Watching Carefully

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

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

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

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

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

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

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

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

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

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

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

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.