ydnicnomel Registered: Dec 18, 2007
Posts: 6
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| | Dec 18, 2007 at 03:49 PM | Reply with quote | #1 |
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MY DAUGHTER IS 13 AND FOR THE PAST 3 MONTHS SHE HAS REFUSED TO EAT FOR FEAR OF CHOKING HAS ANYONE EVER HEARD OF THIS OR HAVE ANY INFO ON THIS WE ARE DESPERATE TO SAVE HER |
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lydia Moderator
Registered: Aug 04, 2007
Posts: 2,769
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| | Dec 18, 2007 at 04:03 PM | Reply with quote | #2 |
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ydnicnomel
Is your d in the hospital? If not, get her there. She needs to be tube fed if she has gone this long without eating. A doctor can help her sort out the fear of choking...but right now, she needs to get nutrition in, right away. |
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ydnicnomel Registered: Dec 18, 2007
Posts: 6
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| | Dec 18, 2007 at 04:23 PM | Reply with quote | #3 |
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my daughter is in the 3rd different hospital right now and is going to the fourth on thursday and all of the hospitals say they do not tube feed for this ? i'am so scared |
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lydia Moderator
Registered: Aug 04, 2007
Posts: 2,769
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| | Dec 18, 2007 at 05:31 PM | Reply with quote | #4 |
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ydnicnomel
What is your d's weight? Is she getting any nutrition? |
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IrishUp Mentor
Registered: Sept 05, 2007
Posts: 307
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| | Dec 18, 2007 at 11:46 PM | Reply with quote | #5 |
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I'm so sorry you are going through this. I can tell you our d was in 4 hospitals in 4 weeks. The first two also told us they were not willing to support d with a naso-gastric tube - both were community hospitals with limited facilities, so your experience may not be that uncommon. Does your d have a diagnosis of an eating disorder? If her condition is not adequately diagnosed, this may be the initial reason for reluctance to give her a feeding tube.
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LauraCollinsUS Moderator
Registered: July 31, 2007
Posts: 4,036
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ydnicnomel Registered: Dec 18, 2007
Posts: 6
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| | Dec 19, 2007 at 10:31 AM | Reply with quote | #7 |
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my daughter is getting ensure plus for all meals plus as a snack before bedtime but she still cannot overcome her fear of choking enough to take a bite of solid food her weight is still good because she was a little overweight to begin with but it just scares me that she is not getting enough nutrition thanks for all of the info |
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DJ Registered: July 31, 2007
Posts: 137
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| | Dec 19, 2007 at 11:31 AM | Reply with quote | #8 |
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I have no experience with this fear, and she does need treatment, but I was wondering if she would take in baby food?
My d never had this fear, but during refeeding we let her pick out different foods to eat and for some reason during her really bad times, she wanted baby food. I almost forgot about this stage (we went through so many), but perhaps it will help during the time you look for help for your daughter.
Debra
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tryingmom Mentor
Registered: July 31, 2007
Posts: 328
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| | Dec 19, 2007 at 09:51 PM | Reply with quote | #9 |
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Have your clinicians used swallowing therapy?
Tryingmom |
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ydnicnomel Registered: Dec 18, 2007
Posts: 6
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| | Dec 19, 2007 at 11:20 PM | Reply with quote | #10 |
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what is swallowing therapy? I don't know anything about it
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tryingmom Mentor
Registered: July 31, 2007
Posts: 328
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ydnicnomel Registered: Dec 18, 2007
Posts: 6
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| | Dec 22, 2007 at 08:56 AM | Reply with quote | #12 |
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MY DAUGHTER HAS BEEN AT SHEPPARD PRATT IN BALTIMORE FOR 2 WEEKS. SHE IS NO BETTER AND THEY SEEM TO BE REALLY MEAN WITH HER. SHE HAS TO SIT AT A TABLE IN THE DINING ROOM FROM BREAKFAST TO LUNCH TO SUPPER IF SHE DOESN'T EAT A REQUIRED AMOUNT OF FOOD. THEY WILL NOT GIVE HER SOFT FOODS EITHER. I THINK THIS IS UNFAIR BECAUSE SHE IS AFRAID OF CHOKING. SHE CONTINUALLY CRIES BECAUSE THEY WILL NOT LET US SEE HER OR TALK TO HER ON THE PHONE IF SHE DOES NOT EAT A CERTAIN AMOUNT EITHER. ON CHRISTMAS WE CAN SEE HER FOR 1 HOUR AT 3:00 AND THATS ALL DOES ANYONE HAVE ANY EXPERIENCE WITH THIS PLACE OR OPINIONS ON THE TREATMENT? THANKS FOR ANY INFO |
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LauraCollinsUS Moderator
Registered: July 31, 2007
Posts: 4,036
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| | Dec 22, 2007 at 09:48 AM | Reply with quote | #13 |
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I do not find it mean that a clinic makes sure the patient eats - it would be inhumane to do otherwise.
I do think that any treatment that excludes family is inhumane and antiquated. That one's family is not completely welcome to visit, and fully informed about the treatment methods, IS inhumane and based on misguided ideas about parents being part of the problem.
You have the right to be fully informed and included. Your daughter has a right to see and be with you. For your rights: http://www.aedweb.org/documents/WWCharter3.pdf
Your job is to fully educate yourself on this illness and work carefully with the caregivers you believe are operating in the most ethical and effective ways. Don't be passive about this, and don't wait for others to educate you - your daughter's health depends on you..
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roly Registered: Dec 11, 2007
Posts: 15
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| | Dec 24, 2007 at 10:40 PM | Reply with quote | #14 |
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I am so sorry to hear of your troubles, and your daughter's. I think you have gotten very good advice here, and I just wanted to mention something that may be way off the mark, so please take it for what it's worth. I obviously don't know you or your daughter, so this is simply something I have learned in my travels...not specific to your situation. IT is this: Sometimes fear of choking can be linked to sexual abuse --a symptom. I have read this in different places, and have run into people for whom this was true. Just putting this out there in case it mgiht be helpful.
Barbara
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anneli Registered: Feb 25, 2008
Posts: 4
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| | Feb 25, 2008 at 01:49 PM | Reply with quote | #15 |
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Hi, I am so grateful to have found this forum as we are going through the same nightmare with our 11 year old daughter. It is 7 days now since she has chewed and swallowed any real amount of food. She felt that she had a real physical lump in her throat and was terrified she would choke on her food. That constant fear that she had a lump has now diminished but she is still fearful of choking and dying. She will drink ensure with a straw with no problem and she will eat yogurt and the odd spoonful of soup.She has no body image problems and cries when she tries to chew solid foods as she enjoys eating and wants to be able to eat normally again. When she chews any solid food, she feels the need to ask us if she has taken a bite that is not too big and she then chews it for an abnormal amount of time and then ends up spitting the food out.This came on so suddenly.My heart goes out to anyone else who is going through this with their child. I welcome any suggestions or experiences in what others may have done in supporting their child back to normal eating behaviors.
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tryingmom Mentor
Registered: July 31, 2007
Posts: 328
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| | Feb 25, 2008 at 02:02 PM | Reply with quote | #16 |
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Annell,
I would go down two tracks. First, I would try to find a "swallowing" expert who can do an evaluation and possibly prescribe swallowing therapy. I'd call a large teaching hospital. Look at the link I posted before in this thread.
At the same time, I'd pursue a psychiatric evaluation to determine if this is anxiety manifesting in this particular fear or the beginning of an eating disorder.
Good luck.
Tryingmom |
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LauraCollinsUS Moderator
Registered: July 31, 2007
Posts: 4,036
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| | Feb 25, 2008 at 02:28 PM | Reply with quote | #17 |
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Anneli,
The information early in this thread should help. The key is to get the very best clinical help as soon as humanly possible (hard to do both, I know). And I'm going to make this even harder: you will probably have to do the above while remaining very calm yourself. Your anxiety can make things worse.
I'm not saying don't feel anxious (OF COURSE YOU DO) but kids who are anxious need adults around them that are calm, self-assured, confident, and hopeful.
This book is particularly good at discussing phagophobia: http://www.amazon.com/gp/reader/1583918604/ref=sib_dp_pt/103-6577464-5906248#reader-link
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anneli Registered: Feb 25, 2008
Posts: 4
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| | Feb 25, 2008 at 02:35 PM | Reply with quote | #18 |
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Dear Trying Mom, THANK YOU for your quick reply!! I feel so alone in this nightmare as it came on so suddenly when our daughter was thriving and happy. I appreciate your thoughts and have put calls in to some of the eating disorder clinics here. We do not have any large teaching hospitals but I will call some of the speech language therapists and see if any of them do swallowing therapy. I also think it is more anxiety related that has manifested in this fear of choking. There are no other symptoms or signs of anorexia or bulimia and she truly wants to eat. It is hard to focus on anything else right now and to hear from others like yourself who have lived experience with this....is incredibly comforting. Thanks you for taking the time to share your thoughts and compassion.
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Ro Registered: July 31, 2007
Posts: 60
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| | Feb 26, 2008 at 08:49 AM | Reply with quote | #19 |
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I have no experience with this problem, but in googling 'phagophobia in children' I came across this information that was a good description of it.
http://www.lib.okayama-u.ac.jp/www/acta/pdf/61_5_261.pdf
"A Study of Psycho-athology and Treatment of Children with Phagophobia" from 2007. This 9 page PDF document has a graph explaining phagophobia and AN differences and similarities.
In either case, getting refed is a priority along with proper diagnosis.
I hope this helps you.
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anneli Registered: Feb 25, 2008
Posts: 4
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| | Feb 26, 2008 at 01:20 PM | Reply with quote | #20 |
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Thank you to each of you for sending your thoughts and suggestions and excellent books and articles to read. I am so greatful to have found this forum and do not feel so alone in this challenge now. Our daughter will swallow liquids with little to no problem, so drinking Ensure, water milk etc is fine. She continues to eat yogurt and today has taken apple sauce also for her school lunch. She tried homemade soup last night at her request and spooned out the broth only. I am wondering what solid foods others may have been successful with when dealing with someone who has such fear of choking.
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ruralmomUSA Mentor
Registered: Aug 21, 2007
Posts: 443
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| | Feb 26, 2008 at 02:56 PM | Reply with quote | #21 |
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Hi,
I wanted to share some additional info. Kennedy Krieger in Baltimore used to have an excellent feeding program for children with disabilities. Even if your child does not have a disability, you might check to see if they can help. They used both medical and behavioral management of problems similar to what you are describing. It sounds like a thorough medical evaluation is war rented and then, if there is not a medical reason for the swallowing problems, someone with behavioral expertise could be very helpful.
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lvanmierlo Registered: March 05, 2008
Posts: 1
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| | March 05, 2008 at 10:47 AM | Reply with quote | #22 |
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Our daughter is 8. Monday evening at the end of dinner she declared that she could no longer swallow. She does not claim to have been choking, but she may have had difficulty at the moment....
Monday morning she had two bites of breakfast with difficulty and drank a glass of juice.
She came home Monday afternoon with the contents of her lunchbox uneaten. She did drink her milk.
Monday afternoon we called the Dr. and she saw us right away. She checked her throat (which was red) noticing that our daughter had a mild cold. The nurse did a strep test just to rule out any infection. It came back negative. The Dr. seemed to think that our daughter had a choking or near-choking experience which triggered this fear of swallowing.
At the moment she can "eat" yogurt with no texture (no fruit in it, no chunks) and has had soup broth. She tried a bit of mashed potatoes and gravy with some success. She is drinking milk and juice and can tolerate the yogurt type foods, but eats extremely slowly, taking only miniscule bites.
I've put another call into the Dr. today to say that she has not improved and I also put a call into the school to alert them to what is happening.
I've been reading up on phagophobia (although she has not been diagnosed yet) and am waiting to hear from the Dr. and figure out a plan of action. This is definitely foreign territory for me.
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anneli Registered: Feb 25, 2008
Posts: 4
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| | March 05, 2008 at 04:43 PM | Reply with quote | #23 |
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My heart goes out to you with great compassion and understanding for your situation. The many posts above hold such truth and great advice and suggestions if you have time to read through them. Our daughter is now into her 3rd week of not eating any solids and has been checked by several doctors to make sure there is no physical problem causing this. She too will drink the Ensure, any liquids, eat yogurt without anything in it, have soup broth and a little bit of cream of wheat porridge....but can not chew solids and swallow them. I have gone through all the emotions and am trying hard to stay calm and confident that she will get past this and back to normal eating. I am still hoping that we may be able to connect with a therapist that offers swallowing therapy. There are many great articles on Phagophobia and Functional Dysphagia on the Internet, which you may find helpful.
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CBTherapist Registered: March 06, 2008
Posts: 3
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| | March 06, 2008 at 02:58 AM | Reply with quote | #24 |
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You may also want to look for therapists with expertise in treating anxiety disorders in your local area, particularly those who use cognitive-behavioral and exposure based treatments. Anxiety disorders therapists are often comfortable (and quite successful!) in treating these fears as a specific phobia, particularly when they have had a sudden and/or "triggered" onset, as you describe. Two good resources for identifying such providers are the Association for Behavioral and Cognitive Therapies (http://www.abct.org), and the Anxiety Disorders Association of America (http://www.adaa.org).
An appropriate CBT therapy would provide education and coping skills for dealing with anxiety, followed (quickly!) by a behavioral plan that gradually reintroduces feared foods into your child's diet. Exposures may also specifically target fears of swallowing or gagging by helping your child desensitize to these physiological sensations (through holding in the back of the mouth and later, swallowing, gradually increasing sizes of candy or other food, for example). You will want to work closely with your pediatrician and therapist (and make sure they are communicating directly) to ensure that you are carefully monitoring your child's weight and physical health, *and* providing the necessary nutrition through other means (non-feared foods and/or liquid supplements) while you are working through the exposure process as a family. The good news is that this is typically easily treated, particularly if addressed soon after onset.
Best of luck!
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kartinimd1 ED clinician - FEAST Advisory Panel member
Registered: March 03, 2008
Posts: 48
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| | March 06, 2008 at 11:04 AM | Reply with quote | #25 |
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I read your blog titled FEAR OF CHOKING because we have had many young patients with this exact problem. Dr Bryan Lask described it in his book Eating Disorders: A Parents Guide, as "food phobia". At Kartini Clinic we have developed a protocol for treating food phobia in children. It is NOT anorexia nervosa, despite the refusal to eat, is often preceded by a choking episode, something being caught in the throat, a traumatic experience, or nothing at all. It is more common in younger children (under 15) and can be boys or girls. Most of our kids were in the younger age 6-12, although we are currently helping with a 4 year old. Food phobia can be frightening because young children have little physical reserve, can lose weight rapidly and become dehydrated if they will not drink. In our experience, it is best treated in the hospital with an NG tube and medication. The tiny pediatric tube allows us to make sure the child is physically safe, restore their weight/hydration status and let them and the family relax for a while while the child gets to know the treatment team. Again in our experience, medication is needed to allay anxiety. The introduction of food is done gradually; the family is included in doctors rounds every day and meets weekly with our family therapist. Although the treatment of food phobia can take some time (weeks) we have never had a treatment failure, except for the very first patient, when I did not yet have a treatment protocol in place and did not (like many pediatricians) know what I was looking at.
I have no idea where you are, but my heart goes out to you. |
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jlsmith Registered: March 11, 2008
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| | March 11, 2008 at 10:08 PM | Reply with quote | #26 |
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my daughter is 18 years old. she is 5'2" and used to weigh 106-108 lb. today she weighed in at 99 lbs. i know that doesn't seem like much of a loss, but on her tiny body it is. She is now eating some solid foods. She existed for months on Ensure, ice cream, milk and juice. We slowly moved to soups, and then very, very thin mashed potatoes and bread dipped in melted butter. Today we got three very, very small bites of baked chicken in her. It took her 69 minutes to eat that. (Yes, I timed it, and yes, I went outside and cried when she finished.) This all started from anxiety over big changes in our family life. She is now on Xanax and Lexapro and sees a therapist weekly. Fear of choking or swallowing was never a problem for her - there is no incident that started this other than general anxiety. However during testing it was discovered that she had asthma and reflux. Both of which can cause throat issues. So when anxiety overtook her, it focused on her throat. For all of that, she is on Asmanex, Xopenex, and Prevacid. If your child is having swallowing/eating issues, please check into anxiety/depression also -it can manifest itself in many ways.
I believe there is a light at the end of the tunnel - maybe it's soup, or mashed potatoes or maybe even a bite of chicken,, even if it is chewed for 20 minutes before swallowing.
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lydia Moderator
Registered: Aug 04, 2007
Posts: 2,769
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| | March 11, 2008 at 10:55 PM | Reply with quote | #27 |
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jismith,ivan, & annell,
It wouldn't surprise me if low blood glucose levels worsen the anxiety for your children.
Since weight loss is such a serious concern, don't forget there are other things besides Ensure that you can use. V-8 Fusion & Haagen Das Ice cream for smoothies, and Ice Cream milkshakes can be some good calorie boosters. We added 2 Carnation Instant Breakfast packets in each smoothie and milkshake we made for our d during refeeding. We also added Carnation Instant Breakfast to Hot Cocoa made with whole milk and heavy cream.
Our d hated the flavor of Ensure & Benecal, and we couldn't figure out how to make high protein powders taste good. But some other parents here may have some suggestions about how to do that.
Switching to more naturally flavored beverages made the "medicine go down" much better for our d.
We also used cream based soups. Our d liked cream of tomato, cream of potato, etc. and these kinds of soups can also help with calories.
Sending strength and hugs |
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Registered: Member deleted
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| | March 29, 2008 at 06:19 PM | Reply with quote | #28 |
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Just like to add my story here and give my sympathies to the parents and kids going through this. My son who is 8 has had swallowing difficulties for almost 4 years. It began over the course of one weekend. He choked mildly on a piece of broccoli (ddint even really choke, just went down wrong way a bit) and then overnight he was just unable to swallow. He went from a normal diet, not picky, loved all types of food, to only being able to eat yoghurt's, smoothies, soup. Our doctor was useless really, said it was just in his head pretty much and sent us away on declaring that physically his throat was all normal. We have basically had no help - i feel very alone with this. I found a feeding program about a month after it began on-line from Great Ormond Street hospital in London and began to follow ti on my own. Introduced very small bits of solids (ie a tiny square of bread with his soup), and then he would get a sticker on a chart. 5 tries of bread (over 5 days) = 5 stickers and a treat (usually a small toy or something) and the food would be added to the 'list' of foods he could eat. This seemed to reduce his anxiety over the swallow. Over the course of 4 months my partner and i got him back to almost normal. Sadly though the problem keeps returning. In fact he has never 'got better'. At his best he can eat a limited range of soft foods (jacket potatos, quiche, soft fish, tuna mayo sandwiches) We have had only one referral to the child mental health unit at our local hospital 2 years ago. He only got as far as being evaluated by a nurse, and she decided that his situation didn't warrant treatment, as "he seemed to be ok at the moment". I just didnt know where to turn! Friends and family suggested he was manipulating for attention!! No way, when he so desperately wants to eat and he tries so hard it makes my heart break. He has frequent setbacks, and even at his best it takes him one hour of painfully slow swallows and pocketing food to finish a tiny meal of something soft like a jacket potato and butter. Now, finally after much research, we discover that our nearest city hospital has a FEEDING CLINIC(!) for children with swallowing problems that no doctor has ever mentioned to us. They mainly deal with physical problems though so i dont know how they will approach his phagophobia. I suspect they will suggest what i have already been doing (the gradual re-introduction of more 'difficult' foods whilst trying to keepi anxiety and stress to a minimum) We have got an appointment on Monday. I have to say, its my last and not very good hope (i don't have the money for private help) - he's so thin, and i find it increasingly difficult to be patient with him when he sits hamster-like with the same bit of bread in his mouth for ten minutes.. Sometimes i get angry with him and then i feel so bad because i know it will only make him worse. We are a happy house usually! Sorry - I'm ranting here! but its the first time I've read of other parents who have children with similar problems... If anyone has had success with this i would love to know how..
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tryingmom Mentor
Registered: July 31, 2007
Posts: 328
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| | March 29, 2008 at 09:32 PM | Reply with quote | #29 |
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I just have a few thoughts. First, I would try to increase the caloric content of his soft foods, using high calorie ideas on this board. Second, I would definitely work with the feeding clinic. He's having difficulty swallowing, whether it's physical or mental in origin. Finally, I would try to get a psychiatric consult with someone who is knowledgeable about anxiety/OCD. Also, there are books on helping your child with anxiety and with OCD, e.g., The anxiety cure for kids, Talking back to OCD, etc. Some of these might help.
Tryingmom |
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Registered: Member deleted
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| | April 01, 2008 at 04:28 AM | Reply with quote | #30 |
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Well, we had our much lauded feeding clinic appointment (for our 8 year old boy with a 3 year history of phagophobia) which we had been waiting for for 4 months.. I was disappointed. They told us to use a reward chart, introduce 3 small bites of new foods a day, let him choose the foods (they said even if that is cakes and icecream which i found strange) , and limit his meal times to 30 minites so he doesnt get bored. Well. Thats all well and good except we have been trying that for the past 3 years and his problem still hasnt gone. Good advice for others who are just at the start of this problem though. It worked for us at the beginning, it just didnt make it stay away.. They said they would see us again in 4 months to see how he has improved. I have to say, im not feeling especially optimistic!
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LauraCollinsUS Moderator
Registered: July 31, 2007
Posts: 4,036
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| | April 01, 2008 at 06:41 AM | Reply with quote | #31 |
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M,
I am so sorry the appointment was disappointing. I have arrived at so many appointments with the weight of days, hours, even weeks of hope and worry and anticipation - and leaving without clear answers is scary and disappointing. It may take establishing a relationship with a clinical team so they can see a fuller scope. But it seems to me that months away is not possible with such an urgent problem.
Can you get into another clinician, a private one perhaps? Can you escalate the urgency and request an appointment much sooner?
Please don't despair, or give up. There are solutions. Go back to the basics they offered you, and at the same time pursue other avenues to get care.
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Maria Mentor
Registered: July 31, 2007
Posts: 2,613
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| | April 01, 2008 at 07:54 AM | Reply with quote | #32 |
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Just because your Dr didn't recommend therapy, doesn't mean that your s doesn't need it. Did you look back over the posts from CBTherapist and Dr. O' Toole at Kartini Clinic? If your insurance requires a PCP referral, call or go back with some research and tell him you want a referral to a CBT clinic. I have found that I have to be very informed and firm to get my children what I believe that they need. But, you have to show them some research. Do a search on PubMed and see if you come up with some treatments for phagophobia (sp). Wishing you the best |
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Registered: Member deleted
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| | April 02, 2008 at 03:22 AM | Reply with quote | #33 |
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Thanks to you both. my partner and I are thinking what to do next. He was so bad last night he only ate 3 mouthfuls of cream of tomato soup in 45 minutes. And THEN, as directed by the feeding team - we gave him dessert, and he ate a great big chocolate muffin in no time at all. It doesnt make sense, its so driven by his anxiety/and/ordesire to eat. Obviously im not goingt o just feed himk cakes and sugar! Despite what the team said, i feel like a carrot and stick apporach works wioth him. Eat all your soup, you get a cake. I just dont know. As for finding other clinicians etc. I'm in the UK, so insurance doesnt apply as we have the national health Service which is free. I cant afford private care as i am on a low wage. But the NHS is pretty rubbish, so im kind of stuck. Ive already pushed for all the referrals on offer, and once he had a couple of NLP/hynotherapy sessions, which were laughabley uselesss. Oh dear!
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laradtek Registered: April 27, 2008
Posts: 4
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| | April 28, 2008 at 08:33 PM | Reply with quote | #34 |
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Please help me. I googled kids who choke and don't eat and ran across this website. I have heard of anorexia and bullemia, but did not know fear of choking had a name. On April 20,2008 my son and I went to my mother and father's house for dinner. My uncle (my mom's brother) also was there. My mom made boneless, skinless chicken breasts bar-be-qued on the grill (no sauce), sweet potatoes and green beans. My son is 7 years old. He can eat..I mean eat when he wants to. Sometimes he is picky with some vegetables and it's like pulling teeth to get him to eat fruit. He had a choking episode that evening. I was sitting across the table from my son...my uncle was sitting next to him. When he began to choke, I immediately started to get up, but my uncle started hitting him on the back and it came out. I work in a hospital so I know that wasn't the correct thing to do but I quess it was my uncle's initial reaction. Anyway, I forgot about it. My son didn't. My mother and I took him to the hospital (ER). I was afraid because he was acting peculiar and was not eating the usual things that he loves. They really could not help me. They told me to make sure he did not get dehydrated and to follow up with his pediatrician in 3-4 days. So I did. I had to go through the nurse. She checked with the doctor and advised me she would fax or send by mail a list of psych doctors. I was like...what? Nothing like really making him think something is wrong with him. Different people in my family give advice and I know they all mean well. The fact is...he is eating applesauce, chocolate pudding, mac-n-cheese, icecream and sometimes eats M&M's. I cannot make him a turkey sandwich for lunch to take to school with him like I use to because he throws it away. I took him to McDonald's a couple of days after it happened and he ate one chicken mcnugget and spit the rest out. If it is something he says he cannot eat...he spits it out. Today, he came home with a headache. I am not sure what to do. My other uncle who lives in Florida advised me he had a client who had this happen to him and his family. The advice was to do not make a big deal about it and when he is hungry he will eat...do not force him. Just make sure he is hydrated. At first I thought that was logical, but now I am not sure. Any suggestions or reccommendations would be appreciated. |
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LauraCollinsUS Moderator
Registered: July 31, 2007
Posts: 4,036
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| | April 29, 2008 at 05:23 AM | Reply with quote | #35 |
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As the earlier advice has emphasized: there is reason to be concerned. But not to panic, and certainly not to put pressure or more anxiety on your son.
Some people are wired to react to fearful situations with extreme vigilance - it saved our ancestors from danger. Those people need extra support and love and to shut down the alarms. And they need that help EARLY in the process in a loving and nonjudgmental and organized way.
Don't panic, don't delay: get expert help. And now that you know he has this sort of heroic temperament, nurture him accordingly.
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tryingmom Mentor
Registered: July 31, 2007
Posts: 328
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| | April 29, 2008 at 11:23 AM | Reply with quote | #36 |
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If you haven't already identified the official term for this problem, it is called functional dysphagia. I would try to find an expert, even if you need to consult by phone. My bet is that most doctors are not trained to diagnose and treat this.
Tryingmom |
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laradtek Registered: April 27, 2008
Posts: 4
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| | May 05, 2008 at 09:48 PM | Reply with quote | #37 |
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Thank-you for your comments. Since the last time I wrote, I have done nothing but try to be calm with my son and make sure he is happy. He can eat. He is still being picky with some things. I am not sure if he is trying to use this to his advantage or if he is still afraid. He had taco chips tonight with chili con queso and a soft burrito. Last night he ate a bar-be-qued hamburger and pork and beans. He did not eat any bread, but he ate the whole hamburger. What do you think about this now? I just do not want to run to a psych and blow everything out of proportion. Sometimes love and understanding and patience go a long way. I quess I am saying this because if there is anyone out there who is still having a problem...maybe they can try this approach. |
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LauraCollinsUS Moderator
Registered: July 31, 2007
Posts: 4,036
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| | May 06, 2008 at 06:10 AM | Reply with quote | #38 |
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I thnk calm and love are wonderfully healing things.
But please, don't be afraid of seeking psychological help! It is a resource, not a scary or negative thing. If you are concerned with your child being freaked out by it - go by yourself for a consultation.
The thing is, if this kind of fear reaction happened once, it can happen again. It is an important AND GOOD thing to know that your son has this capacity for anxiety and necessary to keep that in mind as he develops.
Not to hover or worry - but to be aware and nurture his coping skills. Each person is unique and needs different kinds of supports. An anxious person may need fewer pressures and more coping skills. A fearless person may need more judgment skills and more motivating pressures.
In my case, my two kids have opposite needs. And I learned to my dismay that *I* have trouble with anxiety when I saw how my children's problems made me react. I had to learn to de-stress A LOT. Which was, again, a good thing!
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lyon150 Registered: May 11, 2008
Posts: 1
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| | May 11, 2008 at 06:23 PM | Reply with quote | #39 |
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It may sound outlandish, but if the fear of choking/not eating is a sudden onset thing, it's worth getting seeing the pediatrician to get a blood test for strep. It can be physically symptomless and can cause mental symptoms, including extreme anxiety and OCD. Antibiotics can treat it (but behavior therapy will still help for coping skills and conquering the fear of choking).
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kartinimd1 ED clinician - FEAST Advisory Panel member
Registered: March 03, 2008
Posts: 48
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| | May 13, 2008 at 09:39 AM | Reply with quote | #40 |
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| Functional dysphagia and food phobia are the same thing. The usual presentation is in a younger child, the onset is sudden, usually--but not always--preceded by a choking or vomiting episode followed by refusal to swallow food. In extreme cases the little person will refuse to swallow liquids and even their own saliva (which they then spit out). You can imagine that they easily become dehydrated. At the Kartini Clinic we treat several such children every year and have developed a protocol. To date we have had no treatment failures, but treatment does require a hospitalization and initial re-feeding with an NG tube. We always have the parents as a part of treatment. Food phobia can be more challenging (than childhood onset anorexia nervosa) to treat at first, but does extinguish. It seems to me, that the first step is to get an accurate diagnosis, then begin treatment as quickly as possible before considerable weight loss and dehydration set in. Hope this helps. We have had several parents of children who have been through this offer to speak to other parents about their experience. |
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laradtek Registered: April 27, 2008
Posts: 4
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| | May 14, 2008 at 11:44 AM | Reply with quote | #41 |
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My son is eating. He will not eat certain things, but I think he is using that to his advantage. If he can eat taco chips, hamburger helper, chicken quesadillas,pasta,crackers,cheese,etc,etc...I do not want to go to a psych to tell me what is wrong with him. At first..after it happened...of course he was afraid. I tried a different approach and he seems to be doing ok. I think he is going through a phase like some kids do. I also think when he saw how afraid I was and reacted at first...he knows how to not eat vegetables anymore or things he does not want. |
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LauraCollinsUS Moderator
Registered: July 31, 2007
Posts: 4,036
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| | May 14, 2008 at 11:55 AM | Reply with quote | #42 |
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L,
I understand you are feeling as if you don't want to make a bigger fuss and you are skeptical of professional help on this - but I have to emphasize to you that using professional advice is not something to be feared or avoided. It is a resource, a tool that most families can benefit from at some time in a child's life. How you use is it up to you.
Kids with anxiety problems need parents who are aware of and trained to respond with good tools and with appropriate clinical advice. Otherwise we end up protecting their anxiety instead of them.
You are interpreting your child's behaviors as willful, but a good clinician could help you negotiate that - someone who has seen this issue play out in many families. Please reconsider?
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nhugs Registered: May 18, 2008
Posts: 3
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| | May 18, 2008 at 11:20 AM | Reply with quote | #43 |
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I just found this site and am very grateful. I know it will not make what is happening go away but I had NO IDEA that the fear of choking in children was even an issue. My daughter,8 and turning 9 next week, stopped eating a month ago after being ill with the flu. Having a degree in psychology I thought less attention the better. But it didn't go away. It got worse. I started reading these entries and said "Oh that is it! That is what she does!". I have been crying and she has been crying but nothing changes. We saw her pediatrician for a physical and he said she needs a counselor and that she is "behaviorally" controlling her environment through not eating. I was confused. I did not agree. She was a happy waffle, pizza loving child until she threw up during her illness. Then she told me, crying, that she was afraid the food would go down the wrong way. She was crying because she WANTED to eat the food in front of her but couldn't. Looking back she was terrified and I was helpless. Which is terrifying. I have printed out information on this disorder for her pediatrician. He needs to know what we are dealing with. In my panic and fear I haven't been able to come up with many food ideas for my daughter. We are trying a weight lifting drink with high amounts of protein. But I have read many suggestions here and feel there are more choices. Thank you. Like many who have written my daughter will only eat pudding, yogurt (no lumps), soup (just Tomato), and was eating sweets...and toast but has stopped eating things that she has to chew. I definitely feel she is going backwards. I panicked and started to cry and feel very very scared. She lost 2.5 lbs in one week. She is already tiny. We live far in the North Country and any experts will be 2-3 hours one way. But finding this site is a start. I should have looked before we went to the doctors. I also thought "it" would go away. She would get hungry and eat. But she just cries. She is my whole world. When does the fear of survival kick in?! Sorry, just scared and who wants their child to fight this battle instead of playing and eating too much....normal childhood. |
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LauraCollinsUS Moderator
Registered: July 31, 2007
Posts: 4,036
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| | May 21, 2008 at 09:32 AM | Reply with quote | #44 |
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As difficult as it is to get our minds around, this reaction is not a choice and our children cannot be left to figure it out or be motivated themselves.
This is time for authoritative, protective, loving ACTION as a parent.
No more fear (in front of them), no anger, no cajoling - this just scares them more. Get expert advice, get nutrition going immediately to prevent further damage to the brain, and put aside everything else for as long as it takes. (And that might be a while. Our kids are worth it.)
You can do this. And you are not alone!
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nhugs Registered: May 18, 2008
Posts: 3
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| | May 27, 2008 at 08:49 PM | Reply with quote | #45 |
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Has anyone else had their child tested or seen by pediatric GI or ENT? I am taking my daughter this week and next week. She struggles even to get her nutritional drink down. We have also started counseling and relaxation techniques. It has been a huge help for both of us. She is using bunny puppets to talk and it is interesting to see how she identifies her feelings and just how much she doesn't. She honestly hasn't a clue as to why she isn't taking a bite of anything. I want her completely checked before she is given a functional disorder label. I want to know what we are dealing with. Then get the right help. If I had followed her doctor's advice we would be doing nothing. He didn't even suggest nutritional drinks. She had lost almost 6 lbs. Anyway, if anneli is still reading this log how are things? |
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lydia Moderator
Registered: Aug 04, 2007
Posts: 2,769
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JohnSmyth Registered: Aug 07, 2008
Posts: 1
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| | Aug 07, 2008 at 08:21 AM | Reply with quote | #47 |
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Hi, My wee girl has recently (1week)went off her solids too. She has always been an anxious child, worrying about aspects of life that a child shouldn't be worrying about. I think she may have developed her anxieties through the death of a grand aunt who was very good too her. Recently she had to stay overnight in our local hospital following a panic attack and since then her anxieties have increased. She now has went off her solids, only eating fruitless yogurts, soup and fluids. She is constantly saying she is hungry but cant swallow the food. I've read through some of the threads and I feel she has Phagaphobia. I took her to a hypnotist/physcotherapist to try and have her hypnotised however it didn't work. Does anyone know of any specialists in Ireland who deals with this condition? |
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lydia Moderator
Registered: Aug 04, 2007
Posts: 2,769
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| | Aug 07, 2008 at 11:07 AM | Reply with quote | #48 |
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JohnSmyth,
Welcome to the forum.
I'm so sorry you're seeing your d struggle this way. Not being from Ireland, I don't have any specific information to offer. I can only suggest 2 things:
1. You might try this link, for a list of psychiatrists at St. John of God Hospital.
They have an eating disorders program (I can't vouch for it) so perhaps they have treated young patients with swallowing disorders...or could help point you in the right direction.
http://www.stjohnofgodhospital.ie/gps-corporate-profiles.html
2. You might contact Maudsley Hospital, to see if they can offer suggestions for help in Ireland.
http://www.slam.nhs.uk/services/sitelist.aspx?site=Maudsley+Hospital
We do have UK families on the forum, I'm sure they can be more helpful.
Wishing your "wee girl" a speedy recovery.
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kmtmb Registered: May 13, 2008
Posts: 53
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| | Aug 07, 2008 at 12:02 PM | Reply with quote | #49 |
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My daughter was in a combined inpatient/outpatient program where one of the outpatient girls was afraid of choking. She would have to try to eat some of every meal, and make up for what she didn't eat at the end of the half hour by drinking Ensure. It was inspiring for my D actually, because she said that the girl showed no fear of having to drink a supplement even on the days when she came so close to finishing up her meals, and even though she gained weight she still kept coming to her day program because she wanted to defeat her fear. My daughter said they gave the girl lots of soft foods; mashed potatoes, oatmeal, french toast with syrup, puddings, applesauce, cottage cheese. Then she started trying cereal and muffins and began eating the bread of her sandwhiches. My D was amazed that this girl would ask for extra juice boxes or milks so she could finish the meal. Apparently, having something liquid to swish down after a solid food helped her really feel like she had swallowed. My D says that the girl did start to do really well, and the week she left she had gone the whole week without having to supplement her meals. It is a very serious fear, though I don't think its quite the same as a real eating disorder. As long as you help your daughter through it with small steps, I am sure she can overcome the fear. Just take it day by day - aim to get most of her calories and nutrition in with liquids and very soft foods at first, and gradually change over into more solid foods. Help her rebuild trust in food and her body's ability to process it. So if she can drink an Ensure, she can swallow some oatmeal for breakfast. And then she can try for cereal thats been let to sit and soften a bit. And then she can go for the crunchy goodness. You know, small steps here and there. But only as long as she's willing to get her calories in with liquids, then its trully just fear of choking. If she starts fighting over liquids and calories; I would start to wonder if it was a guise for anorexia.
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rebeccastarr Registered: Sept 03, 2008
Posts: 9
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| | Sept 03, 2008 at 09:08 PM | Reply with quote | #50 |
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Hi. On Monday my 5 year old daughter came home from school and refused to eat. She said she was scared of choking. If she even nibbles on a biscuit ie a few crumbs she asks "Am I turning blue?" When other people eat she says.."Why does their food go down the right way? Mine doesn't." She gets very sad aboyut food as she says she wants to eat but can't. She turns down all her favorites and even yoghurt or smoothie type things or milk. She does drink water from a pump bottle and has drank juice once.
Before this she ate like a horse. This is her 2nd week at school and I thought maybe she was just anxious about school but the first week she was really happy. Now she is miserable and lethargic and does not want to go.
I took her to the doctor to get her throat checked and she is fine. He said come back in aweek if she still hasn't eaten. I have been insisting she still goes to school because I don't want to reinforce the non-eating in any way but am so worried about her tryoing to cope in a new environment on no food. She also gets ver upset at lunch at school. At home she gets very worries when her brother or baby sister eat food in front of her, she thinks they are going to choke. I don't know if she has choked at all.
Help! What would you guys do?
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