November 2012 Update

Well, we survived the summer.  It was good for N to have a hard job and to learn that he can work.  He earned some money to save and some to spend.  School continues to improve.  He got all Bs and one A on his last report card.  He is a Junior in high school now and he is starting to think about college.  He took his ACT test last week with hopes that his scores would reflect his smarts.

We've had a slight change in his future plans.  I've talked before about N wanting to serve a mission for The Church of Jesus Christ of Latter-day Saints.  Last month an announcement was made which changed the minimum age from 19 to 18.  N has informed us that he fully intends to go when he is 18 now.  The original plan had been to do one year at college and then leave for two years on a mission.  I liked the idea of that first year at college.  I suspect that he would attend locally.  We would insist that he live on his own, but we would still be able to check up on him regularly (especially if he went where his dad is a professor).  I felt like that year on his own would help us determine if he would be able to handle the stresses and independence of a mission.  Now that one year buffer is potentially gone.  We'll need to talk about a lot of these details with his religious leaders and doctors.   He doesn't have to go at 18.  He can still wait until he is 19 or older, if needed.  But he wants to go as soon as possible. 

He continues to thrive emotionally and physically.  We did have one really bad 30 minutes just about two weeks ago.  N saw a recent picture of himself on the computer slideshow.  I've always kept the picture folder that the screensaver accesses dated back a few years because this was a problem in the past.  I thought it would be fine now, but I was wrong.  He saw a picture that made him look "fat" and he refused to eat dinner.  It was on a casual eating night where we hadn't been able to eat as a family.  I think he thought I wouldn't notice, but I watch carefully and did notice.  He threw up all sorts of refusal arguments - completely dredged up from his past issues with anorexia.  Finally, I said that if he refused, I would go right back to a magic plate (a plate that I completely prepare) and sit with him until he ate.  He also knows from past experience, that I was completely serious.  He backed down and ate.  I could see that it was an emotional release once he let go.

After he ate, we talked about the danger of what just happened.  I always say that he can't EVER skip a meal, which he insists that he understands.  However, in that moment, he was able to see the realities of where he was headed.  To stop it, he had to eat.  He has to remember that for his whole life!

July 2012 Update

Is it possible for N to continue to improve?  I continue to see his anxiety and depression reduce.  He still has hiccups, but they come less and less frequently.  He got his driver's license last month.  His first trip in the car afterwards was to visit a cute girl (so brave of him!).  And last night there were two cute girls sitting on our porch with him.  Even N's younger, 14 year-old brother said, "I'm so proud!"  Both of these things, while they might seem silly, are actually demonstrations of N's reduced anxiety. 

We've had two suicides here recently.  One was a close friend of N's brother.  We held our breath through both, but N seemed to be fine. 

I mentioned a long time ago about some struggles that N's brother, J, was having.  He ended up getting worse before he got better, but now he just seems so normal  We must have a tendency towards some OCD behaviors in our family.  But I feel like we dodged a bullet with J because of our extensive education on all things eating-disorders and OCD.

We have another little boy in our home.  IB is 6 years old.  He was born right before N got sick.  N and IB are so similar.  I can already see immense amounts of anxiety in this little brother.  I've learned how to handle it better, but it doesn't necessarily fix it.   Strangely, I find some relief in knowing that.  If I could have a do-over with N, there are a million things I would do differently.  But this just shows me that doing those things differently still may not have changed the outcome. 

N just started his first full-time job today.  He'll be doing hard physical work.  My new challenge is to help him to apply regular eating appropriate to his workday.  I'll also need to help him adjust his breakfasts and lunches in order to provide him the energy he needs (and so that he won't lose weight).

March 2012 Update

N continues to do well.  We've had a handful of conversations about suicide since the first of the year.  I've begun to realize those conversations are sometimes a cry for help, but honestly, often they are a manipulation.  Either way, he needs to talk.  So, whenever he starts talking that way (regardless of his motivation), I make sure that I listen and listen and listen.  We've encouraged him to shun even thinking about suicide by singing a song or saying a scripture or whatever it takes.  We're teaching him that dwelling on the idea of suicide can fill him with despair instead of faith and hope.  We don't want him to pretend that those thoughts aren't there, but teach him instead how to deal with them productively and realistically.

His blessing (that I mentioned in the last post) was very special and filled us all with a lot of hope.  We've tried to steer him towards thinking of the future and the plan that God has for him.  I am sure that there will be hard times ahead.  But every day that passes feels like he is less defined by his illness and despair and is turning toward hope instead. 

Real life is still sometimes hard.  He wants so desperately to be independent and to be an adult.  Yet, sometimes he makes decision that make me wonder what he is thinking (I think this is just the 15 year old boy in him).  He still struggles with grades, loves to hang out with friends, and doesn't like to do chores.  Sometimes he surprises me - like today when I came home late, I found him home, already doing his homework, and being so polite.  He's such a good kid and I'm so grateful to have normal days like this.

Blessings

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

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

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

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

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

Mystery Illness Baffles Doctors

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

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

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

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

Therapist

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

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

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