I'm playing the game

So the funny thing is about treatment centers is that it's all a big game.

There is a definite terminology unique to the game, a few key players, and a definite game plan/strategy. Some terms include "projection," "warning," "range," "chair rest," "reset," "cafe," "passes," "staff supervised tables," "peer supervised tables," to name a few of the most important ones. The players are: yourself, nutritionist, CRCs, personal therapist, family therapist, dietitian, nurses, and psychologist. The strategy/game plan, well that all depends on weight gain and how fast or slow it's occurring but mostly if being on/off projection is what matters most.

there are daily weigh-ins as well as specific gravity tests done on urine samples and then vitals are taken mon, wed, fri. These weigh-ins hold the most precedence however when deciding the game plan. yesterday it became quite clear to me that i AM playing the game now.

when "the list" was put up which shows who is on "warning" and "chair rest" and such, i found that i was on the list for warning. this means that i am not on projection for my weight gain and that i better not move around much because if i don't make projection the next day, then i'll be on chair rest until i am reset or starting making projection. so seeing that my personal game plan for the day was to not walk much up and down the hallways and to sit as much as possible. however, my team--therapist(s), nutritionist, and dietitian--all had there own say to add to the game plan and this came in the form of a meal plan increase. the nutritionist pulled me into the kitchen and said outright "ok Alyssa, your meal plan is going up today because you are on warning." here it became very apparent that i AM now playing the game. in order to try and make projection and gain weight, what is the next most logical thing to do? EAT MORE! how does that happen? MEAL PLAN INCREASE. granted they can't increase someones meal plan every time they are on warning but this is a start for me since i am still in the earlier stages of the process/treatment.

it just seems rather odd/funny to me. i feel that as far as the weight-gain goes, it totally turns into a game. people are constantly planning if they have passes to eat more when they are out so they can compensate for the increased amount of walking that is bound to happen on a pass so that they don't get on warning the next day so that they don't lose any passes they may have planned for that day.

example: one of the girls here had an elton john/billy joel concert to go to. everyone on her team knew about it well in advance and she really wanted to be able to go. but in order to go on passes you must be 85% of your range and not be on warning. so a couple of weeks before they increased her meal plan so that she could get into the 85% of her range so that she could start applying for passes. this worked, even though she had to eat a lot more and deal with feeling uncomfortable and full. then once the day before the concert came she had a dinner/snack pass. however, she needed to shop for an outfit which would require walking around in a mall or at least many stores. so in therapy we strategized with her what she could do to minimize the walking so that she wouldn't be off projection the next day and be put on warning and subsequently lose her pass for the night of the concert which would then have defeated all the work she did as far as eating a lot more to gain weight faster. so we came up with ideas like "get a wheel chair and have your mom push you," "have her drop you off at the door and pick you up at the door," "map out your route so you know what stores you are going to and pick a path that minimizes walking," and the most obvious of any plan "eat more food than normal when you go out to eat so you will have a better chance of making projection."

it's all a game when it comes to the weight gain. as much as it sucks to gain weight and no one wants to do it, it is the most vital part of treatment for so many reasons when treating some one with anorexia nervosa. it just seems a bit ridiculous at some times because you hear people talking about adding all these "extras" to the meals so that the can get into their range faster and hopefully lessen the time of their stay in treatment.

this being my first time in a treatment center, i didn't know what to expect when i came in here, but i am quickly learning and i have definitely begun playing the game.