F.E.A.S.T's Around The Dinner Table forum

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My daughter and her twin brother had to go to their regular pediatrician for 7th grade shots (they cannot start school in the fall without them).  Usually my D goes to her team doctor, however, her pediatrician knows she has RAN.  Her pedi is NOT an ED specialist.

So, first they tell her her weight even though it specifically says on her chart to blind weigh.  THEN, she tells her that she is at the 40th percentile for BMI and she should NO LONGER GAIN WEIGHT. 

My D had her first period last month.  She will NOT EAT intuitively (although she eats without too much difficulty if its put in front of her).

Since then, my daughter has spit out her medicine, had major emotional meltdowns, screamed about how much "I make everything about me" and has overall made life impossible again.  She does not want to go to work with me or her adult brother but will sleep till noon (skipping breakfast, morning snack and lunch) if I let her stay home.

This past weekend, I let her go to the mall with her one friend.  I gave her $20 and told her she needed to stop and get lunch at the food court.  I even told her best friend to make sure they eat.  Of course she did not.......said she "forgot".

Sunday, I got her chix fries and French fries from BK (she loves).  I found the chix fries under the seat of my car (she said she ate them).

Yesterday, I took her to work with me.  We made it as far as the parking lot when she fell apart, crying she wants to be left alone and be home with her siblings.  She cried and cried and grabbed at her hair.  She is also cutting again.  She basically went ballistic to where I had to turn the car around and miss work.  As soon as I turned around, she was fine.  Of course by this point I'm frazzled because once again I'm having to call in sick.

I've calmly explained that she can stay home without supervision WHEN she will eat her lunch (we make it before we leave) and snacks on her own.  She says her sister can watch her eat (I'm not wanting to put that kind of responsibility on her 14 year old sister - even though she said it was fine).  It seems to me she's not ready, but suddenly it's impossible to take her to work with me.  Not to mention, she's trying to throw at me that Dr So and So says...........  blah blah blah.

She's not been seeing a therapist since May but I'm thinking of calling the RO-DBT group that is here in town.  I feel like I'm between a rock and a hard place again.  I really don't believe she is where she needs to be (her behavior seems to prove that) but it's hard for her to trust me when her doctor told her different.  She's back to giving me 'that look' of such anger and hatred.  But she managed to turn it off in TWO SECONDS when she got her way (which wasn't to eat, but to go home).  I'm feeling very angry and manipulated right now and I'm back to not being able to separate anorexia from teen behavior.

Any thoughts or suggestions?  She will be starting school again in August.
Oh how frustrating!!!  Can you arrange to have her talk to the team doctor who is the ED specialist? 

I think DBT is a good idea for everyone to be honest.  The skills that are learned are extremely valuable so that would be a good option.  If she can go back to her therapist, it might be time for a tune up.

It sounds like you need to go back to full supervision at least for awhile.  No more meals out with friends and I think you are extremely wise not to let her sister watch her.  I tend to separate any behavior with food out as ED behavior and deal with the rest the way I would deal with any behavior from any kid.  If my daughter went ballistic in the parking lot about work, I'd wait her out just like any 3 year old throwing a tantrum and then she would go to work with me.  To me that is just behavior that should be dealt with like you would any child.  The behavior around food-I would just look at it as a blip in the way and make sure that all meals are covered again, gets up on time and any hidden food replaced-exactly how you got her there in the first place.  I don't know how many days you can afford to call off sick because daughter is throwing a tantrum in the parking lot but I can easily see how you would feel manipulated. 

It is inappropriate comments like this that make recovery so hard for our kids, more to the point comments like this though may be the sort of thing that encourages a kid with a predisposition to ED to restrict their intake. I would be considering writing a letter of complaint about how inappropriate the comment was for ANY child, let alone yours. 
As for your D, you are absolutely right. Your D clearly is showing she cannot do this on her own at the moment, no matter how much she protests. The older they are the harder it is to take back control when someone undermines you like this. Hopefully you can get her ED team to offer you more support and perhaps looking for more skills for D too. Best of luck.  
D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
So very, very sorry you are going through a frustrating backslide situation due to another non-ED medical professional mistake.  Sure happens to all of us far to often.  The medical community as a whole is not trained very well (even pediatricians) in the latest on eating disorders.  There are some excellent pediatricians out there but they are few and far between.  Unless someone at the office has taken the time to communicate to nursing staff etc. there can be unintended consequences all the way down the line.

Last week I had to take my d to a cardiologist.  The doctor is fantastic and has worked with ED patients before.  His nurse is very nice but I always get that "vibe" like she doesn't really "get" my d.  She is trying to understand but there is that little invisible undercurrent. So, we start reviewing the meds my d is taking and we get to a recent add on...dropping one to try another.  Nurse says, " oh Lamacitl....her doctor introduced that to help with weight gain, right?"  This said right in front of my d who is doing ok but struggling greatly to maintain.  Aaaargh!  I covered quickly....using lots of my DBT skills....(DBT is great for parents as well.) I remained calm and kindly validated her and then told her no....the pysch doctor is very well informed regarding meds for ED and did not put her on Lamactil for weight gain at that dose...rather he carefully chose the med for other reasons specifically as a mood enhancer in conjunction with other meds.
(Loud Mental Scream!) Hoping my d was not really listening to nurse...but fear ED was. 

Just thought I would try to make you feel a little better....not your fault but you have to "clean up the mess".  I would definitely see if the current ED specialist team can add support for you and a phone call to educate the ped concerning the dangers of such comments for eating disorder patients.  Crazy we have to help educate but sadly we do. 

DBT is very helpful for emotion disregulation...would recommend it for both you and d.  It does take awhile to generalize skills learned but I find it super helpful in stressful times.  Not sure what DBT-RO is but standard adherent DBT is very good for anyone with extremes of emotion, suicidality, self-harm etc.

All the best to you....I can understand your extreme frustration. Sometimes we have to take off yet ANOTHER work day to save our kids....we'd do it for cancer....so why is this any different?  Judgement from the rest of the world?  This situation is just as important....food is the medicine.

Daughter diagnosed 2010 (9th grade) with AN/Binge/Purge.  D. had brewing ED thoughts as early as 4th grade. Constant battle with ED from 2010-present.  Co-morbid anxiety & depression & suicidal thoughts & self-harm.  Most recently in intense DBT/ED program outpatient . Weight restored but not happy about it.
You have to keep your resolve and dig deep right now.
You take control. You tell her that the pediatrician is not educated in her illness and nothing the doctor said apples to a child with an ED. Her brain is different. Her metabolism is different. Her needs are different. If it would help to take her to someone in the Ed world who will back you up then go for it, but make sure that person DOES fully support you.
She needs to be watched when she eats. Unfortunately you have hit another very steep wall in the climb up to recovery. We all face many of those unfortunately.
Time to shake things up. Let ED know who is boss. Continuing to show your daughter that you will keep fighting for her to be rid of this horrific weight on her back.
That's what you do. And you will do it. I have faith in you.
Persistent, consistent vigilance!
ARGHHHH!  I'm so angry at that idiot doctor!  Who the *&$%@ tells any 7th grader to stop gaining weight??????  It sounds like ED heard that message loud and clear and is tormenting your D with it.  Re-group, close loopholes and don't apologize.  And maybe there is some way to "sweeten the deal"? (something she likes? wants? enjoys?)  What does she do when she comes to work with you or brother?  (Btw - that must be hard for you to take D to work.  Kudos to you!)

My D seems to find talking with T helpful.  I feel good that she has someone she can talk to who she trusts (most of the time) who understands EDs; especially for the times when she is angry with us.  I think T is helpful in reminding D and us of the big picture and of the progress that we have made.  We can get lost in the daily battles.

Towards the beginning my D's pediatrician said 108 would be a healthy weight for her which was WAY too low.  I can't tell you how many times that came up.  Now D thinks her pediatrician thinks she is overweight but is too nice to say so.  ARGHHHHH!!!  Pediatrician tried to explain that she meant 108 was a healthy short term goal, but that once D reached that weight she would set the next goal.  What?  I didn't remember that, and neither did D.  But it's possible as sometimes we don't hear everything the doctor says.  Finally, one time when D brought up 108 I flat out told her that the pediatrician was wrong.  I told her that the pediatrician is a a doctor, but not an ED specialist.  Now D is seeing an Adolescent Medicine doctor who specializes in EDs.  D still sees pediatrician for annual physicals, etc, but I feel anxious when I take D to pediatrician.  Now I always talk to the nurse before she takes D back to be weighed and I always talk to pediatrician before D is seen.  I probably drive them crazy, but I don't care.  Under the circumstances it is reasonable and necessary.

And it is rotten to feel manipulated by your child.  When it happens to me I get angry too.  But as others on the forum have said - consider it "feedback, not failure".  You learned from that experience.  
DD diagnosed with anorexia at 14; FBT at home with the help of psychologist and medical dr; 3+ years later and doing well (knock on wood)