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freedomfighter

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Posts: 23
Reply with quote  #26 
So, since first posting on this site just over a month ago we are into our first day of refeeding (or renourishing, as we like to call it!). 
We prepared carefully for this (as D is chronically underweight but not acute).  We finally got a diagnosis from camhs, last week.  They were brilliant actually (after a year of not being brilliant).  And they are supporting our refeeding, and have offered D a therapist to talk to throughout. (which D has angrily refused). 
Just hearing the diagnosis was - I am not joking - a joy.  After so long of feeling we have not been believed or taken seriously.  It felt like there was a firm foundation for refeeding.

We started yesterday suppertime with buttermilk pancakes.  Although being furious for a couple of days previous to this, she ate them like a lamb (an angry lamb).  This threw me into confusion.  Then she presented us with a bitterly angry letter, explaining how she is NOT underweight, how she hates the way we are spreading lies about her, how she hates us... really hard to get, but kind of expected. She agreed to eat with us evenings but do her own thing for breakfast/lunch, promised to eat extra protein, said she would see a counsellor if we did that, said she knew her own body.  Again this threw me into confusion.  Spent all night replying to it in my head.

She is almost 17, has been fairly independent for a good while, one of those children who gets herself out the door and to college on time, not needing to be prodded.  It must be awful for her to realise that we are serious about her having to eat what we want her to eat, and if we don't we will go after her to her college/workplace, whatever, not to embarrass her in any way, but just to make sure she eats it.  She feels so disrespected.  She spat in the kitchen this morning, poured cereal on the floor, through a banana skin through the door.  Heading off to where she works shortly, to bring her lunch.  I remind myself: all I am asking her to do is eat some cous cous.  No biggie.  But my heart is thumping in my chest the whole time.  Dreading tonight. 

Anyway, just wanted to thank again all those caring people who have responded to my posts.  I think I will start a new thread called 'Re-feeding'.  We would still be watching her helplessly if it wasn't for this forum. I don't think we would have gotten her back to CAMHS.  But I am frightened.  God help us.
tina72

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Posts: 1,043
Reply with quote  #27 
Hi freedomfighter,
don´t be afraid. Parenting a teenager with ED is not normal teenage parenting. Yes, it is awful for her to realise that you are serious with refeeding now, but actually it is not awfulfor your d, it is awful for her ED. She cannot hold on to this ED and live a normal young adult life. The ED will tell her what to eat and so it is better you will do that instead of her ED. All you want is make her able to live a normal life without ED. That is achievable and realistic and nothing you should feel awful about.
Great that CAMHS is supporting you now and that you have a diagnosis now. That helps a lot.

"Although being furious for a couple of days previous to this, she ate them like a lamb (an angry lamb).  This threw me into confusion."
We had that very often. A new food was announced and she got through the roof just by thinking about it. And then, when it was served, she ate it with nearly no discussion. But you will see the other possible reaction, too. She might freak out about something you never thought is a problem about.

"She agreed to eat with us evenings but do her own thing for breakfast/lunch, promised to eat extra protein, said she would see a counsellor if we did that, said she knew her own body. Again this threw me into confusion."
No, she does not know her own body. If she would know what he needs to eat, you were not here. She will promise heaven on earth to you. ED makes the patients lie a lot about food. My d did never lie openly to me, but I had to ask everything very exactly. If I had asked her "what was there to eat at your friends house" she would have said "noodle soup", but that would not mean that she ate one spoon of it. I had to ask "what did you ate?" or "how much noodle soup did you have" and then my d did say the truth (because she cannot lie). But I know of many patients who told their parents "I ate a pizza at my friends house" and they ate nothing. So please be aware that ED might make her lie and that it is not her fault. And that you can only count what you have seen her eating.

So please try to forget what she wrote in that letter. She is not hating you, ED is hating you. My d said a lot of terrible things to me and now she does not even know that any more. She just seem to have forget the very bad days of her illness.
So if you require he to eat some cous-cous, remember that this is not an awful meal and that eating that is the most normal thing a young adult should be able to.
Keep on going. You will get used to it and feel more secure with what you are doing in a couple of weeks.
Tina72
toothfairy

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Posts: 2,174
Reply with quote  #28 
Hi there,
Well done on "grasping the nettle".
OK so the letter is par for the course , and aside from that, its likely  she is suffering from anosognosia.

https://www.mirror-mirror.org/anosognosia.htm

Regarding her independence, This is different. This is a life threatening illness. She can work towards independence when she has had a long time in recovery with no behaviours. This is the illness trying to bully you as it is bullying her. Separate the illness from your D. 

Keep going, do not let the illness have control. The time is very short now to get her into recovery before she reaches 18  and can refuse treatment.
Here is a book I would advise you to get asap/

https://www.amazon.com/Survive-FBT-Undertaking-Treatment-Adolescent/dp/0994474601


__________________
Son,DX with AN, (purging type) in 2015 ,had 4 months immediate inpatient,then FBT at home since. He is now in strong recovery,  and Living life to the full, like a "normal"[biggrin] teen. This is with thanks to ATDT. Hoping to get him into full recovery and remission one day at a time. Getting him to a much higher weight, and with a much higher calorie plan than his clinicians gave him as a target, was instrumental to getting him to the strong recovery that he is in now. Food is the medicine.
toothfairy

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Posts: 2,174
Reply with quote  #29 
Here are a few tips that I learnt along the way....

 You prepare meals

 Do not allow your teen in the kitchen during meal prep
 
 Your teen should not go grocery shopping.

 Do not negotiate - whatever you serve has to be eaten

 Use whatever leverage you have - phone, Internet, tv - whatever they hold dear is to be removed if they refuse to eat, until they have eaten. If they're older and are not financially independent, this is your leverage

 Separate the two - Your teen is not the ED

 Detach yourself from the situation during meals. Do not get drawn into emotional discussions. THIS IS NOT UP FOR NEGOTIATION

 Remember that your teen wants to recover - the ED is stopping them
 
3 meals and 3 snacks per day (supervised) - do not deviate from this. Add time limits to the meals (as a guide/goal!). Ours (and the hospitals) was 30 mins for meals and 15 mins for snacks. In the early days this could extend A LOT. I made my teen's meal times the same as they'd be at school so that when she transitioned back to full time it would be easier and less anxiety provoking.
 
High calories are needed throughout refeeding with lots of full fat dairy. Some need as much as 6,000 cals with hyper metabolism, but the norm would be minimum 3500-4000 cals (for you to track not your child), wen needed 4000-5000 every single day, and still do in recovery.

When they know you will not negotiate, I promise you will see the weight lifted from their shoulders... If only for very short periods

 BE THE CAGE that keeps ED away from your teen.

 Be calm and consistent, consistent, consistent, confident, compassionate but FIRM!

 Don't congratulate them after a meal or say 'well done' - just cheer inwardly! Likewise when (for girls) their period returns!

 Recommended reading: 'Brave Girl Eating' by Harriet Brown
 
Be prepared for resistance, and lots of it! You will find your own way to manage this, but NEVER back down. Any compromise is a win for ED. Remember, you have to see the beast to slay beast!

LEAN ON US - WE ARE OPEN 24/7

__________________
Son,DX with AN, (purging type) in 2015 ,had 4 months immediate inpatient,then FBT at home since. He is now in strong recovery,  and Living life to the full, like a "normal"[biggrin] teen. This is with thanks to ATDT. Hoping to get him into full recovery and remission one day at a time. Getting him to a much higher weight, and with a much higher calorie plan than his clinicians gave him as a target, was instrumental to getting him to the strong recovery that he is in now. Food is the medicine.
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