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Foodsupport_AUS

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Reply with quote  #51 
I too would be concerned about just saying it is her ED talking. It may be, but as toothfairy points out Anorexia has a very high suicide rate, much higher than other illnesses. I would ask the therapist if she feels comfortable assessing suicidal thoughts and behaviours. I would also ask specifically how she recommends you respond and what she wants you to do if things reach crisis point or you are urgently concerned. When my D was at her most ill she was intensely suicidal. She was admitted to a psychiatric unit briefly because of this. We had a clear crisis plan, who to call and when with numbers etc. as well as urgent medications for sedation if needed. It made a big difference to dealing with things. Her psychiatrist also regularly assessed her risk. 
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D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
njh1919

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Reply with quote  #52 
Thankyou again for your replies. The therapist did say we can call the police or mental health services but I do feel that she is dismissing the threats as just part of the illness. I feel she should have handed me some phone numbers of EXACTLY who to call or where to take her. We feel a little lost with lack of information so this forum is such a godsend.
Sotired

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Reply with quote  #53 
Please call marinoto tomorrow and ask them for the crisis team number for your area.whilst your therapist was remiss and is being far too casual,a sharp wake up call to her that you take this very seriously and that you need an action plan today please means she has no further excuse not to provide you with those phone numbers (if you have not rung marinoto) and a very firm action plan.dont take no for an answer and be prepared to change therapist if she does not do what you ask.
We actually started with a private therapist but she was very clear that she would only help us to a certain point and that if she felt she was no longer the best person that she would refer us onto the public system so that we had access to all the services needed.she did this within a month.
A good therapist knows what she does not know.she looks for answers.she gives proper information to public services that may well be needed.
Look after yourself and your daughter,

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njh1919

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Reply with quote  #54 
Thanks i have just googled Marinoto and found their contact details. It's good to have a backup if I need it.
I think it might be worth asking our therapist in front of my D, for the numbers. Then she knows we will take action if the threats continue.
No suicide threats today, just tells us she has been googling lawyers to see how she can leave home.
Sotired

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Reply with quote  #55 
She can be put under the mental health act and I would not hesitate to do this if she threatens you with that again.she is ineligible for any benefits as far as I'm aware so that would mean living on the streets.so she hasn't got a leg to stand on with this,also lawyers charge by the minute for advice-so make sure she knows she's paying for it.
There isn't anything I didn't hear I think when anorexia was in full swing,so I learned to have a quick answer and not to debate it.
You have weapons in this war hon so don't panic.

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Torie

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Reply with quote  #56 
Quote:
Originally Posted by njh1919
Or are any of your children recovered and are things back to how they were?


Yes, some of us have our kids back.  This vile illness drags the whole family through hell, but there is tons of hope that you will get your kid back.

Whatever you do, keep feeding.  That's the ticket. xx

-Torie

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"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
njh1919

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Reply with quote  #57 
We had a great week with a 900g gain - ecstatic, our first real gain! Then D saw the porridge recipe I was using with cream and 900 calories and had a meltdown. Says she no longer trusts us as we are sneaking cream in to her food. Feel like we are back to square one. She is now battling to make her own meals or stand there watching us make them. Im gutted. We were making such progress [frown]
Foodsupport_AUS

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Reply with quote  #58 
It does seem like such a set back when this sort of thing happens. When it happened to me, and it did on a number of occasions, I found the best way forward was to own up to it and keep on pushing forward.

You were not sneaking cream into her food. You were giving her the food she needs to help her get better. Ideally still keep her out of the kitchen. If she insists on watching I would go ahead and make that porridge and get her to eat it if at all possible. The fear is the illness, giving into the fear allows her illness to stay around. 

I found it helpful to acknowledge my D's distress but also name it as her anxiety (she hated this too) but it doesn't change the fact that she needs to keep on eating, and if it makes her too distressed to watch or supervise it is better for her to be out of the kitchen. 

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D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
njh1919

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Reply with quote  #59 
Thanks Foodsupport_AUS. We have had a terrible day. It has spiralled in to her stopping eating and climbing on to the roof threatening to jump.
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Reply with quote  #60 
Hi,
This is horrific, Is there any way she can be admitted to a higher level of care immediately?

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Son,DX with AN, (purging type) in 2015 ,had 4 months immediate inpatient,then FBT at home since. He is now in strong recovery, (Phase 3 ) 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.
njh1919

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Reply with quote  #61 
I threatened to call the police and she came inside. She wanted to show me old photos of her before she lost the weight and told me how fat she was. She was 56kg... my husband is concerned that FBT doesnt focus at all on her mental health or her thoughts about her weight. Do you think she should be seeing someone about those thoughts as well as doung the FBT?
Foodsupport_AUS

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Reply with quote  #62 
Hi njh, we were unable to successfully get things started with FBT. When my D first became ill she was both medically very ill and was also suicidal. Her suicidality increased during re-feeding.  My D was re-fed with many of the principles but she also spent a lot of time in hospital (there are no residential units in Australia) being re-fed on a medical ward which had ED specialists. Because of her suicidal intentions and behaviours she saw a psychiatrist from very early on in her illness. He does not do FBT but again agrees with the principles and is very familiar with eating disorders (the bulk of his practice). She saw the psychiatrist as he was in the best position to assess the risk her suicidal thoughts and behaviours posed. Even though she has seen him for some time (we are coming up to seven years here) his main role early on was in forming a therapeutic relationship, helping her cope with the distress that refeeding posed, and assessing her risk. When seeing FBT therapists some were not keen to include him in her treatment whereas others were happy for him to do what he was doing. 

FBT traditionally only deals with those issues in Stage 3 but for some children the risks of waiting till then are too great. My D would not have survived without having psychiatric support and continuous risk assessment. If the risk is becoming too great, then perhaps things need to change tack, a higher level of care which still includes family in treatment so you can go back to FBT down the track may be a great plan.

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D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
njh1919

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Reply with quote  #63 
Thankyou, yes I do wonder if she needs more than FBT. I can understand the theory of refeeding first, however it does nothing to assist her mental state. She clearly has terrible/dangerous thoughts and noone is helping her with that.
Sotired

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Reply with quote  #64 
don't forget you have the child and family unit available for suicidality and as it is part of starship your d will be moved onto the ward for NG feeding if there is a refusal to eat and drink.both of these are only available to you for a short time st this point-starship til 17 and CFU til 18 so use them now if you have to.suicide threats trump everything else so always deal with that first.
Good luck,

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njh1919

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Reply with quote  #65 
Thankyou sotired. She seems to have calmed down for the moment, but is still refusing food. We were doing so well, I feel so frustrated!
Sotired

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Reply with quote  #66 
Ok.the rule is 24 hours no fluid and you can go to starship,48hours no food you can go to starship.they have pretty clear criteria for admission and your d may meet this.one criteria is exhaustion of caregivers,so if that is where you are then take your d for assessment today.always ring the crisis line when your d has a suicdal episode as a paper trail also helps with admission.
Don't be brave if this is too much for you.we are only human too and our kids have no idea how exhausting it is to constantly be on high alert.
Have a plan and follow through,no matter what your d promises because that might be what it takes to get things to change.
Good luck

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njh1919

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Reply with quote  #67 
Thankyou so much for your support. I would be lost without this forum! I will definitely ring the crisis line next time. I think she is so torn. She says she is depressed and wants to kill herself but then says her friends are the only thing that makes her happy (none of them know fully what is going on). So i dont believe she actually wants to kill herself it is just to threaten us to get us to back off. But it still wont stop her doing something silly...
toothfairy

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Reply with quote  #68 
Hi,
So sorry that tnis is so hard.
You have been given great advice.
FWIW here's mine now..
I am not trying to scare you but anorexia has the highest death rate of any mental illness.
20% of sufferers die from complications of the illness or from suicide.
This horrific illness has a very high suicide rate.
If it were me I would take her to Starship today & have her admitted.
Best wishes
TF

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Son,DX with AN, (purging type) in 2015 ,had 4 months immediate inpatient,then FBT at home since. He is now in strong recovery, (Phase 3 ) 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.
deenl

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Reply with quote  #69 
Hi njh1919

Quote:
Originally Posted by njh1919
Thankyou, yes I do wonder if she needs more than FBT. I can understand the theory of refeeding first, however it does nothing to assist her mental state. She clearly has terrible/dangerous thoughts and noone is helping her with that.


This is almost exactly word for word what we said in the beginning. Our son had definitive plans and suicide notes written when we stopped him following through. We were screaming for some sort of help for him. But all he needed was food. He has refused to attend any sort of therapy and yet the suicidality receded very quickly with adequate amounts of food. And his mental health has continued to improve with weight.

Of course, this is not the case for everyone but it is true that the starved mind cannot take in any lessons from therapy and many medications cannot work on very underweight people. 

And naturally, we were EXTREMELY careful regarding the suicide threats/plans. He was professionally assessed, in a locked unit for a week and we watched him like a hawk when he came out. We removed dangerous items, locked all the doors and windows (he would sneak out at night), screwed closed the one with no lock, we kept the keys in our pockets, together with always charged phones, the car always had fuel and was parked for a quick departure, the hospital was forewarned and pre planning was done, etc. At times we slept in his room or outside the door. We were afraid. 

I would encourage you to continue feeding but with assessment for the suicidality.

Warm wishes,

D

PS I refused to engage with ED related talk with my S. I would just tell him it was unhealthy for his peace of mind or change the subject or go to the loo. Too much talk just strengthened the beast. Although it took practice not to respond automatically! 

__________________
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.
njh1919

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Reply with quote  #70 
Thankyou so much for your suggestions toothfairy and Deenl. I m keeping a very close eye on her mental state and will not hesitate to take her to starship next time.
Weight gain is very slow - we have only had 1 week of meaningful gain followed by a setback so could be a long while before we are clear of the suicide threats.
mjkz

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Reply with quote  #71 
I was one that had her daughter in therapy the whole time during refeeding.  My daughter would never have survived otherwise (and darn near didn't even with it).  She used not eating to numb her feelings and avoid dealing with things so I really felt that in order for her to move forward, she needed help learning new coping skills and new "healthy" ways to deal with her emotions.  She saw a private therapist who did both CBT and DBT with her all through refeeding.  At first she didn't get as much as she got the more weight she gained but for me it was another opinion on how suicidal she was and what steps needed to be taken to keep her safe during that time.  I was fine paying for it even if she got nothing out of it.

My daughter has a trauma history so I felt she needed support around that too because it seemed that the two issues fed off one another and doing just one didn't work. If she worked on trauma stuff, the ED spun out of control and vice versa so it was a very fine balance of working on both in a way that she could continue doing what was expected of her (eating, staying safe) while moving forward.  Her therapist also really helped her ground herself during panic attacks and high anxiety whether it be from things remembered, gaining weight, having to eat something she was afraid of, etc.

She was never in an inpatient program that didn't provide therapy along with refeeding and weight gain so I never even considered trying just refeeding.  There are people on here who have had marvelous results with refeeding to a good weight and state followed but my daughter had comorbids and the past trauma so I felt it was essential.
njh1919

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Reply with quote  #72 
Help! D refused to finish her dinner last night despite hours sitting with her. So we had to say that she couldnt go to soccer today. When it came to today and she realised we were serious she lost it. Suicide threats and total food refusal. I called the crisis line and they advised us to keep a close eye on her all night and take her to hospital if things get worse.
We are ok to do that tonight but my question is - do we try and get her to eat dinner tonight? (She refused at dinnertime an hour ago and we havent pushed it). Not sure what to do...
deenl

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Reply with quote  #73 
Hi njh1919,

Something similar happened when my son was in hospital. He refused a meal and the rule was that he then had to have a supplement to replace it, he refused. The next step was that he had to have an NG tube feed but he refused to allow them to place it. In The Netherlands children from the age of 12 may refuse treatment against the wishes of their parents and doctors. So we were at an impasse and he had learned that there were no consequences to refusing food.

The nurses were all saying 'Do we bother serving up lunch? It's such a shame to have to throw out the food' [mad] Really, WTF? Talk about getting your priorities messed up!

Anyway, I said 'Yes, serve it, totally normally, calm, no bad vibes' Let him know that he needs to eat no matter what. A bad meal is just a bad meal and we move on. I thought it important to let him know that even when he was losing the plot, the people around him would be his port in a storm and would stay calm and give him what his body needs. And guess what? He ate the meal as if nothing had happened!

Some people insist that their child eats and keep going until the meal is eaten so that the child learns that they have to eat, no matter what. For us, after an hour or 90 mins we used to take it away, say nothing, let him calm down and just serve up the next meal at the normal time. It takes some trial and error to find what works best for your child. But at the end of the day they must eat.

No drink for 24 hrs (our S condition was so bad that this was only 12 hrs) and no food for 48 hrs (again our son was so sick this was 24 hrs) then off to ER. It is vital that your child is under the care of a medical doctor who understands EDs. But, under the doctor's care, we had a home monitor for our sons vital statistics, heart, blood pressure and temperature. He knew that if they strayed into dangerous territory because of not eating that we would not hesitate to save his life and bring him directly to the locked ward again, via the ER. This firm line in the sand allowed him to eat and by the time his life was no longer in danger, eating had become a routine (or course still with lots of stress, fear and resistance!)

Discuss options with your husband and any professional support you can. It is essential that your d does not get the message that a freak out = no need to eat.

When we were in these situations we took deep breaths, served the same meal as usual at the same time and did not let our stress show. Be conscious of where your body holds its' stress and deliberately release the tight jaw, frown on the face, taut shoulders etc.

But have your plan B. At the stage your are at I had the doors and windows locked so he couldn't run away, knives, meds, ropes were locked away. If he was going to make a suicide attempt, I was not going to make it easy for him. My phone was charged in my pocket at all times, together with the car keys and the crisis team and ER forewarned by our pediatrician. We slept in his room or in the hall outside the door. And never left him alone.

Think what your daughter really needs; food and parents who will fight the ED for her. Be brave and good luck.

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.
njh1919

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Reply with quote  #74 
Thankyou so much Deenl. You have helped me so much. This comment especially made me see sense " It is essential that your d does not get the message that a freak out = no need to eat.".
I took her some food (hasnt eaten it yet) but we are trying to carry on, business as usual so to speak.
Fingers crossed...
toothfairy

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Reply with quote  #75 
Hi there
My advice is to take her to Starship today.
Best wishes,
T

__________________
Son,DX with AN, (purging type) in 2015 ,had 4 months immediate inpatient,then FBT at home since. He is now in strong recovery, (Phase 3 ) 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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