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

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Becs
Hey - haven't posted a while but thanks to those of you who have been so supportive on my Early Refeeding/Vegan post. That title is pretty redundant at this stage so I've started a new post which may resonate with some.

My D has been an absolute rock star in IP. She is now there exactly one month (having spent 10 days in hospital prior to that) and has gained from 70% to 82% weight for height. All vitals now normal. Every meal and snack taken. 1.6kg weekly gains. We are eating meals with her a few times a week (now nurse free!) and she has taken two exams. She is mobile though no exercise and has her first time off the unit this weekend to visit her Grandmother. Her cognition 'appears' very good (noted by staff as well as ourselves) Meds have been discontinued. And she's managed to maintain a very loving relationship with her family throughout. So we are beyond delighted (Sorry if this come across as rather smug for those struggling with IP)

BUT! (always one of those....) She wants to come home - big time. She believes she's stuck to her side of the deal. ED is gone. She has no desire to over exercise. She will take every bite at home. All that stuff. She's getting increasingly angry with us for keeping her in there... says the only reason she's there is that we're scared (partly true) and she knows she can do this. Why can't we believe her?

She obviously has a very long way to go for WR and beyond but what on earth do we do to keep her motivated in IP? She's very bright and her exams are now finished. There is a lot of down time on the unit and she thinks that the therapy groups are lame. There are some very sick (non ED) kids in there and its obviously not a fun place to be. However, the team have obviously done an incredible job with her.

I really want to push for time at home now and see how we go.... I know its such early days though. Anyone else been here?
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ValentinaGermania
Becs, that sounds really great! I am so happy for you and your family.
Our case is not at all comparable to yours but as we took our d home from IP a long time before WR and because she begged to come home maybe helpful as well.
We did it that way: We explained to her that ALL rules from IP will be the same at home and if she refuses to eat ONE meal or snack she has to go back (that was a teethless tiger in fact as we faked that - she could not go back).

In your case I would ask IP if she can come home for some days to try how it goes. First one day, then a weekend, then 3 days in a row for example.
It might be the case she is ready to go home. Mine was.
It might also be the case that she is a very good actor and ED wants to go home to start restricting again. You will see when you try it.

Are you ready to take her home?
Are you prepared to run your home like IP if needed?
Can you have time off from work for 24/7 supervision and is supervision of meals and snacks in school possible?

You will need to take all IP rules home and you will need to stick to all these rules for a LONG time.
Keep feeding. There is light at the end of the tunnel.
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Enn
Hi Becs,
So nice to hear she is doing so well.
Before I would take her home there are a few things I would want to do if it were me.
1: what does the team say? What  is their general practice for discharge planning.
2: is there a graded discharge where you can take her home for a full day and night and see how that goes.
3: if she is discharged soon what are the plans if she does not comply? Are they able to readmit sooner rather than later if things go backwards?

My d was so compliant and happy IP and all went south at home. Their policy here is to discharge at 80% WR.
Having plans well documented prior to discharge can be helpful. 
Having a plan of attack for every or most eventualities will likely keep you on good stead no matter what you decide to do.
All the best,
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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Becs
Thanks as always Tina and Scaredmom. Your very different experiences of IP discharge show just how individual this journey is.

I love the huge expertise and support we have from the IP unit and D was in much better form this evening and a bit more realistic about 'staying the distance'. Our IP team are more about state not weight; they have a patient currently who is WR but not in any way better and they continue to treat. 

Psycho-education starts around 85% so that will kick in in the next couple of weeks for my D. We will overlap with OP for a while before discharge. We are very lucky because the social worker who worked with us in OP previously coincidentally moved to the IP unit at the same time as us. She is adorable and knows us so well and will be a conduit between IP and OP when we need it. There is another ED patient on the unit who is going home for 5 days out of 7, yet still has her bed. So I think we're in a great place for graduated discharge. I don't know about criteria for readmission - will explore that when the time comes but that's a really valid point and I hadn't really thought that far ahead. 

D and I had tea together this evening - she was so relaxed and we actually had a laugh. She ate the optional salad. Ate at the same pace as me. Saved the piece of toast with the most peanut butter on til last because 'I love peanut butter'. I'm still smiling.
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ValentinaGermania
That sounds like a perfect plan and a perfect team!
Keep feeding. There is light at the end of the tunnel.
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Foodsupport_AUS
It is great that things seem to be going so well. She has a long way to go, and it is not unusual for things to get worse before they get better. The way you are describing things I would be very suspicious that all is not as it seems. ED just does not disappear like that. Even those who in the end describe relatively straight forward recovery don't find it comes that fast. So I agree, it all seems a great plan for graduated discharge, but even then things can still turn backwards. Full meal compliance can turn into complete refusal quite quickly when there is no pressure from a waiting bed. 
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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Becs
Yep, still super suspicious of ED and where he'll pop up next. I've no doubt that the strict rules of IP are keeping him in check. We will wait and what the graduated home visits bring. Just trying to enjoy the relative calm for now :-) 
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