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

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My D20, restrictive AN with overexercising, diagnosed aged 13y. D has been very ill in the past, unable to go to school for 2y- separate years. She was under CAMHS then Adult ED services. No inpatient care (though very close). We have done lots of FBT, Maudsley etc. Weight restored around 6 months. Daughter has engaged very well with Adult ED Service doing CBT-E, this past 10 months. She did her A levels last year and has a place to study Medicine in September 2019 at university 2h from our home. This year has been a 'gap year' prioritising recovery. She has had a part time job and has been rebuilding her life- her social life and sibling relationships. 
Our daughter has worked so hard towards recovery. She is looking forward to Med School and University but is very daunted about the academic work, being away from home, cooking etc. She has barely been away from home, ever.
Eating has improved but is still hard. Feelings of guilt and anxiety continue but are reduced.
She is currently keen to start uni in September. Many of her old friends have already done 2y at uni. Due to missing school she feels 'behind' her friends. Uni is aware of her illness and she will be transferred to the local Adult ED Service.
I have discussed/ suggested that she delays going to uni for another year so that she is more/ fully recovered but she is not keen. Shall I push this or allow her to go?


It sounds great that your D is doing so much better than she was in the past. She has obviously worked hard at her recovery as well as at her studies. 

It will be an enormous change for her to move out, starting a very challenging course, as well as caring for herself. The fact that she is raising this suggests that she has some doubts herself about whether she is ready for this. It is much easier to defer and move into the course later than to have to drop out part way and then get back in. At the same time she may never feel truly prepared for this. 

My D is also doing a very challenging course and like yours had several years out of school. This illness can mean they are late getting to that full stage of independence. I don't think there is any way to be really ready for this, but at the same time there are many plans you can put in place as a safety net. Things that may help include looking at if you can offer food packs to help her feed herself, you can set up a contract to help give her boundaries, you can include things like regular visits home, requirements for weigh ins, sharing information. You could also put in ideas for how to help her if she is struggling. 
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.
My d went to University last year, about 14 months WR. We had a contract with her and I would suggest you make one with your d, too.
I suspect you pay for University so you can set rules.

Our rules are:
- half schedule at the start (at least for the first 2-3 semesters), eating at home at least 3 days a week (long weekend) - here chronical ill students have the right to lengthen their schedule up to double time and I think something similiar will be possible in UK
- eating in cafeteria EVERY day she is on University (you can cotroll that when she pays with card)
- regular weighings, regular checkups at GP, we stay in contact ALL THE TIME
- weight loss more then 2 kg and not turned around within 2 weeks means she must come home for a gap semester
- she must stay living at home and chose a University that she can reach by public transport in the first 2 years at least

I hope I did not forget anything.
We told her we will pay for University, living, insurances, phone, car and everything else but she must follow these rules.

AN patients need fix rules and supervision for a long time. If your ds University is 2 hours away I would at least visit her every 2nd week with a scale under my arm and take her out to a restaurant. Then you will know wether she is o.k. or not.
Keep feeding. There is light at the end of the tunnel.
Foodsupport has given you some great ideas to consider if your d does begin her medical studies this fall.  I suggest that you put as much 'scaffolding' in place as possible and ensure that your d has great resources on hand if needed.  
Our d also began challenging postgraduate studies this past year, and I admit to some nervousness that she would be able to manage the pressure.  We definitely did check-in quite regularly by phone, text, and FaceTime, especially during the first couple of months.  Our d was several hours away by plane, so monthly 'eyes on' visits were not possible, but we did visit twice during the year, and d came home for the Xmas break.  As your d is 2 hours away, I would definitely suggest visiting regularly, perhaps every 3 weeks or 1x/month, and bringing 'care packages' of prepared food & extras with you as well.  Our d's close friends loved that we took them all out for an ice cream 'study break' while visiting.  I sent boxes of things like nuts, granola bars, grocery store gift cards, and pampering items (bath salts, hand cream etc) every month.  Our d's roommate's parents lived in town, and invited her for some family meals from time to time, and prepared food for the girls during especially busy weeks. We were so grateful for this on-the-ground support. 
We encouraged our d to reach out to student health services towards the end of the year when she was struggling with anxiety over year-end exams, and she went and coordinated some follow up strategies. 
This summer, she is part of a group coordinating practical info for incoming and continuing students, and they have prepared a document with resources for both mental and physical health, birth control, dental care, finding a primary care physician, and insurance issues. It's been a really good experience for her, knowing she is helping others with accessing services, some of which that she had to find out about for herself too. 
If your d does go to med school this year, or even if she defers for a year, making sure she has the skills, tools, and access to resources that she needs to help with physical and mental health is essential.
Wishing you all the best,
It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou

Dear Rosa,

Our daughter took some time off from college to focus on her recovery, and then went back at age 19. She was not fully recovered when she went back but after intensive treatment the illness had remitted enough that she was able to focus on classes, have relationships and a social life, and have dreams for her future and even do some traveling.

She needed more support from us than a typical kid who goes off to college needs. We did find that she wanted so badly to go and be successful that it worked as a motivator for her to try and stay in recovery and weigh enough. There were plenty of steps forward and backward though and weight loss at times and me stepping in. It was and still is not a straight line. There have also been a few times where she needed to come home for a few weeks between semesters and we did some high calorie feeding again.

Some of the safety nets we put in place included:
Asking that she stay in treatment as long as she needed to. (she is still in treatment) Right now she sees a therapist and goes for check ups with an MD who is part of an ED unit, so very specifically trained to work with patients like her.
Maintaining a certain weight for us to pay her tuition.
We also asked that she sign all the paperwork with her team so that if we needed to we could speak with them as a safety measure. 
I visit frequently, still, and eyes on visits as well as eating together are important. When I visit we do food shopping trips and go out and eat together.
I gave her a credit card which i pay every month with instructions that she can use it for food shopping and eating out, and stressed that she is never on a budget when it comes to eating. 
Recently I started sending her care packages with items which can be made quickly if she is studying a lot. Brownie mix, dried fruits, granola bars, etc.

One important thing has been that her apartment mates know what happened to her and they eat some of their meals together so she has some support at home.
I also found that maintaining a loving and close relationship with her was really one of the biggest tools in my toolbox of how to help her. When I visit I also try to plan some fun things to do together, for a treat. We text and talk on the phone often. 

Anyway, I hope for your daughter's success whatever you and she decide to do whether it is to take one more year off or start in the fall.



Dear All
Thank you so much for your wise and prompt responses, I am extremely grateful. Thank you for the practical advice and positive suggestions. I now feel more confident in supporting my D to go to uni. I had been worrying that she should be more fully recovered before starting uni.
This forum is so valuable, thank you all.
It is all try and error. It might work and it might not. Most important is to have a plan B. And a plan C....
Keep us updated how she is doing!
Keep feeding. There is light at the end of the tunnel.