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

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atdt31_US
Just a quick vent -- our current team is a FBT-believing Psychiatrist we have seen three or four time since April 2018.  He is supportive of our efforts at home, acknowledges we have no available FBT support providers (dietitian/nutritionist; pediatrician; psychologist) in our area.  Knows I am a Feastie and as of our last visit, said he doesn't need to see us for us for six months unless there is a change in the meantime and I think we need him.  In other words, he likes our twenty pound gain in the last 11 months or so; he knows I concur we need to keep pushing weight up and ideally push it up faster so as to continue to raise bmi (from 12's to 15's currently); knows I do a loose magic plate and do not do lsuye; etc; knows I am monitoring state and that when I see it slide I know calories are the answer.  

BUT, we do still get weight checks by pediatrician and today we went in for one.  She does orthostatic testing (not by the book, but at least she is trying to see if there is a postural difference in pulse and blood pressure); she has d void bladder first and does the weight blind and always in a gown --- all good and all a vast improvement over prior pediatrician (we switched in August 2018).  BUT this new pediatrician still refuses to take my lead on food discussions (and I am okay with zero such discussion).  Today, after a great weigh-in (up five pounds since January 2, 2019), the pediatrician started to review current strategies with d --asked about what she has for meals; reviewed how new constipation meds might help and encouraged d to be willing to try some; etc ... all okay even if not great in my mind (pushed fiber supplements and I think they will bloat and hurt the cause not help, but I am okay trying it I guess ...).  BUT THEN pediatrician asked about drinks (to see what she could put the fiber supplement in) and d said she mostly drinks water ... d said can't drink juice in school. That is not true and has never been suggested to d ... but doctor immediately said "no, you can only have water at school."  Well obviously, she could get a medical note to have juice or pop or milk ... the point is d prefers water (I do not think as a means of restriction, she truly prefers it).  SO I jumped in and said, well, she could get a note from you and drink milk or juice or pop in class ... and dr said nothing and since I know d will only drink water anyway I let it go.  BUT THEN dr again asked about drinks and d said "I don't like pop" in response to some question, and dr said "that's okay there's no nutrition in it anyway."  I had had enough and said, somewhat snarkily, "actually, there is a lot of nutritional benefit to her drinking pop if I could get her to do it with a meal." NO comment from dr but stopped characterizing foods and drinks as nutritious or not at that point, at least.

I am so mad at that discussion.  She could have said nothing. Or she could have done as she did well in some areas, encouraging d to see new ways to do things to help the cause (got d to agree eating dinner in 15-30 minutes was more reasonable than our current 60+ minutes) ---- as far as I am concerned she just robbed me of 180 calories (I think that is a can of pop's calories).  Of course d won't routinely drink it anyway, and I told d the doctor was wrong and that in our situation pop is a good addition to the day and that for some other people pop might be less awesome.  D has heard it all for her whole life ... so probably no lasting damage done ... but why go out of your way to invite an issue or sabotage the parent's efforts!!!  

So so mad right now.  Vent over.  Thanks for letting me get it out.
Mom of either pre-diagnosis or non-ed underweight 12 yoa (as of March 2018) kid here to learn how to achieve weight gain.  BMI steadily in the mid 12's for nearly her entire life.  Born 2006. UPDATE:  April 2018 diagnosed ARFID, based solely on weight being less than 75% of Ideal Body Weight.  Mildly picky, but mostly the problem is a volume/early satiety issue, along with abdominal discomfort and chronic constipation, all present since birth. FWIW ED-D is a fraternal twin and we have no other kids.
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Effortlesspath
I feel you!  How awful to be undermined in front of your child by someone who should know better. I am in the same situation of having no local Ed resources. This morning therapist told my d, “The more a mother is involved, the worse the outcome.”  Wow.  Not only does this make me feel like garbage, it has caused me to lose credibility in my d’s eyes. I’m not sure what I can even do at this point, I don’t know how to handle it. Your situation is a tough one and it sounds like you’ve been through a lot already. You are winning with every ounce, and I definitely know you deserve support from that Dr at the very least. Good luck and keep fighting. 
Heidi
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Foodsupport_AUS
How frustrating for you atdt31. As you say no comment is better than the damage that she is offering. She forgets that your D needs those calories so they are not "empty" calories at all. 

Effortlesspath welcome to the forum. I suspect that you may need a new therapist. A therapist who thinks a mother being involved is a problem is unlikely to have a good up to date idea about how eating disorders function, and may well lead her to be sicker for a lot longer.
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.
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scaredmom
atdt31_US,
I get it!! Would you feel comfortable writing the doctor a letter that calories is what d needs and they are NOT empty!! I would put it in writing exactly what you need from her regarding nutrition. It is a pain because they may slip up when we are there so we could not prevent it!! 
I hope the doctor is someone who feel that parents are the path to health and allows you to lead and she needs to follow a bit.
that is maddening for sure!!
XXX
Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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atdt31_US
scaredmom wrote:
atdt31_US,
I get it!! Would you feel comfortable writing the doctor a letter that calories is what d needs and they are NOT empty!! I would put it in writing exactly what you need from her regarding nutrition. It is a pain because they may slip up when we are there so we could not prevent it!! 
I hope the doctor is someone who feel that parents are the path to health and allows you to lead and she needs to follow a bit.
that is maddening for sure!!
XXX


i will address it in writing in advance of our next weigh-in, which I am supposed to schedule in about a month. I could go on and on and on about the crazy ways of their treatment.  Things that just look ludicrous when laid out side by side by side. I hope to educate them at some point but never have the time to dedicate to getting my thoughts down and have the cites to sources that I think would be needed for our local doctors to ever decide there is a better way. They are soooooo behind the times.    I did just give our therapist (have not seen her since August) a link to the newest arfid treatment book and she said she ordered it.  Baby steps. 

Meanwhile, I just got home from work and asked d if she had any questions about the dr appt and she said no. I said I thought it was not a great appt and that i disagreed with several of the things the dr said. She nodded as tho on same page. So I said, like what are you thinking I disagree with and she shrugged. So I said don’t say you know if you don’t and I said I disagree about the pop and that I think the doctor was forgetting about our situation and that for a lot of patients she thinks that way to make sure they don’t have crumbly teeth or get obese if pop is all they ever drink always. She nodded and I reminded her how hard we try to get enough growing food in her (I am not allowed to discuss calories) and that if she is gonna fill her belly with that much liquid (a glass of water with a meal) we might as well make it be liquid that helps your body grow.  She nodded and I know this is all stuff she knows and goes in spurts with playing ball and drinking caloric drinks with meals. I might be very passive aggressive to the dr and serve some pop with dinner tonight. 
Mom of either pre-diagnosis or non-ed underweight 12 yoa (as of March 2018) kid here to learn how to achieve weight gain.  BMI steadily in the mid 12's for nearly her entire life.  Born 2006. UPDATE:  April 2018 diagnosed ARFID, based solely on weight being less than 75% of Ideal Body Weight.  Mildly picky, but mostly the problem is a volume/early satiety issue, along with abdominal discomfort and chronic constipation, all present since birth. FWIW ED-D is a fraternal twin and we have no other kids.
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scaredmom
Do it! The pop with supper!!
when ED d was little they learned the term “grow foods” in school and now they talk about sugar and obesity!! Aaargh!
Grow food is a good term, very apt for what we are all trying to do.
All the best,
XXX
Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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atdt31_US
This morning therapist told my d, “The more a mother is involved, the worse the outcome.”  


Unless you can have a private face to face with therapist to review how wrong that was and have him/her explain how it came out wrong, etc, I would move on.  Of course I don't know what your child is seeing a therapist for, so perhaps you can't easily move on. But if just as an ED support provider, I'd be very hesitant to stay with that therapist.  That is truly outrageous. 
Mom of either pre-diagnosis or non-ed underweight 12 yoa (as of March 2018) kid here to learn how to achieve weight gain.  BMI steadily in the mid 12's for nearly her entire life.  Born 2006. UPDATE:  April 2018 diagnosed ARFID, based solely on weight being less than 75% of Ideal Body Weight.  Mildly picky, but mostly the problem is a volume/early satiety issue, along with abdominal discomfort and chronic constipation, all present since birth. FWIW ED-D is a fraternal twin and we have no other kids.
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atdt31_US
scaredmom wrote:
Do it! The pop with supper!!
when ED d was little they learned the term “grow foods” in school and now they talk about sugar and obesity!! Aaargh!
Grow food is a good term, very apt for what we are all trying to do.
All the best,
XXX


I asked her if she wanted pop with dinner.  She smirked and said she might have one later.  We are doing speed training tonight (pizza and spaghetti) and she is supposed to eat it all in 1/2 hour.  So I will try again with the pop later or some day soon.  

LOL!!! As I was typing this and reminding her the half hour is half gone, to prompt her to eat faster, she said "I'll take that pop now."  I laughed and said I was sort of joking and I said I don't even know if we have any.  She said we have a grape.  So I confirmed she really wants it and got up to get it. I de-bubbled it (necessary for her belly to accept pop) and asked her if she wants it all or just some.  She said all of it, in a red wine glass.  Okay -- here you go.  Now eat and drink.

I am guessing she got it for some of the taste, which she does like (so I actually don't know why she told the doctor she does not like pop), but I guess we'll see if she finishes it.  I am more concerned with getting her to finish the pizza and noodles (my kids are odd and have always paired these two foods -- both used to like the idea of pizza but not enough to get full, so they'd have a bite or two of pizza and fill up on spaghetti -- now both like both but they still think of that as a paired meal.). So we'll see how much of each she gets in her by the end of the half hour.  Walking on egg shells here to prompt more and of course she is slowly sipping on the pop.  Score one for me that she asked for the pop but take off at least half the point and give it to the doctor because in reality I bet she does not consume much of the pop).  
Mom of either pre-diagnosis or non-ed underweight 12 yoa (as of March 2018) kid here to learn how to achieve weight gain.  BMI steadily in the mid 12's for nearly her entire life.  Born 2006. UPDATE:  April 2018 diagnosed ARFID, based solely on weight being less than 75% of Ideal Body Weight.  Mildly picky, but mostly the problem is a volume/early satiety issue, along with abdominal discomfort and chronic constipation, all present since birth. FWIW ED-D is a fraternal twin and we have no other kids.
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atdt31_US
Dinner took about 70 minutes.  Drank the whole pop (180 calories); ate 3/4 of the individual pizza minus the crust (guessing 200-250 calories consumed); ate 1/3 of the pasta (served full serving in case she chose pasta to eat not pizza -- guessing consumed 100-150 of pasta).  I shoot for 400-500 calorie meals (I eyeball and round down so I am not really very sure what she is getting, but roughly).  So she got enough in for me tonight.  School was cancelled due to cold weather conditions, so on days like this where the schedule is off I can count on meals also being off.  Good enough for this meal AND SHE DRANK A POP (which made all the difference -- if she had been drinking water and eaten same amount of food, I would have not been able to put this in the "okay meal" column).  Maybe I'll ask the doctor to come over for dinner ... I remember when my mom used to invite our teachers or principal over for dinner and how awkward it was -- but maybe I'll resurrect that and have the pediatrician over for dinner and she can fix it all.  Man, I am snarky tonight. 
Mom of either pre-diagnosis or non-ed underweight 12 yoa (as of March 2018) kid here to learn how to achieve weight gain.  BMI steadily in the mid 12's for nearly her entire life.  Born 2006. UPDATE:  April 2018 diagnosed ARFID, based solely on weight being less than 75% of Ideal Body Weight.  Mildly picky, but mostly the problem is a volume/early satiety issue, along with abdominal discomfort and chronic constipation, all present since birth. FWIW ED-D is a fraternal twin and we have no other kids.
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Mamaroo
atdt31_US wrote:
AND SHE DRANK A POP


Yeah!!!!!!!!
D became obsessed with exercise at age 9. Started eating 'healthy' at age 9.5. Restricting couple of months later. IP for 2 weeks at age 10. Slowly refed for months on Ensures alone, followed by swap over with food at a snails pace. WR after a year at age 11 in March 2017. She is back to her old happy self and can eat anything put in front of her.
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tina72
I feel you!  How awful to be undermined in front of your child by someone who should know better. I am in the same situation of having no local Ed resources. This morning therapist told my d, “The more a mother is involved, the worse the outcome.”  Wow.  Not only does this make me feel like garbage, it has caused me to lose credibility in my d’s eyes. I’m not sure what I can even do at this point, I don’t know how to handle it. Your situation is a tough one and it sounds like you’ve been through a lot already. You are winning with every ounce, and I definitely know you deserve support from that Dr at the very least. Good luck and keep fighting. 


Take you feet and run and change that therapist! He will do more harm than help with anything!
I hate that! I hate that we need to fight ED and are judged for that! You are a wonderful mom and I hope you know that!
If you were not involved, her outcome would be much worse and that is EVIDENCE BASED!!!
Keep feeding. There is light at the end of the tunnel.
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tina72
atdt31_US wrote:
Dinner took about 70 minutes.  Drank the whole pop (180 calories); ate 3/4 of the individual pizza minus the crust (guessing 200-250 calories consumed); ate 1/3 of the pasta (served full serving in case she chose pasta to eat not pizza -- guessing consumed 100-150 of pasta).  I shoot for 400-500 calorie meals (I eyeball and round down so I am not really very sure what she is getting, but roughly).  So she got enough in for me tonight.  School was cancelled due to cold weather conditions, so on days like this where the schedule is off I can count on meals also being off.  Good enough for this meal AND SHE DRANK A POP (which made all the difference -- if she had been drinking water and eaten same amount of food, I would have not been able to put this in the "okay meal" column).  Maybe I'll ask the doctor to come over for dinner ... I remember when my mom used to invite our teachers or principal over for dinner and how awkward it was -- but maybe I'll resurrect that and have the pediatrician over for dinner and she can fix it all.  Man, I am snarky tonight. 


I am so glad she drank the pop.
Can you change that pediatrician? I would not be able to go there again. I am so frustrated about so many "professionals" that are not worth one single letter in that word!
I am so proud of you that you did not listen to this stupid things. You know your d best.
Keep feeding. There is light at the end of the tunnel.
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atdt31_US
I will keep trying to educate the pediatrician at this point.  There is nowhere to go locally that would be any better in terms of ARFID or eating disorders and certainly no FBT-educated pediatricians in town. 
Mom of either pre-diagnosis or non-ed underweight 12 yoa (as of March 2018) kid here to learn how to achieve weight gain.  BMI steadily in the mid 12's for nearly her entire life.  Born 2006. UPDATE:  April 2018 diagnosed ARFID, based solely on weight being less than 75% of Ideal Body Weight.  Mildly picky, but mostly the problem is a volume/early satiety issue, along with abdominal discomfort and chronic constipation, all present since birth. FWIW ED-D is a fraternal twin and we have no other kids.
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