Inpatient Treatment – Episode Two: The first 48-hours of your stay

In the first episode of this series, I explained the differences between inpatient and outpatient treatment as well as an example of the daily routine I experienced during one of my inpatient treatments. For episode two, we’ll dive a bit deeper in the first 48 hours upon entering an eating disorder treatment facility – looking at what to expect, and giving you a few quick tips and lessons to learn to make adjusting to inpatient life a lot better for all parties involved.

When you first step foot inside the doors to your new temporary accommodation, you are greeted by both existing patients on the ward and introduced to your lead nurse/s who will be your go-to guy or gal/s during your stay. They’ll give you a tour of the place, show you where bathrooms, medication dispensaries, dining room, tea facilities, therapy/art rooms, and most importantly – your room. Lesson #1 to learn – there is no such thing as privacy entitlement; your bags may be checked, and you can be put under supervision/watch at any time, always while you eat, and can be while you sleep, shower, and pee.

You will also be given a plethora of information, fact, and rule sheets about the ward and how the ward operates. Take your time to have a good read through this, it should have key answers to all of your when/where/who/what/why/how questions you will have buzzing around in your mind. Lesson #2 – you will no doubt forget at least one of the rules of the ward during your time, and that’s okay and expected; after about a week you will have more clarity and understanding about the new structure and routine of the facility.

Alongside sheets of paper, be prepared for a few long assessments and consults with an array of people – namely your key psychologist/psychiatrist and key nurse, and possibly a dietcian. They will ask you about your life history, personality, food and exercise habits, mental/psychological state, and family structure. Be as clear and comprehensive as you can muster – the more they know, the more specific and refined your care will be. An important Lesson #3 arises here; there is only little time that you will be able to have 24/7 support from mental health specialists – utilise them! They will be there to guide you in what will undoubtedly be a very arduous and life-changing times. In addition to psych evaluations, you will also receive a full physical observation review – obviously measuring your weight, but also; height, bloodwork, lying/standing blood pressure, temperature, and an ECG heart recording.

Next up – the food. Lesson # 4, the longer you delay eating what is put in front of you – the food you need – the longer you will be spending in that facility, and the harder it will be to make progress. It is non-negotiable and for the most part completely out of your control – the choices, the portions, the times, the way you eat. The food you will eat may not be what you are used to, and will no doubt cause an absolute fuss with your eating disorder. You are expected and required to eat 100% of every meal and snack – regardless of whether you/your ED doesn’t like the look, amount, or taste; however, your dietitian may grant you a few “dislikes” where you will be provided an alternative option if that ever appears on your meal plan – don’t let your ED use these in their sneaky way. Dietary choices that have been either verified by your family or medical testing – such as vegetarianism, gluten-free, or dairy-free – can often be catered for. However, they are not stupid, if you became a vegan around the time your disorder appeared or when you start recovery, be prepared for your diet to change. If your diet is inhibiting your recovery, you may need to put aside your ethical reasoning in favour of saving and restoring your body; after all, you need to make sure that you are well and healthy in order to exert health and wellness in other areas of your life. My advice? Stare it down, scoop it up, and chug it down. Believe me, you do not want to become dependent on supplement drinks or be given and NG feeding tube – from experience these things are nasty, and can become too easy to rely on and make eating food a whole lot harder.

Finally, your weight. You will be weighed, and your care team will know – get over it. They will not judge you, or talk smack about it, they are professionals and weight is one of the measurements used to ensure that your body is appropriately restoring from the effects of your eating disorder. Whether you are there for weight management or restoration, the monitoring of this is non-negotiable. You will not get away with losing weight on the ward, the consequences of which are much worse than any ‘satisfaction’ your disorder gets. They are not afraid to make increases to your meal plan, NG tube you, add supplements to your diet, and restrict your on-ward activity and potential leave.

The last Lesson # 5 applies everything - don’t try be a sneaky sausage and trick the rules of the ward – believe me when I say that they have seen everything and know every trick in the book. I will not list what people I know – including myself – have used to try and cheat the system as a) it doesn’t help anyone, and b) there is not enough time for me to do it. The sooner you go with the flow of the ward and fully embrace everything they are offering you the better – THEY ARE GIVING YOU THE BEST CHANCE OF GETTING YOUR LIFE AND LIVING BACK!

Embrace the tears, ride the emotional rollercoaster, use the resources, get artistically creative and crafty (knitting, crochet, painting, colouring… the list goes on!), ask questions, and above all – do not let your eating disorder take away any more time in your life.

Inpatient Episode Three will be focussing on my experiences with my inpatient admissions – incorporating past journal entries, storytelling from my loved ones, and a current reflection on that time in my life.

As always, your friend,

Rawing Meg

xx