1. Weekend with Alexis and Simi
Alexis and Simi came to visit Boston this weekend and saying it was a blast is a complete understatement. Friday we had lunch at Dig Inn and then explored Boston on bike and then ate dinner at Kava – an amazing Greek restaurant in the South End I highly recommend. Saturday was the greatest – we took a day trip to Portland, Maine. I’ve been wanting to go forever! We picked up donuts from Holy Donut when we got there and planned to take a ferry ride but then the boat got too full and we couldn’t get on which was a bummer. Oh well.
Instead we sat on the dock eating donuts and then spent the morning walking the Back Cove Trail along the water before stopping for lunch at Local Sprouts Cooperative. After lunch we went stand up paddle boarding (the water was choppy and the tide was strong – aka it was HARD) and then went to Urban Farm Fermentory – a really cool place that has all kinds of kombucha, hard cider and beer on tap.
We ended the day with dinner on the water at Portland Lobster Co. where we listened to live music, sat outside, and ate lots of lobster. I’ve never eaten a whole lobster and probably never will again – give me lobster already cleaned and stuff. But it was delicious and the atmosphere was so fun.
Sunday, we brunched over in Cambridge at Alden and Harlow and then strolled around Cambridge and then drove over to Jamaica Pond to walk and explore. We grabbed Whole Foods hot bar for a quick dinner on the way back and then sadly said goodbye. It was such a great weekend. I wish they lived here!
2. Pinterest Gem
I found this image on Pinterest and thought it hit the nail on the head. I love when you find words from someone else that articulate a thought so well. I hope this is encouraging or motivating or whatever you need it to be for some of you reading. <3
3. Update on my NP job
I had a few people ask for some updates on my NP job in one of last week’s post and so I thought I’d share some. I’m not intentionally withholding, I just forget/didn’t think about sharing. Oops! I mentioned back in May that I was starting a new NP job at an inpatient eating disorder hospital. For those of you that have stuck around long enough for the saga…essentially it took WAY longer for me to get licensed in Massachusetts than I ever anticipated (5 months vs what I naively thought would be 6-8 weeks) so the delay in job was partly my fault, some of MA Board of Nursing for being characteristically slower than normal, and quite honestly…finding a job in women’s health and/or eating disorders was slim pickings. It made me realize how lucky I was for the quick job search process after graduating in New York!
I’m about a month in now and really enjoying this new job. The biggest adjustment for me has been 1) not being in the outpatient setting and 2) not have the responsibility of also being a patient’s primary care provider. I have always worked outpatient as a nurse practitioner (and an RD) so being in the inpatient setting is a totally different environment and higher acuity (obviously) so that was an adjustment. I’m use to caring for people for months and months, but with inpatient it might be a few weeks to a couple months max. I do LOVE the collaboration, multidisciplinary environment and high quantity of clinicians and providers in this setting versus my old job where it was a primary care office with myself and the physician. There are A LOT of things I miss about my last job (the physician was amazing and thankfully we still collaborate since he medically manages some of my private practice clients, I loved being able to do a lot of eating disorder work but also bits and pieces of everything else – mainly women’s health and then anything else that walked through the door, I loved the family like feel of the clinic, and much more) but I am finding myself enjoying the unpredictability of the inpatient setting and the acuity of patients and everyone at this new job has been so kind and welcoming.
Right now I do admissions on the inpatient unit and then also cover when the attending physician is out – I also see some patients in residential when they’re admitted. One perk, the flexibility! In the outpatient setting it’s normal business hours and you have to stay on time with patient appointments. I suck at staying on time, so I found that really stressful. In the inpatient setting, I can spend more than 15 minutes with a patient. Because there aren’t “times” you meet with patients, you can spend as much time as you need. If a consult comes in, acuity is prioritized and I see the patient as soon as I can. All new admissions must have a history and physical and initial assessment within 24 hours. Before that, they are seeing other important people like the RD, therapist, nurse etc. So for me, not being on that “only 15 minutes for each patient” time crunch is less stressful and my work feels more thorough. I also really love the non conventional hours – sometimes I work 7am to 2pm and sometimes 10am to whenever all the patients are seen. Some people thrive in a structured, regular schedule. I’ve learned over the years that I really work best with a lot of flexibility. That’s that for now!
4. Tips and strategies for eating foods once “off limits”
I think one of the most frustrating and misleading things when beginning your IE journey is this idea of “if you give yourself full permission to eat ____ food you’ll stop binging, overeating or having negative experiences with that food.” That idea is a lot of times false and can possibly make someone feel a lot of shame and like they’ve failed if they give themselves permission to eat a food, and then they aren’t able to eat that food intuitively right off the bat. Maybe that resonates with you? If so, I 100% hear you and you aren’t doing anything wrong. Think of intuitive eating as a skill. You have to learn the fundamental skills in order to move onto more advanced skills. If I came home tired and stressed from the workday and was feeling really hungry and there was a pizza leftover in the fridge and I was by myself that night…I’d probably overeat that pizza too. I’m really vulnerable in that situation! I’m having a human experience. So when we are working with clients, we get strategic about introducing previously “off limit” foods to bring down as many vulnerabilities as possible so you’re in the best position to have a positive experience. Here are some things to consider that might bring down some of those vulnerabilities..
- start with a low anxiety food not with a food that you feel most anxious about (for example, a homemade granola bar versus a cookie)
- make sure you’re not super hungry before eating – if you’re eating ice cream or a cookie, maybe you eat that after a nourishing lunch or dinner, if it’s pizza maybe you have a slice when you’re about a 5 (neutral) on the hunger/fullness scale
- eat with safe people – sometimes eating alone can make us more vulnerable to negative food experiences, but eating with a close person (parent, spouse, friend, etc) can make it easier
- eat in a calm environment, not when you’re feeling really stressed or highly emotional
- plate the food and have a plan for what to do afterward finishing the portion – will you go on a walk, do deep breathing, journal or do some painting or coloring?
Then once you build some skills around that food you can move onto more vulnerable situations because you have more skills to deal with that.
5. We’re having a baby boy!
Saturday, I let the cat out of the bag on instagram that we are having a BABY. That feels nuts to type out. I didn’t have a plan for when I’d share, but as the weeks went on it felt really special to be sharing in this with just our closest people and family for the first half of this pregnancy. We will be halfway to 40 weeks this weekend and now time is flying by! It’s been a wild mix of emotions over the past several months – surprise, shock, deep gratitude, fear, sadness and guilt, excitement and anticipation all mixed into one. As we were planning to try for a family this summer, I was prepared to face fertility struggles. My mom had fertility challenges and I struggled with 10 years of hypothalamic amenorrhea. I also work with so many women who walk the painful path of infertility and have friends and family struggling to conceive right now and friends who have lost babies.
When we found out we were pregnant, knowing all that loss in the midst of our gift was really hard for me to process. I was excited we were pregnant, but also felt really sad and guilty that we had the gift of a baby when others wanted that gift too and had been through so much pain and heartache. It felt too good to be true, so for the first trimester I was terrified something would go wrong. I’m still fighting anxiety and fear which I think some of that is normal based on what other women have told me. I was all over the place emotionally. I was also nauseous most of the time, exhausted and just blahhhhh. Seeing human life form within my body though, has given me a deeply rooted sense of gratitude for pregnancy that I didn’t have before hand. It is nothing short of a major miracle. If seeing baby announcement is hard for you, my heart is in both places and I’m thinking of you. And know that this will not be a space filled with pregnancy posts. If there are topics that people would like to hear about related to pregnancy, you can email me or share in the comments and I’ll make a note of them, but I won’t be posting regular updates. And lastly, THANK YOU SO SO MUCH for all the love you showed us on social media – I was BLOWN away by all your caring comments and read every single one. You are so incredibly kind. Thank you for celebrating with us in this new adventure!
Have a wonderful week!
![When You Need Some Introvert Time [Weekend Recap]](https://www.thereallife-rd.com/wp-content/uploads/2017/08/FullSizeRender-146-1-150x150.jpg)
First of all, CONGRATS on your baby!!! I’m so excited for you and Nick! I would love to see some posts about IE while being pregnant as well as handling body changes while pregnant.
Also, thank you for your thoughts on eating formally off-limit foods. This is something I want to be better at. I do eat formally off-limit foods, but still experience guilt many times. Thank you for all you share!
Thank you Katherine! <3
I've gotten A LOT of requests on body image + pregnancy so I think that will be really helpful for many readers in addition to an IE posts - I'm writing those down.
Glad the content was helpful!
EEEEK BABY! So excited for you, I’m sure I’ll enjoy reading updates 🙂
Thank you Emily 🙂
I am SO happy for you both – you’ll be the best parents! Congratulations!
I’m also really interested to hear what an inpatient eating disorder facility is like… I’m sure you can’t share much but as someone who considered going to something similar a few years ago, I’m always curious. I hope you continue to enjoy working there!
I’ll share as much as I am able 🙂 Thank you Katie!!
Thanks for sharing the big news with us!! I’d love to hear about IE during pregnancy and if that has changed at all, how you’ve been feeling and dealing with bodyhanges emotionally, etc. I actually am someone who is struggling to conceive and I SO appreciate your empathy and just carefulness with your words. That being said, I am hopeful and want to see how IE/HAES gets played out in pregnancy because it is a vulnerable time, and we will all face vulnerable times (whether that be pregnancy or some other life event). So much love to you Robyn!!
Thinking of you Becca and thank you for reading while being in a hard place <3
I think I will write out IE/HAES In the context of pregnancy since a lot of readers would find that helpful.
love to YOU Becca!!
Robyn,
Thank you for sharing your thoughts. Glad your new NP job is going well. Thank you for providing tips on how to eat “off limits” food.
Congratulations on your journey of becoming a mother!! I pray all goes well! 🙂
Thank you Becky!! <3
Congrats again!!! I am so so excited for you <3 You guys are going to be fantastic. Love the tips on off-limits foods, especially not being super hungry before eating them. In the past, I had discovered that was key for me. What an amazing weekend with two amazing ladies! Sounds like one for the books 🙂
Thank you for sharing how that was helpful for you Nicole!
I am so happy for you and Nick, Robyn. God has blessed your son with wonderful parents!
Those words from Pinterest were PERFECT for me today. My husband and I are on vacation, so the words touched my heart and soul. Thank you for sharing!
Love,
Julie
So so glad those words resonated Julie <3
Enjoy your vacation!
This post was everything I needed to hear today. Honestly, I was debating whether or not I was going to read the Monday posting after seeing your Instagram. I was so happy to see you are expecting, but I am one of those women who has been trying to get pregnant for many, many months and it just doesn’t want to happen. Not that I think women should have to be so careful about announcing a pregnancy, or check their happiness and excitement, but thank you for your candor and compassion. With the space that you work in especially, pregnancy can be such a sticky subject. Your baby boy is so lucky to have a mother that cares so much and has such an emotional awareness. Thank you for offering such a safe space for everyone to learn, share and be vulnerable.
I hope this is a safe and compassionate space for you Hillary and I hope it stays that way, but if it all becomes hard know that you are human and I am thinking of you! Do what you need to do to care for yourself. <3 Love to you!
Honestly I’m a little shocked that you mentioned one of the perks of your job being that you don’t have to be punctual. Your patients are the sickest of the sick. They’re absolutely terrified, especially during those first few hours in the IP setting where they’re clinging to their disorder so tightly. As a clinician, shouldn’t it be your first priority evaluating them as quickly as possible? The women you treat are physically and psychologically vulnerable and they shouldn’t have to wait up to 24 hours to be seen just because it’s more convenient for you not to be in a “time crunch.” Imagine one of your patients reading this post. Is that the image you want to paint of yourself as a provider in this community? One who works with complex patients at their lowest points, but doesn’t care to treat them in a timely manner?
First time commenter but saw this and had to say something because you’ve obviously never been in an inpatient setting. I think you’re imagining it to be like an ER…which it’s far from. I’ve been admitted to inpatient many times as an ED patient and it’s probably nothing like what you’re imagining.
You’re monitored full time by nurses and nursing assistants. There’s a protocol. You get labs and evaluated while being admitted (which is done by a doctor btw). Yes, some patients are “life or death” and they would be admitted to a hospital if that’s the case. Most are not and at that point they just need to start going through refeeding (which is not done by the MD) and stopping symptom use. In inpatient, the nurses are the ones that have the most contact with patients.
It’s also during the initial admission (before any evaluations) that IVs, feeding tubes, blood sugar checks, or any other order is placed. Then, it’s the nurses responsibility to administer.
There are SO many evaluations: therapist, dietician, occupational therapist, physical therapist, health practitioner, and a doctor. At the point that Robyn is talking about, that “24 hours”, the patient is stabilized and under full time care. A working day is 8 hours, so that’s fitting 6 evals in an 8 hour time frame. A patient usually wants to see the dietician first (meal plans, food preferences), then the therapist second.
If they have a MEDICAL emergency, they will talk to the nurse and the doctor/NP will be notified immediately.
And lastly, from the vibe and obvious passion Robyn gives, do you really think she wouldn’t evaluate an incoming patient’s needs and not treat them in a timely manner? Are you crazy??!
Hope this clears things up for you!
I actually spent several stints in an Eating Disorder Inpatient setting, surrounded by caring docs, nurses, therapists, psychiatrists, technicians, etc, which is why I was so taken aback by Robyn’s original statements about her hours at her new job.
Perhaps you were in a different sort of facility, but my initial intake process was very similar to that of the Emergency Department.
To answer your question – no, I am not crazy.
I wish you the best with your continued ED recovery.
Like Laura, feel like I have to jump in too, because there is a zero percent chance Robyn would handle patients the way you’re implying.
I think the point of that paragraph, which I found to be very carefully worded, was that she likes the flexibility because it allows her to spend MORE time with her patients. She did NOT say “I see a newly admitted patient when I feel like it”, she said “I see the patient as soon as I can”; meaning if she’s with another patient she’s able to give that patient as much attention as they require, while a newly admitted patient is seeing “other important people like the RD, therapist, nurse, etc.”. You make it sound like an acute patient is sitting in a waiting room somewhere, which is definitely not the case based on what Robyn wrote.
Hi Hillary – it sounds like your experience in the inpatient setting is different than the flow of where I work – we aren’t triaging patients like in an ER. I hope the other commenters were able to clear up any confusion for you. If you have questions, feel free to ask to bring some clarity. Caring for patients in the way you describe in your comment would be unethical and malpractice and would certainly not fly in any inpatient setting nor is it how I practice.
Congratulations! What a blessing and your words were so kind to think of others that may be hurting! I can tell you totally “get it”. I’m so thankful to have found your page and the information you share has been very helpful to me on my journey to recovery.
<3 thank you Jennifer!
I am so excited for you and I look forward to following you on this journey! I just recently found out I am pregnant, very early, but he/she is in there! Your worst fears became my reality when after years of hypothalamic amenorrhea, my body was not cooperating with my plans. After a year of several procedures and medications, we ended up at IVF which thankfully worked (for now… fingers and toes crossed)! I hope you do include pregnancy related posts if you feel inspired, perhaps just have them in a separate section of the blog for those who are interested. Xoxo
Congrats to you too Allison!! And my heart goes out to you in your journey to a baby – you are so brave and I admire you so much.
Lots of love to you and prayers for a healthy baby <3
Hi Robyn!
I just wanted to wish you congratulations!! And tell you how much I appreciate the thoughtful and inspiring content you put out. Your posts have been incredible helpful in my recovery process, and are continually useful for helping me to understand intuitive eating. I love #2 – it is absolutely TRUE. Do you know what the source is?
Thanks! Hope you have a wonderful week 🙂
Thank you Rachel!! I am so glad the content has been helpful for you <3 I linked to the image link that was provided on Pinterest in the first sentence 🙂
Are you for real?
1. She’s PREGNANT and therefore should not not be trying to lose weight!
2. This is an anti-diet blog…
3. “Detoxes” are bogus, unnecessary, and unhealthy.
Thank you for your response Katie! That commented on detoxes ppl should try was deleted 🙂
sending you a big congratulation! it sounds like you guys had a lovely weekend. Boston and Maine are both so lovely to visit esp this time of the year.
Thank you Dixya! Maine was lovely!!!
Congratulations to you and your husband! I love being a boy mama. My boys (4 and 1.5) are energetic and don’t stop moving and yet always have time for cuddles with Mama! Pregnancy anxiety is so real and when that baby is born, you’ll never stop worrying about him. Being a mom is the best and yet scariest thing I have ever done. Thank you for your sensitive announcement as well. I had HA and anorexia which caused infertility for years. While that ship has sailed and there won’t be any more babies in my house, I appreciate you thinking of those suffering.
And I love the Pinterest quote in #2! That is exactly what recovery looks like.
I grew up with 4 brothers so I can only imagine what it will be like to have one of my own! I heard someone say, “you’re worrying now, wait until they get into the world.” and that hit me hard. Thank you for sharing some of your fertility journey Amy – I know others will be able to relate <3
Yaaaaay!!! Congrats on your pregnancy, you and Nick will be amazing parents.
Thank you Mary!!
SO beyond excited for you! Also, thank you for sharing your fears and concerns so honestly and vulnerably. As someone recovering from hypothalamic amenorrhea, I am SO encouraged to hear how, despite your 10 years of battling, have become pregnant. I know this is not everyone’s story and I definitely do not want to downplay those, but I am so ecstatic and encouraged by yours. <3
Thank you Sarah!! While not everyone’s story, I am beyond grateful for this little life. I’m glad it was encouraging <3
OH ROBYN!!!! I am SOOO sooo super pumped and excited for you; what a gift from God this little boy is. It’s incredible to me when a girl who has gone through HA or fertility struggles gets pregnant. I often wonder if I would ever be able to have a baby when/if I get married, but I LOVE your story Robyn.
Thank you for that way of describing true recovery. It is stepping out of the boat and really going after gaining some weight, gaining fat, gaining life, gaining happiness. 🙂
Thank you for your kind words Emily 🙂
And you gain so many positive things!!
Congratulations on your big announcement!! I am also pregnant (10+ weeks) after trying for a year and dealing with HA for about 7 years. I can totally understand your hesitation to share your news and your mixed feelings. Like some others have mentioned, I would love to hear how you manage intuitive eating during pregnancy, given the aversions, nausea, mood swings, fatigue, etc. It’s challenging but also fun to be so in touch with my body during this time. I feel like intuitive eating has never been more important that it is right for now for me. Wishing you all the best!
I’m making note of the IE topic request and congrats on your gift!! Love to you!
I can’t believe I missed your announcement on IG this weekend! I was SO surprised and excited for you when I read your email newsletter this morning!! Congratulations 🙂
🙂
Thank you Brittany!
Congratulations, Robyn! I truly admire your honesty on the variety of emotions this pregnancy has brought to light. It is also very humble and considerate of you to acknowledge the painful emotions it might stir in others. Tempering the number and frequency of pregnancy posts further demonstrates your empathy❤️
Thank you for your supportive comment Kerragh <3
And thank you for the congrats!
Hi Robyn!
Congrats from the Azores!
I loved being pregnant with my now 20 months daughter and I always focused on the thought that it is such a happy and beautiful gift. That’s my greatest advice 😉
Thank you Ines for that <3
Congratulations!
Thank you Susan!
New town, new job, new BABY!! Amazing!! Congratulations on all your success Robyn. I have been following you for what seems like a really long time now and it really has been great to hear about your life. I am excited about hearing more about your job and it sounds SUPER interesting. I also have no problem with pregnancy posts. I have in the past with other bloggers, but I think it was more because I struggled with the thought of having a child and the responsibility that comes along with all that. But after reading about Anne and Kylie’s journey, I have found it so grounding and refreshing to learn through their eyes the reality of motherhood. Congrats again!
Thank you Amber for your excitement and sharing in that with us! 🙂
Congrats!!! What an exciting time for you! Thanks for sharing this post. XOXO
Thank you Shoshana!!
First off congrats!
Second, one topic I wouldn’t mind if you wrote a little bit about would be overcoming the idea that you need to clean your plate.
I’ve read “Intuitive Eating” and am currently reading “Health at Every Size” so maybe it’s mentioned in the latter, but that’s something I’m having trouble with. When I was growing up we were always told to clear our plate or we couldn’t leave the table and I’m finding that that is something that is still impacting me that I can’t seem to shake even if I’m full. Thanks!
I havne’t had that topic but I love it! Know you are not alone in that mindset from childhood
Congratulations!!! I cannot wait to see little bits of your journey into motherhood that you choose to share. I am in my first trimester now and could see how your occupation and public life would impact how much you want to share with readers.
I do have a pregnancy related questions. I’m wondering how you took care of yourself with food and movement first trimester. I am normally active, but feel so much lower energy and have not been moving as much as usually feels good. Additionally, I’d like to listen to my body about foods that sound good, but all the bland foods that work for nausea don’t always help the slower digestion. How do you strike a balance?
Also, how do you combat the discomfort that comes up normally with a changing body – and all the pressure to not “gain too much.” Unfortunately at my very first appointment, the midwife proceeded to tell me how important minimal weight gain is and how she’d like me to gain less weight than the range normally discussed. (And I’m not in a larger body!) So many challenges with IE/HAES and pregnancy, even if you’re in a good place. (Sorry – so many words!)
Thank you so much Emily!! And congrats to you as well!! I will write some posts on IE, body image and movement in the coming weeks/months since I got many requests so look out for that! I hear you with IE/HAES and obstetrics!
I had the biggest smile on my face when I saw your instagram post announcing your pregnancy! Also thank you for your humbleness and gratitude and awareness of those of us struggling with fertility issues but your story inspires me as a fellow HA (trying to recover my period) that it is possible! CONGRATULATIONS!!! I look forward to watching your journey to becoming a mother and welcoming your baby boy!
Thank you so much Courtney for your kind words!! I am thinking of you in your journey of HA recovery <3
Congratulations!!What an exciting time for you. I cannot wait to see little bits of your journey into motherhood that you choose to share. Thanks for the sharing such a inspiring article.
Thank you Leslie! 🙂
You are a remarkable woman. No matter how many times I get off track, I always come back to your wisdom. It’s real. It’s what’s true. It’s comforting. Congratulations on becoming pregnant and your next journey in life! What a special time for you and Nick. It’s so nice to hear baby news and to know life is going to be full of so much joy in a new way for the two of you. I also find it just so YOU that you would think about the pain that so many of your followers may experience with baby news and updates. I really appreciate you.
That means so much to me Dee that the content has been a source of encouragement for you so thank you 🙂
And thank you for celebrating with us – I appreciate YOU!
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