Wednesday, July 31, 2013

Digestive Difficulties & Menstrual Regulation


 Alright. Publicly talking about my digestive difficulties and menstrual cycle isn't my idea of a good time, but I have been wanting to write about this for awhile. Both are potentially triggering issues that many of us face in recovery so I decided to go for it and do this TMI (too much info) post. Here we go...


Digestive Difficulties

Bloating, gas, pain, abdominal distention, and of course constipation are all common digestive difficulties during the early stages of recovery. After a period of starvation, digestive enzymes and a crucial bacteria needed to digest food are reduced causing these uncomfortable symptoms. For many of us recovering from eating disorders, this phase is often so bad it turns us away from recovery all together.

In my personal experience (TMI warning), during the first 3-4 weeks of eating normally I didn't have bowel movements once. Not exaggerating. Other patients going through this process with me, said they had similar "back up" anywhere from a few days to a full month. Depending on duration of the disorder prior to re-feeding, consistency of eating, and even the types of foods consumed, the amount of time this process takes varies from person to person.

Even after my first bowel movement - the most exciting day of my life - I still struggled with irregularity for quite sometime.  I've read that spacing out food throughout the day as much as possible and yogurts with live active cultures can both help regulate the digestive system during this phase of recovery. It is also tempting to cut back on calories during this time, but that is actually one of the worst things you can do. In order for the metabolism to regulate again, it needs those calories to keep the "fire burning."

Unfortunately, it is one of those things I had to suffer through in order to move forward. I wish there had been a way around it, but at the same time it keeps me motivated to never (ever ever ever) fall back into eating disordered behaviors. Going through that process once was enough for me.


Menstrual Regulation

After about four years without having a period, due to lack of body fat, the day I finally did get my first period last year was somewhat traumatic. In my disordered mind, getting my period back meant I had reached a healthy weight and at the time, a healthy weight made me fat. Yes, if you must know I did cry the morning it returned. 

At my treatment center if someone did something out of the ordinary or made an important stride in recovery, they were given a star (it was just a sticker). This was always a big deal because they were rarely handed out. Everyone would ask what the person did to deserve the star and they would get to spend the day bragging about their progress. Exciting stuff. 


During our morning weigh-ins the day my period returned, I told the two therapists weighing me the big news and to my surprise they were both THRILLED. I remember them congratulating me and saying how proud they were of me, all while I was throwing myself a pity party for officially being "fat." One of the therapists reached in her desk drawer and gave me a big star to celebrate getting my period.

Sounds kind of silly, I know, but it really did help me realize what a huge sign of health this was. Getting your period back during recovery is one of the most triggering turning points for most patients and I can fully understand why. Honestly, I kind of enjoyed not having my period; what girl wouldn't? The real reason it is so traumatic, however, is it meant I finally had enough body fat for my hormones to regulate themselves again. But I was forgetting the many benefits that come with menstruation - as odd as that statement might sound.

One common misconception surrounding the return of menstruation is it automatically means an individual has reached their body's set point weight. This is simply not true. I know girls who got their period back 10-15lbs before their goal weight and other girls who didn't get it until 2-3 months after reaching their goal weight. Again, like so many aspects of recovery, everyone is completely different. Also, it has taken my period this entire year of recovery to regulate. The thing that helped me most was consistency with my meal plan. Just like with my digestive difficulties, the more stable my weight was, the quicker my body could begin functioning properly again.

With the discomfort involved in digestion regularity, knowing I was officially at a healthy weight thanks to the return of my period, and all of these new emotions surfacing, this was by far the most difficult phase of recovery for me. The good news is, however, I am finally beginning to see the light at the end of the tunnel. As my insides continue to normalize, the better I feel about every aspect of my life. 

Spending an entire year feeling uncomfortable in my own skin has been difficult, but if it means I will finally begin to find a happy medium, it was a year well spent.

Progress.

29 comments:

  1. Thank you for being honest. Sometimes "TMI" is the information someone needs! Going through those changes was difficult, I'm sure, but seeing the overall picture of health is a great outlook! Blessings to you--Alison

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    1. Phew! Glad you weren't too grossed out by this. ;)

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    2. Kelsi, I've gone through two childbirths, and read over my husband's shoulder while he studied through med school and residency. This is nothin'. ;)

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    3. Hahaha.. Oh boy! Childbirth. Yikes. That absolutely trumps this. Scary stuff haha.

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  2. My digestion was HORRIBLE and still is, slightly. My stomach is at that 'I must have all the recovery weight' stage so I have a constant 'bloated' belly. Hopefully it'll distribute it's self soon!

    As for my period? No matter how low I got mine never really went this time (could have something to do with the contraceptive pill maybe?). When I suffered from anorexia at 15 it left me until I was 17, almost 18 years old. The day it reappeared I was of mixed feelings. I know girls who were triggered by the return of their cycle and relapsed, but I suppose I just took it on the chin (and instead decided to relapse a year late!).

    Lovely blog as always love!! xx

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    1. Yes, that bloated belly for the months after weight restoration is horrible. I'm so sorry you're going through that. It really, truly does get better though. Keep up the good work! I never really thought about the effects the pill would have on your period & low weight. Interesting... I might have to do some reading on that.
      Thanks for your comment on tumblr. Seriously, that's one of the nicest things anyone has ever said. How did I not know you had a tumblr blog on until now?! I instantly bookmarked it & will be spending way too much time on your page. :)

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  3. Regarding to menstrual regulation, I have lost it for more than 2 years, and honestly, I feel weird, because in the past, when my weight was lower, it never happened due to my low weight. I have read that some people have not had it after they are released from the treatment center. It is definitely one of indications of having ED condition, but honestly, I think it can be over looked sometimes. Our bodies are one of the most mysterious gifts from God, and sometimes, we just need to trust... Yeah, I would definitely connect from coming that back to my life to healthy weight and fat directly too, but I also know benefits of having it. We are meant to have it, and it is a mechanism to keep our bodies healthy. I can be very knowledgeable, and the worst case of Ed....

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    1. I don't know if this relates to you, but sometimes we can lose our periods due to stress (I think). Maybe you're going through a combination of that and ED symptoms? It's really hard to say. Our bodies definitely are mysterious and amazing, trusting isn't always easy. I was just talking with my therapist yesterday about how I logically know what to do (like you being knowledgeable), but don't always do it. Why is that?? Human behavior is so fascinating... <3

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  4. Yes, definitely... When I lost my period, my weight was actually 114 lbs for my height, 5'5". I just started to lose weight, and that was exactly the same time when I started to work for my new company. I was laid off, and it took a year to get this (2009... when the economy was corrupted...). I kept losing weight for the first year of my new job, and I think that's why my doctor didn't really pay an attention only to my eating situation. I didn't know if it was due to stress or losing weight. That is the reason why I get so irritated when people connect my not having cycle due to my low weight. My instinct says this is not the reason...

    Logic and instinct are kind of opposite... Our bodies work based on instinct. It knows what to do and how to adjust. Knowledge can be sometimes an enemy... and yes, too much information... I actually wrote about it for my MS thesis... hahaha... I will email back to you soon. <3

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    1. Yeah, it sounds like it could be stress then. You know your body better than anyone. Knowledge is an enemy! Sometimes ignorance really is bliss. Sounds like an interesting thesis topic. No hurry on the email. xx

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  5. can we not even talk about how backed up I was in treatment. It was the biggest difficulty of getting back. but as you said, you just have to go through it. no easy way out. Mine was even more out of whack because of my 2+ years of abusing laxatives, low point of my ED and hardest to rid myself of but so happy I am not period full and laxative free! haha

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    1. Laxative abuse wasn't something I got into, but I know digestive health is a million times harder to regain for those who do. Good for you. I'm happy you're laxative free too! lol ;)

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  6. I love you, Kelsi. Thank you for your courage and honesty.

    Digestion and menstruation are two sources of anxiety in recovery. My tummy turned into a tam tam drum and all I wanted to do was to lie down and breathe. I did allow myself to feel a bit sorry for myself because woah, the pain, but at the same time I knew this was a phase I had to go through. Even though I despised the bloating and constipation, I despised the anorexia even more. I knew this was my body telling me how much suffering it had been through over the years and I trusted my therapist when she told me my body worked as hard as it could to repair the damage and that proper nutrition was the golden key to regulate body functions.

    When it comes to menstruation, I am still waiting. The potential triggering aspect is one I am very much aware of. As with most things in recovery, this too is met with ambivalence. Our bodies are increasing in strength and life, which is a reason to celebrate for my "healthy self". For the eating disorder on the other hand, this change feels very scary. It is like entering an unknown world of health and life, I need to learn to get to know my body and trust it.

    " Spending an entire year feeling uncomfortable in my own skin has been difficult, but if it means I will finally begin to find a happy medium, it was a year well spent." < - It was worth it, Kelsi. You have gained so much through your challenges. Life, wisdom and courage.

    Keep shining <3


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    1. I remember having to lay down on the floor and pray the pain would pass, too. Every single night after dinner that was my routine. It felt like I was going to explode. You are right, however, anorexia is WAY worse than the temporary discomfort during recovery. When your period does return, it might be triggering, but that's totally normal. It seems like you have the right mind set though. Trusting in our bodies and knowing it will repair itself is all we can do.
      And I love you too, Hedda!! <3

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  7. I remember myself also crying when i got my period back - because i was so happy about it :D It was one of the most horrifying changes in my body due to the ED,when i havnt had it, it just scared me so much and it is still a reason for me not to try losing the weight again - because my period were missing from the moment when i started restricting and beeing underweight and came back when i just reached the healthy weight range - so its kind of a motivation. <3

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    1. Aw that brought a huge smile to my face! It's always nice to hear that someone can recognize their health while struggling with an eating disorder. You're awesome! :)

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    2. How do you mean "recognize their health while struggeling" ? YOU are awesome ! <3

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    3. I mean you were happy to get your period! Rather than being triggered, you were happy, which meant you recognized it as a sign of health. :)

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  8. Hey Kelsi,
    A bit on the flip side of the digestive issues... I suffered from malabsorption problems while in treatment this last time. It was super discouraging, and frustrating. I went into treatment after my relapse ready to go in and get things taken care of. I wasn't going to play any games, I was going to get all of my calories in, follow my meal plan perfectly, tackle this ED once and for all and get on with the rest of my life. I had braced myself for the discomfort I knew was coming with the refeeding and weight gain process. After two weeks of pushing myself to do absolutely everything I was supposed to, all I did was continue to lose weight... at a faster rate than when I was restricting! I felt like I was working my butt off, and made zero progress... it felt like the opposite even, like I was going backwards! After a month in treatment and eating all of my calories, I was no closer to being back in my weight range, no closer to getting out. Things did eventually start to even out, and my body is now able to absorb and use the calories I give it properly...but just wanted to throw out there that for me instead of being blocked up, everything just ran right through me because my body had forgotten how to absorb nutrients.

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    1. Ohhhh yes! Thank you so much for bringing this up! I was in treatment with a girl who had this problem too. I'm sorry you had to go through all of that, I can't even imagine how discouraging that must have been. Glad to hear everything eventually evened out! This is just another example of how much destruction the ED can do to the body. It blows my mind that you began losing weight at a faster rate than you did while restricting. Unreal.
      Thanks again for sharing this!

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  9. It's the TMIs that need the shout-outs. Let's face it -- the taboo topics are always the ones that freak us out the most, probably because we don't know what's going on with everyone else with regards to "the unmentionables" and we feel completely isolated (yet again).

    My digestive system and I have finally overcome our irreconcilable differences. I was very angry at it for a very long time. During my original weight restoration, I was like you -- no movement for about 3 weeks. However, somewhere along the line, those gut flora changed and by the time I was weight restoring after my second relapse, things were the other way around. I did a supervised "reset" of my flora via structured elimination and reincorporation, and I'm more than good to go now (thankfully!!). Kinda have to keep an eye on the fibre/veggie intake, but other than that, good to go.

    And my period ... sigh. I'm alongside you -- ready for the freak-out. Preparing for the worst ED mind leaps, but hoping for the best, for the excitement. I've gotten it twice in the past ... six? ... years now. Here's a dumb question -- do tampons expire? I think I still have some tucked away from way back then. I think I should see if I can find them. Here's hoping that I'll need them soon and that I'll be happy when I do!!

    Thanks for breaking the taboo, girl!! Not always easy, but totally necessary. Thank you for being that voice. <3

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    1. I don't know what's worse - being backed up or the opposite. I'm sure in a way the opposite and what you experienced the second time around was a little less uncomfortable, but still gross haha. I'm glad to hear you have things figured out now!

      Do tampons expire? I can't imagine why they would. You should be safe. I hope that when you do need them it isn't too traumatic. There's a good chance you will have mixed feelings, but that is totally normal. <3

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  10. You and my little daughter got me thinking a lot about "progress", and I rambled a little about it last night in my blog.

    I have been encouraged by this post of yours as well as all the comments that have followed. The honesty and support are wonderful! Prayers for full restoration of health, and courage as it comes!!

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    1. Progress is my favorite word for many reasons. Your post was exactly what progress means to me! Celebrating our tiniest victories can help get us through some pretty difficult times. <3

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  11. Yay for TMI posts! hehe really, this stuff is so important (and so common) and it's much harder to deal with when it's hidden behind a veil of embarrassment. Thank you especially for the bolded sentence about the period = set point misconception! Seriously, I have had several health professionals tell me "you will know you're at your set point once your period returns" without even ASKING my history...when in reality, my period stops and returns at BMI 16. Which I sure as heck know is not my set point! It has been very triggering and destabilizing for me to hear that, because then of course I think 'I shouldn't gain more than that...' (despite my pre-ED weight and the weight I maintain when eating sensibly being at least BMI 20). Thankfully I'm wiser now, but that misconception (especially when perpetuated by clinicians) has disrupted my weight restoration process multiple times.

    As for the digestion part...I won't go into that right now, but suffice it to say, it is an ongoing and extremely uncomfortable issue for me too :/ and one of my main motivations in recovery. AN is definitely not worth it!

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    1. I have said this before on this blog, but it never fails to amaze me how clueless some health professionals are. I know it's not necessarily their fault, but it's still frustrating. I'm so glad you have learned what a healthy weight is for you despite your period returning "early." Keep fighting your digestion issues. Eventually it should all work itself out. The body is an amazing thing! <3

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  12. This comment has been removed by the author.

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    1. I deleted my comment, because it was for the wrong post! LOL.

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