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Obligatory Post-NEDA Week Post

Last week was National Eating Disorders Awareness Week, and I never finished my obligatory “I hate anorexia” post. I had planned on describing my experience with the disease. I was going to tell you how I suffered for eleven years, how I weighed 70 pounds, how I refused to eat more than 200 calories a day, and how I was forced to dropout of school (twice!) to go to treatment. I had intended to throw in some gruesome details about hospital stays, ambulance rides, residual health problems, and diet pill overdoses. I was hoping to include some statistics, too—pie charts featuring mortality rates, bar graphs with instances of relapse, colour-coded information about demographics, etc. I had even picked out some literary-rhetorical devices to enhance the gravitas of my manifesto. I was supposed to convince you that anorexia was the worst thing in the world and that recovering from it is the best thing you could ever do. But I can’t, because that would be a lie.

The truth is I loved being anorexic, and I loved anorexia. It made me happy like nothing else ever had, perhaps like nothing else ever will. I genuinely enjoyed losing weight, and starving myself gave me an irreplaceable sense of self-actualization. I found solace in every pound that I lost. Each new bone that protruded was a badge of honour. Exercising five hours a day became a point of pride. Hunger made me feel elated, and there was no euphoria like resisting it! I delighted in the scared looks from strangers on the street. I greeted each hospitalization with a smug smile, because at least, they meant I was doing something right. Cutting up a protein bar into seven pieces and eating it–and only it–throughout the day was thrilling. And most of all, there truly is no greater joy than stepping on the scale and seeing that you’ve reached your ultimate goal weight.

But Let’s Get Real—that was this year’s theme, after all—there are other things I want to do with my life; I have hopes, I have dreams, I have goals, I have plans. I want to go back to school to earn my PhD in English Literature. I want to be Shakespearean scholar. I want to publish a variety of criticism and lecture at universities across the globe. I want to act in the Royal Shakespeare Company. I want to write a novel. I want to dance. I want to win a Tony. I want to perform in Carnegie Hall. I want to fall in love. I want to get a dog. I want to visit Australia. These are all things I cannot do with an eating disorder, so I have to make a choice. Anorexia is an all-consuming illness. It’s it or everything else. And I choose everything else; I choose a life, I choose the future, I choose recovery. Not because I want to, but because I have to.

Our Unhealthy Bodies Can’t: The Problem with Project Heal’s New Campaign

“My Healthy Body Can” is the title of Project Heal’s new campaign. In conjunction with Straight Curve Film, the organization is encouraging participants celebrate their recovered bodies by posting pictures of themselves engaging in various (presumably physical) activities that they are now healthy enough to enjoy. The endeavour and its endeavourees are admirable, but there are some very obvious issues here.

This is a remarkably ableist, exclusive, and offensive campaign. With its tagline, “My Healthy Body Can” this movement neglects and excludes a huge portion of the recovery community–the chronically ill, the disabled, individuals who settled at unconventional body weights, and those with irreparable damage done by their eating disorder. What about them? Their unhealthy bodies can’t. Does that somehow disqualify them from celebration? Does that deprive them of support? Does that discredit their achievements? Does that discount their recoveries?

It shouldn’t. They have had to fight even harder for recovery. Treatment resources are harder to come by, care is more expensive, certain problems are taken less seriously, and every day is a struggle to balance the mental and physical components of their recovery. Some of of them will never recover from their eating disorders; some of them literally can’t.

I am one of those people–one of the unhealthy, one of the excluded, one of the perpetually sick. I will never recover from my eating disorder. I have incurable cardiovascular, endocrine, reproductive, digestive, and metabolic damage from ten years of severe anorexia. I suffered a heart attack that has led to irreversible myocardial tissue death and dangerous tachyarrhythmias, which will only get worse; I do not get periods, have a less than optimal body fat percentage, and can never bear children; I eat a specialized diet of 4000 calories a day, catered to my numerous acquired food tolerances and permanently low electrolytes, to barely maintain a below minimum BMI; I see doctors weekly, exercise daily, and take medications (nearly) hourly to keep my liver running, my kidneys working, and my heart beating, but, despite all that, I will someday need transplants anyway. My body is not and never will be healthy, and because of that, there are many things I cannot do. Maybe you can ride your horses and do your yoga (thank you, Amalie Lee for that gem!), but I’ll be here in a hospital, hooked up to a heart monitor, trying not die.

So, Project Heal, I’ll ask you once again. What about us? I see you’ve replied to your dissenters with a copy-and-pasted link to a tokenistic (phrase borrowed from the wonderful Michelle Elman) blog post, but I think I speak for everyone when I say, that isn’t good enough. Please apologize, please revise your campaign slogan, and better yet, please help us. We want and need, deserve and demand change. Increased support and resources for the minority members of the eating disorder recovery community–for those of us who don’t have the perfect, conventional recovery–are essential. Our unhealthy bodies can’t, but we matter, too; we deserve help, too; and most importantly, we can recover, too.

Valve Disease Day

Heart valve disease is a generic term for any instance or event of heart valve malfunction. It includes both congenital and acquired abnormalities and applies to all four of the heart’s valves (aortic, mitral, pulmonary, and tricuspid). The three types of valvular ailments are enumerated below:

  1. Prolapse: When a structure prolapses, it falls down or forward. In the case of a heart valve, this means that the leaflets thereof do not close properly during myocardial contraction, flopping or bulging outwards instead. Often times, this leads to a condition known as regurgitation where blood leaks backwards into the chamber from which it came. In most cases, prolapse is relatively benign, resulting in a mere murmur or mild palpitations and warranting little to no treatment. It is commonly a phenomenon of the mitral valve, but technically, all valves are susceptible.
  2. Stenosis: A stenotic valve is narrowed and hardened. This makes it harder for blood to travel through the valve; consequently, corresponding chambers have to exert more force to achieve their purpose, which, in time, will lead to hypertrophic cardiomyopathy and/or heart failure. Regurgitation can also occur. Generally, stenosis affects the aortic and pulmonary valves (particularly in congenital cases), but it can occur in the other valves as well. Stenosis is a much more serious condition than valvular prolapse, and it is consequently treated much more aggressively. Surgical intervention (keyhole or open heart) is often needed, and although valvuloplasties provide a temporary relief, the aim is either replacement or repair; valvular stenosis can also be the underlying cause of problems that warrant other surgeries including but not limited pacemaker implantation and complete heart transplants.
  3. Atresia: Similar to stenosis, atresia is an abnormal closure of a bodily passage; the term is typically used to refer to mal- or non-formed heart valves where (nearly) solid sheets of tissue disrupt blood flow. It is typically a congenital condition, and it is most frequently seen in the pulmonary valve. Cases of atresia require immediate surgical attention; catheterization treatments include radiofrequency ablation, balloon valvotomy and/or sepsotomy, and stent placement while the open-heart options feature procedures such as shunting, the Glenn repair, and the Fontan procedure; in some cases, a complete heart transplant may be necessary.

All of the above share relatively similar symptoms, including fatigue, dizziness, weakness, palpitations (and other non-perceived arrhythmias), heart murmurs, angina, edema (especially in cases of stenosis), and cyanosis (especially in instances of pulmonary atresia). They also have common risk factors including age, hypertension, diabetes, drug use, and an unhealthy body mass; connective tissue disorders (such as Marfan Syndrome), pre-existing heart disease (e.g. a history of myocardial infarction and/or atherosclerosis), and prolonged infection also predispose patients to valvular illness; congenital defects, although themselves idiopathic, are also causes. If you experience any of the aforelisted symptoms or display any of the above risk factors, consult a doctor immediately. These ailments are diagnosable through uninvasive, relatively inexpensive tests (a physical exam, an EKG, and an echocardiogram). Getting heart-checked does not take long, and it might just save your life–this Valve Disease Day and every day!

National Frozen Yogurt Day

“Food holidays” are a rather contentious topic in the eating disorder recovery community. Some people see these occasions–specific calendar days given over to the celebration (and consequent consumption) of certain food items–as detrimental, arguing that they promote binge eating and/or facilitate restriction. I can certainly see this side of the matter; one could binge on the designated food and/or “carb-load” (restrict carbohydrates to “justify” a future surplus) in preparation for the day. A case could also be made that such events sabotage intuitive eating; they could theoretically create a sense of obligation where a patient feels they have to celebrate–that they have to eat the special food on the special day–or conversely, that they can only eat the special food on the special day. These points are valid, and I completely understand where the dissenters are coming from; this just hasn’t been by experience at all.

I, for one, find these “food days” to be extremely beneficial. In recovery from anorexia, it is very easy to get stuck in an limited diet of “safe foods”, and at the very least, these occasions offer variety. They present the perfect opportunity to conquer a fear food in a structured setting; in fact, they may very well be the push you need to move forward in your recovery in that regard. Additionally, such holidays acquaint you with new food items, which, in addition to providing personal enjoyment, nourish your body with a differing array of micronutrients, contributing thereby to an overall healthier nutritional profile.

By no means am I suggesting that you celebrate every food holiday in existence with a jumbo portion of whatever the occasion calls for. No! In fact, I’m not suggesting anything. I’m just sharing my personal experience and encouraging you to find what works for you. Maybe that’s food holidays, maybe it’s not. Talk it over with your treatment team and decide from there. For now, though, I’m going to celebrate NATIONAL FROZEN YOGURT DAY!

Making Pancakes on a Sunday Morning

You’ll wake up one morning, and you’ll be really, bizarrely hungry. You’ll yawn, rub your eyes, and contemplate going back to sleep. But you won’t; you’ll swing your legs out of bed and slippers half-on you’ll wander into the kitchen. Without a second thought, you’ll start making pancakes, greasing the pan with butter and adding extra chocolate chips. You’ll flip them, and it’ll feel so easy, so fun. They’ll fly through the air, and you’ll laugh as they land on the stove with a plop. You’ll have to put them back in the pan and wait a couple minutes. The edges will turn golden-brown, and you’ll switch off the stove. You’ll finally find that syrup in the back of your cabinet, and you’ll open it for the first time in years. It’ll all spill out, too much, but you won’t really care. You’ll just dip your finger in it, and you’ll realize that this, this is what recovery tastes like.

Ingredients:

  1.  1 1/2 cups all purpose flour
  2. 2 eggs
  3.  3/4 cup blueberries
  4. 1 cup milk
  5. 3 tablespoons melted butter OR mildly flavoured (I recommend either vegetable or canola, but coconut can be substituted if necessary) oil, extra for greasing and garnish
  6. 1 1/2 tablespoons vanilla extract
  7. 1 3/4 tablespoons sugar
  8. 2 teaspoons baking powder
  9. 3/4 teaspoon salt
  10. Maple syrup, optional, to taste

Preparation:

  1. In a large bowl, combine flour, baking powder, and salt. Mix thoroughly and set aside.
  2. In a smaller bowl, combine the eggs, vanilla, and milk. Whisk well.
  3. Combine the contents of the two bowls. Stir until the batter is uniform.
  4. Add blueberries.
  5. Heat a griddle or large frying pan to medium heat. Grease it with butter or oil so that the pancakes do not stick to it.
  6. In approximately 1/4 cup portions, ladle the batter onto said pan.
  7. Let the pancake cook for approximately two minutes or until golden brown on the bottom.
  8. Flip your pancake and cook for another 2 to 2 1/2 minutes.
  9. Repeat steps 6-8 until you run out of batter.
  10. Serve pancakes with butter and syrup.
  11. Enjoy!

A Walk Down Wardour Street on a Late December Evening

Note: I set out to write a cheery Christmas vignette, but this is anything but! The following post, an account of a past Christmas, contains mature themes, disturbing imagery, mentions of suicide, descriptions of eating disorder thoughts, and “sick photos”. If you are easily triggered, please exercise caution when reading. Thank you, and have a very Happy Christmas.

There were lights on lamp-posts. They flickered—on and off, on and off. Were they dying, too? Blurry through the haze. And they were barely visible now, hard to see; hard to keep her eyes open, she could hardly breathe. But really, they were just lights, lights in the darkness, what was there to see? Incandescent and rainbow, festive and free.

And there were pies in the windows—tiny, white, dusted with powdered sugar, filled to the brim with fruit—with apples, with cherries, with blackberries, with pumpkin, with rhubarb, with mince meat—with pecans, with chocolate, with creams… Should she get one? A smile cracked her lips, ripping through her cheeks, shredding like scissors on wrapping paper, and a laugh clogged her throat—a gurgling sound, a gravelly sort of choking. Was she gagging, asphyxiating? And my god, she couldn’t breathe. It was the thought—the thought of it, the sheer ludicrousity of it, the misery; it was just so funny, so funny that it was killing her. But she had to get going now; she really had to keep walking.

The pies could keep leering at her through the bakery windows for all she cared. She really had to get going; she really had to keep walking. She really wanted one, though; yes, she really did want one. But no, it was fine; she was fine. And no, no, she would not be getting one. Besides, she only needed to see them to taste them, smell them to feel them—in her mouth, against her teeth, down her throat, sitting in her stomach, squatting in her skin, boiling in her blood, infiltrating her cells, turning to fat. So no, no, she would not be getting one.

And there was tinsel on the roofs. She could see it despite the darkness. It was hanging, hanging, hung—silver and sparkly, limp but lovely. Oh how she wanted to take a piece! She could wrap it around her neck, drape it like a scarf, pull it tight and feel the warmth, tie it to a hook, hear a crack and feel the pain until—thank god!—she couldn’t breathe. Well, it was dark inside, too, she supposed.

And there was music in the shops. Tambourines tinkled as jingle bells jingled. Shop doors opened, spewing music, spitting warm air into the cold—yes, the cold, the bitter, biting cold; she could feel it in her bones, taste it in her lungs—was that why she couldn’t breathe?—, hear it in her ears—a popping, a pressure, a pain, a pleasure. There was a heaviness to it, to the music, to how it sat in her ears and how it sunk there; it gave her that airplane kind of feeling—the one you get when you take-off or land (when the cabin pressure changes), the one you have to chew gum to get rid of. But gum has calories, you know.

And there was snow on the sidewalk. Legions of boots stamped through it, leaving lesions on the pavement, letting crusty, brown blood ooze from their scars. The wind whipped them over, beating them like frosting for a cake, concealing them from view; the flakes fell down again, and instantly they were cadavers covered in sheets, those hospital corpses that no one had claimed—hidden from view, under a blanket, yet still so very, very there. She wondered vaguely where they went, the footprints in the snow, but it didn’t matter. She just kept walking, her shoes slapping the sludge, sinking a little deeper into the spoils they had made. It was too cold out, and the snow looked too much like powdered sugar. She didn’t want to breathe it in; it might make her hungry.

And there was a girl in the middle of Wardour Street, standing on the edge of the sidewalk, too close to the cars. She was waiting for one of them to hit her, watching with bated breath as they passed her by. Snow fell all around her, and the wind threw her from side to side; she was a puppet on their string, a statuette of sticks, stuck together with the stuff of nightmares. A clock chimed through the darkness, and her heart skipped a beat. It was Christmas time in London, the perfect time to die.

World Heart Day

Did you know that heart disease is the leading cause of death globally, killing an appalling 17.5 million people a year? Did you know that every forty seconds one person in America will have a heart attack? Did you know that 657 people in the United Kingdom will have a stroke today? Did you know that over 25% of Australian men suffer from hypertension? Did you know that heart disease costs the Canadian economy over $20.9 billion annually? Did you know that a quarter of all deaths in India can be attributed to cardiovascular disease? Did you know that heart disease takes twice as many lives as cancer in Malaysia? Did you know that over half the Mexican population is at risk for heart disease? Did you know that 278,933 Russian males died of coronary heart disease in 2009? Did you know that 26 million individuals suffer from heart failure? Did you know that 1 in 100 babies is born with a congenital heart defect? Did you know that 42 million women worldwide have a heart condition? Did you know that 98% of people do not survive out of hospital cardiac arrests? Did you know that things are only getting worse?

Heart disease is on rise. There has been a 60 million to 1 billion person increase in cases of uncontrolled hypertension between 1980 and the present. 1 in 10 school aged children are now overweight. 7% of the world smokes cigarettes. 23% of adults do not get the recommended amount of physical activity. Diabetes has increased in many countries by 50% in the past ten years. These risk factors, combined with the aging population, urbanisation, and inadequate prevention, are leading to a cardiovascular epidemic. By 2030, heart disease will have an annual death toll 24 million as well as a global economic burden of $1044 billion. These statistics are terrifying, and it is time we start taking heart disease seriously.

So ask yourself, are you at risk? Is your weight healthy? Do you follow your national heart association’s recommended exercise guidelines? Are you a non-smoker who drinks less then 14 units of alcohol weekly? Is your cholesterol below 200 mg/dL? Is your blood pressure 120/80 or lower? Are your electrolytes and blood sugar within the normal ranges? If you answered no to any of these questions, you are, indeed, at risk. Go see a cardiologist as soon as possible. You should also schedule an appointment immediately if you experience any of the following: chest pain (angina) or discomfort, palpitations, shortness of breath, arm/jaw/stomach pain, any cardiac arrhythmia, fatigue, nausea, and/or sweating. It is better to be safe than sorry.

Please, please be heart smart this World Heart Day. Know your numbers, get heart checked, and commit to a healthy lifestyle. Protect yourself and those you love. I know you may think you’re invincible, but heart disease can happen to anyone; don’t let it be you. Thank you so much for reading, and I hope you have a happy, healthy World Heart Day!

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