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dc

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In my previous post Discharge from UCSD, I compared the results before and after the treatment at UCSD in a chart. However, I didn't provide more details about how those results were achieved because I was busy with preparation for the vacation trip when I wrote that post. Today I summarized what I learned at UCSD and will be very happy if it is helpful to you. This post is a little bit lengthy and I apologize for that. To make the reading not boring, I added some pictures taken by D during the vacation.

Food Variety

UCSD emphasizes the importance of food variety. Before going to the treatment, D wanted to be a vegan. D and I had a lot of debating about this topic. No matter what evidence [1][2][3][4] presented to D that being vegan would not help her to recover, she could easily find other evidence to against me. To be honest, I really do not know anyone who has reached full recovery and is vegan. I have been living with D for 19 years. She had been really enjoying eating meat, fish and shrimp before she had eating disorder. How come she suddenly wanted to be a vegan? It is ED to make her to think about this way. Many AN patients want to use vegan as an excuse to avoid some particular food. 

People with eating disorders, however, can use any of these diets as a mask for their ED, and they can get into difficult situations because of them. If you take on a diet for ethical or "health" reasons (lots of people take on gluten free ostensibly not to lose weight but for things like managing acne), it's easier to make excuses for not eating in public situations and harder for the people who care about you to say "no" to your reasons.

I reiterate and reiterate and reiterate that food is neither "good" or "bad".  It does not have a moral identity.  Food is the fuel on which our bodies run.  Given verified medical conditions some of us may need hi-test, some may need diesel, most of us run just fine on regular.  Fad diets come and go and most people who follow a fad diet do so for issues that have nothing to do with their physical health. [8]

The good news is that UCSD and us parents are on the same page. How to challenge D’s vegan thoughts is a really tough task. UCSD has done a very good job on this. Here are some examples about how to achieve this:

- UCSD has its own kitchen and it can prepare more than 70 different kinds of food. In other words, if the patient eats two meals a day at UCSD, there will be no duplicate food within one month! So far I have not seen any other ED treatment center can do that. The two ERC treatment centers we went to just buy food from Whole Food.

- During the first couple of days at UCSD, D always picked up the light meals which only include vegetables and tofu. The staff at UCSD observed this and override the choices she selected. For example, they suddenly replaced tofu with pork. D cried a lot because she couldn’t accept that. Finally, she ate it. After that, eating meat is not as difficult as before.

- UCSD requires the patients to bring their own food for the meals either once or twice a week. If they found the food variety is not good, they will ask the patients to fix that.

- UCSD takes the patients to different restaurants. Sometimes American restaurant, buffet, food court and even Starbucks. This will prepare the patients for living in the real life. I can image that D and I would have a fight if I ask her to go to those restaurants.

- UCSD also teaches the patients how to cook. D learned how to cook the eggs for the breakfast and some meals from the dietitian. Now she uses this skill for her morning and lunch meal when she is home.

- The patients are required to log the meals they ate. If the dietitians found the variety of the food is not enough, they will ask the patients to improve that.

- Before D always showed me the scientific evidence about recovery being a vegan. Instead of showing evidence by myself, I asked her to discuss with UCSD. As a research institute, of course UCSD has more scientific proof to prove why she is wrong.

We have been using FBT to support D’s recovery for 4 years. However, she still relapsed after 4 years. Then I realized that at the early stage of the recovery, FBT is very effective.  However, when we want to handle the control back to our ED kids, to having a treatment center involved is a must. At least, it is true in D’s case. Weight restoring is not enough, state restoring is even more important.

DSC_1221_preview.jpeg 

Treatment Environment

A good treatment environment is extremely important to the effectiveness of the treatment. During the time that D relapsed, we tried to re-feed her at home. Every time we tried to challenge her food, there was a fight. Sometimes D (ED) threatened us to run away and kill herself. We had a dietitian and a psychologist in the team. However, it was not effective because the dietitian and psychologist didn’t have the leverage if D didn’t follow their advice. Even some professional treatment centers couldn’t provide such a good environment. I remembered in a local ERC treatment center, two staff had to monitor about 18 patients’ eating meals. How could this be achieved? I reported my observation to the director and she didn’t listen. No wonder D had lost 7 pounds within 7 weeks at that center. What a shame! So the conclusion I got is: Never choose the treatment center because of convenience, but because of effectiveness. The therapist who treats D manages 2 or 3 patients so that she has enough time and efforts to treat the patients. The dietitian manages about 3 or 4 patients. Each meal has been fully monitored by the staff. The patient could not find a way to skip a meal and even restrict to particular recipe. If the staff finds the pattern of restricting to particular food (like vegetables), they have the right to override it. The patients have been grouped into difference groups based on the progress. Most of them are very nice and D made some friends there. Every Monday evening, there is a session for the parents to talk with each other. Sometimes UCSD will invite someone who had treatment at UCSD and was fully recovered from ED to give a talk to the patients and share her experience. D really liked it.  In addition, San Diego is very beautiful and sunny most of the time. There are so many places to visit during the weekends like beach, zoo, and sea world. D registered one course in summer and two courses in fall. D joined many activities when she was not in treatment like bible study, volunteering to help homeless, practicing yoga, surfing, hiking, photography and dancing. One day I was joking with her, “Are you taking a treatment or taking a vacation here?” She laughed.
DSC_1721_preview.jpeg 

Treatment Phrases

The treatment phrases at UCSD include PHP and IOP. Unfortunately, they don’t provide residential treatment. D started from PHP program for adults. After 10 weeks of PHP program, D went down to IOP program. She stayed in IOP program for about 3 months. Both PHP and IOP programs have been divided into 3 levels. If the patient does a good job, she/he will move down to next level. Otherwise, she/he will move back to the previous level. If the patient misses a meal and her weight drops, there will be a consequence including moving back to upper level. Actually I found this is very effective, it will give the patients the motivation to move forward because it is easy to make a small progress instead of making a big one. D had been moving back to upper level two times. One is because she missed a meal and another is her weight dropped. She cried when that happened. She is an outstanding student and almost never failed in any area. She thought those were failures to her. But a rule is a rule, she violated that, she deserved for a consequence. The highest level in PHP is 10 hours a day, 5 or 6 days per week. The lowest level in IOP program is 3 days, 4 hours each day. They called it Deep Sea. Basically, the patient only eats one meal in the center. Which meal (lunch or dinner) is flexible.

A good treatment center will always catch the problems before the parents discover them. I give several examples here:

Example 1: D had the habit of doing water loading before the staff at the center weighed her. She played this trick in other treatment centers (our local ERC) and University Health Center (UHC). No one could catch her. Because they weighed her under the same pattern: time, location and wearing. It is easy for D to drink several bottles of water and hide some heavy stuff in her clothes. The difference could be up to 7 pounds. Without knowing the exact weight, how can the treatment staff measure the performance? UCSD has done a really excellent job. When we reminded them about D’s water loading issue, they told us that they had already noticed that. They used several ways to solve this problem: 1). They monitored D’s behaviors, suddenly weigh her after she peed. 2). Surprise weighing her on different day when she though they would not weigh her 3). Weigh her by wearing underwear. Once they found her lying about her weight, there would be a consequence. After several failures of trying, D learned lesson and gave it up.

Example 2: We found that D was running during the weight restoration and reported it to the center. They told us that they have already caught that because D didn’t gain weight based on the plan. The dietitian immediately added more calories on her food.

ED is like a sly fox, it uses our kid’s intelligence to fight against the recovery. Only the experienced hunter can catch it at the early stage.

DSC_1575_preview.jpeg 

DBT

As many parents mentioned in this forum, recovery is a healthy state, not weight [5]. Julie O’Toole described the remission as follows in her book “Give Food a Chance”:

Physiological remission:

- Weight restoration (resume menstruation).
- No more restricting and eating a balanced diet on the meal plan.
- Back to normal playful physical activities.

Psychological remission:

- Going back to school and doing well.
- Interacting with friends and having a normal social life.
- Having a normal family life.
- Being able to control symptoms of anxiety such as over-exercising, insomnia, and worry.
- Acceptance of their bodies, at least enough to have normal age-appropriate relationships.
- Return of sense of humor and laughter.
- Ability to ignore any eating-disordered thoughts if they arise.

Menstrual recovery may be more important to cognition than even weight recovery.

I remembered when I joined this forum more than 5 years ago, I asked my mentor (another ADTD member) how long it would take for D to recover fully. She said how long your D was sick would be the time for her to recover. Actually it even takes much more time. It took us 3 months to restore her weight. I thought it was the most difficult thing we had done. The reality is that state restoration takes much more time. To help the kid to restore her state, you need an experienced therapist to treat the kid. One of the most effective ways is DBT. In UCSD, DBT [6] is mainly used for the treatment. The therapist teaches the patient how to apply the same dialectical, validation, and problem-solving strategies in her physical and social environments. For example, when the patient has a conflict with the parents about the food, she can use DBT skills to validate her feelings. 5 years ago when I was reading the book “Off the C.U.F.F.” [7] by Dr. Nancy Zucker, I didn’t understand why the book was talking about emotion management, not the treatment of eating disorder. Later I realized the treatment path was full of tears, fighting, screaming, all of those were related to emotion. Before the treatment, the relief of feelings for D is just crying or threatening us. Now she had one more skill to cope with her emotion. Of course, she needs more practice before mastering it. In last 3 years, we have been searching for a good therapist and learned many lessons. It is very difficult to find a good one. Here are the steps I used to find a good therapist:

  1. Search all of the therapist candidates online or other resources.
  2. Research their background including age, sex, education, experience. (Exclude those who have too much focuses like ED, marriage, couple issues)
  3. Phone interview (ask the same questions and make sure their answers make senses i.e. Can one patient under normal weight still run?)
  4. Face to face interview (understand their personality and treatment strategies on ED)
  5. Insist on family session (This is critical. This is the only way for the parents to judge the effectiveness of treatment)
  6. Periodically check the treatment results. (If the treatment is not effective, terminate it ASAP)
  7. Tip: I found that some good therapists and dietitians had AN before and fully recovered.
DSC_1256_preview.jpeg 

Family Session

Family Session is also very important to bring D, therapist and parents on the same page. During the treatment, the parents should be the part of the team. Any treatment excluding the parents will not be effective. The parents can monitor and report the kid’s status while she is not in the program. The successful recovery means the consistent behavior no matter the kid is in the program or not. In the family session, the parents can learn how the therapist communicate with the patient, how the patient respond to the therapist’s talk. I remembered that in the first family session, D couldn’t stand it and wanted to leave before the session ended. At the last session, we had a very easy talk and everyone laughed. What a big difference. Family session at UCSD is once a week. D will talk to the dietitian and then the therapist. Sometimes the meeting lasts up to 2.5 hours. Before the family session starts, my wife and I will always have a discussion about what issue needs to be addressed. We narrowed down one or two topics. The session always started with asking D 3 questions:
1). What you have done good in the last week?
2) What do you think you need to improve in the next week?
3) How will you do it?
Before the session starts, we will have a talk with the therapist about which topics to discuss and make sure we are on the same page. Each session will discuss one or two problems. Sometimes I feel like each session is like a war fighting against ED. It requires a good plan, strategy and team collaboration.  It is not easy. Sometimes the room is full of arguing, crying and fighting. Our therapist will lead D to calm down and move forward.

I understand it is very hard for D. One day D told me “Daddy, you know it is really hard!”, I answered, “Sweetie, I know.” I feel lucky that we had one of the best therapists and dietitians at UCSD to help D and D likes them. I guess that most of parents here had this experience that suddenly your kid was triggered by ED thought or whatever, you have no way to solve it. The therapist provides 24/7 support. When the bad thing happened, instead of confronting with the ED by ourselves, we told D to talk or text with her therapist. It gives us a buffer to maintain a good parent and child relationship. I don't know other treatment center could do that. During the treatment at UCSD, my wife’s life is getting a little bit easier. What she does is to support D. Anything related to treatment rely on UCSD.  

DSC_1337_preview.jpeg 

Future

Before we left UCSD, we worked with the center to draft the Relapse Prevention Plan. We draft a contract before when D was admitted by a college last year. It defined RED, YELLOW, GREEN zones. But the college contract is only for the kids in full remission. The college is not a place for the treatment. If the kid is not ready, it doesn’t matter GREEN, YELLOW or RED zones are. She will relapse. The only way is to convince her to take the treatment. FBT may bring the weight back to normal, however thoughts and behaviors will determine whether or not she is going to relapse again. That’s what happened to us. After the first semester, D relapsed. We took her home and re-fed her. Her weight was restored when she went to the second semester. She relapsed again. This time the Relapse Prevention Plan is much simpler, if D drops one pound, she had to restore one week. Currently D is eating and maintaining her weight by herself. She still has two issues: 1). Under portion. For example, she may miss 100 calories per day. 2). Refill for increased activities. She is working on it. We still have the same therapist and dietitian at UCSD to support D. They will have weekly meeting and texting any time if necessary. I asked D several weeks ago, “Will you be recovered earlier if we send you to UCSD in high school?” She said, “It may not be possible since my brain was still not developed. Even finish the program, I will still relapse”. I really don’t know if D will relapse again. We are doing our best and preparing for the worst. I called the following picture: The Heart of Hope. "Hope is being able to see that there is light despite all of the darkness." - Desmond Tutu

DSC_1426_preview.jpeg 

References

  1. My Daughter is an “Ethical” Vegan (With Anorexia) …
  2. Veganism and Eating Disorders: Let’s Be Frank
  3. My Vegan Diet Hid My Eating Disorder
  4. Using veganism to hide or facilitate an eating disorder
  5. Recovery is a Healthy State, not Weight
  6. What is Dialectical Behavior Therapy (DBT)?
  7. Off the C.U.F.F. 
  8. WHY I’M TRANSITIONING AWAY FROM VEGANISM…


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19 yr old d Dx Feb 2012. WR June 2012. Now she is in Phase III and enjoy her study and activities. Try to give the control back to her but still keep vigilant. 
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"The darkest night is often the bridge to the brightest tomorrow."
Seabird

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Reply with quote  #2 
Dear DC

Thanks for this inspiring and informative post (and wonderful photos!).   

I can't even imagine such a treatment centre, as this is not available here.  How fortunate your d has been to have this type of support available. 

Those (great many) of us living in areas lacking in expert treatment facilities, can still learn a lot from looking at what brings success and how the experts approach certain problems. 

My challenge will be to successfully challenge my son's veganism, this will be a long term approach as I have no allies in this battle!      At least he is well enough that he is engaging in life, studies, and is able to manage without medication.      He also talks and communicates so can accept help when needed, and is able to admit vulnerabilities and to trust in adults to offer help & support.

I provide a lot of his food so make sure that there is a wide variety and nutritional balance (which is much more possible these days as we have available a huge range of plant based foods including fortified with iron, B12, Vit D, calcium.   We did blood tests recently and found no deficiencies.   I do add eggs into various things I cook, and encourage him to eat snacks & bakery foods that aren't vegan.

He is 20 years old, lives with his dad who is a vegetarian, who doesn't to my knowledge do any research or reading on ED.  I am the one who keeps a close watch on our s however, as his dad obviously has his own issues and reasons why he takes a more hands off approach. 

I can only continue to hope that our s continues in his recovery and at some point becomes mature enough to let go of his vegan "ideals" which of course are the last bastion of his ED.  Having confronted many of his ED behaviours head to head in the more intensive refeeding FBT stage, I don't have much choice but now to take a more supporting role. We successfully fought back on some weight loss earlier this year and s showed me he could turn that around in the space of 2-3 weeks to regain weight, and has been more constant weight since. 

Because of the lack of wonderful treatment options here, so much is on the parent's shoulders.   In my case, my career & relationship took a nosedive due to the efforts needed, and the impact of the ED.   So now I am even less in a position to help my s obtain professional help, as there are now financial constraints.   

I am going to enjoy reading your links on veganism, thanks!   

Seabird 






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Mother of 20 y.o. male diagnosed at age 16 with RAN, exercise compulsion, anxiety, depression & SH, FBT 4-5 mths to WR, WR now 3 yrs; suicide attempt 4-6 wks after WR,  IP 4 weeks.  Steady progressive recovery over past 3 years including support from psychologist on general wellbeing. Slow steady steps to success!! 

When your last bow is broken and your last arrow spent, then shoot, shoot with your whole heart
 [Zen saying}
tina72

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Reply with quote  #3 
Hi dc,
thanks for the great report and the amazing pictures. Your d is a really good photographer. I like the last one the most, it is really wonderful.
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dc

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Reply with quote  #4 
Dear Seabird,

You have done such a great job to support your son's recovery. In your case, it is even more difficult since his Dad is a vegetarian. I don't know your son becomes to be a vegan or was a vegan when he was born. Not many people know how dangerous it is to be a vegan for AN sufferer. Most people will say as long as he/she eats enough and maintain the weight, it will be fine. Actually this is not true. Being a vegan is just a sign of restricting eating. It is a kind form of rigid thinking for an AN. To fix it, it requires both EXP (exposure therapy) plus DBT/CBT therapy. Is it possible to start from a small challenge and then move to a little big one? I know it is very difficult since we have been gone through this.

All of the best!

dc

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19 yr old d Dx Feb 2012. WR June 2012. Now she is in Phase III and enjoy her study and activities. Try to give the control back to her but still keep vigilant. 
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Torie

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Reply with quote  #5 
Great post, DC.  Thanks!  So glad your d was able to experience such good help.  xx

-Torie

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"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
EC_Mom

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Reply with quote  #6 
What an amazing post!! Thanks for this. I can only imagine all the time you spent clarifying all these points. This is a hall-of-famer, right moderators?
Seabird

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Hi DC

My son announced his decision to become vegan about 9 months post WR, and he was almost 18 at that time.

For his entire life prior to RAN he was not on any type of dietary restriction - he regularly ate meat, dairy, eggs, fish and was previously a healthy active kid with no health problems.

During re-feeding (during which time I insisted he live 80+% of the time with me) I ensured he had high nutritional value meals with ample animal fats and animal protein.  I myself have a high level of knowledge of nutrition so no problems there.

We possibly broke the record for weight restoration as I was singularly determined that my son would recover, and was well aware of the dangers and red flags due to his massive weight loss and age.  In plain terms he didn't have a choice, my only mission in life was those 6 meals / day, for the 5 months it took for him to recover physically.  It took 6000 kcals/day, every day. 

I am also well up on animal welfare/animal rights issues (again through my own work) and we live close to nature surrounded by natural parks and the sea, so the environment and nature are influential here. 

Therefore when my son made his announcement "vegan" and subsequently justified it on the grounds of not wanting to harm or kill animals, or the environment (dairy farming is heavily criticized here for issues involving pollution of waterways), I know I am surrounded by other people with similar values and ideals.

Despite the facts (the facts are that a vegan diet is going to supply a reduced variety of fats and proteins when compared to a diet containing animal products; and that some nutrients will need to be supplemented as they are insufficient in vegan diets), and despite advice from a dietician and myself, my son is not amenable to changing his views.

My son is not in a situation where anyone can force him or even surround him by persuasion to eat a wider diet.  He believes he has recovered from the food obsessive thoughts and behaviours of his earlier illness, and to a large degree, he has recovered.

My approach has not been to argue logic with him (it won't work, and arguing with him will just destroy our relationship).

We are in the grey zone of "compromise" here and sometimes, that is the reality - and it can work.

I have advised him not to be too "strict" and not to go overboard worrying about whether everything he eats is free of animal content.  I have told him that is the road to hell and is just nuts and doesn't achieve anything.

I have been prepared to learn how to prepare vegan burgers and slices that pack the most powerful nutritional punch, with oils, seeds and nuts in addition to the bean bases, and using fortified products that include added iron, B12, Vit D, calcium.

The food I have learned to cook is so good that I've changed my diet as I prefer to eat less meat, plus I don't like cooking anyway so if I cook then I might as well eat some of it.

His compromise is that he has taken on board my "not too strict" mantra, and he will readily eat other goodies that I provide including muffins, a bit of cake here and there, pastries from the bakery, and that I do put eggs into some of the food I cook for him.

It's easier for him to eat the food, than to talk about it.  He doesn't like to talk about food and is not to be heard crowing about being a vegan.

So we both make some compromises and there is some flexibility there on his part. 

As time goes by I will point out to him that he needs to prioritise regular meals at all times during work/study, not only when there is vegan food available.  I certain intend to hammer home this message so that when faced by the decision to eat an egg sandwich or nothing, he will find it easier to make the right decision. 

I totally agree that it is "not appropriate" and "not a good idea" for a person recovering from a restrictive ED, to be vegan.  How to get such a person on board with this, is not necessarily possible and definitely not easy. Globally there are food innovators making synthetic meat from plants as we speak, and it will only be a matter of time before McDonalds has a vegan "meat" burger option. The food giants are compelled by consumer "animal rights" type concerns.   This is the world that we live in.

However, rather than bury our collective heads in the sand we (carers) also need to provide education and help for those who are stuck in the vegan mire, to ensure that at least they get the best of the vegan deal and not the worst of it.    Make it look/taste/feel vegan but it has some egg in it.  Why not?

Exposure therapy, DBT, it's all pretty hypothetical from where I'm looking.  

The point of this post is to not to disagree with sound principles but to look at different ways to skin the cat (using a terrible metaphor!!).

Seabird 


__________________
Mother of 20 y.o. male diagnosed at age 16 with RAN, exercise compulsion, anxiety, depression & SH, FBT 4-5 mths to WR, WR now 3 yrs; suicide attempt 4-6 wks after WR,  IP 4 weeks.  Steady progressive recovery over past 3 years including support from psychologist on general wellbeing. Slow steady steps to success!! 

When your last bow is broken and your last arrow spent, then shoot, shoot with your whole heart
 [Zen saying}
Kali

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Reply with quote  #8 
DC, this is a wonderful post and what beautiful photos to remind us of how rich and amazing the world around us can be when our kids are well enough to travel. All best to your daughter. Will she return to school for the spring semester or will she stay home for awhile and solidify her recovery and go back next fall? 

warmly,
Kali

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dc

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Reply with quote  #9 

Hi! Kali,

Thank you and Happy New Year to you and your family! Based on the recommendation from UCSD ED treatment center, she can go back to school this Spring with the Relapse Prevention Plan since her weight has been in the normal range for 3 months and she had two periods in Nov. and Dec.

Since her school will start in February, she will have one and half months to practice her independent eating by herself with UCSD's outpatient support. The college health center will do both physical and mental exams on her next week. We will also monitor her and make sure her weight and state are good in Winter. We are expecting her to have her third period this month. Any failure during this period of time will block her from going back to college. All of the consequences were written in Relapse Prevention Plan and signed by D, parents and therapists. My wife and I agreed that if she relapses, just let it happen quick and early. So far she is doing OK. She lost 0.4 pound in 7 days vacation (She did 5~6 hours hiking/walking with her friend every day, I guess she didn't refill enough). After we came back to home, she started to refill by herself and gained 0.8 pound in one week and will continue to gain several pounds for the buffer in the next couple of weeks. My wife and I are going back to work. D controls all of the eating and activities just like she is studying at college. 

All of the best!

dc


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19 yr old d Dx Feb 2012. WR June 2012. Now she is in Phase III and enjoy her study and activities. Try to give the control back to her but still keep vigilant. 
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"The darkest night is often the bridge to the brightest tomorrow."
HateEDwithApassion

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Reply with quote  #10 
DC, 

Forgive me if I missed this, but do you live in the area and your D came home at night or did she live in supported housing? I was looking into the UCSD five day intensive for my D, but it's full until March and the young adult version isn't even scheduled. She's not going to be able to wait that long for a higher level of care, so I was wondering about doing just PHP at UCSD, but we are not from California.

Thanks!



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19 yo D. AN - since about 15 years old. WR quickly - but the last four years have been tough. Since Sept. 2017, two residential stays, now in IOP, fighting a relapse. ED is hanging on, mental state not great, can't get her to remain at a weight long enough or high enough to see mental healing. She's on a gap year that will likely now turn into two.
toothfairy

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Reply with quote  #11 
Thanks you for such an amazing detailed post. 
Best wishes to you and your family.

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Food is the medicine. Recovery is possible.
dc

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Reply with quote  #12 
Hi! HateEDwithApassion,

I'm sorry that I didn't explain it clearly in my post. We are living in Texas. Before the treatment started, I drove a car from Texas to San Diego by myself so that my wife didn't rent a car there. The next day D and my wife flied to San Diego. My wife rent a one bedroom apartment near UCSD and stayed there with D for 6 months. I am working in Texas. D's insurance is under my name. Every month I visited them once. UCSD five day intensive is very good for education purpose. The parents can learn a lot from the therapists within 5 days. However, for the treatment, I still recommend PHP/IOP at UCSD. If you have any questions about PHP or IOP, please let me know. Good luck!

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19 yr old d Dx Feb 2012. WR June 2012. Now she is in Phase III and enjoy her study and activities. Try to give the control back to her but still keep vigilant. 
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"The darkest night is often the bridge to the brightest tomorrow."
Playball40

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Reply with quote  #13 
DC - I think it's wonderful that your D received the much needed treatment that she deserved.  Sadly, I do not know of many families that can do what you and your family did (have one spouse spend 6 months in an apartment, while the other worked in another state).  Most cannot possibly afford it and those that can may not be able to feasibly accomplish it if there are other children at home. 

Do you know if the UCSD program will be available in other states soon?  Do  you know if they have a scholarship program or a Ronald McDonald house nearby?  Do they have a St. Jude type program? 

Your insight is invaluable, to be sure.  But be careful not to make others potentially feel like they are failing their children if they cannot do the same.

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Caroline
dc

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Reply with quote  #14 
Hi! Playball40,

Thanks for your reminder. If my post makes others potentially feel like they are failing if they cannot take the treatment at UCSD, I would feel sad and regret to write it. It was not my purpose of writing this post. We have been to three ED treatment centers in last two years. Two of them failed us. They not only wasted our money, time and efforts, but also delayed D's recovery. Like most of the parents in this forum, we had no experience and idea about how to choose a good treatment center. Some of the parents mentioned UCSD is a good one in this forum. No one has described its adult program in details. I hope my post will help other parents to know more about it. Even they can't send their kids to take the treatment at UCSD, they still can apply best practices of UCSD in their journey of helping their kids for recovery. I heard that there are other good treatment centers available in the state. When we were researching the eating disorders treatment center, there are other candidates like ERC (Denver, CO) and Veritas Collaborative (Durham, NC). Here is the link for the comparison. Other parents also recommend some other good ED treatment centers in this forum as well.

I don't know the same UCSD program will be available in other states soon. However, The Center for Balanced Living was created in collaboration with UCSD eating disorder treatment and research programs. UCSF Eating Disorders Program has some staff trained at UCSD.

I listed the potential cost (Adult Program) at UCSD treatment center in a table as follows in case some parents want to know the details.

PHP/IOP program

Medical insurance is required. 

Living

Option 1: McDonald House: $20 per day. Limited to certain families. Difficult to get one room.

Option 2: Hotel recommended by UCSD: $50 per day. It has its own kitchen. It’s about more than 20 minutes drive away from the center.

Option 3: Apartment shared with other patients. One apartment with 4 patients. Each pays $25 per day. Close to the treatment center and bus station.

Option 4: Rent a room in a house. $1000 per month and close to the treatment center. 

Option 5: Rent a apartment nearby. More expensive.

Transportation

Option 1: Public Transportation.

Option 2: Share car with others.

Option 3: With your own car.

Food

For PHP program, the patient eats most of meals and snacks at the center.

For IOP program, the patient or family member needs to prepare the meals and snacks which are not eaten at the center.

College Study (For the patients in college)

At UCSD, it costs $1,700 to register one course. Make sure the credits can be transferred.


Originally, we tried to apply for McDonald house and didn't get it. Then we decided to rent a room in a house. It didn't work out. Because sometimes D and my wife were fighting about the food. It really bothered other people living in the same house. Sometimes, we had to make the food for D in the shared kitchen, it conflicted with others' schedule. We also considered the hotel recommended by the center.  Because D was taking the courses at UCSD and she had excessive exercise compulsion, we don't want her to walk to college which would consume too much energy. Finally renting an apartment became the only choice.

In case the patient doesn't have the insurance, she can check out Project Heal and apply for fund for the 5 day intensive program.

__________________
19 yr old d Dx Feb 2012. WR June 2012. Now she is in Phase III and enjoy her study and activities. Try to give the control back to her but still keep vigilant. 
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