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humpity

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Reply with quote  #1 
Hey there,
I have been having a read of this forum and I feel blown away by how courageous everyone here is in providing such hard but loving care to treat their children with this illness.
My d has a history of AN with activity and exercise compulsions.  History now for several years (I should say she is nearly 18 so not a youngster now!).  IP admissions have weight restored to a point in the past but on discharge old behaviours crept back again and before we knew it we were back to square one.  
Now back to a point of not critical IP admission stage yet but hoping to stop it getting there.  We have not tried a serious FBT approach before but willing to try anything.
Right now d weight is maintaining probably on around 2300-2400 a day intake and she has compulsive walking - it is hard to stop her going for two walks a day at least, each for around an hour.  Other than that the same behaviours that others here describe of difficulties sitting and difficulties relaxing.
She is desparate for help and admits that but at the same time is resistant to some of our approaches when anxiety seems to sky rocket.  She is currently on a break from college but says she really wants to get back to her studies and on the one hand seems eager to do 'normal' things but when any further suggestion of any small trips even are made she cries off as small changes to her 'routine' seem to cause her anxiety to increase again.
Advice would be much appreciated on starting out with this FBT attempt.
We are currently not using the ED specialist services as a lot of their input in the past does seem to have reinforced a lot of her eating disorder thinking to a large extent by giving her further 'rules' to follow that ED clings to and their approaches have had little use to now.
I appreciate any advice.  This forum is such a wealth of information and it is great to feel we are not alone.
deenl

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Reply with quote  #2 
Hi and welcome

I am in the middle of making dinner so just a quick reply.

It is wonderful that your d is motivated to recover but as we all know that is easier said than done.

This blog is by an ED patient who recovered after many years illness with help and support from her family http://edbites.com/ You may find it interesting.

Apart from that there is the Hall of Fame http://atdthalloffame.feast-ed.org/

And the FEAST guides http://www.feast-ed.org/default.asp?page=UserFAQ

Read around and ask any specific questions you have.

Warm wishes
D

__________________
2015 12yo son restricting but no body image issues, no fat phobia; lost weight IP! Oct 2015 home, stable but no progress. Medical hosp to kick start recovery Feb 2016. Slowly and cautiously gaining weight at home and seeing signs of our real kid.

May 2017 Hovering around WR. Mood great, mostly. Building up hour by hour at school after 18 months at home. Summer 2017 Happy, first trip away in years, tons of variety in food, stepping back into social life. Sept 2017, back to school full time for the first time in 2 years. Happy and relaxed, just usual non ED hassles. 

  • Swedish proverb: Love me when I least deserve it because that's when I need it most.
  • We are what we repeatedly do. Excellence Recovery, then, is not an act but a habit. Aristotle.
  • If the plan doesn't work, change the plan but never the goal. (but don't give up on the plan too soon, maybe it just needs a tweak or a bit more time and determination [wink] )
  • We cannot control the wind but we can direct the sail.
toothfairy

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Reply with quote  #3 
Hi there & welcome,
Tabitha Farrar has great blogs & podcasts here... so much infotmation!

It could be worth consulting with her. She does private consults,
Best wishes


http://tabithafarrar.com/

__________________
Son,DX with AN, (purging type) age 13 in October 2015 ,  (4 months immediate inpatient) , Then FBT at home since.and making progress every day. He is now in good recovery, and Living life to the full like a normal teen. We are not completely out of the woods yet, but we can see the light at the end of the tunnel, thanks to ATDT. Hoping to get him into full recovery and remission one day at a time.
humpity

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Reply with quote  #4 
Thank you both for such fast replies.
I will look at the edbites blog and hall of fame site you recommend.
I have seen the feast guides and I have looked at a lot of tabitha farrar's site too and listened to her podcasts and agree so much of her work is helpful. Really here for advice I suppose from others who have been there or are there now in getting started.
As you say at least d is motivated- she says she wants to gain weight but the process is so anxiety provoking in making first steps...
Torie

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Reply with quote  #5 
Hi humpity, and welcome.

If you are in the US, I would suggest looking into the UCSD week-long program (or similar), but I'm guessing you are in the UK?

I'm wondering how you know she is "walking" for those hours as opposed to running and other more vigorous activities.  Do you go with her?  One possibility would be for you to join her, gradually slow down her pace, gradually slow down how long she walks, etc.  Others might suggest a much quicker intervention, but I'll let them speak for themselves on that.

Would you mind letting us know more about her reluctance to sit?  Does she sit at all?

It's great that she recognizes that she needs help. Does she understand that she needs to gain weight? Stop exercising so much? Re-learn how to sit down?

Sorry I am so full of questions, but it's hard to know what to suggest without more information.  Most here find it helpful to add rapeseed (canola) oil, butter, double cream (heavy whipping cream) to everything from soup and yogurt to rice and pasta.  If you stir it in vigorously, it vanishes without affecting texture of flavor in most cases. (You can experiment to see how much you can add.) As you probably know, anorexic brains needs plenty of dietary fat to repair themselves.

Please feel free to ask all the questions you like.  xx

-Torie

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"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
humpity

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Reply with quote  #6 

Hi Torie - yes I am in the UK - the program in the US looks great otherwise!
Re the walking - some of this is on trusting that she is being honest with us.  To some extent I think she is - she is very anxious to be well although also ED is resistant to the process of course.  I don't go on the walks with her but she does not go out dressed for jogging often and I am reasonably confident it is just brisk walking.
With sitting - she will sit at home to eat - so will sit at table or sometimes on sofa to eat a meal but otherwise is resistant to sit for any length outside of mealtimes.   She will stand to use computer, will be on the go doing 'jobs' or pottering in the house and generally restless.  If asked to sit she seems to get very anxious and agitated.
She does recognise that recovery is going to mean having to overcome these behaviours and accept weight gain but in the moment of doing it her anxiety rises and we are working now at an agreement of how we start to make FBT approach work.
Thank you for the food tips -we need to start getting tougher with her on what she eats - at the moment of course she has her safe foods which are generally low fat but we do need to start taking over on this and adding more fats and fear foods.

I appreciate your taking the time to reply.

scaredmom

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Reply with quote  #7 

Hi humpity,

You have found a great place for support and advice. I am new to this (Dx 11 yo D with RAN- March 2017) so remember we are still learning, but I have some info based on our experience so far. I hope you can take something from this and tweak it for your own circumstance.

We have really attacked my D's standing and have a lot more to do. She does not over exercise, but the standing has to go! She is 12 yo, recent birthday in April.  We started with 2 min as some on this forum have, but she timed the 120 seconds and jumped up. I got advice from our social worker and she told us to try half hour first. The anxiety in the first two minutes or so was great, but over the next few minutes D noticed that nothing bad would happen... Well we worked up to 45 min in one week then one 1 hour after another week or so and now up to two hours-she watches netflix during that time. She is young and so we still have a lot of authority over her. We use rewards, like shopping for new clothes or having friends over etc.. to get her to sit. She saw the doctor this week and the pediatrician told her she could have a bit of activity - soccer only half hour per week if she sat for 2 hours everyday AND to eat a large extra snack (400-500 cal- not discussed with d but with me) on the days of any extra activity and for sure on "soccer days" . I did not think D would agree to that ,but her love of soccer was bigger than her defiance! So she had soccer half hour only this week and ate really well after and knows that I will take soccer away in a heartbeat if she does not sit for the two hours every day- so far she is compliant.

Does your D like games or crafts, that require sitting? Maybe you can entice her to sit and tell her that you will get her more games, crafts.. etc. Go for a long long drive  just to keep her sitting.

One thing we did a few weeks ago that forced her to sit, was canoeing. That may be hard to do regularly and it was expensive but ok for a day or two a month.

Can you increase the calories without increasing the "foodprint"? I add two- 4 tbsp to yogurt that adds in 100-200 cal! I add canola oil 6-8 tbsp to her smoothies- that is 720-940 cal to the smoothie. Add in half cup of canola or olive oil to pasta sauce. Fry everything! I brown the ground beef with oil in it too. Add whipping cream and butter to potatoes.  If a recipe says milk,use cream if it says half cup use 3/4cup etc...Sweet potatoes- mash them add butter and cream and brown sugar. Add sugar to the juices ( 1 tbsp is 45 cal) and extra tsp or tbsp of any food on her plate is good.  Pasta and quinoa salad, I add in extra olive oil 2 tbsp is 240 cal. I learned here how to do all that and I have more to learn...
We are up to 4500 cal per day. I hope you don't need that much but it is doable. We have 3 meals and 3 snacks.

I hope you find some of what I have written helpful..


humpity

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Reply with quote  #8 
Thank you too scaredmom for such a detailed response and sharing your experiences. It sounds like you are doing some great work and making amazing progress with your daughter.
Sorry I don't have time for long reply at the moment but just to say your ideas are useful and calorie suggestions too.
She is actually I think at a stage herself where she wants to be well and that is a blessing. Today so far she has stayed home and been sitting much more without much intervention from us... I know this is early days but a glimmer of hope she can work with us in beating the ED.
mjkz

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Reply with quote  #9 
Just remember it is a marathon and not a sprint.  Some days will be easy and some you will wish you never got out of bed.  The key is to learn on which days you have to be the one to tell her to sit, eat and help fight the voices in her head and which days she can do it on her own.
tina72

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Reply with quote  #10 
I agree with mjks. At first you will have more bad days than good ones. But it increases quickly and than you will have a 4:3 situation. At the moment (after 6 month recovery) we have about 5 good days and 2 when we have to be watchful. It gets better every week just by gaining weight.
What helped us a lot was presenting healthy looking smoothies made just of fruit and vegetable and adding a lot of oil (granola oil is great, you don´t taste anything). That looks healthy and low caloric and our d took 3 of them free willingly a day (we told her its good for her metabolism). Thats about 2000 calories a day extra. But don´t mention whats in there [wink].
Keep on going. You are doing the right thing.
Tina72
Mamaroo

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Reply with quote  #11 
Hi Humpity

So glad to hear your D is looking for help [smile]. If she suffers from anxiety as well, you might consider medication. Several parents here found great relieve from anti depressants and anti psychotic medications. Have a look around this forum. You can also find great over the counter anti-anxiety medication, which I used for my D (and myself!).

There are other methods to tackle anxiety such as Cognitive Behavioural Therapy, again a quick search on this forum will give you more information.
Best wishes

__________________
D became obsessed with exercise at age 9. Started eating 'healthy' at age 9.5. Restricting couple of months later. IP for 2 weeks at age 10. Slowly refed for a year and WR at age 11. Challenging fear foods now.
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