So I am going inpatient at St. Paul's on the 27th of November. Very nervous about it all. Just being outside the ward makes the hairs on the back of my neck stand on end. While IP can help with many things, being around other very thin girls and being surrounded by people struggling to eat and displaying many ED behaviours is very triggering. Most of the time I avoid situations that would involve this. (ex. A couple of years ago, I was going to a support group for people struggling with eating disorders. Although it was nice to be able to talk about struggles and be understood, I also found myself stressing more about my weight, wanting to be thinner, envying other girls I felt were thinner then me, etc. In the end, I had to stop going because it was doing more harm than good.) I know I need to stay focused on me and my goals but it can be very difficult.
Saw the nurse who does the pre-intake appointment. I like her a lot and I feel supported by her. However, I still don't have a lot of trust that things will go smoothly and that the things we agreed about will be followed by all the nursing staff. It is hard to be locked on a ward where as a patient you have little control.
I will be eating in my room which I am not thrilled about. There is a "minimum meal plan" that everyone who is eating at the table must follow. I don't drink milk at meals and I don't have protein at my breakfast so I can't eat at the table. I have eaten a meal plan that is like this minimum plan in the past, but I have found I do better with smaller meals and more snacks. (I have 5 snacks each day.) In the end, I am eating the same total amount as people who are eating at the table because I have more snacks, but apparently that means I might trigger people at the table at meals because I would have less items. So much for an individualized program. Dr. R. insists the program IS individualized. When I try to demonstrate how it caters more toward a group model (everyone must do the same thing or there could be conflict), she seems to be unable to see how that is so. Sigh!) I did talk to another dietitian about my plans and she was totally supportive of what I was doing unlike the dietitian who works on the ward. That dietitian keeps talking about when I am willing to take more risks and add items to my meals so I will be able to eat at the table. She is failing to recognize I am telling her what works best for me and not that I am scared to do it another way.
However, the intake nurse did talk to the internist and I will be able to take colace and spironolactone. The last two times I was there, it was a major effort to get them to give me the colace as they use something different now (luckily the pharmacist backed me up) and I have never been able to get then to give me the correct dosage of spironolactone. So I am relieved that this has been taken care of.
The one thing that still troubles me is how things are arranged with the internists. Apparently, they are merely consultants - there is no acting internist that "belongs" to the ward. There are also three of them who rotate and they all have their own individual ideas and beliefs about how things should be handled. Also, they often come by only when they have time so they may not see the patient they are making decisions about. I find it very anxiety provoking to have orders written for me without having a chance to talk to the physician writing those orders. While lab work, written notes, book knowledge and experience help a lot, I still think decisions should be made with a patient being able to give personal information as well. There is no stand in for that. I really don't feel it is good medicine to not be meeting and talking with the patient you are making decisions about.
Hopefully having set up some guidelines we all know about will help things go more smoothly. I worry as in the past I have struggled a lot with intense drops in my mood, self-harm, and dissociative episodes. It is strange as these things have only happened at St. Paul's, not at the two other places I have gotten treatment at. I will use the two weeks I am there to see how things go and see how I cope and make a decision if further time there will be helpful.
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