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

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lovemum
AN Daughter 13 -  IP for 8 months at priory Roehampton . They say weight restored and wont change meal plan - she has BMI 18.7. 
Since talk of discharge huge escalation in self harm - she has had five a and e admissions in 5 weeks and over thirty stitches in arm all together. Suicidal talk - made a ligature and no motivation to recover. Yes I know she’s not WR. So we need to get her out that’s clear but CAMHS and crisis team unsure if they can support us due to suicide risk. We were going for day patient intensive program at the Maudsley but D will not agree . Won’t leave house for a day program.  So discharge date keeps getting delayed and she stays in there with a group of self garners who are escalating and competing . She will not and has 
Never let me Supervise  showers - this is where SH has happened at home in past .ive had this fight so many times and never won. She just showers at hospital (lets them supervise)  So Does she just not shower at home? 
I know  I will get her out next week but am so bloody scared of the suicide plans  threats / escalating SH. Have already lived for weeks with sharps and Meds Iocked away but what about else ? What about string/ cords ? Will be on 24 watch - trying to share that with husband . Feel like life is closing in . I cannot live if she does not .
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tina72
It is not her decision on age 13 so you need to decide what is best. If she did not get better there in 8 months and they think she is WR at a such ridiculous BMI (you are totally right that she is NOT WR) that can not continue.
We can help you with ideas what to lock away (ropes and belts and even thick wool is great, all sharps, also paperclips and even the compasses was needed here). Take away locks at bathroom and bedroom door and lock front door and windows in first floor if you have one.
Life is closing in for some time x but it can get better when you get more weight on her.

"she stays in there with a group of self harners who are escalating and competing"
same here, my d "learned" self harm in IP and she learned a lot of other strange ED behaviour and they had a competition who was admitted at lowest weight and who has lowest BMI and who has done most secret exercising... all under the eyes of the staff that did not see anything going on there....


If she refuses to shower at the start so what. A lot of kids did not shower or did not even change clothes (you can imagine how that smells with a teenager). She will not die when she does not shower. Try to concentrate on the essential things. Food going in and safety.

Have a plan when she comes home what to do if x, y and z happens. Have a plan b and c. Get the cahms crisis team on board of possible,

How can we help you more? Does she have a meal plan and can you take most rules of IP home and run your home like an IP for some time x?
Keep feeding. There is light at the end of the tunnel.
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lovemum
Thank you for the reply. She does have a meal plan but it’s a maintenance one and too low in fats and calories. I was planning to stick with it for a few days then drop the bombshell that it’s changing. She’s been away from me for so long the trust has been compromised .the self harm is so severe. She won’t show me her arms even though I’ve been there in a and e she makes me look away. And I have because she’s ashamed and upset and she gets much more distressed if I see it. I have always been unemotional about it - practical and caring . But it rips my heart apart inside . I will go through her room and take out more stuff (already a lot gone) 
doing the whole house is harder especially as I have a ten year old with a room full of bits and bobs . I’m scared I won’t cope right now but maybe I’ll feel better tomorrow   - swas at A and E waiting for her stitches till 6am. Thank you fir the support I’m going to need it x 
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Ellesmum
When she gets home can you have her sleep with you, for both safety and comfort, in fact I’d insist on it.  As for the meal plan can you calorie load that, she clearly needs a lot more nourishment but in this fragile state by stealth might be best for now, we can help with that.  

You’ll obviously sweep the house for clear dangers, lock up meds, bleach and so on.  I’m not clear if she’s on medication, if not there are things you can buy to aid sleep, we’re prescribed an antihistamine which works well but it is available OTC, CBD oil also helped as does a weighted blanket for both sleep and anxiety. We had self harm but not as severe as yours, some people make a safe space to punch pillows and kick things in safety to let off steam.  
Certainly it’s a good idea to remove the bathroom lock, I had a stinky kid for a while but for a long time when she did start washing I had to limit the time and have her talk or sing and keep the door ajar as she’d exercise and take cold showers, this way I could detect the steam from hot water. 

If you need ideas to bump up her meal plan let us know, I still make ‘magic’ porridge sometimes if d needs a boost. 

Sending strength x
Ellesmum
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teecee
Sending you lots of virtual hugs. 
We had suicidal ideation here last year which necessitated us taking it in turns to sleep with her (no sleeping actually done). We had a joiner put a substantial lock on a cupboard where all sharps, medicine, cleaning products sat (and mostly still do). 
Unfortunately life stopped for a few months as we chose to hit it hard and supervise 24/7. We got kick back re sleeping etc but she had no choice (16yr Old D). 
Life is a lot different now - she is doing A levels at college with no trips to A&E in last 12 months. 
It WILL get better for you...hang in there for her.
Priority is getting food in to her and making sure you get a small window of opportunity in the day/week to have time for just you. You need to stay well to be able to help her. I know how easily our own health can suffer when we take the eye off the ball and that doesn’t help anyone. 
Take care and know that she will not be able to remember much of the crisis in her life in 6 months so don’t beat yourself up if things don’t go well initially. There will be lots of ups and downs. 
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blondie
Could CAMHS help you get her IP somewhere that might be able to give her the 24/7 care and attention that she needs right now? My concern is that having her at home would put a huge amount of stress on you and your family - especially your son. I believe there are a few places in London that have both a PICU and EDU and so may be able to handle her ED as well as her self harm
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tina72
lovemum wrote:
Thank you for the reply. She does have a meal plan but it’s a maintenance one and too low in fats and calories. I was planning to stick with it for a few days then drop the bombshell that it’s changing. She’s been away from me for so long the trust has been compromised .the self harm is so severe. She won’t show me her arms even though I’ve been there in a and e she makes me look away. And I have because she’s ashamed and upset and she gets much more distressed if I see it. I have always been unemotional about it - practical and caring . But it rips my heart apart inside . I will go through her room and take out more stuff (already a lot gone) 
doing the whole house is harder especially as I have a ten year old with a room full of bits and bobs . I’m scared I won’t cope right now but maybe I’ll feel better tomorrow   - swas at A and E waiting for her stitches till 6am. Thank you fir the support I’m going to need it x 


A maintenance meal plan is ridiculous and you are right, more fats and calories are needed.
Why not have a new MP from day 1? It might be easier to say "this is the new meal plan at home now" but to change it after some days...
Here the meal plan from hospital was ridiculous low too and I made a new one before she came home and just said to her "the experts told me to stick to this new meal plan" (to be honest - the "experts" were all the others on ATDT 🙂). She never asked who the experts were...🙂

If she won´t show you her arms and is ashamed I can understand that but that is not possible at home. She must accept that you check her body for new self harm marks regularly or the GP must do it once a week. Somebody needs to do it.

Go through her room at least twice (you will find something to use for self harm with every round you do). Ask your younger son to check his room for this with you together, too. He is not that young that he will not understand and I am sure he will not see her using something from his stuff 🙂...

Do not forget the garage and the chemicals in your house. Not only chemicals for cleaning up but for the car and for cosmetics (like nail polish remover).

Supervise her 24/7, organize help from family and friends with that, keep the bike locked and the house locked and have a tracking app installed on her phone (most kids that run away take their phone with them). You can also lock away shoes if needed, its interesting but kids run away very rarely on socks.
Yes to sleeping with her, remove doors if she tries to barricade, yes to a weighed blanket and some sedative meds so she can sleep at nights.

And lock the car doors while driving. There was more than one kid here that tried to escape out of a moving car or at a traffic light. Best is to have another adult with her sitting in the car if possible. They do really strange things in this state...
Keep feeding. There is light at the end of the tunnel.
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