Over or under reacting? *trigger warning*

A different topic tonight.. back to myself rather than on my cat, although she still has me quite worried.

I had therapy today.. and it was not a very successful appointment, in my opinion. Lately, I am struggling with human interaction outside of work.. not sure why I manage ok at work. Much more predictable, maybe? Narrower range of conversation topics? I did almost cry last night, but this is mainly exhaustion.

I still am not sleeping well.. a combination of stress, poor habits, and various pills. I was up fairly late, so I got maybe 5 hours of sleep.. so I was a bit off during the appointment. At some point she commented (not asked) that I was still not eating.. and I corrected her that I have been eating better. She said I seemed more distant, like I do when I'm restricting. I also wonder if I look thinner? mainly because a coworker commented on how much weight I've lost and asked if I was still losing the other day. I shrugged, and she said I still was.. same coworker has told me I don't need to lose weight. I'm confused because I'm not losing weight.. but that's not the point. I explained to my therapist that I was tired and not sleeping well. I said I was staying up late.. I also commented on the fact that I had not been taking my Wellbutrin, but I had started again.

She starts saying something about me being on Wellbutrin, and does my psychiatrist know I've been purging? There's a risk of taking it with bulimia because it increases the risk of seizures, which is already higher because of electrolyte problems.. or something like that. She says she should call him. I say that he knows.. he knows I have bulimia, and please do NOT call him.. I have a terrible history with anti-depressants. I have been on more than I can list, and the majority haven't worked. This is one of the few that has helped some (at least when I take it), and I don't want her making him take me off it and start the search for something else. I've taken wellbutrin in the past while the bulimia was active, and I've never had any problems.. so why this reaction now?

At some point, I think the topic of sleep came up, and I made a comment about caffeine. She asked if I was taking caffeine pills. I should have just said yes, but I said I was taking diet pills. She asked what kinds, and I gave the names.. for some reason, I don't like people thinking I take caffeine pills. Not sure why.. it seems like something only college kids do. I also gave the brands because I am in a sick, little way proud that I take unusual diet pills. Not that unusual, but not the traditional HydroxyCut and things that are advertised on television. She asks if I'm taking laxatives, which I'm not.. that's one thing I have never gone back to after I stopped during my first treatment. Thank God for that. I did mention the ephedrine.

So now she's insisting I see a cardiologist. Well, I have to go through my primary care doctor to get a referral first (insurance requires this), and my therapist wants me to have made that appointment by the next time I see her in 2 weeks. She offered to call and explain why I need the referral, but I said no.. I am not a fan of that idea. But basically she's convinced that because of the bulimia and the weight loss (like 80 pounds in less than a year) and the diet pills and all that, I might have heart damage. I wanted to comment that I was doing all this and more when I went to treatment in 2007, and my heart was quite healthy. That my blood pressure and tests have always been perfect. So why is she so convinced I probably have a leaky heart valve? I didn't argue..

Why did I not argue? well it would be pointless, but also I suppose part of me acknowledges some risk. Wednesday at work, I felt poorly most of the day.. there's this sort of sensation that I normally equate with anxiety that feels like something is wrapped around my throat. A tightness. I wasn't particularly anxious, so I thought maybe the caffeine? I only just recently added the ephedrine back into the mix.. so maybe that was affecting my blood pressure. I have this nervous habit (that hopefully nobody pays attention to) of taking my own pulse. Not sure when that developed, but I spent the evening checking that it wasn't too fast. It didn't prevent me taking another diet pill and another ephedrine while at work because I was tired. Well, add to the throat thing that I have been getting dizzy randomly again. Not often, but if I stand up too fast or sometimes taking stairs.. I get lightheaded. And the occasional odd feeling in my chest, but that may also have been anxiety. So maybe there is something to the risk. Today, I've gotten dizzy a few times when I bent over and stood up again, but otherwise I feel fine. I didn't tell her any of that because knowing the way she was being about the thought of me taking diet pills, she would probably have decided I needed to go to the emergency room or something.

I actually had been doing better with eating. Now.. this meant mostly eating a bunch of chips or crackers while working and then a meal that usually was a salad... although a salad with chicken and cheese and dressing. Together this probably adds up to a decent amount of calories.. then I usually eat something random again if I don't end up binging and purging... which I am not doing everyday now at least. Tonight I did, and at some point I was standing after filling a bottle of water and my vision went a bit white.. like seeing spots. So I'm thinking dehydration is probably behind a lot of the symptoms.
So I'll probably call my doctor and make an appointment.. if she thinks the cardiologist is justified, maybe I'll go.. maybe I'll just hope my therapist forgets about the whole idea. Either way, tonight I'm taking a potassium pill and drinking some water.. then I need to get some proper sleep.