Chapter 15

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Trigger warning: this chapter discusses some specific symptoms of an eating disorder, as well as diagnosis. Once again, the way I'm portraying eating disorders here is a particular one of going through one and it's based on my own personal story. Your suffering and illness are valid and you are worth of recovery whatever your diagnosis (even if you don't have one), symptoms and thoughts are. We all deserve to be happy and free from our minds. Stay safe, remember my DM's are always open if you want someone to talk to. 

You woke up half an hour later than you usually did, since you had the appointment before going to school, so there was no need in catching the bus because your mom was dropping you off. You showered, dressed, and went downstairs to find your mom nervously pacing around. Your breakfast was already served so you sat down to eat it without saying a word. You both jumped into the car and quickly got to the treatment center. Your mom held your hands and spoke:

- "Whatever happens in there I want you to know that I love you so much. I'm willing to do everything in my power to help you. I will be by your side at every step."

- "Thanks mom, I love you too. But nothing bad is going to happen, I actually have been feeling a lot better in the last couple of days". You lied. Well, technically it wasn't a lie, since you really thought that you were still in control most of the time.

You walked into the treatment center and David told you to wait about 15 minutes while all the doctors arrived. You were playing candy crush when Taylor called:

- "Hey Liz. How are you? Are you already at the center?"

- "Hey Tay, I am. What about you? How are you?" You spoke.

- "I'm fine. How are you feeling?" She asked.

- "A bit nervous, I don't like the atmosphere here. I feel like everyone's thinking that I'm sick. But I'm not. I've actually felt better these past days. I think I just lost control a bit, but I'm fine. Whatever they say, which I'm sure won't be bad, I'll tell them that I can do this on my own" you answered sounding convinced.

Taylor wanted to tell you how wrong you were. But didn't want to be the one to break the news to you. She had spoken last night with Blake, who told her what happened after dinner. They knew it was bad, even though you were denying it. Taylor believed you were convinced that you were fine; she knew the eating disorder traps. She just said:

- "Alright. Remember that I love you and that I'm proud of how brave you are. Even though you feel fine, I know that deep down you know you need help. Call me later. I'll be here waiting".

You didn't feel brave. Not even a little. You felt weak and stupid, you had fallen into your own trap. You told Taylor you loved her back and that you would call her later. Then you saw a message from Blake: "Hey Liz. I'm thinking about you. Good luck today. Remember this is for your own good. Love you".

Did everyone know about this? Ugh. You were so frustrated. You let down your guard and now everyone was meddling in your life. You didn't want to be rude, but also want it to make it clear that she had no business worrying about something that was not even happening: "Thanks Blake, I'm sure it will be okay, though".

That's when Dr. Maine called your name and you and your mom walked into the consulting room, where Dr. Pine and Dr. Sach were waiting. Dr. Sach asked you to go with her to an exam room to get your vitals and weight checked while the other two doctors had a quick chat with your mom. You went with her to an exam room that was located at the end of the hall, she asked you to take off your clothes in the bathroom, stay just in your underwear and wear the robe that was hanging behind the door. She took your vitals and told you what she had told you the last time: your blood pressure was low, as well as your heart rate. You stepped on the scales, not wanting to look, but Dr. Sach said - "Elizabeth, you lost weight this couple of past days. Have you been eating?" You looked down and saw the number: you had lost almost 5 pounds since the last weight in. How was that even possible? You told the doctor you were, in fact, eating.

When you came back to the first room, and you saw your mom crying.

- "Elizabeth. After the multidisciplinary assessment, we are going to tell you what we found and then, what treatment option we think suits best for you. Emotionally speaking, we think that you are suffering from a major depressive disorder, this diagnosis relates to the constant sadness, loss of interest and low self-esteem you've been dealing with lately. Nutritionally, you're restricting and over exercising, your labs showed that you are malnourished, your potassium levels are low, due to the ongoing restriction and the purging that happened yesterday, which we suspect it might not be the first one. You also lost more weight in the last couple of days".

(Your eyes wide opened, even though it was the first time you purged, how did they know about it? Oh yeah, probably Blake told your mom, and your mom told them. Great, you were screwed).

- "You're also underweight Elizabeth, which is taking a toll on your overall health. Your body is showing some concerning symptoms: the absence of your period for the last six months is one of them. Medically we call it amenorrhea. Another symptom is the early-stage osteoporosis that your bone scan showed. The most concerning thing we found is your heart rate: you are currently suffering from bradycardia, a term used to diagnose constant low heart rate. A normal-healthy heart of someone your age should be beating from 60 up to 100 times per minute while resting, yours is beating from 42 to 45 beats per minute. You must stop exercising, it's dangerous for your heart and you cannot afford to lose anymore weight" Dr. Maine said.

You were shocked. - "I'm sorry but you must be confusing my labs with someone else's. That sounds pretty serious. I don't feel that sick. Just a bit tired sometimes" you said trying to calm your mom who had panic written all over her face.

-"Elizabeth, you are currently suffering from anorexia nervosa, restrictive subtype, but we want to emphasize that you are not anorexic, you have anorexia, you are not your illness. You can recover from it" Dr. Sach added.

As soon as your mother heard the word "anorexia" she started to cry again. You zoned out. You couldn't believe what they were saying.

- "We strongly recommend admitting you to our ambulatory day program, here, at the treatment center, but if your eating disorder is resistant to outpatient program, we would them move to recommend inpatient treatment. You would come all days, from Monday to Friday, from 12:30pm to 5pm. You'd eat lunch, have some group therapies, as well as individual therapies with each professional in the team, which would vary according to the day of the week. Then you'd have afternoon snack. However, your heart condition really concerns us, so we need to keep monitoring it closely, if your heart rate drops below 40 beats per minute, then we should admit you to a hospital, because you'd be in cardiac arrest risk. You must gain weight, but we can address that if you decide to get into the program" Dr Maine said.

- "When can she start the outpatient day program?" Your mom asked.

- "Next Monday, if you agree" Dr. Pine answered.

You gave a killing look to your mother. You needed to discuss this. You were not going to turn upside down your life because of this.

- "What? What about school?" You asked panicking.

- "Your health is not important than school, Elizabeth" your mom said.

You were furious.

- "She's right. Right now, we need to treat this. It's serious. Life threatening" Dr. Sach said.

- "I guess I could talk with the principal; right? School must adapt to her needs" Andrea said.

- "Yeah. It's not uncommon, we have many patients that only go to school in the morning and then they come here to treat themselves".

They were talking like if you weren't in the room sitting down with them. You were about to cry, but instead, stood up furiously, opened the door and walked out. You didn't know what to do.

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