So yesterday I went to visit the day unit at the clinic. It is based in the same hospital as where I have received inpatient, outpatient and rehabilitation care for my eating disorder, but luckily it is in a different building. I met with J who showed me around the different rooms. The building is shared with other mental health services, which is different to the previous ones I have used which were just purely for eating disorders, however other conditions such as personality disorders are treated there also. I am not sure why this is important for me to write, I guess I am just trying to set some context!
Anyways so J showed me round the facilities, unsurprisingly there is a kitchen with a dining table. This has basic facilities, microwave, kettle, toaster and I am not sure but maybe a cooker. I didn't get a close enough look. There is then the art therapy room, which is no longer used for art therapy and is used for more general sessions. The group room, where patients would spend the majority of their time, this opens up to a little square garden which is quite nice, in case you want some fresh air, but doesn't lead directly back to the hospital grounds, if that makes sense!
Finally and most importantly not least there is the treatment room, where the scales sit. Hmm, no other explanation needed there.
We ran through the program and it is what you would expect if you have ever been in anymore intense treatment before. The day looks a little something like this:
10 am start - Morning snack
- 10:30 am - Group
- 12 pm - Head to the canteen to buy lunch
- 12:15 - Eat lunch
- 1 pm - post lunch supervision
- 1:30 pm - Group
- 3 pm - Afternoon snack
- 3:30 pm - End of the day
To me the timetable sounds quite full on. Everyday attending the hospital for a full day of eating and groups. Do not get me wrong, I work full time and understand the pressures of everyday life but even this daunts me.
On Tuesdays we sit in the Canteen to help us practise eating in public. Every other Thursday we do social eating at a restaurant and every other Friday we do snack, shop and cook with the Occupational Therapist. You would also meet with your key worker and the dietitian once a week.
There is a contract you have to sign agreeing to the term and conditions of the program, including a minimum weekly weight gain, which interestingly is lower then what is expected as an inpatient. Which is good because they take into account the physical activity, while when you are inpatient you are kept sedentary. I have even found where I have tried to make increases myself, my weight hasn't sky rocketed just because I am continuing with every day life. Travelling to and from work, looking after my flat and going out on my daily activities actually takes up a lot of energy, which we definitely underestimate. Do not get me wrong, I sit a lot as well. After a day at work, I physically do not have the energy to contemplate exercising or anything else.
Anyways I am rambling, so my initial thoughts? I wanted to run away screaming, but not for the reasons you would think. It isn't the eating which scares me, okay that is a lie of course it does, but that isn't my initial reaction. I would be signed off work for three months and then be doing a three month phased return. I do not want to be signed off work again, I did this already being signed off for six months when I was an inpatient but that was almost three years ago now.
Also I do not want to eat that food. Yes it is about food but hang on a minute let me finish, I want to be able to eat the food I want and not be dictated by what the hospital offers and what the canteen is serving that day. If I want Belvita biscuits for morning snack, great! If I want chicken and cous cous salad for lunch, yep fab! I want to be able to do this by myself, but I guess I have proved time and time again, that I can't.
So my new plan was to introduce a snack again, like how I was working with my dietitian T before she put me on pause. Then I introduce another snack and slowly build up to the new meal plan I had formulated. So great I now have reinstated my plan, so let me start! When do I start doing this awesome new plan?
Erm...and that is when the excuses come in. Well I need X snacks so I can't start today. Well it is Christmas today and it is all unknown food so I can't do it then. I will start next week. And so the excuses started.
I just need that initial push and I think after that I will be okay almost that I need someone to help me a long and once I have that momentum I will be fine! I think three months is far too long for me, maybe I can ask for a couple of weeks, maybe I should have done refocusing instead which is a shorter term solution where you spend two days a week at the hospital. I said no, because I didn't think it would work for me.
I don't know what to do :(
I will end there.
I hope you all have a lovely Christmas - I know the holidays can be hard, trust me I know, but I hope you have a nice day whatever you are doing.