flagrant disregard

tonight, i told resident doctor #4 to scratch the inpatient idea, but that i was interested in hearing an opinion on the 'general' partial hospitalization program at ucla.

this program runs monday through friday until the late afternoon, is non-specific toward eating disorders, but it has many valuable components. if registering, i would invest myself in total. my doctor agreed ucla's 'general' program would benefit me, but then tactfully stated that it can have "quite a mix of people." later in the appointment, he was free with the f-word as usual. in my case, cedars-sinai medical center offers a better option for psychiatric care if seeking to avoid the eating disorder treatment structure.


aside from the sentiment that the patients of this program can be exceptionally fucked up (even when compared to my current psychiatric crisis) consider the rest of his concern:

- the current level of my sensitivity
- i could develop an enrollment here into a major blow to the esteem
- frightening/threatening patients there? might i retract more?
- or, might i decide to invest in that community?
- how attendance can actually worsen my mental and physical health


there are other components that resident doctor #4 should address:

- might i spend one day with these patients, find an immediate desire to drop the labels i effortlessly throw around, and flat out refuse their future use? perhaps, interaction with shockingly ill patients will be another catalyst for leaving the term "disability" behind? my ego strength is enormous-- won't i be desperate to virtually redefine myself overnight?

the 'general' program isn't going to treat the urgency of anorexia, rather, it offers a simple, yet profound destruction of one major foundation of illness.

the woman who is desperate to be my mother-in-law has requested i purchase a volkswagen beetle convertible to serve as her retirement present. "i don't know what color, though," she said. "not red-- maybe a champagne?"



"ACT I, Scene I: An Appalling Lack of Tact"
"ACT I, Scene II: Oh, Endless Greed"
"ACT I, Scene III: Frustration"

v.

"People Must View My Abilities Much Differently Than I Do"

ha, lucky rhyme/ a need for boxes of perfectly presentable words was announced earlier. other than depression/ anorexia/ and stuff/ why am i going to a hospital now? the lack of a tidy reason makes it worse.

AND another traumatic experience occurred tonight.
AND eventually, that chaotic whoknowswhen/ i will endure its subsequent loss.

laugh nervously when suggesting a phenomenon is not only aware/ but controls/ AND scatters sick tests of doubt at preposterous intervals. shrug/ i ultimately navigate. three easy sentences could reveal vorticity/ inversions/ AND yet all dynamics of this trauma remain off.

finally, a good day. in ten minutes or so, the night will end wrong. made the mistake of reading blog entries which were written while the author was in treatment. the person was positive, but i am panicking-- i was on the verge of making good choices.

consider the competition aspect in a treatment program. i don't necessarily want to, but if involved, would never allow another person to hold the negative success. consider the other side, where just registering into specific therapies is "quitting." perhaps i would rather die than face simultaneous terms. or not. i don't know.

in my opinion, going inpatient, whether it be related to eating disorder or depression/anxiety, is a dead idea. why wouldn't i sign myself out around the third or fourth instance of discomfort? AND other than resulting in a huge bill, what would that produce? nothing other than attitude along with a bad experience. considering this is all voluntary, registering into an inpatient program is not a responsible choice.

there are various day treatment clinics available at ucla-- general, depression/anxiety, or eating disorders. they sound non-threatening enough that i actually want to inquire.

consider:
intensive toward depression/anxiety = food could balance out
intensive toward eating disorders = elevated stress, non-compliance

reduced the stack of online bills to the point of restoring phone service/ perhaps broke 10 rules by taking in half of a container of nutritional supplement/ will vacuum splinters from yesterday's broken furniture/ AND then treat this infected finger.

if i have used the term "rock bottom" before, wtf is this called?

tomorrow is apt to be the greatest day of my life because this low can neither worsen nor persist. the delirious juice is in and, i hate the word 'magic' but if it weren't so cold as to blind the backside of my left eye, it would have tasted like a lifeline. every nothing remains wrong. the metaphor is sensitive. AND look, brain freeze-- from concentrate. "shake well before enjoying." yeah, i did not.

i asked rd#4 yesterday if "i could go inpatient for something other than food." after twenty seconds of uncomfortable silence (- in which i did squirm -) he said yes-- to call him first -- and then go to the emergency room at ucla.

after some thought, that just seems like more stress-- the loss of privacy. i don't want to shower somewhere else. someone might steal my belongings. all that.



consider the confusion, the riddle: a place providing protection and specialized care. you are expected to feel this and be able to relax.

ha, not a chance since you know what's coming:

"no one can take care of you, but you."

"show the sadness" v. "keep the sarcasm"


the last two months are written on the body:
- numbers are down
- in just six weeks, my hair had two distinct bands
- dental issues due to anxiety-related bruxism
- an issue of endocrinology


AND the sick solution: since emotional intensity has been physically recorded, no one can render the way i feel to be meaningless. there is no need to feel embarrassed now if choosing to reveal that a few recent losses hurt tremendously.

no seoul for me.

their newest hotrod project-- 1936 ford

my dad understands. my parents are making the long drive to madison for a car show this weekend but stopped to send me e-mail. they empathize with the exact sentiments i am too uncomfortable to put out there.

it's only been five hours since putting my cat's death on paypal, and i knew it would feel bad, but... i can't even find the joke. something stabby and along the lines of, "actually, his obituary trumps many written of human lives i have met."

paws saw london,
paws saw france...
his first playmates were an iguana and a (caged) tarantula.
quite a life for a little stray born in ely, minnesota.

relief was expected today. this isn't the case. the wave rolls between obsessing over his last sights and sounds, to seeing how his absence-- particularly his continual loudmouthed chatter -- is already accentuating my isolation.

oh kitty, it's all good now. i hope.

aside for two see's vanilla lollipops this week, my problem is still not giving an inch and this is causing great distress for other people. they try so hard, but routinely in the wrong direction. they "want answers" and get upset upon hearing that "there are no answers." then they fight. AND fight. AND fight. AND what does this do? this tightens my problem. the best possible scenario would be for the problem to loosen up and give me some leeway. my physicians understand this, but people who eat meals at my house do not.

resident doctor #4 is concerned and wants me to drink 32oz of water each day this week (hard). he mentioned that given my weight, it is important for me to refrain from any caffeinated beverages right now (not hard).

on tuesday night, he didn't push for the "inpatient" option, but as time goes by-- i don't see myself breaking out of this. it could be alright.





why don't i ever write much about invalid friend chuck anymore?

what in the hell for?
it's just the same old repeated post:

chuck, who does not drive a car and must not be that much of a klutz after all, has just delivered 21 two-liter bottles of diet coke to my home.

when questioned what he was thinking, since chuck knows i never drink "gratuitous filler" such as diet soda unless in a country without potable water, he just looked at me.

AND i, of course, am the asshole since these liquids can only be refused.

"any variety of intervention will initially worsen this episode"

v.

"inaction automatically reinforces illness"

at the time of the last post, anorexia was a current component, but one without structure. my inability to obtain food was not the driving force of what disrupted the week, and it remains odd to think my doctor wanted to focus on this tertiary issue. now that a few days have gone by, and most of the panic and anxiety has subsided, that interruption, or inpatient respite, should have happened.

anorexia is strong, alone, and definitely protecting me from feeling anything. this isn't my typical day-to-day anorexia with rules, distractions, and puzzles regarding exercise and calories. this restriction is very specific to emotion, and similar to weeks which have paralleled great trauma in my life. "food" seems like such a minor issue regarding what is restricted in total. the concept of extracting from this realm merely for food is almost quizzical. keeping this intense restriction and "overwhelming feeling of protection" is 1000 times more important than food. it also feels as though this is a deep state of mourning after an intense ordeal.

but... wtf? why this period of decompensation? all current events which have inspired stress, in my opinion, barely warrant any acknowledgement. sure, waiting on other people to finalize their decision sucks. putting valuables into the hands of an inferior middleman sucks. trying to determine on a day-by-day basis if my cat is suffering or not sucks. these are low level, but typical anxieties. they are unfortunate, or without instant and definitive solution, but i think none of them rank as traumatic. i do not appreciate feeling this way without holding a tangible reason. "i deal with major depressive disorder and all of its components occasionally come around" is not good enough.

first possible genuine reason for this lull: my future job will change how i relate to "anything and everything." i say i don't care, and that i am looking forward to this experience, but my body knows. it has been interesting to see panic attacks produced over "anything and everything." when framing the extremes, this makes sense. my future is a fairly big deal, and it apparently *is* traumatic enough to cause this deficit. the interpretation of panic regarding insignificant events is perfect, but it sounds ridiculous.

second reason: my cat is slowing down. what is the process other than to keep him comfortable? a week ago saturday, i returned home to find blood had been coughed up in several places around the house. the following day, paws was as good as he has been during any time over the last year-- jumping up onto the desk, purring, even cleaning. today was not good to him. it's worrisome. i need a definitive protocol other than "wait." this end is sad and expected, but again, not traumatic.

i have an appointment with resident doctor #4 tuesday night. chuck left him a voicemail message and told him i was still refusing to eat. some type of intervention is apt to happen. inpatient? probably not. partial hospitalization eating disorders day program? summon a useless dietitian? i don't know. at my saturday appointment, resident doctor #4 questioned whether we needed to consider an inpatient stay or get strober involved this week.

in january, i secured a relationship with an additional doctor (resident) at ucla. this doctor's supervisor took me aside and told me to be clear with strober that we all respect him-- but also be clear that we all think he's an arrogant asshole. essentially, i have been avoiding this specialist. my problem might need him, but hell if my problem needs that right now.


old scribbles, previously posted

treating 'this particular episode' of anorexia lacks sense since it ignores the source of the problem. my physical health is stable even though my weight is not. AND i should not leave my cat alone or in the hands of someone else this week.

the majority of this last period of decompensation has subsided. last week, suffocating into dense protection was achieved through any ordinary sentiment. perhaps now, i am merely collecting them and only bound by twisted situations for a few hours per night.

saturday, a resident doctor #4 day. i was completely off this morning-- to the point it was suggested hospitalization prior to my next appointment (on tuesday) was not out of reach. i expressed an unfamiliarity with inpatient procedures and went on to question the therapeutic care for anxiety.

so, it was a little weird when i stopped and he said, "inpatient for anorexia."

ordinarily, ocd can seem cagey because it works on too many planes, but it has locked anorexia into "a frightening state of unshakable no" for the last four days. "i'm not going to eat until i am dead." anorexia's words cannot change. by design, ocd facilitates that nothing is flexible-- not even a sentence.



i expressed concerns over the possibility of an inpatient respite, when actually, invalid friend chuck may need hospitalization first. chuck only intends to help, does not understand why kind actions inspire problems, and therefore refuses to extract any involvement. the subsequent guilt from seeing him bleed as he hits wall after wall keeps me intricate and impossible. he is nervously walking on eggshells for no reason-- nothing chuck can do will be correct.



AND resident doctor #4 continues to hold the ends of ambivalence.

one the one hand, my weight loss is critical and anxiety is the worst he has observed from me. the suicidal ideation, which comes and goes, has arrived and is frightening because my spirits are good.

on the other hand, it's the recent and positive progress which is working to stir up this much turmoil.

last week was the worst. i might be making dramatic changes for the future, and paws took one step closer to death on saturday, but panic attacks continued to stem from trivial or unreasonable situations. there was a lack of investment toward those panicked episodes, and it was disturbed in how they flourished while i actively stated the contradiction. consider how physically intense these panic attacks can be. my nourishment process assumes unwavering allegiance to ritual, but this week my body weight is down a solid four pounds.

one example of a situation inspiring both trivial and unreasonable panic attacks:

at a self-serve kiosk, i sent three letters out by usps certified mail. each transaction produced a receipt and tracking number. after four business days, the only update in the tracking system detailed how postage had been produced at the kiosk but that facility had not scanned or confirmed receiving the items. after seven days, the tracking system finally took note that one letter had entered the system. the usps is historically inferior in regard to this process and the addressees all know this. this lack of information was a real concern, but trivial. given the time span, i didn't care too much, but panic ensued.

the typical fears promoted that *this was a horrible situation* and it could not be rectified had the envelopes actually gone missing. for instance, introversion would restrict me from contacting the recipients in a timely manner, and i would not be able to attend to anything which needed to be done alone or out of the house. it was also perceived to be financially disastrous to reproduce the contents in those envelopes. this panic was very unreasonable to me-- my argument being rooted in my consistent documentation of an ability to thrive.

lately, the counter exchange from anxiety or fear has been that 'the ability to get out there and engage on profound levels' does not confirm the capacity to continue. my production is ordinarily all or nothing, which definitely allows for a return to complete isolation. i *should* worry about any project attempted, even the simple posting of letters, because there *is* the potential for me to withdraw and not attend to any disaster.

this perspective from anxiety is the kind of crap that will dissolve when discarding disability (by signing on to, and then succeeding at full-time, out of the house employment). this process of redefinition will draw out the endless spectrum of uncertainties and possibilities. the anxiety over 'taking a job outside of the house' and then eventually 'living without the pathological doubt' is expected to be huge.

lately, i do not feel nervous whatsoever about redefining myself and/or what happens upon employment, but know the fear/anxiety is gigantic.

it must be here-- misdirected and protective.

perhaps, interpretable:

anxiety has been focusing on anything and everything aside from the great fear of working outside of my home on a daily basis... it stresses over looks from a stranger... the particular word a person chose to use.... but consider those somewhat squashed emotions which stand behind the detail of the notoriously non-updated usps tracking system.

it felt like i was panicking about the postal service.
the potential for ________, _______, and __________.
all of that doubt.

i was probably panicking about "what it is going to mean to leave all of these doubts and fears behind... these fears have been my constant... what is it going to be like to live without them... what can possibly be intense enough to replace all of that... the way i go about thinking and then reacting to everything is about to change... but to what?"

since my 'constant' is about to confirm a radical level of freedom, and then depart without definitive replacement, of course 'anything and everything' has room right now to panic. with this job ("confirmation that i no longer need to act as though i may succumb to housebound agoraphobia at any moment") the way i will go about each seemingly meaningless situation and transaction will be different. i cannot know what it will be like to live without that stress. those answers are neither available nor can they be accurately articulated. lately, my anxiety is everywhere-- and it appears that it should be.

now, if the chaos from the last week is translated and accountable, to what extent can it continue?

actively refused to depress my cns this afternoon:

= found a rain-soaked $20 bill
during the 'first additional' panic-inspired run

= found a $100 bill folded into a triangle
during the 'second additional' panic-inspired run





the fire today eventually inspired the stove, but the greens had greyed.
consider: by fault of dark trunk, time, or suffocation?

AND then why waste the assay on fermentation?

the rest of the week will be spent trying to keep myself from being hospitalized for anxiety disorder. the most insignificant of situations are exciting panic attacks lasting four or more hours. value can easily attach to these trivial concerns which are accelerating, therefore my frustration focuses on the most unreasonable panic-inducing experiences. their origin is real, and understood, but awareness does not (yet) function to mediate or reconcile the physical response.

my solution has always been to suck it up and mend or eliminate the catalyst, but circumstances reducing the threshold cannot accept my authority. none of these anxiety producing agents, neither the trivial nor the unreasonable, are in my control.

what happens when one is hospitalized for anxiety? let me call upon my own television education for a moment and guess "ativan, a blanket, and an offer of apple juice." or, of course, the preposterous: seroquel, as a sleeper, then prn.

obviously, ativan could be taken right now (and there are probably unopened samples of seroquel here, too) but when anxiety is overwhelming, i am determined to remain in this hyper-faux-safe state of ready, set, act.

impending situation X is out of my hands.
so are last night's no big deal stares from Patient Y.
AND Burberry Z.

AND a-f, g-j, kl, m-->

AND the saturday morning security guard (who resident doctor #4 refers to as a "crazy bitch") really needs a separate entry.