Chronic Pain & ED Recovery (Part 2)

The next six months were filled with some of the worst mental health moments I had ever experienced. I think that, although graduate school is stressful, being engrossed in academics had been a distraction for me in many ways - both in regards to the pain and the ED recovery. Since I was no longer focusing so much of my time and energy on school, I felt like my ED and the pain I was in became all I could think about. Additionally, the intersection between sciatic pain and over-exercising tendencies is tremendously complicated. As I mentioned in part one, sitting is certainly the thing that most consistently and intensely triggers the pain. It has been clear over the past eighteen months, however, that the more active I am (i.e. cycling, yoga, pilates, walking, etc.), the less intense the pain is. There is scientific research that suggests that being active does help reduce sciatic pain (which might sound counterintuitive); my orthopedic surgeons both in Chicago and in NYC stressed that strength-building exercises and staying active are essential for recovery. All of the physical therapists that I have worked with have also emphasized this, and have advised that I take frequent walks, stand, and move as often as possible. It is impossible to rate the pain on any sort of objective scale, as the impact of pain on each individual's body is unique; however, I would estimate that, on days where I workout, the pain hovers around a 4/10. On days where I rest (but nonetheless still stand the entire day), the pain often gets to a 7 or an 8/10. If I sit for any amount of time longer than 15 or so minutes, I hover near a 10/10 - just as bad as before the surgery.

Given the correlation between activity and pain reduction, you can imagine that this situation has made ED recovery - more specifically, trying to improve my relationship with exercise - quite tricky. For the first few months of my medical leave, I would feel paralyzed each morning when I had to decide whether I was going to rest or workout. I felt enormous pressure to do the "right" thing, but I also felt like it was a lose-lose situation no matter what I decided - if I worked out, I would reduce the pain. BUT, I also knew that I was then simultaneously continuing to feed into my compulsive tendencies with movement (which was also fueling the ED); however, if I chose to rest, I felt like I was doing the "right" thing for ED recovery, but was subsequently in such pain that it caused extreme mental and emotional distress. No matter what I decided, I felt like I was making the "wrong" choice. I would be so conflicted and overwhelmed about what to do on a daily basis that I was having panic attacks and breaking down multiple times per week. I felt genuinely incapable of making a decision and I wanted someone with authority (i.e. my doctor, therapist, dietician, etc.) to tell me explicitly what I should do.

I would also get SO frustrated when people would tell me to just "listen to my body" (a common sentiment when people are offering advice about how to heal your relationship with movement). Because of the ED, I quite literally did not have the ability to listen to my body and discern when I needed to rest - I had forced myself to push through exhaustion for years without resting, and I had convinced myself that I didn't ever really "need" rest (and, problematically, that resting was "lazy"). Furthermore, "listening to my body" felt impossible when I was in such intense physical pain. This sort of decision paralysis in regards to exercise made me feel extremely isolated - I struggled to find any resources online, in blogs, or on social media that talked specifically about how hard it is to make these types of decisions when you live with chronic pain and are trying to heal from an ED and an exercise addiction. I felt (still feel?) like my experience as someone in ED recovery while trying to manage chronic pain was/is too "niche" and like no one really understood (understands?).

I have another blog post about working out in ED recovery and how I came to the conclusion that I needed to take time off completely from exercise, which you can check out here. In May, I essentially came to the conclusion that the stress I was experiencing from trying to decide every single day whether to workout and alleviate the pain or to rest and suffer through the pain was just too much for my body and mind to handle. I knew that something needed to give; ultimately, I opted to take an indefinite amount of time off from working out, in order to really try and break the connection in my brain between movement and "earning/burning" calories. I felt like this was an essential step in my ED recovery journey, even though I knew it was going to be physically supremely painful and uncomfortable. (Also, I haven't yet written about the physical discomfort that can often accompany body changes and weight fluctuations in ED recovery, but this is certainly another very tricky piece of the puzzle). As I touched on in my other blog post, the concept of acceptance has proven to be critical for me since making the decision to press pause on working out. I have continued to make myself acknowledge that this is the reality of my current circumstances - no matter how badly I wish that things could suddenly be different, they just aren't right now. I spent the first six months of my medical leave ruminating about how upsetting my situation is - this wasn't actually changing anything; rather, it was just adding more stress and frustration, as well as draining my energy. I now try my best everyday to accept the situation as it is, which is much easier on some days than on others. I also spend a lot of time reminding myself that - even though the sciatic pain still persists - choosing to re-direct my energy into healing my relationship with food and movement will ultimately be so worth it in the long-run for my overall health. I also know that this break from exercise will be temporary - while I have been very intentional about not putting any sort of timeline on the break, I do know that my personal goal is to eventually get to a place where I can engage in movement in an appropriately balanced (and fueled!) manner. I do not know, however, whether or not the sciatic pain will be temporary. While it seems plausible that it will lessen over time, this isn’t guaranteed. As discouraging as this is, there is a small amount of peace that comes from directly acknowledging this and being realistic about the possibility that things might not get better, as opposed to just being angry and trying to wish the situation away. (Also, I will note that this concept of acceptance is obviously not revolutionary; furthermore, this is something my therapist had been bringing up for over a year before I was finally ready to embrace it. I think that acceptance is something that cannot be forced or rushed - I do feel like the time I spent being frustrated and grieving what I was missing out on was a necessary part of my journey before getting to acceptance).

I wish desperately that I had better answers or advice to give when it comes to living with chronic pain while also trying to heal your relationship with food and your body - what I can reiterate is, if this situation is similar to something you are currently dealing with, you are not alone. I have felt so, so alone while trying to navigate this, and I am hopeful that my experience might resonate with someone else (even if your circumstances aren't exactly the same - I think that there are probably parallels between my story and individuals in ED recovery who are also navigating illnesses, injuries, disabilities, etc.). One of the biggest practical suggestions I can offer, however, relates to needing support and/or accommodations. For the first year of dealing with sciatic pain, I was extremely hesitant to share with other people how severe the situation was. I felt horrible that my partner had to watch me suffer - I know that it must have been incredibly upsetting to see the person you love the most be in so much pain and to not be able to do anything about it. On top of this, he was also going above and beyond to support me not only with the chronic pain, but also with ED-related things. There were so, so many moments where I felt a huge amount of guilt because it seemed as though all I was doing was taking and all he was doing was giving. As I processed through these emotions during this time, I recognized that - in addition to feeling like my self-worth hinged on my physical appearance and level of productivity - I also struggled with the idea that I needed to "earn" my partner's love through acts of service (which is challenging to do when the pain inhibits me from doing a lot of things). It is difficult to believe that someone else can love you - flaws and all - when you don't love yourself! This is obviously something I still really need to work through :)

Additionally, during that first semester of my PhD program, I was very reluctant to ask for accommodations - I knew that I would be inconveniencing my professors and classmates, as well as drawing attention to myself, which was absolutely something I wanted to avoid. This situation really revealed a lot about how difficult it is for me to ask for help, and how I view "independence" and not needing assistance from others as a core part of my identity. I feel like I had been an independent person up until this point in my life - I was prideful about the fact that I was usually the one people came to for advice and encouragement, not the other way around. Transparently, I viewed relying on others as a sign of "weakness," and I felt like asking for accommodations - and admitting that I needed assistance - was evidence that I wasn't strong. I had a conversation with one of my best friends that tremendously helped shift my perspective on asking for accommodations. She deals with chronic health issues and is one of the most resilient and gracious people I know - I admire her ability to stay so positive and steady, despite her incredibly unfair and tough circumstances. She shared some advice with me that essentially helped me realize that asking for accommodations and telling people what I am and am not able to do is OKAY (and is ultimately the best thing for me to do). Even though I wish so badly that my life wasn't being impacted in such a significant way by my chronic pain, the fact is that I do have a lot of physical limitations that prevent me from being able to do certain things - for example, I can't sit on a plane, eat at a restaurant, ride in an Uber, or sit at a coffee shop without being in an extreme amount of pain. Therefore, explaining my situation to friends, family members, colleagues, etc., and expressing in explicit terms what accommodations I need right now has actually helped alleviate some of the stress and pressure I was feeling. Those who know and love me have been more than understanding and willing to adjust to my needs. Even though I HATE that I don't have the ability to do so many of the things that I want to right now (like trying to push through a three-hour plan ride), I am hopeful this won't be my situation forever, but, for the present moment, all I can do is ask for help, make adjustments, and do my best with what I have. Again, I share all of this simply with the hope that it is resonant for someone else who is going through a similar situation or is in the midst of navigating similar emotions. If you are feeling isolated and are looking for community, please feel free to reach out here. If you made it through this entirely too long post, I truly appreciate you taking the time to do so! Sending love and light to all those working through mental health and/or chronic pain-related issues.

I kindly request that - even if you have the best of intentions - you do not reach out to suggest or inquire about the possibility of the eating disorder being correlated to or causing the chronic pain. This is a thought/fear that has caused me more stress than I can even articulate, and it would be extremely unhelpful for me to discuss this at this time. I have been 100% transparent with ALL of my doctors and the medical professionals that I have seen over the past several years, and I have had numerous discussions about this topic specifically. My doctors have all expressed that they do not believe there is evidence to indicate that the ED is what is causing the pain in my specific situation, however, fueling my body and giving it the nutrients it needs to be holistically healthy obviously is important and continues to be my priority. I will continue to be honest with medical professionals and will continue to adhere to all of their guidance. I imagine that, for many people who have a history of disordered eating, there are a lot of fears around health issues potentially being caused by an ED. Just as a friendly reminder, bringing this up to individuals who have had or currently have an ED is most likely going to cause more harm and panic than it would be helpful. Thank you!