suz
Registered: Feb 25, 2008
Posts: 35
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| | Feb 28, 2008 at 07:26 PM | Reply with quote | #1 |
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Our daughter is 5 ft 1in, aged 13 and has been suffering from an ED since she was 10. She currently weighs 88lbs and eats 2 meals and 2 snacks each day supervised, and 1 snack and packed lunch at school? She still restricts all "junk" food and anything else that she regards as having any "fat" content. We have been seeing a Maudsley based ED therapist from June 2005 and made very good progress for the first 18-24 months, however she is currently struggling and has made no progress for the last year. She began CBT in January 2008 which seems to be having a profoundly negative effect, she is balancing any extra food intake by trying to cut back elsewhere, she is now fully aware of her weight, BMI, calories and saturated fat content, none of which is helping! She is also experiencing very negative feelings almost constantly now and is becoming increasingly confrontational and defiant while also saying that she no longer cares about anything or indeed anyone. At home she eats nothing voluntarily, only what is supervised. She plays some sport, maintains very high standards at school (so far) and appears to be functioning within the school environment. WHAT DO WE DO NEXT? |
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LauraCollinsUS
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Registered: July 31, 2007
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| | Feb 28, 2008 at 08:00 PM | Reply with quote | #2 |
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I'm confused. You are describing a very low BMI, which all by itself seems to indicate why she's doing so poorly.
What do your clinicians say about this?
Why is she choosing her own foods?
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suz
Registered: Feb 25, 2008
Posts: 35
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| | March 05, 2008 at 04:05 AM | Reply with quote | #3 |
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Sorry it has taken a few days to reply, things very difficult at home!
Our daughter does not choose her own food, I do all the cooking, mostly with her removed from the kitchen. However she is permitted a little choice regarding her snacks, she still opts for low fat reduced calorie choices / fruit + water whenever possible, which inevitably leads to confrontation. Since the beginning of the CBTprocess, she has gained 1 lb in seven weeks which is totally insignificant but a huge weight gain to her. This has led to her therapist stopping all sport however throughout this process she is becoming increasingly physically and verbally abusive, regularly threatening that she will stop eating completely if we don't restore sport, be nice to her etc etc etc.
She is still consuming three snacks and three meals as I have said previously, but steadfastly refuses to gain any weight claiming that she likes how she is NOW ! We have pointed out that it is unreasonable to want to stay the size and shape of a small 13yr old but she refuses to acknowledge that this is a problem.
Any thoughts or suggestions would be very much appreciated, we really do not know what to do next?
Given that she is eating just enough to be stable, we feel like we are bullying her or backing her into a corner where she may make some very dangerous choices although she clearly still has some very distorted thinking and is in a dark place!
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MarcellaUK
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Registered: July 31, 2007
Posts: 987
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| | March 05, 2008 at 04:41 AM | Reply with quote | #4 |
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Until I checked your location and realised your child's age, I thought you must be someone I met at the recent UK carers' conference. Your position sounds so similar to her story, except for one detail, her child is now 17 and therefore the legal position is waayyy different.
It sounds as if you are in the words of Ivan Eisler "stuck",. I wouldn't necessarily pull the CBT. Maybe it is doing good although your child does sound rather young for it. Have you read the Lask and Bryant-Waugh book (Eating Disorders a Parents' Guide)?. In it it describes "Stage II" where parents bear the brunt of horrible behaviour, but which is seen as a step forward as the child isn't internalising the illness and focussing only on food - she's externalising it and focussing it on you!! Maybe this horrible phase is a necessary one?
Since your child is so young you have every right, and I would say duty, to question the treatment team and ask them for answers. Can you put the questions you've put here to them and ask them where they think the treatment is going? One option that might be a very real one for you if the Health Service will agree to funding, would be the multi-family Maudsley sessions either at the Maudsley itself, or as now used by other teams. http://www.iop.kcl.ac.uk/sites/edu/?id=13#__anchor00007
The parent I thought you were had actually asked for a second opinion from Dr Eisler at the Maudlsey himself and you are entitled to the same.
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Lisa
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Registered: Aug 01, 2007
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| | March 05, 2008 at 10:32 AM | Reply with quote | #5 |
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I'm sorry you're in such a horrible position. My d also liked the way she looked at her lowest weight and didn't want to gain. That's the ed talking and it's our job not to listen. Your d needs to gain weight before the physical and verbal abuse will subside. It can be done painstakingly slow or painstakingly fast. Either way, it has to be done for your d to heal physically and mentally. It sounds like you're doing an modified version of the magic plate: you're making the food, but she doesn't have to eat everything. It's so much easier to present a plate of food and expect her to eat everything. You choose the amount so that she's gaining weight at a faster pace than one pound in seven weeks. All weight gain will be hard for her, why not do it faster and get it over with as quickly as possible? No sports, lots of food and lots of deep breaths!
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LauraCollinsUS
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Registered: July 31, 2007
Posts: 4,036
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| | March 05, 2008 at 12:01 PM | Reply with quote | #6 |
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Weight and nutritional goals are medical decisions, not a choice that an ill young person should be making. The beliefs and behaviors are natural for a person who is underweight and malnourished - they cannot abate or be reasoned with without gaining weight and having reliable nutrition for months.
You can stop letting her choose. She can't do that on her own.
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marie2
Registered: Aug 01, 2007
Posts: 222
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| | March 05, 2008 at 12:18 PM | Reply with quote | #7 |
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suz,
Can you give a little more information. Your original post mentions that you starte Maudsley in June 2005 and made good progress. Was she at a good weight at some point and then relapsed? I've heard from others on the board that the relapses can be harder to deal with then the first time around.
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suz
Registered: Feb 25, 2008
Posts: 35
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| | March 05, 2008 at 03:32 PM | Reply with quote | #8 |
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Our d has very limited choices , she is having pancakes, crumpets and swiss roll for snacks instead of fruit, however that on top of her three main meals is still resulting in this exceedingly slow weight gain. What methods or means do you use to get your child to eat increased amounts of higher calorie foods when they are totally resistant to everything you suggest. Ice cream, milkshakes, smoothies etc all "off the menu" at the minute? How do you force your child to take more when they believe they are already consuming mountains of food ?
Our d did indeed gain weight for the first 18 months at a slow but steady rate up to approximately 95lb (aged 13, height 5 ft)when she was almost back to normal mentally (still a little restricted but not much), but from last summer until Christmas we believe she slipped back and relapse then set in, I cannot quote actual weights because she was not being weighed.
What is the correct reaction to threats of stopping eating completely unless.......? Has anyone else had this sort of very negative reaction to CBT, and how did you get through it?
We are desparate to help our daughter recover but we do have another child in the middle of all this "confrontation and challenging", any suggestions on how we protect him would be very welcome, particularly given the current physical and verbal abuse?
Thanks for all the support so far
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marie2
Registered: Aug 01, 2007
Posts: 222
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| | March 05, 2008 at 03:56 PM | Reply with quote | #9 |
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suz,
I have never tried CBT therapy for my d, so I have no suggestions as far as that goes. But, I do wonder why you are now trying CBT instead of Maudsley if you felt Maudsley was working for you before.
It is very common for children at such low weights to react the way you describe, and only full nutrition will help to relieve this. Your d is suffering from malnutrition, and needs food, plain and simple.
From your description, it sounds like your d was previously almost weight recovered, but then for some reason weigh ins were not continued. Once a child who suffers from AN is weight recovered, symptoms can still continue for quite some time. And even after that, I'm not sure when or if weigh ins can every be discontinued. Perhaps some of the parents who have had children fully recovered for quite some time can explain how they have dealt with ensuring their children keep up to weight.
But for now, you are basically back at square one, and need to make sure your d starts eating. She shouldn't be choosing the foods, therefore ice cream, milkshakes, and smoothies are not "off the menu". If you cannot get her to eat enough food, please bring her someplace that can.
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bluebooks
Registered: Nov 08, 2007
Posts: 135
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| | March 05, 2008 at 04:21 PM | Reply with quote | #10 |
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Quote: How do you force your child to take more when they believe they are already consuming mountains of food ?
The parents, here at this forum, taught us how:
We placed the food in front of our son and he sat there until he ate it. He yelled, negotiated, threatened, fussed and cried. We told him that he wouldn't be going ANYWHERE or doing ANYTHING until he ate.
At some point he finally believed us and he ate.
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Zeri
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Registered: Feb 19, 2008
Posts: 1,480
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| | March 05, 2008 at 05:58 PM | Reply with quote | #11 |
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Suz - We told our 17 yr old d "no eat, no anything else". She wasn't violent, but 'Ed' was mouthy and sarcastic....we just ignored the bad attitude. She ate. If she had 'chosen' not to, we weren't going to let her do anything else...no Facebook on the computer, no computer period, no TV, no phone, no school...no nothing.
Your d is only 13; you have a LOT more power than you realize. If you're working you may have to take some time off...it's a lot of work (I've found out) to plan and prepare the meals/snacks.
Foodwise, we started w/what our d was already eating and just served larger portions and 'jacked up' the calorie count in what she would already eat. For example we add 3 TBS of heavy whipping cream to her 8oz serving of whole milk; she doesn't know we're doing it, and you can't taste the difference. We use whipping cream in the pancake mix and oil (not water); if you're using those pre-made frozen kind, start making them yourself. We stir 1 TBS of veg oil in a can of refried beans (a favorite of hers) - the oil adds 40 more calories per serving and you can not detect that it's in there.
Others may think this too sneaky, but we are only on day 5 and this is the 2nd day our d will consume more than 3,000 calories. We have realized that it is FAR LESS TRAUMATIC to jack up the calorie count than to add another serving of something. As in the case of the milk, 8oz whole milk has 150 cal + 3TBS HWC 150 cal = the equivalent of TWO 8oz glasses of milk. Instead of two 8oz glasses of milk a day, our d is effectively having 4. More calories; less trauma. As is said in the south, "there's more than one way to skin a cat."
Remember, you have more power than you realize; a 13 yr old can't do anything much or go anywhere much without your assistance. Just say no. In our case, the threat of "no" was enough; she started eating. If your d refuses to eat even after you take control, put her in the hospital or an IP program...she needs/must have nutrition. That's what we were about to do. Bless your heart; it's hard, I know.
Hope this was helpful.
Zeri
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LauraCollinsUS
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Registered: July 31, 2007
Posts: 4,036
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| | March 05, 2008 at 06:41 PM | Reply with quote | #12 |
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I want to urge you not to think of making food calorie-dense as "sneaking." When the parent is in charge of what and how much to serve then the ingredients are up to them.
One of the uglier accusations made about family-based refeeding is that parents "sneak" and "hide." Nothing should be farther from reality. Reaching the level of medically-needed calories is like measuring medicine.
There is no need to hide, to explain, or to apologize!
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BridgetAUS
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Registered: July 31, 2007
Posts: 1,067
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| | March 05, 2008 at 07:44 PM | Reply with quote | #13 |
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Hi Suz - before we started working with our Maudsley doctor we were in a very similar place to where you are now. We had sort of refed our then 14 yr old daughter to a BMI of about 17 but she was still completely in the grips of AN - she was withdrawn, angry, aggressive, controlled by OCD like behaviours and very miserable. We knew we couldn't go on like this but none of the numerous doctors and therapists we were seeing were helping at all. We really were all 'stuck'. Eventually we found a Dr who had recently been trained in Maudsley - and he said he could help us! He said that her weight was still far too low. He sent us to a paediatrician and together we set a goal weight that would give her a BMI of about 20. We began refeeding in earnest. She was required to eat every bit of every meal. We didn't push variety too hard but ensured that all her meals contained a good balance of carbs, fats and proteins. Her AN fought us tooth and nail but eventually each meal went down. Nothing happened until she ate and we explained to her again and again that if she couldn't eat at home with us then we would find a clinic and they would feed her there. Eating was not an option and we loved her far too much to let her starve.
After she had been maintaining her healthy weight for about 6 weeks we began to see small improvements and from that point her recovery was extraordinary. I urge you to find clinicians that will help you - your family and daughter deserve this. If what you are doing now isn't working move on.
take care
Bridget
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Zeri
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Registered: Feb 19, 2008
Posts: 1,480
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| | March 05, 2008 at 07:52 PM | Reply with quote | #14 |
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I was uncomfortable w/the idea at first but no longer. When my kids were babes, I 'doctored' bitter meds w/ice cream or juice. I don't see this differently. Whatever it takes to get the 'medicine' down.
BTW, our d saw us making grilled cheese tonight, and we really slathered the bread w/butter. No issues. We're thanking God that she is going along as easily as she has; we know that's not everyone's situation. And we know we may face resistance in the future.
Zeri
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suz
Registered: Feb 25, 2008
Posts: 35
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| | March 06, 2008 at 03:51 AM | Reply with quote | #15 |
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Thanks everyone for listening, first of all. I would like to make it clear that we have no issue at all with “supplementing “ foods where possible, ensuring calorie rich options at every opportunity. I am already making pies, using butter, cream and cheese where appropriate, we have sauces, and our d does still have a reasonably wide-ranging menu. We are in charge of food! However, I want to know how to get her to knowingly increase her intake, she point blank refuses ice cream, shakes, smoothies, cakes, desserts etc. How do we sit her out, it inevitably runs into the next meal/snack time? Our d is very focused, determined, obsessive, perfectionist, straight A’s, usual personality type ED. We once sat for 7 hrs over a banana, but she did eventually have it! I do not know why but what she is eating is still not enough! Clearly our d is experiencing a serious relapse and is threatening all sorts, however this time around our son is very aware of the situation (he is now 10 yrs old) and sitting our d out for the last mouthful of a meal/snack/drink inevitably ends in physical/verbal abuse, hysteria, rage, things being thrown etc., this is causing him a lot of distress. I will not allow this illness to destroy 2 children! How much abuse are we expected to ignore and blame on the ED? Do we have to be slapped, kicked, screamed at and generally insulted, is this a necessary part of the process? We are in the CBT process at the suggestion of our therapist, who is an advocate of Maudsley, but so far it is definitely not helping, although to be fair our d is eating extra and her weight has increased very slowly, maybe that is all that matters? She seems to be very angry all the time now? We did not have this anger the first time round? |
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MarcellaUK
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Registered: July 31, 2007
Posts: 987
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| | March 06, 2008 at 04:48 AM | Reply with quote | #16 |
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We DID have the anger the first time round (and the second, although d was in an IP unit so the staff there got at least some of the verbal and physical abuse as well as having to be the ones who called the police when she ran away). I am ashamed to say that we didn't cope with it. Our younger daughter witnessed things NO child should ever see - including her parents breaking down and ranting and hitting out as well as her sister. Her teenage years were blighted with this problem and at the age of 12 she basically left home to seek refuge with neighbours.
This has NOT crippled her for life.
She is an active, hardworking, hardplaying and yes, being a British 18 year old, fairly hard drinking, student nurse who is not only ploughing all the practical knowledge she has of living "on the edge" into her nursing career, but not really begrudging her sister and her parents for it either. As a student option because it is cheaper she is actually choosing to live with her sister and they are getting on extremely well.
I'm not saying that you should allow your son to suffer. The Lask and Bryant-Waugh book makes it very clear that you should "allow as much of the behaviour as you can, but set safe limits ". This very much includes keeping horrible behaviours away from other children. What I am saying is if you don't manage it all is not lost and your son will know that you all love him really.
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LauraCollinsUS
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Registered: July 31, 2007
Posts: 4,036
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| | March 06, 2008 at 08:19 AM | Reply with quote | #17 |
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FBT/Maudsley therapy is generally short-term (6-12 months) and done as a family. Is that what you were doing in the past? If it was helpful, why not go back to that?
The trouble you are experiencing now sounds like an ideal situation for family therapy.
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Shawn
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Registered: Aug 04, 2007
Posts: 403
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| | March 06, 2008 at 09:19 AM | Reply with quote | #18 |
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We once sat for 7 hrs over a banana, but she did eventually have it!
Suz,
I hear the frustration and exhaustion and worry in your e-mails, but when I read them carefully I saw much to be hopeful about.
First thing to say is that no family deserves an eating disorder but then bad things happen to good people. And at least there is recovery and hope. So its important to move past the sound and the fury and focus on recovery.
Your remark about your daughter eating a banana should be your inspiration right now. Bananas ahead! That is exactly what you've got to do again, but now with malts and smoothies and whatever else you decide to give her to increase her weight and restore her sanity and health. You've done this before and you can do it again. As others have written, you have got to accept the fact that for the next few weeks you will be in battle mode. Do what you can to clear your schedule---and consider pulling your daughter out of school and all activities until she can eat what you tell her she needs to eat. Perhaps that won't be necessary, perhaps it will---the important thing is that you resolve in your heart that you are prepared to go all out. Your daughter will sense that. She will either surprise you by eating fairly quickly or she will continue to throw fits and behave violently. Push though it. Don't let the worse behavior make you back down. If after a couple days she is still not eating(and you've kept her home and stopped all activities including computer, play, extracurricular and school) then you need to put her into a clinic. She must realize she has no choice.
My heart goes out to you. OUr daughter was also extremely violent and hostile. To the point that I needed to call 911. But as she recovered and as she realized we would not let the ED intimidate us that behavior faded. Today a year later she is pretty much back to her sweet, happy, vibrant self. Please read some of the old threads on this forum. THere have been others who have been exactly where you are and there is much advice and support about handling violence and resistance.
Finally, I can also relate to your fears for the younger child. THere is no doubt that this is traumatic and upsetting for the siblings. Do whatever you can to enlist friends, neighbors, and family to take your son out of the worst scenes. When I anticipated that my daughter would freak out over a meal--say the first time I reintroduced cream sauce and fettucini, I called my neighbor ahead of time and asked if I could send my daughter over for an hour. Also, your son is 10. He will understand your explanations. Indeed, my youngest was only 4. But she understood when we expaliend to her that her beloved sister was acting crazy because she was sick, and that we were helping her get better. And that everyhting would be okay but it would be hard for everybody for a while. And that as a family we would do whatever it took to take care of each other and to love each other and to get each other better. Now, at age 5, my little one has no problem telling her sister that she needs to eat that chocolate cookie she just made so "the Nexia doesn't come back."
YOu can do this.
Shawn |
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Lisa
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Registered: Aug 01, 2007
Posts: 610
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| | March 06, 2008 at 10:10 AM | Reply with quote | #19 |
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Hi Suz,
Have you looked at the folder pinned at the top of the forum, I think it's titled, "Popular Threads"? In it there's a thread on how to get them to eat. It might be useful. I hope it helps.
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bluebooks
Registered: Nov 08, 2007
Posts: 135
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| | March 06, 2008 at 02:47 PM | Reply with quote | #20 |
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Suz,
We also have a 10 year-old son. I found that a tag-team approach helped. My husband and I would take turns sitting/dealing with our son suffering from anorexia. That always allowed one of us to be engaged with our other children. We would swap places as needed. Occasionally, both of us were needed to deal with the anorexia. In those cases, we would allow tv or computer for the 10 year old when we might not have previously. Or I might call a neighborhood mother (who was aware) to see if my son could go play for a while. In some cases, this very perceptive child would say, "can I go outside and play for a while?"
We also tried to increase our one-on-one time with the 10 year-old. We've had mother-son or father-son dates. Or we have taken just him for a shake after a concert or school function. We've had to be very deliberate to address his needs. We've been very open about how he feels. We'll try to resolve his concerns if possible. Time spent driving to and from school seems to be a good one-on-one time for us.
Nothing we do, though, will complete erase the effect of the anorexia on our family. I hope and pray, though, that we'll all be more compassionate and stronger as a family when this is all over.
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suz
Registered: Feb 25, 2008
Posts: 35
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| | March 06, 2008 at 03:07 PM | Reply with quote | #21 |
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Our d is currently refusing to eat her dinner and has already spent all afternoon refusing her after school snack.
She is adamant that since her therapsit stopped her sport last week it is all their/our fault and she will eat when her sport is reinstated !!!
Hoe long do we sit her out?
Urgent advice needed NOW!
At what point do we call out-of hours doctor, go to hospital ???
Things getting worse by the day!
She says she does not care about anything, wants to die, does not like it here on earth etcetc, does not care about her friends , school ar anything else?
How do we deal with this?
We are now desparate!
Thanks for support so far!
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bluebooks
Registered: Nov 08, 2007
Posts: 135
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| | March 06, 2008 at 03:24 PM | Reply with quote | #22 |
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Suz,
I was hoping someone else would respond to your plea. I'm still pretty new at all of this. But I don't want to leave you supportless.
Stay strong. You're doing the right thing. It seems like the first few days were like this for all of us (some worse than others). She just has to understand how serious you are about eating. It may take all night and all day tomorrow, too. But, eventually she will eat.
As for when to call the doctor or the hospital, I'll leave that issue to those who've had to deal with that.
Prayers and lots of support to you!
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LauraCollinsUS
Moderator
Registered: July 31, 2007
Posts: 4,036
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| | March 06, 2008 at 03:30 PM | Reply with quote | #23 |
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I don't know what the answers are for exactly what or when to do these things, but I know that you need to be the one setting them and you need to be confident and fearless in doing it.
Your child needs to know you are in charge, even when she's lost it. She needs to know no matter what she does, it will all lead to the same thing: full nutrition, and safety from the bullying of her disorder.
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bluebooks
Registered: Nov 08, 2007
Posts: 135
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| | March 06, 2008 at 03:31 PM | Reply with quote | #24 |
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Quote: Do what you can to clear your schedule---and consider pulling your daughter out of school and all activities until she can eat what you tell her she needs to eat. Perhaps that won't be necessary, perhaps it will---the important thing is that you resolve in your heart that you are prepared to go all out. Your daughter will sense that. She will either surprise you by eating fairly quickly or she will continue to throw fits and behave violently. Push though it. Don't let the worse behavior make you back down. If after a couple days she is still not eating(and you've kept her home and stopped all activities including computer, play, extracurricular and school) then you need to put her into a clinic. She must realize she has no choice.
I found this quote by Shawn up above. This is great advice!
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marie2
Registered: Aug 01, 2007
Posts: 222
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| | March 06, 2008 at 03:38 PM | Reply with quote | #25 |
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suz,
At this point, it sounds like your d needs 24/7 supervision (as many of our children did). She needs to be watched carefully to prevent any self harming.
Reinstating her sport would be caving into the ed, which would only make it stronger. If she cannot/will not eat or drink, you will need at some point to take her the ER. Depending on her current health, that could mean now or in a couple of days. Those of us on the board cannot know what her current health status is. If you feel she is a in any danger, call the off hours doctors now. Otherwise, try to calm yourself done and explain to your d that she will eat here or in the hospital, but that full nutrition is not optional.
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BridgetAUS
Moderator
Registered: July 31, 2007
Posts: 1,067
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| | March 06, 2008 at 05:20 PM | Reply with quote | #26 |
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Hi Suz - your description of your daughter's thoughts and behaviours is very familiar to me. If you are concerned for her medical health or her safety get help now.
We learned that the only way out of this terrible place is weight gain and regular balanced nutrition that included fats. You need a plan with your d's clinicians and you need to be 100 percent prepared to follow through with it. Your d needs to understand very clearly that eating what you decide is healthy for her is no longer optional. Nothing happens till the next meal is eaten. If she can't eat at home you will take her to hospital/clinic and they will help her eat there. If she can't eat at hospital they will help her with a naso-gastric tube. None of this is punitive - she needs to know that if she can't eat you will do whatever it takes to help her - that you love her to much to let her starve. Show her ED that there is no choice but to receive full nutrition - the only choices are where and how it happens.
take care
Bridget
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Mari
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Registered: July 31, 2007
Posts: 289
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| | March 06, 2008 at 05:23 PM | Reply with quote | #27 |
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Suz,
As Shawn said, you need to clear the decks right now. The details on when you call the doctor, go to a hospital or any other measure will all be specific to your child and your situation. The important thing is that you decide what the criteria will be and be ready to follow through. For example, not eating all today may be considered a medical emergency. What do you plan to do? We had a list of phone numbers ready and waiting and a plan. First number on the list was her grandmom! She could never say no to her grandmom, so that was our secret ace in the hole. Next was her doctor and the hospital, etc. Our daughter knew that we were not getting up from the table until her meal was done. Early on, my husband and I had to spell each other to save our sanity. If you all can hang in there together, that is the best thing. If she did not eat, she knew we were not going anywhere. if she did not eat at all that day, we were committed to taking her to the emergency room. If she did not eat in the hospital, there was the feeding tube. It never came to that for us, but for some families, it did. A couple of families found that just when they thought it was a lost cause, the child relented and ate.
She will resist, and this may come out as anger, tears, violence depending on the child. Some families had 4 plates of food hit the floor or the wall, but she ate the fifth. I once sat on the sofa from 9 PM to 2 AM to get a milkshake into my daughter. That is the kind of determination you need. Sometimes you need to break the initial resistance and get this started. It is different for everyone. It does get better. We know how difficult these first few weeks can be.
As Lisa mentioned, there is a pinned thread called How to Get a Stubborn Anorexic to Eat. There are lots of ideas and stories there.
Sending hope. It does get better.
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lydia
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Registered: Aug 04, 2007
Posts: 2,769
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| | March 06, 2008 at 07:10 PM | Reply with quote | #28 |
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Suz,
Mari's advice and that of others is on the money. How about this? Call the doctor.
Explain the situation. Resolve together at what point you'll take your d to the ER.
If your d reaches that point (not eating X number of hours) move into action.
For many children getting to the ER is an eye opener. Ideally the doctor will be waiting there, informing your d that if she doesn't eat in the next hour, 2 hours, etc., a feeding tube will have to be administered. Again, be prepared to follow through.
Ed is definitely having a tantrum, but cannot be allowed to starve your d any longer.
This is so hard, our hearts go out to you.
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Shawn
Mentor
Registered: Aug 04, 2007
Posts: 403
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| | March 07, 2008 at 03:40 AM | Reply with quote | #29 |
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Suz,
So glad the others saw your plea for help because I know how desperate and alone and frustrated it can be. ANd just plain heartbreaking to see your child so unhappy and so----frankly----strange. Not acting like your child.
You've gotten such good advice. The one thing I might add is that rereading your plea from yesterday about your daughter refusing to eat her afterschool snack lead me to believe that your daughter is still going to school? If so, she's gonna buckle. To be fighting an eating disorder and essentially to be starving(which, again, I was guessing is the case from reading your post?) AND to be freaked out because suddenly your parents are challenging your ED is gonna push a kid over the edge. You need to pull her out of school for at least a week to focus on getting her back on track, and to focus on getting her to eat again, and to focus on getting her to realize that you are dead serious.
Here's what I would do tomorrow:
1. Take her to your pediatrician to be sure she is in no immediate danger. Talk privately with the pediatrician about what is going on, and about what you are going to do, and about what you need from her.
2. Talk to your daugher and let her know that you are pullign her out of school to help her fight her eating disorder. Tell her you love her too much to let her stay sick. Tell her that if she can not eat at home she will need to go to the hospital to eat in----days. (You must decide that.)
3. Feed her. THere's LOTS to inspire you on this forum. You may have to sit with her for hours. Pick up broken dishes, thrown food. Prevent her from leaving the houe. Prevent her from violence. WHatever you have to do, do it. When I sat with my daughter for hours, as you seem to be describing, I would have a prop: a book. The message was, I was prepared to sit there all day. I stayed calm and I pretended to read the book. Of course, I wasn't really reading the darn book. I was heartsick, scared, and anxious. But I faked it. And then, at a certain point, I got so freaking furious at the ED and so darned determined and stubborn that it wasn't going to win that I didn't have to fake it anymore.
4. Take her to the hospital if there is not significant progress in ---days. (Again, this is your decision and your doctor's decision. If she is not eating at all you shouldn't wait more than a day or two, I would guess.) Monitor her closely(my pediatrician checked my daughter twice a week at a similar stage) to be sure she is not in immediate danger.)
Good luck. You can do this.
Shawn |
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MarcellaUK
Moderator
Registered: July 31, 2007
Posts: 987
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| | March 07, 2008 at 07:19 AM | Reply with quote | #30 |
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Suz you have received some very good support and advice here even if some of it will need a little translation as American English and UK English are not exactly the same language - indeed MY language and experience in the mainland of the UK won't be exactly the same as yours either.
That said I think the best advice I received at the UK carers' conference recently (and the most difficult to put into practice!) was to remain calm.
Janet Treasure talks about the "c" words in caring - remain calm, compassionate... - I would also add "collected"
This is necessary not only in the face of the eating disorder which will rage at the sign of any of the "f" words, "fear, flight, family disunity...." but in the face of the professionals who WON'T necessarily all be immediately on your side and MAY harbour old fashioned anti-parent stereotypes which will only be exacerbated if you appear in any way hysterical.
Believe me, I HAVEN'T been able to do this in the past, and our relationships with the professionals have been rocky indeed, but I think it's the only way to get "the system" working with you rather than against you.
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suz
Registered: Feb 25, 2008
Posts: 35
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| | March 07, 2008 at 07:46 AM | Reply with quote | #31 |
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Thank you everyone.
Our d eventually gave in and ate some of her dinner (not all) and then followed up with full supper. Lots of tears, cries for help and promises to not go down the "threat" road again ! At last we had a conversation with our d not the ED.
We have spoken to our local paediatrician and have an agreed plan in place should a visit to the local hospital become necessary and we are waiting for a call from the chief child psychiatrist for our area. At last we are getting some support from the medical profession . Our therapist in unavailable, she is on a ED course and unfortunately ED services in our location are abysmal.
I stayed home from work today and told d that everything would stop including school if she continued with this behaviour, she tried to leave some (v little) of her breakfast and threw it and the plate across the room and spat out what was still in her mouth. I locked the doors , said we were going nowhere until she ate something in place of what she had left and waited. Endured another physical assault but she eventally took something and I let her go to school.
I know we can do this !
Thank you! Only other parents really understand the strength of what you are dealing with!
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judijx
Registered: Jan 08, 2008
Posts: 257
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| | March 07, 2008 at 02:21 PM | Reply with quote | #32 |
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Suz,
That is good news. How are you handling her lunch and snack at school?
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BridgetAUS
Moderator
Registered: July 31, 2007
Posts: 1,067
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| | March 07, 2008 at 07:25 PM | Reply with quote | #33 |
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Hi Suz - good on you - you have made a great stand and I'm so glad you are getting some professional support. Each and every meal and snack needs to be approached in the same resolute way. We found that we had to be absolutely consistent. Any wavering on our behalf only strengthened the ED.
You are absolutely right - you can do this.
take care
Bridget
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Lastdance
Registered: Jan 29, 2008
Posts: 29
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| | March 07, 2008 at 08:35 PM | Reply with quote | #34 |
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Dear Suz,
what do you do next? you keep on going. the main quote on top of this message board by Winston Churchill states "when you are going through hell, keep going." that is exactly what you need to do.
this will hurt you very much, but you can't listen to your daughter right now. every time she speaks, it isn't her talking, it's malnourishment, it's starvation, and it's anorexia putting words into her mouth.
your daughter, once healthy enough to do so, needs to learn how to take control over these distorted thoughts, because she can ultimatly control what comes out of her mouth.
as for the food intake, i strongly urge you to INCREASE, INCREASE, and INCREASE! don't listen to your daughter's cries of fullness. if an alchoholic was begging you for whiskey, would you fufill thier request? i surely hope not. thus, you can't give into your daughter's illness, either.
in regards of your son, things seem really hard right now. it would be wise to reach out to the parents of some of his friends, and maybe try to organize some play dates during meal times. while the conflict may be unbearable, it really is better than the alternative.
don't give up hope! you made it through today. take each day at a time, and eventually things will improve (although, everyday is a victory)
best wishes, thoughts, and prayers,
kerra
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suz
Registered: Feb 25, 2008
Posts: 35
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| | March 09, 2008 at 07:45 PM | Reply with quote | #35 |
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Things stayed calm from Friday afternoon until now, ED has been building all day , ouur d has refused to finish her dinner now since 6:30pm, that is now 5 hours. She has also now missed supper, we are still in the kitchen. She has resisted completely so far ,thrown plates of food across the room, usual bursts of physical and verbal abuse etc etc etc. We have consistently "sat her out" all night, replacing the food each time. She is now almost falling asleep with exhaustion, what do we do ? Do we force her to stay awake and if so how?
All our local medical advisers are saying the same thing, she must eat every last bite, but how long can we prevent sleep, and she has now missed supper as well. If we give in on finishing dinner, she could have supper ( which would very strangely probably do) and get to bed or is that the wrong way to go????
Need practical advice quickly if anyone is listening???
Thanks
Suz
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Zeri
Mentor
Registered: Feb 19, 2008
Posts: 1,480
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| | March 09, 2008 at 08:19 PM | Reply with quote | #36 |
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suz,
It's early in the evening yet; don't give up.
If you can sit up with her and have the support, keep at it. The ed is surely testing your resolve.
I'm sorry you're going thru this; you obviously love your daughter very, very much.
Zeri
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Saraiah
Registered: March 03, 2008
Posts: 23
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| | March 09, 2008 at 08:36 PM | Reply with quote | #37 |
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Suz,
I am new at this, but agree with Zeri that continuing to sit it out with your daughter gives both her and the ED the right message: you love her, you refuse to let her starve, and you are willing to do whatever it takes to help her to heal. I am praying for you both this evening, sending you strength, confidence, and love. Hang in there with your precious child.
Saraiah
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LauraCollinsUS
Moderator
Registered: July 31, 2007
Posts: 4,036
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| | March 09, 2008 at 08:49 PM | Reply with quote | #38 |
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I agree - if you are making a stand, stand. Anything that works to serve the ED you'll see more of. If she falls asleep, get a pillow and a blanket for her right there, a sleeping bag for yourself, and start right where you are when she wakes up - whatever hour it is.
Cheerfully, calmly, but without moving one inch literally or figuratively.
You won't have to make this stand every meal if you make it well enough now. But if you back down you will see this and more next time.
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suz
Registered: Feb 25, 2008
Posts: 35
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| | March 09, 2008 at 09:02 PM | Reply with quote | #39 |
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It is now 1am here , we have been sitting this out for 6 1/2 hours, no sign of weakness at all. We are exhausted but will keep going for as long as it takes.
Thanks for support
Suz
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Malia
Mentor
Registered: July 31, 2007
Posts: 1,044
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| | March 09, 2008 at 09:26 PM | Reply with quote | #40 |
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Hi Suz--
I'm so sorry this is your evening and night. I gather some of the other posters didn't notice you were not in North America. Many of us have been there and done that. It still sucks.
I have to agree with what Laura said. Don't back down. If that means you spend all night at the table, then so be it. What you don't want is to back down at the last minute and have to do this again and again.
Mostly you can expect the ED to ditch tactics that don't work and to escalate the ones that do. So don't let it work, or you'll see more of it.
All the best and keep us posted---
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Zeri
Mentor
Registered: Feb 19, 2008
Posts: 1,480
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| | March 09, 2008 at 10:09 PM | Reply with quote | #41 |
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Suz, Bless your heart. Yes, I didn't catch that you were in another time zone. Sending virtual hugs.
Your d is still in school, yes? I wouldn't let her go to school tomorrow either. You've really taken a stand tonight. Stick your flag on the top of that mountain and don't surrender. If she refuses to eat after a couple days, I would admit her to the hospital.
My d ate, so it's easier for me to 'preach' right now. But my day may come yet. My d considered taking a stand against me at a local take out food place today. I had to 'think fast'. She ate, but we won't be doing take out again for at least a week.
You are a strong woman, and I can 'hear' how much you love your little girl. Remember, it's actually not your d your fighting...it's the blasted ed. He has a strangle hold on your sweet girl, but you are stronger than the ed. What a blessing you are to your daughter.
Resolute but gentle; I'm praying for you and cheering you on.
Zeri
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Shawn
Mentor
Registered: Aug 04, 2007
Posts: 403
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| | March 09, 2008 at 10:26 PM | Reply with quote | #42 |
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I agree.
Your daughter should not go to school tomorrow. In fact, I'd keep her home pretty much the entire week, even if she does cave and eat at some point tonight or early tomorrow she'll be exhausted. And you must keep up the battle.
I'm so sorry---I know how horrible this is. But you are doing the right thing. One way or the other, at home or in the hospital, your daughter must---and eventually will---start to eat this week, and start the road to recovery.
Stay strong. You can do this.
Shawn |
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lydia
Moderator
Registered: Aug 04, 2007
Posts: 2,769
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| | March 10, 2008 at 12:06 AM | Reply with quote | #43 |
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Suz,
I'm the broken record here.
Ed is being confronted, and trying to retake control. You already know that.
If ed tries to stonewall for an extended period, I would go to plan B, a trip to the hospital. Again, pre-arranged with the doctor, and don't second guess yourself. The one unwavering rule, starvation is not an option.
I'm in awe of your love and patience. Sending hugs and strength.
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MarcellaUK
Moderator
Registered: July 31, 2007
Posts: 987
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| | March 10, 2008 at 08:29 AM | Reply with quote | #44 |
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sorry you had such an awful evening. Hope you are all enjoying some much needed rest now and can wake refreshed to tackle the new day. Keep up the good work. |
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ms
Mentor
Registered: Aug 09, 2007
Posts: 675
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| | March 10, 2008 at 02:55 PM | Reply with quote | #45 |
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Suz- I have been gone a few days and have been trying to catch up on all the threads. Your story hit me... A year ago- had I done exactly what the others are encopuraging you to do(stand up to ED- right here, right now)I think we could have avoided a hospital stay in psych ward as well as an inpt stay at ED clinic. I caved several times, even when I said "if you can't eat this, we will go to the hospital"- she would eat a small amount and I would give in.. Then it would start over the next day. Not until we drew the line(you must finish all of this supper) and she crossed it (ate a few bites only after a lengthy sit) AND we followed through with plab "B"(put her in the car and took her to the hospital)did recovery begin. I didn't find this website until May or june. I believed when Dr'stold me she would eat when she was ready. My d would not be here today had I waited. How ever you have to feed her- at home or starting out in the hospital and then follow through at home, let recovery begin. Every day we give into ED, it gains more strength and our precious child falls further away into the illness and further from those who love her. I am thinkning of you. We have been where you are and it has been one hell of a year, (almost) but we have my d back and you will too if you can get through these tough days to come. Take care of yourself too. You are such a loving mom! Stay strong in your fight with ED- For awhile it will be you against it-your d will not be able to fight it. She will get her strength form you and food of course. ms |
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suz
Registered: Feb 25, 2008
Posts: 35
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| | March 11, 2008 at 05:43 AM | Reply with quote | #46 |
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Thank you so much for all the support.
Our d eventually gave in at 3:00 am and finished her dinner and then had her supper and collpased into bed. We got there! Unfortunately I suspect it was exhasution rather than defeat, but we will see!
We have plan in place for local hospital with paed if that becomes necessary.
I have been allowed some time off work with the total support of my doctor and my employer, we are now clear to deal with this ! I do not know how I will ever thank them ! Our d did go to school after she completely finished breakfast, she loves school and it is still our biggest "lever". We will pull her from school if that becomes necessary without hesitation, but at the minute it is not a negative problem, if anything it helps the situation.
We have done this before and we will do it again , this time right up to a fully recovered weight. Hopefully the CBT will help our d to understand that this time she is not 10 and at some point she will be able to take a more proactive part in her own recovery.
Let battle commence
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LauraCollinsUS
Moderator
Registered: July 31, 2007
Posts: 4,036
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suz
Registered: Feb 25, 2008
Posts: 35
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| | March 11, 2008 at 09:14 AM | Reply with quote | #48 |
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Thanks, but we are only starting, we have still a very very long way to go.At least our d knows that she is now our number one priority and her health will come before everything else.
We can now focus totally on this and will not be looking at our watches at 2 or 3 am, thinking hurry up, we have to get up for work in a few hours, one of us will be here 24/7. I have finally realised the seriousness of the situation we are in, she deserves better from us and she is going to get it! I will not give up no matter how long it takes. This will also allow us the strength to make time for our s who is equally important .
This website is keeping us sane at the moment , the support of other parents aho have been successful and know exactly what you are dealing with is essential. Thanks again everyone who has answered us in our time of need, all your prayers, support and thoughts are all welcome.
Any practical advice on how to raise the calorie intake will be welcome, by fair means or foul! We must get the necessary weight increase for the ED thoughts to start to subside. I also hope this dialogue is helpling other parents in the same situation.
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Malia
Mentor
Registered: July 31, 2007
Posts: 1,044
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| | March 11, 2008 at 09:54 AM | Reply with quote | #49 |
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Quote: Originally Posted by suz
Any practical advice on how to raise the calorie intake will be welcome, by fair means or foul!
You go girlfriend!
Check the top of the message board page for "popular threads." (At least I think that's what it says--) Anyway, there's a huge thread there about high calorie ideas. There are also other posts throughout the message board that discuss boosting calories, and you can use the search function above to find those. If you still need some ideas, by all means let us know.
: )
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Zeri
Mentor
Registered: Feb 19, 2008
Posts: 1,480
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| | March 11, 2008 at 11:04 AM | Reply with quote | #50 |
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Suz- 3:00am...you da bomb! As the healthy part of your d is sitting in class today feeling so tired, hopefully she will begin to get POed w/'Ed' for keeping her up so late...because it is the ed's fault. You were battling IT not her. It took a couple days for my d to begin to realize that. We haven't pulled any privileges from her...eat and keep on keeping on - no eat, no nothing else.
While your d is in school today, use the time to plan ahead (meals/snacks) and get some much needed/deserved rest for yourself.
Stay strong.
Zeri
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