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

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Hi everyone. This is my first post... I joined up a couple of months back when I was looking for some guidance and ideas. My 15 year old daughter had at that point been on a waiting list for 8 months following referral to CAMHS from the GP for an ED. CAMHS had previously turned her away when she tried to get help for anxiety and depression, so she was already unsure of the usefulness of the wait, and I was seeking any ideas to help her eat, as her weight continued to fall. She had been diagnosed with severe anaemia by the GP a year before, but no-one had picked up on her eating or weight being an issue at that point.

To cut a long story short we are finally seeing CAMHS every few weeks. It’s very slow going and at the moment she’s still losing weight. The thing that’s concerning me most right now is the wounds she’s getting on her lower legs. I can’t find anything online which links leg ulcers with anorexia, but I can’t help wondering... she’s been getting them since the summer. Her skin splits by itself, and these wounds appear, which are quite deep, raw and ooze a lot. They cause pain which means she can’t put weight on the leg to walk properly. She’s definitely not causing them herself, and is actually quite distressed by them. 
Today one of them split at school, and she had to be sent home as there was blood and stuff on her trousers. 
I’ve read that anorexia can cause slow wound healing, and these are certainly slow, taking about a month each to heal, but could their appearance also be linked to the ED? 
The wounds themselves remind me very much of the leg ulcers my late grandmother had, which never healed and were extremely painful.

The guy we are seeing at CAMHS made a note when I mentioned it but didn’t seem overly concerned... but I am. Does anyone have any experience of anything like this?
Hello and welcome!
I do hope you find the support and information you need to help your child.
As for painful open wounds on the leg for the last few months, I really would consider seeing a doctor for that. There can be many causes and so many different kinds of skin lesions that may not necessarily be  related to ED. 
For sure,  malnutrition can cause poor wound healing, but a proper diagnosis needs to be made.
As we are not physicians here, we really cannot advise as to the cause or treatment. 
Do you have a doctor you can see soon?

I note your d is not gaining. If you Let is know a bit more about your situation we may be able to come up with ways to help you help her gain.
please ask all the question you have.
Sending my best.
When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
Hi Poppybat, I definitely would see a doctor for the leg sores. They could possibly be venous ulcers which occur when the veins in your legs do not push blood back up to the heart as well as they should. This causes increased pressure and excess fluid and in turn causes an open sore. These sores can get infected and cause other problems so I would definitely get her looked at. Better to be safe. Hope you find out what is causing this soon. Best wishes!
Thanks Enn and Frazzled. I was really just wondering if anyone else had experienced anything similar, as our GP tends to be very dismissive of my concerns especially now CAMHS are involved. She actually told us she had no idea what low sulphate levels in blood tests meant after the last lot came back... I had to google it and tell her! 
It’s really hard getting GP appointments here too, it’s currently a 3-4 week wait at our surgery unless the receptionists deem you urgent enough and you queue at 7.30am outside the building. It’s been a fight getting this far, so I wanted to try to work out if it was likely to be ED related before going if that makes sense. Maybe that just isn’t possible. 

I suspect I’m going to be paying an early morning visit to the surgery to join that queue! 

CAMHS have given us a step 1 eating plan, which involves three meals and three snacks a day, and we’ve been trying this for a couple of weeks. It’s a struggle, especially as my daughter is still at school (she doesn’t want to stay at home as it’s GCSE year). School are dragging their feet finding her a suitable place to sit quietly and eat, so I think I’m going to have to pay them another visit too. 
At home we are encouraging her to eat as much as we can, and she’s trying, but there has been involuntary sickness (not deliberate) which I fear will hamper our efforts. I’m really hoping that a careful Xmas holiday from school will give us a few weeks to get a better pattern established. We’re not really “doing” Xmas full on anyway... too much stress! 
Great that you have finally been seen by CAMHS but very worrying that your D continues to lose weight and seems to be having other issues too. I am sure there is the possibility of these sores being due to nutritional deficiency too. It was not something we experienced but you post is suggesting that . she has had ongoing malnutrition for well over a year, severe anaemia last year possibly related to weight loss and then ongoing loss this year. 
If so the best way forward is to get weight gain happening regularly with a broad variety of foods and supplements. 
It is important that your D continue to have regular medical monitoring for medical stability. Given she is continuing to lose weight I would have hoped these were occurring at least weekly - where someone is checking her heart rate and blood pressure - lying , then standing. Reviewing her bloods as needed etc. 
Unfortunately if someone has been at a higher weight in the past, it is not unusual for people to underestimate how sick children can be. There has been a number of studies showing that the actual weight of the child does not bear so much resemblance to how sick they are, rather the rate of weight loss, and the amount of weight lost overall. 
D diagnosed restrictive AN June 2010 age 13. Mostly recovered 10 years later.  Treatment: multiple hospitalisations and individual and family therapy.
Can you take her to a specialised skin doctor?
We did not have that here but my d had chill blaines every winter since ED started (now again) on fingers and toes that hurt a lot and are red and inflamed. The GP said it is because her skin is still very thin and not enough fat in this region of the body. She has very small hands and feet in addition.

I know from a family member that has diabetes that there are problems with bad wound healing at the legs because of bad blood transport, I wonder if that could be the case there too as AN has many parallels with diabetes.
Keep feeding. There is light at the end of the tunnel.
Poppybat wrote:
The wounds themselves remind me very much of the leg ulcers my late grandmother had, which never healed and were extremely painful.

I am wondering if this is an inherited tendency as I don't remember anyone here reporting similar ulcers.  Did they ever figure out why your grandmother experienced that?  

It seems likely that ED could be aggravating the tendency to develop leg ulcers, but I doubt that ED is the whole explanation.  I agree with the others who suggest medical evaluation of the ulcers, along with a good Internet search as that often turns up information a particular doctor might not have.

Please keep us posted. xx

"We are angels of hope, of healing, and of light. Darkness flees from us." -YP