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nutritional drinks : pros and cons ? Real food VS nutritinal drinks ?

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good to know that I am on the good path to recovery even if sometimes it looks like "highway to hell"
i was aware of this refeeding syndrome but not that it could be so painfull.

I went for a little stroll to relieve a bit the pain

Weather is nice today in paris, cold & sunny, but we are now having March intermittent showers
What about you?

About the cooking: this is exactly what I do !

this week end is going to be rest: saturday->pyjamas & TV...Sunday, tea time by one of my sisters (who just informed that she is expecting #2 for sept !) so it will be girl talks !

Keep increasing: friday is "increase day".....600 cal to go before hitting my 2200 miniums (as I am 40)

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I have just read a french Survey on Refeeding syndrome
They say that it is very common with anorectics having a <13 BMI, which is my case.
common when eating a lot of carbs and that in such case refeeding shall be "start slow and go slow"

Calories: 30-40cal/kilo/day...would be for me 1250cal/day, right now....I am at 1600cal ...feel ok

Water intake shall be 40ml/kilo/day ...ouch, i drink way too much...have to reduce to 1200ml (I drink twice i am so thirsty)

Good thing is that a had a full blood scan...and no vit & minerals imbalance.

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Refeeding syndrome is very dangerous so if you start to feel sick or nauseous then go get help immediately. But since you have increased so slowly I think you will be fine Smile The water retention may get worse if you drink too much, because it messes up the electrolyte balance even more. When you drink, try to drink something with calories instead of water as it contains more electrolytes (electrolytes are just different types of salts, I'm a chemist so I know Smile )

I'm glad you are getting blood tests done. Make sure the doctor is checking your potassium levels as well Smile

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Chemist ! terrific in which field?
I work in an aviation insurance company (deal with aircraft liability and hull damages...and crash)

Go idea the juice thing! I can just by a bottle per day (here they come in 1l) and just drink this for the day.

Potassium is ok !

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I'm a materials scientist Smile I'm 1. 5 years into my PhD project.
Your job sounds exciting!

Juice shouldn't be that expensive either so a carton per day should be ok Smile

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for what kind of materials ?

Sometimes dramatic accidents can be laughable, because of the way they are reported...but sometimes it is really dramatic...but I got used to it and it does not bother me.
Except that I will never base jump or skydive ! Way too dangerous !!

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Functional alkali niobium oxides Smile Can be used as ferroelectrics Smile

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my good....it's chinese to me ! just like when aircrafts i dealt with had ashes issues with Eyjafjallajökull...(vulcano) Smile

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Yes I know it's a narrow topic that most don't understand. Smile

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and where does that lead? University education ?

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I will get my PhD after 2.5 more years Smile

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it is almost as long as medicine studies !
Well me to studies have been long 5 years law and insurance studies

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Yes it takes some time, but luckily I get paid now Smile I see you're are a "smartie" too Smile

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more a "never-happy-perfectionniste" Smile

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Me too Smile

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how did you discovered/got into MM?

In France this methode is unknown same for Maudsley...

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I read a blog written by a norwegian girl who had done the same thing. She linked to youreatopia and when I started reading there it all made sense to me. 

The is very little knowledge about this method among doctors and nutritionists in Norway too. Therapeutic methods seem to be lagging behind the science development for many kinds of illnesses. Maybe in 10 years, the MM approach will be more widely used by professionals. I hope so.

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in France, everything is psychogical, they do no really focus or recommend to each so nor explan anything.
It is a little bit considered as a silly, unjustified, mental disease.
France loves pills treatment, freud...but nothing to do with GB/US/scandinavian approach (MM, maudsley, mando...)

Inpatient/prisonner same deal.
Anorectic/offender same deal.

Have you overshooted yet ?

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Well, that's a bullshit approach... Because I could really feel a direct link between my undernourishment and the anorexic thoughts because they decreased a lot in strength when I started eating enough. It a mental problem that gets enhanced by not eating enough. It's obvious that treatment should be both about food and psychology.

I don't know what my set point weight is but it has been sort of stable for some weeks, increasing just slightly. If it tapers down then I know that I have overshot. I have an identical twin and she's still a little bit bigger than me so I guess I haven't overshot.

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I agree with you, that undernourishment makes perceptions become very restricted. In fact anorectic are so focused on food, body, how to restrict more and the desire to be perfect that they do not realise what is really happening.

I had to loose a LOT of weight, be in a extreme dangerous state, to realise thet it could not longer continue this way.
I can consider myself as beeing lucky that I have been able to realise this but i reckon that my thinking is still impaired, that I haven't yet let is go

The only thing I realised this morning is that i just feel a tiny bit more relaxed regarding my food intake and that I can and will increase a bit more this week-end.
An increase I can psychologicaly accept

I have also been reading recovery articles especially on "the physical effects of weight gain after starvation - What to Expect Physically as Recovery from Anorexia Begins " by Emily Troscianko

It is helpful to understand what is going on and how to deal with it (more or less)

I will keep in mind
- the most difficult part of recovery is not the critical "starting-to-eat-again" phase, where change is rapid, but the later stages, between nine months and a year and a half or so into the process; certainly the period during which relapse is most common

-there really is one thing that matters above all else: following a dietary plan that is adequate to induce steady weight gain, and which, doesn't depend on the vacillations of appetite, mood, or any other uncontrollable factor. It may seem impossible to eat when already feeling nauseous, but in those moments where food seems the last thing wanted because feeling physically so uncomfortable, I have to tell myself that eating is the only thing which will ultimately bring that discomfort to an end.

- eating a little more, getting scared, restricting again = continuing to experience all that pain every time I restrict and then attempt to improve things again.
So better not go backward and live a second time, bloating, oedema, swellings, nightmares....but continue as it can get only better, and all the refeeding symptoms will disapear at a time.
I really do not want to go through several times !!!! NO WAY

- Things can ONLY get easier but until you've reached a BMI of about 20 you probably won't ever be free of it completely

- 'overshoot' is temporary (Oups, still fightening !!!). Body seeks to provide a 'safety net' in case of future famine, but within a year or so it then normalises....( Good sake....A year !!!)

- you don't have the privilege that healthy people have, of eating when and what you feel like it.
You have to earn that privilege back by eating to plan, for as long as it takes to reach a healthy weight. Only then, in any case, will it be possible for you to start eating more flexibly in terms of times, amounts, and so on, because only then will your mental state no longer be that of the half-starved person and your bodily state no longer be disrupted by the aftermath of starvation.
(I now understand that I really have to follow my meal plan, whatever i physically feel !!!!!)

It is triggering but reassuring at the same time

Anyway tonight i increase my intake....+100 cal tonight, saturday and sunday
AND probably up to 1800 or around on monday, if i go through those 3 days
1800....i would never imagine I would reach this much and have never reached that figure in 10 years (last time I was inpatient....even when I was inpatient I would just stuff my face to get out ASAP...It was my main motivation, eat - get discharged - do what ever I want once at home, i was not in a recovery mindset, NOT AT ALL)



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To me, it seems like you are finally making this recovery you PROJECT! That is AWESOME is very important because you will then will more accountable to do whatever it takes Smile I'm so happy for you because you have realized so many important thing (and reminded me as well Smile ). Your plan to increase is very good and and I believe you will have made giant leaps in you recovery when you have managed to do what you have planned Smile 1800 kcal is still not much but it's a great improvement and something to be proud of, so keep aiming at the target! I also had a psychological boundary at 1800 kcal but I realized that it was easier than I thought when I just did it Smile And that's something I have experience many times, that every time I force myself through something difficult, then it gets so much better the next time.

Good luck. I'm cheering on you Smile

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Will never thank you enough for your words of encouragement and ideas for handling all my issues

By the way, ankles are getting better, a tiny bit less swollen and painful

As you said: just have to go through....but I do not want to live this one more time
Will try not to relaps

Also I have noticed that my B/P incline has ....disapeared.... I do not have this feeling and urge to B/P in the evening when I come back from office, nor to buy food to B/P
this is surely because I eat more and on a regular basis

Things are starting to settle down, getting better...but I must not ease up.
I am very far from beeing on the save side....recovery will still be VERY long and hard...And i will not be so extactic everyday (as today) and full of good will and feel so almighty

Beware of pitfalls especially as I do not have support at home for each of my meals

Tell me more about you recovery process....what did you experience, feel, discouragements, high hearts.....what I will have to got through ...to get prepared to and not lose faith !

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I'm glad the water retention has decreased a bit Smile I many times experienced a loss of water after eating more than I usually did, so more food definitely helped me.

So glad to hear that the B/P cycles have stopped! It must feel nice to not have to deal with that! And yes, is it definitely because you are eating more.

Enjoy these days where you feel a bit more on top of things Smile You deserve to feel nice, but as you said, don't put your guard down. I'm getting excited about how well you reflect around your situation now Smile 

Every recovery is different, so comparing yours with mine may be difficult. But I can tell you anyways just to get a clue. I increased quite fast, but it didn't cause me to get ill. I had problems digesting the food, but after a couple of months it was better. During restriction a had really bad cramping in my legs, thighs and butt so I was afraid to move my body because it hurt so much. At some point I really thought I was going to die because I imagined my heart would start to cramp. All of this went away after 2-3 weeks eating the minimums. I also got really bad hormone fluctuations which caused my mood to be very bad for a period. It also led to bad skin and hot/cold sensations in my body. All of the hormonal signs were gone after 3-4 months in recovery. I'm so happy my skin is back to normal. My sex drive also came back at this point which my boyfriend was quite happy about Razz I have been on birth control pill all along so I'm not sure about my period, but according to the other hormone signs from my body I think it's back to normal now. I had intermediate bleeding a lot during restriction, but now it's regular again (it was like the pills weren't working correctly during restriction).
I think I have gained about 10 kg and it doesn't seem to increase that much anymore so I think this is how my body should be. The funny thing is that people haven't really noticed anything (they didn't notice when I lost the weight either) I think it's because people just see ME. They may see that I look "sick" or tired but they don't focus on the weight. Some people have noticed, of course, but the comment I've been getting the most is how clear my eyes look compared to then. As if I actually pay attention to life again. I actually laugh when I laugh and smile when I smile. For me it's actually such a great feeling to actually experience life again, and people can see that.
The worst part in recovery was when people gave me compliments on how I looked because my mind would instantly twist the positive feedback into "I can't gain anymore now because people think I look good now". But that's bullshit and I got angry because I had to struggle with convincing myself of that every time I got a comment like that. If I were you, I would prepare a phrase like "Please don't give me any comments on my appearance until I say otherwise, because I simply can't understand the meaning of them right now". It's better to say this instead of getting angry or even worse - start to believe that you should stop gaining. 

In general, recovery is tough, but it's manageable if you focus on doing what you need to do right now. Be open with people a much as you can, because it's amazing how much people really care if they just know how to react. I told everyone about my struggles, although not always in detail, and I told people what I was expecting of them. Sometimes I would say "I just want a hug" and sometimes I wanted to talk or cry. The simple phrase "there is nothing you can do besides telling me that everything will be okay" can be good for someone to hear because they know how to act. 

I hope I answered the way you wanted Smile

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yes of course recovery is very different from one person to an other
Some go through like a charm, with no problems
and for some of them it is just hell

for me its hell...hurts everywhere, can't talk about is except you (I do not want to give hopes once more and fail once more, as i did several times - now i do not want to disapoint you either Sad )
skin condition (itches, flaky like a snake skins when they moult), acnea is appearing, intense sleep/insomnia.....name it, i will tick the list
I am just waiting that it disapear....wait and sight and see

did not have my periods for 15 years....and still do not have them...no control pill (Do not have any sex...and never did....."40 years old Virgin"...yeap, they exist)

Well I have to gain strict minimum 15 kilos....so it is going to be very long, very very very long
and on one side i am affraid to give up once more
so I keep telleing me every morning that this is my LAST CHANCE!

I read a lot US/GB studies on recovery, blogs, others experience. It is so helpful to understand what is happeing, why and what I shall do, that it is perfectily normal (such as gaining weight very fast in the first weeks, to be bloated, to have swellings ....but that is will disapear after)

I am not yet there but the overshooting thing preoccupies me. I try not to thing about it because I have a lot of weight to put on and that when I will be in better condition, i will be able to have a different view about it.

How do you feel now? Comfortable with your weight? Stop there or put on more ?

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I struggle with the weight, but not as much as I thought I would. I feel much more comfortable than I did a few months ago. It surprising me a bit actually. I'm not sure if it will stop here, but it probably will. If it's more then it's not much.

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