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

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Jeneldridge

Our 15yo D stepped down from residential to partial hospitalization on Monday. She’s told us all along that she was only eating in order to come home, and that as soon as she did she would stop eating. Her treatment team told us that is very common to say, but we needed to give her a chance. Sure enough, she refused all food for the first day and has eaten only 25% so far today.

She is very honest that she doesn’t want to recover. She says she wants to be/look sick. She is a calorie counter and can’t force herself not to count as she knows the calories of any food by heart. 

I’ve tried coming up with short term incentives for her to eat, like being able to use her phone or watch Netflix. I told her she had to complete at least 50% for those (and will increase the % as she’s able). She loves the beach, and I told her we’d do a beach trip in August if she stays on track, but she says she doesn’t care. It’s not incentive enough. Nor is much of anything else - she is content to not see friends or do anything that might entice other kids. 

Not sure what I’m looking for other than maybe some hope. We’re only 5 months into this, but it already feels like a lifetime. I feel like her ED has such an incredibly strong grip on her, and I have no idea how we get it to let go. 

We agreed to give her 2 weeks to get back on track before elevating her level of care, so that’s what we’ll do. I just wish we could figure out how to help her find the motivation to recover.

15yo D diagnosed with AN-R Jan 2020. Hospitalized since late January. Almost fully weight restored as of late May; ED voices remain very strong.
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Enn

Hi there.
I have some thoughts.
They all say they are eating to get out. So please don’t much heed to that.
Did the team tell you to keep the routine the same when she got home? Transitions are hard and keeping the same routines at home helped me ensure she got her nutrition. I also paid attention to wha they fed her and did the same at home. If she ate it IP, I knew she coild
eat it at home.
For some kids there is no incentive. Please read the ‘super resistors’ thread. There are some novel ideas there. For some kids repeated admission has to occur.

ED is the only one being honest. Would your healthy d really want to give up? Ignore that. She does not have to want to recover for you to give her her medicine.
It is your hands truly now. How do we help. Did the team tell you when she needs to go back to the hospital? So if eating less than 500 cal then ER may need to see her. As well if no drinking in 24 hrs she would need urgent medical assessment.

I would not wait personally for her to get
back on track for length of time. How do we
help you get her back on track now?
She may require more hospitalizations that is fine. Her ED is strong and we can help you hopefully to be
stronger than her ED.
Have you added in calories ?
It really sucks! I am so sorry.
🤗

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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Enn
Ps the motivation comes after and then ED is small and weak.... 
Don’t expect it soon. The goal now no matter what she says is food.
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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Jeneldridge
Thanks @erin.  I will check out the thread that you mentioned.  To answer your questions, she is not eating at home - she stepped down to a partial hospitalization program that runs 12/hrs a day where she takes all her meals.  Her treatment team at her last center thought she needed a higher level of professional support and was not ready to step all the way down to FBT.
15yo D diagnosed with AN-R Jan 2020. Hospitalized since late January. Almost fully weight restored as of late May; ED voices remain very strong.
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Barberton
Jenelderidge, For what they are worth, here are my suggestions:
1. Let go of an expectation that your d will use her own motivation to recover. It's your motivation that will carry her forward.
2. Make a plan/routine that gets the days going, but take it one day at a time. Two steps forward, four steps back is common.
3. Make sure your team gives you all the facts you need to be able to make deviations in the plan/routine. When do you need extra support? Where do you go to get it? Stuff like that.
4. Just be patient and sit with her while she eats - Life Stops Until You Eat 

Until her brain is nourished, she won't care if she sees her friends or watches Netflix. So the kindest thing you can do is help her eat. If she loves the beach, then take her to the beach. Love and kindness is what will get you through this next bit.

Good luck.
D fell down the rabbit hole of AN at age 11 after difficulty swallowing followed by rapid weight loss. Progressing well through recovery, but still climbing our way out of the hole.
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Foodsupport_AUS
It is so hard at this stage of illness. It really is so normal, and right now she doesn't have to want to recover, but she does have to eat. 

Quote:
We agreed to give her 2 weeks to get back on track before elevating her level of care, so that’s what we’ll do. I just wish we could figure out how to help her find the motivation to recover.


I am wondering how this came around and why 2 weeks were even offered?
The rule is, no matter where you are you need to eat, each and every meal. If she  can't eat in this setting with this motivation then she needs a higher level of care. I am hoping this was not an agreement that her ED convinced you of. 
My D lasted home 4 days after her first hospitalisation. She ate nothing, and lost 4 kg in 4 days as her metabolism had been ramped up so much in hospital. They can get very unstable very quickly. 
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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Jeneldridge

She did eat more in treatment yesterday - around 50% of meals and snacks but better than nothing. She came home very distressed, so I sat with her while she cried for a few minutes, then suggested we play with the dogs to distract her which worked. 

@Foodsupport_AUS - The 2 weeks was suggested by her last treatment team and they included It in her discharge agreement. They reasoned that setbacks are to be expected, and that we should give her an opportunity to stumble and get back on track. I agree 2 weeks is far too long to let her restrict, but I hope that if we have more days like today we can keep her from going back to the hospital. That said, if needed we’ll do it without hesitation. I am keeping a close eye on her weight and will talk to her treatment team today.

15yo D diagnosed with AN-R Jan 2020. Hospitalized since late January. Almost fully weight restored as of late May; ED voices remain very strong.
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