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

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db Show full post »
Kali

Hi DB,

My d.s bloodwork and EKG also came back normal at that bmi. And she was also still menstruating at that low weight.
It didn't mean that she wasn't a very very sick girl. It just meant that we were able to start weight restoration and turn it around before she experienced any health complications. Also could I recommend if you have not already done this, to get rid of any scales you might have in your home so that she cannot weigh herself?

I'm also attaching a copy of the AED medical guidelines for anorexia in case you want to take a look.

Kali

Food=Love
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Enn
https://www.mayoclinic.org/diseases-conditions/orthostatic-hypotension/diagnosis-treatment/drc-20352553
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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db
Thanks. That’s my goal, too. Start turning this around before it impacts her health in more measurable ways.
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Enn
I posted this for you a few days ago and they can help to assess for admission to hospital.

http://cedd.org.au/wordpress/wp-content/uploads/2014/09/Guidelines-for-the-admission-of-children-and-young-people-with-an-eating-disorder.pdf

https://metronorth.health.qld.gov.au/rbwh/wp-content/uploads/sites/2/2017/07/guide-to-admission-and-inpatient-treatment-eating-disorder.pdf

Please print them out and take to your medical specialists. 
The BMI is not the best way to measure health and as Kali notes, even if they seem healthy ie normal periods, even at higher BMI they can be very ill. That is why heavier people don't get diagnosed until they are deathly ill.
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
Hi db, I think you're doing a fantastic job of 'getting up to speed' with this illness, & figuring out next steps and planning ahead.  Just a word on medical evaluations....orthostatic blood pressures must be taken.  That is blood pressure taken lying, and then standing with about 2 min in between.  If there is more than a 20 pt difference between lying & standing, that is a strong indicator of being medically compromised.  Blood work can appear normal, right up to a health crisis point, so don't take 'normal' bloodwork as a sign that all is well.   Not all young woman stop menses, even when ill, though most do.  Here is the Academy of Eating Disorders Medical Care Guidelines for physicians.  It will give you lots of info on the kinds of tests and medical workups necessary.  And recalling our time at UCSD, we had to do an extensive workup that included an ECG; all medical testing must have been done no later than 10 days before program intake.

Our d was 17 when we went to the UCSD program just before summer began.  By the end of summer she was WR, but I was so glad we had the year before she went away to truly get her into a strong recovery.  She was just beginning her senior year of high school, so we did have that time.  It may be possible for your d to start uni or some college classes in the fall, but I would not recommend that she be away from home.  Would there be a local choice that would allow her to still live with you, or at least close by, so you could support her fully in this transitional phase?

You may definitely get 'push back' from your d if she is not able to start uni at the same time as her peers.  But I promise you that prioritizing health will be the best way forward, shorten the time being ill, and get your d back to living a full and happy life as quickly as possible.  Full recovery is definitely attainable.  I do keep an eye on my d during any transition times (new school program, new job, moving) but there isn't any day-to-day worry about her health, and she is doing remarkably well in her grad studies as well as in her social life.

Great to hear that you are getting good FBT support started before you go away to UCSF.  Good follow up care is critical for success.

Wishing you all the best,
sk8r31
It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
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db
Thanks for this. Sounds like you had an optimal recovery experience (if there is such a thing), which truly gives me hope.
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sk8r31
Well, I would say that once we got on board with good evidence-based care, our journey went relatively smoothly.  But my d had been ill for 3 years before we went to UCSD, and sadly, the available services in our smaller community are still sorely lacking.  So it took going farther afield regionally for good follow up care.  I wouldn't wish this journey on anyone, but I do try to help with peer support and advocacy, as I think that getting good care as quickly as possible yields the best long term outcome.
It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
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ValentinaGermania
db wrote:
I appreciate that. Our family doctor here in Stockholm did a full blood work up and EKG. All came back normal. She’s also still menstruating (those haven’t stopped yet, to date). No signs of self harm and I’ll have blood pressure checked again this coming week. She is naturally lanky but 48kg is clearly around 6kg below where I think she should be. Going to check the growth charts this week. I think we’re going to be switching into weight gain mode very soon. It’s been too many weeks of telling her she can’t go any lower. Now we need a plan for moving higher.


They can have normal blood results for a long time and suddenly they drop. My d had worst blood results about 10 months in refeeding. I would also suggest to control what has been checked as some results were not paid by insurance here and therefor not done (for example zinc, vitamin B12). Did she have low Vitamin D? Did they do a bone check already (dexa-scan)?
Ask for orthostatic blood pressure check (lying, then  after some minutes standing, should not differ more than 10). That can be a sign wether there is a heart problem or not.
I agree with scaredmom, switch into weight gain mode asap, best is yesterday. It gets harder with every day you wait. I can imagine that you are scared to start it but it does not get easier by waiting...

Best plan for moving higher is to have a meal plan for next week starting tomorrow that contains 3 meals and 3 snacks in between. Serve full nurished food with high calories if she can eat everything. Go for smaller portions with high calories first as her intestine system has shrunk and her stomach needs to get used to normal amounts/portions again. No negotiation, you decide what she eats and how much until she is in a mentally good state to decide that herself again.
Keep feeding. There is light at the end of the tunnel.
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ValentinaGermania
When I look at that list and what art of crisis we experienced in first Uni semester the biggest challenge for my d was to go to the cafeteria alone when all her friends refused to have lunch (did happen only once for gods sake), and that the meal plan in the cafeteria sometimes changed surprisingly and she had to decide new what to eat within 5 minutes (she can do that now), and that once the lecture was delayed and lunch skipped because of that (created a big meltdown due to low blood sugar and ED thoughts coming back within an hour after having none for nearly half a year before).
So college/university is still a big challenge in year 3 here.
Keep feeding. There is light at the end of the tunnel.
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