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

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casc
My daughter is 17 and we are doing FBT. Have had a few posts since joining recently. Am wanting to know what others do when their child refuses to complete their meal? And what do you do when they leave the table with an uncompleted meal. My daughter is currently at my inlaws and they spent 3 hours at the table last night and she still only ate half her dinner. I will be getting her back on Monday and want to take the power off anorexia but not sure what to do in these situations.
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mjkz
With my daughter when she left the table without finishing, I would follow her with the plate of food.   If she went into her room, I would stay in there and the only way she could get me to leave was to eat the food.  If she refused, the calories would be added to a later meal or she could drink a supplement to make up for the lost calories.  If she refused the next meal with the added calories, she could either eat it at home, drink the supplement or we went to the ER.  There were times that she ate the food as we were on our way to the ER or while we were waiting.  There were other times when she refused to eat at all and the ER would tube feed her.  I would make sure that her team got a call every time we had to go to the ER and after two or three trips, I would start pushing the team pretty hard for a higher level of care.  If she could not eat at home, then she needed to be in a place she would eat either voluntarily because she was required too in a hospital or through a tube.

We also had a time limit for meals and snacks because otherwise I sat at the table all day and far into the night.  She had 45 minutes to an hour for a meal and half an hour for a snack.  If she didn't finish during that time, she got a supplement.  Some people were willing to sit all day but it just didn't work with my daughter.  The food got nasty and she would sit there all day long so we had to use time limits.

Here is a good thread on things people have tried when things like magic plate didn't work.

Also in between meals if she did not finish all the food, she was on complete bed rest.  No electronics, no TV, no reading, only resting in bed because if she couldn't eat enough to keep herself from reversing her weight loss, she needed to expend as little cals as possible.  No one came to visit, no friends over, nothing.  If she finished the meal then she could go about her usual life but with my daughter we had to make not eating more unpleasant than eating. She still ended up inpatient many times but eventually realized that the calories were going in whether she ate them voluntarily or through a tube.
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hbeatsaUSA
In our house, I take a firm but loving stance on eating. I prepare a meal -- usually including at least one food I know she is very comfortable with, but plenty of fear foods as well. While eating with my daughter (in early refeeding I eat with her for every meal), I would gently encourage her to eat faster, stop cutting her food into small pieces, don't mix foods that don't go together, etc. If she continued to do the behavior after being redirected, I would (gently!) tell her "Okay, D, if you do *that behavior* again I am going to replace that part of your meal. I'll keep replacing it until you can eat it without doing that behavior. I know you can do it!" If she completely refused to eat, I would discreetly look at the clock. Then, I would say "D, I'm going to give you an hour to eat this meal. I know you can do it, but if it's too hard, I can get a Boost Plus for you from the fridge. If you can't drink that, I will call your doctor and we will get an NG tubed placed. Hopefully we don't have to do that, though. I believe that you can eat this food!" If she got up and left the table, I followed her with food/ Boost in plan. If she threw food, I replaced it without a fuss. If she got upset, I tried my best to stay calm. I always announced the consequences of restricting long before actually giving her the Boost/ taking her to the hospital. Usually, but not always, the threat of this was enough to get her to eat. When it wasn't, the key was that I had to actually giver her the supplement drink/ call her doctor and take her to the hospital. No exceptions. When this happened, I was very clear that it wasn't being done to punish her. I told her that she had a brain disease and needed extra help right now and I loved her very much. 
She is 20 now. She is back in early recovery after a relapse, but will still readily tell anyone that not being given a choice as to whether or not to eat was vital to her recovery and weight restoration. 
If you are planning to start Magic Plate on Monday (what some of us ATDT parents call it when we take full control of our children's eating), you will need to do some grocery shopping this weekend! Pick up the ingredients to make nutrient dense, low volume meals. I will bump the "high calorie meals" thread so that you can look through that. Pick up some high calorie nutritional supplement drinks. Stick one in a discreet area of the refrigerator. In addition, make a plan for which hospital you will take her to if she refuses to eat. My d swears it tastes better cold. Be prepared for her to be upset -- I promise that she will thank you one day. 
Some parents sit down and tell their child that they are going to be doing Family Based Treatment/ Maudsley and outline the new rules ahead of time, but others don't. This is up to you -- you know your daughter best. 
Other parents will come along with much better advice. I just wanted to share what has worked for our situation/ our family. Stay strong. Lean on those on this forum for support. The mamas and papas on her have so much collective knowledge that it's almost unbelievable. This is going to be hard, but you will have your old d back. Hopefully that will be soon. You are doing hero's work. Please keep us posted and come back here with questions often! 
- Stephanie 
D- 21 w long history of RAN (that seems to be in remission, thankfully)
Me- Stephanie
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hbeatsaUSA
Also, I want to echo what mjkz says! The important part is that your daughter realizes that the calories will go in, whether that is from food or through a tube. Letting her skip a meal/ snack or only eat part of it allows ED to strengthen its grip on her. 
D- 21 w long history of RAN (that seems to be in remission, thankfully)
Me- Stephanie
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casc
Thanks for your replies. I have already taken full control of her meals but she still often won't complete meals and misses some. I usually sit with her but once she's decided not to eat anymore that's it. I haven't been able to persuade her too. We don't have to option of hospital to get ng unfortunately, where we live they do not go to hospital unless they are severely underweight AND medically unstable whichave she is not so makes me feel quite powerless when she doesn't eat
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Foodsupport_AUS
How to get someone with anorexia to eat? This is the question that brought me to this forum. It can be incredibly difficult, and there is no magic answer that will work for everyone. 
The most common techniques that people try is LSU/WYE  (Life Stops/Starts Until/When You Eat). If you are doing FBT of course you should be in charge of deciding what she eats. You can of course enter into some negotiations (they need to be limited) and sometimes this can help get things moving if there are certain foods/tastes that are stopping the process. 

Sometimes certain meals are harder than others, so loading up those that are easier, or where you can pull more leverage eg. Breakfast so you can go to school can also work. 

Having plans for distractions that can continue through the meal once she gets started can also help ease some of the anxiety that goes with eating. Encouraging a reasonable pace so they don't "feel full" before they are well into the meal. 
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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Sotired
Hi casc,
Just wanted to check in that you have instituted proper procedures instead of that half arsed care you were getting from your team?
Currently, if they are not doing or have not done weekly obs, they cannot tell you your child is well.my d could be really sick at 48kg- when they did obs correctly.she was sick at 50kg, 51kg.
Her orthotic-lying to standing ,not sitting to standing- heart rate showed marked differences.you can get the care you need in NZ-but you have to fight and be prepared to completely disagree with the team.if your d us missing meals and half completing others and they are doing nothing to aid you then that is on them to help fix.
You don't mention whether they have done bloods yet ?they may or may not show anything-bloods can show healthy when our children are very unwell.but they are a measure for whether vomiting enters the equation.
You can only place your trust in a team that is working with you and it doesn't seem like they are.
I do remember you saying your d is losing weight- what is their (stupid)'magic number' where they are prepared to step in?
If you are unhappy with your care-and in your situation I would be absolutely ropable- then please look up guidelines for care of patients and see which ones meet your situation.to get any care it's a fight.to get effective care it's a big fight.
The truth is, unless you start getting back up from your team, it's going to be hard to get effective advice and treatment.
How many calories do you estimate are actually going in?if it's less than 1000,you might have a good case there for admittance.you can have the team up about 'ambulance at the bottom of the cliff' v effective treatment now.
Look for loopholes.
In terms of home-one of the things I tried was that EVERYONES life in the house stopped until my d ate.so if she took ages at breakfast or did a flat refusal, I refused to take her brother to school.i disrupted all of our day, until she ate.she would shout and scream, but if I held firm it worked as they don't like their younger siblings missing out.
What else?i took her phone and laptop.i didn't let her watch tv.everything became a privilege-even showering at one point(yes, I was desperate).
I sat withher in her room and hand fed her.
We tried meals at the mall.
My d was not severely underweight when admitted so I do know that that is not a criteria for the most part.ther was however a repeated unwillingness to eat or drink once we challenged anorexia.i decided that given the choice at the time, if she wouldn't eat I could set the clock and take her in at the 24 hour mark to our hospitals a&e and get her assessed there, requesting the orthostatic rate be done.it was a calculated risk-but I knew if I didn't challenge those behaviours I would lose in the end anyway.if she didn't eat I could then take my d to hospital where at that point they would NG feed her.
So I would bring her back from the grandparents and expect every meal to be completed. If she stops eating then use that to your advantage.set the clock and take her in when needed.this is not advice I like to give at all, but I'm in that system that you are and I know what is and isn't available.
The rule is 24hours no fluid or 48 hours no food, then a &e.
If my d decided she would drink a mouthful of milk and have one bite of toast, I didn't count it as having eaten or drunk anything , I took her anyway.her obs were usually bad.
You can ask for second options too if needed.


Sotired42
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casc
Thank you Sotired. My GP is doing some research and has sent several referrals through to different places to see what happens. We don't have a team we just see the 1 psychologist once a week. They did bloods when she was 5kgs lighter and everything came back as normal. She wouldn't not eat for 24 hours but has only been eating half her dinner and no pudding then back to eating breakfast the next day.

I took her to the A & E when she was 42kgs and was weak etc and they did bloods and said she wasn't medically unstable so didn't meet the criteria for being hospitalised. They sent psych team to talk to her and she said she was fine so they discharged us. I wish they would tube feed her as I know it'd be such a turning point for us where she would know that if she didn't eat willingly then it would go in regardless and then she only has a choice about whether it goes in the nice way by her doing it or the horrible way against her will
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OneToughMomma
casc,

It's really hard, we know.

Is she gaining weight?

xoOTM
D in and out of EDNOS since age 8. dx RAN 2013. WR Aug '14. Graduated FBT June 2015 at 18 yrs old. [thumb]
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casc
OneToughMomma wrote:
casc,

It's really hard, we know.

Is she gaining weight?

xoOTM


She has been gaining and losing for past 5 weeks. She got was at 46.6 went back down to 46 then a few in between then this week went up to 46.9 now back to 46.3 so I guess on the whole no not for the past 5 weeks
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Sotired
She is water loading.my d did this -exactly this-and that's what it ended up being.they gain and lose the same kilo week after week.i never knew how she did it either as I thought we were watching her carefully, but obviously anorexia won that one for us.
I can't believe they didn't consider 42kg light enough- that's just ridiculous-particularly as They haven't been doing obs correctly or doing weekly bloods.
I would certainly look into criteria for the mental health act.
The therapist you see is through the public system which means s/he is part of a wider team.we too struggled with both the therapists provided for us from the public system-they were woefully uninformed and the first one was actively obstructive in letting me get my d to hospital.
That's why I'm glad to hear that your GP is looking into further help.what you can do in the meantime is ask to have a meeting with the head clinician.write everything out.take it with you when you go.make it very clear that you have done your part, hit a brick wall and now need them to put your d in hospital with a Ng tube to get weight up-or doing FBT in the hospital setting.46kg is very light.the shifting part can be ignored-they know it's water loading, they just aren't telling you that.our therapist didn't tell us either.
If you are at breaking point it's a good time to be broken in front of them.in some ways the grandparents taking her has worked against you-for as long as they know you have other options , they will 'recommend ' using them, rather than putting the resources into your child.say that the grandparents did not cope and were ineffective at getting nutrition in.thats the truth of it.its no good her having a place other than yours to go if the result is the same if not worse.
I know how ridiculous that all sounds but it's true.we had to make it abundantly clear that we were on our own for feeding.that nothing was changing except the anorexia was getting more and more entrenched as what we were doing proved ineffective.
That you need something more than hope, good wishes and dreams from your therapist-you need a plan.
A what happens if this doesn't happen, plan.you need consequences that are clear-and your therapist can get your d into hospital if needed.
They can.
Ask your GP if s/he can give you options on what to do by the end of next week.there is help.you are allowed to be angry, use it effectively.demand better answers.demand to see the head clinician.demand that they go through hospital admission guidelines.demand that they care.its their job to help you.
Be angry, be broken, be demanding-because they are being ridiculous expecting you to do everything and them doing nothing.
Ask your GP if she can be assessed at starship if need be.there is always a way, you just need someone to help you find it.
Strength your way,

Sotired42
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casc
Yes 46 kgs is very light still. I will see how her weight is on our meeting on Tuesday. They just keep telling us it's not working because there are still cracks
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Foodsupport_AUS
Yes, there are cracks, she is not finishing her meals, you know that.

One option that some have had, although many places will be reluctant to offer this, is an offer of a NG replacement feed for missed or unfinished meals. Those have had this sort of back up often feel that this is what shifted their child to be able to eat at home. It means there is no option for nutrition. In the hospital where my D was the standard was 30min for meals 15 min for snacks. If not finished a supplement to the FULL value of the meal was given. If not completed within 15 min a NG tube was passed with the remaining supplement given. The tube then stayed in for at least 48 hours, with all meals having to be completed in that time for it to come out. 

My D was one of those who bounced in and out of hospital because she was unable to eat at home or was unable to eat sufficiently at home. I pleaded for this as an option for some time. When it finally was offered it was the thing she could use at home to say that she had no choice. ED needs to be backed into the corner of no choice for them to be able to eat. 

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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Sotired
As far as I know NG feed is only offered inpatient in NZ except if you have it permanently.for example, we have it, but it was a god almighty fight to get it and only because we have now got a diagnosis of intestinal failure.so cascs d would have to have it inpatient and NZ clinicians are reluctant to hospitalise because that costs the system $$$.
It's not something where they would do it out patient with returns for feeding, only inpatient.
I honestly believe to get traction with this your d now needs a short hospital stay with NG feed -to show the anorexia that actually there are things that can be done if weight gain has stalled.if your d refuses you will have to section her to get that done though casc- but if that is the only way forward then don't let anyone try to scare you out if it.
The window of treatment for this closes abruptly so despite what someone may tell you,it might not be the same for your child.it really depends on therapists.
For some services the window banged shut for us the day my d turned 17-but we then used the mental health act to get treatment done.even if your d went to residential that might work.they could then see her level of compliance for themselves.that might then give you the proof you shouldn't need but have to produce anyway, to get your d more help.
We may be the test case actually for having an NG tube at home in NZ ,I do not know of anyone else.if so, hopefully we have paved the way to make it easier if that ends up being an option you need to explore Casc.
But yeah, if they were taking her obs properly,testing her blood and with a low weight-I think you have grounds to try again for admission.if not hospital, then residential.
I'm not sure if anything on my thread would help you, but I have definitely had to fight within the system bloody hard to get help for my d.
You could also involve the disability commission.tell your therapist that due to poor treatment options this is something you are looking into in the next week.you could ask your therapist to speak to the REDS team in Auckland to help.stress that time is of the essence.i know how hard it is to do this believe me, but I know I had to.i had to try everything I knew how to do and go outside the box as well.
I won't keep writing reams, I promise, I'm just trying to give ideas of how to start moving forward using the systems we have.
If I think of anything else, I will do a short post (I promise it will be short!)
Sotired42
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mjkz
Quote:
We don't have to option of hospital to get ng unfortunately, where we live they do not go to hospital unless they are severely underweight AND medically unstable whichave she is not so makes me feel quite powerless when she doesn't eat


Casc, maybe they won't do NG but the fact that you keep showing up will get the message across that things are not working and you need a higher level of care.  I ran into something similar after my daughter's diagnosis because "chronic anorexia" from "anorexia".  We were offered little care if any so I kept showing up at the ER (A&E).  It is a pain in the rear end but when the health professionals keep seeing you time and time again it really does help get across the message that things are not working at home and something needs to change.  It also helps get across to your daughter that you are 100% serious about her having to eat and not eating is not acceptable.  My daughter got so sick of being hauled off to the ER she ended up eating on the way or in the waiting room just to stop the waiting and having to talk to the doctors again about why she is not eating.
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casc
Foodsupport_AUS wrote:
Yes, there are cracks, she is not finishing her meals, you know that.

One option that some have had, although many places will be reluctant to offer this, is an offer of a NG replacement feed for missed or unfinished meals. Those have had this sort of back up often feel that this is what shifted their child to be able to eat at home. It means there is no option for nutrition. In the hospital where my D was the standard was 30min for meals 15 min for snacks. If not finished a supplement to the FULL value of the meal was given. If not completed within 15 min a NG tube was passed with the remaining supplement given. The tube then stayed in for at least 48 hours, with all meals having to be completed in that time for it to come out. 

My D was one of those who bounced in and out of hospital because she was unable to eat at home or was unable to eat sufficiently at home. I pleaded for this as an option for some time. When it finally was offered it was the thing she could use at home to say that she had no choice. ED needs to be backed into the corner of no choice for them to be able to eat. 



I 100% believe this would be the turning point for my daughter but they do not offer it here.
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casc
Sotired wrote:
As far as I know NG feed is only offered inpatient in NZ except if you have it permanently.for example, we have it, but it was a god almighty fight to get it and only because we have now got a diagnosis of intestinal failure.so cascs d would have to have it inpatient and NZ clinicians are reluctant to hospitalise because that costs the system $$$.
It's not something where they would do it out patient with returns for feeding, only inpatient.
I honestly believe to get traction with this your d now needs a short hospital stay with NG feed -to show the anorexia that actually there are things that can be done if weight gain has stalled.if your d refuses you will have to section her to get that done though casc- but if that is the only way forward then don't let anyone try to scare you out if it.
The window of treatment for this closes abruptly so despite what someone may tell you,it might not be the same for your child.it really depends on therapists.
For some services the window banged shut for us the day my d turned 17-but we then used the mental health act to get treatment done.even if your d went to residential that might work.they could then see her level of compliance for themselves.that might then give you the proof you shouldn't need but have to produce anyway, to get your d more help.
We may be the test case actually for having an NG tube at home in NZ ,I do not know of anyone else.if so, hopefully we have paved the way to make it easier if that ends up being an option you need to explore Casc.
But yeah, if they were taking her obs properly,testing her blood and with a low weight-I think you have grounds to try again for admission.if not hospital, then residential.
I'm not sure if anything on my thread would help you, but I have definitely had to fight within the system bloody hard to get help for my d.
You could also involve the disability commission.tell your therapist that due to poor treatment options this is something you are looking into in the next week.you could ask your therapist to speak to the REDS team in Auckland to help.stress that time is of the essence.i know how hard it is to do this believe me, but I know I had to.i had to try everything I knew how to do and go outside the box as well.
I won't keep writing reams, I promise, I'm just trying to give ideas of how to start moving forward using the systems we have.
If I think of anything else, I will do a short post (I promise it will be short!)


I know you had a fight I've seen some past posts come up when I've searched. I'm not 100% sure that we have really aced the FBT yet. No one has spent over 1.5 hours at the table with d and there has not been enough consequences when she's missed a meal. I am going to try 100% this week and see how we go. If there is still plenty of resistance and non completing of meals then I will start to kick up a rarkess. REDS have changed their name but our psychologist had weekly meetings with a REDS (not sure their new name) specialist and talks or goes over my d's case. So a REDS specialist technically dictates what we do
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Sotired
I know a couple of people there and can give you the name of the psychiatrist with the adult team-he may have some further thoughts and can help with getting hospital involvement to a degree.
If that would help let me know.
It may change nothing, it may be helpful.
Sotired42
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OneToughMomma
Dear casc,

We got stuck, too. We weren't able to boost up the calories and d hovered at a particular weight for ages. She wasn't water loading, we were just stuck. People's weight will vary by a kilo in everyday life.

We did something along what hbeatsa did. I would follow her with food and remove all privileges if she wasn't eating. Our therapist never told us d had to eat everything on her plate. He told us she had to eat more at each meal than her ed wanted her to. That worked for us, eventually.

Also, I made sure each bite was as calorie rich as possible.

Is d in the kitchen when you are prepping her meals?

xoOTM

D in and out of EDNOS since age 8. dx RAN 2013. WR Aug '14. Graduated FBT June 2015 at 18 yrs old. [thumb]
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casc
Sotired wrote:
I know a couple of people there and can give you the name of the psychiatrist with the adult team-he may have some further thoughts and can help with getting hospital involvement to a degree.
If that would help let me know.
It may change nothing, it may be helpful.


My last post contradicted itself to the first. My inlaws spent 3 hours at the table with her on Friday night but they just kept saying eat, eat and none of the things that I've been reading to say. So I haven't sat at the table with her for that long and have been a little scared too as if I do and she still doesn't eat it all then I lose and Anorexia wins. She is not water loading she has stayed around the same weight give and take because she is not completing all her meals. It is definitely accounted for why she hasn't had gains and has had losses. Half a meal a few times a day instead of the full amount will add up to be quite a number of calories by the end of the week. Sotired do you know of a gp can put in a NG tube and feed fortisip down it? Or is that beyond their scope?
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casc
OneToughMomma wrote:
Dear casc,

We got stuck, too. We weren't able to boost up the calories and d hovered at a particular weight for ages. She wasn't water loading, we were just stuck. People's weight will vary by a kilo in everyday life.

We did something along what hbeatsa did. I would follow her with food and remove all privileges if she wasn't eating. Our therapist never told us d had to eat everything on her plate. He told us she had to eat more at each meal than her ed wanted her to. That worked for us, eventually.

Also, I made sure each bite was as calorie rich as possible.

Is d in the kitchen when you are prepping her meals?

xoOTM



No she is not in the kitchen I always call her in when it's finished or get her up for breakfast.
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Foodsupport_AUS
I really struggled with home re-feeding, that is how we ended up with so many admissions. My D really struggled to eat anything that was not on her hospital "meal plan", and then struggled to eat the plan as well. 

We had many missed meals, and many incomplete meals. I don't think that really gave anorexia strength, rather I think it was a reflection of the strength of the ED. My D knew that if she was unable to eat meals then she could not do her normal activities, she also knew that if she reduced her intake below a certain level I would recontact the team before our weekly review. She knew I would not hesitate to take her to emergency if things appeared to be deteriorating faster. This did not help my D eat but she knew that there was always going to be someone standing up against her disorder. 

It was in this scenario that we eventually got an offer of NG tube for missed meals, but we had had 10 admissions by then. 

It sounds as though your D may be doing more of her normal activities and with this being the case, you probably have a lot more leverage than I had. Make it clear what the ground rules are before you get to the table. Eg. From now on all meals must be finished.  Bathroom before meal, no bathroom for one hour after. If she can't complete the meal a supplement to the meal equivalent (in your mind) will be given. If she can't finish the supplement make a plan: eg. you will add this to the next meal, you will contact the team if this happens x times. 

Our child needs to know that there is no choice. It is really scary for them to jump off that cliff. Unfortunately they need to do this to recover. 


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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Torie
Not sure if I already posted this video by forum member Eva Musby on your thread, but it was a huge help to me:



-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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casc
Torie wrote:
Not sure if I already posted this video by forum member Eva Musby on your thread, but it was a huge help to me:



-Torie


Yes it is great I think you posted it on one of my other topics.
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Sotired
Way beyond GP scope sorry.has to be put in at a hospital because they have to X-ray to check its in the right place.your GP can write a recommendation to the hospital I think, that could work.customarily though in NZ, the NG is done during a hospital admission and removed once they go home.if they then stop eating again you go back to hospital and get it reinserted.
An Ng can be inserted and used for bolus feeds which is the name of the feeding system when you use Ng tube for meals rather than running it 24/7.that can be done in residential and hospital.judging from how hard we had to fight to have Ng feeding at home-and my d has been Ng fed for a while and knows how to use all the equipment-it is very uncommon for it to be used in a home setting n NZ.it requires help from your local hospital as the tube is changed every three months, support from the community team as the tubes connected to the feed must be changed daily and they bring those and syringes.the feed is originally prescribed by the pyschiatrist in charge and then by the nutritionist.
When my d had Ng feeding in the depths of anorexia, she pulled the tube out regularly and was under 24/7watch at the hospital.she would unscrew the feed, lie on the cord til it leaked,syringe feed out-to do Ng feed is not the easy solution as it has to be done with 24/7 supervision for someone in the grips of an eating disorder.
My d has digestive failure rather than anorexia at this moment.that is the reason we can do this at home.
In your situation it wouldn't be applicable and even if it was, you would find that your d may well put up a lot of resistance.
Your GP could try referring to starship where Ng feeding is done.it will be done at your local hospital too-you could try mjkz suggestion of turning up at a&e for each missed meal and getting obs taken.anythings fair in love and war.
Sotired42
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