Friday, December 10, 2010

Depression?

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

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

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

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

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

No Wrestling

After all the discussion, on the day that I went to pick up N from school and take him to wrestling, he informed me that he didn't really want to wrestle. I pulled the car over and we had a long conversation about it. In the end, he said, it was about having a sport - not that he necessarily wanted to do wrestling.

I admit that I was relieved. Though I wanted to be supportive and I wanted to believe that he was well on his way to recovery from the anorexia, I still had warning bells sounding in my head. Thankfully, we didn't have to find out with such an anorexia-prone sport like wrestling. He's looking forward to possibly doing shot-put in the spring. That I think he can manage much better.

(Added 2/18/2011) - We continue to be grateful for N's decision not to do wrestling.  He sat one day after school and described the constant conversations about weight and calories by his buddies that are still in wrestling.  His friends are skipping meals in order to make weight.  Regardless of the changes that wrestling has made to combat this problem, the reality is that the obsession with weight is still there.

Wednesday, November 3, 2010

Wrestling?

Boys at age 14 are so defined by sports. It's crazy, but true. It seems like all the boys at this age dream of being pro-football players. In fact, the school counselor said that it is something like 60% of boys this age that list their planned occupation as pro-sports. It's also the main topic of conversation among boys this age. Unfortunately they can't see how UNimportant being the school-jock is once you hit college.

Because of this boy-sports-obsession, N is determined to find himself a sport. Right now, he is asking to do wrestling.

I just got off the phone with the High School Wrestling Coach. We had an elaborate conversation about the changes that have been made in wrestling "weigh-ins" over the past six years. He told me that N would have to do a hydration test, followed by a body-fat composition test. Using this data, the state wrestling committee devises a personalized weight chart that indicates "allowed" weight classes. In other words, if they felt N was at his ideal weight, then he wouldn't be allowed to wrestle at a weight-class lower than that ideal - even if he lost weight. If they determined that he was heavier than his ideal weight, then they would allow him to wrestle at lower weight classes but would require that he take a certain amount of time to get there (in other words slow, monitored weight loss instead of starving) [In my opinion, they should be careful about allowing any weight loss at all. Is their standard appropriate for everyone? Shouldn't a doctor be making the weight guidelines in consultation with the parents?]. They also don't require wrestlers to maintain weight at tournaments. In fact they raise the entire weight class by one pound each day of the tournament.

It seems like wrestling is making progress towards discouraging eating disorders - but still has a long way to go.

After this conversation, I'm less concerned with the pressure to make certain weight-classes. In fact, the coach indicated that we could request that N only wrestle in his current weight-class regardless of the personalized recommendations, which the boys usually don't see anyway. My main concern now is the constant weigh-ins. I understand that they do this to ensure fair play (wrestle someone at the same size). However, how would N respond to being weighed three times a week? Our scale is still hidden. N hasn't known his weight for three years now.

On the other hand, N is so excited about trying something new. He wants to be good at something. He's taken more initiative towards doing this then any other sport in the past. I'm eager for him to work hard and have positive experiences.

But is it worth any risk? Is it possible that we, along with the coach, could monitor him closely enough to prevent relapse?

Monday, September 13, 2010

Reaching Out

As N continues to heal, I continue to look for meaning in our journey with anorexia. One thing that I'm sure of, is that I want to help other parents know that they can and should be proactive when helping their children get better from anorexia. I want to dispel the myths associated with eating disorders. I also want to help other parents find their way to current and appropriate care that is available out there, but is often hard to find.

I've had several families contact me through this blog. Some have been a constant support for me. I think these families, like Erica (see ongoing comments) have helped me more than I've ever helped them. Other families have wanted to know where to find help. I've been so happy to hopefully save them some of the time that it took me to find the resources we used. In several cases, I'm aware that these families connected with trained therapists. Their children seem to be well on their way to getting the help that they need. Somehow that adds meaning to our struggles with anorexia. I really hope that we can alleviate more suffering than the sum total of ours.

I've also made some mistakes. More than anything, I now realize that parents need support. In one case I was quick to criticize a certain therapy approach. I never heard back from that mother. I still have concerns about the chosen therapy approach - but I now understand that she needed support as much or more than knowledge from me. I should have handled that conversation much more gently.

N having anorexia has been hard - probably the hardest experience of my life. But I have also changed and grown in ways that I wouldn't want to give up. Maybe the changes in me are the meaning that I'm looking for. Maybe there is more. It might take more than a lifetime for me to find full meaning in this trial. I'm still not completely sure how to make a difference, but I want to - and I'm trying.

Friday, September 3, 2010

Seven Days

We are only seven days into the new school year and we've already had two more hurdles.

N's new P.E. teacher offered an "optional" BMI test. I don't know what N was thinking when he agreed to do it. He said that he was "curious." N guessed at his weight (because he still doesn't know what it is) and calculated a guessed fat percentage. N protested that it hadn't bothered him, but then confessed this morning that it was causing him stress. Hopefully lesson learned.

His 9th grade Biology class did a nutrition lab yesterday. They read labels, discussed fat content, and determined which cereals and candy bars were the healthiest. N worked through the cereal page and then refused to do the rest. He came home emphatic that he (or I) needed to let his teacher know how wrong he was, that there aren't "bad" foods and that people just needed to eat a variety. I'm glad that some things have sunk in for N. I couldn't even begin to explain all of the varied nuances and approaches that can be emphasized for different medical conditions. Really these nuances are irrelevant for N right now. It's better for him to have blinders on and just focus on how HE needs to deal with food.

I sent an email off to the teacher asked for a replacement assignment and explained why this one was so difficult. I encouraged N to also talk to his teacher (but knew that I needed to be the official word). The teacher was fantastic, waived the assignment, and agreed to try and be aware of future topics that could be difficult. Besides being clueless about eating disorders and problematic approaches to health, N's teachers have all been great about adapting and adjusting curriculum for him.

Monday, August 30, 2010

Back To School - 2010

The laziness of summer means I'm always a little blindsided by the return of school stresses. My kids headed back to school this past week.

N is still doing well despite having his wisdom teeth removed and getting high-sticked in a street hockey game a week later (resulted in stitches in three different places and two loose teeth). I was surprised to see the question about past history with eating disorders come up with the wisdom-teeth procedure. I hadn't even thought about it, but he had to come fasting. They asked "would that be a problem for him?" All of a sudden I could see the implications of eating difficulties that would result afterwards too. But it was fine. They scheduled him for their first extraction of the morning. And we provided him with a lot of good soft foods to keep his calories up while his mouth healed. It turned out to be very relevant preparation as he healed from his trip to the emergency room a week later - and had to continue his diet of soft foods.

The old question of participating in a sport has risen again. He feels "so out of shape" and wants to run track. My question is how do we help him balance a desire to be active without it turning into an exercise/weight obsession? We are very encouraging and supporting parents. As we had this discussion I could tell that he wanted us to encourage and support him in his desires to be fit and was baffled why we weren't. There were some tears as I explained why we were so hesitant. There are so many ways to be active without it having to be about an ED's version of self-discipline or rigor - both of which could trigger exercise-binging. I can also see him looking to the exercise to solve some of his social reluctance. We made him aware of our concerns that he was expecting track to solve the problems for him.

So, what to do? I don't know.

Friday, April 30, 2010

Spring 2010

N continues to do so well. He is growing so quickly - sometimes as much as an inch in only a month's time. He'll be 14 next month - three years since he got sick. His spirits are high and many of the issues that we've dealt with in the past are only in the background now. He has an occasional bad day, but I see him dealing with his stress and anxiety in mostly appropriate ways. Hopefully we can help him to cement good stress-dealing habits and prepare him for leaving home at some point in the future.

J (12), on the other hand, continues to struggle. It hasn't gotten worse -- and it definitely isn't anorexia, but he is acting similarly (psychologically) in a lot of ways. He has so much anxiety. When he seems to be struggling most, I make sure to feed him well. I increase the fat and protein content in his meals. I don't know if it makes a difference, but it did for his older brother. My gut tells me that it also makes a difference for J.

It's an interesting correlation that raises a lot of questions in my head.

Wednesday, January 20, 2010

J and OCD

Well, it's been several months since I first started noticing issues with N's younger brother, J. He is the same age that N was when he spiraled into anorexia. I was concerned that J's responses were really based on his Grandmother's diagnosis of cancer. However, since then I really feel like they are not related.

J is developing OCD behavior that resembles what we experienced with N -- however there is no indication of anorexia being an issue. I feed him carefully and watch. His sudden onset of the OCD stuff last fall, however, points me back to PANDAS. And then I feel so mad at the pediatric neurologist who so quickly blew me off -- especially in light of some of the new studies that indicate there may in fact be a link.

It leaves me wondering what will happen if my boys are never able to get treatment for PANDAS (if indeed they have PANDAS). Can their bodies recover from this without antibiotic treatment?