My First Step of Treatment: Inpatient
I wrote about my first hospital stay and what led up to it. I’ve written a poem expressing my feelings about my body. I’ve put myself out there in some of the most difficult ways, but that still wasn’t the hardest thing to share. Treatment gets that award.
Eating disorder treatment was more than traumatic. It was embarrassing, scary, and lonely. If you multiply those feelings by 10, that’s how it felt to be a 12-year-old in treatment.
Treatment starts with an inpatient, which is where I went from the hospital. Inpatient facilities are the very highest level of care. The only real purpose of inpatient care is to get you out of the critical condition your body is in. Since that’s the main purpose of it, they didn’t do too much to make it a happy place.
It started with the waiting room. My parents and I had come straight from the hospital, so we were all at our lowest points. Sitting in the waiting room, I saw all different types of people walking in and out of their units. Some looked a little bit more out of it than others. I looked at the people around me, terrified to be in this place. Someone finally came to get my parents and I. They checked over my things to make sure that I didn’t have anything that wasn’t allowed. By check over, I mean CHECKED OVER. They took all of my things out on a table and rifled through them. They checked through the pages of my journals and felt each of my clothes out. It turns out, half of my stuff wasn’t allowed.
In inpatient, you couldn’t have strings, pencils, anything containing alcohol (my shampoo, body wash, mouthwash, etc.), jeans, anything with hoods or pockets, makeup, and even my own phone. They confiscated my contraband items. The hardest thing that was taken from me was my baby blankie. We weren’t allowed to bring our own pillows and blankets from home. My baby blankie is my most prized possession and even ranked as one of the top three things I would save in a fire, so I was devastated. To this day I mindlessly walk around the house with it. It smelled and felt like home.
After they took most of my things away, my parents and I went through hours of admission paperwork in a small, windowless room. There were questions about things that I’d never even heard of before. Innocent and naive little me. They asked me whether I'd ever self-harmed or purged. I’d never heard of either of those things in my entire life. They wanted to know if I’d ever taken laxatives or used any non-prescription drugs. I was surprised and overwhelmed. I hadn’t ever thought of doing any of those things even once. I could tell my parents were pretty surprised too.
Once we’d finally finished doing the billions of sheets of admission paperwork, we were taken on a tour of the unit. The unit was extremely old and had obviously never been renovated. There were few rooms that we were allowed to be in. There was the day room, which is where we spent nearly all of our time. The dayroom was terribly uncomfortable. That’s where the 12 of us would spend all of our time together. The room had a huge window, probably the only one on the whole unit. The view was as depressing as humanly possible. It was a view of the side of the building. It looked like an abandoned parking lot surrounded by dead trees and grass. We had bedrooms but were only allowed in them at night. Everyone had to share a room except for me because of how young I was compared to every else there. The rooms were freezing and damp, almost like an old basement. We weren’t allowed to have drawers, so all of our things were put in these weird cabinet structures.
My parents then had to leave. It was a painful separation from them. I hugged and kissed them through tears. I wasn’t crying too hard, I didn’t have a lot of fight left in me. I remember my dad reassuring me everything would be okay, that it was just like a bump in the road. My mom seemed a little bit less hopeful. She was the one that was with me every day. She drove me to most of my appointments. She dealt with getting more support at school so I could eat easier. She gave my recovery her all, so of course she was tired now. They were allowed to visit on weekends and occasionally during the week, but only for very short periods of time. The only time that I could speak to them during the week was at the very end of the day, and I had to wait my turn to use the phone because all of the patients had to share. The phones were the kind you see at school or in the doctor’s office. You could only use them to dial numbers.
My first night there was miserable. I honestly felt like I was in an alternate universe. I walked in there to be welcomed by the other patients. They were all very inviting. I know that the reason why they were so welcoming is because they too had been through their first night. They knew what it felt like to be so alone and scared. The first girl that went up and talked to me was fourteen. She was super friendly, but off. Her voice sounded super strange and most of the things that came out of her mouth didn’t make much sense which freaked me out. It wasn’t a great first patient to meet there. She talked as if someone was plugging her nose. I would later find out this was because she had recovered from brain cancer and undergone surgeries. She talked my ear off, but I wasn’t in the place to talk much back.
We all had to eat a night-time snack. It was my first snack there. I watched as all of the other patients got snacks. Some would get snacks as big as peanut butter toast with a whole carton of Boost Plus while others only had apple slices. Everyone’s food ranged so much, I was so nervous to see what they’d give me. Staff read off of our meal plan sheets, the sheets that told us exactly what we were to eat. There were two different women handing out snacks tonight. One was short and smiley while the other was tall, lean, and rough. It felt like we were all little kids at daycare with babysitters passing our food out for us. The smiley tech got to me last. When she read my meal plan sheet, she squinted and shook her head. I wasn’t sure what was wrong. Would my snack have to be THAT unbelievably big? Did I already do something wrong?
She went to go talk to the other tech and came back with new information. She told me that since I arrived on a Friday night, I didn’t have a meal plan yet. The regular staff wouldn’t be there until Monday, so I had to be on a standardized one. It turns out the standardized plan was pretty darn small because all I had to have that night was a bite-sized chewy granola bar. I was relieved, but little did I know what was to come.
After my first pretty painless snack, we all hung out in the dayroom until it was time to get ready for bed. I wasn’t feeling as crappy about eating because I was able to walk around and move more than I was while on bedrest. I did already notice that as soon as I stood up for longer than a minute, the staff would tell me to sit back down again. When I asked why I was told that it was an eating disorder behavior to stand for long amounts of time. I was in shock at the number of rules that there were. They all happened to interfere with my usual routine. My life was completely turned around. Everything about it was now different.
Each morning was the same. We woke up at 6:30 and got weights. We would have to change into hospital gowns to get our weight checked. If our weight didn’t go up at the minimum of two pounds a week, we had a meal plan increase. Most of us showered in the morning because only some were allowed to at night, you needed an order for it. An order was an accommodation your treatment team gave you. Some people had orders for things like stuffed animals and blankets. It was hard to get an order for something, so most people didn’t have them. Sadly, you couldn’t get an order for a whole mattress (I checked). After we got ready, we had to gather all of the things we wanted during the day. Staff locked the doors because we weren’t allowed back in our rooms until night. We would go out to the dayroom to take vitals. During vitals, we would all lay side by side while they took out blood pressures. Then we would sit, then we would stand. If our vitals were off, we had to drink a Gatorade, which happened to be a lot of our biggest fears. After that was meds and breakfast.
I remember the first time I ever took vitals, lying next to the other patients. I saw others ribs and hip bones protruding from their bodies, just like mine. That was the first time I felt less alone and crazy. Back at home, I was the skinniest in every room I walked into. That definitely felt good at first, but quickly I realized that a LOT more negative attention was directed towards me then positive. Now, being here surrounded by other eating disorder patients, I was just average. I even called to tell my mom that night about this wonderful experience, but she just sat there in horror as I described what I saw. Some patients had feeding tubes. Some were missing hair, a result of starving. Some people even had self-harm marks on their arms. Don’t get me wrong though, I was in just as bad of shape as all of them there.
Nights there were loud and restless. Staff had to do rounds on us every hour to make sure we weren’t doing something we weren’t supposed to. They would open the doors so the blinding hallway lights would shine into our rooms and the doors would creak as they opened and shut. Imagine trying to sleep through that every hour! The beds were the worst things I’d ever slept on in my entire life. It honestly felt like I was sleeping on cardboard. For some reason, the beds and pillows were wrapped in this plastic wrap substance which made a crinkly noise every single time you moved. I was grateful that I didn’t have to share a room with anyone, but nights were still terrible. I would cry hour after hour, envisioning my cozy bed at home, wishing I was cuddled with my sweet pup.
The weekend was horrid. I thought it would be easier with the usual staff not there, but it was just ten times harder. More than half the time, I had absolutely no idea what was going on. I didn’t get to meet my therapist, dietitian, behavior specialist, physiatrist, or even the usual nurses. I felt so alone and clueless because not a single person there could answer my questions about my treatment. I had no idea how long I’d be there, what my goals were there, or even my own meal plan.0
Weeks were much better than weekends, but still very boring. Each day was taken up by group therapy, therapy appointments, dietitian appointments, psychiatrist appointments, behavioral specialist meetings, vitals, eating, school work, and the occasional free time. For free time, we couldn’t have electronics, pencils, music, or even my spiral notebooks and drawing pads. Group therapy was pretty much useless because we couldn’t even talk about anything eating disorder related. They were less lonely, but still so very lonely. I was psyched when Monday rolled around after my first weekend. I could finally understand what was going on because my real treatment team would be there to explain it. First thing in the morning, I met with a dietitian. I didn’t like thinking about food, much less talking about it. She gave me a meal plan. All of our meal plans had these things called “supplements”. Supplements were different types of high-calorie bars and drinks to add on to snack and/or meals. Everyone had a different amount. My new meal plan was much bigger than what I was eating over the weekend. I was now completely stuffed after every meal and snack. It felt like I was gorging myself on so much food.
Staff was on the lookout for tons of different behaviors, which is why there were so many rules in place. They watched for patients hiding food, which is why we weren’t allowed to wear things with pockets or hoods. That’s also why we had to sit on our butts with our feet on the ground while eating, in case we hid food between our legs or something. Someone always had to have both eyes on us while we were using the bathroom and we were only allowed to use it a half an hour after eating, in case someone tried to purge. They monitored our rooms at night with rounds each hour to make sure none of us were exercising or self harming. There was absolutely no food talk allowed. We couldn’t talk about anything that had to do with food because some people couldn’t hear it yet. I know the purpose of everything was to keep us safe, but not everyone was on the same spectrum and needed the same amount of monitoring. It felt like prison, with a whole staff of watchful eyes on your every move.
Day after day was the same. Inpatient was super uneventful because of our lack of freedom. I got close to some of the other patients and created some real bonds. There were girls I didn’t get along with as well, because ED is really competitive. We weren’t really allowed to talk about anything, because pretty much everything could be possibly triggering.
My discharge came especially fast for inpatient. I was discharged in six days. I remember staff telling me that I could finally leave. I got so excited; I was completely fixed. They then told me that I didn’t get to leave the hospital, I would be going to residential care. I was heartbroken. All I wanted to do was go home. I had absolutely no say, so I packed up my things to leave. My mom and I got a tour. My mom was trying to be as hopeful as possible, but it just wasn’t that simple. I hugged my new friends goodbye and left, just as quickly as I’d come. A lot of them were angry that I got a spot in residential so quickly. I then was transferred across the hallway. On the bright side, I was finally out of the unit. I was beginning to feel more hopeful. If only I could see how COVID would drastically change my treatment, relationships and entire future concerning my recovery.
This blog post was hard to write, but so beneficial in my letting go process. Now that I've put some of my treatment story out there, I feel a piece of the traumatic memories shifting from inside of me. I hope this story brought treatment to light and showed that treatment isn't for crazy people, it's for people that are hurting.
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By: Arden Nickerson