Saturday, January 28, 2012

Blessings

N is getting ready to have a special blessing in the next few days. Several months ago, he decided that he wanted it and that he was ready. This blessing is similar to the ones that Jacob gave to his sons. [You can read about these blessings in Genesis 48 and 49.]  It is similar to a blessing of health or a father's blessing, but this type you receive only once from a specially-ordained patriarch with the priesthood. The blessing is recorded and you get a copy. Think of it as having your own personal guidance from God. It has been a wonderful few weeks as N has been thinking ahead and looking forward to this blessing.

Talking about the blessing has opened up a very productive discussion between us.  N has been so cynical lately.   He has been letting himself become defined by the discouragement and depression that he often experiences.  He has been exploring some edginess and darkness that I have been concerned about.  It's that part that could easily descend into drugs or alcohol if he let himself go. 

Anyway, I mentioned that I thought he was letting his struggles define him.  I talked about two different people with cancer - both experiencing horrible pain and trials.  Yet each person still able to decide (even if in only small ways) how they will respond.  I reminded him that he is not anorexia - he is not depression.  Yes, these are real and painful illnesses that he has - but they don't have to define him.  We contrasted that with this blessing that he is getting.  This blessing is all about who N is and who he can become.  It is about hope and looking forward to the future. 

In midst of this conversation, I saw N's eyes open wide.  It was amazing to see him realize that he could choose hope instead of despair.  In fact, he even said, "but I've been doing this (despairing) for so long, I'm not sure I know how."  It was a huge turning point.   I could see a new enthusiasm about the future, which was so wonderful.  We did remind him that hope doesn't eliminate trials or pain, but that it can change the way that you look at each day. 

Now - to help him implement hope into his life instead of despair.   I realize that change isn't easy and will be hard to conquer when depression is constantly trying to deprive him of any hope.  He already prays regularly.  I know that gives him peace and comfort.  We're going to try a gratitude journal, where we list things we are thankful for every night.  It won't solve the problems of the world, but I hope it can help him change the way he looks at things. 

Tuesday, January 17, 2012

Mystery Illness Baffles Doctors

I was amazed to read this story this afternoon. My initial thought was PANDAS. Someone else suggested Sydenham's Chorea, which I looked up and read about (similar to PANDAS but has more latent time between the strep infection and onset of symptoms). As I read about Sydenham's Chorea and the mention of connections with strep/rheumatic fever as well as OCD behavior, I keep thinking that all of this is somehow connected to and similar to the development of anorexia.

I am flabbergasted about how the doctors have just brushed these girls away and called their reactions, "stress." Sounds like similar things we've all experienced with doctor's flawed reactions about and the subsequent flawed treatment of anorexia.

http://todayhealth.today.msnbc.msn.com/_news/2012/01/17/10173998-teen-girls-medical-mystery-baffles-doctors

http://en.wikipedia.org/wiki/Sydenham's_chorea

Therapist

Like I mentioned before, we scheduled a visit with N's therapist once we knew he was struggling again.  At the point that we finally got in, N was doing significantly better.  The visit was productive and we got some suggestions for helping him deal with stress, responding to threats of suicide, and managing his depression.  The doctor suggested meds again, which we are still reluctant to use because of the increased suicide risk for some kids. 

N has cycled back into a low - but not as low as before.  We are managing things better with him and the reminders from his doctor seem to help.  Food is really not ever an issue for him anymore.  But there must be lingering damage from damage done when he was malnourished or simply from something that harmed his brain.  He is often depressed.  We need to set up another appointment.

It's interesting to me that he is choosing friends that are also dealing with depression.  2 out of 2 is pretty consistent statistics.  I think they relate to each other well, but they can also enable each other. 

Tuesday, November 15, 2011

Suicide

N is talking quite a bit more about suicide again.  It started with a friend that made him angry.  N wanted to lash out at this friend.  At the same time, N's health class tackled the topic of suicide.  The teacher was talking statistics - something like 30% consider suicide but only 17% have a plan.  N was angry with the discussion.  He described comments made by the other students, but that "they don't really know how it feels."  And "I'm one of the 17% with a plan." 

This was all poured out to me in the car as I drove him to a friend's home.  I've always heard that suicide is a cry for help, so I told him that and asked "how could I help?"  His response was that just by listening and taking him seriously I was helping.  I could tell he felt better after our hour-long conversation.

A few days later or earlier (I can't remember now), I had been telling my husband the story of one of my high school friends who shot herself in the middle of an orchard.  We knew she had been talking about suicide.  We even knew she had a gun.  But she had been talking about it for so long, that we really didn't take it seriously.  I asked my husband, "why didn't we tell anyone?"  I can't believe we didn't do anything about it.  (Actually we did tell some adults, but they didn't really take her seriously either).  We tried to talk her out of it and we tried to love her, but it wasn't enough.

Anyway, as I thought about this past story, I wondered why I wasn't taking N more seriously.  No, I don't think he is suicidal, but I do think that he thinks about suicide.   And I do think that he needs some additional attention - and to be taken seriously. 

So, we've made an appointment to see N's therapist.  It's been two whole years since we were there last.  I talked to the doctor briefly enough to ensure that this would be the best place to take N.  I like that they have a past relationship and that Dr. R gets that anorexia is a major complicating factor and/or cause.  Dr. R did recommend getting N onto an antidepressant.  I'm reluctant.  I'd rather tackle the issues than throw meds into the mix - especially where suicide is an increased risk with some antidepressants.  But I'd do it to save my son's life.

My shoulder's ache with the constant heavy worry about N.  It never stops.

Wednesday, November 9, 2011

November Update

N navigated though the health class unit on weight, calorie counting and eating disorders successfully.  He was excused from class for about 4 periods.  He started to write a personal essay about his own experiences, but found that it dredged up too many emotions and he couldn't finish.  Instead, he worked on a project about image manipulation by the media (air brushing, etc.) and the harm it does by promoting unrealistic bodies.  He wrote a poem as a part of the project. I'd like to post it, but need to ask him first. 

N did surprise me near the end of the term (when he was back in class) by doing a news-article presentation about a "beauty" queen who lost weight and then won a pageant.  I was particularly surprised when he described finishing the report and then turning to the class and saying, "but they're wrong!"  He continued talking about loving your body regardless of shape or size and that it shouldn't have matter how much she weighed.  Good for him!  I emailed his teacher and asked about the class response.  She replied that she didn't think anyone was paying attention.  Darn.

Generally N is doing well.  He has some friends that he really enjoys.  They are good kids who make good choices.  However, N would forgo doing his homework in order to hang out with his buddies.  It's been a struggle for us to decide - when is N being a typical teenager? and when are things like the OCD, anxiety, and the anorexia complicating things and we need to give him some allowances?  I would say that he mostly cares about making it through the day and doesn't care much about his school work at all.  We've got to help him find a balance between managing his stress and avoiding stress at all costs.  Right now I think he manages it by simply avoiding everything that is stressful. 

I've been a bit surprised lately to hear him ask questions about drug use.  One day it was a dream about heroin.  A few days later, a question of "what if I smoked marijuana?"   It reminds me of some of the conversations we've had about suicide.  I can't tell if he is just trying to shock me or is worried about it.  We've talked some about it and I tend to think it is more the shock factor, but I have read about individuals with OCD that deal with their anxieties by exploring outcomes and possibilities and I've wondered about that possibility. 

I realize that as soon as I say that I don't think he is doing drugs, many of you will call me naive.  However, he is mostly home or at his friends home.  I'm 99.9% certain that it just isn't happening.  We don't drink or smoke ourselves and neither do his friend's parents.  I know these are common escapes for kids who are struggling with eating disorders and if he were in any different culture, I might worry more.  I think he is just exploring the possibilities in his mind right now, but I will certainly be watching and paying attention.

Monday, October 31, 2011

Media Query

I have been contacted by a representative of NBC Nightly News with Brian Williams who is looking to do a story on boys with anorexia.  If you would be interested or willing to talk with her, please email me at nourishingmyson (at) blogspot (dot) com.  I'll send you the contact information.  You can also contact Yardena directly at yardena.schwartz@nbcuni.com.

Monday, August 29, 2011

Health Class & Weight-Lifting

I finally met with N's health teacher.  He will be excused from three days of curriculum.  One day is focused on eating disorders, the second on obesity, and the third on counting calories and more on obesity.   These are not sequential days which helps his absences be less conspicuous. 

I wondered how N's new exercise plan would change with the start of school.  He and his friend have continued to go to the gym and workout.  In fact, he has gotten out of bed at 4:45 a.m. several mornings to go before school.  This demonstrates a fair amount of discipline on his part which is both good and bad.  Discipline is good, but he was so disciplined during the time that he was most sick with anorexia.  It was more of obsessed discipline.  I'm watching carefully to make sure that the exercise doesn't return to obsession status.  They are only going twice a week at this point.   He also has a fitness class which gives him an additional 2 or 3 days of physical activity.  He has expressed happiness in his muscular arms.  I wish I knew where the fine line was between staying active and starting into relapse. 

Tuesday, July 26, 2011

Exercise

Well, we navigated trek successfully.  I loved that I was able to be there and offer support if needed.  The only time I was concerned was during an activity where rather than feed the youth lunch, they were given a 1/4 cup of flour (which is all that the handcart companies of 1856 had to eat before the rescue wagons arrived).  The accompanying doctor checked in with me right before the activity.  I was able to reassure him that N had been told about the activity (and that they would get a normal lunch afterwards).  It wasn't even an issue.

There aren't too many days until school starts (where did the summer go?).  I've already contacted N's physical education teacher and have determined that there shouldn't be any problems there.  I haven't heard from  his health teacher yet - and I've both called and emailed.  I heard rumors that one of the health teachers had previously suffered from an eating disorder.  Once again there is a unit on eating disorders.  We'll likely ask for N to be excused.  At this point I'm just worried that she hasn't contacted me - that doesn't exactly bode well for communications in the future.

Lastly, N has started exercising with a friend.  They are weight-lifting and/or running daily, all of which are fine if done with compensating calories and without obsession.  We're watching carefully.  So far, so good.

Friday, June 17, 2011

Summer

After my last post - and realizing that N was struggling again - we upped our vigilance and his eating.  As usual, the response was almost immediate.  He is doing much better. 

N finished his 9th grade school year earlier this month.  I'm glad that we made it through another school year, but his last month was pretty crazy.  Sometimes I think that N, in an effort to never feel uncomfortable (not sure if it is the anxiety or ocd), spends most of the school year in avoidance.  By the end of this past term, he was sinking.  In order to help him pass his classes, we had two weeks of late nights and much frustration on my part.  I'm glad for the summer so we can all take a breath before we dive in again.

He's already been out on his yearly church high adventure camp.  It was a good experience for both of us.  He has been on multiples successful campouts, without any food issues.  So, I missed him, but knew he'd be okay.  I send him with oodles of food and knew that, if needed, we could help him recover from any deficiencies once he got home.  Now we just have the hard camping trip (Trek) left to go.

Wednesday, April 6, 2011

Insidious

Anorexia is insidious and relentless. 

I was feeling like everything was going so well and I relaxed a little bit.  All of a sudden I start noticing the ways that anorexia is sneaking back into N's life.

It started a month ago.  J asked for lunch money and I realized that N hadn't asked me for any.  I checked in with him.  He said something like, "Oh, I don't need any.  Sometimes I don't get to lunch in time to stand in line, but my buddies give me some of their food."  I responded with a reminder of the need to each lunch every day.

Then, he started doing push-ups and sit-ups every night.  It's not been obsessive.  But he's doing them in private and won't let himself skip which concerned me a bit.  We talked about the need to be careful.

More recently, I noticed that was no longer eating a full breakfast.  He would be late and grab a glass of carnation-instant breakfast and a piece of toast as he ran out the door.  In not much time, he was only grabbing a glass of milk.

So, two nights ago, he starts following me around the house at around 11:00 p.m. talking about how big his nose is.  I know this routine with N, so I respond that he is tired and needs to go to bed.  [I always try to listen and respond to his concerns, but both he and I realize that sometimes it's just the tiredness talking and everything seems 10 times worse than it is.]  He replies with something like, "so my nose is big!"  I'm also familiar with this conversation which continues in different variations.  As he is talking, everything starts to add up for me.  I realized that not only is he tired, but he also isn't getting fully nourished anymore. 

I put all the cards on the table.  His argument for not eating:  "I'm supposed to be listening to my body and I'm just not hungry.  If I'm not hungry and I eat, then I'm not listening to my body."  What an argument!  He's right that he should be listening to his body, but we explain that he CAN'T SKIP MEALS!  EVER!  I guess this is where I see a bit of a break down with intuitive eating.  How can he eat intuitively when the anorexia can convince him that he isn't hungry?

We had a 45 minute discussion with tears.  He admitted that he has been feeling very insecure and anorexic lately, but didn't want to tell us because  he was "afraid that Mom would start making me drink cream again."  And that we "didn't need to worry."  He wanted us to wait until things were much worse before we intervened.  My husband said at this point, "that is the craziest thing I've ever heard!  We will never wait for things to get worse before we intervene because we love you too much to let that happen again."

We ended the very-late evening with a promise from N to eat lunch every day.  I am making his breakfasts again.  Yesterday I asked if he was feeling better.  Not yet.

I am convinced that the key to his future independence is in his learning to make sure that he never skips meals.   I remember the rigor and craziness of college and how easy it was to neglect my eating.  Somehow we have to train him that he can NEVER neglect his eating - even if he "isn't hungry." 

Friday, February 18, 2011

Doing Well

I realize that I have a tendency to post when things are going bad.  So, today I wanted to post because N is doing so well. 

He is back on top of his school work.  Missing assignments are still an ongoing issue, but we've found some solutions.  It was worth all the energy and worry because his spirits are back up.  He joined the 9th grade choir at the term break.  He is gaining some confidence with his singing and is enjoying singing and playing his guitar even more - especially since we canceled his guitar lessons.  It seems to be a healthy outlet for expressing his feelings and frustrations. 

Soon he'll be registering for 10th grade which also means a transfer to our local high school.  We declined a position with a university study abroad program to London in order to make sure that N could make the transition to the high school this fall with his peers.  His classes are definitely getting harder, but I feel like we've passed all the terribleness of junior high life.  He is starting to make more friends and seems generally more comfortable.  He will have a health class next year and is also required to take a "fitness for life" course during his high school studies.  I'm trying to determine how to best deal with those two classes.

N will head out on two different camping trips this summer.  I worry a lot less than I used to about his participation.  One of these planned camping trips, however, is a re-enactment of the Mormon Pioneer handcart trek.  A blessing is that I've also been asked to participate.  We'll be pulling handcarts across Wyoming on the actual Mormon Trail.   I'm thankful for my participation because I've already been able to warn leaders about potential problems in restricting food (in an effort to help the youth see how low the rations got - 1/4 c. of flour each day).  I'm already trying to brainstorm ways to help N have calories available without drawing too much attention to his being an exception to the regular food distribution. 

He is such a good kid and I love him very much!


By the way, I modified this post on wrestling today.  We're so glad that N didn't stick with wrestling!  It would have been a huge mistake.

Friday, December 10, 2010

Depression?

I frequently check in with N each night after school to encourage him to do his homework or to find out if he has any questions. Several nights ago, after multiple queries where it was clear that he wasn't even trying to get his work done, he confessed that he had been having suicidal thoughts. I discovered that he pictured himself threatening suicide in front of me. We talked for quite a while discussing specifically what that would accomplish. His comment was, "that he would get help." More prodding revealed tears, discouragement and frustration with his school work. And that he needed help.

N is extremely behind with his school work. He started to fall behind during November. We helped him do a huge push to get his work done before we headed out of town for Thanksgiving. He did it - he got it all finished. But never turned it in.

Fast forward to this week: As of yesterday, he was missing 20 assignments, had an F in Math (where he was missing 6 or more assignments), and was thoroughly discouraged. Rather than work on his homework, he would sit down in his room and draw for hours and hours. He once told me that he would rather lie on his bed and do nothing than do any work. (Is this just his avoidance of anything uncomfortable?) N is extremely smart - so it isn't an issue of ability.

As of two days ago, after a break, I sit with N at the dinner table each afternoon. He plods through his assignments as long as I am right there. If I leave for any reason, he gets sidetracked. It really reminds me of refeeding. The frustration is pretty high. Yesterday it took 6 hours to complete a little more than a single math assignment. He hasn't been paying attention and doesn't know how to do the math. So, I teach him. For the other subjects, I stay right by his side. He suggested that we cancel his guitar lessons. I think he's right -- his mental health is more important.

I'm wondering if he has some depression issues. Perhaps we need to see his therapist again. I find myself wondering which came first (the chicken or the egg?): Is he depressed and consequently not able to get his school work done? Or is he depressed because he is so far behind in school?