Tuesday, July 29, 2014

The Heroin-Bulimia Connection

I recognized the name on caller ID. I'd been waiting for this call.

"Hi, Rae."


"So are you home or are you in..." Temporarily unable to come up with the name, I let it hang. We both knew what I meant.

"I'm in. I've been in since yesterday. How're you doing?" No matter what's going on in her own life, Rae is one of those rare people who can ask that question and make you believe it's the most important thing in the world at that moment.

"I'm fine." Only a little lie. I'm way better than Rae at the moment, and the only negative in my life is the state of my knees, verging on a three on my icepick scale, highly overworked both that day and the previous one. I got right down to it. "So, after a full day, what's the worst thing so far?"

"Not throwing up."

"Just that simple and basic, huh?"

"Yeah. I just want to leave!"

"No you don't, Rae. You want to survive. You've got two beautiful kids, and a husband who, from everything I've heard from you, just adores you."

After thanking me for giving her back a little perspective, we spent some time on the real purpose of her call, the schedule of visiting hours. Rae is just starting treatment for bulimia through the Emily program, a process that could last up to 8 weeks, if she sticks it out. She'd asked me if I'd visit and give her support. Since the center is located in a St. Paul suburb, there should be days when it's convenient on my way home, and plenty of times on the weekends when I could make it down, I just needed to know when. The schedule is complicated, changing daily except for a window from 9 to 10 each night. We both agree that's a bit late.

If you've been following my blog, you've been introduced  to Rae. It's not her name. Not even close. I invented it for her by taking the R and A from "recovering addict" and added the E to make a name. Through the years of our friendship, she'd taken me places and introduced me to things that I am unfailingly grateful never to have experienced in person. She's the one who told me that at 14, after her first hit of heroin, she knew what she wanted to do with the rest of her life. I've been learning in bits and pieces what that path has cost her.

Is still costing her.

Rae has a big heart, generous with her time and affection. She tells me regularly she loves me, and we both know that means as a friend. I'm not sure exactly why, but I think it's because I listen. And I don't judge. She's recently given up on a long-time friend because she couldn't say anything to her without being chewed out. It's hard enough to open up when you're vulnerable without somebody landing on you with both feet telling you how badly you're running your life. I just don't figure it's my place to do that. She's not hurting me, and I've long since learned that there's enough shaming in the world to keep people emotionally closed down, unable to heal themselves. I don't need to add to it. It never helped me. I needed a safe place to get past it before I could look at my own issues. I assume Rae is the same way. And if I'm wrong, the 12-step program she's in is plenty confrontational and judgmental already.

She's got plenty on her plate to deal with. I'll happily listen. I'll worry, now that I know there's more to worry about, and hope she can find what she needs to open up and be honest enough to be successful in her latest struggle. She almost died last weekend.

She filled me in on the connection a few weeks ago when she first let me know she was fighting bulimia. Not that she was exactly fighting it at that point, just starting to think about it. Honesty was her first step. It was kind of a hesitation waltz, admit a bit, then admit a bit more.

Here's how she explained it. One of the fairly common side effects of shooting up is that it makes some people throw up, at the same time they're feeling the best part of their high. Think of Pavlov's dogs, salivating when the bell rings. Eventually throwing up without the heroin brings back the pleasure of the high. That's what she feels today. After explaining how it works, she opened up gradually, letting me know just how bad it has gotten. As she opened up to me, she also opened up more to the Emily Program intake people.

Last Friday she told them just how often she was throwing up, and admitted to feeling unwell, even to a minor chest pain that she all but dismissed. They took and EKG on site and rushed her to the hospital. I have since heard that it was almost a heart attack, then that it actually was one. Her potassium and magnesium levels were terribly out of whack. She was also diagnosed as pre-diabetic. A couple previous illness diagnoses were questioned, as they were made without the bulimia information and apparently without testing for its side effects. Once she's stabilized, those things can be reevaluated. At this point, Rae is comforting herself that maybe the pre-diabetes diagnosis is also wrong. It's a very teeny ray of hope.

At any rate, it's not her immediate battle. She says she's taking my suggestion to have the nurse on site keep an eye on her blood sugar, and discuss possible dietary changes with the dietician. I'll ask her about it when I go visit. I'm aware of another contributing factor from her past that I'll ask if she's ready to share in this setting. It may well be the toughest piece of Rae's puzzle. No, I know it's the toughest piece. It just may the most important.

I'll bring it up. I love her too.

1 comment:

Margaretta Cloutier said...

If I could just make one point here, it is that everyone with an eating disorder does not have the same underlying issues. Some do indeed do it for attention, some do it for personal reasons. and others do it because they have no choice. The brain is wired differently and this is not as clear as you might think.

Margaretta Cloutier @ Aspire Wellness Center