Visiting Grandma

We spent this afternoon with N's Great Grandma & Grandpa. They've been aware of N's illness and have prayed with the rest of us for his recovery. At the end of our visit, she asked how N was doing. She then told me about a relative's friend that is suffering from anorexia (and later we found out bulimia).

I've had several talks with Grandma about N's recovery, the research that we've found, and the different ways of looking at this illness. But I was surprised to hear her ask about this 18 year-old girl, "Why would she do this?" I was surprised because I thought we had blasted through those old stereotypes long ago. Yet all of a sudden, I realized that all of our conversations hadn't changed those old perceptions. So, once again, I (along with my son and husband) corrected her and said, "it's not about that, it's a brain disorder." I could hear in her tone a belief that this daughter was "doing this" to her parents.

I must confess that I wondered for the first time if all the education that we're trying to spread is even making any difference.

Weigh-In

I had N weigh himself last night. He is down two pounds to 116. I've been more relaxed about his calorie intake (which in some ways is a good thing) and N is busy with friends and school and is not really paying as much attention either. I've got to stay on top of things. Christmas is a good week to get back those pounds, hopefully without much effort.

Measure-In

I measured N the other day. He has grown so much since February. He is now 5' 1 3/4" -- just 1/4" shorter than me. :o)

Fears of the Future

Lately I've been thinking a lot about how having anorexia will affect N's future. I hear stories of many who have beat the anorexia and have moved on without looking back. Still, I watch him now, doing so well, yet still fighting the triggers. Will that happen his whole life or just through his teen years?

I also hear of set backs that happen as children begin college or move out. How will he do when he starts school? Because T is a college professor, we receive a tuition benefit. Hopefully that keeps N close to home where we can keep an eye on him. We've always been big advocates of the importance of living at college, but will that be the best for him? Will he be better off living at home?

N has a goal to serve for two years as a volunteer missionary for The Church of Jesus Christ of Latter-Day Saints. Typically, missionaries live in less-than-idea conditions. Often they are sent to foreign countries and these 19 - 21 year-old boys work hard! Not only do they teach people about Jesus Christ, but they also serve the people wherever they go. My already skinny husband lost a lot of weight when he served a mission for two years in South America. How will that affect N? Will he even be able to serve? Or will he be kept in the United States because of the anorexia.

What about military service? N recently discussed the possibilities of joining a ROTC program during college. Would they even take him? What if he went to war? War time conditions would almost absolutely result in weight-loss which we already know is a trigger. I worry that he wouldn't survive a relapse of anorexia in those conditions.

What about the lingering OCD issues? Will they stop him from being all that he can be? And mostly, what about a family? Will anorexia triggers always have to be a concern for his wife?

So many worries! Do any of you know (or can predict somewhat) the answers to these questions?

Happy Thanksgiving!

I just wanted to mention how thankful I am for the progress that N has made over the past year. I'm thankful for all of you and your support throughout the journey. I'm thankful for Dr. R. and the fact that he is the really the perfect blend of family and patient support (since we haven't been able to find a Maudsley therapist). I'm also thankful for Laura Collins, her advocacy and support as well as the forum she created (http://aroundthedinnertable.org) that I credit with saving us. I'm also thankful that Heavenly Father has blessed us with a full measure of support and his spirit during this time -- and also his son, Jesus Christ who has already carried this burden.

Weigh-In

I forgot to mention that a trip to the doctor's office a week ago Sunday, put N's weight at 118 lbs.

On The Big Screen

How do you feel about yourself when you see yourself in a family movie? Yesterday, N made a movie for a school assignment. The "I look so fat, my hair is stupid and my voice sounds funny" ended up being a trigger for him. He was cranky and disrespectful last night and this morning. He also cried for several minutes about all those anxieties unearthed by seeing himself on tv. I tried to reassure him that almost everyone feels that way when they see themselves on the screen. He didn't believe me.

Though it was a bump, N hasn't had a bad day since he skipped breakfast back three weeks ago. He did have an appointment with his therapist last night. We discussed the idea of fasting again. Dr. R. just indicated that as long as fasting is a trigger, then N can't do it. I suspect that will have to be something that N will have to be aware of throughout his whole life. N also discussed land mines that he has encountered as well as what to do when he becomes desperate and ravenous. Dr. R. said that N should keep up his blood sugar -- little meals constantly. I'm just not sure how to work that into his school day. I've not been sending snacks and apparently I need to resume.

One Year

It was one year ago that I discovered the forum, Around The Dinner Table and consequently learned about the Maudsley Method. N's weight, morale, and behaviors had been declining until on November 11, 2008 when I began applying the Maudsley Method to our approach. The results were almost immediate. T, upon returning from a family trip, and who hadn't seen N for several days, said the difference was stark. It was one year ago that we first found hope. Without the forum as well as the Maudsley approach, it's hard to imagine where we would be today. I remember N's therapist stating that we needed to think of N's recovery in terms of months and years instead of days and weeks. That was such a scary prospect. What a difficult and yet amazing year it has been. We've come so far!

Recovery

N is doing great. We seem to be in the middle of a good spell. I find myself rarely thinking about the anorexia and our family feels so "normal" right now. I think we've finally reached the point where I can say that he is officially in remission/recovery. N still has bad days, but there are more good ones now.

Skipping Breakfast

Getting up on time isn't a characteristic that N has developed yet. Last Sunday, he was planning to join his youth group at a local developmental center (for older patients) to present a sacrament service. Unfortunately, he didn't get up at 6:00, 6:20, 6:40 or 7:10 when he was reminded. I think he stumbled into the shower at 7:25. He asked me to drive him to our church at 8:00 (he was supposed to be there at 7:30). After I explained that they had already left him, I drove him to the center and he eventually found his group.

Well, in the process he skipped breakfast. It's amazing to me how much of a difference that missing one meal makes. They didn't get back until almost 12:00 and we were in our own sacrament service by then. So, he ran home and ate and then joined us for Sunday School. But by then, the anorexia was extremely strong and overall it was a long day for him and us. He fought low self-image and eating issues all day long. Monday morning was better, but still difficult.

On the first Sunday of each month we fast (don't eat) for 2 meals. We donate the cost of the meals we would have eaten to feed the poor. N was instructed immediately after he was diagnosed with anorexia that he could no longer fast. I've been wanting to ask if he might be ready to try fasting again, but now I know the answer. I won't even ask. I wonder if he'll ever be able to fast again.

Camping

N went camping last Friday night. He has done so well that I didn't reiterate any concerns with his leaders. I think we're to the point that we may need to manage things from home now. I sent him with a good dinner and some candy bars to supplement, if needed. I think dinner was fine. For breakfast, however, they fed the boys donuts, soda, and Doritos. For lunch he had a Slurpee. He came home starving, but candy-bars in hand that he hadn't eaten because he was so sweetened-out. I guess I need to find some portable, dense-calorie foods that he can eat in a situation like that. Any suggestions? I sent an apple, but I think even the idea of eating it was too sweet.

Grades

N finished his first junior high quarter on Friday. His grades were all As and one B. Fantastic! Last year his grades fell as he became ill with anorexia and he primarily got Fs. Those grades seem to correlate with his recovery. In May, I was already seeing him care more. It seems we've come full circle.

He is the kind of kid that is capable of getting all As. But actually, I'd rather he didn't. I feel like it would be better to have a no-stress, easy-breezy attitude about grades. Instead we've been working on turning in all of his assignments. He finally earned some incentive money these past two weeks for having everything turned in. In order to keep things low stress, but still have him working towards something, I rejected goal-plans that were punitive. It seems like a little bit of money was just the carrot he needed.

Two Steps Forward, One Step Back

I got ahead of myself last month with all the great progress that N made. The anorexia/ocd stuff was impacting his/our lives very little. Since my last post, N has continued struggling. It's not anything like the struggles of six months ago. It's constant yet manageable. He is looking in the mirror more, obsessing about his outfits each morning, and debating in his head about anything that he eats.

I took him shopping yesterday for new church pants. I'd like to tell the marketing person that came up with the term, "husky," a thing or two about how that term ruined my Saturday. The size 14 AND 16 waists were too snug. Size 18s were too long. So, that left us with the "husky" sized pants. In my opinion they should call the three waist sizes, way-too skinny, too skinny, and regular, instead of slim, regular and husky. N's weight is great, but to associate the word, husky, with his current shape was devastating. If only I could have pre-bought the pants and cut out the tags. I had no idea what size he was, but that's what I'll do next time!

All throughout N's recovery, he has always taken a few steps forward and then a few back - always gaining some on those steps forward and never quite declining all the way back with the steps back. I guess I thought that he had made enough progress to no longer have those steps back. At least now I understand that continual progress means he'll do even better in the future and likely won't ever be this bad again.

Watching Carefully

Last night I overheard T asking N if he was restricting. I still haven't found out what that was about. I did notice last night that he was acting extremely self-conscious. This morning, with plenty of time to get ready for school, he couldn't decide what to wear. He worked it out, but pushed himself up to the last minute. He has pared down the shirts he is willing to wear, to about four. Everything else is too little, too big or "fits me weird." He also was going to grab something for breakfast and eat on the run. I let him know that that would never be an option.

All of these things are little clues to watch carefully. I'm not sure what is happening, but these are the moments when my job is to prevent any possible relapse.

Weigh-In

N weighed 113 lbs with his clothes on last Sunday. I let him see his weight. I'm not sure if that was a good thing or a bad thing -- but I thought he might be ready.

We've been talking to him specifically about his OCD stuff. He tells me that things are better. So, what is better? He said that instead of having 50 different OCD things, he now only has 4 or 5. One of remaining OCD things is the way he walks to school -- always stepping onto the north side of the driveway (I'm not sure all the intricacies involved). But I said, "Cut across the grass!" He hesitated, smiled, and trotted across the lawn. I can tell that he is winning more of those battles.

He attended his first junior high dance last week. He was particularly picky that morning -- I worried that it was anorexia, but maybe it's just normal 7th grade anxiety. He didn't dance with any girls -- said he almost got the nerve, but then the dance ended. He also attended a football game with dad and some neighbors. He told me that he "felt anorexic." I pried, "what does that mean?" He responded that he felt fat and very self-conscious. We talked about how every other 7th grader in the world probably feels similarly. But then he clarified that it made him ALMOST not have a snack. There's the danger - the restricting. But he was okay. Good deal.

Weigh-In

I weighed N yesterday. He is a little over 112 lbs. Overall, we haven't seen the anorexia for a while now. I did find out that N was skipping lunch on his P.E. days. I nipped that right away. He said he was concerned that eating lunch would make him sick in P.E. if he played hard (he has P.E. right after lunch). It doesn't seem like he lost any weight because of it. But he was ravenous as he walked in the door from school. In fact, he was a little irrational and cranky as he inhaled all the food in our house -- it's what made me ask if he'd eaten lunch.

He broke his wrist two weeks ago. He tripped while running in the halls at school. He has a compression fracture. He was cleared for soccer, but not a lot of P.E. activities (like volleyball and basketball). I'm okay with that. We're easing into his exercise slowly. His wrist reduces the amount of exercise he gets each day. I think that's better overall. They didn't put a cast on his arm, but he has to wear a splint (wrist guard) 24/7 for a month.

Dodging the Land Mines

My son is working on becoming an Eagle Scout and has to pass off the Personal Fitness Merit Badge. We're having to make some modifications because of my son's struggles with anorexia.

Anyway, I spoke with the merit badge counselor today. He is a professor of exercise science. He was willing to work with us, but I could tell that he had preformed ideas about anorexia and maybe thought I was a little crazy. I've had that same response from others with medical/professional backgrounds. [It's also possible that I'm just reacting defensively.]

I guess I'm surprised that those most rigid in their opinions about anorexia are professionals with very limited knowledge and exposure to anorexia. I tried to educate him, but I felt like that because I'm not a professional, he really didn't think I knew what I was talking about.

In contrast, our therapist who specializes in eating disorders has admitted that he doesn't know/understand everything about anorexia. In fact our therapist treats us like we're the professionals. Our neighbor, who is a therapist at an eating disorder clinic, admitted that they come out of college with maybe a one hour class on eating disorders and that any specialization comes as they get jobs in the field (and are subsequently trained by the "older" generation who are familiar with the old research and ideas). He admitted that they don't start out up-to-date on the the current information in the field because of that. Our own therapist is a good humble man. I can tell that he does his best to keep up on current research, but was willing to acknowledge that he doesn't know everything.


Here are the scout requirements for which we've requested alternatives:

Response Questions:
#3 D) Are your body weight and composition what you would like them to be and do you know how to modify it safely through exercise, diet, and behavior modification?
#5 D) The three components of a sound weight (fat) control program.
(We've requested that he completely skip this step.)

Have your parent, counselor, or other adult take and record the following measurements:
A) Circumference of the right upper arm, midway between the shoulder and the elbow, with the arm hanging naturally and not flexed.
B) Shoulders, with arms hanging by placing the tape two inches below the top of the shoulder and around the arms, chest, and back during breath expiration.
C) Chest, by placing the tape under the arms and around the chest and back at the nipple line during breath expiration.
D) Abdomen circumference at navel level (relaxed).
E) Right thigh, midway between the hip and the knee.
After the 12th week, repeat all four tests, record your results, and show improvement in each one. Compare and analyze your pre-program and post-program body composition measurements.
(He'll skip this requirement as well.)

12-Week Fitness Program:
(We've requested that his PE class take the place of any additional fitness requirements.)

Recovery

I'm happy to report that I have nothing to report. N is doing so well. Even with the stresses of starting junior high, he has responded well. I only see glimpses of the anorexia now, here and there, but infrequently. Sometimes I'm really not sure if it is the anorexia that I'm seeing at all -- maybe it's just typical 12 year-old crazy behavior.

He has almost complete control, now, over his eating choices. I still check up on him and watch his food portions. He is dishing up his own plates at every meal, except breakfast (which I think he would skip if I let him). I'll continue to regularly check his weight.

I'm not sure about the OCD behaviors. I need to figure out if he is just masking them. Sometimes he still does things that could be OCD, but they aren't pervasive behaviors. I'm so pleased at how far he has come in just one year. Amazing!

School

Things continue to go well. N is on top of his school work -- which admittedly is almost nothing right now. But he's getting time to do it during school and typically only comes home with Algebra. I weighed him on Sunday at 111 pounds. He got himself up and ready for church on Sunday and even made it to a youth leadership meeting before. He's been playing some soccer. His stamina isn't what it used to be, but he's doing fine. The more time that passes, the less excited he is about P.E. and soccer. That's a good indication in my mind, since he really didn't like sports before he got sick.

The only bad news: I have shingles. I'm sure it is a result of the stress of past few weeks -- scout camp, starting school, and T going out of town.

Visceral Memory

This morning, N got hung up on choosing his clothes for school. It was like a throw-back to months ago. I had to run his brother to school, but asked T to help him. By the time I got back home, both N and T were gone. I called T on his cell phone and he reassured me that everything had come together rather quickly after I left. N had emerged rather quickly and asked T to drop him off with his friends who would still be walking. I was glad that his goal was to catch up with his friends and not just to get to school on time.

This is progress. However, it took me a while to calm down. Apparently I have a strong visceral memory of the struggles of the past year. My shoulders tensed up almost immediately as I saw N struggling with his clothes (and potentially being late) and J asked me why I was breathing funny (big sighs) while driving him to school. It's been almost 5 hours since N headed off to school, but I can still feel the tension from this morning in my muscles. He's okay, but I'm not sure that I am.

Update

N came home with a smile on his face. He kept his same Algebra teacher -- just changed times. They moved his Study Skills class to a different time and teacher. That's it. No more changes for this semester, anyway. Whew, what a relief! I think this change is manageable for him. He'll actually attend Algebra tomorrow, so it's almost like he didn't miss anything (except for a no-big-deal study skills class). He laughed about going to a Spanish class instead of German. And he told me tonight that he really doesn't want to do soccer. These are all good signs -- it reminds me so much of the child that we lost a year ago.

He is doing so well!

Algebra

Boy, I have such mixed feelings about this. I just got off the phone with N's 7th grade counselor. She wanted me to confirm that changing from Pre-Algebra to Algebra was okay with me. I wasn't sure if N would actually go through with the class changes, but obviously he did. T and I talked about it and agreed that we thought he could do it. But it was clear from talking to the counselor, that it would require moving other classes around again. She was going to pull N out of his class and work it out with him. I'm so nervous about it -- for him. It's already been so challenging for him to have such a big schedule with lots of changes from day to day. I can't imagine him having to change schedules, classes and teachers again, all so he can have Algebra. Will it raise his stress levels? I'm pretty sure it will for next few days. This is probably one of the hard parts of being a parent -- letting go and trusting N to work it out. I'll be on pins and needles until he gets home in an hour or so.

First Day of School

N's first day of school, which was actually Friday, went well. I made a very specific schedule and he was able to keep track of where he needed to be. I guess I'll keep doing that for several weeks until he get used to changing schedules. His whole demeanor was much more upbeat upon his return as compared to when he left. I could tell he was so stressed. It helped that he walked to school with a bunch of buddies (which is so much better than walking into a new school alone). He had four or five classes with friends and a good locker location. He also indicated that he wants to shift into Algebra, not because Pre-Algebra is hard -- but because his friends are in Algebra. I told him that it was up to him -- and that he needed to take care of the arrangements.

Tomorrow the real rigors begin. His schedule will only be five classes, but having been a teacher, I know that they'll start to buckle down.

Back To School Night

Last night was a doozie! First N had "Back to school" night. We spent an hour and a half at the junior high. He practiced opening his locker, met his teachers, and purchased lunches and PE clothes. The whole experience was very overwhelming -- even for me. N will have 9 classes divided between two days -- an "A" day and a "B" day. On "A" days, he has first lunch. On "B" days he has second lunch. On Mondays, he has one less class and an early dismissal time (and different lunch schedules). So, he has the potential of 4 different schedules -- depending upon the day of the week. His beginning lunch times vary from 10:50 all the way to almost 1:00. We've already manipulated his schedule in order to get ideal beginning classes as well as good teachers. I don't think there is any way to alter things so that his lunch is more consistent. He'll just have to be good about having snacks. Today, just the 7th graders went to school. He goes to all 9 of his classes. I'm anxious to hear how the day goes.

We were 30 minutes late for his first soccer game last night. This is a low-key recreational soccer team. T and I both agreed that familiarizing N with the junior high was more important than being on time to the soccer game. N is a confident soccer player and often scoffs at his younger brother's soccer team. I've been nervous because N has only played soccer during recess for the past two years. I've been worried about his self confidence once he got onto a team with more experience soccer players. And sure enough, it was a pretty big fall.

Between the Back To School night and the soccer game, I heard a myriad of self deprecating comments. They were sprinkled and repeated throughout the night. He said, "I'm a big fat slob; Everyone is taller than I am; I feel so self-conscious; and I feel like I am relapsing." Talk about a night full of triggers! We talked with him about feeling a lot of stress and emotions. We also reassured him that we would NOT let him relapse. I can tell that it will be future moments like this that we need to worry about most.

So Tired

N is still recovering from the camping trip. I'm amazed at how much he has been sleeping. He's been sleeping in for several hours each morning. I've even caught him napping mid-day. On Sunday, all of the boys his age looked like they were dragging. In the last few days, he has slept less. That's good because he starts school on Friday! We'll go back to a 6:00 am schedule. I'm not sure that I'm ready for that.

He's Home!

N got home about an hour ago. He is stinky, dirty and happy to be here. It sounds like he really had a good time -- and earned 8 merit badges. They did get rained out of their "Wilderness Survival" (build your own shelter and sleep overnight) night. I was afraid of that. He was upbeat about the whole experience, though.

He did mention that three of the boys were mean and crude, which isn't N's style. Eventually these same three boys kicked N out of their tent, which made me so sad. 12 years old is a terrible age that way. But N said he was actually happy to be moved. He was tired of their language and antics. He is better friends with the other boys, anyway.

He enjoyed the waterfront and the classes. It sounds like things went relatively well with his eating. He said that the anorexia was strong sometimes, especially when the boys were being mean or he was feeling anxious/missing home. It sounds like he had most of his snacks. There were some "skipped" or late meals along the way. That's not ideal, but he doesn't seem to have lost much weight. I'll have to weigh him tomorrow.

Mostly I'm glad to have him home. I love him and missed him a lot!

Missing N

N gets home tomorrow afternoon. I've missed him and worried about him and prayed for him this entire week. I'll be glad to have him home and hug him tight.

Phone Call

We got a phone call late Monday night from one of N's scout leaders. He was calling to reassure me that N was doing well. He said that they didn't get a chance for lunch until 2:00 p.m. (with N eating breakfast at 6:00 a.m.). A leader clued into N potentially (likely) being hungry and they made sure to pass him a candy bar around noon. He said that N gobbled it up (I bet) and had been eating well generally. I'm extra glad that we sent snacks for the ride up. I should have better anticipated a possible delay in lunch time. But all is well.

We sent letters on Monday night. He should receive them tomorrow. Tonight is his "Wilderness Survival" Merit badge overnighter (sleeps outside in a shelter he made). I'm extra nervous for that experience to go well. I hope he stays warm.

Scout Camp

N left this morning. He'll be gone for 6 days. He cried last night (was tired, nervous, scared to leave home). But this morning, he was excited.

I've talked with all of the scout leaders about N's illness. His Scout Master has a sheet outlining possible snags, as well as suggestions. I also made a chart listing three meals and three snacks for each day. The idea is that someone will mark each meal/snack that they watched N eat. Hopefully the chart will ensure that someone notices if N stops eating or isn't eating enough. There will be several leadership changes throughout the week and I was concerned that his eating could fall through the cracks. We donated two large boxes of candy bars for all of the boys (and to make sure that N gets one every day). He has a snack built into his evenings already. And he has money and instructions to buy a snack from the trading post every day.

He's been doing well lately and I don't anticipate that there will be any problems. However, that little blip last Friday made me extra concerned. I'll be praying for him. Now, I'll hold my breath and hope that all goes well.

Bad Day

It's a bad day today. N has been crying on and off now for about two hours. He blames the anorexia//can't choose clothes//can't get going. I finally got him to confess that he has a headache. I've given him something for his headache and sent him to bed. I haven't seen this kind of behavior from him for months. Is this a relapse? Or is he just temporarily sick -- which is strongly affecting his emotions?

Wednesday night, N met with his therapist. They talked at length about negotiating land mines that will sabotage his progress. The general feeling was at this point he is solidly in recovery. That was my feeling, too. Though there have been blips, they've been small and quickly taken care of. So strange to have been there on Wednesday only to feel like we've gone back in time (about 4 months worth) just two days later.

Starting school and scout camp are the next two weeks. Perhaps it is the stress of it all.

Letter to the Editor

This is N's letter to the editor:

"I was reading the article on the study that went on in Atlanta to see which diet helped you to lose the most weight. I am a twelve-year-old currently recovering from anorexia and have learned that the best thing for your body can be summed up in two words: intuitive eating, or listening to your hunger. The best thing for your body is for you to listen to what your body is telling you. Are you hungry? Eat. Are you full? Stop. I'm not saying variety and healthy choices aren't a good thing and I'm not saying to go eat entirely junk food, but listening to your body is better than dieting. If your doctor has told you to go on a diet because you are too overweight then it might be okay to go easy on certain kinds of food. If your doctor hasn't, though, then I can promise you that you can go to ANY dietitician and he or she will tell you that intuitive eating is the best choice."

Update on Mental Parity

I've been anxiously watching the progress of the Mental Health Parity bills as they have passed through the house and senate. I've been pleased that they have passed so easily. Unfortunately, the bills were not written exactly the same, so a compromise has to be worked out. So they've thrown the compromise into the Jobs, Energy, Families and Disaster Relief Act of 2008 (S. 3335). And now, even though the majority of senators and representatives agree on passing this bill, it may not pass because of all the junk that has been thrown in with it. This new act spans charity, energy, tax, film industry, education, privacy, relief, and medical issues. It is chuck full of earmarks. Here are two of the low points:

7-Year Recovery Period for Certain Motorsports Racetrack Property.
The estimated cost of this proposal is $48 million over ten years.

Excise Tax Exemption for Wooden Practice Arrows Used by Children.
The estimated cost of the proposal is $2 million over ten years.

I'm so tired of earmarks! Especially when they jeopardize legitimate bills.

Various

We're just waiting now for N's official class schedule. Then, I'll have to go to the school and make all of the class switches myself and hope that the administrators okay our requests. He'll have 9 classes (5 one day, 4 the next). Hopefully we can even out that class load.

N ended up liking his new jeans. So, I've already purchased two more pairs. Too bad he'll just beat them up at scout camp next week - but he's growing so fast and doesn't fit into anything else. He needs some new school shirts. I've only got eight days (when he's around) to fit some shopping in.

Scout camp is just days away. We've approved the menu and only see one potential problem. We're also sending enough candy bars for all of the boys to have one each day. That will take care of a snack for N. He'll have money to get the other snack that is not already provided. His leaders are preparing a spreadsheet in order to track N's eating. I've still got to prepare an "anorexia basics" sheet for them to have as a reference.

Letter to the Editor Woes

N wrote a wonderful letter to the editor this past week. He was responding to an article on dieting. He submitted it and was so excited that they wanted to publish it. However, the newspaper wouldn't accept a partial name, even under these circumstances. So, they won't be publishing it. N was so sad and cried, but understood that we were trying to protect him for so much misunderstanding about anorexia.

Physical

N had a physical last Thursday in preparation for his scout camp. We had N turn around when the nurse weighed and measured him. I was amazed that he has grown almost 2 inches in the last year (61.5 total inches). Our pediatrician walked right in and stated N's current weight - 105 lbs. Arrggh! N immediately began a long emotional tug of war with the anorexia. I had weighed N, the previous Sunday at 97 lbs. How could he possibly gain 8 pounds in four days? So, I reweighed N -- letting him watch (big mistake!) because I was sure it would show the doctor's scale to be off from ours. 107 lbs. What was I thinking by letting him watch? The next day I weighed him again: 106 lbs.

I'm still confused by such varied weights. He was 100, then 97, 104 and then 107. It's the 97 lbs that seems off. Maybe he was dehydrated that day or something. I'm glad, though, that his weight is up. I'll feel much better about letting him go for 5 days knowing that he is on the higher side. However, knowing his weight, led N to really struggle for many days. Next time, I'll have to remember to warn the doctor not to tell N his weight.

On Saturday, I took him to the store to buy new jeans and it was like a less emotional reprisal of earlier shopping trips. I did get him to bring some Old Navy boot-cut jeans home on a "trial" basis (they are a good compromise and not too tight). He wants his jeans to be skin tight - so that his thighs look thin. He found a pair at Target that were so tight. He said he liked them. Right now, though, there are groups of boys around here who wear super tight jeans. N calls them "emo." He tells me that these kids are very negative and engage in cutting and stuff like that. So, I asked him if he cared about people associating him with that kind of a group. He did care and put the jeans back. I'm so glad! My mind was already spinning with how to talk him out of the jeans. What a hard issue to deal with at the same time as dealing with his anorexia. I never want my kids to make choices because "it's what everyone else is doing." But I don't either want him to be erroneously associated with this group. I also don't want these "emo" kids to seek him out. He's so vulnerable right now. It's the last thing he needs. Sometimes you can send the wrong message about yourself by the way you dress. How do you address those concerns without making him even more self-conscious?

Junior High

N is getting ready to start junior high (in one month). I got a draft of his schedule this week and was concerned about two things. First, his beginning classes of each day are both "core" classes - history and science (they have an alternating day schedule). Second, his load is heavier for the first semester and much lighter for the second semester. My son says that he is not concerned about it, but I am. It was such a rough year last year. I'm worried about him being late to school all the time. I'm also worried about the stress of a particularly heavy load. I'm debating about how much to interfere. His counselor at the junior high has the attitude that everyone wants an exception to everything -- so she is skeptical of us (smiles a lot, says the right things, but doesn't actually do anything). We don't have a 504. I know we could force the issue if we did have one, but I'm trying to avoid having it on his permanent record.

After thinking about it for a couple of days, I decided to intervene with my son's junior high schedule. There are other accommodations that we've already made that are similarly invasive, and I decided that this was also worth doing something about. N doesn't know what junior high is like -- I'm not sure how he could make the best decision when he doesn't really have a clue. I've emailed his counselor. We'll see if she'll do anything for us. I hope so. I really don't want it to be a huge battle.

We already passed up a chance for our family to live in London for 6 months. The timing would have coincided with N's first semester in high school. We felt like it would be problematic in his adjusting into high school. It seems that stress and anxiety are huge factors with his anorexia. I'd like to keep things pretty even until he copes better -- and I had no idea where he'd be mentally in three years. It was so tough to pass up that opportunity.

Speaking in Church

N spoke to our congregation for about 5 minutes on Sunday. I wrote last week about our concern regarding his topic, "the body is sacred." We decided that it would be okay for him to speak regardless of the difficulty he might have with this topic. In the end he did really well. He wrote the talk himself and we reviewed it with him. He didn't seem nervous at all -- even though he said he was.

Our church has a health code based on a modern-day revelation called the "Word of Wisdom." You may have heard before, that members of our church have statistically longer life-spans than the general population. Anyway, this health code talks about not drinking alcohol, tea or coffee, as well as choosing whole grains and other whole foods. It also talks about the importance of taking care of your body and treating it like a temple. N talked about the Word of Wisdom briefly and also covered some additional topics as discussed by our prophet. His talk didn't in any way engage the anorexia. In fact, I thought it emphasized many good principles about loving our own bodies and treating them accordingly.

There were three other speakers during our Sacrament service. One discussed the food pyramid as it echoes many principles found in the Word of Wisdom. N said he listened carefully to this talk and was proud of himself for already knowing all the information. The most problematic speaker told a story that went on forever about a woman who was fat, who felt fat, and felt judged. My husband and I exchanged glances (which N saw and knew what they meant) concerning this talk. However, the story ended with the woman eventually being able to attend the temple and feeling beautiful there. She talked about realizing that God gave her a body and that for her to treat it badly or look down on herself meant she hadn't recognized the gift that her body was. She changed her whole attitude about her body at that point. We talked at length with N about this talk. Fortunately, he got the best part of the message from it. He said that God gave him his body and he needs to treat it better and not think badly about it.

If only it was as simple as deciding this. I know it isn't. Perhaps, though, this knowledge can serve as additional mental ammunition against the anorexia.

Sunday Weigh-In

Well, he's down to 96.7 lbs this morning. That could explain some of the increase in anorexic behaviors. N has done a better job of managing some of the eating choices that we've given him. However, I obviously need to monitor things a little better.

N leaves to go to scout camp in less than a month. I realize that regardless of everything I do, he may lose some weight while camping simply because of the increase in physical activity. I'm determined, though, to have him start the week with his weight solidly up to help offset any loss. I've got to get him headed back in the right direction now.

Swimming

N went swimming with his friends from his advanced-placement class this afternoon. He insisted that he was NOT going to swim -- and then then typical anorexic, "I'm too fat" etc. So I sent him out the door and said, "why not wear your swimsuit as your shorts -- just in case you decide to swim, " and "you need some sunscreen -- just in case you decide to swim," and "take this towel -- just in case you decide to swim." Well, he did swim and had a great time. I don't think he was too self-conscious. I'm glad he had a good time.

Sundays

We returned home on Saturday and I could tell that N's struggles continued. T brought N home mid-way through church on Sunday so he could eat. All of a sudden, N is very concerned about the other kids seeing him eat during church. In the past, I've taken a snack for him to eat during our Sacrament service. He specifically requested, though, that we find a different way. We've tried increasing what he eats right before church, but that has only worked somewhat. Sunday, he left early to collect cash donations (fast offerings) to help the poor. He was going to leave without even eating breakfast. I refused to let him go until he had eaten breakfast, which was a bit of a battle because it made him late (I'm actually happy that he cared about being late). He didn't have a chance to make it home before our services started - and he just met us there. I'm not sure what the solution is to this problem. But we'll probably have to continue bringing him home part way until we find a better solution.

On a different note, N has been asked to speak next Sunday in church. His topic: "The Body is Sacred." I'm not sure what to do with that. T and I discussed it last night and decided to have N go ahead and speak. We're going to have to be highly involved in the preparation of his talk. I don't think those who asked him to speak are aware of the anorexia. I think they would be horrified if they knew how difficult this could be. If at any point we feel that it is becoming a problem, I think we'll immediately ask to change his topic.

Independence Day

We went out of town for Independence Day. It was a fun weekend with my whole extended family. My parents have a fantastic blow-up water-slide and oodles of water-guns. So, my boys had a ball playing and having water-fights with their uncles. N was particularly self conscious because he was in a swimming suit. He has been particularly self deprecating about the photos his uncle took. Sometimes photographs are as bad as a mirror.

I made the mistake of not sending a "reminder" email to the relatives like I did at Christmas (or with the other side of the family a month ago). There were a couple of comments made that were real doozies. There was also an assumption made in one case, that because N's weight was back up, that he must be better. I did my best to explain the realities of the ongoing mental battle that N fights everyday. It's frustrating at times to have to continually debunk all the common misconceptions about anorexia.

A Dip

I weighed N several days ago. He had lost 2 lbs and was 98.5 lbs. I guess he isn't ready for control over any of his eating yet.

Movies

I know that N will encounter erroneous information, bad attitudes, and generally things that make him want to diet his whole life. I think he is still developing the skills, though, to process and discard those societal influences that push him towards anorexia. We've seen two movies this month that have challenged those abilities. After each movie, we had a conversation to discuss the feelings & thoughts encountered in the movies.

Kung Fu Panda
At first I was worried about this film. We hadn't read a synopsis (our bad) and found ourselves glancing worriedly at each other as the film began. Jack Black is a panda with a self-esteem issues because of weight. There are several cracks directed his way throughout the movie about his weight. But in the end, it is because of his weight and who he is that the panda succeeds. I thought the overall message was a good one. N said it didn't give him any problems.

WALL-E
Again, I didn't read a synopsis of this movie. But then again, how could a movie about a little robot have anything to do with weight? Actually, one of the main themes in the movie was all about weight. When Wall-E finally encounters the humans on the main ship they are all very obese. The movie illustrates through a series of captain's pictures that the humans have become increasingly obese over the years. The movie tries to make a strong point that if we do nothing // are lazy // are stupid // that we will all become obese. Unfortunately, it didn't make clear that the opposite is not true (that someone who is obese isn't necessarily lazy or stupid). I'm afraid is just perpetuates inaccurate stereotypes. These themes did give N issues. He kept talking about all those "lazy slobs just laying around." We've had to have two or three conversations about what is "normal" eating. We've also talked a lot about choosing to be active, eat well, and be okay with the right shape for your body.

I'm not sure the conversation is over. I've also seen an upswing in anorexic behaviours in the past day. Lesson - don't ever assume a movie can't possibly address weight. And to those of you thinking of taking your kids with anorexia to see WALL-E, you probably want to preview it first. This is probably a movie to avoid.

Weigh-In

I weighed N this morning AFTER he had eaten breakfast. So this is not a completely accurate weight, but it does illustrate his progress. He is now 100.5 lbs.

We've given him some choices in his eating, but it's not necessarily going well. He still tends to eat very little when given the choice. This morning he said that breakfast was a yogurt. I finally got off his case when he had eaten a buckwheat pancakes and some strawberries.

September Log

During June of 2008, I found an old eating/behavior log that I made while I was cleaning out the car for a trip to a family reunion. I originally wrote the log last September before N had been diagnosed or even seen a therapist. He had only been sick with anorexia for about 2 months. I originally posted the log here.

Due to resulting sequential confusion, I've moved last September's log here:
http://nourishingmyson.blogspot.com/2007/10/log.html

Genetic Connections

Well, we're back. It's been a fun, but tense week. N did really well overall. He said that he felt very self-conscious the whole time. He really looks up to his Aunts & Uncles and I think it was important to him that he look good to them. I had several ask (or just listen) about N's story, what we've learned and what is currently happening with him. I'm always happy to make another person aware of the realities of anorexia.

It's interesting to me that this part of our extended family has some eating/feeding issues. I sent an email ahead of our arrival, educating all the adults about things they needed to be aware of. Most of the time everyone was very sensitive. Yet, there were still some low moments. There is usually a large volume of weight/food discussion with this crowd and even with restraint some of that concern still slipped through. Even though the comments weren't specifically about dieting, they were often about eating too little or too much. They were never directed at N, but rather at his brothers or cousins. N also has a four year-old cousin with a feeding disorder. She is currently seeing an OT. Her mom is a registered dietitian. Food issues with this side of the family run pretty deep - even more than I am mentioning.

All of these familial food issues make me wonder again about the genetic connections to eating disorders.

Family Reunion

We're having a family reunion this week. We've changed all of our summer routines and eating patterns again. N is struggling and regressing a bit. It's tough to be surrounded with unfamiliarity and deal with this disease. We try our best to maintain his dignity. But I also take any opportunity possible to educate our extended family about anorexia. Maybe their awareness of the realities of anorexia will help someone else down the line.

Weigh-In

I weighed N on Sunday. He is up to 96.5 lbs.

I'm still struggling with getting into a summer routine. I'm also struggling with N's meals. He seems to be riding the crest of a wave right now and is doing well.

Weigh-In

I weighed N this morning. He gained 1 1/2 lbs over the past (not quite) 2 weeks. I haven't measured his height since mid-April so we remeasured him. He is now 5' 3/8" tall. He basically grew 1/2" in 2 months. No wonder his pants look short all of a sudden.

I've notice lately that weight is coming on more easily. It seemed like, at one point, it would take a month for him to put on a single pound. Now he can put on a pound in a week. Perhaps his hypermetabolism is slowing down a bit.

School and Lunch

I'm tired. My two year-old is very "off" since school got out. I think he is having a hard time adjusting to the boys being around all day. I'm also feeling a bit "off" as is, I think, N. I've incorporated a bit more structure back into our meals today, which seems to be helping N. In the past, we've all just grabbed breakfast as we woke up and got on with our day. Often we ate breakfast and lunch together, but sometimes we didn't. That worked great when N didn't have anorexia.

I hadn't realized how important that N going to school each day was to help me regroup. Some days, he wasn't at school very long. But it was enough for me to get a shower. I was always more ready for the long evening stretches because I had time to catch my breath. When the kids are home all day, I don't ever get that break. It makes for long days when the anorexia is particularly strong.

N ate school lunch during almost all of last year. He would report what he had eaten and was always very honest. We would adjust his afternoon snack if he had not had enough to eat. His eating school lunch made one less meal that I had to plan or worry about. Because he got sick right as school started, I really haven't had to worry too much about his lunches. It's a big change, now, to have to think about all three meals. N is doing a lot better. I'm not having to manage his snacks, really. In fact, I mostly just check to make sure that he has had them. But, I do feel like I'm always thinking about and planning food. I think that his eating school lunch (and staying in school) was a tender mercy for me.

Summer

It's our first official day of summer, today. I like the idea of the lazy days of summer, but I'm not a fan of kids sitting around all day watching tv. So, I've set up loose schedules for my kids. Really, they have a lot of say in what happens and when. I don't think that there are too many expectations:

*Make bed and straighten room.
*15 minutes of guitar practice.
*15 minutes of writing or math.
*20 minutes of reading.
*10 minutes reading to 2 year-old brother.
*One work assignment each day (dusting, weeding, etc.).
*Help clean up dinner dishes (sweep, clear or load).

We limit "media" time to 1 1/2 hours. So really that should leave hours and hours of free time each day. But N has already taken until 2:15 today to complete his list. Both meals have been rough. He is resisting and restricting. I think it will just take some time to set up new routines and expectations. I can already feel the tension in my shoulders.

Regrets

N and I met with his therapist last night. It took almost the whole time for us to really get at the root of N's current issues. And then our time was up.

We talked about handing over some control of food choices back to N. We're going to let him make lunch choices. I'll weigh him extra and watch him carefully. I'll go fully back to the "magic plate" approach if he isn't making good choices. We also talked about continued work on the OCD things. N says that he is doing better but the OCD is still there. We also talked about N's increasing tendency to exercise as much as he can. Dr. R's recommendations were that N only exercise if he really enjoys what he is doing -- and the second it become a chore or that he is only doing it because he has to, then he stops.

There were eventually tears, though, when Dr. R. defined "recovery from anorexia" as really liking yourself no matter what you look like. I turned to N and asked, "how do you feel about yourself?" His response was, "Well, I don't hate myself like I used to." As we talked for the remaining five minutes, it was clear that N still doesn't like himself. The strategy that we're using is to focus on the positive and say, "whatever" to the negative. We talked more about this on the drive home. He cried but tried so hard to not let me see the tears, which made me even more sad for him. I heard N compare himself over and over to all those kids in his Accelerated class. They are smart, funny, athletic, driven and talented kids who also stand out as leaders. All he sees is where he falls short compared to these other kids.

I've really waffled about giving up the accelerated options that N has for junior high. It's so hard for me to let go of those opportunities, for which he is fully qualified. But the real issue is what is best for N. Perhaps, it is for the best that he be surrounded by more "normal" kids in "normal" classes where he can feel talented to some degree and not just compare himself to the "best." Certainly, the courses will be easier.

T is convinced that "we did this to him" and caused the anorexia by putting N into a situation where his self-esteem was hit which caused anxiety, depression and ultimately caused him to feel fat and diet. It's the first time that I've really seen that maybe my husband doesn't fully buy into the genetic/biological/metabolic causes of anorexia. Is that just because he feels guilty? Should I feel guilty? All I know is that we prayed to know whether or not N should go into the ALL program. We had mixed feelings, but I didn't feel bad about it. But it doesn't matter, does it? I can't change the past. Hopefully, we'll be able to make good decisions for N's future, knowing what we know now.

Fat Legs

I should know better.

Last night I made a comment about my 25 month-old's cute, little, fat legs chugging down the hall (it's absolutely endearing!). Almost immediately, N, who I didn't know was even listening, demanded, "are you calling mine and I's legs fat?" My response: "I didn't say anything about your legs." I tried to explain that we can appreciated all shapes and sizes. But he insisted that my calling I's legs, "fat" was a comment about the fatness of his own legs. He had already made a comment earlier in the day about his legs being fat. For the most part, I've learned to ignore those sorts of things. My husband's comment was, "I can't believe you just said that."

I should know better.

Priesthood

You might have detected from some of my earlier posts that we are a Christian family. I don't talk about it tons since this is not really a blog about religion, but religion is a big part of our life and N's life. So please indulge me for a minute. It's been an important week for our family religiously.

We are members of The Church of Jesus Christ of Latter-Day Saints. I accept Jesus Christ as my personal Saviour. I believe in the bible. I also believe that because of Jesus Christ's sacrifice and because of the power of the priesthood, that our family can be a family together after death. I love my family. The idea that we can be together always is one of my favorite teachings of our church. There is a lot of confusion in the world about what our church believes and what it doesn't believe -- a lot of what is assumed and reported is completely wrong. So please feel free to ask any questions that you might have (or you can read more here). I'm happy to clear things up and won't be offended if you're confused.

Anyway, upon turning 12 years old and because he was worthy, N was able to receive the priesthood and be ordained as a Deacon this past week. This means he'll be involved in passing the bread and water of the sacrament to the other members of the congregation. He will also collect fast offerings (this money goes to feed struggling families). Our extended family traveled to attend church with us on Sunday. They were there when N was ordained. It was such a nice day and a special experience. I can see a difference in N since then. It's been a good thing for him.

He has also started attending our church youth group. I'm pleased that he is able to interact with such a good group of kids (both girls and boys). These kids are good examples of choosing the right and being kind to others. I know that N already looks up to many of them. I think that they will serve as important mentors in N's life.

With these changes, come some new challenges, though. He'll be going on a week-long camp out this summer. We're already making special arrangements for him through his church leaders. I'm also watching carefully for any additional stress or pressure.

These events have made a subtle difference in the anorexia. N continues to progress and is often eating without having to ask us for permission. I've had several people comment recently on how much happier N seems. I agree. He has his color back. He is full of energy, enthusiasm and happiness. It is such a contrast to his demeanor last November.

Wii Fit

I mentioned earlier that N's birthday was this week. N has been saving his money for months trying to purchase a wii system and he finally reached his goal this week. So, on his birthday, he purchased his wii. He's had a blast playing the wii sports program that comes with the console. It's no surprise to me that he prefers the wii over his ps2. After all, the anorexia seems to compel him to exercise as much as possible, and movement is the big selling point of the wii.

I think I knew that he would also be drawn to the new wii fit program. Again, it's the same magnetic draw of exercise in any form. I also knew that we wouldn't let him purchase the game, especially because we are already limiting exercise -- as much because of the calorie drain as because of the OCD compulsion.

I've read a handful of reviews since wii-fit's release. I was horrified to find out that wii-fit has you input your height and weight, in order to determine BMI, and then adjusts your mii's appearance accordingly. One disgusted woman described her amazement as the program made her custom-created mii (your character) "even fatter" after she entered her BMI. She said it adjusted her character to a setting even higher than those available where you create your characters. I also watched a youtube video where a man's character was made to look fat because he had a higher weight due to muscle mass. I can't believe this! There is no way I would let N buy this program now that I know this fact. It's one thing that he struggles with his own actual body image. I'm sure that any wii-fit adjustments to his mii would just mirror the body image distortion that exists in his disordered brain. How is that society has taken warped body images even to the virtual world?

Update: I read this article this afternoon. Apparently, the wii-fit program doesn't even use appropriate BMIs for children.

Sunday Weigh-In

I weighed N yesterday. He is up to 94 lbs. I'm thrilled that he continues to gain.

His behaviours have improved quickly this past week since we returned home. The past few days, though, he has eaten several times to the point of making himself sick. I want to encourage him to listen to his body, but don't want him to learn to binge and purge. I've tried to help him make varied food choices, but he seems to lean towards sweets and carbs. It seems like a careful dance to help him choose foods that will help his body and brain heal, yet to encourage him to listen to his body and celebrate the fact that he is eating of his own free will.

End of School Stuff

We've been busy with all the end of school year stuff that happens in the last few weeks of school. Today N's class danced and sang. Tuesday, it was Shakespeare. He seems to be doing well. Our routine is back completely and he responds well to that. He even went to school today with a terrible hair cut (too short). He told me last night that he wouldn't be going to school. Given his tendency to feel self-conscious I worried that he really would stay home.

12 Years Old!

We celebrated N's 12th birthday this week. I think the past year of N's life has been the longest ever for me. N was 11 years and 2 months when we first exhibited signs of anorexia. I am amazed with how far he fell in 4 months and then how far we've come in the 6 months since his low point. At the same time, I am keenly aware of the long road we still have to travel.

He ate his birthday (ice-cream) cake, but did balk at the proportions. I insisted that he "had" to eat it and then it wasn't an issue after that. He choose crab cakes, red potatoes with garlic, butter and dill, fruit salad and izzy soda for dinner. Using money he had "earned" over the past few months as well as money from allowance, babysitting, and grandparents, he purchased a wii on his birthday. I like that it is more interactive than typical video games (which have served as a good "distraction" as N has recovered from the anorexia). I think N likes that he is moving/exercising as he plays.

I've been worried a little bit about N exercising lately. We've not allowed him to exercise at all outside of school and scout activities. He is still clamoring to play competitive sports. At first he wanted to play soccer, now it is lacrosse. We've agreed to sign him up for recreational soccer this fall (it's low key, 1 hour of practice and 1 hour of a game each week). Beyond that, I'm seeing him attempt to add exercise back into his life, not sneakily, but not up-front either. While on vacation, he would always take the stairs instead of the elevator. I know that using the stairs is not a huge calorie burner, but it's the thoughts behind it that worry me. Also, our neighbor let us know that she saw N "jogging" off course as he walked home from church on Sunday.

Disneyland

It's been almost two weeks since I lasted posted. We took a long overdue trip to Disneyland. It was a nice break for all of us to get away from the ongoing pressures of home, work and church. Unfortunately, though, we weren't able to leave the anorexia behind. I wish we could have.

In fact, N's anorexia seemed to get worse while we were on vacation. I'm sure that has something to do with all of the altered routines. I realized by the second day, that N was restricting and taking advantage of our busy schedule. We had to watch him much more closely after that. We had a continental breakfast available at the hotel, but there weren't enough calories available in the selection, so we supplemented with milk and Carnation Instant Breakfast (I was thankful for our in-room fridge). It was also easy to forget about N's snacks. I forgot several times and, of course, he didn't remind me. There was also a lot of extra exercise involved with all the walking around California. But we did have some yummy meals at Disneyland and vicinity that I'm sure more than made up for all the calories that he walked off.

We all had a lot of fun. It was also nice to have T around to help with N, 24/7. We are all tired from all of our adventures, but I think are also rejuvenated some. We probably needed this vacation back in January.

I weighed N this morning, not knowing what to expect. Luckily, his weight was up to 93.6 lbs.

N's routine is back now, but some of his past week's struggles are still ongoing. We're down to the last few weeks of school. N has a major project due tomorrow as well as Shakespeare lines to memorize. It will be nice to have a summer break. Taking school out of the equation eased some of the stress this past week. I assume the absence of school-stress will also help throughout the summer.

N ate well each day of this past weekend. We were gone for a lot of hours and he had to take care of eating himself -- and he did. But at the end of each day and again the next morning, he would have anxiety about what he had eaten. He would feel self-conscious and make himself feel sick. I suspect that he is overeating slightly, but I feel like that tendency will normalize over the next while. I also think he probably needs to learn to live with anxious feelings.

More Progress

I felt like N was headed downward at the beginning of the week, but things turned around midweek and he did better than ever these last few days. I still see some of the OCD stuff here and there. But the past two days he has eaten his meals and snacks without any prodding from me! He'll check in with me here and there, but is mostly taking the initiative himself. Amazing.

Progress

Progress is still very slow. But everyday N seems to do better. Sometimes I don't recognize the progress until I go back and read past posts. N is doing so much better with homework. School has stopped being the immense stress that it was just a few months ago. He will get his homework done without too many reminders. Some evenings I find myself so surprised that he is done with his work and has extra free time.

Yesterday, N had a very scary moment. I asked him to help me with his two year-old brother. As N got up off the couch, a piece of ice, on which he had been sucking, slid into his throat. He couldn't breathe and walked towards me looking so frightened as he tried to get a breath. I was surprised to find that I stayed very calm. He knew what I needed to do, but I talked him through the procedures of the Heimlich maneuver. It took about five tries before he expelled the ice. He cried hard when I hugged him afterwards. I'm so grateful for having learned that procedure clear back in high school. I've had to use it on two of my children in the past several months.

Should I Have A Snack?

I weighed N on Sunday at 92.2 lbs.

He has continued with the OCD stuff. I can make him go back and walk down the hall straight, but the very next time he'll do it the OCD way again. I can't imagine how much energy it must take to keep track of which way he has to turn.

He is also hungry a lot lately, but about drives me crazy asking if he should have a snack. "Yes!" I say over and over and over again. He'll say he isn't sure if he is hungry or not. I'll say, "listen to your body." And he'll ask me again, "should I have a snack?" Sometimes this goes on for an hour before he'll eat. He asks every five minutes. The answer doesn't change over the course of the hour, but that's how long it takes for him to work through the all the brain resistance.

Declining

On Monday, I posted about N pushing back about eating. It was interesting to me that when I finally made my way into the kitchen that afternoon, he actually had made himself a "super pretzel" without further prodding.

N is still declining some. He got up 45 minutes early this morning to do some homework. He was completely ready for school 30 minutes before we were supposed to leave. He spent that entire 30 minutes changing his shirt and never got to his reading. He was actually supposed to go into school late this morning to accommodate a special activity this afternoon. He was so concerned about whether the other kids would be participating or not. He decided to go in during his regular time and not participate. As he realized that most of the kids would be there this afternoon, he changed his mind again. He wanted to come home and wait for the later "start" time, but I encouraged him to stay. I knew that if he came back home, he would just spend his time changing shirts. Plus, he had some homework that he could complete at the library.

I really worry about how much weight he places on what the other kids think or what the other kids are doing. He is entering into a time in his life where he'll have to make a lot of hard choices. Will he be able to make good choices when the kids around him are making bad choices? Right now I worry that he is way too influenced by other kids.

N has also started doing his OCD dance again. He is trying to hide it.

Pushing Back

N's been challenging me a bit today. He's done so well the past few weeks at eating when he is hungry. It still generally has to be my fault -- he'll just throw in a "do I have to?" He knows what I'll say. Sometimes he asks twice, but he always eats. One or twice, he has even eaten without asking. This afternoon, however, he told me he was hungry. I told him to eat. He asked if I was going to "make" him or punish him if he didn't. When I replied, "no," he came back with, "then I'm not going to eat anything." Why the need to push back all of a sudden? I've heard a bit more of the "I'm fat" dialogue lately. I get so spoiled with his forward progress. It's always an abrupt awakening when he takes that one step back.

Sunday Weigh-In

N's weight this morning was 91.7 lbs.

Distractions

Our visit with the therapist last night was very productive. We discussed N's OCD behaviors at length. Dr. R recommended a book called "Brain Lock" by Schwartz and Bevette. I've also heard some parents at http://aroundthedinnertable.org/ recommend a book called "Off The Cuff" by Nancy Zucker (Duke). I've looked for that second title and haven't been able to find it.

Anyway, Dr. R described N's OCD behaviors as a distraction. He called them a waste of time that distracts you from important stuff. He illustrated how much time and energy it took to maintain all the OCD stuff. N was very persuaded by his explanation and has already eliminated most of the behaviors. Hopefully it sticks.

Accepting and Rejecting

We've been out of town for four days, so I haven't posted. N did well with our visit with relatives. There were one or two moments when he was trying to fight me and I was trying to not make a scene. It ended well, but he and I had an intense "whisper" conversation happening in front of the family and guests.

N has had really strong OCD behaviors lately. He seems to always be substituting new things as he gets over the old ones. He told me that the anorexia pushes him to be disciplined and OCD things are one way of showing discipline. He is doing this thing right now where he turns his body as he walks. He puts his right side towards things he "accepts" and his left side towards things he "rejects." He walks into our home backwards (rejects the garbage can). He is constantly dancing everywhere we go. This is the most persistent OCD behavior yet. It affects him all day and I'm a bit concerned. We'll see his therapist tomorrow and this will be a major topic.

Hyksos Warrior

Today, N is participating in a "wax museum" project at his school. He can tell you all about Hyksos Warriors and their connections to Egypt. For that project, he was required to have a costume. Because image/clothes are sill such a big deal to him (but he is learning to manage it better), he spent probably 7 hours creating a costume for his character. In contrast, he maybe spent 3 or 4 hours on the actual report.

It just demonstrates that the anorexia is still present, but being better managed. He's been getting to school late again, but only 20 minutes on average. He is picking his clothes out the night before, which can take an hour sometimes. He's also fallen behind on some math assignments. I worry that falling behind at all will cause enough stress to bring a relapse. But I didn't want to press the issue, especially yesterday when he really did spend every available moment working on his report (which he has been working on for 30 minutes every day for weeks now).

Monday Weigh-In

I did weigh N on Monday. He is basically the same at 90.7 lbs.

Sparse Posts

The last few days have been more of the same. N's doing a good job of trying to listen to his body throughout the day. Sometimes it is a real battle, but N is winning more often than not. I forgot to weigh him this morning. I'll have to check him tomorrow.

I've noticed that I haven't been posting as much recently. There isn't as much to tell. Somethings just continue as usual with the anorexia. Mostly, N's progress is very good. I think it's probably a good sign when I don't post.

Afternoon Snacks

N's battles with the anorexia have been more apparent recently. I've wondered if he was having a bit of a set back. But yesterday, he actually listened to his body and ate well (without any prodding) during the afternoon. He still needed me to assure him that it was "healthy" to listen to his body. He also fought with all those hungry urges for a couple hours before he ate. He wanted me to trade afternoon snacks for dinner calories, but I wouldn't do it. Perhaps this is the anorexia making another stand as N continues to progress.

Also, N has been getting to school increasingly later again. I switched our morning routine today. Instead of getting ready and then eating breakfast, we had breakfast first. N was 15 minutes early to school. If nothing else, it got him moving earlier. Hopefully, we've solved that problem.

Sunday Weigh-In

90.4 lbs this morning. I'm afraid we've hit another plateau.

"Everyone" Knows (2)

I think the issue with C is resolved for now. N said that C approached him yesterday and indicated that N had indeed been correct, that anorexia is a "mental disorder." C had gone home and talked to his mom -- who either looked it up or clarified her original statements to C. Anyway, I could tell that it wasn't bothering N anymore because I had to ask him about it.

N is going camping tonight. I'm not nervous about it in the same ways I've been in the past. He'll eat fine while he is gone (or he knows that he won't get to go camping in the future). I'll also make sure that he eats well before and after. I hope he has fun and is able to feel confident with his friends.

"Everyone" Knows

N told me last night that "everyone" in his class knows about his anorexia. Apparently at lunch yesterday, one of N's friends started talking about suspecting that his sister had anorexia. N responded by saying that he didn't think she had anorexia (given the few facts that C shared). At that point, and obviously I'm missing parts of the story, C stood up and started shouting that N had anorexia. Maybe it was a joke, but N responded so vehemently that the friend immediately knew it was true.

The hardest part of this exchange, for me to hear, was the comment made by C that anorexia is a "life choice." I know this isn't true. N knows this isn't true. But way too many people think it is true. N tried to convince C that anorexia is a brain disorder, but C was insistent because that is what his mom told him. I told N that I could go talk to his class about anorexia -- "No, they'll think I'm weird." I told him some things that he could tell C. I also sent him armed with a Newsweek article (not exactly scientific, but a little more accessible). I'm not sure what else I can do. I'd like to have a loud voice that everyone could hear while I explain what anorexia is and what it isn't. I'm not sure anyone is listening.

Monday Weigh-In

N weighed 90.4 lbs this morning. This is slightly down from last week. But I weighed him after he had eaten last week. So, I'm not concerned about it.

This weekend has mostly been anorexia as usual. I did take him shopping for shorts. I timed it carefully and spend more money than I like. But I'm happy he found something that he likes. He did fine in the store. He wanted to buy a pair of shorts on the small side and I said, "no." I was really up front about him still needing to gain weight. I didn't want to pay $15 dollars for shorts he might wear once or twice. Plus, growing out of clothes is never a good thing for the anorexia.

N told me that he hasn't been counting calories since last week. I'm thrilled.

Shorts

Apparently yesterday was not the lull between the waves. This morning, N decided to wear shorts. That would have been a great idea yesterday (very warm temperatures), but today snow and storm warnings were in the forecast. He's worn the same two pair of jeans for months now. Shorts would have been a good change. He said, "I can't believe you're not going to let me wear shorts, just when I get the courage." It was terrible timing. Then ensued a 30 minute battle complete with lots of disrespectful language and consequences. It wasn't over food, but it was about the anorexia. N has continued to not count calories. He's winning the war with the anorexia on the food front. It's still a draw, though, when it comes to flexibility.

Waves

I shouldn't get so excited after a couple of days of good progress. I have to remember that recovery seems to come in waves. This week the wave seemed to peak on Monday. Yesterday's lull wasn't terrible. I let N go to a friend's house after school to complete an assignment. He ran in the door only to leave 15 minutes later for scouts. Thankfully, he didn't have additional homework. But it did mean that he missed his morning snack and his afternoon snack. So at 9:40 p.m. last night, he was fighting his evening snack, which was larger than usual because of his missed snacks. He said that it wasn't that he didn't want to eat something, but he was tired of everything we had at our house. We insisted. He fought back. After 30 minutes, he finally ate two ice cream sandwiches and he went to bed late.

I am so frustrated by his complaint. I shop so carefully and deliberately to refeed him. For so long he has only wanted predictable foods. He was willing to eat a variety of different things, so I was happy to stock those foods. Now he wants more variety?!?! And he complains! I'm not completely sure that it wasn't the anorexia trying out a new tactic. He seems to only want to eat food that he loves. I don't think he can stand to put calories into his body associated with something that tastes just okay. I also think he was a bit stressed about junior high registration today. We had been talking about that right before the problems with his snack occurred.

Hungry!

N informed me yesterday afternoon that he was hungry and asked if he should he eat. Of course! 10 minutes later he was hungry again and asked the same question. He did this all afternoon. He asked me why he was so hungry. I explained that his body needed the calories so desperately. I also explained that he was probably growing. I didn't mention that part of his extreme hunger probably was a result of him finally acknowledging that he was hungry. A huge step in my mind! Because I was sick, I slept through dinner. But T mentioned that N had been worried that he would throw up because he was so stuffed. I believe it. T also mentioned that N had fixated on the fact that he might be growing. Hopefully that doesn't backfire. It's good that he is hungry and eating, but he still needs to "blame" something for his eating. Maybe that will fade as he continues to recover.

N told me that he didn't count his calories yesterday. Two days in a row! I only saw N briefly before he left (early) to school. He was wearing a shirt that he hasn't worn for months. He has always insisted that it was too big. Hopefully, that is also a good sign.

Strep Again

Well, I'm sick with strep again. Apparently, the 10 day course of medicine didn't kill the bug. So, I'm back on antibiotics again. And I'm worried again about N. Without a positive strep test last time, it could mean that he is very vulnerable again. I'll have to watch him carefully.

Sunday went well for N. He said that he didn't tally his calories for the first time ever. He also kept telling me that he was hungry and I kept telling him to eat. Actually eating was more of a struggle, but the fact that he expressed hunger was a good step. This morning he was pretty cranky. I wasn't fully engaged with him so I'm not sure if it was just tiredness or the anorexia pushing back.

Sunday Weigh-In

N's weight this morning was 90.6 lbs. He had already eaten breakfast. So, this weight is not quite accurate.

N spent all day Saturday resisting and restricting. He wasn't angry on the outside, but I could see it simmering below the surface. He had tears several times. I tried to get him to go play outside, but he was also isolating himself. At the end of the day, T and my Dad gave him a healing blessing. I'm not sure N wanted the blessing (I'm not always sure that he wants to be healed). But I felt like, just like we couldn't wait for him to want to eat, I couldn't also expect him to want to get better/want a blessing to get better. Hopefully, I have enough faith for both of us to make up the difference.

A Second Visit to the Children's Hospital

N had another appointment at our local children's hospital yesterday. His weight was basically the same (though my scales show an increase). The team was happy that he had even maintained. They were also extremely complimentary about the role we've play in his recovery. I was surprised to hear that there aren't any other parents taking this same active role in their child's treatment.

N was honest about his ongoing anxieties with food. They explained that it often takes a while even after a child is fully nourished to have mental healing. That is consistent with the Minnesota Starvation Study, so I knew that already. We also discussed strategies as we register N for junior high. We are having to make decisions right now about his courses for this fall. It would be nice to have a crystal ball and know that he will be recovered by then. But I don't, so we have to make our best guesses. I'm concerned about his physical education class (which he wants to take twice as an elective). I am also worried about him being late for his first class. Maybe we can schedule a less important class for that first hour. Or maybe it would be better to have a class that he is excited about at the first of the day. The social worker did recommend that we establish a relationship right now with his school counselor. I had been thinking the same thing. So, I've already put a call in this morning.

In my prayers recently, I've had the repeated thought that N needs a blessing. T already gave him a father's blessing -- that's not what I'm thinking of. I think he needs a healing blessing. So, I'm going to ask my Dad and T (both have the priesthood) if they will give him a blessing tomorrow.

More Good Days

I'm seeing an upward trend with N right now. He's been getting to school more or less on time. He's also getting his homework done each day. He wants to go to school and seems to be enjoying it. I did see some hesitation in his clothes choice this morning, but the threat of missing school was stronger. He was iffy, but made it to school only 15 minutes late. We still have issues over food. He still resists eating here and there (usually when I change/add something), but even those episodes are spacing out. He might be getting to the point that he can start making some food decisions for himself. However, I'm not willing to let him do that until I see him make consistent choices with his school lunch (which he doesn't do yet).

Almost to 90 . . .

N weighed in on Sunday at 89.3 lbs. We're so close to crossing that 90 lb threshold. Despite our doctor's contentment with 90 lbs, I'd like to see N at at least 95. He is growing so fast, so I may need to revise that based on his height this week.

N had a good weekend. The only real glitch was Sunday dinner. He flat-out refused to eat. But I made something new (that wasn't fantastic). I think his refusal was less about the anorexia and more about anxiety aimed at a new food. He went to his room, thought about it, and came right back in when I invited him. He ate, but it took a while. He voluntarily ate his evening snack on Sunday evening.

Early!

Another good day! N ate well. He got his homework done. He had a good talk with his therapist last night. He was EARLY for school today!

A Pretty Good Day

I was right about N's homework being too much last night. He was in avoidance for hours yesterday afternoon. He cried and yelled and was generally upset and mad. We were having three issues simultaneously: 1) homework, 2) eating and 3) wanting to play his new video game.

N has been responding violently to his anger. He's kicked and seriously hurt his brother several times now. He'll also throw things and kick walls. Our concern has been big enough that we've banned him from any fighting or battling video games, computer games and tv until he changes the way he responds to his anger. We already limit that kind of stuff anyway. We've never allowed "M" games and only purchase occasional "T" games. We avoid all "first person shooter" games. N purchased a new game on Saturday, knowing about his current situation. He was mad yesterday because I wouldn't give in and let him play it.

After a long afternoon, he perked up in the evening. He got his homework done and spent some time on a make-up work assignment. This morning he was up early and he made it to school on time. We've had a few battles over food and some stuff (like the anger issue), that may or may not have anything to do with the anorexia, over the past few days. But overall, I feel like he has done better -- two steps forward -- this week. Is it the antibiotics?

Future Plans

N was pleased with himself for getting all his work turned in yesterday. He felt like it entitled him to a break yesterday. Having seen him fall behind quickly, I felt like that was a bad idea, but gave him the choice. Of course he pushed the homework to today. I think it might be too overwhelming tonight.

Speaking of overwhelming there have been so many decisions to make over the past few days. N wants to attend a different junior high, connected with his current elementary school. However, he wouldn't not be allowed to choose that connected high school, but instead would be required to transfer back to our own high school. We said, "no." It's a hard call, because he could use the stability of friends now. But how likely is it that he would continue to see these kids in his classes anyway? Junior high is a time when most kids have to make new friends. I feel like it would be harder to change into a different high school three years from now and have to make new friends all over again. It will probably take a deliberate plan, on our part, to help him make new friends with the new school year this fall. Plus he knows many of the kids already (even though he doesn't realize it yet) from church, sports and school.

We've also been considering a temporary situation that would take us to the UK for 6 months. It wouldn't be for several years. The whole trip would be paid for separately from T's salary. I feel like it would be a wonderful opportunity for our whole family. It is so hard to make future plans not knowing how N will be doing at that point. Will an interruption in school cause anxiety? Or might it be a needed break? Will he be so well established with friends that leaving would be hard on him? All these questions! If things are still bad, we probably would be able to back out, but they are wanting a pretty firm commitment now. All we can do is be prayerful.

No School

There wasn't any school today, which is good since my kids wouldn't have gone anyway. I'm feeling mostly better, but pretty weak.

N has had a fantastic day. He made a list of all the things he wanted to do today. He had 3 hours of homework to do (because he didn't do 1/2 of it on Friday). I helped him organize them so that things were in reasonable increments. Then he jumped into his schedule and got everything done. I really think it helped for him to see all the possibilities for his day as well as what he would loose if he just laid around. He also had a prioritized list for his homework (make-up work actually). He burned through that list so fast. We talked about objectives (to complete the assignment quickly) and how trying to do things perfectly might get in the way. We also talked about making best guesses a moving on even if he didn't know the answer. He got a lot done! I made sure to praise him and remind him of all the free time he had because of his hard work.

Sunday Weigh-In

I forgot. This morning N weighed 88.9 lbs, but he had already eaten his breakfast.

Family Strep

In the past 24 hours, 3 of us have been diagnosed with strep. This morning N's little brother was running an 104.5 degree temperature and we were quite concerned. Now, all of us are on antibiotics including N. N, actually, tested negative for strep -- though he has all of the symptoms. But thankfully, they put him on antibiotics anyway for a bad sinus infection. T never gets strep, go figure. So hopefully he stays well. Regardless, we should all get better soon.

The strep brings up some interesting questions. Has N's relapse the past few days been tied to getting sick? He confessed to me that he has been secretly weighing himself. I'm pleased that he told me, but I'm doubly concerned that some "sneakiness" has started. I'm eager to watch and see if the antibiotics (a z-pack) change anything.

Paul Wellstone Mental Health and Addiction Equity Act of 2007

I haven't talked about the problems we've had with our health coverage and N's anorexia. Our insurance isn't good about covering his anorexia. Many insurance companies won't cover anorexia because they view it as purely "psychological" even though a decade's worth of research is proving that anorexia's origins are actually biological (though there are emotional/psychological repercussions). We're lucky because our out-of-pocket costs, though costly, won't break us. We haven't had to consider inpatient services or other very expensive treatments because N is doing well with out-patient therapy. But many other families aren't as lucky and the costs are huge.

Anyway, on Wednesday the Paul Wellstone Mental Health and Addiction Equity Act of 2007 is coming up for debate in the house. It is not a perfect bill, but it makes great strides in acknowledging that many mental illnesses are indeed medically based and merit similar coverage. Paul Wellstone initiated this legislation (before his death from a plane crash) because of a little girl that died from anorexia because her insurance would not cover her treatment. That little girl could have been N. I have seen the research and can also tell you that N did not choose this disease. He wants to get better just like we want him to.

If you are comfortable supporting this legislation, would you please contact your representative and tell them to support the passage of this bill? I've included information about the bill below and links to your representatives.

Paul Wellstone Mental Health and Addiction Equity Act of 2007

http://thomas.loc.gov/cgi-bin/bdquery/z?d110:hr1424:

Paul Wellstone Mental Health and Addiction Equity Act of 2007 - Amends the Employee Retirement Income Security Act of 1974 (ERISA), the Public Health Service Act, and the Internal Revenue Code to prohibit treatment limits or the imposition of financial requirements on mental health and substance-related disorder benefits in group health plans which are not similarly imposed on substantially all medical and surgical benefits in any category of items or services under such plans.

Click here to contact your rep: http://www.house.gov/

School Work

On a different note:
We've been working extra hard, the past few days, to get N caught up in his school work. Rather than have him stay after school, he's been spending an extra 1 1/2 hours at home. I really thought he was doing better with his school work. But even though he is extremely smart, he has terrible organization skills (both physical and mental). He doesn't turn in his assignments. This is usually because 1) they aren't done (but he won't turn it in even for partial credit -- a perfectionistic characteristic for sure), or 2) he just forgets. His backpack is a nightmare. I reguarly communicate with the teacher and I also check up on which assignments are missing.

If I didn't intervene (regularly go through his backpack with him), his grades would be even worse. I've had him stay after school to finish assignments, but his teacher says he doesn't use that time well. I've even sorted his papers for him (with posted notes and everything) and sometimes he still doesn't get them finished or turned in. I'm good with follow-through. I'll ask, "did you turn this in?" when I pick him up from school. And if not, I'll send him back into the school to turn the assignment in. Even with all of that, I'll sometimes find the assignments in his backpack a week or two with post-it notes still attached. I've even walked back into the school with him to turn things in. I'm so nervous for 7th grade (next year).