Nourishing My Son

Blessings

2012-01-28T15:56:00.000-08:00

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

2012-01-17T16:24:00.000-08:00

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

2012-01-17T15:33:00.000-08:00

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.

Suicide

2011-11-15T15:18:00.001-08:00

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

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

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

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

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

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

November Update

2011-11-09T12:09:00.000-08:00

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

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

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

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

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

Media Query

2011-10-31T20:30:00.000-07:00

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

Health Class & Weight-Lifting

2011-08-29T08:15:00.000-07:00

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

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

Exercise

2011-07-26T12:15:00.000-07:00

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

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

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

Summer

2011-06-17T10:46:00.000-07:00

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

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

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

Insidious

2011-04-06T09:10:00.000-07:00

Anorexia is insidious and relentless.

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

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

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

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

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

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

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

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

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

Doing Well

2011-02-18T09:59:00.000-08:00

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

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

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

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

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

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

Depression?

2010-12-10T12:57:00.000-08:00

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

2010-12-10T12:53:00.001-08:00

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.

Wrestling?

2010-11-03T12:59:00.001-07:00

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?

Reaching Out

2010-09-13T12:41:00.000-07:00

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.

Seven Days

2010-09-03T10:18:00.001-07:00

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.

Back To School - 2010

2010-08-30T12:20:00.000-07:00

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.

Spring 2010

2010-04-30T16:40:00.001-07:00

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.

J and OCD

2010-01-20T08:17:00.000-08:00

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?

Supersize Me!

2009-12-21T10:43:00.000-08:00

Just found out that N was shown "Supersize Me" in his Foods class. I'm dumbfounded. I just can't believe it. How did this get past me, his teacher and/or N? Not sure what to do with this information. N seems fine about it -- but is he really?

His Brother

2009-11-11T11:44:00.001-08:00

The last few days have been interesting for me. My shoulders are tense all over again, but not because of N - it's his brother, J.

J is currently 11 years, 9 months. He is only 7 months older than N was at the onset of the anorexia. I can't remember if the beginning was Sunday or Monday, but it was like a light switch got flipped. J has experienced three days of intense anxiety, and paralization. He said that he only feels it here at home. But last night it was enough to keep him from heading out to scouts. I had asked him to sweep and he had played on the computer instead. I got after him about it, but then he obsessed over my being mad at him -- said he couldn't leave if I was still mad.

This is so unlike him. I've got warning flags going up all over, but know I need to wait before reacting. There is a major possible cause of his anxiety. His grandmother was just diagnosed with stage 3 - vaginal cancer. We're all out of sorts because of it. He insists that it isn't related -- but I'm not sure that any of us know how much our anxieties tie into fear and death. So, I'll give J a few weeks and see if we can work/talk through this.

Then I'll panic.

A Lonely Parent

2009-09-29T08:00:00.000-07:00

Being the parent of a child with anorexia is terribly isolating. We continue to be quite private about our struggles. I really wish that the public perception of anorexia was more accurate and not so based on assumptions of the past. It would be good to speak publicly and help change these inaccurate perceptions. But the reality is that those old perceptions are prevalent and most of those around us really don't understand. And N is going through such a tough time in life anyway. I just feel like we can't openly discuss the anorexia and not have people prejudge him (because I continue to see evidence of that judgement). N is a great kid -- but it seems that the anorexia gets in the way of people seeing that.

In the past few weeks, I've felt this loneliness more than usual. I've had several conversations with people who are aware of N's illness. I thought that they understood the realities of the disease. But in these conversations, I became quite aware of how much they don't understand. I spent many minutes last week, for example, trying to explain to someone how exercise figures into the problems of anorexia. It was hard to help her understand the idea that not exercising (regimentally) was in N's best interest. The media's misunderstanding of weight right now just adds to the isolation as I realize just how much of a paradigm shift I've already had (and how crazy I must sound sometimes).

Thankfully, I have a few friends and family members who really listen to me and believe in me regardless of understanding. [Edited to include]: And I also have a wonderful community of parents supporting each other as we all go through the same thing!

A Trip to the Therapist

2009-09-24T07:35:00.000-07:00

N's OCD behaviors have been increasing significantly since school started. So last night, T & N went and met with his therapist for the first time since January. We had some new concerns because the OCD patterns have changed some. Instead of touching door jambs and holding his breath when someone "fat" is on the tv, he has started being concerned about chemical contamination, becoming autistic, becoming gay, and masturbation. Some of these are pretty tough topics - which we don't avoid, but are trying to be sensitive about how to talk with him about them. He hears his friends bring up these topics (in a less sensitive manner) and it scares him. I've been concerned about whether our reassurances "that he isn't autistic" for example, were just feeding the OCD loop. I didn't know whether to reassure/discuss (and potentially enable the cycle) or to refuse and potentially make things much more difficult.

N's therapist indicated that it was okay for us to reassure him once -- to give him the information and reduce his anxiety. But after that, if he seeks reassurance on the exact topic again, we should refer to our earlier conversation. His therapist didn't seem to think that the intense topics were indicators of larger issues, but rather were just the anxieties N was encountering at this moment.

Other than some of this new information, the appointment was just a rehash of many concepts and principles that have been addressed before. In some ways, it felt like a waste of time, but I wonder if N needs to be constantly reminded of the ways he can address the OCD.

I also suspect that the stress of a new school year is aggravating the OCD behaviors. N is doing well with his grades and assignments. I'm trying to let him be responsible for when he does his homework and the potential natural consequences of waiting to the last minute. He's had some of those consequences and it seems to make a difference. N is pushing himself pretty hard to get all As. We don't really care about his grades - just that he turns his assignments in. But he often lapses back to that typical "all or nothing" approach. He would rather not turn in an assignment than turn in one that is imperfect. In fact, last night I drew attention to the fact that he had very little time left to do his homework -- but he was so wrapped up in finding the perfect "third argument" that I could envision his essay taking another two hours (and it was already late). So I reminded him that it was better to get the paper done, turned in, and get a B - than to not have it done at all. I don't know if that helped or not.

His doctor was very surprised to see how much N had grown -- and that his voice has now deepened (I knew that it was happening, but it just isn't as noticeable when you live with him everyday).

8th grade

2009-08-24T07:25:00.000-07:00

School has started and N seems to be doing fine. We met with his counselor prior to school and she agreed to "pull" N out of his health class during the week of questionable curriculum. She also gave him a pass that he can use if he is ever in a class and can tell that he needs to leave (because of how he is feeling or what they are talking about -- whatever).

N is taking a Foods class that we discovered may also cause some problems. I thought it was just a cooking class, but it turns out they do much more with calories and food analysis, etc. It looks like they will have one day on the problems of obesity and another which is just about fats/oils. I'm a little nervous about the class on fats/oils because the teacher was coming from the camp that these are "bad" foods only to be eaten occasionally. So that's two more classes that he will be missing.

I think P.E. will be fine. He has the same teacher that he had last year and there weren't any problems at all. I did opt him out of a scoliosis check (they have to remove their shirts to get checked). I knew that would be an issue for N. And on top of all of this, we had to give approvals for sex-education. But that's an entirely different issue.

Health Class

2009-08-10T11:07:00.001-07:00

I met with N's health teacher last Wednesday. She provided worksheets for a 5-day portion of the curriculum, which included:

1) Fitness - flexibility, strength, endurance, BMI, pulse, workout principles.
2) Food Pyramid - a discussion of the nutrients and important aspects of all portions of all food groups.
3) Calories - how many do you need, burning calories, creating a menu within a calorie range, ideal percent of fat in a diet.
4) Nutrition - create menu using pyramid, self assessment profile that uses emoticon to asses amounts in each area including fat, oils, cholesterol, sodium; determining exercise needed; caloric intake and expenditure summary;
5) Eating Disorders - anorexia, bulimia, obesity, movie (Little Miss Perfect).

She was willing to excuse N from the entire unit.

I'm so glad that I met with her. I (and N) could see potential triggers on most of the days. I suspect that he would be fine on day 2 -- but that's borderline. And would we want him to be there for just one day of the unit anyway? N really wanted to be there for the discussion on day 5, but I can see huge issues with that! On day 5, not only do they discuss "potential problems" from being overweight, but the bulimia discussion includes "other" methods of losing weight like laxatives, etc. I've never seen the movie, but suspect that it wouldn't be healthy for N to indulge in seeing someone else's methods of losing weight.

N was concerned about his "smart" friends figuring out that he was missing for this whole unit (yet he was unconcerned about making comments during the anorexia discussion - go figure). We'll be meeting with his new school counselor this week to determine if she can pull him out (thus N can state that the counselor "made" him leave). I think she'll be willing.

I've known this class was coming and would be an issue. Hopefully we can handle this in the best way possible.

A Question

2009-07-27T18:33:00.000-07:00

Would you, experienced parents, answer a question?

We seem to have reached a stalemate of sorts with the anorexia. For the most part, N is eating normally. He is currently weight-restored. With growth spurts, he'll sometimes drop his weight in proportion to his height which results in a resurgence of anorexic behaviors, but usually we're on top of those drops and help him to bring his weight up as quickly as possible. He has several OCD behaviors that he just can't seem to shake. He is still quite self-conscious and is always fixating on his clothes as well as his relationships with friends. He is struggling a bit to find his identity (but I really attribute that more to his age).

Will we just be maintaining this stalemate indefinitely? Is that what recovery from anorexia looks like? Or will there be a cessation of these low level issues as he matures and stops growing? Is there more we can do to eliminate the current stalemate?

Staycation

2009-07-24T18:29:00.000-07:00

Our family took a week-long staycation this past week. N had a few struggles, but we were so busy that he wasn't able to indulge them too much. He did fixate on a few OCD behaviors late in the week. I'm thinking that he was also tired from a long, packed itinerary which had weakened some of his strength against the OCD.

Scout Camp 2009

2009-07-10T17:30:00.001-07:00

N just returned from this year's scout camp. This year the leaders planned a local trip for just the 11 or so boys in our congregation. N had a fabulous time! He fished, shot arrows and shotguns, rode a tube down a river, went rock climbing and even repelled. I love that the leaders also included religious discussions nightly.

We donated 60+ candy bars like we did last year. We sent them to make sure that N always had something to eat, which apparently was not a problem at all. His leaders said that N ate well the entire time. N did say that he struggled the first few days with feeling ultra self-conscious. He coped, I think, by relying on some OCD comforts, which is too bad, but typical.

Now, if I could only get him to take a shower! He is so dirty that he literally has dirt caked on the back of his neck.

Planetarium Pitfalls

2009-06-24T15:47:00.001-07:00

N went to our local planetarium last night along with his peers and leaders in his scout/church group. He arrived home, holding back tears, telling me about a "giant scale." All of the boys weighed themselves and then pressured N to get onto the scale. What could he do? He stepped onto the scale and was, unfortunately, the heaviest of the bunch. I think he is also the tallest, but that detail didn't reassure him at all. He said that he was the heaviest by "like 15 pounds." When I pressed him, it turns out that one boy weighed two pounds less and another 10 pounds less. But to N the difference was monumental.

My first question was, where were the leaders? My second thought was that there was no way I could expect them to anticipate everything. They probably didn't even think twice about the boys climbing onto the scale.

The devastation to N's spirits has been huge. He stood back while the other boys loaded up one of the vans to come home. He rode home, instead, with two other leaders and no boys. Thankfully, they threw in a stop to McDonald's which helped N's spirits a bit. He came home afterwards instead of playing street hockey with the boys. Today, he begged me to not let him ride bikes with the boys who had come to our front door asking.

He seems to be eating fine, but he is very anxious and sad. I'll need to watch carefully and hug him a lot.

A Genetic Link Between Anorexia and Autism?

2009-06-19T12:42:00.000-07:00

Interesting article: A Genetic Link Between Anorexia and Autism?
http://www.time.com/time/health/article/0,8599,1904999,00.html?xid=rss-topstories

I was actually more interested in the end of the article. They discuss Maudsley as being the only treatment with evidence-based success. The article also addresses problems that parents are encountering with traditional therapy that are similar to hurdles faced with autism 20 years ago.

It's good that the media is finally catching up with the reality of anorexia as a biologically based illness. Now, I just wish these things would sink in with the public (and all of their preconceived, but erroneous notions), and more importantly, the doctors, therapists and psychologists that treat anorexia.

Boy Scouts of America

2009-06-11T07:49:00.000-07:00

We are members of The Church of Jesus Christ of Latter-day Saints. Currently, our church uses boy scouts as the activity arm for the boys' youth activities each week. That is why N is doing so much with scouting right now.

Just recently the Boy Scouts of America released their new health form which is required to be filled out annually by both boys and leaders participating in any activities. Anytime that they participate in "any event that exceeds 72 consecutive hours, a resident camp setting, or when the nature of the activity is strenuous and demanding, such as service projects, work weekends, or high-adventure treks," they are required to fill out "form b." What concerns me is that "form b" is an extended health form with a heavy emphasis on BMI.

Here are two quotes from the form:

"It is important to note that the height/weight chart must be strictly adhered to if the event will take the unit beyond a radius wherein emergency evacuation is more than 30 minutes by ground transportation, such as backpacking trips, high-adventure activities, and conservation projects in remote areas."

"Individuals desiring to participate in any high-adventure activity or events in which emergency evacuation would take longer than 30 minutes by ground transportation will not be permitted to do so if they exceed the weight limit as documented at the bottom of this page. Enforcing the height/weight limit is strongly encouraged for all other events, but it is not mandatory."

There is a doctor's allowance (that basically transfers liability to the doctor) that can override the BMI requirements up to a point. But the basic guidelines suggest that anyone with a BMI in the "overweight" category (BMI of 25 or higher) should not be allowed to participate in the activities listed above. Interestingly, they don't restrict anyone who falls into the "underweight" category.

I have several HUGE concerns with this. BMI is NOT a good indicator of health or fitness levels. It's not even a good indicator of fatness. In fact, the most physically fit tend to fall above the "normal" weight category because of additional muscle mass. My Brother-In-Law who regularly rides his bike 25 miles, is considered border-line "obese" (which is basically where the doctor can't even make a medical exception) based on the BMI scales.

Also, my boys tend to gain weight, grow tall, gain weight, grow tall, etc. If you weigh them right before a growth spurt, you are almost guaranteed that they will not be allowed to participate in the youth BSA activities because of these new BMI guidelines.

My biggest concern is for N. His BMI has traditionally fallen at around the 75% percentile. So that is where we've aimed for his weight gain as he has recovered from anorexia. He is currently above the 75th percentile for height and right about the 75th percentile for weight. In other words, he is right where we want him. However, if we utilize the BMI charts, he is just a few pounds away from being considered "overweight."

It would be completely devastating for him to be assessed using this new BSA "form B" and consequently restricted from participation in many of these youth activities because of being "overweight." In fact, I won't let that happen. I don't think our local leaders will let that happen either. I suspect that they will change activities from being BSA activities to simply "church activities" in order to protect N in particular. They will probably have to do that anyway because I think that 95% of the men in our congregation (potential youth leaders) will fall outside of those BMI guidelines anyway.

Here is a link to the new BSA health form.

4.0

2009-05-28T16:59:00.000-07:00

I think this is both good and bad news. After much last minute work, N was able to get straight As (a 4.0) this quarter. It was a personal goal and I'm proud of him for working so hard to achieve his goal. He is very smart -- I've never doubted that. It shows how far he has come from a year and a half ago when his grades were all Fs. But I also don't want these grades to create continual pressure. It's okay if he doesn't get a 4.0 in the future. He definitely doesn't need anymore perfectionist tendencies.

Physical Fitness Merit Badge

2009-05-27T14:52:00.000-07:00

Last night N attended a church youth group meeting and worked on his Physical Fitness Merit Badge. I talked about my concerns about the requirements for this merit badge in a previous post found here.

Our previous plan had been to keep N home and work on a modified worksheet (that I had already created). But, N's merit badge counselor checked in with me during the afternoon to let me know about the changes he had made to the requirements. The counselor had rewritten much of the worksheet to accommodate N. He had eliminated the body measuring, anything about weight loss and the emphasis on obesity as a risk for cardiovascular disease. [The Boy Scout program allows for modification of merit badges based on medical needs.] The counselor wanted to know if we had any specific instructions regarding diet. I just indicated that we emphasize eating a variety of foods and staying active. I didn't want him to talk about counting calories or regimented exercise. I also didn't want him to "ban" any foods. The counselor was willing to do as I asked. I was pleased with the changes he had made and I allowed N to go to the meeting.

It went really well. The only hang-up that N seemed to have afterwards was his risk for diabetes. We have a huge genetic diabetes history. He fixated on that for a while last night. I can't take that risk and his awareness of it away. But now isn't the time, either, for him to restrict or exercise with the prevention of diabetes in mind.

I'm thrilled that N was able to participate with his peers for this merit badge. I really appreciate the extra effort that his merit badge counselor gave to help accommodate N's needs.

Good Read

2009-05-16T13:31:00.000-07:00

I loved this article in yesterday's Huffington Post by Laura Collins: She's Anorexic and You're a Bad Mother.

Reconsidering

2009-05-08T07:15:00.000-07:00

Well, I'm not sure that N is going to end up doing his Eagle Project as I described two posts ago. We're trying to figure out if there is a way for him to demonstrate leadership without having to fully disclose the anorexia to his peers. Unless, we can spin things the right way, he probably won't do it. Right now the idea on the table is to involve the other scouts in fundraising only and label his project as "providing resources for pediatricians" or "pediatrician education" or something like that.

I have to admit that I'm disappointed. I'd like to attach some meaning -- and making a difference -- to this whole experience. But it's not my project, it's his and it's his life and his friends.

Time Travel

2009-05-06T07:20:00.001-07:00

N is struggling a bit again. He's probably growing. The last five or six days of school, he's been late. His friends have stopped waiting for him, which is so sad because they really are part of the motivation some mornings. But he was making them late repeatedly. I can see why they would be frustrated. This morning was like a throw back to last year. He even was angry and lashing out.

School is almost over. Most of his teachers have already stopped requiring "regular" work and are instead working towards end-of-year-testing, which actually might be stressing him out. We continue to utilize the magic plate at all of his meals. I may need to magic-plate his snack in order to force some more calories. If we can survive the next two or three weeks, then we'll have the whole summer to address his growing caloric needs at home.

Eagle Scout Project

2009-04-09T06:30:00.000-07:00

N is currently considering doing an Eagle Scout project that would involve eating disorder advocacy. He is thinking of putting together informational packets about anorexia and distributing them to local pediatricians and middle-school counselors. He is thinking of including a page telling his story, a list of symptoms and treatment options, a pamphlet with local treatment resources, and maybe the Kartini Clinic DVD. What else could he include?

Previously, as N had thumbed through lists and lists and lists of possible Eagle Scout projects, he just ho-hummed. I could tell that he felt like these ideas wouldn't make much of a difference in the world. After several days of throwing ideas back and forth, he started exploring the idea about helping others with eating disorders. As soon as we starting talking about all the possibilities in this area, he really got excited.

You may remember that N's pediatrician was really unknowledgeable about anorexia. The pediatrician didn't recognize his symptoms as an eating disorder. Once we identified the problem as anorexia and asked for a referral, his pediatrician referred us to a psychologist that deals with children with behavior-disorders (which is obviously an inappropriate referral). As I look back now, I'm also so surprised that the pediatrician didn't immediately order tests and set up a weekly-check-up schedule. At one point when we really needed to have a quick medical work-up, we lucked out and saw a different on-call pediatrician who had done a rotation in an eating disorder clinic. He knew what tests to do and how to read the results. I know that was a huge blessing at the time. Until we found a team at our local children's hospital, N really didn't have the medical attention that he should have had.

Anyway, N feels like it could really make a difference if he provided additional (especially local) information about anorexia to pediatricians like his own. I'd like to help him find a way to do this so that he can maintain some bit of privacy and yet still make a difference. Any suggestions?

Still Good

2009-04-08T15:17:00.000-07:00

N is still doing really well. I am still monitoring his calorie intake pretty carefully. In fact, I'm mostly doing a magic plate with him for breakfast and dinner. Though I let him fill his own plate, I'll add to it if I feel like it is deficient. He doesn't resist at all. This is where it is easy to relax and let down my guard. But I just keep relearning that I can't do that.

Doing Well

2009-03-19T17:05:00.000-07:00

N had a great day today. He's busy doing his homework and practicing his guitar -- all in anticipation of getting to play some video games. It's the end of the school term. His grades look like they'll all be As. We've really come a long way!

I don't think I'll have to worry about class order (because of perpetual lateness) or unmanageable stress for next year. He has done well, for the most part, with the stressful moments of school this year and he's not really been late at all. Class change was a small challenge, but he has settled in now.

I will have to meet with his teacher in preparation for his health class next year. He will likely need to be excused for the curriculum portion on eating disorders -- not because he can't handle the discussion -- but because it may put him in the precarious position of feeling like he needs to correct the teacher (who may not have current information about anorexia). We also don't want to "out" him by revealing that he is an expert about eating disorders. It's not that we are embarrassed about his being sick -- though it has been an unexpected trial -- but too many people still don't understand the medical origins of anorexia and judge him and our family unfairly. We've been more open about the disease generally, but I don't think a Junior High Health class is the place for full disclosure.

I hope I can educate his teacher about anorexia. I also hope his teacher will be willing to proceed cautiously, especially when addressing any topics about weight and diet. I really wish our kids would be taught more about eating well and being active, instead of the need to be a certain weight.

Improvement

2009-03-18T11:52:00.000-07:00

After raising N's calorie intake for several days, he's doing great. He was just a little over-concerned about what he wore this morning. Other than that, I haven't really noticed any break-through symptoms.

Everyday-adequate-calorie-intake seems to be just as important as his weight. His symptoms rapidly disappear once he is getting what he really needs.

Military and Missions

2009-03-16T13:41:00.000-07:00

In this post (http://nourishingmyson.blogspot.com/2008/12/fears-of-future.html), I described some of my concerns for N's future. I've done a little research since then. Apparently, the military would reject N because of his eating disorder. Eating disorders are included in the "unwaiverable medical conditions," but they are only documented if they occur after the applicant is 12 years old. I wondered about civilian positions, but wasn't able to find any additional information. This makes total sense to me. In tough conditions, especially those with high calorie expense and low calorie intake, someone potentially relapsing into anorexia could compromise a mission.

As far as him serving a mission for The Church of Jesus Christ of Latter-Day Saints, they do ask about eating disorders on the application. His Bishop (like a Pastor) would attach a letter explaining the terms and severity of the anorexia. Then depending upon his current health, he would be assigned. I hope that he would be asked to serve in a country with good food. :o) I really think he could contribute positively on a mission as long as he didn't have to walk everywhere and struggle to find good food.

He's Growing Like A Weed!

2009-03-12T13:14:00.001-07:00

I've noticed another resurgence of anorexia symptoms in N recently. This time it's been a little worst than in the past. And that usually means one (or both) of two things: 1) He isn't getting enough calories or 2) He's lost weight. So I weighed him - 119 lbs, which is down about 1/2 pound. Then I measured him. I was so startled by the results that I measured him again. A conservative measurement shows that he has grown a full inch in the past month. With that much growth, a stagnant weight is just like loosing weight. That explains the up and down struggles that he has been having over the past month or two.

So, we've gone back to a similar routine like when he was really sick. I dish up his plates. He eats it all. I track his calories. It's just been two or three days since I measured him and I can already see a decrease of those pesky symptoms. I just have to be so attentive right now -- especially since he is growing so rapidly.

And just to clarify, these reoccurring anorexic symptoms are so minuscule compared to how sick he was a year ago (at most a "1" on a scale from 1 to 10, with 10 being his worst symptoms ever). I might notice that he is acting a little more self-conscious or emotional. He starts to be a little picky about what he eats. He also might struggle to get going in the morning. Mostly these resurgences don't interfere with his (or our) normal lives. I'm just so highly attuned to these warning signs that I try to address the problem right away.

I continue to be amazed about how consistently important it is for him to keep his weight up. A drop in weight always correlates with an increase in symptoms. At a reasonable weight, he is just like a "normal" 12 year old.

Now he is officially taller than his mom.

Nourishing My Son

2009-02-24T09:13:00.000-08:00

I submitted this article as a possible guest post and thought it belonged here as well:

Just four months after my son’s 11th birthday, he was diagnosed with anorexia. You might be surprised that my son has anorexia, both because he is a boy and because he was so young. In reality, 1 in 10 anorexia sufferers are boys and it isn’t uncommon for kids to be diagnosed as young as 9 years old.

My son wasn’t the rebellious teenager with anorexia that I had always pictured as described in my high-school health class. In contrast, my starving son was well-adjusted, kind-hearted, smart, obedient, and good. Yet, he was restricting and counting his calories. He exercised excessively and started to drop pounds quickly. He became so incapacitated about eating that he would often curl up on the floor and cry for hours. He was starving, but just couldn’t eat.

Because of his diagnosis of anorexia, we sought out the best medical and psychological care. But, he continued to decline. For four months, despite therapy and medical care, he continued to lose weight. We were desperate as he reached his low weight of 76 lbs. – a total loss of 30 pounds. He had missed tons of school because he literally couldn’t get out the door each morning. His grades had gone from As to Fs. Our whole family was really suffering.

At this low point, we held an extended family fast and I felt that I needed to become an expert on anorexia in order to help my son. I sought after and read everything that I could find about anorexia. Within a week, I discovered a wonderful parent-support-forum (http://aroundthedinnertable.org). These parents, all with children suffering from anorexia, steered me to research that suggests that anorexia is a brain disease and not psychological in origin. Consequently, this research advocated a different approach at treating anorexia. I shared this research my son’s doctor and he indicated that it was valid research. So we changed our course.

The traditional approach for treating anorexia is to try and talk the sufferer into eating and simultaneously deal with assumed underlying psychological issues. This approach has controversial success rates, a high incidence of relapse, tends to separate the children from their parents, and usually involves years of treatment and thousands of dollars. We had started with this treatment approach. But after months of continued weight loss, our son wasn’t getting better, and was actually getting worse.

Our changed approach (based on Maudsley treatment methods), encouraged family involvement and emphasized food as medicine. I learned that treating anorexia is like treating cancer. If you had a child with cancer, you wouldn’t try to talk that child into having chemo. Instead, you would acknowledge to your child that chemo is horrible, but is ultimately what was necessary to save your child’s life. With anorexia, food is the chemo. And as horrible as food seemed to my malnourished son, it is ultimately what would save his life.

Just days after my son reached his low weight of 76 pounds, I presented him with a plate full of food. I told him that the world had stopped. We wouldn’t be going anywhere nor doing anything until he ate – no school, no scouts, no church, no meetings, nothing. He argued, sobbed and yelled. After several hours, he realized that I was serious and he took a bite. It was a long night of taking one bite at a time, but he ultimately finished his food. This began an ongoing routine. Every meal was hard for him. We made jokes that food was “scary,” but eating literally was scary to him. I became an expert in making calorically dense foods. He started gaining weight. His improvement came one pound at a time. But with every pound, I could see my son emerging. It took seven months for him to regain those 30 lbs. It has been 18 months since my son got sick. We consider him to be in remission now.

In writing this post I have two desires. My first desire is to spread the word that there is an alternative in the treatment of anorexia which works. The second is to help break down many of the negative stereotypes associated with anorexia. 1 out of every 10 girls and 1 out of every 100 boys will suffer from anorexia. These are huge statistics and you might find yourself confronting anorexia at some point in your life.

Loose Pants

2009-02-22T19:08:00.000-08:00

I can already tell a difference in N's responses. After two days of supervised eating, his calories are up and his spirits are up. But, his pants are looking loose. I've also not been very regular about weighing him. He seems to be growing so quickly now, yet his weight is stagnant. I'm sure we need to push calories better and keep up with his growth spurts. The danger of falling behind is absolutely a motivator to me.

Update

2009-02-19T18:58:00.000-08:00

N started guitar lessons today. Hopefully they serve as an outlet for both achievement and relaxation.

N had a really good two weeks. I relaxed and let him choose his foods again for those weeks. But he's been off the past few days again. A friend told him that his arms were chubby. He struggled to pick a shirt the other day. He hasn't been eating very well. He hid his toast one morning (I think he didn't like it -- not necessarily restricting, but deceptive none the less). He's also been more moody. All are clues that I need to be more diligent. So, I've reinstituted the "magic plate" for breakfast and dinner. I'm checking more carefully that he's actually eating lunch. After a couple of days of increased attention on my part, I can already tell that he is doing better. I've got to watch carefully for those dips. They don't happen so often anymore which is wonderful. But this one went on for too long before I picked up on the clues. I can't let that happen.

Hmmmmm

2009-01-29T12:54:00.000-08:00

N is still struggling with the term change. I've had to take back control over his breakfasts. He was either restricting or just not taking care of himself. I'm certain that he is still growing like crazy, but his weight has been static for two months now. Either way, I'm seeing his self-consciousness (and temper) increase.

I'm also seeing increased concern with exercise or wanting to have a sport. He's decided that he wants to run track. Boy -- that's a potential problem. Do I let him try and watch him carefully? The boys at this age are so defined by what sport they participate in. I get that N feels like a "nerd" because he doesn't do sports. Is it possible for a boy who has anorexia to do a sport at a reasonable level?

We've got a winter campout coming up. N is resisting anything "puffy." We've told him that if he won't wear the appropriate equipment, including coat, snowpants and boots, that he can't go. I find myself just wanting to keep him home and protect him from the weather and the other boys. Boys at this age are so mean to each other.

Check Up

2009-01-15T10:20:00.000-08:00

N and T met with Dr. R. last night. It was a positive visit and in fact, they didn't even stay for the whole hour because "they ran out of things to talk about." Our next appointment isn't for another four months. The topic of discussion was long term recovery.

N just started a new term at school. He has been significantly more self-conscious (even to the point of calling himself "fat") because of new kids, expectations and teachers. I think some of the anorexic feelings have increased because of the change, but I also see N dealing with it better than he has previously. Hopefully, each time he experiences change, he'll get even better at dealing with it - until it's just not an issue anymore. Dr. R told him to address the self-consciousness and any OCD stuff before it ever became about eating.

N also made an interesting confession. He said that he eats in order to avoid his homework. Wow. I'm pleased that N is honest about his motives. So they also talked about avoidance (everyone does it) and to stop and really find out why he doesn't want to do his homework. At some level I don't know how much these things really have to do with the anorexia -- but it was good for him to discuss them.

Bulimia

2009-01-05T13:20:00.000-08:00

N is now 12 1/2 years old. When he first got anorexia, he was barely 11. At the beginning of his treatment, his therapist stated that it was good that N didn't also have bulimia -- that the characteristics N was demonstrating at the time were evidence that we would have a long, long road ahead if N's illness led him toward purging. Because of this concern, we've watched him carefully for signs of purging, kept the research books hidden (with mixed success), and haven't really talked in depth about bulimia. I assumed that N didn't really know what bulimia was and that to talk about it was to also put ideas in his head.

I briefly talked to N after our visit with his Great Grandmother (last post) and wondered whether it made him uncomfortable. You can imagine my surprise, though, when he shifted subjects and started talking about the girl with bulimia, confessing that he had "thought about it" (throwing up), but couldn't stand the idea of making his throat burn. I looked at my husband, who was also processing the comment in shock.

I'm not sure what to do with this information now. I think it was naive of me to think that by not talking about bulimia it could prevent N from purging. It leaves me wondering if we should have (or should be) engaging that topic more directly. Thankfully, though, I really believe him when he said that he has never done it.

Visiting Grandma

2008-12-29T16:29:00.000-08:00

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

2008-12-20T19:32:00.000-08:00

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

2008-12-15T16:34:00.000-08:00

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

2008-12-05T07:56:00.000-08:00

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!

2008-11-27T07:38:00.000-08:00

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

2008-11-24T07:19:00.002-08:00

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

2008-11-20T07:28:00.000-08:00

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

2008-11-11T06:30:00.000-08:00

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

2008-11-05T19:27:00.001-08:00

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

2008-11-01T12:34:00.000-07:00

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

2008-10-29T12:22:00.000-07:00

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

2008-10-27T12:12:00.000-07:00

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

2008-10-12T15:58:00.001-07:00

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

2008-09-30T06:47:00.000-07:00

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

2008-09-23T12:42:00.000-07:00

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

2008-09-14T16:16:00.000-07:00

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

2008-09-03T13:13:00.000-07:00

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

2008-08-28T08:25:00.000-07:00

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

2008-08-25T16:27:00.001-07:00

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

2008-08-22T11:56:00.000-07:00

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

2008-08-19T17:11:00.001-07:00

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

2008-08-19T13:10:00.000-07:00

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

2008-08-18T15:50:00.000-07:00

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

2008-08-15T13:08:00.000-07:00

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

2008-08-13T15:39:00.000-07:00

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!

2008-08-09T12:17:00.000-07:00

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

2008-08-08T15:35:00.000-07:00

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

2008-08-06T14:01:00.001-07:00

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

2008-08-04T08:21:00.000-07:00

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

2008-08-01T14:46:00.001-07:00

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

2008-07-31T09:20:00.000-07:00

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

2008-07-30T11:21:00.000-07:00

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

2008-07-29T09:35:00.000-07:00

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

2008-07-25T15:16:00.000-07:00

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

2008-07-22T10:15:00.001-07:00

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

2008-07-16T09:16:00.000-07:00

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

2008-07-14T10:28:00.001-07:00

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

2008-07-13T07:44:00.000-07:00

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

2008-07-09T11:45:00.001-07:00

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

2008-07-08T10:00:00.000-07:00

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

2008-07-07T13:44:00.000-07:00

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

2008-07-02T11:05:00.001-07:00

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

2008-07-02T10:20:00.000-07:00

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

2008-06-26T09:48:00.000-07:00

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

2008-06-22T16:53:00.000-07:00

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

2008-06-22T09:03:00.000-07:00

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

2008-06-16T12:09:00.000-07:00

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

2008-06-10T13:07:00.000-07:00

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

2008-06-04T14:36:00.000-07:00

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

2008-06-03T08:28:00.000-07:00

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

2008-06-02T13:07:00.000-07:00

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

2008-05-30T11:15:00.000-07:00

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.