Recent Feedback
Im still nervous about the EGD. I think I should cancel it
Hi--what's your concern about the EGD?
Uh the sedation
Why the concern with that?
What if i die
You understand the term "conscious sedation?"
Ya but i still worry
Understandable, but so far I haven't had a patient die with conscious sedation.
I just worry
You'll be fine--it really isn't anything that comes near an overdose.
If im dehydrated or hypoglycemic on that day it wont matter
What won't matter?
Im afraid if im dehydrated/hypoglycemic during the egd i will some how end up dying. I know that that is an unrealistic thought
Yes--unrealistic--the procedure itself will not take any water from you or drop your blood sugar any.
I think i just dont want to get it done
I kinda knew that but I wasn't going to go there.
Do you think I need it done
Not as a semi emergency procedure, but yes for a check on peptic ulcers, gastritis, reflux, H pylori, etc.
Thats not the answer iWas looking for
So what was the answer you were looking for?
That you dont think i ever need one
Can't tell you a falsehood just to make you happy with the answer.
I dont think its something i need next week
No, especially if you supercede it with going into treatment, but, otherwise, it would just be a put-it-off thing.
I guess
No guessing--you would just be procrastinating for no good reason.
Its not for no good reason. Its because it scares me
As good an excuse as any. It may scare you but we've already discussed that your fear is somewhat overblown.
I know. It just seems soon
Soon?
I dont know why it cant wait til the end of summer. Instead of in a week. It doesnt give me time to think about it
Nothing more to think about--you won't have anything new to come up with by the end of summer.
Ok
OK
What else
That's entirely up to you.
Not sure i want to be away from my family if i do the eating disorder treatment
Well, from what you've told me it would sound like a welcome relief from your mother and maybe your father, and by your own admission, it doesn't sound like your sisters will miss you much. And, looking at it another way--a little silly, I know--a two week vacation is something many people take.
But i love my family and 2 weeks away is a long time. And my little cousin is only here til august
Two weeks is not a long time and you owe it to your cousin to get well so you can be there for him--let's not get into excuses and if onlys and what if's.
Maybe im not ready toGo
I never said you were ready, but that doesn't matter--in a case like yours I'd be very surprised if you said you were 100% sure it was time to go.
I dont think im even 15% sure anymore
It doesn't matter
It does matter. I dont know if i want to mention it to my dr
No, whether or not you want to go doesn't matter. It's just like the alcoholics and drug addicts I work with--hardly any of them are ready to go to treatment, or so they say. I just say I never expect them to be fully ready and, if they refuse, I just say they're entirely welcome to continue to suffer and to get worse.
Im ok with suffering and getting worse
Fine--you have my permission to do so.
I think that you are angry with me
Not at all--if you will, it's called tough love. I just won't fall into your trap of agreeing to feeling sorry for you along with yourself.
I dont think i feel sorry for myself
I do.
How so
Doesn't really matter for the point of our discussion but your saying you were OK with suffering and getting worse was one clue. But we've neatly gotten off course here--back to just because you don't want to go to treatment or don't think you're ready is absolutely no argument against biting the bullet and going.
It is an argument for not going. If i dont think im ready to gonwhat do you think the odds are that i will work on my issues
You can argue all you want--it won't change facts. I've known you long enough to be straight and to the point here--I don't think you can ever make any progress with the eating problem without inpatient treatment.
Thanks for that. It was a real confidence booster. Just what i needed to end my already crappy day
Now you are definitely feeling sorry for yourself. Don't ever expect me to tell you something I don't believe just to make you feel better--that won't help you in the least. Let me put it this way--if you do go into treatment, I would consider that to be a greater show of power on your part than if you refused to go.
I need my family. I cannot be away from them for 2 weeks
Pardon my French--that's BS but let's drop the subject. I'll just finish with saying that if you refuse to go, you're in a deep denial and you aren't capable of recognizing that. Not your fault--I've had a lot of experience with it.
Everyone makes it seem like my fault. The drs ive seen in the past week make me feel like this is all my fault. That all i need to do is deink/eat and i would feel better. Yes they are correct but its not that easy for me to do
I never once have said the disorder is your fault.
Not you. But everyone else does
So stick with me and let go of what they think
No because it makes me so mad. I am not stupid. I know that if i eat/drink i will feel better. But they dont realize that i cant do that. I may have an eating disorder but i still deserve to be treated with respect. They could atleast try to treat the symptoms
Remember what I said long ago about resentments--like resenting the fact they don't treat you with respect--they don't lose any sleep over that. Getting angry over others' ignorance is really a waste of energy.
I dont care
Thanks for sharing that--so what?
Im just having a really bad day. But im sure tomorrow will be better
Do you realize how much anger you have right now?
Yes i do
Important--very important--who all are you angry at and why?
I feel like Im angry at everyone which i know is impossible. Ive just been angry lately
Not any anger towards yourself? And, another important point--why exactly does one get angry?
I am constantly angry with myself
Why?
I get angry at myself for getting angry at others
That's the only reason?
That and for continuing to let this disorder kick my butt. But mainly because im angry at others is why im angry at myself
OK--so we're basically talking about a control issue, or, rather a lack of control over other's reactions and your anger towards that and towards your not having the power to control the eating disorder by yourself.
Huh?
What part of that wasn't clear?
Nvm. I read it again.
And your response?
That its true
OK--at least with my alcoholics and drug addicts I tell them that the only way you regain control is to let go and admit that you're powerless over the addiction--that you've tried your best to beat it and it just didn't work. If you don't stop fighting an unwinnable battle, all you do is exhaust yourself.
But i still think its winnable
That's the denial part
So what
And i dont have plans on it ever getting bad enough that i would need to be admitted
Too late--it's already that bad.
It is not that bad. I still have the say whether or not i be admitted
You've missed my whole point, but no matter.
What exactly was your point
You're in denial and you either don't see things clearly (which I think is the case and not your fault) or you're just ignoring and refusing to talk about how you need the treatment. Either way, it will probably mean you won't agree to treatment. It's the old analogy of one expression of insanity is doing the same thing over and over expecting different results or the guy that keeps pushing the already illuminated elevator button again and again thinking it'll make the cab arrive faster.
I see things clearly
If that's true, then you have decided to go to treatment--congratulations.
I can think clearly and decide i dont need treatment
OK--I've heard the same thing from drug addicts and several times they were dead not long after they made that statment.
Thats comforting.
Just the facts, ma'am. Listen--whether you realize it or not, what I've been trying to do with all this is to hold a therapy session with you, limited as it is with this internet thing. My goal was not to convince you of anything in particular like going to treatment, just to make some comments that hopefully made you think for a moment. My experience with the denial problem is you usually can't get through the wall but sometimes you can chip away a small piece of it so that a little water seeps through the dam. Then, later, maybe the dam will eventually burst. Sometimes, though, the wall holds no matter what. I'm not at all angry if you don't accept anything I've said and if you think I've got it all wrong--I wasn't trying to win any battles here.
Sleep well--either get back to me early in the morning or tomorrow evening if you'd like.
i have taken 50 mg of metoprolol. Instead of 12.5
How did that happen?
Sometimes ill just take a whole one instead of taking it twice a day. I just took one about 5 mins ago but im pretty sure i took One this am
Could cause a significant drop in your blood pressure--are you able to measure that?
Even if its just 50mg. Half hour ago it was 118/82
That's still double the usual dose but so long as your pressure doesn't drop to say a less than 100 systolic, you'll be OK. Were you to see your doctor today?
I saw him earlier
And?
Nothing
OK--'nuf said.
Oh and i may have take 3 25 mg tabs
Same answer--watch your blood pressure.
For how long. Right now its 112/58
At least for another two hours.
I feel dizzy and woozy but my bp is fine
So long as it stays above 100, no problem.
I know its stupid of me
Well, no real harm done.
Im just really sad
About?
I dont really know
Well--I really don't see a need to talk much about it, but I assume you've decided not to go into treatment?
Ya basically.
OK--no need ever to discuss that again.
Nope I guess not
So what does that leave for us to talk about?
Nothing really. What would happen if i took the whole bottle of metoprolol
I won't go there--that's against JA regulations.
What else?
So i dont have to worry about my bp later this evening or tonight.
No
K i have nothing more to say. I think i wont need you anymore
Entirely your choice, but I'll be here if and when you do. Hope at least you consider all the things I've said and what we've talked about.
im admitted to the hospital. Just a plain hospital mind u not an eating disorder one
OK--what's the plan?
Get lots of fluids. Talk to a psychiatrist and ya
How did you end up in the hospital?
I called my dr cuz i had blurred vision and seeing spots and thats what he recommended
So what has the physical workup shown?
Low blood sugar. Idk what else
Well, what about the cause of all the problems--just low blood sugar? Any testing to see why it was low?
The cause if the low blood sugar is prob cuz i havent eaten
OK--so is this a new psychiatrist you'll be seeing?
Its someone ive never seen before
OK--earlier you said you didn't think you'd need me anymore. While I'm glad you came back, can I ask why you did?
Im lonely right now. Early when i said that i had plans on taking my whole bottle of pills
OK--I'm here like I said I would be.
You still with me?
Sorry fell asleep
How long you gonna be in the hospital?
I dont know im hoping im out today sometime
Have you seen the new psychiatrist?
Aren't you supposed to before leaving the hospital?
Ya
So I guess you'll be there until you do.
I was thinking id grt out today but am not so sure anymore since i developed diarrhea
Anybody visited you yet while you've been in the hospital?
My fiance came last night for an hour
How did that go?
It went alright
What about your sisters?
Havent talked to them
Still sad and lonely?
How can I help?
You cant
That's very cynical or defeatist, but if and when you think I can, let me know. And we need to close this page--much too long again.