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Wednesday, 2 December 2015

Things that being an inpatient taught me

There is A HUGE difference between adolescent and adult treatment programmes. As an adolescent there is a lot of pressure and focus on weight gain and it being done regardless of whether you're 'on board' I guess the way it's viewed is you're too young to make appropriate decisions about your health and treatment but over the age of 18 you're more maturity... Or something? What they seem to forget is that EDs have nothing to do with age and maturity. An ED is as irrational at 12/13/14  as it is in your 20s/30s/40s. Under 18 they will send you IP at a much higher BMI, sometimes not even taking weight into account, which is something that as an adult is the complete polar opposite of. You have to be at deaths door to even qualify for IP treatment, most places only taking those under a BMI of under 13 as there are so few beds. So those with the lowest BMIs are deemed to be the highest priority. (truth be told yes those with a lower BMI are in a more 'at risk' category but when you're older if you've had an ED longer, more damage has been done to your organs so BMI is more irrelevant).
Whereas in adolescent units there was an expectation to eat everything and if you didn't you would be NG fed, the units I've been in the attitude is 'well we can't force you to eat as much as you can, if you continue not to comply we'll discharge you'.  Threats of being sectioned or NG tube are a rarity. It's like all the effort goes into fixing under 18s and as soon as you hit over 18 if you're not 'cured' then they consider you fucked so don't see why they should bother as they will always have a new lot of younger anorexics who have a better chance of recovering and will be easier to treat.
Being able to regulate your body temperature is vastly underrated.  When you're underweight being cold is a given yes, and in my last unit I had a window that didn't shut properly. In December... And due to health and safety the hot water bottle I'd brought in couldn't be filled up with boiling water but they did kindly offer to fill it up with tepid water from the tap. At this point, hypothermia was setting in and I was losing control of my vocal restraint and snapped "you know it's called a hot water bottle for a reason". Depending on the hospital I've been in, there are units that think a single sheet will suffice to which my own duvet is bought in. At the other end of the spectrum the hospital regulation plastic duvets. These duvets are made specifically to be flame retardant but feel like they're actually made of fire. If the every 15 minutes torch in your eyes doesn't keep you awake then the pool of sweat forming under your body will.
Being able to choose your mattress is vastly underrated. Going into a unit with a very low BMI they insisted I had this stupid inflatable/deflatable mattress to prevent bed sores but I couldn't sit on it let alone sleep and after 3 days I was losing my mind from lack of sleep and begged for a normal mattress and they refused so I tried disassembling it myself at which point my Dr who had taken a shine to me agreed I could have a normal mattress as I was only in for an emergency admission (much to his chagrin as he wanted me in for the full programme, 18 months, no thanks). I got a normal mattress and a decent nights sleep. Well as decent as you can get in hospital.CHECKS
There is always a nurse of doom. For some reason there is always a member of staff that takes an instant dislike to me and it is usually the staff nurse in charge. Thus ensuing panic attacks whenever I see their name on the board when they're on shift.
Potato is overrated.
You say potato, I say potgetthatfuckingthingawayfromme
For somewhere that is supposed to be showing you what normal eating looks like they certainly had a funny way of showing it. Who in their right mind eats macaroni cheese with rice and mashed potato.... and the mashed potato hadn't been mixed properly so it was still part powder. I had an ongoing 'disagreement' with a nurse who insisted the mashed potato was made fresh on site. The people making it didn't even attempt to mix it properly. It was half 'smash' half powder, I showed her the evidence and she was still in denial. Why? because the canteen in the hospital DID get freshly made mash on site as I saw when I went own on my last day. Nice. Every meal came with either Smash, boiled potatoes, fried little potatoes, just some form of potatoes... Have I mentioned something? One of my least favourite foods in the world is POTATO. It tastes like wet cotton wool. I even hate chips and crisps, I KNOW..... I'm THAT weird, the only potato thing I like is potato waffles and only then if they're burnt so you can't taste the potato. There is no potato I like (sweet potatoes don't count, they're not potato, they're little angels in disguise).
The NHS needs to do a course in how to cater for vegetarians. Cheese. Apparently the only protein source for vegetarians, maybe beans once a week if you're lucky and not of the baked kind more of the in some kind of indecipherable sauce kind. Whilst the meat eaters got curry and sweet and sour dishes and casseroles and things with flavour and not to mention the different varieties of sandwiches the vegetarian options are piss poor in hospital. Actually that's a lie, in one unit I was in we had our own on-site chef and he made our own vegetarian versions of the meat dishes with quorn, which was great, however not so great that one of the nurses revelled in telling the vegetarians that the meat dishes were vegetarian. But that place was a rarity and the unit I've been in most often is what I've been used to and I've been served up still frozen food, meat (VEGETARIAN HERE), fish.

 Here's an example menu of what it was like and I'm not exaggerating the choices. All the meals served with some variety of overcooked of semi defrosted vegetables.
Mon cauliflower cheese, rice. Dinner Cheese sandwich
Tues macaroni cheese, mashed potato. Dinner cheese sandwich
Wed Macaroni cheese and cauliflower bake, fried potato
Thurs Bean bake, rice, mashed potato. Cheese sandwich
Fri Quiche and chips (fish and chip Friday). Cheese sandwich.
The weekend was leftovers from the week but worse as even less fresh. I should point out by cheese sandwich that there were no variations on the type of cheese it was always thick slices of fake tasting cheap cheddar maybe some coleslaw or slimy cucumber. The worst were the days when it was the ready grated cheddar days. I have a real problem with ready grated cheddar, I got ill from ready grated cheddar once and now the texture, thought, taste, anything makes me feel sick. It's that added potato starch around each piece of cheese. Blerghhhhhhhh. so yes that sandwich always went uneaten. and yes the nurse of doom was usually supervising me that day. I tried asking if I could buy the unit a toasted sandwich maker to make the sandwiches palatable but noooooooooooooo 'health and safety'. I remember my very first snack in an inpatient unit, quite possibly the most uninspiring dry and dull combination you can get. I'd spent all year starving myself and I get 2 rich tea biscuits and a cup of water. I make jokes about the food in ED units but I've always been very vocal about how poor it is (how typical, an anorexic moaning about food), especially for vegetarians. Hospital food in general is poor but for people who are in dire need of being reminded why food is there for nourishment and to be enjoyed the NHS is failing.
Don't expect to be able to rely on the staff for support.Whilst the staff are more than happy to throw their weight around if they feel you're breaking a rule (more often than not wrongly) in terms of emotional support unless you really strike it lucky, they will be too busy doing the practical stuff to really offer any support if you're feeling distressed, more often than not offering PRN medication as that's quicker and easier than sitting and talking to you.
You put on weight. Well, no shit sherlock. My point is you put on weight and that's pretty much it. If you go in expecting a magic cure or anything to happen in your brain in terms of recovery whilst you're in there, then prepare to be let down. First of all as an adult in inpatient units therapy is lacking. It's expected to come from you, second as I've talked about before the mental recovery to your brain happens when you're at and stayed at a healthy weight with adequate nutrition for approx a year. Your might start to feel positive and ready to start recovery but that's not your brain healing that's just attitude and positivity.
That half a teaspoon of ketchup is nowhere near enough to make overcooked swede or semi defrosted carrots palatable. One sachet. ONE MEASLY SACHET OF KETCHUP. That's enough to cover maybe three peas? Seriously if you're trying to normalise my eating, one sachet ain't gonna cut it! Now, my first stay at Leicester I suffered terribly from ketchup deprivation, I even tried bargaining to swap my salt for another ketchup as I hate salt, but they wouldn't have it. But my second stay I went in prepared. Yes, dear followers, I smuggled in contraband Levis reggae reggae ketchup as a little of that stuff goes a long way. For the first few days, I'd find an excuse to be left alone with my meal and squirt a bit then be found putting my ketchup sachet on top of it  so it looked like I'd somehow squeezed a huge amount out of a tiny sachet. GENIUS and it made the meals almost palatable (thank you Levi). I obviously got caught but as I was only in for a few weeks as an emergency admission I told them it's a case of me eating more with the sauce or less without it and even got to have it with my sandwiches in the end. Half a tsp measured by a nurse but better than nothing. Yeah, because that's not weird...
Be prepared. If you're going to insist you go outside for your designated 5 minute cigarette break because it's a breach of your human rights (and you've read in the ward rules it's allowed, even though you've never smoked) you might want to think it through and maybe borrow a lighter or cigarette instead of getting caught trying to go to the hospital shop to buy a magazine. In my defence, I was batshit bored.


And finally....Anyone that tells you dunking your biscuits isn't normal is the one who probably needs to be in hospital. IN WHAT TOPSY TURVY FUCKED UP WORLD IS A BISCUIT  WITH A HOT DRINK OR ANY DRINK FOR THAT MATTER NOT ALLOWED TO BE DUNKED. AN EATING DISORDER UNIT THATS WHAT FUCKED UP WORLD I TELL YOU. THE MINUTE YOU THINK YOU CAN HAVE A SNEAKY DIP THEY'RE ON YOU LIKE A FUCKING HAWK. YEAH LIKE THEY'RE SAT IN THERE OFFICE EATING DRY MEALY RICH TEAS  WITH TEPID CUPS OF TEA. NOOOOO THEY'RE ALLOWED THEIR DRINKS OF A DECENT FUCKING TEMPERATURE BECAUSE THEY'RE NOT BOUN BY HEALTH A SAFETY REGULATIONS. THEY'RE ALLOWED SWEETENERS IN THEIR TEA (TO BE FAIR I SNUCK SWEETENERS IN TOO\), THEY GET DECENT FUCKING BISCUITS NOT NHS KNOCK OFF VERSIONS AND STALE ONES OF THAT. JUST GIVE ME A HOB NOB OR MALTED MILK OR ANYTHING WITH CHOCOLATE. AND LET ME DUNK
Thank you and good night.....
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Nail of the day
Once again showing off the beauty of the moyou nail art stamping plates., a simple neutral nail featuring the one and only Marilyn Monroe

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