Sunday 5 April 2015

When I was an inpatient.......

I wanted to share my inpatient experience with everyone as I thought it may give others who may be going into hospital or a clinic an idea of what to expect. Firstly I want to say that the treatment I received at the hospital I went to was not helpful FOR ME. I am not saying that It wouldn't be helpful to everyone as different hospitals and clinics are run very differently and some individual sufferers are better suited as inpatients then others.

As there are no eating disorder clinics in the state I live in, going into a hospital was my only option. Luckily they let me go into the child's ward even though I had just turned 18. This meant that I didn't have to go into the psych ward which I'm sure would have been an even scarier experience. When I was first admitted to hospital I was actually only just underweight. I still saw myself as fat and would have liked to lose more weight. I felt like all of the doctors and nurses were judging me as I didn't actually look anorexic. I mean I was pale and sunken looking in the face but to look at no one would have guessed I had anorexia. The reason I was admitted was because I had lost the ability to eat anything at all, I had hypothermia and my heart was getting very weak. My doctor didn't see the point In letting my weight get critically low before she took action. I give my doctor a lot of credit for this as I know lots of doctors wait too long before taking anorexic patients seriously.

My dad drove me to the hospital and sat with me and a nurse while I battled through my first meal. My nurse explained that I had 30 minutes to complete the meal and If I was unable to do so I would have to drink a supplement drink. I sat and cried for the first 10 minutes but with the nurses help I was able to get through the yoghurt, juice and sandwich. I felt extremely sick after eating this initial meal for two reasons. Firstly my stomach was no longer use to food and secondly I was sick with guilt over what I had eaten. My dad had to leave after a while to get home so I was left alone, in the place that would be my home for the next 6 weeks.

For the first few days I wasn't allowed to get out of bed at all and I was even wheeled to the toilet in a wheelchair. I was only unable to eat one meal while I was in hospital which resulted in me having to drink a 400 calorie supplement drink. The worst thing was I had eaten 3/4 of the meal but still had to get through the entire drink which was truly disgusting. After that I always managed to finish each meal as I knew the calorie intake was inevitable. We were told that if we couldn't drink the ensure we would get tubed.

There were many other rules and routines we had to follow while in hospital;
1. we had 20 minutes to finish each snack and half an hour to finish each main meal
2. Eating was supervised closely by a nurse and the nurse had to stay for another 20 minutes after each snack and 30 minutes after each main meal for further supervision.
3. We were not allowed to go to the bathroom alone ever so a nurse had to stand and listen outside the door while you showered or went to the toilet.
4. We were weighed twice a week In a scale chair so we couldn't see our weight and had a weekly meeting with our doctor, dietician and parents where our progress and new care plans were discussed.
5. we were allowed different privileges depending on how compliant we were with our care plans and whether or not we were gaining enough weight.
6. Every time we were weighed we had to provide a urine sample so the doctors could check we weren't secretly water loading and we were not allowed to drink any water the whole time we were in hospital. We were only allowed to drink juice and milky drinks.


Daily routine In hospital (week 1)
6:30-7:00 wakeup and observations (heart rate, blood pressure and temperature etc),
8:30-9:00 eat breakfast
9:00-9:30 supervision, blood tests and more observations
10:00-10:15 shower
10:30-10:50 eat morning tea
10:50-11:10 supervision and observations
12:30-1:00 eat lunch
1:00-1:30 supervision
3:00-3:20 eat afternoon tea
3:20-3:40 supervision
5:30-6:00 tea
6:00-6:30 supervision and observations
8:00-8:20 eat supper
8:20-8:40 supervision
While in the first week our observations were done many times a day by the end of my hospital stay my observations were only done once a day. It was also not necessary to have a blood test every day as I became more and more medically stable so only one blood test a week was eventually necessary.

Most anorexic patients require their meal plans to increase every few weeks so they can gain the required amount of weight each week (0.5-1kg) but this was not the case with me. I continued to rapidly gain weight the whole time I was in hospita, even though I stayed on the minimal meal plan. Even once I was allowed to go for a 30 minute walk each day  (which I ensured was a very fast power walk) I still continued to gain weight. Obviously my metabolism was still very slow after starving myself but this just made me more frightened of food as I was consistently gaining weight while not eating very much.

My meal plan was;
Breakfast: 1 small bowl of cereal with milk or 2 slices of toast with butter and jam and 1 glass of juice
Morning tea: 1 milo and 1 piece of Fruit
Lunch: 1 bowl of salad with mayonnaise, 1 meat sandwich and a dairy dessert (yoghurt, custard, Ice cream etc) and a glass of juice
Afternoon tea: 1 milkshake made with ice cream, 1 piece of cake or 2 cookies and a platter of fruit salad
Tea: meat, gravy and vegetables or pasta and vegetable or fish and chips or fried rice or pizza and chips
Supper: 1 milo and 2 biscuits with cheese

Once I reached my goal weight I asked my dietician if I could reduce my meal plan so I could start maintaining my weight and she told me that I was already eating a 'normal diet'. This made me feel like a  failure. Like the only way I could stop gaining weight was by starving myself. The other anorexic girl I was in hospital with had to eat a lot more then me and still failed to gain the required amount of weigh most weeks. I think perhaps the fact that I had not spent very much time at a low weight effected the rate of weight gain I experienced. I suppose it makes sense that the longer someone stays underweight and how severely underweight a patient is, the longer it takes for their body to repair and the longer it takes for them to regain weight.

As I was in a hospital and not a clinic I didn't have anyone who could actually help me with my anorexia. While I was forced to gain weight in hospital, my thoughts were just as unhealthy the day I left the hospital as the day I was admitted. I finished each meal because I knew I had no choice but all I thought about for the 6 weeks I was In hospital was about how I was going to lose the weight again once I got out. I secretly exercised In my room and tried my hardest to cheat with my meal plan which was extremely difficult to do. While in hospital I experienced many extreme emotions. At times I felt the most angry, sad, helpless and unhappy I have ever felt in my life but that was to be expected. I was being forced to do all the things I had become most terrified of, like rest, eat and gain weight.

While going to hospital didn't fix my anorexia at all I know it was still necessary as without the hospital I probably would have died. It's just a shame that while in hospital I couldn't have received some help to recover mentally as well as physically. To anyone who may be going to hospital keep an open mind. Just because I didn't get any help for my mental health in hospital doesn't mean you won't either. I didn't write this post to scare you about what being an Inpatient is like, I just wanted you to gain an insight about what being an inpatient was like for me.

Please if anyone has any questions about my time in hospital, feel free to ask. I know how helpful it would have been for me to have someone to give me advice and help prepare me for what to expect before I went into hospital.


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