Scared

Last night was rough! N was really low on calories by the end of the day, so I insisted on a very large evening snack. We were watching a movie and I hoped to distract him while eating. But he refused. By 10:00, he still had not eaten his snack. I had to be very firm. N pushed back and blatantly refused. He hasn't pushed back that hard for a while. In the end, he cried for a while and I hugged him. He kept saying that he was scared -- scared of getting fat, scared of eating so much, scared of no one liking him and scared of the food. I'm glad he was able to face and admit his fears. I asked him to sit by me on the couch so I could hug him while he ate his "scary poptarts." He laughed at my joke and relaxed a little and ultimately, we helped him eat his food.

Improvement

Since yesterday, N has done really well. He volunteered to eat a high-calorie snack during the afternoon. He's also been cheerful and cooperative. He is such a good, sweet boy. I think he really wants to please me -- and is extra sad when I'm frustrated with him (like yesterday). I think at some level, he is trying to make up for the past few days.

A Message

Several days ago, a knock at my front door revealed a neighbor who I see at church and school sometimes. But I was surprised to see her on my front steps. She looked so nervous. She jumped into her explanation that she had felt for some time now, that she needed to tell me something, but had put it off multiple times. Still, the impression had been persistent. She said that God wanted me to know that I was a good mother -- that we were good parents. She talked about watching us and our boys and knowing that they were just good kids. She finished by saying that she also thought I was a good mother -- that we were good parents. She said that she would be happy to have any of her girls marry any of my boys -- and that anything we were struggling with would be okay.

Wow. I can't believe her courage. I immediately called my husband. I think her message had even more of an impact on him than it did on me. Those were just the kind of words that we needed to hear. We so often find ourselves wondering what we did wrong, wondering if we messed N up, wondering if the accelerated program was really the right thing for N. Like my husband said, maybe Heavenly Father wanted us to know that we are okay, that we really are good parents, so he sent us a message.

So often recently, as I've shared our struggles with those that need to know, I see a change come into their eyes. I see them wonder what we did wrong. I can see them thinking, "I didn't think they were bad parents." I know this is because of old ways of thinking of anorexia. I've been asked about N's orientation, whether he has been abused, about control issues, and N's selfishness. I know it's just the way people think of these things. I've tried to take those opportunities to change their thinking. I've tried to talk about current research, chemical changes in the brain, puberty, nutrient & metabolic deficiencies, and food as medicine. Sometimes, though, I don't have the time or opportunity to say these things. Then they leave thinking all these terrible things. It's sometimes a heavy burden. But lately, I've also been able to think about my neighbor's words. And it helps.

Prayer

It was a rough morning again. N was more than an hour late for school. I'm hearing more of the "no one likes me, I'm stupid, I'm fat" recently. He repeated these thing multiple times this morning. He's also claiming that he can't finish his food because his stomach hurts or he is too full. But I won't let him not finish it.

We tried some "calm down" time this morning. That worked for about five minutes. He wouldn't try relaxation at all. I finally got him to go pray. He came back and wanted to know why prayer wasn't working. I asked him if he listened or just talked. He admitted that he was only talking. So he went back to his room. When I went to check on him, N said he felt like he should listen to the things I've been telling him. He also felt like he should play his guitar (I think a good relaxation and distraction technique). So he spent 10 minutes with his guitar and was good to go.

Broken Record

As I reread many of the entries over the past few weeks, they start to read like a broken record. But, that's really how I feel like our lives are right now - a broken record. We live and fight the same battles and issues over and over again, day after day. N has only suffered from anorexia for five, going on six months now. And already the fatigue has set in.

We've had a lot of good days over the past few weeks. I think the bigger picture is that N is progressing slowly. However over the last few days, he has regressed a bit. I feel like we're skirting the edge of the cliff right now. I've given him a few additional choices recently for meals and snacks -- but I think he is exploiting those choices. Each meal or snack comes close to a breakdown. Weight and calories and feeling fat are daily topics all over again. Mostly N doesn't dissolve into those breakdowns, but almost. There have been a few rough moments. He pulls himself out more quickly now -- with some exceptions of course. Usually after a quiet moment of contemplation, he'll start apologizing. And that's a whole different issue that I've already discussed.

Today we've skirted multiple fits that have culminated in a late night and accusations of us "accidentally" increasing his calories each day.

84.4 lbs

I weighed N on Sunday morning. He gained 2 pounds and weighed 84.4 lbs. This is the first real weight gain sinced we started refeeding. I'm thrilled. Though we don't tell N his weight, his automatic assumption is that he is up to weight and that we need to reduce his calories. So he was resistant on Sunday morning and again Sunday night to the continued high amounts of calories. Monday morning was also rough. This morning seemed better. He actually made it to school on time.

Food

N is an hour plus late for school right now. He is paralyzed over choosing a shirt. He is so picky about how they look on him. If the fabric hangs out at all then he freaks out. He'll be fine with wearing some shirts one day and then the next time he hates that shirt. I'm sure it is the anorexia still warping how he looks at himself. He also confessed that he can tell that he is gaining weight and that he feels fat because of all the extra calories. Which, of course, is ironic given that he hasn't even gained a pound since we started refeeding. He has cried now for about 30 minutes. Then he apologized profusely, saying things like, "I suck" or I'm pathetic." I've helped him find positive messages and I've hugged him a lot, but it's not making a difference this morning. He is crying again. I've asked to him to go lay on his bed, do some relaxation and try to calm down (we call it "calm-down time").

I'm struggling to get his calories up. With a lot of effort, I can get his daily total to around 2300. I'm using the tricks that other parents have passed on (adding carnation instant breakfast etc.). Here is a sample menu:

Breakfast
4 large pancakes (made with whole milk) - 350
1 T. syrup -100 (he wouldn't eat this until yesterday)
2 pieces of bacon - 70
1 c. cocoa (with carnation instant breakfast & whole milk) - 430

Snack
PopTart - 200

Lunch
Peanut Butter Roll - 250
Orange - 30
1 c. Juice - 100

Snack
1 mini candy bar /package of starburst – 300

Dinner
2 c. Wild Rice Soup (made with half and half) - 340
1/2 apple - 60
Carrots - 50
1 c. of Juice – 100

Snack
1 cup of Breyers Vanilla ice cream - 300

Total - 2680 Calories

The problem is that he is stuffed (particularly at breakfast and dinner). I would be too! He is eating a ton of food. Yet, 2680 calories is a good day. Most days, I struggle to even get him up to 2300. Some mornings I'll make him a high calorie shake (that replaces the pancakes) or a bowl with two packets of oatmeal and instant breakfast. I'm going to rotate bagels and muffins into the breakfast/lunch mix. I just can't make him eat more of everything. Somehow I need to find better ways to make calorie dense foods.

Sick

I've been much more diligent over the past two days about watching N's calories. Sure enough, his moods and obsessions have responded accordingly.

We've had a terrible cold going through our family. It's a cold with the works: fever, aches, coughing and fatigue. N and his brother have both been feeling it. They've been lethargic and cranky. N, however, has continued to complain about a stomach ache. He doesn't want to eat very much. I've wondered if that, in part, is him taking advantage of the situation. And I feel like I can't let him eat less. I've seen what happens when we back off on his caloric load even a little bit. I don't either want to aggravate a sick stomach. So, I've insisted that he eat. He's been a little more reluctant. But after I made it clear that eating less wasn't an option even with a stomach ache, he responded. I've tried to choose foods that are a little more bland and less heavy. For example, I let him have left-over wild-rice soup last night instead of stuffed shells with tomato sauce. I've also been suggesting hot cocoa -- but for some reason that hasn't appealed to him.

Counting Calories

N has been doing so well over the past 2 weeks. I'll admit that I haven't been as exact at counting all of his calories. I could tell he was getting a good amount of food each day. But now I know better. Last night, N began to spiral. I could tell that he was struggling as soon as I picked him up from school. By the night's end, I had to push to get enough calories in him. This morning, he cried again. It took a long hour to get him to school. He was feeling so self conscious. I've upped his calories again and am diligently keeping track -- but I suspect it will take a day or two to have his mood swing back. I think that the return to school (after a long stress-free Thanksgiving break) also affected him.

Weigh-In

I weighed N this morning: 82.1 lbs.

This is actually down .1 lb from last week. I've heard other parents talk about this happening (loosing weight even though calories are significantly raised). I wonder how it's possible, though. He has eaten so well this week!

He had a great morning. He was only a few minutes late for church. There were not any delays over clothing (he did have a new white shirt).


Note: (added in 2011)  What I learned later is that kids recovering from anorexia typically have a hypermetabolism.  They need double or even triple the amount of calories normal for other kids just to maintain their weight. 

Thanksgiving

I am so thankful that N has made so much progress. We'll weigh him tomorrow, so I don't know exactly where he is. But he's had a great week.

He met with Dr. R. on Wednesday. The doctor was so pleased with N's progress that we've shifted our appointments to every other week. Dr. R. said to continue with all that we're doing.

The anorexia isn't gone. N will argue and resist when his meal has a lot of calories. But there hasn't been any yelling or crying these past few days. He'll protest and then quickly relent. I'm sure that no school and no scouts have helped keep his stress down. Also, his dad has been able to take these days off. There has been a lot of support and love. Hopefully, this trajectory will carry into next week as the pressures start up again.

More Of The Same

N continues to do well. It seems like each day he has one or two moments where his anorexia resurfaces. Those moments seem to happen around meals -- especially with new menu items or in the morning (dressing time) and evening (when he is tired). Those moments, though, seem to get farther between, shorter, and less severe. I hope that continues. Often he will yell and get mad, but will regret it and apologize pretty quickly.