determined
Registered: June 01, 2008
Posts: 229
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| | Jan 29, 2009 at 04:54 PM | Reply with quote | #1 |
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I tried to add this to a previous post but I dont see it so Ill try again.
My daughter is still binging and I do mean bingeing and its getting worse. She has done 180 from an/ r to complete loss of control. She is now hiding food in her bed and getting up at all hours of the night to eat jars of peanut butter etc and all the carbs she can find. I have to hide food in my drawer at night because she would sneak out and get it.
She is getting all she needs during the day incl. carbs protein and fat that is not the problem, She says when she eats she is not even hungry she is back to her original wt before an, She says she doesnt care about anything anymore she says she is a fat slob and in her words has now a huge muffin top.She is noticeably heavier in the last 3 weeks. I think she looks fine where she is but obv. she disagrees, She says she cant stop herself and I see her mood getting more depressed.
I had to leave town for ten days as I just got word that my Mom fell and broke her back and has been diagnosed with alzheimers and my Dads health is failing. Not being here she increased the binging and took advantage of my being away,she actually tried to convince me to stay a little longer.
I know Im going to have to go back to help my poor parents in the near future but I am afraid of leaving her to her own devices while Im gone.I feel Like Im being pulled in 2 directions right now and I dont know what to do.!
Im not sure if this is the right forum for me anymore as no one else seems to have run into this problem .Is there anyone who has experienced this and if so what did you do?!
Has no ones child who has ocd tendencies run into this?
Please let me know. please.
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LauraCollinsUS
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Registered: July 31, 2007
Posts: 4,036
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| | Jan 29, 2009 at 05:14 PM | Reply with quote | #2 |
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Jane,
This is VERY common and many families here have described this behavior. Your daughter needs help, and so do you. You need a plan, you need professional care, and your daughter needs 24/7 support.
This temporary, natural, but very serious condition deserves complete attention: it threatens her recovery and her life.
What clinical support do you have right now? What practical support do you have - family, neighbors, friends, clergy, co-workers? What help can you call on with your parents?
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Maria
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Registered: July 31, 2007
Posts: 2,613
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| | Jan 29, 2009 at 05:27 PM | Reply with quote | #3 |
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Dear Jane:
I sense your desperation and I am so sorry that things feel so out of control for you and your d. I hope that you get the clinical, psychological and hands on support that you and your d need and deserve. I have read several threads from parents on this same issue. I will search around a little later and see what I cam bump for you. Hang in there.
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determined
Registered: June 01, 2008
Posts: 229
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| | Jan 29, 2009 at 05:56 PM | Reply with quote | #4 |
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My d is seeing a psych who works for renfrew, and a psychologist who both her and her husband work for renfrew, unf. they do not take insurance at all and between the meds and cash up front for both we are limited to how often she can see the therapists. There is abs. no maudsley T's here in south fl.and acc to her psyhc md most T's who accept our m,h,insur. plan are prob not quality or experienced in eds. Almost all T,s tell you they are but I learned the hard way when I took her to one who told me not to discuss food etc with her so I knew she was not up to date. with ed trx.
As far as help with my parents All my sibs are taking time off work and flying down to help .They also are dealing with some other health issues with their families as well so we all are trying to chip in. Unfort with the way the economy is my husb had to take a paycut and my job has gone from partime to occassional at best,so financially I am stuck like so many others with limited access to therapy.
I am sorry if I sound whiney I know alot of people here are dealing with way worse scenarios . I am just scared and feeling a little hopeless and sorry for myself right now,
Thanks for taking the time to answer.
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lydia
Moderator
Registered: Aug 04, 2007
Posts: 2,769
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| | Jan 29, 2009 at 06:24 PM | Reply with quote | #5 |
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jane,
Have you contacted Dr. O'Toole? She has a program called "ordered eating" and it seems to be important to use this approach in some cases.
http://www.kartiniclinic.org/node/4393
Here is her contact information:
jotoole@kartiniclinic.com
I'm so sorry that you're caught in the middle of so many needs. Little wonder you
feel overwhelmed right now.
I hope this helps. |
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Linda
Mentor
Registered: Oct 03, 2007
Posts: 328
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| | Jan 29, 2009 at 10:49 PM | Reply with quote | #6 |
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We also struggled with this and ended up locking fridge and pantry. I know some T's don't like this but for us it worked well. My D had been b/p for some years. We made sure we used the locking as a tool and a step not just a means to keep her away from food and feel safe.
Once fridge and pantry locked we all slept better and were therefore better equipped to deal with all the daytime supervision. My d was on 24/7 watch for b/p and safety. She noticeably relaxed when food locked away. We then took small steps in unlocking. e.g unlocked when i was home, her daily food in bar fridge, getting her used to getting only the things required from a full fridge with others around etc etc.
We also had to practice going to the supermarket buying only what was required - again tiny steps. e.g into supermarket with me, on her own no money, on her own buying specific items and having to give receipt and change etc etc etc.
My D was a big binger whilst driving - she'd stop later at a kerbside to purge. So she also needed the small steps here to retrain her thinking and feeling confident driving alone without having to buy, binge and purge.
These steps worked better than anything we had done before. The tiny steps, short time to consolidate and then move on to next step was actually - in the scheme of the things- quite quick. Once we had got through two months of no b/p she herself became determined not to do it again and became active in the goal setting, voicing her risk times and fears. Once the b/p stopped there was a HUGE change in mental state. We still had to work on the desire to restrict but even this was better with the b/p out of the way.
From what my D has said even though she was able to control the b/p in a few months with this big support it was a battle in her mind for about 11 months (all up) when the urge just faded. Although she still had some lingering body image issues the disgust and hatred of herself also lifted with the regular nutrition and no b/p.
Hopefully your psychologist can help you with CBT and help you set a plan and steps and work out the support required. My D tried to do it without the boundaries tightening and then loosing up and just couldn't do it- it made her hate herself more. Like with many of those with ED the 24/7 support may be required.
Having had two young adults with ED I tried to keep myself in the moment and not worry about what might be -dealing with each day as it happened. You certainly have got a lot on your plate. (sorry). If you focus fully on your D now then you can review where she is at when and if you have to go back to your parents. She may even be able to go with you- who knows deal with it when it arises. don't apologize all scenarios are dam hard.
I hope our experience is of some help to you. I've tried to give the overall impression sorry it's so long. If you'd like more specific things that worked for us don't hesitate to email.
Best wishes I'll be thinking of you
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Malia
Mentor
Registered: July 31, 2007
Posts: 1,044
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| | Jan 30, 2009 at 01:10 AM | Reply with quote | #7 |
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Hi Determined,
Echoing all advice so far. I'll only add:
What you're seeing is in no way rare. This phase is described in the Minnesota Stavation Study. The subjects of the study were able to pass through this stage safely, and with help and structure, many kids here have too. Like Lydia, I think what you're seeing is one reason why Kartini uses a structured eating plan for a year, and I suspect it's why also why Kartini doesn't include sweets on it. My own observation has been that eating a lot of simple carbs seemed to fuel the binging cycle. I can tell you how we managed the structure here (we were making it up as we went along), if you like.
Many b/p patients are helped by antidepressants. Some also take antipsychotics to further help level mood and ease obsessionality. I don't know if your daughter takes medication now or prior, but don't count it out. B/p patients (or AN patients in the b/p stage) tend to get more benefit from pharmaceutical help better than underweight and undernourished AN patients.
I know that Jacksonville is a long way from South Florida, but The Boswell Center in Jacksonville has an excellent reputation. Laura has visited there, I think. (I don't remember if anyone has added them to the treatment page or not, actually. If not, they have a webpage.)
I'm so sorry your plate is so full. You must be very worried for your parents and stretched thin. Please let us know how things are going, and come vent whenever you need to.
Malia
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JennMcG
Registered: Aug 25, 2008
Posts: 124
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| | Jan 30, 2009 at 02:33 AM | Reply with quote | #8 |
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I am so sad for you that all of this is weighing on you at once. I send you heartfelt hugs.
I do not have personal experience with this but my friend's d went from almost dying with an (hospitalized at 6' and 80#) to bingeing and more than doubling that weight. Her d became completely out of control with bingeing and since this is a relatively recent development, I don't have any tried and true advice to pass along yet. It's still a work in progress.
Linda's story, however, seems to offer a great step by step. I wish you the best and hope you are able to set a plan of action.
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TX
Registered: Dec 08, 2008
Posts: 51
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| | Jan 30, 2009 at 05:05 PM | Reply with quote | #9 |
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Hi determined
I am so sorry you have to go through this. I can very much relate to your story . Our an d started binging and purging soon after we took control of her meals and just as her weight started to go up. It started very insidiously, grapes at first, she could eat 2 p in one setting. I was relieved at first thinking she is getting her appetite bad but soon we realized that we are dealing with another problem. I looked for advice from her ind therapist about what should we do and was told to just let her eat it "It's healthy".UNBELIEVABLE! It is a very confusing and difficult situation. On one hand we are refeeding her and on the other we are preventing her from eating. But I turned to this forum and as always got an excellent advice from Lydia and everyone else. Observation 24/7, she is never alone at home. She is not allowed to go in the kitchen between meals. When she is found eating unscheduled meal it is addressed the same way as missed meal. We also keep bathroom door locked because she purges, thank god you don't have that. Also I think the fact that your d admits to it freely and asks for help is huge. Prevent her from being able to access the food easily, put the lock on the cabinets if you have to and just take the food that she is not supposed to eat from her. There is just no easy way, but it does sound like you need to take the control back. I am so sorry it is so hard.
btw i know of one Maudsley therapist in Palm Beach, Carolyn Fishbain. I spoke to her on the phone, she practices MM, but I personally never used her so can't vouch for her.
I also wonder kind of on the side if b/p that recovering an develop is a different disease than primary bulimia without preceding an. It seems to me that it is and should be easier to get control of.
I wish you all the strength in the world and faith that it will get better because it will.
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determined
Registered: June 01, 2008
Posts: 229
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| | Jan 31, 2009 at 03:38 PM | Reply with quote | #10 |
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Well we had her apt yesterday with psychiatrist and basically told me what we already new,that this was a continuation of ed and have to go back to dtcn and continue with therapy. He said she needs to be able to think in the middle and not black and white. He did agree with me that we need to up her ssri, we will start today. I have had to hide the food but unf. she is more independent now makes her own money and drives so I am not sure how to monitor her 24/7 when not at home.
I did look into that kartiini site and it makes alot of sense, I will show it to her dtcn and try to modify it to our circumstances.
It WAS encouraging to read your posts about how you managed to overcome this. I thank you all so much again for your responses! .
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Maria
Mentor
Registered: July 31, 2007
Posts: 2,613
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| | Jan 31, 2009 at 04:27 PM | Reply with quote | #11 |
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Determined,
I am glad that you have a plan in place, I hope that it is effective in helping your d through this stage.
Our T said that she had seen B/P develop in former restrictive ANs quite often. It scared me because our d, at one point, could not stop eating all day. She wasn't eating entire jars/boxes/bags of food, however. T created a plan where d had to have order in her eating, though no restrictions on quantities or quality of food. She had to eat her nutritious food first and then the deserts. I know that this is not the case with your d as she truly feels out of control and you feel that this is the case. Apparently, the stage when they start wanting to eat constantly is quite common and they need as much of our support as when they are restricting and refusing food. Even now, I remind d to have her food first instead of reaching for the choc chips or a big glass of juice and then being too full for dinner.
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tryingmom
Mentor
Registered: July 31, 2007
Posts: 328
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TX
Registered: Dec 08, 2008
Posts: 51
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| | Feb 01, 2009 at 10:45 PM | Reply with quote | #13 |
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Hi determined. I am not familiar with Katrini approach, but we had the same situation when we could not watch her 24/7 because of school, and my h used to say if she wants to b/p she will find the way. I didn't see it the same way. I couldn't stop working,but I did (still do, it is not over, but getting better) what i could given the circumstances and when i was home it was constant supervision. I strongly believe it made a difference. What about taking car keys away or telling her that she would have to stop working at least for a while. It is such a difficult problem. Be strong, you can do it |
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TerrifiedFather
Registered: Sept 16, 2008
Posts: 587
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| | Feb 01, 2009 at 11:05 PM | Reply with quote | #14 |
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I will admit I haven't seen Kartini's actual meal plan list but I think the concepts behind it do make sense. With Kartini's plan I'm not sure if they completely disallow any simple carbohydrates and anything sweet? (Is syrup allowed on pancakes? Can you serve juice as a beverage? We do both things although we now mostly make our own juice so it does have more fiber. I presume they allow fresh fruit.) For us, this started out not expressly as avoiding sweets, (although we did not routinely have dessert before and still don't, and we rarely had soda, candy, or other low nutritional value sweets in our house and still don't) but as trying to get sufficient nutrients in. That just wasn't going to happen with a glass of soda and a handfull of gummy bears. We also, at this point, could not safely make the Kartini transition to only 3 meals and 1 snack because her blood sugar is still too labile for that (and this may not be a strict malnutrition issue we're still trying to figure that out). The reason I mention this is because I wonder if some of this carbohydrate craving/fix is a blood sugar phenomenon for your daughter. From what I understand, there is a phenomenon called reactive hypoglycemia, although I think for some people it more of a pseudohypoglycemia meaning the actual blood sugar reading would not be considered low but it is lower than what the body expects so it evokes feelings of hypoglycemia which leads to more cravings and restarts the cycle. I know we have always been careful to give something that will raise the blood sugar quickly (because our daughter's drops into the 40s and that isn't good so we want it higher ASAP) but to follow it with something with fat and protein to help sustain the rise.
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Malia
Mentor
Registered: July 31, 2007
Posts: 1,044
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| | Feb 02, 2009 at 01:20 PM | Reply with quote | #15 |
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Quote: Originally Posted by TerrifiedFather
The reason I mention this is because I wonder if some of this carbohydrate craving/fix is a blood sugar phenomenon for your daughter. From what I understand, there is a phenomenon called reactive hypoglycemia, although I think for some people it more of a pseudohypoglycemia meaning the actual blood sugar reading would not be considered low but it is lower than what the body expects so it evokes feelings of hypoglycemia which leads to more cravings and restarts the cycle. I know we have always been careful to give something that will raise the blood sugar quickly (because our daughter's drops into the 40s and that isn't good so we want it higher ASAP) but to follow it with something with fat and protein to help sustain the rise.
TF--
I don't think I've seen a Kartini meal plan, either, but for some reason I tend to think what they don't include is frank sweets--desserts, candy, etc. But maybe I just assumed that from what Dr. O'Toole has said.
Interestingly, I evidently sometimes have the sort of pseudo-hypoglycemia you're talking about, and I have as long as I can remember. It's not all the time, but maybe a couple of times a month most months. My childhood doctor called it intermittent hypoglycemia (now called reactive hypoglycemia). So, I always assumed my blood sugar was dropping, and I'd eat something like you describe and I'd always get better quickly. Actually, I learned the best fix was 1/2 a PB sandwich and a glass of milk, or a boiled egg and juice. Last year my current doctor gave me a glucose meter and asked me to chart it. No matter how pronounced the symptoms--dizzy-ish, queasy-ish, crabby, shaky, hard to think, did I mention crabby and shaky?--my readings stayed solidly in the 90's. Maybe low 90's rather than my more usual high 90's, but nothing that anyone would call anywhere near low. I don't know what that is. My doctor didn't seem to believe me.
Back to simple carbs in the binge cycle. I can still tell a big difference in my daughter's behavior and anxiety level--even post-AN--if she includes adequate to slightly high protein and fat with every meal and snack, and minimizes the most simple carbs, including crackers, bread, simple cereal, and juice.
We'll know more about this someday, I trust.
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LV
Mentor
Registered: Oct 19, 2008
Posts: 954
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| | Feb 02, 2009 at 01:59 PM | Reply with quote | #16 |
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Quote: Originally Posted by Malia
Interestingly, I evidently sometimes have the sort of pseudo-hypoglycemia you're talking about, and I have as long as I can remember. It's not all the time, but maybe a couple of times a month most months. My childhood doctor called it intermittent hypoglycemia (now called reactive hypoglycemia). So, I always assumed my blood sugar was dropping, and I'd eat something like you describe and I'd always get better quickly. Actually, I learned the best fix was 1/2 a PB sandwich and a glass of milk, or a boiled egg and juice. Last year my current doctor gave me a glucose meter and asked me to chart it. No matter how pronounced the symptoms--dizzy-ish, queasy-ish, crabby, shaky, hard to think, did I mention crabby and shaky?--my readings stayed solidly in the 90's. Maybe low 90's rather than my more usual high 90's, but nothing that anyone would call anywhere near low. I don't know what that is. My doctor didn't seem to believe me. Back to simple carbs in the binge cycle. I can still tell a big difference in my daughter's behavior and anxiety level--even post-AN--if she includes adequate to slightly high protein and fat with every meal and snack, and minimizes the most simple carbs, including crackers, bread, simple cereal, and juice. We'll know more about this someday, I trust.
Malia,
Our standby has become juice that she drinks while I make her half of a sandwich---often peanut butter but we have done turkey with cheese or tuna as well. The juice is really too much of a simple carb but since she has true hypoglycemia---and seeing 38 or 44 or whatever on that glucometer scares---me juice it is. Unsalted nuts also work well---and they travel well so we've done them as well. I'm probably directing this off topic but this is interesting to me because we're having more blood sugar problems and our pediatrician asked the nutritionist to go back and look at all of our ratios of carbohydrates: protein and complex:simple carbohydrates and how that tracks over the day. We're hoping there is something we can tweak to fix this. We're also seeing an endocrinologist later in the week to see if they have any other ideas.
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determined
Registered: June 01, 2008
Posts: 229
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| | Feb 03, 2009 at 01:51 PM | Reply with quote | #17 |
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unfortunatley she is stilll bingeing she has been trying to stick to the plan but she isnt. I cannot watch her 24/7 as she is 19. I have no legal recourse as she is no longer underweight and I cant threaten her with hospitalization which I have in the past and admitted her for 2 wks. No one can admit her for eating too much as her hrt. rate wt is normal.
She has a scholorship at school which she earned so I cant have a say about that either.It is hard when they are at legal age.
I told her I was going to put a lock on the fridge at night and she said that will just make her more agitated and she will retalliate by eating more in the day,I said to her that she would only be hurting herself .I am totally frustrated!!
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determined
Registered: June 01, 2008
Posts: 229
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| | Feb 03, 2009 at 01:54 PM | Reply with quote | #18 |
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I forgot to add.. she is definatley getting enough of all nutrients during the day and rarely goes 2 -3 hrs. without eating.I diont think her blood sugar is the problem I think its an obsession with food. |
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LauraCollinsUS
Moderator
Registered: July 31, 2007
Posts: 4,036
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| | Feb 03, 2009 at 02:59 PM | Reply with quote | #19 |
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Quote: Originally Posted by determined
. I cannot watch her 24/7 as she is 19.
To be completely basic on this, could you watch her 24/7 if she was bedridden and needed care? Being under the control of a TREATABLE compulsive behavior that can kill with no notice deserves the same level of urgency.
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Zeri
Mentor
Registered: Feb 19, 2008
Posts: 1,480
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| | Feb 03, 2009 at 09:31 PM | Reply with quote | #20 |
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Laura,
I REALLY appreciate your comment. Our homes are OUR homes, and we shouldn't allow ourselves to bullied by eds, and we do have considerable control in our own homes.....so much more than we usually realize and exercise.
And allowing a child to enjoy all the benefits and support of 'home' knowing that the child is practicing dangerous behaivor when away from home is still providing safe haven for the ed, in my opinion. If my child were abusing drugs or alcohol away from home - but not in my home - and I allowed them to remain living with me....seems like aiding and abetting their unhealthy behavior. I used the example of drugs/alcohol because, for whatever reason, I think many of us have an easier time taking action w/those destructive behaviors/illnesses than we do with an ed. I don't know if I'm making any sense.....
determined, I think you have a lot of 'say' about your d's attending university (scholarship or not), and I think it is completely appropriate, even necessary, for you to take action. You are providing her housing, food and a lot of support otherwise....and it sounds like she's in real trouble. I wish you the best in this very trying time.
Z |
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Linda
Mentor
Registered: Oct 03, 2007
Posts: 328
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| | Feb 03, 2009 at 10:46 PM | Reply with quote | #21 |
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One thing I keep coming back to is that your D seems so determined in advance that she needs to eat alot of food. Which does seem quite obsessive. Out of curiosity is she worried about her shape, size or body image? Is she panicky when she feels she wants to eat and can't control it? Is she anxious in advance about how this will be?
We actually only put locks on our fridge and pantry with D's agreement as it turned out she was disgusted and scared of her "lack of control". Our D needed considerable help and support at those times she wanted to binge and in her case purge. This actually meant company at night.
My S who was incredibly hungry when weight restored and wanted to eat all the time was also quite spooked and frightened. He also needed quite structured support to help him deal with this. The support and medication really helped along with very high protein diet especially before bedtime. Also at first his body couldn't get through 10 hours at night so he left a protein bar ready if he did wake up and after waiting and going to the loo felt he was still hungry, he would eat this.
Interestingly neither of my two wanted to "binge" on sweet food it tended to be nuts.
I can't remember and can't see it but does your D take any medication for anxiety or OCD.
I like Zeri's mention of alcohol. If your D was an alcoholic would you still have alcohol freely available around the house? I know food is slightly different but both are problems that need a lot of support. Yes they could get both out of the home.
Just a thought when we did lock the fridge and pantry 24 /7 a very healthy ( I mean large size) days allowance of food was kept in a bar fridge which she could freely access.
Has she tried Dr O'Toole's steps when she wants to binge? Where she has a drink and waits 20 mins etc etc....
But back to her talking about binging in advance. If she is so adamant that that's how thing will be, it's no different from those refusing to eat. So maybe it's back to the "no life unless..........." I know you must be relieved she is back at school after AN but maybe more timeout is required - probably no where near as long.
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