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

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moonlove
We are almost 6 weeks since diagnosis.  12 yo D is at home after 4 weeks IP. She has been gaining weight but is not weight restored with about 10 pounds to go.   We had a nice first few days home but are now under constant assault from her ED,  it is full time anger, grief and hate.  She is eating every meal and snack with some resistance.  The real fury comes afterwards.  Her behaviour is downright strange teetering between glum and morose to fidgety restless and frantic.  Lots of standing, jumping and racing around the house, running out the door for private walks etc.

Her T has suggested she is ready to return to school starting next week. Convenient timing as its the end of spring break and an easy return time. Part of me thinks this a good idea so she has some distraction.  The rest of me wonders if she is too deep into her illness to be out of my sight for any length of time at all.  (She would have meal support at school through a designated teacher).

Thank in advance for your comments and advice.


12 YO D, Diagnosed Feb 14, 2017, RAN, 4 Weeks IP, Currently enrolled in OP ED program supporting FBT at home, Stage 1
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EDAction

Hi moonlove,

I remember that behavior from my D - being extremely upset after eating and doing strange things to try to burn the calories.  ED is giving her hell for eating.  I consider her behavior "normal" under the circumstances unfortunately.

As far as returning to school . . . I would take the approach of trying it and seeing how it goes.  Maybe it will prove to be a good distraction for your D and a good breather for you.  The risk is that she may not eat her lunch even with a teacher present, or at least not all of it.  Another option is to send her to school, but pick her up for lunch.  She can eat her lunch in the car with you and then return to school - IF - she eats her lunch.

I see that you are very new to the forum and only a few weeks from your D's diagnosis.  Welcome.  I am sorry that your D has been diagnosed with an ED.  But you have come to the right place for support, advice and information.  Are you in the US?  There are forum members from a number of countries and knowing where you live helps as the healthcare systems are different in different countries.  What type of treatment did your D receive in IP, and now from T?  Is it FBT (Family Based Treatment) based? (If you don't know what I'm talking about, please say that too. [smile]) If you are comfortable doing so, tell us your story.  How did you know something was wrong?  What was your path to a diagnosis for your D?

If it hasn't been recommended to you already, I recommend the book "Helping Your Teenager Beat an ED" by Drs. Locke & LaGrange.  It's the place to start.

And when I said that your D attending school might also provide a breather for you I meant it.  If she is able to go too school, it will give you time to continue your ED education, research recipes, shop, cook and fortify yourself for when she returns home so that you can be as strong, patient, calm and loving as possible.  This is a marathon.  

Thinking of you . . .

DD diagnosed with anorexia at 14; FBT at home with the help of psychologist and medical dr; 3+ years later and doing well (knock on wood)
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Torie
animated-sign-smiley-image-0331

It's hard to know what will happen at school until you try.  I wonder if you have discussed the possibility of 1/2 days if your d is overwhelmed by jumping back in full bore, and I also wonder what your d says about going back.

You may know this already, but it's prudent to keep your d with you for an hour after each meal / snack to guard against purging.  After hearing about all the difficulty in dealing with this after it's ingrained, I took the advice of the veterans here who suggested requiring my d to visit the restroom before each meal so she would be able to stay with me for an hour afterwards.  

It sounds like you and your d are making great progress!  Kudos to you both.  xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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K63
Hi moonlove, welcome to the forum. Returning to school could go either way. It may be good to distract your d so long as she is getting full meal support. We had a problem as before I took my d out of school she was restricting every chance she could and she wanted to stay in school. She did have meal support but this person did not fully understand how good she was at hiding food and eventually we knew it wasn't working and I used to go for lunch times but she needed frequent meals and snacks and it just didn't work . So if you can put structures in place for full nutrition while she is at school give it a go. On the other hand my d missed a lot of one school year it was her last year in school prior to college year . She needed to repeat this year . Thankfully she is did and is now in college still needing some support but doing better . So if you feel school would help give it a go if weight gain doesn't continue I would pull her out of school again.
Daughter started restricting in February 2014, tried re feeding at home hospital admission 4 1/2 months weight restored started restricting post discharge, back on meal plan full supervision weight restored april 2016. Starting to hand back responsibility for meals it's scary. 
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Sotired
Welcome.has anyone talked with you about the fact that a percentage of anorexic people also have exercise compulsion?when your d ate at hospital I'm pretty certain that they would not allow any exercise at all other than gentle walking .my d suffered from the exercise compulsion part of anorexia and whatever I saw her do-she was doing at least twice the amount.
What I read from your post is that your ds anorexia is making her exercise.when sending them back to school (and this is something I learned only from hard bitter experience) the opportunities for anorexia are too many for our kids to handle.my d would ditch her lunch in the bin, palm it-so it looked like she ate ,but it went in her pockets or waistband to be thrown out later or purge it.(vomit).
If she did eat she would spend lunchtime and time between classes runnning up and down stairs, knocking her kneees together endlessly,jiggling nonstop-anything that kept her on the move.
At home,if not monitored she would set a target of starjumps,sit-ups and push-ups and she would do as many of those as she could,whenever she could.she set her cellphone alarm to go off at night to wake her to exercise.
You won't want to believe it.i didn't.but they just can't help it-the anorexia is still fully in control at this point,so sending her back to school could undo all the traction you have managed to gain.
If you do decide to send your d back,I would start very slowly-my d did two hours a day three days a week.in truth her brain was so foggy that she didn't remember anything she was learning,nor was she interested in her friends,though she pretended to be.school was where her anorexia could regain full control over her
because I wasn't there.
I think your therapist is pushing too far,too fast and she needs to realise that this is not an easy illness-a lot of time and care needs to go into each transition.this is a time to consolidate weight gain and work on reducing the need by your d to exercise.
School is always there for later,it can be used as a carrot to get weight on even.
I hope this advice is helpful
Sotired42
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moonlove
Thank you for all the thoughtful and helpful replies.  

I like your suggestions about half days and the car for lunch.  These have been discussed and I will make them part of the program.

I am aware of exercise compulsion and have seen this brewing.  Not before but since hospital - the jiggling and trying to eat standing.   

Thus far our D is a very compliant patient (until the after meal rages) so I am thinking lunch with me is the best option. Then home afterwards if it gets messy.

Although diagnosed only 6 weeks ago we have been suspecting ED and seeking advice for almost 8 months.  And as I look back she may have been avoiding and restricting since she was 8 - to some degree.  

Our sweet girl has had lots of issues over the years, difficulty in school, complicated friendships as she misses social cues and a very tense relationship with her twin sister who is easy and happy in the world.  

In all honesty I would like her to go to school for a couple of hours each day to regroup, exercise and not be at battle.  I find this like having a newborn with the stress of a feeding schedule, the immediate and emotional needs and the constant intensity.

Lastly, in answer to a question above, she was in a regional hospital for the first part of her IP and in a specialized ED treatment centre for the last part. Each was scary - the first as it was home to a lot of teenage problems ie cutting, suicide attempts, psychotic episodes (I had no idea that this was a paediatric ward on this inside).  Then an ED inpatient treatment program.  They initially suggested 3 months, but after a week realized that she does eat everything, is very young and has a pretty great support network in place.  We moved quickly to FBT.  We are happy to have her home, free of any influence from the ED ward as she is so young, but are seeing the enormity of the task at hand.
12 YO D, Diagnosed Feb 14, 2017, RAN, 4 Weeks IP, Currently enrolled in OP ED program supporting FBT at home, Stage 1
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Ping_Pong
Phased return to school worked well for us. The School allowed us to choose which lessons D went in for, and were incredibly supportive, letting us call the shots. Started with the core subjects (English, maths, science) and built up from there, including break times where poss so she could be with her friends. Lunches and PE came quite a bit later. Helps that the School is v close to our house, and that I was given sick leave from work to deal with all the toing and froing. Returning to school was a huge motivator for her, so we used that as leverage, but I appreciate that might not be the case for everyone.

And the meal rages were v common with us, too! Usually before a meal, in our case, as if she was psyching herself up to eat. Eva Musby's book was a huge help. And things gradually did get better and easier and more normal.

Keep coming back and asking Qs!!

Chinstrap.
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moonlove
Thank you for the replies. We are having an incredibly hard weekend which tells us that we still have some work to do before she heads out into the world - even for a little bit. It's possibly that she is ill this weekend, but is suffering in some way.

12 YO D, Diagnosed Feb 14, 2017, RAN, 4 Weeks IP, Currently enrolled in OP ED program supporting FBT at home, Stage 1
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EDAction
So sorry to hear about the weekend moonlove.  Thinking of you.  Let us know if we can help in any way.
DD diagnosed with anorexia at 14; FBT at home with the help of psychologist and medical dr; 3+ years later and doing well (knock on wood)
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Kali
Hi moonlove

Sorry the weekend has been difficult.
Have you read any of mamabears posts? I believe her d. was 10 or 12 when she fell ill and her posts are very informative and her daughter has recovered.

Kali
Food=Love
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tdm13
Hi Moonlove

sorry for the hard week end.
Our d is about same age (fell sick at 11 and now 12) and for her/us it really helped a lot to get her back on the activities she liked before getting sick, go out in the real world. We mainly made sure that 1) it was not ED driven but genuine (a little of guessing here, but we have found our d quite transparent with her motivation and behavior), 2) meals were not part of these activities until she got better; for instance she would go to school, which was very distractive with her friends, but come back to our house for eating. We for sure never regretted to try out things as we learnt from them and explained to d that we would quickly adapt and find what is helping her the most.


tdm13
___________________________.
parents of d who started to restrict food at 11yrs in Aug2015, diagnosed as AN. Hospital resident mid-Dec to mid-Apr2016 under traditional treatment (isolation+weight contract). Total failure made us  switched successfully to FBT at home. WR in Aug 2016. No more symptoms since Jan 2018, follwoing growth & bmi percentile
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moonlove
Thanks so much for all the support.  D did return to school this week and it was largely a success.  The first attempt was a disaster as she put on her uniform and it fit differently.  (12lb weight gain so far).  Although I had let this out it was still a nightmare for her and kept her home that day.

She was up and ready to go the next day and attended the morning.  She had her am snack with the guidance counsellor (with whom she is very close) and I came for lunch.  She decided to come home for the afternoon and we spent a pleasant afternoon together.  I could see the positive effects of the distraction and that she was pleased to be back.  The next day she went for a whole day.  The third day was more difficult and she came home after lunch.  

Day by day with the option of a distraction seems to be a great step in this journey.

At this point we are taking and celebrating all movement forward and are really thankful for a supportive school.  The headmaster is totally on board and comes to the door to greet her and has said that the only goal here is health and the rest will follow.  She is invited to come and go as she needs.  Small blessings....... 
12 YO D, Diagnosed Feb 14, 2017, RAN, 4 Weeks IP, Currently enrolled in OP ED program supporting FBT at home, Stage 1
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Ping_Pong
Small blessings, indeed!  Actually, quite big blessings as having a headteacher with that sort of attitude makes such a difference to how we as parents handle a difficult situation. Sounds like a lovely guy.  Our D's HT has a very similar stance - totally supportive and on side, allowing us to call the shots, for which we are very grateful.

I'm really glad that your D has been able to enjoy some time at school this week, and hopefully spend time with her friends.  She seems to have made good progress in a relatively short time - whatever you're doing must be working!!

tdm13 - totally echo all you said in your post.

Chinstrap.


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Foodsupport_AUS
Moonlove great to hear about the transition going relatively smoothly. The attitude of the school in this circumstance can make a world of difference. We had a very supportive school for my D but have heard some alarming stories from others.  Hopefully it keeps on going well. 
D diagnosed restrictive AN June 2010 age 13. Mostly recovered 10 years later.  Treatment: multiple hospitalisations and individual and family therapy.
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