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toothfairy

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Reply with quote  #51 
Personally I would take her from school and aggressively re-feed given she is 17....Education
can wait and can often be part of the problem with the perfectionism..It was with us anyway..


https://www.eatingrecoverycenter.com/blog/2016/02/26/returning-child-to-school-after-eating-disorder-treatment-ashley-solomon

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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.
frazzledmum

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Reply with quote  #52 
Thank you Petelly and toothfairy for your replies. I am not convinced she is lactose intolerant, using my common sense and reading the replies here, she just doesn't like milk, which is fair enough. Currently we are going with hot chocolate, which she mixes herself after I have put the milk in the mug. If she didn't mix it herself she wouldn't drink it at all. 

I also found some food in her bag over the weekend, I think it was from Friday, which she claimed she had eaten. She didn't deny it when I confronted her and apologised, she even ate extra food to compensate.  Has anyone got any ideas on how to deal with this? She said that it had only happened on Friday because she thought I was trying to control her. Ever since she was small she has always responded better to negotiation than being told what to do.

Thank you for your ideas about school toothfairy, it's something I am thinking about, and will no doubt continue to think about.


toothfairy

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Reply with quote  #53 
Please do not negotiate with the eating disorder,
The anorexia is like a terrorist trying to kill her.
She needs agressive intervention.
This illness has a very high mortality rate & is very serious. The mortality rate is 20%.

I advise you to take control & try & re-feed her to get her into recovery before she is 18.

Please do not give in to her eating disorder.

__________________
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.
toothfairy

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Reply with quote  #54 

http://www.edfa.org.au/skilled-families/confidence-to-address-the-ed/tips-for-commencing-fbt/

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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  #55 
Hi frazzledmum,

Quote:
Originally Posted by frazzledmum
Ever since she was small she has always responded better to negotiation than being told what to do.


This is something we struggled mightily with. I believe that each parent(couple) and child develop their own style over the lifetime of the child. This is based on all the character traits of the people involved, parents priorities and, at the end of the day, what works and doesn't work.

Our son has a particularly high sense of personal dignity and self direction. He is a well behaved, hard working and honest person. There were obviously times where we, as parents, needed to set boundaries but this was usually done by discussion and agreement. All in all, a really workable, balanced parent/child relationship. Until...

Well, you can imagine how all those tools we had used up until the point of anorexia were totally and absolutely useless in the face of the fear, anxiety, stubbornness and illogic of a starved brain. But, of course, he still retained all the characteristics of our son but super powered. We have never won power struggles with him, for example, as a toddler a time out became something he would simply not put up with and we would all lose sight of the discipline point so I had to use other ways of making my point.

So what did work in the depths of AN. Well, it's really hard to put into words actually. Overall, I had to be prepared for a lot of trial and error, feedback and to be very observant about what worked. But I was and still am 100% committed to ensuring not a grain of ED remains in my child's brain. I was very careful to control what I could and not engage in power struggles unless it was life/death in that moment.

- We used atmosphere; affection, the least stress possible, warm tone of voice and body language, an attitude that he had a biological illness and it was not his fault. Any consequences or boundaries were spoken in a very matter of fact, this is a symptom of the illness, we need to keep you safe tone of voice. During the horrific melt downs we would remain close, in the room or just outside, but quiet and the other parent would be with the other kids. There were no punishments as I told him I would not punish the consequences of his illness (other parent/child combinations have needed different approaches to this, as with most things when dealing with EDs, if only it were a one size fits all [frown])
-  We used humour; when we were challenged I say, laughing, things like 'Yeh, good try! But I'm not falling for that old trick' or 'Jaysus, if your brothers tried that one! No chance!' or 'Are you trying to pull the wool over your oul mother's eyes? Go on with ya!' And then with my body language give the expectation that he would do what needed to be done. Obviously, this was a technique that we could only use for the less stressful incidents.
- We used consistency; 3 meals, 3 snacks at predictable times, safe foods (but I gradually increased the nutritional density), same bowl etc We did over time loosen routines but still have 6 eating moments. 
- We used distraction; he still eats watching videos on YouTube
- We used expectation; meals were provided on schedule, he was called, he was given time to gather his courage, after 10 mins or so we would go to him so our presence supported him but also told him he had to come. But we never fought over the last bite; it allowed him to retain some of his dignity and nutritionally the fight was not worth it (as long as it only remained at one bite!)
- We closed loopholes in response incidents. For example, he hid food in his clothes and it was found down the loo. So we started frisking him on top of the observation. It was matter of fact and calm and he allowed it (I think he was kinda glad as he is an honest kid who was forced due to the illness) During the period of self harm/suicidal ideation all dangers were removed from the house and the doors and windows were always locked.
- Medical oversight was not negotiable. One time he refused to go to his check up. I rescheduled the appt for later that day and told him, again in a calm but firm tone, that his body was in danger, he had to be checked, the appt was rescheduled, if he didn't go I'd make new appts for tomorrow morn, tomorrow pm and so on. It would not go away and he would have to face it day in, day out until he was checked. On the other hand, if he went this afternoon he wouldn't have to think about it for the rest of the week. He went that afternoon.
- I used scripts and techniques from Freeing your child from anxiety by Tamar Chansky

I've probably forgotton lots and your path may be entirely different from ours. I got lots of diverse options on this thread.

But the biggest driver of his recovery was my absolute determination not to settle for less than 100% recovery, with full nutritional rehabilitation as the first big step and the foundation for the rest of recovery.

Stay curious and keep asking those questions. I couldn't have saved our son without the support and knowledge from everyone here.

Warm wishes,
D

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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.
frazzledmum

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Reply with quote  #56 
Thanks Deenl, I appreciate such a long post and the link. I did find food hidden in her bag on Sunday, which she had put there on Friday in response to me taking her peas out of the freezer and measuring them out for her.  When I asked her about it she was very honest and said she thought I was trying to control her and wanted to punish me. It happens when we modify any deal made with her Dr. It's very hard as you said.

She caught some kind of viral thing on Tuesday and has spent the past 3 days in bed with aches and a temperature, luckily she has drunk more, but won't eat as she feels so awful. It will take her so much longer to get over this as she was so weak to begin with, though she has said she never wants to feel this ill ever again, maybe some leverage there?
Foodsupport_AUS

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Reply with quote  #57 
I hope your daughter gets better soon. If she has not eaten for three days she may need urgent medical assessment, as she is already malnourished lack of food for that period of time can lead to serious deterioration. 

Quote:
 It happens when we modify any deal made with her Dr.


This is always a problem, especially when the Dr or other care provider is colluding with ED, a very common occurrence, just like we frequently inadvertently collude with ED. Measuring out peas is a mark of this too. ED wants everything under control to the last crumb because it is terrified of anything else. Your D needs urgent re-feeding. Sometimes as in deenl's case a gentler method is required, others we need to go in all guns blazing. Either way your D needs to feel that she has no choice but to eat, and to eat to gain weight. 

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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.
mjkz

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Reply with quote  #58 
Quote:
I have tried magic plate, that led to a 5 hour stand off, then she took an overdose and ended up in A&E, so I am unwilling to do that again. Negotiating a meal plan seems to be working a bit better.


Negotiating doesn't seem to be working so well either.  I know you think it does but from what you are writing, it doesn't sound like you are getting very far with it and skipping meals to punish you is totally not acceptable. 

Quote:
Either way your D needs to feel that she has no choice but to eat, and to eat to gain weight.


Totally agreed.  I wouldn't give up on Magic Plate.  Ed knows it has you running scared.  I never thought my daughter would accept it but she did.  I had to watch her 24/7.  We tried all the negotiating and doing it her way for too many years.  It is what kept her sick.
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