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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saima4059

Good afternoon fellow ED parents and caregivers, 

My 13 yo daughter has a diagnosed severe eating disorder with anorexia.  We started treatment recently with a very competent and accomplished psychologist at Drexel University in Philadelphia, but she has been extremely resistant to going to the psychologist.  She is resistant to any family intervention whatsoever at home.  We have had multiple conflicts when trying to implement an eating plan or make any changes to her diet under the guidance of her psychologist.  She now refuses to go to the psychologist and would rather have the medical doctor follow her (which I know is just another tactic to avoid treatment).  She will not take medication prescribed by the psychiatrist (Remeron, which was too low dose in my opinion, then she stopped taking it).  Currently, she is restricting during the day (probably eating 1000 calories a day) but is also gaining weight slowly, so there 's a possibility she is engaging in binge-eating as well.  She's a vegetarian (rest of the family is not), has no dairy or meat, and has not had her period in more than a year (she had reached menarche at age 11). 

Since she is not seeing the psychologist, taking her medication and any talk of treatment sends her over the edge, I have secretly been in contact with the closest eating disorder facility that is covered by our insurance as well as well the most renowned in our area.  This ED facility declined an inpatient admission (saying she did not meet “medical necessity”), but have recommended their IOP that runs 9a-3p M-F. They do not provide transportation to where we live.  This facility is 1 hour from where we live, but I am willing to take the time off of work and take FMLA so she can get the treatment she needs. The psychologist thinks that once they see how reluctant she is and the level of her restriction and inability to see the severity of the ED, they will likely recommend inpatient admission anyway. 

 

Now my anxiety is coming from her intake appointment for the IOP tomorrow.  Although I think she knows (she snoops in my planner and notes on my desk) I am 200% sure the conversation about the IOP will not go well.  I have asked her psychologist for guidance, but my daughter can be very cruel and manipulative towards me (which I know is normal in her position), so I am looking for some tried and true (or untrue, for that matter) techniques any of you have used in this situation for an unwilling teen starting an ED program.  Any and all support is appreciated.  Ideas on how to make the 1 hour drives go by are also appreciated 😊

Best,

Saima 

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Torie
Welcome to the forum, although sorry you have the need.

Since you are in the Philly area, have you been in touch with CHOP?  THeir team (headed by Rebecka Peebles) is top notch.  Also, it's prudent to make use of child locks for the trip there. xx

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

I agree with Torie that child locks are essential; there have been children so scared that they have tried to escape a moving car. In your position, I would absolutely have another strong adult available to help. My husband and myself had to each hold strongly to our son's arms and frog march him to the car, I had to sit beside him to make sure he did not try to escape or grab the driver and on the other side we had to again hold firmly to his arms and force him into the hospital, in our case. He was screaming and shouting while we did so. It was one of the most painful experiences of my life and there were many tears shed. The good news is that it was a case of short term pain for long term gain; a case of being cruel to be kind. My son is now happy, healthy and excited to be looking around at universities. Had we not gotten him started with treatment, he would still be living in that absolute hell of illness or dead.

Another time, later in the process, he refused to go to the doctor. I knew it was because he was scared and anxious but he was extremely ill and need medical monitoring so missing the appointment was not possible and would have set a dangerous precident. I rang his doctor and we came up with a plan. I knew that he hated being nagged and hated having things hanging over his head. His doctor knew how important it was that she saw him for even a short time to measure his vital signs etc. and she was supportive and flexible. So, after missing our morning appointment, I told him that I had made another appointment for the afternoon and for the next morning and the next afternoon and so on until he went (the stick). If he went this afternoon, that would be it, he could forget about the medical monitoring until the next week and just do his crafts (the carrot). It took him probably a half an hour to find the courage to slowly walk to the car. He was verbally lashing out. But he went and we got all the medical essentials done and he never tried to miss an appointment again.

It does take time and lots of trial and error for us, as parents, to change. The parenting techniques we used on our kids when they were healthy don't work when they are ill. In general, we have to be stronger, firmer and more determined than we have ever had to be. Usually our kids have been very well behaved prior to the illness so we have little practice when their behaviour becomes so difficult. I think accepting that we have to change our parenting focus and techniques, that there is no way for them to get well without lots of fighting and pain, that we have to temporarily give up the warm relationship we had with them in order to do what needs to be done and believing that our relationship will reccover when they are well again (as is the experience of 99.9% of parents on here) are all part of the process of supporting our kids. It is not easy, for many months my son only snarled at me, walked out of the room if I walked in, acted as if I had assaulted him if I touched him but the sweetness and joy I experience now when we laugh together, when he asks for help, when we do normal things is the most precious thing.

The first steps are difficult but essential. I held a picture of my son, well again and happy, in my mind to keep me focused on the goal when we had to do difficult things. It does get easier.

Wishing you strength and courage and I will be thinking of you tomorrow.

D
2015 12yo son restricting but no body image issues, no fat phobia; lost weight IP! Oct 2015 home, stable but no progress. Medical hosp to kick start recovery Feb 2016. Slowly and cautiously gaining weight at home and seeing signs of our real kid.

May 2017 Hovering around WR. Mood great, mostly. Building up hour by hour at school after 18 months at home. Summer 2017 Happy, first trip away in years, food variety, begin socialising. Sept 2017, back to school FT first time in 2 years. [thumb] 2018 growing so fast hard to keep pace with weight
  • Swedish proverb: Love me when I least deserve it because that's when I need it most.
  • We are what we repeatedly do. Excellence Recovery, then, is not an act but a habit. Aristotle.
  • If the plan doesn't work, change the plan but never the goal.
  • We cannot control the wind but we can direct the sail.
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CED123
no advice but thinking of you today and wishing you luck.
Currently no light; only tunnel 🙁
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Foodsupport_AUS
Sorry that you have to do this, but it sounds like you have tried a number of things and are not getting anywhere. I would be dubious of the weight gain and thinking much more likely of weight manipulation. Is there food missing? Weight manipulation tricks are very, very common. .  My D did need to be taken to an appointment against her will, she was actually meant to go for assessment but ultimately she was admitted on the day. 

I absolutely agree this is a task for two adults, not one. 
Be prepared- she may run, lock herself in the room, do all sorts of things prior if she gets wind of your plans. 
I would not give her advance notice. 
I would suggest letting her know that she has an appointment with respect to her eating disorder and she will need to come with you and whoever who is standing next to you. 
Know how the child proof locks work, my daughter leapt from a moving vehicle and ran. 
Try and stay calm and firm. 
 
D diagnosed restrictive AN June 2010 age 13. Initially weight restored 2012. Relapse and continuously edging towards recovery. Treatment: multiple hospitalisations and individual and family therapy.
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saima4059
Thank you, admin and all others, for your support today. 

Although she was a little irritated and rude, by the end of our almost 3 hour intake, she was a calm little girl again.  The program psychiatrist recommended medication (something that has worked for me in the past - he seems to believe strongly in the genetic factor of major depression), wrote fasting lab work, and we got a mini tour of the small unit.  I will be missing work to be taking her there, and am filling out FMLA paperwork as we speak.  Thank you again for all your support.  
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Enn
Hi saima4059,
Just wondering how it went?
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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saima4059
Thank you for everyone’s reply. My daughter’s  intake itself went OK. There were some moments where I felt like she was a little rude, especially to the psychiatrist, but overall the process went smoothly. Today is her second day at the program, and she has actually been very pleasant at home. She says “I don’t really want to go, etc.“ frequently, but nothing over-the-top. The program we are going to has a parents group every Monday, which runs for nine weeks, so the first session yesterday was very helpful. They have breakfast and lunch for attendees at the program, so I have to only monitor dinner, which last night my daughter did refuse, saying she was not hungry (we did get a milkshake on our way home from the program). Overall, I am hopeful, even though taking the week off for FMLA is probably going to be a financial loss. Again, thank you for everyone’s support. <<<Hugs>>>
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Enn
I am glad to hear so far it is moving forward. 
She may not kick up a fuss now but later so just be on your toes. 
The parents group sounds nice. I wish we had one here. 
Sending my best.
please keep us updated.
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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