Tuesday, 15 April 2014

Happy Easter!

This coming weekend is Easter! I would like to wish you all a Happy Easter. This year is unique because my Easter, that is, for Coptic Orthodox Christians, is actually on the same day as for other Christians (it usually is not!). I hope everyone enjoy this wonderful time.

Why is Easter important? For Christians, Easter is more than just the death of Christ. It is realizing that Jesus - God, gave up His life for us. He saved us from our sins and took the burden upon Himself. God, in all His glory, chose to die for us. What humility and what love! Do you love others as this? Can you honestly say that your love for others mirrors how Christ loved us?

I can't. I wish I could - this is something I am trying to work on. This doesn't mean that I have to die for others, but it does teach me that I need to refine what I mean when I say that I am Christian. Am I Christian by name only, or do my actions show it? Can others see Christ through me?

The season of Easter is also a celebration; not just a remembrance of Christ's suffering. The celebration is in realizing that Jesus arose from the dead. Death cannot hurt us - God is alive! He has triumphed over death; we need not be worried about what the world can do to us. We have God to lean on, and He alone can give us peace and joy. We celebrate and  become joyous in knowing that we are not left alone to suffer in this world - God is near to those who believe and call on Him.

For those who are not Christian or do not celebrate Easter, I still urge you to take this time to spend it with those you love. Or, take the time to evaluate your life: what is going well now? What can be changed? Is there room for God in your life? Are you showing love and kindness to others? Is your life so focussed on work and money and sensual desires, that you have lost sight of what is truly important? What IS important to you? Take this time to make new goals. Easter is about starting anew: seeing that we are no longer the same as we are before, for we must learn to see that new beginnings can have powerful and positive changes in our lives.

So, Happy Easter to everyone! Rejoice that Christ in not dead; we are not alone in this world!

"For God loved the world so much that he gave his one and only Son, so that everyone who believes in Him will not perish but have eternal life" (John 3:16).

"But thanks be to God! He gives us victory over sin and death through our Lord Jesus Christ". (2 Corinthians 215:57)

Monday, 7 April 2014

ED and Medical Education

Throughout my studying, I noticed that very little information is available to students about ED. In elementary school, the focus of health teaching was on nutrition and how to avoid obesity. We hardly mentioned anorexia or bulimia. But what about in nursing or medical education in universities? Is it included? In my experience, not very much. Now, I know that obesity may seem to be more of an epidemic, but does that mean that we should not learn about ED and how to help our patients? Maybe it will be covered in a 'mental health' setting as opposed to general medical information. Bur I still feel that it should be given its time. As well, when ED is mentioned, I still believe that people are not getting the facts right. Let me explain...

One of my nursing textbooks (this is a paraphrase, not direct quote; nonetheless, the message is essentially the same) says that anorexia is a 'disease where young women feel overweight when they clearly not. They are irrational and perfectionist. Often dying from lack of body fat and nutrition, this girl typically is not engaged in sexual relationships and does not usually associate with others. She is preoccupied with food and weight, and this impairs her social life. Research shows that causes of anorexia nervosa are: having an unsteady relationship with one's mother, having overprotective parents, and not being permitted to express emotions in the family unit'. (I will not quote wher this is from out of respect to the authors, who honestly do a great job of explaining all other diseases - except for anorexia and eating disorders).

Do you spot the problem with the text? First, not all patients are 'irriational'. Yes, the fear of gaining weight may not seem proportional to the issue at hand, but it is a REAL fear because ED is a MENTAL illness. Calling patients irriational is, in my opinion, a bit harsh. Now, what about not being engaged in sexual or other relationships? There are MANY ED victims who are in a sexual relationship - it is not right to assume that their ED stops this from happening. And the social part? I was sick with ED and has lots of friends, and I spent a lot of time with them. Yes, ED may hinder some parts of our social lives, but it does not mean that we are loners. Lastly, the causes that they list are not supported by evidence. Maybe some people with ED have the above characteristics, but until now, no UPDATED and SUPPORTED research has shown that having overprotective parents or a bad mother causes ED. To blame a mental illness on such things is, in my opinon, unfair and biased.

What should we learn in medical school or nursing education? That ED is a MENTAL or psychological illness with many different causes and triggers, but no one thing solely causes it. In fact, a mix of genetics, brain chemistry, hormones, social amd personal factors interplay with one another. ED is also serious, and it is life-threatening. To characterize patients as perfectionist and irrational may be applicable to some patients, but maybe it would be more appropriate to say that patients with ED are usually perfectionist, and due to their mental illness (which they cannot control), they fear gaining weight and being fat. Finally, we need to focus on how ED should be treated and how we can help patients. Food is medicine, but so is therapy and expressing emotions. Helping the patient regain their lives that they lost due to ED is critical. Understanding and helping them see that they are victims and not the cause for their disorder is of the upmost importance. Not blaming the patient is NUMBER ONE.

Like with many mental illnesses, we still have a long way to go before medical education perfectly explains what ED is and how we can help our patients. We get so focussed on learning and teaching about other disorders like heart disease, kidney failure, diabetes, etc that we forget that mental health is deadly and serious as well. I think it's time that we put aside these wrong patterns of thinking and start to realize that as medical professionals, we need to learn about the other diseases that patients may present with - mental and emotional illnesses that require time, healing, trust, and empathy.

Tuesday, 1 April 2014

Published Again: Being Strong and Courageous

God is so good! He has yet allowed me to be published on Fr. Anthony's website. What a blessing! http://franthony.com/2014/03/are-you-strong-and-courageous/

This time, I write about a specific Bible verse and how it can motivate us to stay hopeful when times are tough. This is very important for all of us - even if you are not religious. The verse in the Bible tells us that we are not alone; God is always with us. You do not need to rely on yourself because God is with you and He will help you.

Have you ever felt overwhelmed? Tired? Frustrated? Angry? Hopeless? Sad? Stressed? I am sure these feelings are not strangers to most of us, if not all. Well, this post is about how to maintain hope, even in the toughest times. It is about staying hopeful and realizing that you are not alone in whatever you may do. It is about realizing that sometimes, we need to take time to breathe. Take time to know that you are not alone, that God is there for you. Pray and ask others, God first, to help you.

Lastly, stay hopeful. Tings always seem tough, but they get easier. Life will always throw challenges at you. But know that you are strong enough to get through this. YOU WILL SUCCEED. You will be stronger than this obstacle. And at the end of the experience, you will see that it made you stronger, wiser, and braver. And then you will see that you were never really alone - God, and those who love you, were always there. You just need to stay strong and courageous.

So, please take a look at this post and leave a comment here and there if you can! Thank you all for your love and support. Your kindness has kept me strong!

Thursday, 27 March 2014

21!

I am beyond blessed to be living today and to be able to celebrate what makes today special - it is my 21st birthday!

I have so many mixed feelings about this day. Part of me does not even have time to celebrate because of all the work I have to do. Part of me does not want to think that I am already 21. Last year was a great birthday as well. But for the seven years before that, each birthday was clouded by ED. I could never have fun, enjoy my day, or even have a reason to live. For seven years, I suffered this way. But last year was different. Last year, I was recovering.

This year is different, too. This year, I am FULLY recovered. And I can feel the difference. There is no place for ED in my life anymore. Yes, there are still things that I am working on. For example, I still do not get hunger cues, and I still need to eat by the clock. I still get slightly uncomfortable if I feel too full after a meal. But, I am so much stronger now. If gaining weight makes me feel uncomfortable, I quickly ignore the feeling and realize that I am not fat. If feeling full bothers me, I realize that this is a normal feeling and it too shall pass. I can now look at my body and realize that I am not fat; I am healthy - and beautiful. And I am beautiful and unique, in my own way - because I am God's creation. Of course, I don't always have easy days. Some days are tough. But that is life. And we all have tough days. But now, I am learning how to cope with these days.

All of my experiences in the past 21 years have taught my numerous lessons. I'll be honest: my life has not been easy. I suffered with anorexia for seven years and nearly lost my life to this illness. Time and time again, I felt so overwhelmed by all my school work and I felt frustrated  and stressed. I've dealt with challenging situations in life. At times, I wanted to give up. I was tired of fighting, time and time again.

And some days, I still feel this way. But now, as I turn 21, I see how these experiences have turned me into the young woman I am today. I have learned to never give up, and to never stop fighting for my rights. I have learned to reframe each challenge as a tool that will make me stronger and wiser. I have learned that life does not get 'easier' - it is I, through the power and guidance of Christ, who becomes stronger. I have learned that I do not need to rely on others to give me happiness, appreciation, or praise. I have learned that each day I stay strong in recovery, eat all my meals and eat enough, and write my blog, I become more aware of why recovery was the best decision I ever made. I now see that each obstacle has made me the resilient and determined person I am. And no one can take this away from me. I refuse to let anyone or anything stand in my way of attaining success, happiness, and peace.

So, on my 21st birthday, I am grateful. I am thankful to God for keeping me alive. Each challenge I faced made me feel weak, angry, and sad. But now, looking back, I see why each situation happened. I changed because of each struggle I had. I became stronger, wiser, healthier, and happier. I learned lessons that no one could ever teach me - life alone taught me these lessons. I WILL be celebrating my birthday, because nearly dying in the ICU taught me how valuable and precious life is. I am blessed to be alive today, to have the chance to see what life looks like when one is not constantly hungry and starving to death. Is recovery always fun and games? No. But no one's life is always easy. My struggles have shaped me to become the girl I am today; a happy, healthy, strong young woman who will never give up on my dreams and will not allow anyone or anything to take away my inner peace and satisfaction. This alone is a reason to celebrate my 21st birthday. Happy birthday to me! I would not have come this far, nor would I be this strong and healthy, if it were not for the blessing of God, the love and support of all my friends and family, and the overwhelming kindness, love, and support that all my blog readers and online friends give me. THANK YOU. I am blessed to be living another year, fully recovered. 21, here I come!

Friday, 21 March 2014

Why many patients don't feel 'sick enough'

'Maybe I have an eating problem - or maybe I don't. I don't know. But I don't feel sick enough to get help, or to need or deserve help. My case is not as bad as what others might go through...'.

I have heard this statement from many people with ED. Heck, even I used to say and think it a lot! But why? Why is it that so many people with ED never feel sick enough? Why do they keep getting sicker by the day but not realize or see that they are getting weak and ill?

A study (http://onlinelibrary.wiley.com/doi/10.1002/eat.22045/full) showed that in patients with ED, there appears to be an altered response to pain and body image related to their size. What this means is that the part of the brain that senses pain related to weakness (ex. from not eating enough or getting enough nutrition and energy) does not function properly. So, someone ill with ED might be very weak, but their brain does not sense this. They may therefore live their lives and not realize or feel the effects of ED because their brain cannot do so. This also means that even if a patient with ED is very sick, their brain might not register that this is the case. As a result, patients can actually be very ill but truly not 'feel sick enough'.

This definitely happened with me. I knew that I was ill, and I was fully aware that I was not eating enough. But I never felt weak or sick enough to get help. Sure, my legs hurt everytime I walked, but that was not enough of a good reason to seek help. Or maybe everyone told me that I looked thin, but I did not see it like they did. Perhaps this research has helped me understand why. When I hear from others sufferers that they do not feel ill enough, I understand what they mean. With ED, you actually DO NOT feel sick enough. It seems that the brain develops this adaptation in order to protect the human from feeling pain. Think about it: if you were hungry and starving and your body was weak tired, would you want to feel pain? Maybe for the first few days, your body would. But after chronic starvation, would it be helpful if your brain registered that your body was weak and malnourished? Likely not. So, the brain seems to develop this mechanism to protect the victim.

What this means for victims (and for those who recover, in fact) is that we need to be aware that patients with ED might actually be sicker than they FEEL. If they cannot feel pain or weakness, then they likely will not seek help for it, either. Perhaps this is why many patients must be 'forced' into treatment - they literally cannot see or feel how ill they are. On top of that, they are scared of gaining weight and eating, so that makes it even worse! Remember how before I discussed how the patient with ED might not be able to feel hunger cues as well? It all relates! The combination of all these brain and hornone changes makes it very hard for patients to get help and stay in recovery. This is why recovery takes so much work, patience, and motivation. Taking steps to recover from ED means that the patient is likely doing everything that they DO NOT want to do. This is definitely not fun. But what is helpful to remember is that it is worth it.

To be honest, we don't yet know if the brain ever gets back to normal after ED. Or maybe some parts do, while others do not. That is not actually important, anyways. What is important is that you choose recovery and stick with it. No matter how hard it is, no matter what is going on around you, you must remind yourself that this is worth it. Do not give up, and surround yourself with people who can support and help you. Know that even though your may not feel sick enough, everyone deserves to get help and support. We ALL deserve love, support, help, and treatment. YOU ARE WORTH IT!

Friday, 14 March 2014

Barbies: Causes for ED...?

As a little girl, I loved playing with Barbie dolls. I didn't have many, but was nonetheless fascinated by how beautiful they were. I brushed their hair, changed their clothes, and thoroughly enjoyed my time. Note: You can read more about the Barbie issue here: http://www.bbc.com/news/blogs-magazine-monitor-26465106

You may have heard about how Barbie dolls aren't realistic in that their bodies are 'made' to be smaller than what the average female is like. There is no doubting this - Barbie dolls are, of course, not your typical female. They have ever so slight curves and slim bodies.  This has caused some distress along some people, who say that the bodies of Barbies promote unhealthy ideas about what our bodies should look like. And to some extent, I think they are right. Barbie dolls aren't accurate depictions of what most women look like. But then again, who said they were supposed to be?

As someone recovered from anorexia, I can tell you right away that I never felt angry that I didn't look like a Barbie doll. Yes, I may have compared myself to others or celebrities. But never to a doll. Why? Because my Barbie doll was a toy; it had no saying on how I felt about myself.

However, I see the point of view of others. The concern is that young girls who play with these dolls may come to think that they need to look like them. But, are Barbie dolls to blame for eating disorders and body image ideals in society? I don't think so. I believe there is so much more to this issue than we are considering. Little girls aren't surrounded by Barbie dolls their entire lives. Girls grow up in a society filled with ideas about bodies. These ideas come from other places, such as the media, their friends and role models, the opposite sex, etc.

What's the point? I think Barbie dolls aren't realistic in terms of their bodies. But at the same time, I can't say that this causes little girls to think that they have to be skinny like the dolls. Sure, it may contribute to these ideas, but dolls don't cause eating disorders. Barbie dolls are toys, and if a girl begins to feel that she wants or needs to be skinny, this is likely attributed to a variety of reasons. We can't solely blame the Barbie doll. It would be interesting to see the new proposed Barbie doll, which is supposed to have more accurate body proportions than the current one. Maybe this is a huge shift in our ideas about bodies. However, again, changing a Barbie doll's body isn't going to change the way society sees body image and beauty.
 

We need bigger things to happen. We need education about eating disorders, prevention, and realistic ideals. We need strategies to help redefine the way we view ourselves and our bodies. Maybe we need to help little girls see that they shouldn't compare their bodies to anyone or anything else. Maybe we need to change society's view that our bodies always need to be perfect. Maybe we need to stop thinking of what is causing the problem and instead look at why the problem even exists. is the issue that we compare our bodies to dolls or others...or is the issue that we have become 'trained' to pinpoint what we don't like in our bodies or appearances, and then stop appreciating what we love about ourselves? Food for thought? Yes. And yes, that pun was intended.

Friday, 7 March 2014

ED and Quality of Life (QoL)

Why do we want ED victims to get treatment quickly? By now, you likely have a good idea of a few reasons....
1) ED can kill victims quickly and without warning, even if the patient looks and feels 'fine'
2) ED is hard to recover from and the longer it goes untreated, the harder it is to recover
3) ED patients need a lot of help and support, so they need professional assistance

But what about the damage that ED does to the person's LIFE? I'm talking about quality of life (QoL), a general term for your health in all aspects (physical, mental, emotional, financial, etc.). QoL is like a summary of your entire life: is it good or bad? Do you have enough money? Are you eating well and healthy? Can you afford to buy what you need and want? Are you happy? Do you have people to support you? Do you feel relaxed once in a while? How stressed are you? Do you ever feel depressed or unable to engage in daily activities of life?

Now let's shift to the effects of ED on a patient's QoL. Finally, I found an interesting article about this: http://link.springer.com/article/10.1007/s11136-012-0157-z. Basically, this article followed some sufferers with ED (anorexia, bulimia, and binge) over time. Some recovered, while others did not. The goal of the study was to see how ED influenced their lives in the future - not just on a short-term basis. Can you guess what they found?

Sufferers described that ED had lasting impacts on their lives. Some were depressed, while others stated that they recovered fully. Some still struggled with eating enough (or too much, depending on the ED), while others stated that they still ate by the clock to be safe. Some patients described that they were stronger from their experiences, while others stated that they would never recover and would die with an eating disorder. The researchers were able to make a bold statement: recovered or not, ED has a significant impact of the QoL of patients. In a way, this is bad because some never get treatment and thus do not recover. On the other hand, it may make patients who recovered become stronger, healthier, and wiser. But in the end, whatever the outcome of the ED was, the life of a patient is forever changed.

I can relate to this. My life will never be the same again, now that I have experienced ED. I used to think that I would die with ED because I would never recover.  In recovery, I would cry that I would never be able to sit and eat a meal without crying. But now, after so much hard work (and crying, screaming, shouting, yelling, feeling full, gaining weight, and dealing with all that stress!), I can strongly say that YES, my life is changed. But not in a bad way. Yes, I will always remember my experiences with ED. I will remember the hospital stay and how depressed I was. I will remember how many times I was poked with needles and medications, and how I cannot remember the three months in the ICU when I was sedated. I will remember how I gained weight and had to get rid of all my favourite clothes.

BUT I will also remember how I became stronger and wiser. How I wrote this blog and did many interviews and got published many times. Or how I gained the support and love of family, friends, and people who read my blog. I will remember how I suffered and how this taught me to take care of my body and ignore people who judge me based on my appearance and body shape. I will remember how I became a better nurse, caring for all my patients with love and respecting their dignity. I will remember how my experiences in the ICU made me appreciate life and my family.

Did ED change my life? Of course. But the great news is that it does not all have to be negative. With complete recovery and health, I can remember what I learned and gained from this experience. I can use my experiences and suffering for the greater good - to appreciate my health, life, and to help others. My quality of life IS changed - but for the better. My message to those suffering with an eating disorder or any other illness - whether it be physical, mental, or emotional: your illness does not define you, nor does it have to be a life-long battle that negatively impacts your happiness and life. Be strong and do what you can to help yourself, and realize that all experiences will make you stronger in life and teach you new things that you never imagined you would know. Do not give up - and do not let anyone tell you or make you believe that your illness will inevitably cause you to be depressed or sad for your entire life. My dad always tell me 'the stick that does not break you makes you stronger'. And I never believed him until now, two years after surviving a deadly mental illness.