Tracking food:
I still track food exchanges (well, sometimes), and originally I could only find one app that was appropriate for this in the app store: EatRight.  After that I discovered Foobi, and most recently have converted to FoodTrackerPro.  Note: none of these apps use calories — just servings/exchanges — and I’ve been pretty pleased with all of them, but FoodTrackerPro is definitely the coolest.  PLUS, it works on the iPad, so bonus points for that.  You can customize your meal plan and make charts and set goals and all of that… but it also has a great food servings cheat-sheet — for all those times that you’re trying to remember how much hummus equals a protein exchange (for example).  iPhone/iPad, $1.99.

Tracking mood:
I started doing this on paper awhile ago and found that it was actually a good exercise for me (not only to see the patterns in mood but also just to check in with myself).  I’ve seen several apps for this, but currently my favorite is MyMoodTracker (same company as FoodTrackerPro, actually).  It’s only for iPhone (no iPad yet, bummer), but it tracks mood using a 1-10 scale and little emoticons.  You can track sleep on here, too, and see how that influences mood.  iPhone, $1.99.

Meds:
You know those times when you’re at the drug store trying to purchase something to help with your nasty cold, and you can’t remember if it’s okay to take Sudafed with the Wellbutrin you’re on?  That’s when you need Epocrates.  Or… when you have a headache and have already taken Tylenol twice and are not sure if it’s okay to take another dose yet?  Okay, maybe it’s just me, but I run into situations like this all the time and would be lost without this app! Plus, when you’re on more than one med at a time (which is pretty common these days), things get complicated (drug interactions, dosing, side effects, etc), and it’s just good to have it for reference.  iPhone, free.

Countdown:
By now you’re probably thinking, “okay, you track way too many things”–and it’s probably true.  BUT, do you know what’s even better than personally tracking something?  An app that does it for you!  That’s Countdown.  I have countdowns for everything — how long I’ve been married, how long it’s been since I last acted on symptoms, how many days until my next therapy appointment, how long until my birthday (hey, why not….), etc.  Random countdowns aside, there’s something really motivating for me about knowing that I haven’t skipped a meal in three months, or drank coffee since…. err, yesterday (okay, really bad example), or that I have therapy in 1 hour, 42 minutes and 18 seconds (and really need to do my therapy homework).  I just love seeing that.

Coping Skills:
Remember my series on coping skills?   Well, for each of those items, there is of course an app for that:

1. card stores – it’s not a card store, but someecards can entertain me for an embarrassingly long period of time (both the app and the website).
2. bulletin boards – Corkulous would probably by my favorite app-equivalent of a regular cork bulletin board.  However, the real purpose of bulletin boards for me are to serve as reminders, so that the “out of sight, out of mind” thing doesn’t kick in.  For that, I’d probably actually use a todo app or custom background/wallpaper (not going to link these because there are a million and I don’t have a favorite!)
3. kudos chart – again, this is something you could probably find in a todo app, but if you’re looking for something a little more…. sticker-chartish… try GoalTracker (ipad).
4. crafting — there are a million apps for: coloring, collaging, drawing, photo-editing… really, a million. You might start looking in Apps for Kids.
5. dvds — you can download just about anything from tv/dvd onto your iPhone/iPad from the app store.  Additionally, ABC has an awesome media player that lets you stream shows for free.

Okay, that’s the end of my list for today.  If anyone has any other app suggestions, I would love to hear them!

While I’m not in a position where I have to calculate hours spent on a task, I was thinking about how the eating disorder would affect my focus factor.  It’s kind of scary (and pathetic) when you really think about how much of your time the eating disorder can consume.  Obsessing about your weight, what you’re going to eat, what you already ate (etc) is really distracting.

I tried to break down the components of my focus factor, and came up with the following pie chart:

Eating disorder-wise, this isn’t really current for me.  I’d say the numbers are accurate for when I’m struggling moderately — not at my best or my worst.  When you add it all up, I’m really only focused on work for 1/3rd of the time I should be working (this isn’t including the rest of the non-work day).

One time when I was struggling, I cut back my work hours to do day treatment.  I fussed about what a disaster it was going to be to not be getting work done.  I was afraid I’d be letting my coworkers done and hurting the overall quality of my team’s work.  As it turned out though, by getting more treatment I drastically reduced the amount of time I spent on all those ED thoughts and ended up being MORE productive.  Go figure.

My therapist still loves to bring it up, in some kind of “remember how you are actually more productive and successful when you make treatment a priority?” comment.  While it’s definitely true, I knew I shouldn’t have admitted it…

I could not, would not, on a boat.
I will not, will not, with a goat.
I will not eat them in the rain.
I will not eat them on a train.
Not in the dark! Not in a tree!
Not in a car! You let me be!
I do not like them in a box.
I do not like them with a fox.
I will not eat them in a house.
I do not like them with a mouse.
I do not like them here or there.
I do not like them ANYWHERE!

I do not like green eggs
and ham!
I do not like them,
Sam-I-am.

–Dr. Seuss

There are more than a dozen interpretations of “Green Eggs and Ham” out there (just google it, you’ll see), but I’m pretty sure that mine isn’t one of them. When I hear the rhyme, I think of all the rules that individuals with EDs have surrounding food. Sometimes we’ll get a new patient who is not going to eat the meal if any of the following are true:

• One food is touching another food.
• Something requires a spoon.
• The food can’t be picked apart or cut into tiny pieces.
• There are caloric drinks (milk, juice, etc).
• Something is “not warm enough.”
• A piece of fruit has a spot on it (even a microscopic spot).
• The food can’t be eaten in a particular order.
• The room is too hot or cold.
• She’s sitting at the end of the table.

…and I could go on. I will definitely confess to doing some of these things. I hate juice and/or milk. My point is, though, that said new patient is against eating the food here, there, or anywhere. She’s wrapped up in the eating disorder and not even considering any of the above.

While I totally sympathize, part of me can’t help thinking “Well…. actually, you will eat your green eggs and ham – and you’ll (learn to) like it.” That’s kind of how treatment is. You come in screaming, “No no no! I will not I will not I will not! Not in a box or a house or even in the dark!” And you learn (or slowly realize) that not only are you going to eat them in the dark, but with a goat in a tree while it rains as well.

On the 12th day of Christmas,
my therapist gave to me…

12 new feeling words
11 prying questions
10 goals for eating
9 self-affirmations
8 ways to be mindful
7 coping skills
6 restructured thoughts
5 empathetic statements
4 problem solutions
3 anti-depressants
2 more diagnoses, and
a reminder she won’t be here next week

My dietitian once told me “don’t bring Ed to dinner – leave him at home.”  I have this vision of my sitting at a restaurant, with Ed at the end of the table with just a glass of water.  Very silly, I know… but for some reason that helps me.  Maybe it’s because I am separating the eating disorder from myself.

People with eating disorders are competitive — that’s (one) reason why you have to be careful who you put in groups together.  I have some friends who I really like, but feel competitive with or triggered by.  It’s easier for me to think of our two Ed’s fighting.  We brought them along with us and now they are arguing.

Okay, now it sounds like I have an invisible friend… and usually I don’t think of the eating disorder as “Ed” — but there are certain situations where it’s helpful for me.  But, my question is — what does your Ed look like?  Do you have a mental image of it?  I’m curious to hear how others envision it.  I’ll draw mine and post it in the next entry…

1. You measure the cost of things in nutrition appointments (ex: That shirt is one nutrition appointment. These shoes are worth two appointments).
2. You start dressing like your professionals (or maybe, they starts dressing like you…)
3. “Treatment” is a recurring event with no end date on your calendar.
4. You’ve never needed to purchase “Eating in the Light of the Moon” because at some point you have been given a photocopy of every chapter.
5. In group, no one sits in your seat, even when you’re not there (because you’ve been sitting there since last year).
6. The group therapist wishes you would just finish treatment already so that she could start recycling therapy topics.
7. You remember when some of the current therapists were interns.
8. You’ve modified the standard food log template to create your own (improved, of course)
9. Your therapist notices when you buy a new outfit (since she’s seen all of your other clothing).
10. When considering changing jobs, the new company’s mental health insurance is a deciding factor.

I am not guilty of all of these…. but more than a few.

I’m sure you’ve heard these before… like FINE – Frustrated, Insecure, Neurotic and Emotional.  Now, look at a few of Gary’s…

Doubt - Debating On Understanding Bewildering Thoughts
Romance – Relying On Magnificent And Necessary Compatible Energy
Fear – False Evidence Appearing Real
Fun - Finally Understanding Nothing
Sober – Son Of a Bitch! Everything’s Real
Fraud – Finding Relevant Answers Under Deception
Faith – Fantastic Adventures In Trusting Him

So, I thought that I would create some of my own, relating to eating disorder treatment.  Personally I don’t think they’re useful — I just think that they are amusing.  However, since it took me 2+ hours to come up with these couple of Greyisms, I think that they are a little less fun.  Anyway, here’s what I’ve come up with:

• Cope – Changing Overwhelmingly Problematic Experiences
• Shame – Sense of Hurt And Malicious Embarrassment
• Fear – Flee Emotions Around Reality
• Want – Wish About Needing Things
• Denial – Dismiss Every Notion Implying Anything Less
• Therapy – Telling Her Everything Rough About Previous Years
• Support – Someone Understanding Pretty Painful and Overwhelmingly Rejecting Thoughts
• Know – Kinda Not an Original Word

So there you go — those are my best Greyisms.  If you come up with better ones (which you will surely do), definitely post them!

I’ve been told more than once that I have “anorexic handwriting.” Aside from the fact that this label is very non-PC, I never really put eating disorders and handwriting together. When I was inpatient, I remember this girl had really, REALLY tiny handwriting. We’re talking microscopic, get out your magnifying glass-tiny. I’ve had both a nutritionist and therapist refer to my handwriting as “anorexic.” How exactly are you supposed to respond to that, by the way? Um, thanks? I’m working on it? (I would like to note, though, that the girl I knew with teeny tiny writing has since recovered from anorexia and changed her handwriting–interesting, don’t you think?)

Googling “anorexic handwriting” is pretty much a waste of time (there is one scientific article on the subject, which I will admit I have not read)… but I did read up a bit on “graphotherapy.” I’d never heard of it myself, so to quickly explain (from The Complete Idiot’s Guide to Handwriting Analysis):

A specialized branch of graphology sometimes referred to as ‘graphotherapy’ is actually a form of handwriting remediation. It makes sense that if handwriting is a true reflection of one’s psyche and the result of accumulated experiences, that changes made deliberately to handwriting can help one change uncomfortable personality traits.

Some systems of graphotherapy require the client to make changes to bits and pieces of their handwriting. For instance, the client might be instructed to change his writing slant, raise his t-bars, or adjust his lower loops. While changing one’s t-crossings might not be a big deal, meddling with the lower zone is.

In effect, making changes directly to the handwriting is like ripping away the client’s defenses without replacing them with something more positive. This kind of graphotherapy can be very damaging.

….hmmm, interesting. Maybe I should go back and add this information to my, Who said therapy couldn’t hurt anyone? post.

Using a series of writing movement patterns can help the writer make changes from the inside out, rather than the band-aid effect of changing bits and pieces of handwriting. Some amazing results have been reported by graphologists working with clients to change what they view as undesirable traits.

In Tucson, Ron Laufer has received media attention for his work with anorexic and bulimic clients. These young women had tried numerous other treatment without success, but the graphotherapy exercises seemed to make the difference.

So, next thing you know, there will be ED graphotherapy group. Right between Equestrian therapy and psychodrama…

Anyway, if I had to connect EDs and handwriting….

1. Perfectionism — a common trait among individuals with eating disorders. Why wouldn’t this extend into handwriting?
2. OCD — again, common among those with anorexia.
3. Control — I hate to perpetuate the “eating disorders are about control” theory, but I could tie EDs, handwriting, and control together.
4. Obsession with being small – okay, a stretch, but small handwriting and small bodies… why not.

Personally, I’m a little neurotic about handwriting. I will erase and re-write words and sentences if I think something is messy or if I make a mistake. Sometimes I’ll start all over with a new piece of paper. Let’s say I’m writing a card… sometimes I’ll write three versions of it (with different spacing and/or colors) and then choose the version that I think is the best. A little OCDish, yes.

Also… the physical act of writing is therapeutic for me. Some days when I am so anxious about work and just cannot get started, I will sit there and write a copy of my to-do list. Heck, I’ll find a psych article online that I like and take notes. Just because focusing on the letters and the organization of the paper somehow helps my anxiety. So…. maybe I just have nice handwriting from so much practice.

Just something to think about..

(because I know you are now just DYING to see it — this is a clip from a food log of mine from… oh gosh, I don’t know, sophomore year of college?)

There is a lot of terminology used in the eating disorder world, and it’s funny how it still catches me off-guard when similar acronyms / terminology is used in the real world.

BP: Binge/Purge — or a gas station
AN: Anorexia Nervosa — or atomic number (that was always weird to see on paper in chemistry)
BED: Binge Eating Disorder — or Bachelor of Education
OD: Overdose — or overdue

And one of these days I’ll compile a comprehensive ED Glossary… but for now, a couple of terms that I’d like to add to the regular N, T, ED etc.:

ortho: orthostatic hypotension
MP: meal plan
DC: diet coke (maybe not universally recognized )
episode: binge/purge
MFG: multi-family group (therapy)
CS: combination snack
HNC: honey nut cheerios (okay, so this probably won’t make my “official” glossary, but I used to use this abbreviation all the time)
traz: trazodone (sleeping med)
DP: diet pills
lax: laxatives
BR: bedrest
log: food log/journal
exchanges: dietary exchanges (used for meal planning)

1. You must abide by “ED recovery etiquette” – By this I mean, no matter how crappy you are doing, when you go out with a friend that you know has an ED or whom you know from treatment, you better suck it up and act as normal as possible… because triggering a friend is not okay.

2. If I can’t get a salad for dinner, neither can you – And I can’t, because then it would be considered eating disordered. So order something else.

3. It’s not fair for you to skip breakfast and skimp on lunch, and then give me crap when dinner isn’t my largest meal of the day – While you were sleeping, I was enjoying the most important meal of the day (breakfast). All meals being equal, your skipping 1.5 of them doesn’t put you in a position to be criticizing my dinner.

4. Please please please don’t order the same thing as me at a restaurant – Because restaurants are challenging enough, and I don’t want to be comparing how much I ate to how much you ate.

5. Don’t eat my yogurt – I’m sure this is unique to me… but there are 100 kinds of yogurt in the world — why eat mine? I think it’s more the switch from a different yogurt to my yogurt that bothers me…

6. Things you can’t say: You’ve lost weight. You haven’t had an appetite lately. Wow grey, you’re always cold — you must have no metabolism. You’ve doubled your workout plan lately. You’re not eating ____ food anymore. Our friend has lost so much weight. Our friend needs to gain weight — she’s too thin.

,,, I could go on, but I’ll stop. feel free to add your own

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