We've had one, yes. What about second breakfast?

Aragorn: Gentlemen, we do not stop 'til nightfall.
Pippin: What about breakfast?
Aragorn: You've already had it.
Pippin: We've had one, yes. What about second breakfast?

 
[Aragorn turns and walks away] 

Merry: I don't think he knows about second breakfast, Pip.  

Pippin: What about elevenses? Luncheon? Afternoon tea? Dinner? Supper? He knows about them, doesn't he?  

Merry: I wouldn't count on it.

~~*~~

The above quote is one of my favorites from the Lord of the Rings movies. It's always struck me as both funny and sweetly innocent. Little did I know that one day all those meals Pippin lists off would share a shocking resemblance to my daily life. When I first went to Mercy I was put on a meal plan designed for weight gain. Three full meals (2 with dessert) and two snacks. Before Mercy, the amount of food I let myself eat in a day was maybe – maybe – calorically equivalent to just one of the meals at Mercy. Suffice it to say, those first few meals at Mercy were a bit shocking. The first few weeks I steadily gained weight, the meal plan was working; however, at a certain point the gaining stopped and I entered into a weight plateau. The Dr and dietitians in the program explained that this was a typical thing to happen to patients and that when it did the go to fix it was to add an Ensure Plus to ones meal plan.

In case anyone isn't familiar with what Ensure is, here is the description for it on the company's website:

Ensure Plus Nutrition to help gain or maintain a healthy weight.

Each bottle of #1 doctor recommended brand Ensure Plus has the right balance to help you take charge of your health. Every ready-to-drink shake has 350 nutrient-rich calories, 13 grams of protein, and 23 essential vitamins and minerals.

It was a drink every patient at Mercy was familiar with. When we first started that was what we were given for our afternoon snack, and if for any reason we did not finish our breakfast or lunch we had to drink Ensure as a replacement. Each morning we would have to hand it a sheet of paper documenting what we'd eaten for dinner the night before, and if we had missed any part of our meal plan we were given Ensure to replace it. And like I said before, it was also what was added to a meal plan to bump up weight gain, or at least we had to add something calorically equivalent to an Ensure. Some patients just wanted the Ensure because the idea eating more actual food was just to much. Others preferred food to the drink and this tended to be the case with me.

By the time I was discharged from the program, I had had two extra Ensures added to my meal plan. It truly felt like I was having breakfast, second breakfast, elevenses, luncheon, afternoon tea, dinner, and supper. Not to long after, something happened that led me to think I had reached a healthy weight, and backed off a bit on the intensity of my daily food intake. For awhile that seemed to be working, I felt good and my weekly weight checks showed most weeks my weight had remained at a healthy number,whatever that may be (I still don't know what I actually weigh).

However, five weeks ago I started a training class for a new job at work, and the initial set up of the training class really did a number of me. I've already posted about the incredibly close brush with relapse I had because of those two weeks, and while I'm definitely on stronger firmer ground there are still bits of those first weeks that echo through my days now. I've talked about the up tick in walking I'd been doing and that hasn't stopped. That in and of itself would probably be fine, but with an increase in energy spent there needed to be an increase in the amount of food I ate and that didn't happen. I have never skipped a meal since starting at Mercy, but there have definitely been times when I have cut out parts of meals, or chosen less calorie options. As much as I hate to admit it, I know that this has occurred with increasing frequency since the training started.

Yesterday I went in for my weight check and I found I'd lost weight. It was the third time in the last four weeks that's happened, and that fourth week I'd only maintained. I don't know how much I've lost, but I think that matters as much as the fact that it's now a trend instead of an anomaly. When I found out last week that I had lost, I tried really, really hard to not cut anything out. I made a huge effort to add one thing to my meal plan each day. It was not fun, and while I had a few good days, there were some so emotionally awful I had people I barely knew stopping me to ask if I was ok. There were a couple of days I did skip dessert, and most days when I tried to add something, the most I could do was an apple, or yogurt or a few almonds. It was better than nothing, but apparently, definitely, not enough.

The way it is set up now, I go in for a weight check Friday mornings at the health center at work. The nurse takes my weight and then calls my therapist to let her know what it was. If the news is good I would just get a text from her letting me know I was fine. If the news is bad I get a call, so when I checked my phone yesterday morning and saw a voicemail from my therapist I instantly knew what was up (or rather down) and that something needed to change. I called her back and she let me know in no uncertain terms that both she and the nurse were really concerned. She wanted to know what I thought, and I said it was clear that my adding 'something' wasn't cutting it, and it was time to fall back on the Mercy go-to, I needed to add an Ensure.

So that's the plan, I'm back to having 'second breakfast', and if next Friday my weight still drops then 'elevenses' it is. My therapist also said that when we next meet we are going to have a talk and come up with a concrete agreement of just how far this can go before I have to consider going back to Mercy. Now, I am incredibly grateful for that program and the staff there; they did phenomenal things for me. And the days spent there weren't the worst ever, sure there were a lot of pain and tears and overfull stomachs, but there was also laughter, love, support, crafts, cooking and even some karaoke. However, I am bound and determined not to go back there. I am motivated to make sure I don't. I am supposed to be doing a walk for Eating Disorder awareness on April 26^th and I want to be there. I don't want to go back to not being allowed to walk down my street, or be put on another caffeine ban, or be out of work on disability. I don't want to reach a point where my family and friends are so worried about me that I have to be supervised at all times. These however, are all secondary factors to the main underlying reason of why I'm determined not to return. I don't want to go back to a life where she is in charge and I am just along for the ride. That wasn't life, wasn't living, that was hell.

When I got home after work yesterday I had an Ensure first thing. It was harder than I'd thought, but I guess the universe knew it would be, because there was a letter from my sister waiting for me and I read that as I sipped. This morning I had Ensure right after my morning coffee, and I already know when I'll have it tomorrow. Thankfully they're not the worst tasting things, but I do tend to prefer eating my calories vs drinking them, so I've bought some extra snacks to get me through the work week. I also think it would be slightly less awkward to simply be eating extra food at work rather than pulling out an Ensure. My amazing best friend has agreed to keep me on track and will be texting me nightly to make sure I've followed my meal plan plus one Ensure, and for anyone reading this feel free to do the same. Most days my appetite ranges from meager to so non-existent that the thought of food makes me feel sick, so it helps to be held accountable. Hopefully, next weekend I'll be able to share good news – that the weight loss has stopped. And it looks like I'll have to get accustomed to 'second breakfast' being a regular thing again. Wish me luck, I'll need it.