A Letter to the Insurance Company

I am currently going through an appeal, hoping that my insurance company will see the error of their ways and reimburse my family for some of the money they paid out of pocket for me to remain in residential treatment. Below is one of the letters I wrote in my appeal.
*Trigger Warning, as always*

Even though my eating disorder began at the age of four, it took seventeen years for someone like Dr. Hermann to confront my problem. She referred me to The Renfrew Center for Eating Disorders in June of 2011, because I had gone from weighing above 135 lbs to below 110 lbs in a very fast amount of time. My percentage of suggested weight and my restrictive eating habits were more than reason enough for her to send me to specialists dealing with eating disorders. At Renfrew, I had a two hour long intake with Dr. Cooper who immediately recommended residential treatment, saying that I was “too sick for a lower level of care”. When I mentioned possibly doing an Intensive Outpatient Program (IOP), Dr. Cooper told me that I was too “medically fragile” for that level of care, anything lower than residential treatment was not going to be offered to me by the Renfrew Center. This was on June 20^th of 2011.

I started to try recovery on my own. I was seeing a dietitian and a therapist on a weekly basis while working full-time at a magnet school teaching middle and high school Latin.

In October, I taught all day feeling as if at any moment I could have a heart attack. After school, I saw my dietitian, Katherine Fowler, who immediately sent me to the Vanderbilt ER. I was admitted into the emergency room with dangerously low potassium levels and low magnesium levels.

Even after missing work for a life threatening situation, I still did not make the progress in recovery that one would hope. It was after this, hitting rock bottom and knowing it, that Dr. Herrmann and my dietitian decided that I must go into residential treatment. My life depended on it.

Jenni Schaefer makes a very profound statement in her book Life Without Ed, a book about eating disorder recovery. She says that she was at a seemingly “normal” weight when she was the deepest in her eating disorder, when she was restricting, bingeing, and purging the most. The same is somewhat true for me. What many people look at when they see an eating disordered patient are the numbers. The phrase, “But you don’t look sick” comes out of their mouths more often than not. If my exposed collar bones, my clearly evident scapulae, and my countable ribs were not enough to make me sick enough by the standards of an outsider, then I would encourage them to dig a little deeper. What about restricting to only 300 calories a day? What about forcibly vomiting a minimum of forty times a week? What about bingeing on Taco Bell, Sonic, and ice cream only when my body was so deprived that I needed something to stay standing only to forcibly remove the food from my body within two hours of consumption?

Not only did doctors and trained professions urge me to seek residential treatment, but I also saw the horrible nature of the life I was living. My only hope is that the insurance company sees that too. 

Rules

Every time I talk about treatment, I mention some of the crazy rules or nuances of treatment. These normally get me a "wtf face". I decided I will compose a list of the craziness of treatment. :)

This is a work in progress, much similar to my recovery :)


1. You cannot break your cookie. You must take the entire cookie, raise it to your mouth, and bite into it. It does not matter if the cookie is stale and is too hard for you to bite. The only exception to this rule is if you are at Panera.

2. When you have cereal, you must make sure that all the flakes of cereal and all the almond slices are cleaned from your bowl. You cannot have any food particles remaining in your bowl. If you leave almond slices or cereal flakes in your bowl, you will be redirected to take your spoon and get all the remaining pieces before leaving the table. This sometimes will result in you having to spend about five minutes working on getting tiny slivers of food from your bowl, but that is not what is important. What is important is that you are not acting on your eating disorder.

3. If you are having cereal, you can have Raisin Bran and yogurt. You can have Cherrios and yogurt. If they are out of Cherrios, you can have Frosted Flakes with yogurt. If it is any other cereal, or if you do not mix your yogurt into your cereal creating some weird somewhat gelatinous substance then you must put milk in your cereal. This rule gets very complicated, so I will subdivide.
a) You cannot have yogurt with cereal unless you mix the cereal with the yogurt.
b) If you don't have yogurt, you must have milk. If you have milk, you must put it in your cereal. You cannot have dry cereal and drink milk.
c) Frosted Flakes cannot be mixed with your yogurt if Cherrios are available.
d) You can put extra raisins into your Raisin Bran as your fruit component.
e) You cannot put raisins in other cereals if it "doesn't make sense" to the dietitian. This subdivision of a rule is up to the interpretation of dietitians and online staff.
f) Having dry cereal is "eating disordered".

4. You cannot put your Mini Wheats or Frosted Mini Wheats in the microwave even though the commercials and the box tell you to do so for a "warm cereal during winter months".

5. You cannot put salt in your oatmeal, including non-flavored, original oatmeal, even though it says on the instructions to add salt.

6. You can put fruits in your yogurt if they are fresh and cut up or if they are dried and bite size. Prunes (even if cut up) cannot go into your yogurt. Dried apricots, though much larger than bite size, can go into your yogurt. Apples, bananas, strawberries, plums, etc. all can go into your yogurt and can be cut into insanely small pieces to fit into your yogurt container. Preparation of the fruit + yogurt combo can take up to fifteen minutes. I've seen this happen.

7. You cannot put apples and peanut butter on your bagel, but you can put bananas and peanut butter. Duh, that's so less eating disordered...

8. You cannot make your bagel into a peanut butter and jelly sandwich by having peanut butter and getting jelly.

Proposals

Before my nineteenth birthday, I had been proposed to three times: once by my high school sweetheart and abusive boyfriend when I was eighteen, once by a street vendor in Monaco when I was sixteen, and by Ed when I was four. I refused to recognize almost all of these as proposals until I was in my twenties, particularly Ed’s proposal. Some things are just better left forgotten, or so I believed. While all of these proposals were insanely strange, I suppose I shall start with what I still consider to be the strangest of all.

I was eighteen, a college drop out, and in a relationship with Daniel. Daniel did not have a job, and he had been homeless for the majority of our relationship. As you can imagine, his proposal was not very elaborate. It was what I refer to as the “Hey, I’m going into the military, and there’s a possibility you might be pregnant, so let’s do this thing” type of proposal that was all too common around my hometown. As we stood in my parents kitchen, Daniel threw his class ring at me, still engraved with the initials of his ex-girlfriend, and he said, “So… Yeah… You know… What do you say?” I said no, and we broke up a few weeks later.

My proposal in Monaco was not really a proposal, but I group it in here with the others because it is the happiest of the three. I had just fed a crepe to a seagull, and I was meandering the alleyways of Monaco with some close friends. The menagerie of Lamborghinis and other expensive cars caught our attention until a young man and his father in a street side shop called out for us in French. I, speaking only Latin, could only pick up a few words. Beautiful. Ladies. Something about a boy or his son? I turned to my friend travelling with me, who translated for me. “Beautiful ladies! American women! My son! You marry? You marry?” Next thing I knew, the kid was on one knee. I ran away giggling with my friends as any scared American would.

 Finally, the proposal I remember least vividly. It was the summer I turned four. I was at my maternal grandmother’s house. Somewhere along her hallway lined with mirrors, which I often compare to the Hall of Mirrors at Versailles, Ed proposed to me. I accepted without hesitation. Who’s Ed you ask? Ed is my eating disorder. Ed is the man who saved my life and nearly killed me a few times along the way. Ed and I are currently in the process of filing paperwork to finalize our divorce.