Nocturne

I'm a little concerned about my nocturnal eating habits. I'm not a good sleeper, never have been--and sometimes I wake up hungry. I've been lectured about eating during the night--one doctor went so far as to assert, "You're not hungry, it's just a bad habit". Of course, if it were up to doctors, no fat people would never eat anything ever again until their ribs could be counted (she snarked, peevishly).

Back when I was on Ambien, I was binge eating during the night with no memory of doing so--we would find the evidence in the morning. That was a legitimate problem. This isn't binge eating and I'm conscious for all of it. I'm awake, my stomach growls, I go and get a snack. They are gastric-bypass-friendly snacks, like sugar-free Jell-O or string cheese or a South Beach cereal bar. Sometimes I take a Muscle Milk back to bed with me, sip on it and finish it in the morning.

I eat so little now, I wonder if this is even a problem. If I could reliably sleep through the night, maybe I wouldn't want to eat. Sometimes I do sleep through the night, and usually the first thing I do in the morning is eat because I'm hungry.

I know in an ideal world, sleep isn't interrupted for food. I'm debating whether to even discuss this with the nutritionist or one of my doctors--I don't want to make more of it than it is. I'd be more worried if I wasn't losing weight, or if I was finding mystery crumbs and packaging in the morning.

Night moves

Waking up in the middle of the night wanting sweets has been part of my life since I was seven years old. I don't remember exactly how it began, but I can certainly put it into some context.

My father was in prison; my mother had died five or six years previously. It was the third U. S. state in which I had lived in my short life, and was at least the third family group with which I shared a household. I was just beginning to figure out that my mother was really gone for good and what that might mean, but I didn't talk about it with anyone; I had long since learned that the more invisible I could make myself and the less demands I appeared to have, the better off I would be. I had also been molested by this age, and as a result, did not sleep well.

So--I'm seven. I'm living with a relative I'll call Mr. Forced Starvation, who I mentioned previously in this blog. Mr. FS has a wife, too, but, as I recall, she mostly serves as a Greek chorus for his (largely negative) pronouncements, though she has a few choice ones of her own. Needless to say, they are not the most pleasant of people to live with. He seems to really enjoy eating in front of me, talking about what he's eating, taunting me about how I can't have it--and it's usually chocolate ice cream, which is my favorite. To add insult to injury, some friends of theirs have a little girl who comes over to our house frequently, and she's allowed to eat whatever she wants, whatever they're having. A point is made to send me to my room, where I can hear everything that is going on. I haven't misbehaved; the only way I have failed at this point is to be born shaped in a certain way. In the pictures from this time period, I'm not particularly heavy yet, but I'm definitely a child that a practiced eye can see will be struggling with her weight later--even if the environment in which I was living wasn't already handing me an eating disorder on the proverbial silver platter.

I can remember waking up in the middle of the night and looking out the window, hearing other people's snores, knowing I had reliable privacy for the moment. There was a tendency in this particular household to be walked in on in the bathroom, a distinct overall lack of healthy boundaries. This household taught me not only the necessity of, but joy, even revelation in my own ability to hide: not only who I was, but what I felt and needed, and simply to get away from the world.

I remember the light of the moon shining down on my contraband roll of Sweet Tarts, which I had either stolen from the store or stolen the money to buy (probably the latter). As low as the moonlight often was, I can still remember the sound the wrapper made as I peeled it off, and the quiet shot of glee within me when I could distinguish that the next piece of candy was pink or orange. How appropriate this memory is now, more than thirty years later, when I still awaken in the night with similar cravings. This memory, and many others like it, contain the presence of the only true sweetness I was able to rely on for the first half of my life; but the very weight of articulating this truth is sour, and its tartness burns.

Going off Ambien CR

I decided this evening that I am just going to quit taking Ambien. I forgot to bring any with me when I went to visit my friends out of town last night, just toughed it out and tried to doze a bit with the Ipod on my special insomnia/quiet playlist. I didn't sleep all night.

When I got home today, I thought: why am I taking this stuff? I've been taking it for years, and it's not helping me much. I'm eating in the middle of the night, and I definitely don't need THAT. (I can imagine the complications that could cause over and above potential weight gain, particularly post-op when some foods are going to make me sick--I'm going to want to remember what they are so I don't eat them again.)

So, I'm awake for the second night in a row. I'd rather just stop taking Ambien and have a bad day or two, not have it in my body, and not pay for it--even with insurance, it is not cheap. I was also reading online tonight about some of the side effects others have had with it, both while taking it and while trying to discontinue its use. I have escaped unscathed compared to many of these folks.

I just hope I will be able to sleep at some point before too much longer.

Sleep or lack thereof

My sleep has been really, really bad lately. It has never been good, not since I can remember. I'm a lifetime insomniac, since I was a young teenager anyway; I also have PTSD (post-traumatic stress disorder). The PTSD has improved drastically over the years, since I am no longer attacked while sleeping or awakened to the sound of violence and haven't been for decades. I've also been taking medication to help me sleep for the last ten years. My current fears involve possible intrusions from the outside world, and I do have them sometimes to an irrational degree. ("Did you lock the door? Are you sure? Well, I'm going to go look.") Unfortunately, I don't think this will never leave me completely, but I do the best I can. I would feel better with more locks on the doors (like about ten) and a really large, protective dog that loves me best. A razor-wire electric fence around my house and an armed guard might be nice, too. (I wish I was kidding.) A doctor looked at me once and said, "You have sleep apnea AND insomnia?" and I could tell he was thinking, Well, you're screwed.

Part of the problem with waking up often during the night--at least while I've been on Ambien/Ambien CR--is nocturnal eating. I've found wrappers and crumbs in different places in the house the next day and had no memory of eating anything or even being there. I have tried and rejected several sleep drugs over the years, and am about to try a new one. The only one that worked for me was Remeron, which provided the loveliest, most restful sleep of my life. I gained fifty pounds on it (one of the side effects is increased appetite), so I had to discontinue its use. (I managed to lose half of the fifty pounds I gained and keep it off, but at this point, who's counting?)

The other I wrote something weird in my food journal when I had a middle-of-the-night snack. Of course, I didn't remember eating or writing. That assignment was to write down why I was eating, what, what time, whether it was need-based or for some other reason. I wrote was "3:00 AM, 2 cookies. Want or love?" It creeped me out, and, taken literally, probably revealed more than I wanted it to--even to myself.

I have also been having nightmares, which isn't unusual for me, but some are easier to shake off than others. Like any nightmares, it feels as if my subconscious took a laxative and what comes out comes out. Last night's involved having to watch a dog be burned alive as part of some twisted ritual I wasn't part of but couldn't escape. The night before that, it was about being in the hospital with my mind alert, but unable to communicate with anyone, and being wheeled around on a gurney. I could feel the wheels wobbling under me.

These two examples are upsetting to me, but actually quite mild as my nightmares go. My dreams in general tend to be vivid and involved, like movies, with people I don't know taking part and plot twists aplenty. In the past, have had PTSD flashbacks manifest themselves as dreams, and we've all had those anxiety-based "naked in high school" dreams. I know a lot of dreams are symbolic, but I try not to spend a lot of time analyzing them, just chalking them up to the aforementioned laxative of the subconscious processing everyday life.

People are asking me lately if I am scared about having this surgery. The answer is, of course I am. But I've had several surgeries in the past few years, and this one is a lot less invasive than most of them. This one also has the capacity to really be a tool to help me improve my life. Yes, I could die, but anyone can die from any surgery. If my number is up, I have no control over that, so I don't see the point in fussing about that aspect of it. I'm more focused on the ways my life has to change and determined to make the most of what this could do for me.