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

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WorriedMum68
Hi All

This is my first post, my teenage daughter has been diagnosed AN after 8 months of increasingly restrictive eating. I am trying to refeed at the moment, and her mood has gone very low and she won’t stop pacing around at home. I manage to get her to sit down after meals for 30 minutes, but for the rest of the day she refuses to sit down and tries to walk around. At the moment she just blanks me when I try to get her to stop, does anyone have any ideas what I can do to get her to rest more?

Many thanks

WorriedMum
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ValentinaGermania
Hi and a very warm welcome from Germany!

It is nice to have you here although I am so sorry that you need to be. You will get great help here.

There are many ways to stop exercise and walking around. It depends a bit to your situation and the state of your d. How old is she?
Some are not able even to sit for 5 minutes and the parents had progress with driving around in the car (because you cannot stand or walk around in a car).
If your d is already able to sit for 30 min after meals that is great. Try to extend that by reading a book together, watching TV or Youtube videos, playing card games.

You can tell her that she is allowed only to walk x minutes and if she ignores that and walks more she has to rest in bed. You can tell her she needs to add a supplement if she wants to walk for more than x minutes (that stopped my d from doing anything).
Try to distract her with things that can only be done at a table. Have some holiday catalogues and plan future journeys together. Have some furniture catalogues and plan some redecoration of the house (these are things that do not need to happen in reality). Do some tinker work together. If she will not engage first, sit down yourself and do some scrabbooking or crosswords and ask her now and then to help you ("What should I fill in there?" "What word could that be?" "Can you help me with the glue?"). At first she will be lurking around but than I hope she will be too curious not to join you.

It is all try and error.
Tina72
Keep feeding. There is light at the end of the tunnel.
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WorriedMum68
Hi Tina

Thank you so much for your reply, you have given me some very useful ideas!

To answer your question, my daughter is 15 years old and although she is fortunately not severely underweight, her heart rate is lower than the doctor would like and she needs to rest as much as possible. I am on a very steep learning curve at the moment, as her recent diagnosis and subsequent treatment is challenging the disorder, and my previously sweet and funny daughter is cold and aggressive a fair bit of the time.

One of the things I struggle with the most is knowing how firm to be. I try to show empathy and be firm but caring, but I think I get so ground down with it all I am not always firm enough. It’s very hard, and it’s lovely to be able to write about it in a place where other people understand, as I know no one who has been through this themselves.

Thanks again
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ValentinaGermania
You need to be firm where it is needed and to be compassionate wherever possible.
To give you an example:
If your d was playing with matches at age 2 you would not discuss with her about that and take it away asap.
If she was playing besides a busy street you would have asked her to come in and have no discussion about that.
That is ED. It is playing with a very bad friend.

So you need to be very firm and strict with all food related things. Have a meal plan and no discussion about that. Have fixed hours for meals and no discussion about that.
I know that is not easy. My d was 17 when we started refeeding. I thought I cannot do all that with a nearly adult person. Guess what? I did and it worked. There was a lot of screaming and hatred at the beginning. It was not easy. But once we fought that battle to the end and my d saw that we are serious about it and we will do anything that is needed to get that food in, she started to eat. And she was able to eat, because it was not her fault any more, she ate because we "forced" her to eat. And it was a big relief for her not to be in charge. We are now 1,5 years in refeeding and 1 year after WR and I am still plating lunch for her and that is the best meal for her because she eats it will great pleasure.

So be strict with food and with exercise and offer her love and compassion all other hours of the day. Even if she seems not to love you any more. Even if she says horrible things to you. That is ED and your d behind that needs to be sure you still love her.
But you need to show the cold and agressive ED the front door to get your sweet and funny daughter back.

Tina72
Keep feeding. There is light at the end of the tunnel.
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WorriedMum68
Thank you for your reply, Tina, there is some great advice there and I’m glad your daughter is doing well.
Can I ask how what length of time it took from starting refeeding until your daughter was eating exactly what you gave her? Did you have days when she didn’t eat at all, and what did you do if she just refused?

Many thanks
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ValentinaGermania
So, tea-time in between but here is my answer:

In our case that was a bit special. My d refused eating at home and in the end even refused to drink water and I had no idea about FBT and refeeding at that time and she went IP as emergeny case. On the IP ward the nurse put lunch in front of her on day one and I sat besides her and encouraged her to eat like I had read Eva Musbys book before but in fact it was just panic and I did not knew what to do else. And surprisingly it worked. She ate all they put in front of her in the following days even without a meal plan. I realised that this was the secret. She was not asked to decide. She was not asked if she would eat at all. They put the plate on the table and now eat that.

After 3 months we took her home and I was anxious wether she would eat at home or not. At that time I had already found the great people here, even when I did not join them officially. I read and read and read and then we decided to take all the rules from hospital to our house. We had the same meal times and I served the same food (not really the same, I cooked with much more "ingredients"). We had rules what will happen if she refused to eat and I remember only one time when I needed to say "if you do not eat that now, go and have your bag packed, we will drive you back to hospital." It was so hard to do that but I only had to say that once. At that time she was already convinced that I mean that seriously.

She sometimes tried to refuse with other tricks, no hunger, not now, I have stomach pain, what ever. She tried to discuss and she yelled at me. I tried to be a brick wall. Whatever she said, I only said: this is your meal, please start to eat now. No discussion about what to eat and how much. We had a meal plan for the next week in the kitchen and if it said spaghetti carbonara for Tuesday there was spaghetti carbonara on the table no matter what happens.

So you need to have a plan B and C for everything that could happen. She is leaving the table and goes to her room? You follow her with the plate. She can eat there. She is locking herself in? Take away the key. Hang out the door if needed. You need to do EVERYTHING that is needed to make the food go in. Eating must be not negotiable. You want to go to school? Finish your breakfast and you can leave. You want to go to a sleep-in? You can go after dinner and I will catch you up for breakfast. She throws the food on the ground? Stay calm, take her plate and fill it again. And again if needed.

Give us some more informations where and how you struggle. Tell us what is happening and we can help you with ideas what we have done in that situation and you can decide what you want to try and what not.

And please do not open and close all your post with "thanks" [smile]. We are just giving back what we recieved from others here. So it is a win-win situation. Having ED in the house is a very lonely and isolating situation. We have lost nearly all family and friends. So you are my rare social contact. See it that way, please.
Tina72
Keep feeding. There is light at the end of the tunnel.
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Enn

Hi WorriedMum68,
I too welcome you here to the place no one want to be, but please take heart, it is the best place to connect with those who have been there and can support you.
We too had issues with standing all the time and it is hard to extinguish. We kept feeding and like tina72 says, we distracted and made her sit without her knowing. We took her on a canoe ride for three hours. We made her sit for one hour every evening and then after a few days added a half hour. She used to yell at me so her father would sit with her for the time watching Netflix videos. At first she would time every last second and then once she got used to it ie distress tolerance and got over the first few min she did get better. She would try to get up and walk about "I have to use the toilet etc.." and then we would just tell her she had to sit and if she got up we added that time on top.

We traveled too and she had to sit on the plane of course. I does get better
You say "One of the things I struggle with the most is knowing how firm to be. I try to show empathy and be firm but caring, but I think I get so ground down with it all I am not always firm enough. It’s very hard, and it’s lovely to be able to write about it in a place where other people understand, as I know no one who has been through this themselves." I had to change how I saw parenting. I had to be the tough lady when it came to food. NO NEGOTIATION AT ALL. It is counterintuitive, I know, but it has to happen. Until I got my mind around it, it was really hard.
Having a plan if she does not eat, drink, if she throws things, etc.. was helpful and took time. (get plastic plates in case of flying objects)

Use incentives, like phone, friends, shopping, makeup whatever she likes to get her to eat. "You  may have your phone when you eat, you may call a friend over when you have eaten". Some do well with friends to eat. My D ate like she was normal when others were around. If the friend had pizza she would too. You have to learn from trial and error ( a lot of errors really helps us learn) what works. Torie said in one post recently and it is so good, that you have to learn how to make eating the only option and that eating really is the preferred option than not eating. So if she want so see her friends, it is easier to eat than not to.

Keep asking questions.
XXX

Food+more food+ time + love +good professional help+ ATDT=healing---> recovery (---> life without ED)  

 

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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WorriedMum68
I’m so glad I posted today. I was very nervous to do so, but the replies I have received have been wonderful and so helpful, it is indeed very isolating when you have a child in this position. I feel a bit more confident in tackling the refeeding and exercise issues now, and see that I need to be much firmer and less hesitant than I have been.

Best wishes to all of you

WorriedMum68

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ValentinaGermania
Be aware that you might see much more resistance when you act more strict now. It will get worse before it will get better.
Imagine ED as a long dark tunnel and just try to walk through.
You will get that!
Tina72
Keep feeding. There is light at the end of the tunnel.
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Torie
WorriedMum68 wrote:
I feel a bit more confident in tackling the refeeding and exercise issues now, and see that I need to be much firmer and less hesitant than I have been.


Hello, and welcome!  It's ironic that when we most need to project confidence and certainty in refeeding is when we actually feel the least confident.  "Fake it til you make it" is something you will often read here as a reminder to act confident, regardless.  So much easier said than done, but it does get easier.

Please feel free to ask all the questions you like.  We're glad you're here (although sorry you have the need).  xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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teecee
Welcome.
Please don’t back down when the real resistance occurs...it is normal. There is no way round it...you have to go through and keep pushing for full nutrition. You will know when you can stop...when you get no resistance and life is ‘back to normal.’ It will happen. Believe that.
Virtual hugs xxx
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WorriedMum68
That’s an excellent link, Toothfairy, thanks for that. It’s pretty clear it’s going to get worse before it gets better, I have had such a lot of excellent advice today to help strengthen my resolve....
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tammy
Hi WorriedMum68, you have had loads of great advice. I just wanted to reassure you that we too had a major problem with exercise and now my 9 year old son sits and plays the x box for hours! In February this year he would not sit still. He would stand all day. He would squat in the car. Now he can go to the cinema and then out for dinner!
Just keep on feeding and follow all the great advice above. Try to remember that she doesn’t want to do this and is probably exhausted. She is being tormented by ED.
Eva Musby has just published some very useful fact sheets on her website.
Tammy x
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Mamaroo
WorriedMum68 wrote:

Can I ask how what length of time it took from starting refeeding until your daughter was eating exactly what you gave her? Did you have days when she didn’t eat at all, and what did you do if she just refused?

Many thanks


When my d was discharged from IP, we received a mealplan and ensures (in case she didn't follow the mealplan). Guess what, she couldn't and ended up only having ensures for all the meals and snack times. So she needed 6 ensures a day, but it took us 7 weeks before she was able to have the six. The first couple of weeks, she only could manage a couple and lost all the weight she had gained. She had a weekly medical and with the threat of going back to IP, she managed to have more and more every week until she had 6 ensures a day.

We used a lot of incentives to get her to eat. She was allowed to play on the ipad after every completed meal and if she was able to complete the mealplan (or just have more than the day before initially) she got points, which went to itune cards, which went to playing games on the ipad. 

When she didn't eat after 30 minutes (or even 10 if I see her digging in her heals), I would step away and do something else and my d could rest on her bed with no ipad. Afterwards we tried again. If she continued to refuse, I would start to pack a bag, saying that if she lost weight she would have to go back IP. Sometimes I got upset with her and she ate just not to disappoint me (but that only happened later when we got some weight on, before she couldn't care less about my feelings). 

You can use anything she values as incentives, but it needs to be given immediately after the meal. Their time frame is very short when they are so ill.
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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