Surviving Anorexia Nervosa and COVID-19

Surviving Anorexia Nervosa and COVID-19

I knew before the doctor spoke, but that didn’t stop the fear coursing through my body that was curled in a ball on the blanket-laden hospital bed.

“Oh ‘shoot’,” I said through tears.
“Yes,” he said.

I knew this diagnosis was “not good,” but I didn’t realize having Anorexia Nervosa (AN) and now newly diagnosed with COVID-19 – the virus pandemic literally putting the world on hold – would lead to such pain, misery, and depths of despair. Two weeks earlier I had been hospitalized due to the ravaging eating disorder that was putting my life at risk. I had entered a medical unit where a team of doctors and nurses worked around the clock to ensure my health and safety.

I have been sick with an eating disorder for a long time and these medical admissions were nothing “new,” to me. But this time was different because I was being admitted in midst of a raging pandemic.

I was afraid of entering the hospital due to the pandemic outbreak and fear of contracting the virus, but I also knew my eating disorder was out of control and would kill me if I did not access medical help. There is nothing quite like entering the hospital with the knowledge that a virus is breaking out killing people all over the world. I was scared and yet my doctor, family, and I knew that even with the risk of contracting COVID-19 my life depended on the medical care the hospital would provide.

Treatment for an eating disorder at the best of times is extremely difficult and great strength, and courage, is required to accept the help. I have been in an ongoing battle with AN in different treatment settings for years. My care for my eating disorder requires the medical team to be strong against the eating disorder to help me get the life-saving nutrition (treatment) I need.

I had neutropenia or low white blood cell count because my body was feeding off the bone marrow due to starvation. I essentially had no immune system. Another complication was consistently experiencing hypoglycemia. My body had used up any glycogen my liver had stored and I experienced dangerously low blood sugars that could cause brain damage, coma, or in the worst case scenario, death. I also presented with a low heart rate, low blood pressure, generalized weakness and muscle loss, loss of coordination, extreme anxiety, gastrointestinal discomfort due to slowing of peristalsis of the GI tract, gastric reflux, edema (swelling due to low albumin) and other complications. These were just some of the physical symptoms I was facing due to my eating disorder.

After two weeks in the medical unit I began to get consistent headaches, bouts of GI upset, and body aches. However, as mentioned above, these symptoms could all be explained away by refeeding my body from a starved state.

I began experiencing symptoms I knew were not “just refeeding discomfort.” The unit I was on was already experiencing a virus outbreak and so I was swabbed with the rest of the unit when I started to feel ill. Sure enough, my swab came back positive for the COVID-19 virus and everything changed. My treatment plan of moving from the medical unit to the specialized Eating Disorder Unit in a few days had to be delayed for an unknown period as I would have to first test negative for the virus.

First, I had to be isolated on the designated COVID-19 unit. I was moved from the general medicine unit to the COVID-19 floor. Once in the room I could not leave at all. The nurses only entered the room to give medications and I was mostly watched over through a tiny window. I felt very “animal in a zoo” like, and this strange situation took some getting used to. I wasn’t allowed to shower for two weeks as this could further spread the virus. I was confined to a very small space and I felt more alone than ever.

Thankfully, I got a mild form of the virus. My treatment team and I had difficulty distinguishing between refeeding symptoms and the virus. I knew that I was slightly congested and constantly exhausted and weak. Knowing my immune system was very low I had a huge fear of the virus worsening. I began eating everything on my trays as well as receiving the NG feeds overnight. Out of sheer fear I began to nourish myself. 

As my body battled the virus, my mind battled the eating disorder, screaming at me for eating. While my doctor would visit daily and nurses would come and (quickly) go I was mostly alone. My mind was tired, and I broke. Then I rallied. And then broke again. This was the cycle for four weeks as my body restored some of its health and my mind waged a constant war within.

After several days I was moved to a private room where I had a nice big window, and a shower, and these simple luxuries helped a lot. I received mail from dear friends, family, and even strangers who had heard I was isolated in hospital. These messages of hope, love, and strength kept me going during this tumultuous time.

While my symptoms of the virus were relatively brief, the virus stayed in my body and four weeks passed before I tested negative. I was allowed to go home, exhausted as I was,  and yearning for my mother’s warm hug.

Those four weeks in isolation in hospital were possibly the darkest, scariest, and most difficult I have faced. The isolation, though necessary to slow the pandemic, was as excruciating as the combined illnesses themselves.

Yet, I know I sit from a position of not having experienced the worst of the virus. I know there are others out there who are fighting for their lives on ventilators or who have lost loved ones to COVID-19. I know in many ways that though I experienced pain both mental and physical, the outcome could have been much worse. I sit here humbled and grateful having contracted and survived a dreadful virus that has killed so many.

I am home now, and I continue to fight my eating disorder. My body tires easily as I am still recuperating. Recuperating to full energy and function will take time. So, for now, I focus on one day at a time as I try to be patient with my body. I continue to nourish myself and rest when I need to. 

While thankful the virus was a mild case, I will forever be affected by my experience with COVID-19 and battling AN. Even as I type this story to share in its simplistic form, I am continuing to process all that has occurred over those terrifying, lonely, and tumultuous weeks in the hospital. Just as my personal recovery and adjustment will take time, we all will take time as a society to process and rebuild after the devastation that COVID-19 has brought to the globe. One day at a time. One foot in front of the other. This too shall pass.