A little background...our daughter has been in a residential treatment center here in the US. This is her third stay (different places each time). She has been there since Oct 31, and is scheduled to start PHP next Saturday (the 17th) until Dec 31, when she will be released to come home. During her stay there she has gained about 20 lb, and has about 20 lb to go to be in the middle of her range.
I just got this email from her dietitian. Does anyone have any experience with tube feedings for nights only? She is currently taking in 4250-4350 calories a day on her current meal plan. Here is the email (of course I changed her name to Daughter):
I just wanted to check in after (Daughter)'s session today. (Daughter) attempted to discuss her goal weight once during session and continued to report resistance to continued treatment/meal plan increases/weight gain. With some encouragement she was agreeable to an additional meal plan increase. She reported quite a bit of distress related to the meal plan, mostly emotional distress but also physical discomfort. I discussed the option of nocturnal tube feedings to alleviate some of the physical discomfort. At first she was completely against this option, reporting the she's not "sick enough" for that, and mentioned concerns that her family would look at her differently. I explained to her the tube is often a sign that a patient is accepting nutrition and accepting treatment and should be viewed as a tool to complete the meal plan/continue toward recovery. I also told her that most often, nutrition through the tube is easier for the body to utilize, which often leads to quicker/easier weight gain. Even a few weeks of using the tube can make a big difference.
By the end of the session she was open to thinking about this option. I told her that she can continue to complete the meal plan orally if she prefers, but wanted to let her know all of the options. If we do use tube feeding, she would still have an oral meal plan, but the portions would be smaller and easier to tolerate. We discussed the likelihood of continued meal plan increases and the possible benefits of incorporating some nocturnal feeds. I let her know that if she chooses to have a tube then she cannot participate in fitness activities due to the medical risk, but that otherwise no changes would be made to her privileges.
I imagine (Daughter) will bring this up sometime this weekend and I didn't it to catch you off guard. Let me know what your thoughts are and if you have any questions. She's planning to try the next meal plan increase this weekend and will let me know next week if she thinks the tube is needed.