I would say that generally the reward system is working for N. He is almost regularly making it to school on time and is also getting to bed on time. His moods have also improved as a result. However, the reward is not really helping with his school work. I would venture a guess that the problems with school work are more affected by the anorexia. We'll leave that reward in place, but may have to set up a reward just for the school work later. N's school load is extra heavy right now. He is trying to get caught up, finish his homework and anticipate upcoming projects. I would be overwhelmed, too. I'm just not going to worry about it or push him. I'll let him set the pace on the school work issue.
N's calories were low yesterday. He didn't eat his lunch and was behind, calorically, the rest of the day. I suspect the anorexia will affect him more today because of it. I asked him if he had a battle with the anorexia this morning. He told he that the anorexia had been quite strong. When I asked, "who won?" He said, "me." He is getting better all the time at pushing back at the anorexia. Hopefully, he'll be able to do that today.
We received a packet of information yesterday from our local Children's Hospital. It listed all of the services and checks that will be available to us - dietitian, physicians, social worker, etc. It sounds like a true team will be assessing N at his appointment. The packet said to plan on at least two hours. The hospital is about an hour away, so it's going to be a long afternoon I'm sure.
As I read the information, I was struck with how valuable this resource is to us. I also realized how much more valuable this information would have been three months ago. N's therapist once mentioned that there is very little awareness of anorexia amongst our local pediatricians. Not only do they not screen for it, but then when parents, like me, bring it to their attention, they don't know where to send the kids. If only our pediatrician or therapist had been aware of this eating disorders clinic at the Children's Hospital, I can only imagine the time and anxiety it could have saved us.
I'm not going to do it right now -- N is the main focus of all my energy. But once he is better, I've been thinking about creating a packet that includes a list of resources and maybe some screening questions and send it to all of the pediatricians in the area. The local treatment center provides a wonderful resource for adolescent girls over 14. But there is almost nothing available for younger patients or male patients. The treatment center gave me a list of doctors which was of no help to me. They were all adult doctors that just happened to diagnose anorexia once or twice. None of those doctors had any real specialty or training with eating disorders (I know because I called them all). Maybe this is where I can make a difference. It would be worth it if even one family could find more appropriate care more quickly because a doctor knew what resources were available.