Dear weight-watchers (Not the company…)

I write this in a state of conflicting emotions. I write this both openly to the world and to the loving friends and family who come across me in their life. I write this in the hope of bringing attention to something that you have most likely simply never thought to consider. I write this to open up a conversation while closing down a behaviour you’ve perhaps never thought to question. I write this because I feel I need to, if only to get it all of my chest and out of my head.

Care-free Days before diet culture invaded

I wouldn’t consider myself someone who is overly concerned about my weight. I have been lucky that, despite my mental health struggles, food, weight and eating have not really been a source of anxiety. I grew up in a house that had both a vegetable garden and a consistently heavily stocked chocolate biscuit selection. I like to think I was one of few children in my year at school who enjoyed both brussel sprouts and celeriac and Sunday lunches that ranged from your standard roast chicken to pork and crackling and, a favourite of mine, Goose – on special occasions only. Did I grow up around some diet culture conversation that probably had a minor impact on my body image? Yes. I definitely have family members who talked – and still talk – about weight with a more negative view on the ‘bigger’ end. Phrases like “I need to lose some weight so I’m not eating potatoes” were not that unfamiliar and, from others, suggestions that having that ice cream on a hot day was a slippery slope to eating ice cream every day…with the dreaded possible result of – dun dun duhhhh – “getting fat”. Do I blame these friends and relatives for having these behaviours and beliefs? Of course not. Am I grateful (if only for this reason) for social media that exposed me to ‘diet culture’, ‘fatphobia’ and ‘body confidence’ at just the right age to grow up knowing what I do now? Hell yes. Does it mean I feel completely unaffected by the effect of diet culture? Hell no. Hence, here I am, writing this letter to you all.

Enjoying moving for my own joy...

...While eating what I please

So, I guess I should start by explaining what I mean when I say diet culture. Diet culture, put simply, is the belief, and the way the world validates and encourages this, that what we look like is more important than anything else. Diet culture is the way in which we are told from all directions, from the moment we are born, that we need to look a certain way to be accepted. Diet culture ignores health and focuses on size. What’s more, it changes its mind all the time about what we should be striving for. At times, it’s been the super skinny body we associate with traditional runway models, but sometimes the diet lords decide we need narrow waists but big boobs, flat tummies but big bums, gorgeous pregnant bellies but these must vanish immediately into toned tummies as soon as the baby is out…The rule of the game is, once you think you’ve understood the rules, the rules must always change. So, in conclusion, you can never win. As soon as you start going to the gym to get toned, abs and muscles on women and girls are no longer ‘acceptable’ and curves are ‘in’. As soon as you dare to accept your body how it is, you’re becoming lazy. Diet culture will spread the rumour that as soon as you gain weight, you’re less worthy. Diet culture will tell you that the reason you’re bigger is because you’re not trying hard enough; not eating enough salad or going to the gym for enough hours in the week. Diet culture will shame anyone over a size 12, telling the world that they aren’t looking after themselves or putting the work in, and that they are the ‘before’ photo of an ‘after’ that they are just not obtaining yet…but if they just eat less ‘bad’ food, they will get there.

Early days of being introduced to Body Positivity and the
dangers of Diet Culture

What’s ‘bad’ food? I don’t’ think I even need to explain this as it’s ingrained in everyone and parents teach it to their children from the moment they’re born. Bad is anything that might possibly bring you joy. ‘Bad’ is all those delicious chocolate biscuits in the tin that I routinely had 3 of – signs of my OCD evident as a child – after school. ‘Bad’ is that stack of delicious pancakes you made with flour, eggs and milk, perhaps drizzled with sugar and lemon or chocolate sauce for breakfast last weekend. ‘Bad’ is the daily ice cream you’ve had in the 40-degree heatwave just to give yourself that tiniest feeling of refreshment and joy while you’re otherwise busy melting into the floor. ‘Bad’ is the hamburger you dared to choose instead of the grilled chicken on the menu. You get my drift. ‘Bad’ is ridiculous. You know what happens when you start labelling food as good or bad? You create a hierarchy and separate foods into moral categories rather than just accepting them for what they are. Brussel sprouts are brussel sprouts. They’re a vegetable. Some like the taste of them, others don’t. They contain things that help your body but if you ate just brussel sprouts every day for a week, I can assure you…you’d probably feel pretty awful and your body probably would not thank you. Chocolate biscuits are also delicious and so is my 1kg Lindt bunny I brought for easter. I don’t care what the ‘calories’ are. My bunny will sit on the counter top, being nibbled at each time I walk past, until he’s all gone. Between nibbles, I’ll probably consume some delicious vegetables and maybe even some cheese…Food is delicious. It’s fuel for my body and I will not let magazines, adverts and voices in my head and the heads of others, tell me it’s ‘bad’.

My first 1kg Lindt Bunny...2020
not the one I'm currently consuming

I feel like I got slightly side-tracked there, but it was necessary in a way before I get onto the real crux of this letter: The response of people around me to my recent change in weight, and how it makes me feel.

Even writing this letter makes me feel slightly uncomfortable as it draws attention to exactly that which I am complaining about, and appears to almost ask for what I’m trying to express makes me uncomfortable. Last summer, as all those who have read my recent letters will know, I had a major emergency surgery, months of pretty bad recovery and general health in relation to this, and then, during it all, a significant break-up. I’d go as far as to describe last summer as relatively traumatic for me. I spent a lot of time both physically and mentally unwell and in pain, both physically and emotionally.

The beginning of my 'weight-loss journey'
if this was some disturbing article about how to lose weight fast!

I should preface the next part by saying that in the 3-4 years preceding summer 2022, I’d gained the most weight I’ve ever gained and been the biggest I’ve been in my 27 years. I think this came from becoming very comfortable in a relationship where my behaviour around food, particularly take-aways, and Ben and Jerries ice cream, changed and I found myself eating significantly more of many things that brought me joy while also bringing my waist and belly size, several sizes up. Am I complaining? Not at all. As I said before, I am lucky to have been exposed to some amazing body positive, anti-diet culture influencers that taught me to stop caring about what a set of scales – had I owned one – might say, or what number might be written on the irritating label scratching the back of my neck. I got great joy of dancing around my flat, and my boyfriend, with minimal clothes on, showing love to my belly and my rolls and describing myself as ‘curvy’. My boyfriend at the time loved my body and I spent a lot of time telling myself that perhaps this is just how my body was right now and that’s ok. When people around me discussed weight loss and not eating certain delicious things to lose weight, I would find myself feeling simultaneously smug that I was not forcing myself to stop eating anything while also feeling slightly like their choice to not eat the potatoes or the chocolate cake was a judgement towards me. I was living largely in neutrality, leaning towards kindness and love, towards my body size and shape, while also surrounded by whispers of diet culture occasionally slipping into my subconscious before I’d swipe them away and dig into my KFC bucket or Chocolate Fudge Brownie tub.

Bigger and Happier days compared to the smaller and physically/mentally unwell days

I was mentally incredibly low here and yet probably physically appeared my most 'healthy'
i.e. fitting the socially acceptable body shape of the time

heSo, back to last June. I fall ill. I have major surgery. I spend 7 weeks off work, months recovering and healing. My diet confused and my tummy shrunken from weeks of not being allowed to eat and then fearing food in case it should send me hunched, cramping and crying back to hospital. By the Autumn, I was coming to discover the effect of the preceding months on my body size and shape. My pyjamas of the previous winter fell down with every step and my previously fitted tops hung off me. Re-building my wardrobe, I was finding that that little number with so much power over so many, had shrunk by at least 2 sizes, sometimes 3 (shop dependent, because as we all know, another way you can be made to feel bad about your body is thinking you’re a ‘small’ and then going into the next shop and the small is just ‘too small’ and you’re in fact – got forbid – a ‘medium’). Diet culture would have me dancing around my flat, cheering myself on for shrinking, and what’s annoying, is that part of me does want to. Even though I call myself body positive and confident, my brain has to acknowledge the perks of being smaller in a world where this is celebrated, envied and encouraged. Yet, battling with this celebratory voice in my head, is the one screaming at everyone who dares to comment on my size change. As with every new interaction I have with someone who perhaps hasn’t seen me since early last year, or has mostly known me through photos from the past few years on social media, I am received with comments of ‘Have you lost weight?’, ‘You’re looking very slim!’ with the added insult to injury of ‘You look great’ or ‘You look so healthy’.

‘What’s wrong with that?’ I hear you asking yourselves. ‘Take the compliment’, I hear you say. But while I’d love to say it’s that simple. It isn’t. Behind these so-called compliments, is the implication that I didn’t look great before. That before the ‘great’ me of now, was a less great, larger me. And don’t get me started on the irony of being told I look healthy, when I only got to this size through excruciating pain, the risk of an imploding bowel, being unable – not unwilling, and, in actuality, starving hungry – to eat what and when I wanted and the continuing fear of it happening again. Yes, I acknowledge that my body now is pretty much what it probably is meant to be. It’s at its baseline, the place where it sits when I am just living my life, eating a relatively standard diet which includes a good mix of vegetables, meat and Lindt chocolate bunny and never setting foot in a gym or moving faster than a standard walking pace. This is the me I recognise from my late teens and early 20’s and yet I do not appreciate it being celebrated quite as openly as it seems to be.

Beach Body Ready - because everyone body is, as long as they are on a beach...with their body

I find myself struggling with what to say when told how great I look following this significant weight loss. I won’t thank them because I don’t see this as a compliment. To be a compliment implies that I am now improved on what I was before. My value is somehow higher now than this time last year. It also implies that I have done something to get this way rather than it just being a natural consequence of a combination of events: having major surgery, not eating for a while, being more anxious around eating, my relationship ending and losing certain eating habits, being sad and anxious about both the surgery and break-up and therefore losing my appetite…These reasons are 99.9% not things I’d like to repeat.

I would rather be pre-emergency me, larger but not in pain, and mentally more stable, than the me 4 months later, still healing, still fearful of hospital, still uncertain about what she can safely eat and crying daily with anxiety that also stopped me eating regularly. I would take back my bigger size in a heartbeat if it meant I didn’t have to go through any of last year again. Yet people tell me how great I look and are surprised when I'm not instantly grateful for the intended compliment... Should I be grateful for all of last years trauma? At least I know now that, in the event I gain the weight back, all I need to do to lose it is get a blocked intestine, surgery at 3am and months of emotional and physical discomfort.

“But it’s a compliment!” you say again? And we return to the problem at the bottom of all of this. I should be grateful to be smaller and that people are noticing it and congratulating me for it. My poor health, and heartbreak, behind it are not relevant. It isn’t relevant that someone double my size could be significantly healthier than me physically and just be naturally bigger. I have bigger, much healthier friends. Yet those individuals may never get the ‘compliments’, because they are not what society thinks is aesthetically ‘good’. What’s more, and what’s perhaps worse, is that part of me writing this, hopes it does draw attention to my weight loss and lead to some compliments. Because society has taught us all to be this way.

Recent photo that I like for the memories 

I sit here writing this with my self-esteem, heart and confidence playing a game of tug-of-war both wanting to scream at the world to stop treating bodies like their size determines their worth. To stop saying that smaller is better no matter the cause or consequence. To think before they speak. While from the other side of the rope, screaming ‘tell me how great I look!’, ‘hey, nobody congratulates you on your non-existent pregnancy or offers you seats on the bus or tube anymore! Win!’. It’s a constant battle but my overriding belief is this: nobody should be commenting on other people’s bodies uninvited. I specify the ‘uninvited’ part as I appreciate that some people are trying, intentionally to change their body – whether it be gaining or losing, muscle or fat – and they actively want or ask for validation.

The rule I follow, which I struggle to understand why not everybody does, is that, unless invited, do not step into anybody’s body image world. Do not invite yourself to decide how someone should be feeling about their body through choosing to give your opinion on the way they look. Of course, it’s natural, that as human beings, when we see someone, our brain may direct us to thoughts on how they appear to us: “wow, they’re so slim”, “look at his muscles”, "I would never dye my hair that shade of green" “that is a large individual. He/she must eat a lot of cake”, “I wish I looked like that” etc. but have the courtesy to not speak these thoughts aloud, and have the growth mindset to question why your brain is identifying these individuals, labelling or judging them, in this way. You know nothing about them or how and why they are the size or shape they are.

You know when you’re with a young child who hasn’t learned social etiquette and boundaries in the supermarket or on the street and someone with a visible difference walks past and the child exclaims loudly “why does that person look like that?”? The embarrassment you feel and the speed at which you intervene to hush them and rapidly move away? We are embarrassed because children are curious and haven’t learned what is acceptable to say in front of other people without a filter. As we grow-up and are exposed to the different people in the world around us and taught about what is socially acceptable, we learn not to say these things. Apart from nasty, uneducated people on public transport or who have drunk too much shouting rude things about those they deem unattractive, mostly, we know not to reference people’s appearance to their face. Yet, for some reason, when it comes to losing weight or being smaller, especially if your smallness and weight-loss fits within the current diet-culture model of an acceptable, or even highly valued, body size and shape, it is deemed complimentary and therefore acceptable to verbalise our views on these situations out-loud, without considering that it might not actually be received as a compliment.

Look at that happy face of me several sizes bigger than the smaller me,
crying every day a few months ago

Even in instances when I know someone has been trying to change their body and I notice it, I intentionally will keep my observation to myself until it is brought up by them. I intentionally did not compliment my friend who had lost weight on purpose through dieting when it was clearly visible to me, because I didn’t want to place value on her appearance above the rest of her value as a human being and friend. I waited until she brought it up and then made a comment that intended to place no particular value on her body, acknowledging her success at meeting her own personal goal but not implying in anyway that she is better or worse than she was. I simply expressed my hope that she is happy with the situation and how she got there. Because that is what really matters.

So, rant over.

I’ve said what I need to say. We live in a weird world, and we can’t be blamed for thinking the way we do based on what everything and everybody around us tells us to. What we can do, is learn to tune into those voices and question them. To ask why and, perhaps next time, to remember not to give those voices in our head the opportunity to speak out-loud because what you're thinking might not always be 'just a compliment'.

Would rather be her - bigger and in lockdown...

Than her...smaller and in pain...

Thanks for listening,

Dear 2023

Normally, I’d be writing to you at the end of the year to thank you for what you gave me. So, really, this letter is very premature and I should be addressing todays to 2022. However, I feel I’ve conveyed everything I can about my feelings towards the turbulence of the last 12 months, so instead I’d thought I’d focus forwards.

I caught sight of you around November last year and began telling myself that when I finally reached you, all the negative feelings around the year I’d had, the anxiety and overwhelm, would be left behind in the hands of 2022 and you’d reach out yours and off we’d skip down the 12-month road of a new year, new me. So far, that hasn’t happened. It turns out, you don’t bring a magically clean canvas with you for me to start afresh at designing my life. Your entrance is more subtle than that. It happens overnight…literally, and I can only forgive my brain and my body for expecting them to acknowledge your arrival with a revived sense of calm. To them, Saturday simply became Sunday and there’s nothing special about Sunday.

So I’ve decided to write to you, perhaps as a form of what I believe is sometimes called ‘Manifestation’ – making something real through the sheer act of focusing on it, visualising what I want, or in this instance, writing it down. This is not something I’d say I believe in, however, I’m willing to use it as a base to put my desire for our 12 months together out into the world in the hope it gives my year some positive focus. So let me begin:

1. I will do more things for my own sense of joy. The last year (at least) has been driven by my crippling anxiety’s need for me to feel I’m being ‘productive’ – whatever that may mean – all the time. As a result, I have chronically failed to give myself permission to just sit and do something that could possibly have no other purpose than giving me enjoyment. As a child, I would sit for hours, when there wasn’t homework to be done, curled up reading a book. I didn’t feel guilty. I didn’t feel there was anything more ‘worthwhile’ to be doing. I want to go back to that. I want to feel that sitting and reading my book just because I feel like it, and in spite of the inevitable to-do list that will never end, is valid. That goes the same for doing some mindful colouring, cross-stitching, baking something just because…If I don’t give myself permission to do these things when I feel like it, or even when I don’t but my anxiety could really do with the downtime, then I might as well throw all my books out of the window and my craft unit onto the street. I have to confess there have been many times since last summer when I’ve envied the version of me post-surgery, lying in hospital or at home in bed, with nothing more important in the world than simply resting, doing things that relax me and make me happy while my body recovered. 2023, I do not need to wish myself in pain. there is always time for me and my list of ‘things for joy’ stuck to my fridge and it doesn’t only come around when I’m unwell. And if it feels like there isn’t, I’m determined this year, to make some – to pause, to say no to things, to leave more empty spaces in my calendar, to look at my list and book in more, much-needed, time with myself or even to just stop moving, sit down somewhere comfy and breathe.

2. I will prioritize my mental health. Sometimes I wish that I could experience walking through the day in someone else’s body. I want to know if how I feel is normal or whether there is an existence out there where butterflies do not life 24/7 in my chest and tummy and my brain is not running at 100 miles a minute. I briefly remember discovering that this reality did exist when I was first medicated. I became aware all of a sudden that the pit in my stomach had gone…oh the irony of the momentary anxiety this caused. But then I celebrated. Oh, the joy of not feeling constantly on the edge of a precipice or at the doors to an exam room, with the knowledge that there is no exam to relieve the feeling once it’s over. I remember that relief and I want more than anything to regain it. I want to feel less overwhelmed by the world and terrified for the future. I want to be excited about things to come. How will I do this? Well, to start, I’m going back to regular appointments with my therapist. I’m making myself a safe space, weekly at first, to look towards when the days and weeks are feeling too much.

I’m also going to review and reassess the medication first prescribed to me in December 2015 and that I still take daily. I’m no medical expert, but at this point, it feels more like a habit than anything else, as I lie here in the warmth of my bed, writing this letter, listening to my brain, with my body physically still feeling like I’m being threatened by a bear around my caveman campfire. I will never feel ashamed that my brain requires help but I do feel perhaps we need to assess whether the current help is the right one. As we walk this journey together 2023, I want to feel like my brain and I are becoming more connected, and that, as stated in a previous letter addressed to the rascal itself, my anxiety and I can become companions, rather than rivals.

3. I will embrace the unknown. Last year felt like a year of unexpected changes that my anxiety struggled to manage internally even while I seemingly dealt with them pretty smoothly from the outside. Although my heart was set on your arrival bringing consistency and no unexpected surprises, that is not realistic. I already had change lined up before you even got here: a new career path in the pipeline. I guess what I want from you now instead is to help me approach these changes more as exciting adventures to try, rather than possible regrets in the making. I want to be able to tell my brain – I guess that’s partly what this letter is aiming to do – that nothing is permanent. There isn’t harm in trying something new just because it scares me. The worst that happens? The new work isn’t for me…I was wrong. I step back. I reassess and I move forward. The best that happens: I discover a new passion and a new source of joy and fulfilment in my day-to-day. What’s more, I want to remove the pressure I constantly put on myself to be ‘perfect’ and to need to know everything from day 1. If I wasn’t slightly scared, that would be more of a concern. It is ok, good even, to enter the unknown with the openness to learn.

There are other unknowns in the year ahead: my living situation – where and who with, my medical dramas – do I choose to have surgery or not? Will I inevitably end up back in hospital again, my favourite nasal accessory dangling from my face? Some things can not be planned or known ahead of time. This year, 2023, I’m going to be ok with that.

4. Meet new people and start dating again. It’s been over 4.5 years and it’s scary. A large chunk of my 20’s has centred around my relationship with my best friend. It’s hard to imagine a life lived with someone else. And yes, my mental health is pretty low right now, and yes, this year feels like another year of changes, but the reality is, I like meeting new people and getting to know them. My side goal of dating is to try all the best hot chocolates in London so I figure, what’s the downside? Plus, if I succeed at following through with the first item on this list, perhaps I’ll meet a like-minded companion, who shares in something that brings me joy, along the way.

5. Focus on my own path rather than where others are or are going. I want to remind myself every time I open Facebook or Instagram, that I’m never seeing the whole picture. I’m seeing the highlights but not the moments in between. What’s more, there is no rush. 26-year-old me felt like time was not on her side - that I should be settled in a ‘career’ and a ‘relationship’. I don’t need to be though. Firstly, it’s ok to change my mind and try new things. No one, single job needs to be my one and only for the rest of my working life. Maybe the last 4 years, nannying was my thing. Maybe 2023 will show me that, for now at least, maternity nursing is what I love. Secondly, if I’d found the right relationship to be in right now, for being ready to settle down (whatever that means), then that’s where I’d be. But I’m not. Because I haven’t. Others have and that’s ok. They’re on their path and I’m here, bumbling along, on mine. I’ve got a lifetime ahead of me and if I spend it looking sideways at other people living theirs, I’ll miss out on what’s right in front of me and moving forward in mine.

And that’s pretty much it. Yes, 2022 was a whirlwind but it’s behind me. Now is the time to look ahead. You didn’t make the entrance I’d hoped for, 2023, bringing with you a whole different mind and body to take over from the broken ones of the previous 365 days. But you arrived none-the-less as you inevitably would. You brought the possibility of things changing for the better, new adventures, and another 365 days to learn to love the person I should probably aim to love first and foremost: me.

2023, here’s to you

Onwards and upwards,

Dear Change

I’ve got to be honest with you: I’ve never been your biggest fan. I like familiarity and comfort, routine and confidence in knowing what’s to come. I do not like the prospect of you appearing, neither on the horizon with an element of warning before you, or suddenly and uninvited. This year, you’ve been far too familiar, making yourself at home in my life. Just as I get settled after one of your drop-ins, there you are banging on the door again. I thought when I first decided to write this letter, that it would be largely a telling-off, a complaint towards you and your thoughtlessness when it comes to letting me just live my life in peace. However, I do also want to thank you. For every visit that you’ve made, has brought with it, something good.

Your first major visit this year came when I went from happily working one day, picking up an 18-month old without question, to lying in a hospital bed the next, my insides torn apart and put back together. You were most definitely uninvited then, as I had spent a long time prior, confident in my body’s health status and, thus – perhaps a little overenthusiastically - enjoying all the joys that food had to offer. Waking up bright and early that Sunday morning in searing pain, I could sense your arrival was imminent. Things weren’t going to be as they had been from here on in. You took my physical and mental health and threw them into the air with no pre-agreement with me about where they might land.

Yet, had you not visited then, I would have not gained so much time in the home that I loved. Because of you, I got 7 unexpected, bonus weeks at the childhood home about to be sold. Instead of the odd weekend day noted in my diary to go and help sort and pack up, I gained so much more: my favourite bedroom turned, not for the first time, into a very comfortable recovery suite, mornings spent propped up with pillows next to mum, with a view over the garden and field, keeping my brain exercised with games of Wordle. Summer days spent with visits from family and friends, sitting in the garden or in the sunny shade of the drawing room, resting on the sofa. Because of you and your unexpected and uninvited presence, I can thank you from the bottom of my heart for the extra time that you gave me to say goodbye to a piece of my heart.

Of course, that goodbye was a whole other visit. By the point of completion, I had returned to work with you in my pocket, leading a slightly more trepidatious day-to-day routine with the children. But, at least with this visit, you were booked in. I knew you were coming and, thanks to your previous stay, I’d been given plenty of time to prepare for this one. In this sense, your presence at the end of the summer almost passed me by. It is only since then, on the odd weekend, or now as I spend my Christmas entirely within London’s city boundaries, that I am forced to reminisce on what I had and my heart aches, just a little. What you did teach me though, as you always seem to bring some lesson of sorts along with you, is that – not to be cliched – home isn’t really a place, but the people it contains. My family and I said goodbye to some walls, but really, nothing more, as the memories contained within them are carried with us wherever we go. Now, I write this from bed in my parents flat, in London, where I am, as ever, spending my Christmas break, at home.

For me, home has always been where my family is. I remember returning home to London after my recovery from surgery and feeling like I was leaving home in order to go back to work. Not long later, and you knocked on the door again. This time, in your hand, an invite to throw my life back up in the air, in the form of saying goodbye to my 4.5-year relationship and the life we’d shared from 2018 until that moment. I’ve always been scared of you, you know. And my relationship had been a particular area that you book-ended rather neatly. At the start, I feared you because I didn’t want to lose the friendship he and I shared. By the end, it was the same – my fear of you and not knowing what would happen to the relationship I so valued with this man I loved and cared about, made me terrified of doing anything about how I felt. But I pushed through and apparently let you lead the way, as I moved out of the flat we’d shared for over a year, and onto new living arrangements…

The first time living with a friend, as opposed to with my parents, in a home owned and operated by them, or with my boyfriend, a home jointly rented, but the admin and finances largely led by him. Suddenly, I was flailing in the open, my mind whirring with worries – what needs paying for? Who does the paying? What accounts do I need to set up? How do I take a bath for 3 hours when I share a bathroom with someone who doesn’t necessarily wish to see me nude…? You were everywhere and I felt overwhelmed by your presence. I cried daily, over every little thing: shopping – how, where, what? Managing meals after long-days out of the house. How do I spend my evenings without the consistency of the routine I’d become accustomed to over the last 4 years. Every single thing was new. I often woke up confused, not sure where I was and took a moment or 2 to remind myself where this bed was and where this room sat, and where my life was centred, in this new arrangement.

And yet, once again, you brought so much good with you. Almost 3 months on, and it’s hard to imagine not living where I am, with my friend, eating cheese at the kitchen table at the end of almost every meal, filling the fridge with Tupperware’s of batch-cooked lunches ready for the week ahead, asking questions such as ‘would you like to brush your teeth before I have my shower, or are you happy to wait?”. Evenings spent catching up on our day while we eat or sit on the sofa with an evening chocolate selection. When I first moved in, I took on the broadband account, and having never done anything so admin-like in my life, was filled with anxiety about what I needed to do. Yet, despite the hiccups that accompanied it, within a few weeks, I was able to declare we had Wifi and Netflix was on the cards again. You may have begun this particular visit bringing bags packed with anxiety and uncertainty, but I think, without me noticing, you did finally take your leave. Normality, in regards to my living situation, has taken your place.

Then, just as I was adjusting to you in my new home, I decided to introduce you to another aspect of my life, so that you might make yourself acquainted there. Dear Change, meet my work-life. I was getting too comfortable at home, and so used to having you around somewhere, I decided to discuss my future at my job with my bosses. Every conversation had – gentle discussions of the future of my role and where it was going, gave you a little more space to wiggle in. Not long into November and an agreement had been made that I would move on in 2023. So there you had it, somewhere new to take root. You were touring my life and this was a big stop for you. I’ve been in my job for almost 4 years so your impact was significant here. I’ve been through excitement, anxiety, uncertainty, imposter syndrome, back to excitement. You’ve taken me through all the emotions and now I sit somewhere in the middle of them all. While I’m terrified of the unknown, I’m also a little bit excited about what you might bring in 2023 in relation to my work. Together we decided I’d pursue something slightly new; helping care for tiny babies and their parents in those early days and weeks. I know you’ll be sticking around with me for a while now as all of this starts, but I think this time I’m ok with that.

So, for now that’s all. I just wanted to write it all down in a letter to you, to remind you how busy you’ve been in my life. I wanted to acknowledge how present you’ve been and remind myself how much I’ve been through as a result. And, more than that, I wanted to thank you. More times than I’d have liked this year, you’ve walked into my comfort zone, taken my hand and dragged me kicking and screaming into the unknown. Yet now, here I sit, approaching the last days of 2022, and it all feels like you simply did what was inevitable. You saw what needed to be done and you did it.

I don’t know what 2023 will bring but, if you come and visit, I’ll try and remember through the uncertainty and the bits that fill me with anxiety, fear and doubt, that at the end of it all, you might turn out to not have been all that bad. Now settle down for a while please so I can read and colour, stitch and see friends, and, above all, relax into the New Year.

Yours Sincerely,

Dear Feeling in my Chest

Hi there. I feel we need to get acquainted as it appears you’ve made yourself comfortable and do not plan on departing anytime soon. You’ve found a comfy spot it seems – the perfect space for practicing your gymnastics, or jumping on the bed. Did you bring your butterfly friends too? Only, you don’t appear to be alone, and, while the butterflies are regular visitors, they too appear to have joined you this time for an extended stay.

I know you’re the not the most welcome of visitors, and you’re probably used to being told to “go away!” and “leave me alone!” and I confess I’ve often said this to you in the past…However, I was listening to The Anxiety Advantage where, in one episode, Yang-May talked about her own relationship with Anxiety – with you. She suggested that we all too easily treat you as the enemy, someone to fight off and send away. But what if we flipped our attitude towards you. What if, instead of treating you as a pain in my backside, I calmly approach you like I would a friend who is only trying to help. I do understand that’s what you’re trying to do. You're acting as you always have since humankind existed, keeping us safe from the dangers of the world. The thing is, the world has changed my friend. No longer are we cooking and sleeping in the open, contstantly needing to be vigilent for wild animals approaching and eating us for dinner. Back then, it was important that you were there, ready to warn us and to set our hearts beating faster and blood pumping so we could get up and run or fight for our lives and our families. Those days are gone. The world is a different place now and those wild animals now appear in the shape of long to-do lists, the never-ending feeling of pressure to be busy and to achieve things, financial worries, social media. Instead of being out in the open and our bodies simply setting us up for the best possible means of survival, we are sitting in our houses, or at desks, or surrounded by friends, with adrenlanine surging through our bodies with nowhere or way to be released. In these instances, we don't need all that blood pumping to our muscles ready to run our fastest or fight our hardest.

So, what am i trying to say to you? Well, basically, what I learnt listening to Yang-May the other week, is that I need to remember why you're there. I need to remember that you're just doing what comes naturally to you, and doing your best to try and keep me safe from the dangers of the big wide world. Instead of trying, and failing might I add, to send you away, I should talk to you and perhaps reassure you - and myself, my brain - that there is no iminent threat. I should have a gentle, understanding conversation with you and explain that, while I know you're only trying to help, I don't actually need all this adrenaline and you to sit in that comfy spot you've found, when things are actually ok. So, I wanted to write to you perhaps to begin this new relationship, to re-introduce myself as a friend and to reassure you. In doing so, I'm also hoping perhaps my friend Brain may intercept this letter and get the message too. Perhaps then the two of you could work together to improve your perception of real danger, and just relax. Ha! I'm the ultimate hypocrite. Relaxing is something I need to learn to do too. But perhaps, if we all work together, you, me and and Brain can learn. It sounds ridiculous, but even writing this letter is a big step for me. Not in terms of specifically writing to you about this topic, but in terms of writing my letters at all. I enjoy doing this, it is something that bring me comfort and satisfaction, that gets my creative brain whirring and releases the goings on inside my head. It's a form of therapy, of self-care. Thus, it is not something that I feel you actively encourage. There you sit, telling me I need to be "busy" and "productive", that my to-do list needs adding to or there are important adulting things I'm probably forgetting about. You tell me, not with words but just by being there, that lying in bed writing and listening to the rain outside my window, doing something I love and that, as an added perk, will help my mental health, is not achieving whatever it is you believe I should be doing. What if I find that I spend all this time writing this letter when I could have been...what?

So here's my message to you: I am allowed to relax and to do things that bring me joy. A conversation with my parents the other day centred on them telling - perhaps reminding - me that I work hard and that I am allowed - in fact i should - use my time off to do things that make me happy. I do not need to be "achieving" things (whatever that means) every moment of the day. If I want to spend an entire day in my pyjamas after a full working week of looking after two small humans, then I can do that. They reminded me that I'm one of the lucky few who has many solo pass-times and am very happy in my own company - that if I want to, there is nothing and nobody stopping me from spending my non-working time reading an entire book cover-to-cover as I did over afternoons as a child, or quietly cross-stitching with the radio on. The only thing that does feel like it's stopping me, is you. For a while now, particularly prevalent during the last few months of change in my life, you've sat there and made me feel - rightly or wrongly - that every moment must be filled with more "important" things than those that simply make me happy. Perhaps you simply don't value well-being and happiness in the way that I do. It's ok if you see things differently to me, however I want you to see things from my point of view, so that we can, as long as you're here, live in harmony together.

With all this in mind, here's my thinking. Let's keep communication channels open. I understand you're probably not planning your departure right now and I get it. There's been lots of change and you're stepping cautiously. I don't blame you. However, when you're feeling energetic and throwing out adrenaline here there and everywhere, let me talk to you and reassure you. Let me assess the reality of the situation and I'll - hopefully - most likely be able to tell you there's nothing going on right this moment that could result in somebody dying, the world ending, general impending doom. I'll tell you that we don't need to restart that to-do list of dread, writing down every little thing that I think of, because if something is important, either I'll remember it, or someone will remind me, or, worst case, something will happen because I didn't. And unless that thing that happens is the world ending or somebody dying, it's probably something that can be rectified.

Remember: THERE ARE NO WILD ANIMALS PROWLING THE STREETS OF NORTH LONDON. I want us to be friends, not enemies. Anxiety and you have been part of my life for as long as I can remember and so, while my ideal would be to let you check-out indefinitely and find somewhere else to stay, for now, I'll simply try and give you the reassurance that you need. All that adrenaline pumping must be quite tiring for you, as well as me, so we just need to learn to give each other a break.

And, I promise, if I am in a situation where wild animals are present or my life is otherwise in iminent danger, I'll let you do your thing. I'll sign off, by thanking you. Thank you for allowing me to write this letter. It did my heart and soul good. For now, my friend, speak soon.

Dear Ellie-May...Again

Dear Ellie-May,

When I last wrote, I ended with you leaving hospital but hinting at more to come. So, here’s a letter to remind you of the next hurdle you overcame.

With mum in the driver’s seat, you headed on the open road back to your childhood home: a bonus 6 week period up ahead, signed off work, to enjoy a place that will soon become another family's playground to build memories as they grow (but that’s another story). First there was mum’s birthday, a celebration with family, perhaps enjoyed too much as you retreated to the sofa in the mid-afternoon to rest and receive visitors, some baring the delicious beauty of chocolate tiffin, others the simple joy of company and conversation.  

A pretty dress and putting on some make-up
for the first time since pre-surgery

The week was filled with visits from family friends, cups of tea, delicious home-cooked food and early evenings spent sat on the lawn watching the colours change as the day drew in. You read, crafted and coloured and found admin slots to claim on insurance and seek heart specialist appointments (high heart rate, blah blah blah). Every other day, the local GP surgery where you’d grown up welcomed you with their kind smiles and sympathetic eyes, to inspect your wound, change your dressing and discuss your worries. You laugh quietly to yourself remembering the nurse at the hospital who reassured you “you won’t need to see your GP for dressing changes, you can just do it yourself for 2 weeks”. Now 5 weeks later and, until 2 days ago, removing your dressing entirely was not an option. The wound has been tricky, the healing complicated. Your scar almost resembles an exclamation mark, a straight line following the scar that already existed, but finishing at the bottom with more of a full-stop…a circle that has gradually shrunk in diameter but will always look that slightly bit different. You’re still not able to consider swimming or even, god forbid, have a bath. It’s only in the last week or so that you’ve ventured into the shower, progressing just that little bit from sitting on the outside of the bath, your hair draped back for mum to wash it. Perhaps later today, you’ll remind yourself what it’s like for water to wash over your tummy, the skin exposed to the elements, no longer hidden behind its protective gauze barrier.

A completed craft project:
a Bookmark for mums birthday

Anyway, I deflect. The point is, that minus the healing pain and the exhaustion, you were moving forwards, the direction one usually hopes to travel in life. Then things changed. Monday 27^th June, 11 days post-discharge, you began to feel something different. You’d been used to the pain the wound carried, and some sharp internal stabs which you continue to put down to internal healing…but this was different. It was both unfamiliar and familiar at the same time. Cramping. Struggling to stand up straight. Bending over just a little. You felt off, but not off enough to retreat to a horizontal position and stop eating or drinking. You ate a little supper. You watched tv. You went to bed. Two hours after falling asleep, around about midnight, you awoke with very familiar pain. Blockage pain. It wasn’t the worst you’d ever had, but it certainly wasn’t nothing. It was you, twisting and turning in bed trying to get comfy as every few minutes your stomach gurgled and spasmed, the pain radiating to your back. It was: trying to doze even as nausea sat on your chest. At 5am, after several failed attempts, the nausea was somewhat relieved…need I say more. After hours of contemplating whether the situation was bad enough to disturb our parents slumber, you hobbled semi-hunched, to their room. From there, things moved a bit more smoothly.

Considering briefly your options: waiting it out for a few hours, going to the local hospital, driving back to London…you decided on the latter. As you lay, activity buzzed around you; mum packed bags, for you and for her, dad, downstairs, readied his chauffer hat. A few false starts later, and you were on the road. It wasn’t yet 7am and you were on the motorway, pillows protecting your tummy, a bowl beside you. Google maps predicted 2 hours…possibly more. It felt like an eternity.

When you arrived, however, things seemed to speed up. You were able to find a chair while mum explained who your were to the stranger behind the glass. Mum mentioned your recent surgery and the doctors parting words that we should return with any concerns. Less than 5 minutes from walking in the door and you were being triaged, the surgical team were being called and, as mum kept reassuring you “you’re where you need to be now”. Unlike last time at least, no-one dared tell mum she had to leave. You sat shivering on the plastic chair while internally laughing as the triage nurse picked up the phone and described her concern over your tachycardia…been there, done that. De ja vu.

A familiar look - nasal-gastric tube, face mask and headache cool-pad

The surgical team didn’t feel the need to rush and see you, they wanted A&E to asses things first. You already knew the day was going to be long. You could only be grateful it was day and not night. There’s something far worse about the hours of waiting, not being able to sleep, counting down until dawn. You were quickly moved to a trolley (I would call it a bed, but they don’t come with pillows or with the fun remote control that the ones on the wards do). Only patients beyond this point, so it was “bye bye” to mum…tears brimmed as you watched her part the curtain and head for the exit. You were moved right to the end of the department, in a space with 2 other beds, tucked around a corner from the staff desk. It took a while but you were eventually hooked up to pain relief, nausea medication and fluids, familiar steps in the process. The male nurse in charge managed to make you laugh more than once, a miracle in the circumstances. He apologised profusely when at one point you were abandoned without access to the little bell button required to call for help. He even found you a pillow (“shh, don’t tell”).

“Eleanor Russell for CT”

You heard the robotic voice echo and were filled with confidence that things were moving much faster than usual. You were even allowed to stay on the bed as a kind porter transported you through the department, past police guarded doors (curiouser and curiouser), to the imaging corridor. Just one other patient sat waiting, You breathed a sigh of relief, knowing the 20 minute wait you’d had that first admission was clearly not an issue this time. Ha. Over an hour later, sobbing with frustration, your back to the door to the CT scanning room, you still waited. As other patients behind you arrived, waited 5 minutes, were called, and left. As the door to the room opened and closed, the warning lights flashed on and off, as the robotic voice from inside repeated over and over “breathe in and hold your breathe. Breathe normally”. Twice, someone came to your tearful side and explained they were still waiting for instruction from my doctors, or “there’s other people waiting, you just can’t see them”. Finally, your turn. Almost 90 minutes had passed. Within 5 more you were in and out of the machine, the sensation of having wet yourself a familiar one by now as the dye seeped through your body. You didn’t even have to wait for the result, as the radiographer reappeared to detach you and stated:

“No wonder you’re in pain. You’ve got a blockage again”.

Not long after this, back in A&E, some familiar faces appear around the curtain: The kind face of Saxon, one of the doctors, and her senior, a lovely pregnant lady who’d been responsible for getting you on the morphine pump only weeks before (lets call her Dr. B, B for baby). Their sympathetic eyes and words of “We’re so sorry you’re back here” were all you needed for the tears to come again. Their news wasn’t bad though. It’s just a partial blockage. No twists this time. No closed loop. “We will need to put a nasal-gastric tube down, and give you some medicine to try and unblock it though”. You were so relieved that none of that mattered. The tube was inevitable. And, last time, the medicine hadn’t even been an option. Bring it on. Along came your new favourite nurse. In one go, he got the tube down. Don’t get me wrong, I hate it with every fibre of my being, but when we work as a team and successfully insert it first time round, it’s a pretty proud moment.

“Oh, I was meant to use the bigger size tube”

“what?"

“no, no. It’s ok. We’ll leave it for now and see what the doctors say”

A little while later, de ja vu struck again. Saxon and Dr B reappeared. They tested the tube and confirmed your nightmare: “you need the bigger one I’m afraid”. Kindly, they said it didn’t need doing immediately and they’d give you time to compose yourself, to breathe and someone would do it later. Later came, after changeover, and another nurse took 2 attempts to get it down. Even more unpleasant than the last, the tube wider, the sensation worse. Only an x-ray could reassure her (and therefore you) it was where it needed to be. At least the wait for this scan was non-existent. The tube was in, the positioning fine, just a wiggle here and there. The medication was given late at night, a disgusting drink that reminds you of bonjela. As Tuesday night turned to Wednesday morning, you were moved back to the familiar confines of the ward you’d spent 11 days on, a familiar nurse appearing in the half light of the men’s bay (no space elsewhere) to re-canulate you before your least favourite drip, potassium, was connected up to your body.

The bigger tube is in...

What followed over the next week was both better and far worse than the days spent recovering from being cut open down the middle. It was better because the medical situation wasn't as serious. The tube was doing its job of clearing the blockage, the pain relief was effective, the doctors visits were, largely, reassuring. I say largely because, although in the moment things were fine, the particular doctor in charge of you (no longer Dr B. may I add) liked to look ahead. He would start by showing you the scans of your tummy, explaining, with a slight smile, that what you were seeing was good. Yet by the end, he would have explained that, should things not progress further, and should you still be unable to eat or drink by the following week, then surgery may be on the cards. He spoke of the unwillingness surgeons have to operate so soon in succession and the risks attached. Then he moved on from surgery and talked of parenteral nutrition – a necessity in the event that you reach a week without eating or drinking. You would be hooked up to some form of intravenous nutrition, either via another nasal tube (that would be one per nostril…) or via the veins. Both of these futures gave you nightmares. All this to say, while all these horror stories were verbalised, the reality, in the moment, was good and things were progressing well.

Gloomy with the state of my world
as you consistently sweated off the tape that stuck the tube to your face

The “far worse” part of this admission wasn’t really physical at all (the back pain, and bed discomfort equally as frustrating and painful as before however). No, instead, the problems arose from your mental health. With every admission into hospital, you end up somehow off your anxiety medication. This tends to occur because you are instructed not to eat or drink and you have to disclose the pills you require daily for your brain to work. The box of dopamine boosters is required to be put to the side and doled out by some medical professional who, more often than not, hasn’t even heard of that particular brand of pills. In fact, this time, aware of this, you’d intentionally not disclosed the box that sat in your backpack. You figured this meant you were in control. Except, you were also still highly aware that you couldn’t consume anything orally and therefore didn’t feel confident that you could take them at all. So you didn’t…1 day passed. 2 days passed. Your head felt foggy and dark. You were incredibly low. You wanted to be put to sleep until it was all over. You were scared.

Attempting to quell the shivering with your blanket from home
only to find it was too hot for that

Finally, you asked the question and were told that you should be able to take them. So you did. 60mg – that’s 2/3 of your usual dose. Within 20 minutes, mum and Steve held your hand and stroked you as you shook uncontrollably, your teeth chattering. You weren’t cold. You needed help and you wanted it to stop. Mum asked a kind stranger with a lanyard, walking the ward, if she could see someone from the mental health team. This kind stranger, a dietician, as it happens, was reassuring and within half an hour, a doctor appeared. She crouched down and asked you to explain how you felt. She reassured you that someone would come by in the morning. You would get help. They were going to help you. For now, you were told, take the pills but take less. You’d been off them a while and perhaps the jump was just too big for your brain to land comfortably. Start small.

The next morning, after your daily visit from the future-focused doctor man, 2 unfamiliar faces poked their heads around the curtain. A lady and a man, notebook in hand, heads tilted in that way of saying “tell me your woes. I’m here to help”. You blurted everything out and was reassured by comforting sounds and words. It was understandable you felt trapped, you were hooked up to all sorts of places and physically you were restricted. What could they do to help you? You explained about the Dr. Future and the anxiety his forward-thinking provokes. You asked again about the pills. They left and you felt slightly more seen. More heard.

From there, things improved: your head started to feel less foggy. Your tummy gradually unblocked. You followed instructions from the weekend consultant and walked 1 hour a day, 5 minutes every hour. The nurses became used to you pottering up and down, past the desk, between the window overlooking the hospital entrance, and the double doors at the other end. They’d smile: “another walk?”. Thumbs up from the jolly-faced surgical consultant, pleased to see you were on the move.

Saturday 2^nd July, day 5 of admission, and the good news really started. If nothing comes out of your tube by the end of the day, they’ll take it out! Never have you wished so much for something…or more accurately, for nothing. You were determined that nothing would come out of that tube. That day dragged…every half an hour you checked to see how much time had passed and calculated how much longer until the 8 hour timer the doctors had set would be up. Finally, you spotted Dr. B. Around 5pm, she popped in to visit the lovely lady lying opposite, and as she came to wash her hands, her departure imminent, you caught her eye.

“Shall we look at removing that tube then?”

Freedom!

Finally, you could drink comfortably without a straw. Finally, you could try eating little bits of ice cream and soup. Finally, you could sleep more comfortably, able to lie on your side without feeling the tugging sensation down your throat. Finally, finally.

You were told to take it very slowly with food. Dr. B. said low fibre for a week or so, no bread, no meat. The nutritionist gave you a list. Meat has no fibre. White bread is fine. Confusing. Sunday came and went with soup for lunch and supper, back to declining pain relief. Monday came and discharge was in sight…when mum arrived at 2pm, it was simply a waiting game.

"soft diet" - whatever that means...

You were finally free.

Since then it’s been a bit of a rollercoaster. You’ve been much more nervous. More…trepidatious. Nervous about eating and being very careful about trying new – by which I mean, old standard meat and vegetables you once ate without a second thought – things. Meanwhile, anxiety-wise, you’ve never been better…well, for a while that is. Despite being on 60mg less medication than before going into hospital, your heart rate has settled, and you’re suffering far less from the daily butterflies you had been before. For now, you’ve cancelled the heart specialist. Back at the GP, you left your last appointment with the nurse exclaiming how impressed she was with the progress of your scar – and that’s despite the poor wound care you receive in hospital, the lack of appropriate bandages. You’re bending over now without thinking about it and yesterday you ran (in as much as you do this faster pace of walking) up the drive.

Ironically: lower the dose of anxiety medication
and your heart rate normalises...

Next week you aim to start back at work, a week later than first planned, but not a week too soon. The last month and a half, almost 2, have been such a whirlwind. Emergency surgery, a triple bowel twist and a blockage, (very) slow healing, lots of sleep, lots of sitting, your brain all over the place. But finally, now, you feel ready. You know going back to London life, working 40 hours a week, 10 hours a day, is going to be a shock. You know you may need to be more patient with yourself than you normally are but…let’s give it a go.

2 days after discharge, mum arranged a spa afternoon:
hair wash and blow-dry, facial and pedicure

The countdown to, some semblance of, normality begins.

Be kind to yourself,

Yours,

Dear Ellie-May

Dear Ellie-May

It is perfectly fair to feel hard done by right now. Only a little over 5 weeks ago you were minding your own business, living life. In fact, that last normal day was very much that: normal. Working overtime to help out - and because a wedding is always fun to be around even if your attention is to be focused on the smaller guests. You may not have been able to catch up on the telly you planned, but you made a new friend - a fellow babysitter, sharing the empty house to the back drop of a live band and excited partying guests just beyond the window. You battled with the decision of whether to abandon your new friend or not and finally accepted it was necessary knowing the early hour you may be awoken by your adorable roommate, currently sweetly snuggled in his cot. You headed to bed, a few minutes of reading ahead of you, and fell asleep, waking on and off to very carefully reposition yourself noiselessly.

And then that final wake up...the identification of that slightly too familiar discomfort somewhere in the centre of the abdomen...really? Could it be the usual? You felt fine as you drifted off, you felt well enough for the 2 pasta-based meals you'd made yourself the lunch and dinner time before. You even took advantage of the beauty which is the ice cream drawer, filled to the brim with tubs and packets of dessert delight. At 10pm...was that what did it?

There's no use questioning it all now. The point is that 24 hours later, you were on a trolley in A&E. After a gruelling morning spent navigating your way home via taxi, train and Uber, while your insides felt like tiny men with pickaxes taking to your internal organs. After what momentarily felt like a relieving bubble bath that has been known, in the past, to carry you through an episode. After discovering you couldn't sit, lie or, God forbid, move, anywhere comfortable. A call to 111. A returned call from an out of hours GP. Advice to head to the hospital.

This is where it really began. Told to leave you at the entrance, Steve was sent home and you forced to hunch, tears streaming down your face, as you were asked question after question by the receptionist, to register before you could be seen by a medical professional. Luckily, after that, they did move a little faster. Your extreme discomfort clearly evident, you were triaged relatively rapidly. "Tell me a bit about your medical history and what's going on today,," Says the nurse who, to all intents and purposes, is just figuring out who to give you to. Between heavy breathing and the shivers, your sobs and the spasms of pain, you run through your history, making it clear this isn't unusual for you and you're pretty sure you know what it is and what you need.

Shortly following the insertion of the NG Tube

Several hours later, it is clear you do indeed know what is wrong. Although, in this instance, it is far worse than you could have imagined. They tell you early on that what they're seeing on the scans is worrying and it's possible an operation will be needed but you are able to distract them with the story that your previous medical adventures tell. That is, until 2 am, when back the junior surgeon comes, surrounded by friends of indeterminate status, to tell you they could wait no more! White blood cells are mentioned. The bowel is twisted...not once, not twice but three times. Infection is inevitable. Blood supply is hindered. Waiting is not an option. The choice is yours. But if you choose wrong there's serious repercussions.  Are these men in scrubs simply being knife-happy? Its 2am. You're tired but unable to sleep. You're in pain and you're alone. You want someone to tell you what to do. You call mum. "They want to operate". Well, you've been here before. The same questions as ever: can't they wait and just see what happens by the morning? Is it absolutely necessary? Are they SURE they can't wait just a few more hours? Of course, it's your choice. It's your body. You ask to meet the surgeon who will do it. The one who has supposedly "heard" about your scans and wants to intervene. You, understandably, want to meet this man with the knife. This man who holds the future of your bowel in the palm of his hands...almost literally. The young surgeon rolls his eyes as mum - over 40 miles away but clear as a bell over your Samsung phone - and you, foggy with pain, beg (in your case) and demand (in mums) to talk to this boss man face to face.

Half an hour later, there he was. The kind, smiling face of a man who stroked your hand and spoke softly. He explained the situation simply: leaving it could be life-changing. There wasn't even the need for mum to use her go-to question as Mr M. Reassured you himself that "if it were my daughter, I'd be doing the surgery". What's more, he went on, he would not be here, at the hospital, at 2am, out of the comfort of his own bed at home, did he not feel it necessary. So that clinched the deal.

Risks hazily understood and paperwork signed, what followed was the only really enjoyable bit of the whole affair: the anesthesiologists. Kind faces joked that this first drug would make you feel like you'd had a triple G&T. Wonderful. This second one would do something else...then the mask...

"Hello Ellie. It all went well"

Fade out again. Waking under a warm blanket in a large room. An empty room. Just you and a man pottering around. He gave you another blanket and told you you'd be moved soon. You couldn’t feel your legs...you couldn’t feel anything. It was blissful. You dozed some more. Eventually, via a brief pit-stop elsewhere, you were introduced to your home for the next 10 days. A room with a view: London’s skyline in the distance beyond the foreground of Archway, North London. The shard stood tall in the distance. A beautiful view for those who could move sufficiently to see out of the large windows lining the wall feet from the bed. Had it been a hotel room, one probably would have been pretty pleased with what they got. For you, the outdoor beauty mocking as you lay inside, the numbness gradually fading to be replaced by indescribable discomfort and pain. You genuinely can’t describe it because you've probably blocked it out. Every movement was defined by the reminder that you'd been sliced open, right down the middle.

I made it to the chair

From your bed, you couldn’t even see the door to the ward reception outside. You couldn’t indicate to a passing nurse that you could no longer reach the buzzer or ask “When am I due more pain relief?”. Occasionally, one would wander in, hand you a syringe of oral morphine, or attach a new drip of Paracetamol or potassium rich fluids, and then leave again. Nothing seemed to dull the pain really though. The nights were the worst: right from the start, you dreaded the drawing in of the days and the very gradual darkening of the sky. You can only thank your lucky stars it was summer and the day only ended as the time hit double digits again: 2200 and the sky still light. Even then, you dreaded the quietening of the ward activities, the departure of the day staff. You didn’t have the energy to read or distract yourself, no way to make time run faster. Instead, you’d lie there, on your back, tube scratching at the back of your throat, unable to turn your head comfortably one way or the other. You’d watch the clock ticking directly ahead on the wall opposite; 23:09, 23:10. The minute hand seemingly moved slower and slower with every second. Maybe you’d doze…23:29….so it continued. Watching the sun rise again. Another night of sleeplessness. At least the buzz of activity began early: Between 5-6am the first visit from a Health Care Assistant, arriving to take your blood pressure and pulse. To remind you, once again, that you were tachycardic, something consistently heard from seemingly every member of hospital staff since walking into A&E with a heart rate of close to 150bpm. By this point, it was nothing to write home about: 120? 105? That’s practically nothing.

“let me just put this on your other hand”

“I’m just going to put it on me…70bpm? Oh, so it’s not broken.”

“I think we’ll do an ECG”

108bpm...practically nothing for me

They were always normal. The ECG’s. Nothing of concern. Nothing of note except your body just ran slightly fast…Wouldn’t anyone's pulse be slightly fast too if they were in serious pain and had a cut right down the middle.

Through all this, not a doctor or surgeon in sight. Surgery: 06/06/22, your first visit from a doctor or surgeon: 08/06/22. Her first questions: “so, what pain relief have we got you on? Why are you so anxious about coughing? You’ve got a morphine pump, yes?” No. No you do not. “why not?”. You had been wondering the same yourself. After your last surgery, in 2015, you woke up in ICU with the pump already attached. You could recall the magic of being able to press that button every 5 minutes and the increasing numbness of your body as the morphine rushed to do its job and take control. Not this time.

“oral morphine? You’ve got a nasal-gastric tube…anything and everything you take orally comes back up. That oral morphine won’t have touched you”.

Well…that makes sense. Great. 2 days post major abdominal surgery and, essentially, You’d been receiving minimal pain relief.

“I won’t stand around making small talk. I’m going to get the pain management team onto this”. You could have cried when she walked in the room and introduced herself. Manage the pain! Hook you up! Take it away! Within half an hour, you had your button. Within an hour and the arrival of your sister, she exclaimed “I’ve never seen you high before”. Finally, things were on the up. 15:30 – Press, 15:35 – press, 15:40 – press. Well, this is great.

The magical Morphine button

The physio got you out of bed: teaching you how to avoid using your core, to raise the bed upright, lie on your side and swivel your legs. First, you just sat on the edge. Then gradually built the courage to move to the chair half a metre away. Day by day, the chair became your new place to sit. Much more comfortable than the plastic mattress-ed, backache-inducing bed.

You were taught how to breathe and how to cough. You were encouraged to exercise your lungs every hour: 3 breathes in and out, in and out, in and out. In, hold, out, in, hold, out. In, pretend-to-fog-a-mirror, out. Repeat. Cough. It turns out, after all that breathing and coughing malarkey that your lungs still weren’t happy. An infection was identified and antibiotics introduced. You even got a bonus face accessory in the form of an oxygen tube. Another toy to drag around when You moved from bed to chair and back again.

Then the joyous day came: Saturday 11^th June. The nasal tube came out. The catheter removed. It almost felt like freedom. “free fluids” your board stated in dark blue marker. A cup of orange juice, water, water, water, tea? Yes please!

Notice anything missing from your face?

That didn’t last long though. A discomfort began to sit with you again, something indescribable. You couldn’t figure it out but you lay all night unable to remove it from somewhere inside. Unable to get comfortable and, again, watching the clock count down the minutes until just before 6am when you guessed youe dad would be awake. You sobbed on the phone, unable to clearly express the discomfort you felt. You sobbed to dad, to your cousin, to your sister, to your aunt, to your mum. A nurse readjusted your bed, lowering it entirely and tinkering with the support beneath your back and legs. Unbearable. You tried standing, you tried sitting. Nothing would ease the feeling inside. Until it did. All the fluids they’d confidently encouraged you to start on the day before, reintroducing themselves and informing you that the internal set-up still was slightly frozen in time. Nothing, as of yet, that you introduced to your body, was going to be dealt with, and must instead be removed through the way in which it came. The relief. A weight lifted off your chest: a weight of orange juice, water and tea.

Everyone took a step back.

You moved to a bay, a men’s bay, because your room was needed for someone else…then another side room where more people could finally pay attention to you as they passed.  Please can you leave the door open, you'd repeatedly ask. Your fairy godmother brought you dry shampoo and brushed your hair, your mum distracted you with stories from home. You began to listen to podcasts outloud on your phone and occasionally get an hour or 2 of sleep. You grew slightly more confident to look at the scar when a nurse would finally come to change the dressing. It wasn’t pretty. Certainly not neat. you’d have forgiven them if a small child had admitted to over-excitedly drawing it on with a pink or red marker. Without warning, a nurse pulled at your skin drawing 2 or 3 staples out. You squeezed mum’s hand and cried. You’ll never be able to forget that, not while you look in the mirror and see that wider, circular area of scarring, that’s still taking far longer than the rest to heal.

You began to drink again, and then to eat: “soft diet” the board above the bed said. Shephard’s pie? Don’t mind if you do. Finally, the last 8 days of no food are hitting that spot just in the middle of your tummy. The growling has reappeared. You’d missed it. Jelly? Not the best. Ice cream? Yes please. Then day 11 came round. Over the last few days, a change had occurred. Instead of lying in bed, in pain and exhausted, you sat out in the chair, crying with boredom, fed up of the discomfort of the cannula in your hand, declining the offer of pain relief because you didn't really feel the need. You wanted to go home.

Day 11. The doctors round brought with it the words you’d been dreaming of: “well then. What do you think about us getting you out of here?”.

That evening, a plastic bag of drugs and dressings at your side, the cannula removed, you slowly manoeuvred yourself to the chair, out of your hospital gown and into pyjamas, out of those tight, anti-clotting, green hospital socks and barefoot into your shoes. You gathered your bags of belongings, slowly drew yourself to your  - slightly hunched – fullness of height, and walked out of the hospital and into the light.

Ready to go home...for now

“If you have any symptoms, don’t hesitate at all to come back…” reassured the doctors to your departing back.

But that's for another day's letter.