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

Welcome to F.E.A.S.T's Around The Dinner Table forum. This is a free service provided for parents of those suffering from eating disorders. It is moderated by kind, experienced, parent caregivers trained to guide you in how to use the forum and how to find resources to help you support your family member. This forum is for parents of patients with all eating disorder diagnoses, all ages, around the world.

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Robin1
This is my first time posting here although I have been reading your stories and your words of comfort and wisdom since finding this site a couple of weeks ago now. Our story briefly so far is that our 13 year old DD started restricting her food intake in September. She has had a terrible year with a traumatic family bereavement, and a year of social and emotional bullying from her so called friendship group. We noticed her anxiety increase and weight loss in early October and put a lot of measures into place. School support, a counsellor and new friends have helped with some of the issues, but anorexia had gripped her and she was dx formally on 21st Dec at a local CAHMS ED Unit. We had already put her on 3 meals and 3 snacks in the weeks before but this had only maintained her weight. The following week she has lost 0.6kg. Her rages and hitting/throwing furniture etc got to a point where we felt she was unsafe so we went to the local Paediatric A&E on 28th Dec where she has been admitted to the ward and is on bedrest and 3 meals 3 snacks with parents not present at these times. She is cooperating with the doctors because she knows they will put a tube in if she doesn't. We are seeing the ED team in the hospital tomorrow with the doctors to put a plan together. We need to know how to get the weight back on her quickly, and what support we need in place to cope with her at home. She was 162cm and 39.4kg on admission. Please if you have any advice, we would very much appreciate it.

Robin1

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tina72
Hi Robin1,
just a short welcome from Germany, sorry that you need to be here. I will have more time later but wanted to give you the feeling that you are not alone. We all have gone through this and you will find a lot of help here.
First there are some good things in your post (although this might not feel so for you at the moment):
1. your d is quite young and that is good for recovery
2. you got it really early and she is safe now and refeeding already started which is great.

2 questions: Do you have/had problems with purging or over exercising? Are you sure she is not doing that? If you can surely say yes, than I think the intake was just too low and that was the cause why she did not gain weight at home. They need a lot of calories to gain weight, most kids need 3000-4000, some up to 6000 a day which is really a huge amount.
Read the threads of KLB and Ellesmum to get an idea what to feed them.

And come here to ask your 1 million questions and to vent if needed. This forum is a lifesaver, not only for my d but also for my sanity!
Tina72
Keep feeding. There is light at the end of the tunnel.
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scaredmom

Hi Robin1, 
I too welcome you to the club no one willingly wishes to join. I am so sorry that your D had some horrible times this past year. She has been through a lot. And as a parent, it is hard to bear.

For coming home ensure you have a very specific plan on what to do when she does not eat. Ie You will give her liquid supplements (ensure) or you will take her to the hospital. The team needs to be clear with you and D that you are in charge and what you say goes. D needs to know that violence will not be tolerated and in a calm moment discuss with her that you will need to keep everyone and her safe. Ie if she gets upset a time out in her room may be appropriate and if need be, emergency services need to be called and you will call them. 
You need to mimic the hospital schedule too, Same meal times and types of food. That way when she refuses at home, you can say that it is the same as the hospital. When she gets home, the transition is hard for many. Try to portray that you are confident even if you are not. She needs that, she is scared to death, she really is. She needs you to be the strong one here. 
You will likely need to boost calories with cream, oils, butter, cheese to get the weight on and we can help with that. 
Keep an open line of communication with the team, even in between appointments. That can help support your efforts too. 

Hide all sharps and poisons and meds, just in case. That way if there is an issue you know the household is safe. 

I am glad she is safe. I am glad you got help for her.
You will learn a lot and it is a hard road to travel and it is so worth it. I wish you the best. I am glad you are here. We have been there just like you. We speak from hard earned real life experience and we all wish to help you. So ask away, and welcome again, friend

XXX

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)
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sk8r31
Welcome to ATDT, and hope that the resources and peer support you find will be of much benefit.

Tina & scaredmom have given you great advice.  I would also like to add that especially while your d is in hospital that you take time to read as much as you can, as well as putting in place some good self-care strategies.

This is a marathon, not a sprint, so be prepared mentally & make sure you are also taking the best possible care of yourself physically so that you are strong and capable of managing.  If you need either meds or a therapist for yourself, that can be helpful.  I needed both in the 'bad old days'.

Perhaps you can organize some family or friend support to help when your d returns home.  Prepping and putting some meals in the freezer, preparing a 'plan B, C, or D' for what to do if meals/snacks are not eaten.  

Hang in there...sounds like you are on top of things early, and that bodes well for full recovery.  

Sending warm support,
sk8r31
It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
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teecee
Welcome from the north of England. In terms of reading have you seen Eva MUSBYS resources? She has a fantastic book which you need only read the relevant chapters so you don’t have to read in any particular order for it to be helpful. She also has YouTube videos on coaching your child.
Try to separate the illness from your D if you can and understand your D is still lovely, caring and selfless underneath the poor behaviour. The poor behaviour is ED not your D. Much patience is needed. You may find that normal parenting rules go out of the window with an ED child.
Finding out what motivates her may make your journey less complicated. We did ‘life stops until you eat’ which is very intensive - the hardest thing I’ve ever had to do in my life. We effectively supervised her 24/7...we had to. Her motivation was getting her independence back so we were effective in refeeding quite quickly. This illness is vile and as has been said it is definitely a marathon and certainly not a sprint.
Make the conflict over a meal worth it ie. don’t butt heads over a piece of fruit...make it something calorific. Fats/carbs/sugars are all needed to repair the brain and for a long time after WR. We are 6 months WR and still managing her illness however we are in a much better place than during refeeding. We now have a family life and D goes to college/has a social life, something we didn’t have at the beginning of the year.
Virtual hugs. Xx
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Robin1
Thank you so much for your replies. We're just back from the hospital and I feel so low. It's so hard to see her like this and I can't think more than half a day ahead at the moment without feeling completely terrified of what's ahead.

Tina72, thank you. She is definitely not purging or over exercising. I have been with her day and night watching like a hawk. She's slept with me since October. I think we were getting 2000 calories in her, which isn't enough to get the weight on but it nearly killed all of us trying!

scaredmom, thank you that's very practical advice. Tomorrow I hope we will start to get practical plans into place with the ED team and the doctors. And I will get started on proofing the house.

sk81r31, again thank you, very practical advice! I am not staying in the hospital overnight as we are only a few minutes away and I know I need to sleep to be strong for the weeks ahead. I hate leaving her though and worry that she will feel rejected. She says she's doesn't need me to stay but I don't know what is going on in her mind really. MIL has come to stay for a few days to help out with DS while DD in hospital and she has some over the counter pills that I'm having to help knock me out at night as I haven't slept properly in weeks.

teecee, thank you, I've ordered the book so hopefully will arrive soon. I think her motivation is getting back to school and her sport quickly. Up until Friday her battles were escalating each day until it was over every drink, snack and meal no matter how firm and consistent we were being. I think the ED is doing everything to cooperate in hospital so she can go home and battle us again. I want her home but I'm scared for her and us if that behaviour continues. Her level of mental distress was awful.

Robin1 


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teecee
Robin1 yes you are possibly right re the cooperation at hospital. Another forum member Toothfairy posts lots of good articles and some were about carer distress and enduring our children’s distress. If you search carer distress you will find them.
You are doing the right thing taking one day at a time and not thinking too far ahead. Nothing stands still, things will always change so just deal with it when it happens.
Self care is a priority. Unfortunately my supermum powers came to an abrupt halt and I made my self ill trying to ‘fix’ everything. I am more accepting of what has happened to our family now and therefore more resilient to the inevitable ups and downs of this illness. Please know it will get better. I said to my daughter that If love could have cured her she would have been well a long time ago. Sadly it takes all our reserves to boot ED out of our homes but it can be done. Xx
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Mamaroo
Hi Robin, welcome from me as well.

Here is a blog about tolerating your d' distress:

https://www.kartiniclinic.com/blog/post/tolerating-our-own-childrens-distress/

My d directed her distress towards me, I was kicked, bitten, slapped and my hair pulled out. I separated the illness from my d, but it was not always easy. Today she is back to her old self again and can hardly remember anything from being ill.

Here are Eva's videos:



D became obsessed with exercise at age 9 and 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. View my recipes on my YouTube channel: https://www.youtube.com/channel/UCKLW6A6sDO3ZDq8npNm8_ww
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Mcmum
Robin1. Morning from the UK. It is absolutely terrifying and I hear your dread loud and clear. Honestly, I had to go to the doctor myself for antidepressants and that has helped enormously as this illness is sooooo demanding. I'm not saying that's right for everyone or that it's a quick fix but desperate times and all that....
There are many on here who have been through what you are going through, especially the anticipation of coming home after hospital. KLB's thread is an excellent and inspiring one to look up. You're not alone xx
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tina72
Robin1 wrote:


Tina72, thank you. She is definitely not purging or over exercising. I have been with her day and night watching like a hawk. She's slept with me since October. I think we were getting 2000 calories in her, which isn't enough to get the weight on but it nearly killed all of us trying!



No purging and no exercising is GREAT. So "only" thing you need to learn is how to increase calories (2000 is not enough, you are right with that) in a small amount of food (so she will think it is a tiny portion but in fact it isn´t).

We can help you with that. Here are a lot of receipes going around (use the search button). First thing is to go to your local supermarket and search for the products she is already eating and looks for the brands with the highest calories. It can make a difference of 300-400 if you just change brands of bread, yoghurt, cookies, noodles etc.
Second thing is to cook like your grandma would have done. Add oil, butter and cream to EVERYTHING. You can push up yoghurt and full fat milk with cream. Appleasauce with rapeseed/canola oil (that is also great for fruity smoothies - you can add up to 100 ml oil to 400-500 ml fruit and juice and it disappears in the blender and you will have 1000 calories extra just with 2 drinks). Oil to rice, cream to sauces, butter both sides of the sandwich and so on. There are many ways to get some "special effects" into your meals. If you need help, tell us what you want to serve and we can helpy ou with ideas how to make the fight worth it.

Try to increase calories every 2-3 days about +300 until you see steady weight gain.
You can do that. All you need to learn is how to do it. It took us about 6 weeks to see a steady weight gain so it is all about try and error and you need to find out what works for your d.
Keep feeding. There is light at the end of the tunnel.
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Robin1
Today has been another rollercoaster ride but my DD is home and has managed dinner and evening snack with milk. Huge anxiety but she did it without raging. Now asleep next to me and I am hopeful that we start 2019 as we mean to go on. 2018 can get stuffed! I’m so grateful to see your posts with so much information. It’s such a help! Eva Musbys book has arrived and looks brilliant. I wish you and yours a peaceful and happy new year.

Robin1 x

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teecee
The section in the book re dinner time conversation was a life saviour for us when my D refused her meal. I literally read it out loud verbatim with feigned confidence in a calm way and she responded by eating. She later said she could hear the mantra and wanted so much to eat but the words that came out of her mouth were different.
Try to have some encouraging mantras. Mantras also penetrated the ED voice when it was too loud for my D. Things like ‘food is medicine’ ‘ this is what you need’ ‘trust me I will keep you safe, I will not let you come to harm’
Even if she screams she doesn’t trust you or to shut up just persist. It really helps for them to hear caring words when the voice is screaming at them.
You can do this. We ripped the bandaid off and refed as quickly as possible but it is very intensive.
You will be rewarded though. Try to acquire as many skills as possible from Eva’s book...trust in the advice you get from it and from those on this forum....such valuable advice. It’s trial and error...you will find what works best for you as a family as no two journeys are the same, just very similar.
Warm wishes for 2019
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Mamaroo
That's great Robin! Thanks your the new year wishes. All the best for 2019!
D became obsessed with exercise at age 9 and 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. View my recipes on my YouTube channel: https://www.youtube.com/channel/UCKLW6A6sDO3ZDq8npNm8_ww
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Torie
Hi Robin and welcome.  So sorry you needed to join us here.

It's really great that you are on this so quickly.  My d was on a similar timeline, and eventually things really did get back to normal.  You're wise to take things one day at a time because it is a long, tough slog and can seem overwhelming if you look at a bigger chunk of time.

Does the hospital offer backup if your d refuses a meal?  That would be so awesome, but unfortunately most can't rely on that.  It is always good to have Plans A, B and C something like: A - she eats her entire meal.  B - she drinks a supplemental beverage (Ensure, Boost, Fortisip depending where you are) C - you take her to the hospital.  

Please feel free to ask all the questions you like.  We love questions. xx

-Torie


"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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Robin1
A mixed bag today. DD has eaten everything but there was quite a meltdown at lunch. She was discharged from the hospital yesterday afternoon unexpectedly so I haven't had as much time to plan todays meals and have had to make do with what we had. This is what today looked like:

Breakfast: Quakers protein porridge sachet mixed with 200ml gold top milk and glass of OJ (I will start to add cream to this as per advice). 

Morning snack: 2x ginger biscuits and a Reeces cup with 150ml gold top milk as a drink

Lunch: Charlie Binghams fish pie, muller corner yoghurt

Afternoon snack: Cadburys mini roll and 150ml gold top milk

Dinner: Roast chicken, 3x roast potatoes, stuffing (with sausagemeat) yorkshire pudding, veg followed by a treat size bag of chocolate buttons 

Bedtime snack: alpen bar and 200ml gold top milk

I think i can add cream into mash and sauces for her. I'm new to adding oil to things though. She is very observant. It needs to be impossible to detect! Any advice welcome. She likes rice. She has refused smoothies previously. Should I push this one now? She has been having some ice cream for afternoon snack previously so I will get the Haagen Das. 

Robin1 x



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scaredmom
If you keep her out of the kitchen, you can add in whatever you need to to her foods. 
Add small amounts first, then she won't notice as much then you can add more over time.
As for the smoothies, they were great for us ie 1000 cal bonus! But can be hard to do. If you can start small and add over time that would be great. 
So many roads to Rome. There is no one way. It takes awhile to figure it out.
XXX
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)
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teecee
Hi Robin1 this was what my D ate during refeeding....I found it hard to believe but it was absolutely needed and now she is eating normal portions:
Breakfast: FULL bowl of porridge with whole milk + 1 banana + handful of almonds + 2 slices toast and topping (butter/peanut butter)
Snack: 4 digestive size biscuits or 2 ryvitas with cream cheese and prawns or smoked mackerel pate + glass milk
Lunch: 2 sandwiches (4 slices whole meal) with ham salad or cheese salad or chicken salad with crisps and fruit.
Snack: similar to am snack.
Tea: third of a plate of meat/fish third carbs (rice/noodles/potato etc) third veg or salad + pudding (ice cream/cheesecake wedge etc)
Supper: bowl of porridge or 2 slices toast with topping (jam/ peanut butter etc + glass milk.
Throughout the day she had water too.

It is needed as they are starved. If she started to go and have extra between we let her without looking shocked or telling her to stop as it does not continue.

Keep fighting for her. You’re doing great.
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tina72
Keep her out of the kitchen. Cook when she is not at home or sleeping if necessary. Freeze portions that you just need to warm up. Have food in back if she throws the plate so you can have a new plate.

200 ml milk at each time. Use a bigger glas and fill it less so the portion looks smaller. Use big plates so the portion looks smaller. Use deep plates for noodles and rice - so the portion looks smaller...[wink]

You can add canola oil /rapeseed oil to joughurt, apple sauce, other warm sauces, rice. It disappeares if you stirr it well and it has no taste.

If she eats vegetarian paddies that would be great. You can fry them in a lot of oil and then leave them for some time in the pan and the oil will be sucked in and she will not see it any more. Then rewarm the paddies for dinner/lunch.

If you get her to drink smoothies that is a great possiblity to add. I did the fruity version with fruit, juice and canola oil. It looks light and healthy and I said she needs it for vitamins. You can get 1000 extra with 2 glasses with that. If you offer a glass of milk or a fruity smoothie I would bet she would take the smoothie because she thinks it is less fat than the milk...
Keep feeding. There is light at the end of the tunnel.
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Robin1
Thank you for the replies. Things are very bad today. DD is escalating with violence again. She is targeting me, she's almost my height and strong. We've had glasses thrown, punching, kicking. She threw a remote control at my head and I managed to duck in time. It smashed to pieces on the wall behind me. It got so bad last time we had to take her to A&E. I am worried that I can't keep us safe. I have DS here too. DH struggles when she is attacking me. The doctors said we could consider Olanzapine so we are going to talk to them today when we are at the ED unit and try to get DD to agree. They had also mentioned IP in an ED unit if she continues to escalate. 

Robin1 x

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Ronson
Hi Robin

Try changing to plastic cups, bowls and plates during refeeding. They still get thrown but not so dangerous. Many have phoned the police of violence escalates. I understand that in some units they will send someone out to calmly explain to the child the consequences of the violence. If you can do so safely for you and d then I would remove myself from the situation. In the early stages of refeeding there was very little interaction between d and I as it always deteriorated into tears and an am I fat conversation. It is much better avoided - a few weeks of regular meals and your d will be in a better place for normal conversation.

We also have a sibling and I would take her out if things got to bad or send her for a sleepover at a friends house.

It sounds very similar to our experiences and it does improve. Keep getting the calories in and keep pushing.

Good luck x

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tina72
Robin1 wrote:
Thank you for the replies. Things are very bad today. DD is escalating with violence again. She is targeting me, she's almost my height and strong. We've had glasses thrown, punching, kicking. She threw a remote control at my head and I managed to duck in time. It smashed to pieces on the wall behind me. It got so bad last time we had to take her to A&E. I am worried that I can't keep us safe. I have DS here too. DH struggles when she is attacking me. The doctors said we could consider Olanzapine so we are going to talk to them today when we are at the ED unit and try to get DD to agree. They had also mentioned IP in an ED unit if she continues to escalate. 

Robin1 x


Take away all that can be thrown and used to hurt someone. If needed have only a table and chair in the room she eats in. Go to plastics as Ronson suggested. This is quite normal for that state but will get better. If it escalates too much, think about calling the police. In fact I would call them before that happens and tell them you have a mental health problem in your house, they often have special officers for that. It sometimes helps just to take the phone and TELL them you will call the police now to calm them down.

There is a genetic test which psychopharmacas work and which don´t so ask for that or use search button for more information. Problem is many do not work with underweight people ;(.

"and try to get DD to agree"
She is 13 years old. She does not have to agree to take meds that are needed. If she had cancer and would need to take chemotherapy to save her life, would you ask her to agree? No, you would sit besides her bed and say "I will not leave until you have taken those meds". Same here. If she refuses to take them think about hiding it in food. It is not mean, it is necessary.
Keep feeding. There is light at the end of the tunnel.
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sk8r31
Really sorry to hear that you are dealing with raging at the moment.  Safety does need to be a priority as well, both for your d and for your family.  

As suggested, calling the police ahead of any outburst to alert them to the difficult situation at home, so if there is an episode of violence, they can be prepared to talk to your d.  

As hard as it is at the moment to maintain your calm, try to do so.  It can help to diffuse or shorten the outbursts.  I used to try to be steady in the face of an emotional outburst, but then I would cry in private to release some of the upset and tension...

Hang in there....

Sending warm support,
sk8r31
It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
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tina72
Another idea, can you have a second adult there for meals? A friend or a realtive? Sometimes they do not freak out with "whitnesses" as they want to be "normal" when someone else is around. Just an idea...
Keep feeding. There is light at the end of the tunnel.
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scaredmom

Robin1 wrote:
Thank you for the replies. Things are very bad today. DD is escalating with violence again. She is targeting me, she's almost my height and strong. We've had glasses thrown, punching, kicking. She threw a remote control at my head and I managed to duck in time. It smashed to pieces on the wall behind me. It got so bad last time we had to take her to A&E. I am worried that I can't keep us safe. I have DS here too. DH struggles when she is attacking me. The doctors said we could consider Olanzapine so we are going to talk to them today when we are at the ED unit and try to get DD to agree. They had also mentioned IP in an ED unit if she continues to escalate. 



I am sorry this is happening. It is very stressful and anxiety provoking for everyone. 
Good ideas above regarding the plastic plates and cups etc...
I would suggest in a calm moment discuss with her that violence is not OK ever. Everyone needs to feel safe in their own home and in order to keep everyone safe, you may need to call the police if she cannot control her upset.( when you say it, you will have to follow through on this and it is OK if you need to call them) Or you need to take her to the hospital again and again and again.

I would have to walk away when D was violent, first saying " violence is not accepted in this home. I will walk away now." H would take over and distract a bit and sometimes she had to go into her room. Yes the room has some damage from ED and it still pains me to see it and we have to get it fixed. Oh well. 

Olanzapine can help calm them down and has good reports for AN. My D tried it but no effect whatsoever.. But we did try and I was hopeful. 
If you feel that you cannot handle her at home and she is very resistant to eating and there is no weight gain---> YES to IP. 

What else are you dealing with? Many of us have been exactly where you are. 
The best advice on how to feed my D came from this forum. 

I hope it is a better day. 

XXX

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)
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KLB
Robin1 wrote:
Thank you for the replies. Things are very bad today. DD is escalating with violence again. She is targeting me, she's almost my height and strong. We've had glasses thrown, punching, kicking. She threw a remote control at my head and I managed to duck in time. It smashed to pieces on the wall behind me. It got so bad last time we had to take her to A&E. I am worried that I can't keep us safe. I have DS here too. DH struggles when she is attacking me. The doctors said we could consider Olanzapine so we are going to talk to them today when we are at the ED unit and try to get DD to agree. They had also mentioned IP in an ED unit if she continues to escalate. 

Robin1 x


The rages and violence can be scary can't they? We had to use paper plates for a while and now use plastic everything. Hubby has had to restrain our son quite a few times by standing behind, holding him in sort of a bear hug and then sitting down whilst still holding him. He has to be able to get close enough to do that though. He's had a few bruises unfortuately and lots of our furniture is damaged. Our main rages come from restricting his exercise but we haven't introduced fear food challenges yet.

He was put on onlanzapine which did seem to help initially, but not so much anymore for some reason. It's definitely worth a try. He didn't want to take it but it's part of his treatment so he has to.

Perhaps you could try tag teaming with your partner? If she becomes agitated with you can partner come and take over?

Definitely try the coaching techniques and mantras from Eva Musbys book. I actually wrote myself a little cue card to keep in my pocket and refer to when I was floundering a bit. It helped me fake some confidence.

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