Inpatient

Hi everyone,

Im looking into IP treatmeants and programs for myself (recovering from anorexia) but the thought of going to one scares me to death! Can anyone whos been give me an idea of what a typical day in IP looks like?

What activites were involved, foods you ate..etc

Thanks!

Hi chcolate,

i am going to be completely honest with you here, so I apologise if it seems odd.

My personal experience with IP was a horrible one, due to the conditions and other reasons, I ended up discharging early...but that is another story.

However, I am NOT trying to discourage you from going IP, I am saying you find one that you have heard alkot of positive feedback from. It is an easier way of restoring weight, and the responsibility is taken from you. This approach does not work for me, but everyone is different, so it is just a matter of finding the right approach for yourself.

Onto answering your question,

My typical day included, school in the morning, group therapy a couple of times a week. It wasn't really a good programme. It was more about getting the weight on and getting us out of there, they didnt believe that we were ready to recieve psycological treatment yet, which was the wrong approach for myself.

With meals, breakfast was at 8am, Morning Tea 10.30, lunch 12.30, afternoon tea 3pm, dinner 5.30pm, and supper at 7.30pm.

My IP was in a hospital, so we ate hospital food but large amounts of it. I started off being tube fed overnight, this lasted for about 3-4 weeks, and as my 'feeds' were decreased, my meal plan was increased. Once my tube was removed I was put onto a higher meal plan plus 4 ensures a day. I lost weight after my tube being removed and was still gaining slowly on about 4000kcal and bedrest. I WAS NOT cheating, and the doctors wouldn't believe that I wasn't and were always accusing me of this which was so wrong.

My meal plan looked roughtly like this (if youre interested):

Breakfast: Cereal & Milk, 2 slices WW bread, margarine, apple, fruit juice, hardboiled egg

Ensure

Morning Tea: 6 large crackers, vegemite, margarine, 200ml yoghurt

Ensure

Lunch: 2 sandwiches (WW bread, margarine, cheese or egg), apple, fruit juice, dairy dessert (gluten free ice cream)

Ensure

Afternoon Tea: 9 small crackers, 50g? cheese, margarine, apple

Ensure

Dinner: 2 servings vegetable, 1 carb (rice, noodles, mashed potato), serving of a course (eg. vegetable lasagne, omelette, whatever was on for the day), 2 slices WW bread, margarine, apple, fruit juice

Ensure

Supper: fruit salad, fruit juice (I can't remember really, cos I was always changing it)

Hope this has helped. good luck with recovery.

I had the opposite experience. My inpatient treatment was at a clinic (set up like a family home) and the treatment I received really helped my recovery and set me on the right path to getting well. Without IP I am not sure I could have recovered on my own - probably not. The environment was supportive, everyone was great and I felt looked after, while still having to learn to do things on my own. I look back at that time as fundamental in my recovery - I am so glad that I went and have never regretted it. That was in early 2006 and I am now fully recovered.

There was a weekly schedule of activities, so it changed daily. We had individual and group therapy sessions, art therapy, yoga, massage, craft projects, lessons on body image, the media, nutrition; guests who had recovered from EDs who came to talk to us, lessons in assertiveness etc.

We got up at 8am, showered and were ready for breakfast by 9am. We were allowed about 5 different choices for breakfast, and could choose between two options for each of lunch and dinner. We also had three snacks. My breakfast was muesli and yoghurt; lunch would be something like a sandwich or soup and toast, followed by fruit; and dinner would be something like chicken with veges and a baked potato, followed by a very small portion of dessert. Snacks would be something like a cup of frozen yoghurt; a latte; a granola bar or biscuits. We could choose the snacks too.

Everyone started on a meal plan of around 1800 calories a day. Once the risk of re-feeding was reduced this was gradually bumped up by making the snacks bigger and adding juice to meals. But I wouldn't say anyone was eating more than 3,000 calories per day at the most - of course, if a patient had been eating that and not gaining, their meal plan would have to be adjusted.

There was a good balance between free time and structured activities. We had breaks every now and then, but most of the day was filled with lessons, activities etc; which was a really good way of keeping us occupied and keeping our minds off food obsession. I found I really enjoyed the art therapy and craft activities. It might sound cheesy but it was really therapeutic just to do something relaxing instead of doing whatever the ED dictated.

There were different levels of freedom. When you first arrived you didn't have much (ie, someone would have to be in the bathroom with you at all times), but you could earn it. Before I left I was allowed half-days to go into town by myself. Others were allowed to go on 30 minute walks. We had a lot of supervision in general, but I think that's fair enough - EDs can be so sneaky.

Good luck in your recovery and on finding an IP programme you'll feel comfortable with. I was scared of going too, but I'm so glad I did.

I went to Remuda Ranch around this time in 2005. I'll try to remember as much as possible-

5am- wake up, weights and vitals, shower, get dressed, meds

6am- stretching- if you were on good status, you were allowed to do stretches in under instruction, so you wouldn't over do it.

6:50am-breakfast- (when you are first admitted, they will have you on a re-feeding diet, to slowly get your body back to eating, so it will be less than normal)- Remuda had some great breakfast-it was always my favorite meal- we would have 2 choices to pick from for protein, fruit, carb, etc. My favorite was  a tropical parfait (yogurt, pineapple, bannana, coconut, and granola with a bran muffin (with butter)

8:00am- home group- kind of like group therapy. All the girls with the same therapist were grouped together. We would do a "feelings check" (how we were feeling at the moment, about breakfast, yesterday, etc) then discuss any issues anyone was having. We also all wrote and told our life story in home group at one point.

9:30am- snack time- we also got to choose snacks (we always did this before hand) It'd be something like cottage cheese with fruit mixed on the bottom

10am- (this is where my memory gets fuzzy- it was different for different days) Some days art therapy, other days maybe meeting with therapist/dietician/psychiatrist/doctor, other days free time.

12:10pm- lunch- gardenburger on a bun with lettuce, tomato, ketchup and mustard (they limited our condiments to 1-2 packs each, they also did that with salt and pepper), potato chips, and an orange

1pm-either free time, meeting with dietician/psychiatrist/doctor/therapist, Christian living class, or body image therapy

2:25pm- snack time- maybe a granola bar and grapes

3:00pm-Mail time!! We loved getting mail- it was the most exciting part of the day! Free time

4:00pm- Chapel- Remuda is a Christian based treatment facility, so everyone was required to go. I personally enjoyed it a lot!

5:30pm- Dinner- Something like Chicken stir fry with rice and veggies, salad with dressing, vanilla ice cream with strawberries

6:30pm- Certain days Equine therapy (so much fun!), some days Rec group, some days free time (one of the few times we were allowed to watch TV)

8:00pm-Snack- maybe pudding and caramel corn rice cakes

9:00pm- allowed back in our rooms for the night (we couldn't go in them during the day). Normally by this time I was exhausted and went to bed.

This would be a weekday. It sounds like we were pretty busy, but there was more free time than it sounds like. On the weekend we didn't have group or meetings, so we would have free time to do crafts, puzzles, play games, watch movies, etc. Also, this meal plan was supplemented by either tube feeding or Boost Plus. I chose the tube feeding and I am so glad I did. It was a lot easier that way. We also had a family week where our family came and we had to tell them what we thought contributed to our ED. We were allowed to go out on pass. I chose to go shopping- I was deprived! We also went on a Restaurant challenge and were challenged to order a fear food. They also had a reward system where if you finished your meal (all of it, including condiments and drinks) you were allowed to get coffee or tea afterwards and if you finished all your meals during the week you got to go on Privilege Ride (an extra horseback riding session) Sunday morning. That's all I can think of right now. Where are you thinking about going? If you're not sure, I'd highly reccomend Remuda. I loved it there! I didn't want to leave and lots of times I wish I could go back!Hope this helps hun!

i gotta say rcj92, that was a most unhelpful post. like seriously. this girl clearly is sick enough to need ip help and your post would turn anyone off.

my ip was : up at 7.30 - 8.00 breakfast at 8.30. consisted of: cereal with whole milk (proper size bowl), juice, 2 slice of w/w bread or toast with butter and jam.

1 hr in the lounge - where everyone had to relax after meals. morning snack at 10 - ensure to start and then work in a real snack of 300 cals

group at 10.30 til 12.30

lunch at 1: 2 potatoes veg and portion of meat. gravy or sauce as associated with meat or fish. dessert varied from day to day

1 hr rest in lounge. snack at 2.30 or 3 (same as before). group from 2.30 to 4.30. on some days we were allowed to do activities or go into town for an afternoon. but the group had to stay together and had to consume a snack together and the snack had to be adequate.

tea at 5 stir fry, or an omlette, or beans and sausages and potatoe cakes. and 2 w/w bread with butter and jam.

hang out with the girls for the evening in the lounge. watch a dvd or play board games.

final snack at 7.30 - 8.

its really ok. ip. its great doing the refeed thing with a bunch of girls who understand the fear and psychological turmoil you are going through. its also great to have the staff there for support

I have not been to IP, but my best friend has been twice.  The first time she resisted and hated it, but the second time around she was much more willing to receive help and she grew to like it a lot.  She started to really open up in group sessions and ended up making a lot of fantastic friends who she has stayed close with even now that they are in different outpatient therapy groups.  She now says that allowing herself to be helped in IP was the best thing she ever did.

I wish you the best!

My IP stay was in the spring of 2006, it was fairly brief because it really kicked my butt into gear, meaning it motivated me to recover like nothing else had and also gave me the means to make that recovery complete and lasting--3 years later and I'm still going strong. I started with a partial day program for about a month-this really was not very helpful to me because I was still allowed to engage in behaviors and restrict at home (we were only there from 8-3ish). My typical day went like this:

Wake up at 6AM to get weighed and get vitals checked (in a gown with scales facing away from us), go back to sleep.

Get up between 7:30 and 8, go into the main lounge room area, watch TV/relax until breakfast at 8. For me, breakfast was usually a small bowl of cereal, 2% milk, a bagel with pb, a hard boiled egg, juice or fruit or cereal, yogurt or cottage cheese, an english muffin with butter, juice/fruit and milk. We had an hour for breakfast and had to finish everything or we'd be given ensure.

After breakfast we had group from 9ish until 10:30, so we basically just went around the room and checked in with one another and talked about how we were feeling or what we were struggling with, and the counselors helped us--this was so much better once I actually started participating!

Morning snack was at 10:30. I had about 350 calories, maybe graham crackers with pb and milk for example, although ensure was an option if you ddin't feel like eating. And water.

11-1145ish was usually either a spirituality session, art therapy, movement therpay, or nutrition class. So anything from coloring and listening to music to yoga and collage making.

Lunch was at 12. We had a system where every 2-3 days we got a menu with multiple options and we sat down with our nutritionist to choose items that fit our meal plan and were varied and somewhat challenging. Lunch might be a veggie burger with chips, steamed veggies, fruit, and milk (cheese and mayo for fats) with maybe cookies or something. Again, we had an hour to eat and relax.

We had another therapy session after lunch-this was mostly run by the counselors, who might talk to us about body image or perfectionism or something related to EDs.

Snack was from 230-3, something like an apple, yogurt, and cookies for example, and we had some free time to write in journals, do puzzles, read, etc. We also got to make a 10 minute phone call here.

School was from about 330-5 for those under 18--our teachers sent in work and we did homework or read or took tests in a little room with a teacher, those who weren't in school had more free time or did more expressive therapy or something. On weekends we had free time instead of school, or visiting.

Dinner was from 5-6, and it was usually a main dish of meat with potatoes, bread, veggies, etc or stir fry, pasta with salad and bread, a sandwich with chips and veggies, a burger, etc. We had a lot of choices and they were quite varied, although there was a lot of food.

AFter dinner we had another group check in like the one in the morning until about 730, after which we could make phone calls. one or two nights during the week we had visiting as well as on the weekends.

Evening snack was about 8-830, and might be a banana, pudding, and a granola bar. Then we got our vitals checked again and could go into our rooms and shower and read or whatever until bed around 10 pm.

Bathroom trips were monitored, meds were distributed throughout the day and they checked to make sure you took them, items like razors that could be used to hurt oneself were locked up by the staff and use was monitored, gum chewing wasn't allowed, coffee and smoke breaks were allowed only if you were over 18 and strictly monitored and considered rewards, no exericse (even stretching) was allowed...that's all i can really think of! Good luck!

Of course it is going to be scary cause you have to change and there is a lot of unknown. I have been ip residential and reg hospital. I think that yes it can help especially if in medical crisis but often people use it as a vacation from the ed rather then to really work on ways to cope and the reasons behind the ed. Regardless I think it is very key when one leaves to have a strong support team and structure within. Most programs have the meals/snacks and if you have to gain then they have you on a mp to do that. If recovery from OE or bulimia etc of course stopping the behaviors. There is group and individual therapy so you can work on the why behind and coping skills/goals. Of course many have meds to help as well to deal with the anxiety so on. I think ip etc can be a good starting point but it is not a cure and when you leave there still will be a lot of work ahead.

I've never been to inpatient treatment for anorexia. You're going to wonder why I'm writing, then. Well, I'll tell you.

I know you're scared, and I know that reaading about experiences might be scary, that the thought of change is daunting and overwhelming. But from one stranger to another, if you have the opportunity to go, GO. Please go. Go, get better. Take it seriously and get better. Get the demons out of your head.

I developed bulimia when I was 11 and my parents just didn't seem to care. It stayed with me. There was restriction and anorexia, diet pills, laxatives, yo yo diets, NO self esteem, terrible food issues, isolation, anxiety, isolation... everything. I was 21 when I found out I was pregnant with my daughter, and the day before I found out I'd taken PACKAGES of laxatives and binged. When I got married, it changed my life, and I got a lot better - but not all the way better.

Here I am, 26, in love with my husband, the mother of two, and I love my family and would do anything for them. But I'm still not "cured" because I am not able to snap out of whatever is holding me back and realize that my BMI is way too low, that my breasts are virtually gone, I haven't had a period in years, and even though I eat, its obviously way not enough considering I am a runner. I don't talk about good and bad foods and I don't talk about calories and fat. But for how long can I shield my daughters? Even NOT saying those things won't keep these little beauties from maybe thinking "mommy looks like that, I have to look like that." My husband, God bless him, is still attracted to me because he loves me, but in our intimate moments and when I'm changing my clothes there is always a look of worry on his face.

I could probably eat 2,500 calories a day and maintain. But I don't believe that to the core. I can't bring myself to do it. I look at the idea of inpatient as something that would be positive, but now, I don't have the time or ability. I think I'm too old for it to work, this thing has been around for too long. I would take inpatient just to get some REST if you can believe it, and rest from these thoughts. It's not that its an active disease now, its just that weight issues are so permeating that I swear they have become part of my genetic make up. That makes me pathetic.

If you can go, go. Don't sentence yourself to a life of this. Get out now. As scary as inpatient sounds, being plagued by this, being haunted, feeling that at 26 years old an ED has been the most constant thing in your life (before my husband and daughters because obviously I'm referring to my case!)... isn't that a lot scarier?

Original Post by bsh0611:

I think I'm too old for it to work, this thing has been around for too long. I would take inpatient just to get some REST if you can believe it, and rest from these thoughts. It's not that its an active disease now, its just that weight issues are so permeating that I swear they have become part of my genetic make up. That makes me pathetic.

When I went inpatient (I was 20), I was the youngest one there. There were plenty of people in their late 20's, some in there 30's and even a 40 yr old. You are never too old to get help. I know this is something that you have had for 15 yrs, but if you truly want to get better (for your husband, for your daughters, for yourself) then it will work, you just have to commit to it. Most of the women in treatment had had their ED for that long or longer, and many of them are in a MUCH better place now than they were when they came. ED is what is telling you that treatment won't work, not you. It is a lie!

 Please get some help. You deserve to be better, to be happy. I hope the best for you!

I went into my last ip at your age bsh and there were women in their late 60's. It is never too late. I also have a mom who is and was anorexic my whole life. I can remember knowing something was wrong even at like 5. I feared my mom dieing and still do. Kids are smart and they may not know exactly what it is but can sense things. It goes deeper then the looks and is the why you do this. You are not pathetic but are in a struggle and can get through it.

See, I'm not "super restrictive" or a "super over exerciser" or any of that jazz. I eat enough to live, not always enough to lose, just not an average of what I need to maintain or gain. I don't even think I would get admitted. But really, the thing is, there would be no affording it, and I couldn't live with  myself taking money from the family that we just don't have just to "get away from it all." This girl has a real chance, an opportunity. I just hope she takes it.

bsh--You are no less deserving than any of us to get treatment.  I've been inpatient with 10 year olds, I've been inpatient with 78 year olds!  Eating disorders do not target just one age group, but eating disorders will find any excuse to avoid help, lie or fool others into believing they're just fine.  

I'm almost 16, and I've had anorexia for 8 years.  I've been inpatient 11 times, and I've been residential twice.  I'll give a sample day of the "average" facility:

6:15  Wake up, get weighed (some places let you know your weight, most places don't especially if you're under 18), get vitals done, shower, get ready for the day

8:00  Breakfast:  If on weight gain (for me 4000-4750 calories a day, no exercise) this might be a sample breakfast:  2 medium-ish muffins with 2 tsp butter, 1 serving cereal with 1 cup whole milk, 8 oz juice and 1 Ensure Plus

If you're under 18, you'll probably have school, usually 1-2 hours.

Groups (DBT, nutrition, CBT, process, daily planning, addictions, etc are typical groups)

Lunch:  On weight gain, it might be...5 oz chicken, 1 cup rice, 1 cup cooked veggies, 2 tsp butter, 2 oatmeal raisin cookies,  8 oz juice, 1 Ensure Plus

Groups (see above)

Free Time

Dinner:  5 oz chicken salad sandwich (with 2 slices bread), 1 cup cooked veggies, roll, 1 tsp butter, 8 oz juice, 1 Ensure Plus

Usually Visiting Hours

Snack:  1 pack cookies, 1 Ensure Plus

Free Time

Allowed Back to Rooms (shower, etc, bed)

As tempting as it is not to, It really is best to be compliant.  Most places will make your life a living hell if your not, then tube you.  Not fun.  

Other advice:  BE HONEST.  A therapist once told me that if you lie to your treatment team, your treatment is a lie.  How can you get anything out of your hospitalization if you aren't being honest?  It won't reach the real issues then.  I can't think of any more profound advice, but pack comfy clothes, lots to read and a journal to write in.  

Best wishes.

fidget,

everybodies IP experiences are different. I'm sure there are good places elsewhere, but the place I got put into was not. I was giving her an honest answer on what my experience was like.

Chocolate-

Sorry if I turned you off in any way. IP facilities are not all bad, and can be very helpful in relaxing your mind and taking away from the anxiety of making decisons. if the offer is there, and you are ready to actively recover, take it.

lena123 - your IP experience sounds so much like mine! I forgot to say that we also got weighed, but only every Wednesday and Sunday, and we could choose whether we looked or faced away from the scales. I always chose to look.

We also had our condiments limited, because the staff said people with EDs have a major tendency to go OTT with the salt, pepper, soy sauce or relish. I think that's probably true - perhaps because of eating little we were all used to trying to squueze maximum flavour out of our meals.

We were also not allowed to have things like razors, although we could borrow them back for showers. People who also cut themselves actually had the staff shave their legs for them. It sounds crazy, but it actually turned out to be quite a laugh when the cutters got excited about "shaving day." You do develop a very morbid sense of humour!

swimfan - totally agree with you about making the commitment to be HONEST. When we were admitted we spoke to the nutritionist about our likes and dislikes before the ED - we were allowed to have 3 "dislike" foods. I kind of couldn't remember what I didn't like before the ED so I didn't have any dislikes on my list. But plenty of people put their current "fear foods" like cheese, bacon or avocado on the list, just to avoid eating them. All it meant was they never really got over their fear - I did, and can now eat whatever food I want, so I'm really glad I was honest.

also to bsh0611 - like others have said, there are plenty of older people in treatment programmes. Most people at my IP facility thought they "weren't sick enough to be admitted" - myself included. But we were, because we had tricked ourselves into thinking our habits weren't really so harmful. If you're unsure, perhaps talk to a counsellor about your eating habits - getting confirmation that something isn't right is a great motivator for change.

I think when one makes a choice to go ip that they do it with the idea it is not a vacation. This is not supposed to be fun. It is about getting your life back or the start to it. Everyone has different experiences based on where they are at mentally etc. It may not be the best place to be but it may be what you need to not have huge problems and a destroyed life. There will always be reasons to not go. Financially,school,family what ever and if that is the case then one needs to use that as a motivator to do more in the real world. It is not ok to just be better with behaviors because it can really kill you. For moms hough who state they don't want to leave their kids or for othe reasons I really think it is not only a gift to you but to your family. You may be a way for a month or something but will give you and your family a lifetime of better. Lastly if one chooses an ip it is nice if it is near your area you live which is not always possible but that way you can transition easier.

Sample Week Day:

6:00-7:30 - Wake up, Vitals, Shower, Get ready for the day, Chill Out

8:15-8:55 - Breakfast

9:00-9:45 - Community Meeting/Team Gathering

9:50-10:10 - Morning Meds

10:00-10:30 - Menu Selections or Track Orientations or Chillax time (if you have nothing else to do)

10:30-11:30 - Group

11:30-12:15 - Free Time

12:15-1:00 - Lunch

1:00-1:25 - After Meal Support Group

1:30-2:30 - Group

2:30-3:00 - Free Time

3:00-3:20 - Snack

3:30-4:30 - 'School' (unless you're an adult)

4:45-5:45 - Contact Time (meet up with counselors and chat about anything you'd really like to, from how your day was to the color of the sky)

6:00-6:45 - Dinner

6:45-7:10 - After Meal Support Group

7:45-8:45 - End of the Day Group (like journaling group, affitmations, TV night, Game night, Movie night)

9:00-9:20 - Snack

Throughout the week you have individual/family therapy, nutritionist appointments, psychiatrist appointments.