And I’m not getting headaches every day anymore. Most telling of all, I’m able to finish meals much more easily, meaning my GI system is working better.
Continuing with better nutrition is going to be an ongoing challenge due to my health issues, but at least now I know I’m capable of fueling myself in spite of everything.
Perhaps I’ll do another post about what I actually eat since there’s a misconception that paleo means all meat and no carbs—not the case at all! And yes, it’s a delicate balance to not demonize foods the way eating disorders try to and to instead look at my dietary restrictions in a more positive light… I have a bunch of other posts almost ready to publish, but I’m sure I’ll get around to writing about this soon.
So for now, I want to take a moment to say thanks to all of you who have left comments and sent encouraging messages over the last few weeks. It has been so helpful and meant a lot!