Reviewing 2019: Part 1

Happy New Year! I can’t believe it’s 2020 already!

For those who read my blog, or for my own personal acknowledgement, it has been a while since I have posted a blog post. I believe my last one was possibly posted in March (of 2019)?
I was, for a few months, working on a blog post that I wanted to post, I just never had the energy– the motivation to finish the post.
(Maybe because it was probably going to be an even bigger downer…sooo, “Topic Change!”)

*** Trigger Warning: ***
Content below may contain sensitive topics, please read with caution ♥ 

A small catch-up since my last post and a bit of a review: Since finishing the DBT Program back in December(2018), I was quickly slipping back into habits I should not be getting into (i.e. not taking meds, sleeping all day, not caring). I let this happen for several months before hearing finally back from the Eating Disorder Program I was trying to get into. My name was near the top of the waitlist, and a start date was given to me. This made me realize, I needed to get back on track a bit– getting myself back into a routine was important. For the next couple months while I anxiously awaited to hear from the ED Program, I attended a few outpatient programs, at the hospital where I attended DBT.
June 10th, 2019, I was officially coming face-to-face/to the reality of my eating disorder.

. . .

I have personally been trying to get into this program for over a year. Personal obstacles always were in my way, but truly, I needed to put my ego aside as I started the hospital’s E.D. Intensive Program. I was told, as I started the program, that I would be a day-patient (in day-hospital — which is usually 6-8 weeks of programming), also that I would be put on a individualized meal plan (containing “choices” to fill), and will be monitored throughout my time in the program. I was also told  because everyone is on a different meal plan, different things are expected from each of us at meals. This included having our own breakfasts, and evening snacks at home, and if we did not have these meals, we would be required to make up what we didn’t eat in program.
The Intensive Program consisted of in-patients and day-patients. For those in day-hospital, (like myself), we were to attend programming Monday-Friday, each day attending different groups and programs designed around our diagnosed eating disorders.

(Schedule below, will only explain groups once to avoid repetition)
Mondays: 9am-6pm
– Starting at 9am, we had our Individual Weigh-Ins, which consisted of a nurse monitoring our weight on a weekly basis.
– Weekend Review and Goal Group was time set aside for everyone to have a turn sharing struggles and success that they may have had over the weekend, and to state a goal they were wanting to achieve that day.
– Lunch was then next. Everyone had a chance to use the washroom before our trays were served, then were locked by staff to try to prevent any symptoms. After everyone had got their tray, staff monitored everyone’s eating. Almost every day, we had a form of a sandwich or wrap to eat. We were given 40 mins to finish our total lunch, which broke down into: 15mins for the first half of our sandwich, then another 15mins for the remainder of the sandwich, and 10 mins for what the program classified as a “high energy item” (3 choices). This was also labelled as dessert, as it could be a food item that covered all 3 choices with that individual food item, or we were allowed to have an item that was 2 choices and another item that was classified as a 1 choice. Everyone was required to remain seated while eating, and required to finish their meals. If meals were not completed, a supplement drink was given to replace the remainder or the meal that was not finished (first week only), after that a contingency plan was put in place to make up any of the choices (food items) missed.
– DBT Group was after lunch (1hr 30mins). This group was very similar for myself, because of doing the 18 months Dialectical Behavioural Therapy for the Borderline Personality Disorder; this time it was in relation to the eating disorder. As a group, we went over a segment of the DBT Module, focusing on different skills each time and how we can relate/change our behaviours with the eating disorder.
– Then we were allowed a Break-20mins, which allowed us to have a break from program, use the washroom, and have a moment before Snack started. Staff again, locks the doors of the washrooms after we are done, and snak has begun. 20mins was given for everyone to finish their snack. Like at lunch, everyone was expected to remain seated while eating, and expected to finish their snack. If snack was not completed, a supplement drink was given to replace the remainder or the food that was not finished (first week only), after that a contingency plan, again, was put in place to make up any of the choices (food items) missed.
– After break we would attend a Rotating Topic Group (50mins). This group changed every Monday, going over topics like mindfulness, or nutrition information.
– Once we finished our group, it was time for Dinner (50mins). Dinner consisted of everyone taking turns to serve themselves dinner (scooping out our food from trays to learn portions for ourselves). Everyone was given 40mins for their main dinner, and 10mins to finish our “dessert” which could be a dessert item or a fruit. After everyone finished their food, we would go around the table for Check-out (10mins). Check-out consisted of how dinner went, any goals/plans for the night, and any difficulties we may be feeling.
– At 6pm, for those who where in day-hospital, we were allowed to leave for the day. For myself, I would usually hurry out of the hospital, so I could catch my bus home at 6:18pm, and prepare to come back tomorrow.
Tuesdays: 11:30am-6pm
– On Tuesdays, we started the day with Lunch, given time to come in and get settled before our 40min time frame.
– After we finished lunch, everyone would attend Feedback Group (1hr 30mins). Feedback Group consisted of going over food logs from the previous week, and receiving feedback from the group (counsellors/doctors/nurses). Everyone had a chance to say anything they would like at this time, ie. any problems in group, and conflicts. Individuals would also be given their discharge dates from the program, and when they could start the Transition Program, which was a part-days program at the hospital. This group could be very long and exhausting, and everyone would be in need of break by the end of this group.
– Break-20mins/Snack-20mins
– After break, we would attend Skills Group(1hr). Skills Group was an hour set aside a week to apply DBT skills to our Eating Disorder. Many times, in our group, we would go over personal examples, and would be assigned homework for the following week to take up in group.
– Dinner/Check-out
Wednesdays: 9:30am-6pm
– On Wednesdays, I would have a one-on-one appointment at 9:30am, with my assigned “counsellor”. Some people would see actual counsellors, some saw the nutritionist, and others, like myself would see one of the nurses. For about 45mins-1hr we would talk about anything that has been bothering me over the week, and we would work on a way to resolve the problem.
– When I finished my appointment, she would walk me to the unit, as everyone else needed to be at program for the day at 10:15, for Menu Marking(1hr). Menu Marking was time set aside every week for everyone to go over certain days of the following week that would have special meal days. This gave everyone time to prepare if any outside food was needed to be brought in for the following week.
– Lunch Out- leave at 11:30am-12:50pm/Lunch on unit-40mins
– After everyone had finished lunch we all would head off to Check-in Group(50mins). This group was an hour set aside from Wednesday-Friday, for everyone to do a group check-in. We would say how we were feeling today, how things have been going, and anything we may have been struggling with recently. Everyone would get an option to share and give feedback if they would like to one another, before we moved onto our next group.
– Mindfulness or Nutrition Group- 30mins (similar to Rotating Group)
– Break-20mins/Snack-20mins
– Education Group(1hr) was after break. In this group, each week we would go over a different topics of eating disorders, and how they affect individuals. Many weeks, this group would be really triggering for everyone, as we would end up remembering things from our past, or even connecting things from our past that has affected us over the years. This group, usually made dinner difficult for everyone next.
– Dinner/Check-out
Thursdays: 10:30am-6pm
– Check-in Group- 50mins
– Meal Prep- given 20mins (3 individuals where assigned each week to prep their own meals, which they would cook on the unit)/Lunch still 40mins
– When everyone was done lunch, we would have our CBT Group(1hr 30mins). Cognitive Behavioural Therapy Group consisted going over what is this therapy?, thoughts, and cognitive distortions. Many times, we would do a group example of applying the skill on someone’s personal example.
– Break-20mins(sometimes/most of time)/Snack-20mins
– Every Thursday, after break, we would attend our Life Worth Living Group(1hr). This group was an hour of time set aside “to enjoy life”. Usually, the person that was being discharged that week would come up with an activity to do. Some people did arts and crafts while listening to music as a group, others would pick a movie that we would all like to sit and watch together. This hour was time for us to all relax and focus on something other than our E.D.’s.
– Dinner/Check-out
Fridays: Alternating Breakfast at Hospital (8am), regular start 9am-1pm
– Breakfast 8am, every other week I would have to be at the hospital for 8am to have a small group breakfast that was usually from Tim Hortons. Those that were selected each week would have from 8:15am-8:50am to have breakfast. Those who were not required to attend this breakfast would be required to be at program for 9am to start check-in.
– Check-in Group- 50mins
– 10 min break
– Weekend Planning Group (1hr 20mins) gave everyone time to think of what their weekend might entail, and also gave everyone the time to pan what they might eat for meals and snacks over the weekend. Everyone would take turns going over their weekend planning with the nutritionist to make sure it met all our meal plans. This lead right into lunch.
– Lunch (40mins) , no check-out after lunch before finishing program for the the week at 1pm.
– On Friday’s, we were able to leave to go home at 1pm. Everyone would wish each other a safe, and happy weekend, and hope to see everyone again on Monday.
(at times, we would return on a Monday, and some people would either have discharged theirselves, or would not return.)

Most days, it took about an hour to the hospital, and another hour home at the end of the day– this alone was exhausted, not to mention how mentally and emotionally this program is/was.
Everyone on different meal plan which for me consisted of, expected to have breakfast before starting program

. . .

Week 1: anxious, did not fully finish meals, supplemented for 3 days during some meals, was shocked that I was being asked to eat 5 times a day, when in reality I would really only eat about once a day before coming into the program. by end of week, was starting to finish all the food at all 5 meal times.
Week 2: hoped this week would be easier, meals and snacks were difficult to finished, and still finished all meals and snacks. Body image issues we getting harder to fight off as I had already started to gain weight.
Week 3: getting into the groove of the routine, just as a long weekend approached. Started to open up more in groups, feeling more aware of self, yet still feeling anxious as I come off one of my medications. Emotions were starting to feel very overwhelming (as I was no longer restricting, this was stopping the numbing of my emotions, and lots were coming up).
Week 4: a shorter week due to a long weekend, and getting into the routine of “eating at normal times”. Able to identify personal vulnerabilities easier (which was very difficult in the past).
Week 5: given a discharge date for next week (July 18th), staying on track, realizing after next week I will be on my own more, exciting yet nerve racking since I will have to be even more accountable for myself.
Week 6: final week of day-hospital before starting the Transition Program the next week, the week of my birthday (which I tried to avoid) but the girls on the unit made sure it was still celebrated, hosted the Life Worth Living activity this week with another girl that was leaving the program this week. Was actually hard to say goodbye to the others in group (even though I saw a few of them when they started the Transition Program for themselves).

. . .

Once I was finished my 6 weeks, I was very ready, and anxious to start their Transition Program (explained in next blog) at the end of July.

To say 2019 was a year of Transformation, would be an understatement.
I spent the rest of the year focusing on me, and recovery, which is an odd statement for me to say. The rest of 2019, I will write about later,

But, until next time,

~S.J.