When You're Hospitalized for the Medical Complications of an Eating Disorder
If you live with an eating disorder, the following post could be potentially triggering. You can contact the Crisis Text Line by texting “NEDA” to 741741.
The last time I was hospitalized for my eating disorder, it felt like the hospital’s only aim was to get me out.
I understand why this was the goal. In the past, the hospital has exasperated my symptoms and only made things worse. However, this time things were different — and many things were missed.
I was admitted to the hospital with an extremely high heart rate. The doctors were concerned. I didn’t refuse the first nine bags of fluids they gave me overnight because I too was worried about my heart. After medication and fluid, my heart rate still remained high. I was subsequently admitted for tachycardia. Within hours of admission, my sugar dropped so low it could have resulted in serious injury to my life. I didn’t refuse the first several doses of dextrose. (Which is different for me.) Nor did I refuse to stay, which would have required me to get certified and petitioned. I tried to display I was there for help — not to “break or get away.”
After many rounds of dextrose, I questioned if anything else could be done, because one, my eating disorder started to get louder as fluids and pure sugar entered my body. (This is normal for eating disorder patients and isn’t a reason a patient isn’t doing well in the hospital.) Two, my sugar was dropping within the hour and the dextrose didn’t seem to be lasting nearly as long as it had in the past. Three, I was malnourished, and didn’t really know what was best for me at the time. Nonetheless, I continued to receive dextrose because of my “refusal or inability to eat.” I was also experiencing these symptoms at home four to five days prior to admission, which again is why I decided to seek help from medical professionals.
On Monday, February 8, after spending the weekend still dealing with tachycardia and hypoglycemia, the social worker came and almost immediately insisted I be discharged because my behavior would only be “exacerbated” if I stayed in the hospital. The nursing staff and I disagreed with this plain at the time because my symptoms where still not under control. I had a hard time walking on my own and because of my low blood sugar and fast heart rate, I actually fell and hit my head quite hard while trying to get myself dressed to leave the hospital. A doctor did not order any kind of scan after this fall, though I clearly had a mark on my forehead from hitting the floor.
We spent hours arguing back and forth about whether it was a good idea for me get discharged, and I kept changing my mind. This is also typical of someone with an eating disorder. Sometimes when we start to receive medical help, we look for ways to talk ourselves and others out of it for fear of losing too much control or gaining weight. The flip-flopping for hours wasn’t me being “borderline,” but in fact was my eating disorder screaming for me to leave while I had the chance and continue to starve myself, all while my rational voice was screaming how much I needed medical help. How thin I had become. How I couldn’t even stand on my own two feet. How I felt like my heart was going to beat out of my chest at any second. How I was scared this time. How I really might die because I really am “that sick.” How I truly wanted to do things differently.
Over the past few months, my new therapist had started telling me things I never thought about before. Like how complex my eating disorder is. How much it gets in the way of me being able to articulate what I really want or need. I wanted to try and fight anorexia more than ever, but she was also louder than ever. I was able to give up some control and go to the hospital, stay at the hospital. So I felt let down when I was told the hospital “wasn’t the place for me” and that “I would get any better.” What was better? Being sent back to my empty apartment to die alone? After much debating, the social worker wheeled me out to my car and advised me to “pivot” myself to my car from the wheelchair because they weren’t helping me drive in my condition. This is why I refused to drive away. It made no sense to me — if I was too medically unstable to drive my car, how could I walk up my steps or even get out of bed if I made it to my bed. To me, this wasn’t “borderline behavior,” this was me trying my hardest to prove my point. I wasn’t stable enough to care for myself.
After I drove off, I lost consciousness fairly quickly and crashed my car. I knew I couldn’t drive. But I had basically been kicked out of the hospital and I wasn’t going to allow myself to stay there another second. I woke up to nurses and doctors screaming and pounding on my window. Luckily after some time, I understood what was happening and opened the door. I was immediately taken in a triage where again my heart rate was through the roof, and I of course couldn’t stand on my own, let alone drive a car safely.
I was admitted back to the sixth floor after waiting in the ER for 18 hours. No one seemed to care how this affected my mental health. And after I refused to stay any longer, I was then certified and petitioned and threatened to be restrained if I even attempted to stand up. The same hospital that had discharged me just hours before told me I wasn’t safe enough to leave. (How was this not to confuse me and/or cause my anger?) Back on the floor, my physical health was slowing getting somewhat better, but the doctor still felt my sugar levels were too dangerous for me to be sent home. One day, I apparently became combative and incoherent. I began threatening to rip out my lines and was then put into restraints and given dextrose. (Being combative or displaying abnormal behavior is very common for someone with low blood sugar.) Despite this obvious medical information, and the fact that I had no memory of the outburst I had just displayed after receiving dextrose through a shot, I was still held in four-point hard restraints with one of my arms raised up in the bed for over four hours. Only after I complained because I knew this was against the restraint policy were both of my arms able to be by my side.
I had already pulled out my pic line and feeding tube being I was put in restraints, so what more of a threat did I pose? I felt like this was their attempt to punish and control me after everything that had happened. What other conclusion could be drawn? I was immediately calm after being in restraints, but still was locked in them and was even told to “eat” while in four-point restraints for displaying inappropriate behavior during a hypoglycemic episode.
Another time, after hearing nurse “discuss” me in the hallway for hours, I decided I was going leave to hospital. The nurses said things like, “The social worker already said this was for her mental health, she shouldn’t even be here, I got a dude dying next door. This is fucking bullshit and I’m not going to deal with her if she is the one refusing to eat.”
Please, let’s remember millions of people struggling with eating disorders. This is the kind of attitude that hurts us and prevents us from getting the help we deserve. I felt so discouraged, and like I was taking the space of someone who “really” needed to be in the hospital. All the thoughts of finally getting some help — not “recovering,” but making that huge first step — left my head. I had been eating small amounts. Agreeing to receive things like potassium and magnesium. In the past, I fought these things tooth and nail. I was in fact “doing something different.” When I left, I walked down six flights of stairs before being “tackled” by security and taken back upstairs. See, I was actually getting better this time. A week ago, I couldn’t walk from a wheelchair to my car door. This time I walked down all those stairs and though my heart felt like it was going to burst wide open, I didn’t fall. I was eating little by little and getting stronger. I was trying — until I heard those nurses talk about me for hours.
When security found me I fought to not go back. I just wanted to go home and be left alone. What was I to do if the very people who went to school to help sick people and care didn’t even want me there? I was frustrated mentally from fighting my eating disorder for days and eating food no matter how small a bite. From telling myself I needed the medicine and fluids, the feeding tube. From hearing person after person say how this “wasn’t the right place for me to be helped” and “would only made things worse.”
When they brought me back to my bed, I was in restraints for over eight hours. I cried, looked outside and realized it was dark. Memories of the sexual abuse I experienced as a child and an adult flooded my heart. My abuser had tied me down. These memories only got more vivid when I was told my only choice that whole night was to use a bedpan. I promised that I wouldn’t even walk close to the room door. That all I wanted was my hands free. This night caused just as much trauma as the night my abuser actually did what he did. What was different is I kept expecting a nurse or doctor to come in and say, “OK, you can get out.” I knew that wouldn’t happen then with my abuser. But I never thought a hospital that claimed to understand trauma would put me in restraints again for so long just for packing my things and walking down stairs, basically.
Of course it wouldn’t happen again. I now had a sitter and all the nurses and security were on high alert. Yet for hours, I laid and cried begging to just be let go so I could get up and pee. Even at one of the most recognize and respected medical facilities, I was ignored and treated with very little empathy. This is why on February 15, 2021 when I knew I would be OK to at least make it home, I signed a paper to get discharged against medical advice. Even though the doctor didn’t feel I was safe to go home, no one said I should stay and not sign the paper. The nursing staff and security seemed quite happy to see me go actually. Despite the numerous times I was told “I would do better at home,” I am not. I’m still struggling to eat food. I am not medically stable.
Imagine if I was your daughter, sister, friend, or someone you loved or cared about. As a “medical professional,” would you have wanted me to leave the hospital because I was too much of a headache? Or stay there and potentially get medically stable, then go home and continue outpatient therapy and look for treatment centers? These words have come from my heart. From a heart who maybe wishes she hadn’t left against medical advice and could let words roll off her back. Who wishes more people in the medical field understood anorexia and eating disorders and how much they just kill and destroy. Coming from a socially compromised and diverse background as well, I wonder how my treatment would have differed if I was a white women with insurance presenting with the same symptoms. If perhaps I would have been given the opportunity to be forgiven and start a new stay, instead of immediately being told I was just going to fail. I hope by reading my story, next time you’ll stop and try to be a little kinder to the next patient who has been in ER room 23-26 hours because the social worker can’t find a psych bed. We too matter and have voices just begging to be heard. Thank you for reading.
Getty image by Anastasiia Zvonary