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

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hopeburch
Should we remove our son from sports until he's at a healthy weight? He is 5'1" and 80 lbs.
Have any of you had any success keeping your children in sports while they recover?
Are we just kidding ourselves?
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Torie
I can't answer your question. But I can tell you that your s needs to eat enough to gain weight each week. If he is not well enough to do that, most definitely he is not well enough for sports. I'll let others with more experience help you sort out the sport or no sport question.

xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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Sotired
We had a year with lots of injuries which I now realise (much further down the track) were caused by restrictive eating.there are two problems as I see it with keeping your s in sports.
1) he isn't eating enough to sustain good muscle mass so his body is eating his reserves to sustain him doing this.
2)this is more of an action/consequence concept.where is there incentive to get well?how do you prove to him how serious this is?by saying to him that health comes first and that until he can eat often and a goodly amount then it is too risky for him to do sports.
By doing these sports at a reduced capacity his heart gets put under a lot of extra pressure.his ligaments tear,his bones may break.this has all happened to our d a very good net baller and tennis player.
If you stop him now,there is a very good chance he can return to them later.if you don't there can be damage done that is lifelong.i am not sure that our d can ever return to sport,there have just been too many injuries that I now realise were caused by malnutrition.i don't say this to frighten you,just to give you our perspective.good luck.also watch for your son setting the alarm on his phone to go off early morning or during the night to do exercise.exercise compulsion is a hard habit to break and took us a good long while.
Sotired42
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OneToughMomma
Dear Hope

Let me just say that I know my D has lost weight and is feeling a bit 'EDly' when she starts exercising.  Her desire to exercise comes from her ED.  The more she wants to do sport, the sicker she is.  The more weight she has lost, the more she wants to work out.

I didn't fully understand that when she was first ill, and would have said that she had no exercise compulsion because she could sit and watch TV, etc.  Some of the families here have seen such extreme behaviours and I thought we had no problem in that way.  But, with the wisdom of hindsight I can see that sport is a symptom of her ED.

I wish we had stopped it completely from the very start.

Another factor is fueling his body and his sport.  You are saying that he is only eating 'healthy' snacks, so it sounds to me like he is in charge of his food.  Is he gaining weight? 

The next questions are very blunt, but I do wish someone had asked me them when my D was 10.  Can you justify him burning up precious calories on the sports field when he is fighting such a serious illness?  Which is more important--his long term health or his short-term happiness?

I know it's hard.  I wish you didn't have to do all of this.

xoOTM

D in and out of EDNOS since age 8. dx RAN 2013. WR Aug '14. Graduated FBT June 2015 at 18 yrs old. [thumb]
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Foodsupport_AUS
Another vote here for no sport. To a large degree it is the ED driving his urge for exercise. He may have enjoyed sports before but now he is tormented by his ED, and there are clearly some very distorted thoughts. His ED will rage at him being stopped from exercising, but ultimately your son may be grateful for being prevented from the self torture which is compulsive exercise. Many of us here have found that once the exercise is stopped and the weight goes on, miraculously the urge to exercise dramatically reduces or disappears. I now have a couch potato rather than a compulsive runner. 
The other components of this is that it is hard enough to feed them enough to gain weight without exercising. Why make it harder? Then there is safety, is he really safe on the sports-field?
D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
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trusttheprocessUSA
Hello and welcome. I have a son with severe restrictive anorexia. He was diagnosed at 12.5 yrs old and is currently in remission. I know what it's like to be exactly where you are. The thing I didn't know at the time was how damaged my son's heart was due to starvation. If you are putting a team together for care you MUST have his heart checked weekly - simple tests: orthostatic blood pressure taken and resting heart rate. Things can change quickly with a child whose body is trying to grow and the same time they are restricting AND if you add sports to that - he is at risk of a sudden cardiac event.

The good news is it's all reversible. We had to stop all sports for 7 months. During that 7months we needed to restore all of the weight he had lost (32lbs) and have him continue to grow and gain. This takes a huge amount of calories in 5 meals per day. Breakfast, lunch, snack, dinner, snack - same time every day about 3 hours apart. Lots of high fat high protien foods. We can help with that.

My son's sport was/is soccer. He was able to return to play and then we used it as leverage - after his eating disorder was in remission. I am able to report that he has been able to gain and grow into a young man. He is now 17 and plays soccer in a very competitive league. Has it been easy - no. But the key to his recovery was finding his historical growth pattern (90% for height and 95% for weight). Re-feed him until his weight matched his growth pattern AND keep him there as his grew in height AND played soccer. It took so many calories for many many months.

You can do it and we can help. So glad you found us.
Son diagnosed @ 12.5 yrs old with Severe RAN 2/11. Co-morbids - anxiety, Active restriction for 3 months. He stopped eating completely 2x. He needed immediate, aggressive treatment from a provider who specialized in eating disorders, adolescents and males. We got that at Kartini Clinic. WR since 5/11. 2017 getting ready to graduate slipping lost 8lbs. Fighting our way back.
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mnmomUSA
I don't think it's possible myself.  We removed our daughter from dance until she was at a healthy weight.  Oddly enough, she has somewhat lost interest in dance. I believe she was dancing, in part, not because she "loved it" but because her ED MADE her do it to burn calories. Others have found the same thing.

He will need a LOT of calories to get to a healthy weight.  A real lot.  And, every calorie he burns in sport is a calorie that must be made up with even more fuel.  You are working against your objective if you let him remain in sports while trying to gain weight.  

It is VERY painful to remove your child from activities.  I know that.  My D spewed all sorts of garbage at me when we made the decision to remove her from dance (on the eve of a major recital, literally).  But, it had to be done.

If your son broke his leg, you wouldn't hesitate to remove him.  The same applies now.  His body is broken by ED.  You are adding strain to an already severely compromised body.  
D, age 18, first diagnosed March 20, 2013, RAN, at age 13 Hospitalized 3 weeks for medical stability. FBT at home since.  UCSD Multi-family Intensive June 2015. We've arrived on the other side.  :-)  D at college and doing great!
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Tenacious
Agree critical to weight restore and then some before sports. Our doctors suggested no activity (no gym class at school or other) initially, minimal energy expending activities for overall well being such as easy paced yoga ok now. We told our d (14.5 y/o RAN) supervised stretching ok. She is out of previous activities. She is working with a coach for cross fit who does minimal energy expending isometric strengthening work with her once a week. We let her go only if she is in weight restoration range. She is still in hypermetabolic state. We have told her when HM state subsides, any additional activity would require additional daily energy intake. I have asked the dietitians and coaches to make recommendations for added energy, so we all know what the expectations will be when the time comes to allow exercise more regularly. Again it will be with the rule that the defined state of health be maintained in order to participate in activities. I applaud you- the fact that you are asking means intuitively you actually know what needs to be done! Be strong, it is a long journey.
Mom of d caught in RAN- diagnosis age 14y 3/2015. Inpatient 4/15 CBT, then again 5/15, converted to FBT. WR 6/15- hovered few # in and out. Stable in high WR range since mid Nov. 2015.
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Boysmum
Hi, at the same weight and height, in February this year, my son's heart rate was affected (becoming slower) because of the malnutrition. We were told by our consultant that he had to stop playing all sports, including phys ed at school because he was at risk of a cardiac event, especially if he did anything that raised his heart rate, so no cardio at all. It was very hard on him, as he truly loves sports and is very talented. We were on weekly obs for his pulse and blood pressure, as well as weekly weighing and it was made very clear to us that he was quite unwell.
The good news is that he has put on lots of weight since then, his heart rate has improved greatly and he can now do a certain amount of sports again. It has to be carefully managed and he doesn't do everything he wants to do, and he has to eat to be able to play. If he does not eat, he is removed from the team. He also has to have a large snack afterwards, and if this is refused he may not play the next game. We usually give him a hot chocolate made with half double cream, half full cream milk, 2 scoops of vanilla pediasure and 2 teaspoons of chocolate powder, plus a muffin afterwards.
He was off sports from Feb - Sept, but was cleared to play cricket over the summer months - not a very fast paced game and it helped him to be with friends and maintain normality. Also it involves tea and cakes afterwards! That was once or twice a week. In the meantime he put on 27lbs and grew 2 inches [smile]
13 yr old son diagnosed April 2015 with Anorexia.
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mdmama
Thank you for the replies to this thread-- I am finding it very helpful as we look to the future with a newly diagnosed 12-year-old girl whose story sounds VERY much like bicycle's daughter. My girl was hospitalized for six days and released last Sunday, a week ago today, only a month after her initial diagnosis with AN. She was at home with me all last week, goes back to school tomorrow, and is going to have to give up PE, recess, and her team sport. For an athletic child, this is going to be a huge adjustment, but everyone's stories in this thread are reminding me of why she simply cannot exercise for now, or for some time to come. Thank you.

_______
D diagnosed with AN November 2015 , the week she turned 12. Gaining slowly but steadily, fingers crossed...
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alwaysvigilantCAN
Just a reminder that if there is exercise compulsion that is being pacified by sports, when you stop the sport ED may try and make your son exercise secretively, at night, in the closet, you name it, ED will try....
5 years in active recovery; With many, many days of full nutrition and closed loopholes, insight, life experiences and brain maturity we are slowly loosening the safety net
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Psycho_Mom
Hi,
Is your son gaining an average of two pounds a week? If so, and if he shows no signs of exercise compulsion or compensatory thought (and it's hard to tell if this is so, if he is exercising regularly) then sports might be possible.
If not, then no. Just no. His brain and probably his bones and muscles are being starved and damaged by this illness. Why in the world would a sport be more important than rectifying that asap?

That said, our d was able to gain about 2 pounds a week and was wr in 3 months. She sat out a term of school sports (hard), and we required her to stop all exercise esp. jogging (harder.) And after wr, we let her slowly return to basketball, beginning with a skills class 2x a week for two hours, with close monitoring of weight and state. Two years later, she is doing fabulously, with no symptoms of ed, and enjoys varsity basketball and soccer. WE emphasized that any physical activity, now and for the rest of her life, needs to be done for FUN and not for any other reason (like losing weight or "getting in shape").  It is telling that, tho she has returned to team sports, she has shown no interest at all in returning to track or cross country, activities she was also doing previous to ed. 

It was really hard to say no to something it seemed she genuinely enjoyed. Especially at a time developmentally when teens are supposed to start being able to make life decisions for themselves. But stopping sport not only helped her become wr faster, I think it also helped her understand and remember the consequences of not eating enough.  

best wishes,
D diagnosed with EDNOS May 2013 at age 15, refed at home Aug 2013, since then symptoms gradually lessened and we retaught her how to feed and care for herself, including individual therapy, family skills DBT class, SSRI medication and relapse-prevention strategies. Anxiety was pre-existing and I believe she was sporadically restricting since about age 9. She now eats and behaves like any normal older teen, and is enjoying school, friends, sports, music and thinking about the future.
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mamabear
My experience now of 5 years has lead me to the conclusion that it is best to STOP ALL sports. Your child is at a very very low weight and sports are literally DANGEROUS. Electrolyte imbalances, the heart etc- why risk that? Would you let a kid going to chemo volunteer at a walk in clinic? Why do we treat this illness differently? 

My daughter was 10 she diagnosed (5th grade). She was in many sports including a travel basketball team. We had to quit all of it. After finding her in her closet at 3am drenched in sweat hysterically crying we knew she had a severe exercise compulsion. After a month of hospitalization, she came home to no gym, no recess, no anything. We did not even let her get the mail. The kid would not get in the car without circling it 6 times and jumping in and out 5 times. She was very severe…..

But I have relationships with many in the ED world who did not have a kid who had an "overt" exercise issue- in other words, they did one heck of a good job "acting" like their sport was not tied into their Ed. But it usually always is. 

This experience has definitely taught me that we put way too emphasis on sports in our culture. We put too much pressure on kids. 
After weight restoration and on a path to a strong recovery complete with willingness to eat more to make up for sports etc- only then in my opinion should any sports be reconsidered. 
Persistent, consistent vigilance!
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hopeburch
I would like to thank everyone for the advice and sharing your personal experiences. I took a few days to process and to talk with my husband. I feel in my gut that we should stop all sports. But, that's easier said than done. I called the therapist to find out what therapy we are using and why we weren't using the Maudsley Method. She had we were using some FBT and using "Off the Cuff" parenting booklet. I'm going to research and find out success rates. She also said the reason she hasn't suggested to remove him from sports yet is because he is eating and to use practices and games as consequences if he doesn't eat appropriately. We have good days and then we have a set back. Tonight, I couldn't get him to eat a french fry from McDonald's. He cried and told me it was so hard and that I didn't understand. I'm trying so hard to keep my sanity. I called his Principal today and told her that he had some health issues and that starting in January, he needed to be removed from speed and strength PE class. She was very supportive. My son is not happy. I explained that it was necessary for his recovery. He goes to therapist and MD on Dec. 15. We are going to weigh to determine if he will continue with basketball. He has to gain weight in order to play. My son is more important than sports but it is a delicate path we're heading down. We're learning as we go. We will continue to be diligent.
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Foodsupport_AUS
hopeburch - FBT is a term also used for Maudsley method and Off the Cuff is well known around here. You may like to read this book discussion thread from the Hall of fame. http://atdthalloffame.feast-ed.org/home/understanding-ed-treatment/book-discussions-1  You can also do a search for "Off the Cuff". It works best using the Google search box at the top of the forum home page.
D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
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mamabear
5 feet 1 inch and 80 pounds is a very low weight.
I am surprised that your therapist does t seem to be concerned about the stresses being put on your sons bones, muscles, organs specifically his HEART. This illness kills people. It has the highest death rate of any mental illness.
I am not saying this in judgement- I just get frustrated by the " professional" world and their often lack of understanding of the severity of this illness and the very real threats.

My daughter was four feet 7 inches and around 68-70 pounds when hospitalized for a month. It took us 3 solid years to get through 8 inches of growth and a gain of over 60 pounds total.

I am personally of the mindset that sports should not be used as a carrot. It is like giving an alcoholic a beer. I'm not saying it has to be forever.... But many of us have been surprised after pulling out kids and getting into a recovery path that they do not want to return to the sport or at a very different level.
Persistent, consistent vigilance!
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Psycho_Mom
"I feel in my gut that we should stop all sports. But, that's easier said than done. "


This is why my moniker is PsychoMom. Because everyone including often me, thought that the way I was handling my d's illness was extreme. Stop all sports. Follow her around with a plate. Insist every single bite was eaten or yes we will be late to the event and everyone will be inconvenienced. I also required my d to get 8 hours sleep and told her if she didn't get it I woulnd't take her to school in the morning (otherwise she'd stay up late studying and stressing), and told her she could only be in the bathroom for 5 min at a time and set a bathroom timer and took the lock off the bathroom door. It's all CRAZY what you have to do to get your child well. It's PSYCHO and everyone will think you are PSYCHO and you know what:

I had to DO IT ANYWAY because my child's life was on the line and there was just no time to futz around.

Trust that gut and go with it. 

I missed the fact that your son weighs only 80 pounds. I'm not a doctor, (I'm just some psycho lady on the internet! whose child by the way is well now) has your son been evaluated by a qualified ed expert? What is his orthostatic heart rate? So sorry if you've posted these things already and I missed them.

Sports takes an enourmous amount of energy, and even more so for kids with restrictive eating disorders. Search on this site for "swimming" and there's a long helpful post, by Amoma I think, on the astounding amount of calories her d needed to do an hour of competetive swimming. Like 1200 extra per day. When we first stopped our d's jogging, she was jogging 15 minutes a day 4x a week, so only an hour a week, and she gained 3 pounds as soon as we stopped it. 

I also agree and have seen on this site over the past three years that offering sport or activity as a reward generally backfires, and fuels compensatory thought. (Compensatory thought is the thought process that goes "well, I can eat that because I jogged three miles.") It doesn't lead to any eventual understanding that LIFE takes energy and food, and that it doesn't matter what one does, one still needs to eat. It also is not an immediate reward for eating, the way getting to leave the table (and have everyone quit bugging you about food) is an immediate reward. Also, my d needed to learn that she wouldn't die (or get fat) if she didn't exercise. She was deathly afraid of sitting around. I expect your son is, too, and that fear needs to be confronted.

Anyway. You're doing great. Keep researching, follow your instincts, feel free to ask lots of questions here, and you will find the right road for your family. It's a long hard road, but a healthy happy child at the end of it. 

best wishes,
D diagnosed with EDNOS May 2013 at age 15, refed at home Aug 2013, since then symptoms gradually lessened and we retaught her how to feed and care for herself, including individual therapy, family skills DBT class, SSRI medication and relapse-prevention strategies. Anxiety was pre-existing and I believe she was sporadically restricting since about age 9. She now eats and behaves like any normal older teen, and is enjoying school, friends, sports, music and thinking about the future.
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mnmomUSA
PsychoMom tells it like it is.  Follow your gut.  Please.  Advise to let him keep doing it is probably wrong headed, even from a so-called professional.  My D said she would rather DIE than give up dancing.  Of course that's hard to hear.  Of course it rips your heart out.  Of course you feel like an ogre.  Of course you second guess yourself.  But, I did it anyway because she was far too medically compromised to risk dying while dancing, and it was a risk.  A very real one.  We don't say that to scare you, but to tell you bluntly what can happen when children with an ED keep up their sports or other activities.

My D was put in the hospital she was so sick.  Not an ED hospital, but a regular children's hospital.  She was confined to bed EXCEPT to go to the bathroom and walk a short ways in the hall to meals.  That was it.  Otherwise, in the bed, hooked up to a heart monitor and an IV.  

And, this very same daughter who SWORE that dance was the "ONLY" thing worth living for now barely dances.  She has given up lessons (HER decision, not mine).  Once she was weight restored, she went back, but her old "drive" was gone and she ultimately stopped entirely.  She now does theater, with a little dancing for musical roles.  But, nothing like the dance intensive program she was in before she got sick.  I found this fascinating since "before" she claimed it was vital to her well being.  Turns out, it was a way for her to burn calories in a  "socially acceptable" way.   And, I KNOW I'm not the only one here with that exact story, although the activity might be different...maybe it was soccer or competitive swimming or track...it's all the same.  

Just something to think about.  
D, age 18, first diagnosed March 20, 2013, RAN, at age 13 Hospitalized 3 weeks for medical stability. FBT at home since.  UCSD Multi-family Intensive June 2015. We've arrived on the other side.  :-)  D at college and doing great!
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Sotired
I think that regardless of what the doctor says sports should never be used as an incentive.its pretty likely that that stimulated his illness.it certainly did for my d.the easiest way for you and those that treat him professionally to see how bad this is is to stop all sports for a month.by the end of that month everyone will have a much clearer idea of what aspects of anorexia you are fighting-exercise compulsion,purging,refusal to eat unless followed immediately by exercise...etc.
I'm curious as to what kind of doctor would prescribe exercise as a way of treating an eating disorder.isnt it a bit like asking you to row a canoe up Rapids?whilst you are refeeding you want minimal energy expenditure.it will be hard enough (and will most likely require 24 hour supervision)to get your son to STOP exercising.my d would run up and down our stairs to 'get something she needed'.so much food is required just to get the weight back on and then allow for growth and add more.
I won't lie.you will get more than pushback-you will get RAGE andANGER but beneath it all your boy needs you to weather that and tell him compassionately but firmly that you are his parents and this has to happen for now.not forever but definitely for now.
The doctor and you will need to come up with different incentives to help him get well because exercise won't.im sorry.it just won't.
Good luck with making the hard decisions,
Sotired42
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mamabear
If our kids had cancer we would all have no issues pulling them from sports. Kind of strange when you think about it. Our kids bodies in the grips of Eds are compromised.
Persistent, consistent vigilance!
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hopeburch
I appreciate your help so much. My husband and I discuss the posts and they've helped us become more focused as a team.

The weekends seem to the hardest. Today my son wanted to go outside and exercise. He begged many times and we told him no. He ended up crying and said he was going to be fat if we took his exercise and sports away.

Of course we knew that this was his eating disorder, affectionately called "butthole" talking. I just laid with him and tried to explain that the exercise makes his ED voice louder. He was very agitated and punched walls. I saw how desperate he was to exercise. It was eye-opening.

He finally calmed down and he ate lunch. We all watched a movie together to occupy his mind.

We are just trying to keep him busy. We are also trying to have some form of normalcy for our girls. It seems our son is taking all our energy.

He told me today that his mind "gets stressed" right before he eats or if he can't exercise.

He tries to be open with us so far. I'm thankful for that. I hate "butthole" and all he stands for. I'm going to fight him with every thing I've got.

Thanks!
Keep the suggestions coming.
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Torie
Great work keeping him from exercising so you could see BH's true colors.

Hopeburch 1
BH 0

I can't remember if anyone mentioned how BH will want to wake your s up for exercise in the middle of the night - others here have taken away phone / alarm clocks and / or slept in room to ensure BH doesn't win that one.

Great that you were able to get him to eat, even after keeping him from exercising.

Always remember that it does get better. And that we're with you in spirit.

xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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mamabear
I often share this story:
My d begged to run cross country for 3 years. She ran the fastest mile in gym with only 1 boy beating her. She begged and whined and we said no.
This past fall I asked her if she still wanted to run cross country. She looked at me with this annoyed face and said " God no. I hate running. Why would I want to do that?" I said " you begged me for 3 years" she said " THAT WAS NOT ME MOM".

3 years. From 10.5 to 13.5.

She has told us many times now how relieved she was when we are with her, slept with her. Are at school with her, took her from sports, have her chocolate etc, ED wouldn't let her tell us at the time and in fact made her fight us, but SHE was in there so relieved that mom and dad were fighting for her.

Trust your gut.
Persistent, consistent vigilance!
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hopeburch
Torie wrote:
Great work keeping him from exercising so you could see BH's true colors.

Hopeburch 1
BH 0

I can't remember if anyone mentioned how BH will want to wake your s up for exercise in the middle of the night - others here have taken away phone / alarm clocks and / or slept in room to ensure BH doesn't win that one.

Great that you were able to get him to eat, even after keeping him from exercising.

Always remember that it does get better. And that we're with you in spirit.

xx

-Torie
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hopeburch
Thank you, Torie.
I do remember reading about how individuals will wake up in the night. He's been sleeping with me lately. I think he finds comfort and says he sleeps better.

He got out of the shower today and had a towel on. I noticed two carpet burns on his back. I showed them to my husband because I thought it was from doing sit ups on his rug. My son said it must have come from PE class. We are watching him closely and not leaving him alone.

I talked to him before bed tonight. He asked me if he would ever get better. I told him of course. We are all going to beat this together. But, I honestly don't know. We're scared but not showing it to him. He told me he feels like he's not getting better. Breaks my heart.

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