Self-Managing

I recently signed up for a six-part workshop on chronic-illness self-management offered by one of my healthcare providers. I’d say I’m pretty good at self-managing my primary chronic-health condition—I do my best, anyhow—but God knows there’s always room for improvement, and since I’m currently making optimizing seizure control and my recovery from anorexia nervosa my “job,” I’m eager to do all I can to get it right. To do it perfectly. In as balanced a manner possible, of course.

I missed the first session due to a dental emergency (yup, my teeth continue to hate me, almost as much as my brain does). I arrived at the second one, however, eager to learn and to participate.

I should preface what’ll come next by stating that the workshop is very professionally run, and it’s clear that a lot of thought has gone into its format. I’ve especially benefited from the peer-support aspect of the group.

Maybe that’s why I’m annoyed that it puts so much emphasis on diet and exercise—because I really, really want to be able to get assistance for one chronic condition (epilepsy) without it interfering with the progress I’ve made in recovering from another (anorexia nervosa).

If the description of this workshop had mentioned that increasing exercise and modifying diet are aims of the program, I could’ve made a better-informed decision about registering for it. Hearing people talk about choices they make for themselves doesn’t bother me—I’m recovering from anorexia for myself, and I’ve become proficient at the art of not letting what others do or what I see in the media affect my own actions, critical to navigating our diet-obsessed world with a history of an eating disorder. That said, I’m self-aware enough to know that putting myself in a situation in which I’m asked to make exercise goals, track food and portion sizes, and report back about my behaviours has the potential to activate some, uh, feelings.

When I looked at the workshop’s schedule and saw the sections related to exercise and food, my first instinct was to quit. More time for embroidery and writing, how I currently spend most of my waking hours! My second instinct was to suck it up and sit through the problematic content in silence while hoping that I wouldn’t be called on to share my goals with the rest of the group. (“This week my action plan is to drink four Ensure Plus beverages every day, eat dessert every night, and move only as much as is necessary for my activities of daily living in order to minimize how many calories I burn.”) But THEN, fuelled by those four Ensure Plus drinks and a newfound willingness to risk being assertive, I decided to look for another solution, which I found by communicating my needs to a facilitator and asking the person I currently see on an outpatient basis at the eating-disorders program at a local hospital for advice re how to proceed. I’m confident that I’ve figured out how to have it both ways, and I’m happy that I was able to speak up in the interests of my health, not something that comes naturally to me. Still, this has been a frustrating reminder of how frequently food and exercise pop up where it doesn’t occur to me that they might. It’s also been an opportunity to build much-needed resiliency.

Look at me with that silver lining!

I realize that maintaining a healthy, varied diet and a reasonable (i.e., not excessive) exercise routine is important for many (most?) people, including those who live with a chronic illness. However, how information is framed is key. The assumption in this workshop seems to be, as is often the case, that every single person would benefit from reducing portion sizes, eating more fruit and vegetables and less sugar, and moving more. Nope. Bodies are different. Brains are different. People are different. Things shift over time. If I’ve learned one thing during this recovery process—and I do learn, albeit slowly—it’s that we should all treat ourselves, and our bodies, and one another, with respect, taking into account our individual needs given our specific circumstances.

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