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Dear Leanne,

When I was reading your post, I thought I was re-reading something I

wrote!! Especially about the eating!! My daughter was diagnosed at 8

(she is now 10) with OCD. She was hospitalized for a few days because

she basically stopped eating. The doctors initially thought eating

disorder but I knew it was OCD. Her list of " safe " foods were slowly

dwindling to nothing which lead to her hospitalization.

Your daughters diet and my daughters diet are very similar. She will

eat chicken Mcnuggets but only if it looks a certain way. She will

eat cheese pizza but only if her OCD/anxiety level is low enough. She

will eat scrambled eggs but only if my mother makes it. You get the

picture ... ?

" She would rather not eat than try anything new or eat something that

isn't the brand that she likes. "

My daugher is also like this but now if she says something looks good

or she wants to try something, I give her only a tiny bit and not make

a big deal out of it. I tell her if she doesn't like it, that's ok

and I praise her for trying. I tell her that eventhough it's not

something she likes now, her taste buds will remember it and may like

it later.

I used to get overly excited when she wanted to try something and give

her a normal sized amount of the food but then I would be upset at her

for not eating it. Obviously, this didn't work so now I do the tiny

bit and praise.

" And slowly but surely the few foods that she will eat are

disappearing from her list of things that she'll eat for reasons she

can't explain other than to say that she just doesn't want to eat them

anymore. "

I am so sorry that you are going through this. <<<<<big hug>>>>> I've

been there and continue to be there. Reading your post is bringing

tears to my eyes ... I know how you are feeling.

If she starts losing weight or is basically eating next to nothing,

take her to the doctor. If your doctor doesn't do anything, have her

admitted to the hospital.

At first, my doctor did nothing. I felt helpless. I felt I shouldn't

go to the hospital then I realized it hasn't/wasn't going to get

better at home. So I took her to the hospital. She was so dehydrated

.... she just slept and I cried. I'm getting off track. I guess I

just wanted you to learn from my mistake. You know your daughter best

and if she is not getting better and the list of " safe " foods are

getting shorter, do something.

I don't know if I was any help. I want you to know that you are not

alone!!

Take care,

Dawn

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Hi Leanne, welcome! I thought I was reading my son's menu for a

minute there!! You might get lots of responses to your post

regarding either the limited food choices or the OCD related issues

(or both!).

My son is *both*. He's 17 now. His OCD began in 6th grade.

However, he had OCD behaviors at a younger age, just no

actual " disorder " until 6th grade; then all these 24/7 rituals,

compulsions popped up.

So as to diet for my son, let's see....chicken nuggets or patties;

will eat fried chicken and used to just be the " skin " part but now

will eat the meat; macaroni & cheese; potatoes - baked, french fries,

mashed, fried...; tacos - only beef he gets; some types pasta like

fettucine alfredo or Lipton chicken noodles; Ramen noodles/soup; no

fruit, no other veges; biscuits; cake; brownies; Hershey's candy

bars; 3 Musketeers bar; regular potato chips, some particular BBQ;

cheese pizza; cheese; crackers (not w/cheese); pancakes, no

syrup....that's all I can think of at the moment. Oh - only corn on

the cob, no other corn and also hotdogs. So, starchy for him too.

As to OCD and food. WELL, just this month he began having

scrupulosity/religious issues and had made all these little " I

swear... " regarding food, as in " I swear I won't eat... " or similar.

And he had to stick to them. Also, he was confused a bit as to what

the Bible said you could/couldn't eat. We were down to a baked

potato with only salt for him to eat for 3 or 4 days. BUT we talked

to minister and that helped LOTS re the food issues. Now there are

still other scrup/religious issues to work on, but he's eating.

Just wanted to show you that you NEVER KNOW the why of food issues,

they can be so different from person to person, whether contamination

or other, like my son.

I will say that my son has food *texture* issues. Also other sensory

issues. Back in elementary school, the speech and occupational

therapists figured that out for me. And I also wondered about his

teeth and asked the dentist and later the orthodontist if perhaps

his " chewing " might be a problem since he did say to me he had

trouble chewing some meats, etc. But I never got a clear answer from

either one of them.

That said, I'm also not a big vege eater, though I like fruit. I

just don't like the taste of them. And I'm 48 so I've made it to

this age with not many veges! :) I can eat veges in things like

vegetable soup or mixed with rice or chicken pot pie...but not

alone. The other food masks the taste of things like green beans,

etc., or perhaps blends in with the taste enough for me. Anything

similar for your daughter???

For her mouth - when 2 of my sons were very young (including my OCD

son), I used to give them a baby washcloth (they were thin and easier

to do this with and had a slightly rough side) and have them put the

cloth over their finger and dip it in the fluoride rinse (like Act)

and rub their teeth with it. This was their brushing. Wouldn't use

a toothbrush and toothpaste made them feel sick. It worked well,

they had no cavities! The cavities came when they finally began

using toothpaste! Anyway, a thought for you, maybe she'll dip her

brush in a flavored fluoride rinse. And use soft bristled

toothbrush.

Wish I had more time to talk more of OCD, but gotta run! Hang in

there, and, again, welcome!

single mom, 3 sons

, 17, with OCD, dysgraphia and Aspergers/autism

>

> Hello to everyone. I am so glad to have found this online group!

>

> My daughter was diagnosed with OCD about a year ago (she is now

9).

> Her main issue is with food. She just doesn't eat much of

anything.

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Hi Leanne and Dawn,

My dd started restricting food based on " safe " foods and " safe "

rituals, over a year ago, at age 12, after a vomiting flu/illness.

Since she was only in 5th percentiles previously she could not afford

to lose weight. I ended up taking her to emgcy room twice but both

times she was found " stable " . The second time her bmi was only 12.5

yet she was found " stable " and could not be admitted overnight.

Have you ever experienced having your daughter with ocd/ED

transferred out of the hospital without your consent to a teen locked

psychiatric ward? Is this in any way standard approach with eating

disorders? (Btw have you noticed that the ED/anorexia community does

not know too much about eating disorders secondary to ocd?)

This happened to my daughter when I took her to our local Children's

Hospital to determine if she was stable and b/c I felt (basically in

panicked state myself b/c she had gone on a fast to " fix " the

rituals) she needed medical monitoring and probably admission.

Her bmi had fallen to 12.5. Since her vital signs were medically ok,

but she was considered a danger to self b/c she was not eating

enough, and b/c of resisting treatment (resisted the ekg b/c of ocd

issues-but if they had allowed her to place the electrodes herself as

I requested it would have been ok) they transferred her to an

adjacent teen (age 13 to 18) locked psych ward, at nearly midnight,

after a whole exhausting day in emgcy without eating, with a brutal

admission procedure (forcibly restrained by male orderlies,

unclothed, searched, screaming, other residents yelling obscenities

b/c of the noise) that had an ED " track " . I cannot believe they

manhandled her in such a fragile 70 lb state, while totally

exhausted, and with all her extreme modesty and sensory acuities and

defensivemess.

There was an armed security guard present, I was shut away from

overseeing what was happening in another room, but I could hear and

see (straining to look around a corner). Four men carried her off two

on each side. I also heard the orderly laugh at her when she

screamed in fright, after they left her alone on the floor, to bring

her a sheet. I had to leave that night without speaking to her or

having any way to know what was happening b/c she was in state

custody.

She lost over 3 lbs lbs there in 5 days. They had no understanding of

ocd or of eating disorders. They expected her to choose her own foods

with the other residents. When I asked about her ocd issues with the

staff psychiatrist, she said she would have to " white knuckle " it.

When I asked about the fright she experienced on admission they

said " well she's not been complaining about it " . They thought I was

being overprotective.

Maybe they thought I was not competent b/c she is homeschooled and

b/c I have 6 children. I don't know, but I in effect lost custody of

her for that time. I basically had to flatter them, accept their

determination that my over protecting and sheltering had damaged her,

and play up to them to get her out. She had (still has) sevre ptsd.

(Btw she had the highest ever score on their academic test they

administer to assess grade level-they found her at 12th grade level.

Not that I am bragging- she is the one who is smart all on her own,

but they complained about her being homeschooled).

Afterwards I became more a hostage to her ocd eating rituals (to keep

her weight up-and additionally with ptsd breakdowns) than ever b/c I

could not rely on the hospital to oversee her care in an emgcy

without fearing they would transfer her against my will. Her rituals

are diminishing very gradually, maybe as some of the ptsd is getting

a bit better, it makes her less rigid about the rituals. (Though she

had a nightmare again only last week).

What we do have lined up potentially, is a clinic an hour's flight

away, so it cannot be handled on an emcgy basis. We are taking a wait

and see approach on that b/c my d is not the type who will fare well

in a setting far away from family support.

In the meantiome though, I feel like I have no recourse if we should

feel like we are in an emgcy. Her weight has improved though, but

stll around 5th percentile which I feel is borderline esp if she

should get sick (plus her puberty is delayed) What if I want her

medically monitored in an emgcy-but I cannot trust the hospital.

They actually tricked me, telling me they were transferring her to

the adjacent hospital, (not the psych ward) b/c she was too old for

Children's hospital. Why did they do this, and why treat someone with

an eating disorder like a criminal (no music, no books, no visitors

but for an hour each evening, isolation in an empty room with only a

bed, extremely dingy atmosphere, unprofessional staff (they yelled

insults at her) no windows, no time outdoors (on 4th floor of

building) so on.

I feel sorry for the other kids there, but none of them were as

fragile or as young as my daughter. Out therapist thinks we should

consider a lawsuit. The 12.5 bmi, but denied hospital admission, and

being misled about the psych admission might be enough to go on.

I cannot quite understand how the hospital here cannot or will not

admit someone malnourished with ocd/ed, whether to feed her in a

hospital bed with care of a nurse, or to tube feed if necessary, they

will not do this for an Ed. Our closest hosptal will not take her

b/c she is too young, so they will transfer to Children's hospital,

but then they will not take her (unless dying I guess) b/c they do

not treat eating disorders.

I did not necessarily want treatment, just stabilization and

temporary help to keep her medically safe. Wouldn't they help a child

malnourished from vomiting, or cystic fibrosis, or some other cause?

I don't really get it. I guess kids with eating disorders just have

to go far away even if an emgcy, but then you have the catch that no

bed may be immediately available at the far away ED unit. Sometimes

there can be as much as a 4 week wait. It seems pretty sad medically

that a parent has to be so on their guard for a child's safety at the

Children's hospital. This kind of reminds me too, how badly my son

was treated (who had a vocal tic at ages 4 to 6) by the doctor at

Children's hospital when he did not answer questions quickly enough

(he was being seen for a limp). They seem to have this no nonsense,

we won't coddle (like the parents') approach, and parents-get-in-the

way attitude.

nancy grace

>

> Dear Leanne,

>

> When I was reading your post, I thought I was re-reading something I

> wrote!! Especially about the eating!! My daughter was diagnosed

at 8

> (she is now 10) with OCD. She was hospitalized for a few days

because

> she basically stopped eating. The doctors initially thought eating

> disorder but I knew it was OCD. Her list of " safe " foods were

slowly

> dwindling to nothing which lead to her hospitalization.

>

> Your daughters diet and my daughters diet are very similar. She

will

> eat chicken Mcnuggets but only if it looks a certain way. She will

> eat cheese pizza but only if her OCD/anxiety level is low enough.

She

> will eat scrambled eggs but only if my mother makes it. You get the

> picture ... ?

>

> " She would rather not eat than try anything new or eat something

that

> isn't the brand that she likes. "

>

> My daugher is also like this but now if she says something looks

good

> or she wants to try something, I give her only a tiny bit and not

make

> a big deal out of it. I tell her if she doesn't like it, that's ok

> and I praise her for trying. I tell her that eventhough it's not

> something she likes now, her taste buds will remember it and may

like

> it later.

>

> I used to get overly excited when she wanted to try something and

give

> her a normal sized amount of the food but then I would be upset at

her

> for not eating it. Obviously, this didn't work so now I do the tiny

> bit and praise.

>

> " And slowly but surely the few foods that she will eat are

> disappearing from her list of things that she'll eat for reasons she

> can't explain other than to say that she just doesn't want to eat

them

> anymore. "

>

> I am so sorry that you are going through this. <<<<<big hug>>>>>

I've

> been there and continue to be there. Reading your post is bringing

> tears to my eyes ... I know how you are feeling.

>

> If she starts losing weight or is basically eating next to nothing,

> take her to the doctor. If your doctor doesn't do anything, have

her

> admitted to the hospital.

>

> At first, my doctor did nothing. I felt helpless. I felt I

shouldn't

> go to the hospital then I realized it hasn't/wasn't going to get

> better at home. So I took her to the hospital. She was so

dehydrated

> ... she just slept and I cried. I'm getting off track. I guess I

> just wanted you to learn from my mistake. You know your daughter

best

> and if she is not getting better and the list of " safe " foods are

> getting shorter, do something.

>

> I don't know if I was any help. I want you to know that you are not

> alone!!

>

> Take care,

> Dawn

>

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Hi Leanne,

I spouted off about my own problems but thought I should add, if

your dd is medically stable and not in danger of serious

malnourismnet- is the therapist doing exposures for the eating

issues, like trying new food bit by bit, maybe just bites, with

reward system? I think it could be good to make progress on this now

b/c when growth spurt hits, or illness, or puberty etc and extra

calories are needed, a resticted diet can present a bigger problem.

My daughter never restricted foods, but was very very slow eater, so

she did not get as much food at a sitting as her siblings, and if we

were having a busy day she might not get enough to eat. (I see this

more with hindsight). She also had migraines occasionally esp in

summer causing her to skip dinner. So when her ocd eating issues hit

(triggered by illness/vomiting) with already low weight, and around

puberty and growth spurt, she was quickly medically compromised.

The trouble with eating isues, is that doing exposures may create

anxiety that interferes with eating, initially, and this can be a

dilemma if the child is in malnourished state. But over time, I think

there can be progress. My d has to learn to eat faster (as well as

eat w/out her rituals) but it has to worked at steadily and

methodically, I don't think it happens (that eating normalizes) just

naturally (as I sort of hoped back when my d was such a slow

eater). Best wishes-this is a frustrating area of OCD to deal with.

nancy grace

>

> Hello to everyone. I am so glad to have found this online group!

>

> My daughter was diagnosed with OCD about a year ago (she is now

9).

> Her main issue is with food. She just doesn't eat much of

anything.

> Since moving her off of baby food as an infant, she hasn't had a

fruit

> or veggie (the only fruit she gets is from apple juice). Her only

meat

> that she'll eat is a chicken nugget. So she mainly eats crackers,

> pancakes, cheese, bagels with cream cheese, cheese pizza, and

cheese

> sandwiches. Do you see the pattern here? :-) She is a starch and

> dairy girl but will eat very few things from those areas and

usually

> will only eat certain brands. She would rather not eat than try

> anything new or eat something that isn't the brand that she likes.

She

> used to tell us she was afraid of throwing up but now tells us that

Mr.

> OCD is telling her not to eat things but isn't giving her a reason

to

> not eat them. So her " compulsion " is pure avoidance. And slowly

but

> surely the few foods that she will eat are disappearing from her

list

> of things that she'll eat for reasons she can't explain other than

to

> say that she just doesn't want to eat them anymore. She has

trouble

> eating near other people for fear that their food will touch her.

Her

> food that she will eat, she arranges in specific ways.

>

> She also has extreme mouth sensitivity - toothbrushing is so

difficult

> (she will only do it with water and no toothpaste), dental visits

are

> torture, no one can kiss her anywhere near the mouth, etc.

>

> She has some tactile sensitivity as well. She is afraid to touch

> things or let things touch her that may be sticky, slimy, or

messy.

> But then she loves to play in the mud and pick up bugs. Go figure?!

>

> She is currently on Celexa and Klonopin and has been attending

therapy

> for nearly a year now (therapist is doing ERP). I've read some OCD

> books and obviously talk with her therapist weekly but haven't met

> anyone with a child with eating OCD issues. My daughter just

doesn't

> seem like the typical case you read about in the books. Does

anyone

> out there have experience with this? Any words of wisdom for me or

> things that we may not have thought of?

>

> Thanks so much for opening your group to me. I appreciate it.

> - Leanne

>

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I don't have time to give a full reply this morning with our story,

we're off to basketball! I did want to second the point about not

waiting to hospitalize if she is dropping foods. We were actually

working with a family therapist, a psychiatrist and our pediatrician and

STILL they waited until she was medically unstable before admitting her

and renourishing her through an n-g tube. Our daugher, Mikayla, age 10,

also has OCD that was misdiagnosed for 1 1/2 yrs. She had tried Celexa,

but it didn't work for her. She is now on Prozac and it's the right

match for her. She is leading a normal life--eating great and having a

regular kid life. It's been a long and bumpy road and will send out

more information later. I'm sorry you are going through this! I know

exactly how you feel. Eating issue come up every few hours at the next

meal and food dominates our social lives as well and makes everyday

living so difficult.

Dina

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I think you were mistreated as well. It sounds like a horrible ordeal

that will take a long time for you all to get over.

I can't speak to all of the issues, but I can say that hospitals

without the proper psychiatric services located in that facility will

not treat eating disorders because they are classified as a

psychaitric condition. They cannot recieve reimbursement for that

care. Also, they are liable for mishandling the care of a psychiatric

patient when they are not " equipped " or licensed to provide that care.

When someone comes into the hospital with a primary psychatric

disorder and they are also medically unstable, they get medical

treatment to become stable before their psychiatric disorders are

addressed. If your daughters blood pressure were low or she had some

other medical problems related to her anorexia, they would have begun

hydarting her with fluids and perhaps inserted a tube feeding.

Also know that whenever you see or believe that you or a loved one are

being mistreated in a health care setting or that the care should be

provided another way, ask to speak with an administrator immediately.

They have the ability/duty to address your concerns. I know because

this is what I do for a living.

Best wishes,

Bonnie

> >

> > Dear Leanne,

> >

> > When I was reading your post, I thought I was re-reading something I

> > wrote!! Especially about the eating!! My daughter was diagnosed

> at 8

> > (she is now 10) with OCD. She was hospitalized for a few days

> because

> > she basically stopped eating. The doctors initially thought eating

> > disorder but I knew it was OCD. Her list of " safe " foods were

> slowly

> > dwindling to nothing which lead to her hospitalization.

> >

> > Your daughters diet and my daughters diet are very similar. She

> will

> > eat chicken Mcnuggets but only if it looks a certain way. She will

> > eat cheese pizza but only if her OCD/anxiety level is low enough.

> She

> > will eat scrambled eggs but only if my mother makes it. You get the

> > picture ... ?

> >

> > " She would rather not eat than try anything new or eat something

> that

> > isn't the brand that she likes. "

> >

> > My daugher is also like this but now if she says something looks

> good

> > or she wants to try something, I give her only a tiny bit and not

> make

> > a big deal out of it. I tell her if she doesn't like it, that's ok

> > and I praise her for trying. I tell her that eventhough it's not

> > something she likes now, her taste buds will remember it and may

> like

> > it later.

> >

> > I used to get overly excited when she wanted to try something and

> give

> > her a normal sized amount of the food but then I would be upset at

> her

> > for not eating it. Obviously, this didn't work so now I do the tiny

> > bit and praise.

> >

> > " And slowly but surely the few foods that she will eat are

> > disappearing from her list of things that she'll eat for reasons she

> > can't explain other than to say that she just doesn't want to eat

> them

> > anymore. "

> >

> > I am so sorry that you are going through this. <<<<<big hug>>>>>

> I've

> > been there and continue to be there. Reading your post is bringing

> > tears to my eyes ... I know how you are feeling.

> >

> > If she starts losing weight or is basically eating next to nothing,

> > take her to the doctor. If your doctor doesn't do anything, have

> her

> > admitted to the hospital.

> >

> > At first, my doctor did nothing. I felt helpless. I felt I

> shouldn't

> > go to the hospital then I realized it hasn't/wasn't going to get

> > better at home. So I took her to the hospital. She was so

> dehydrated

> > ... she just slept and I cried. I'm getting off track. I guess I

> > just wanted you to learn from my mistake. You know your daughter

> best

> > and if she is not getting better and the list of " safe " foods are

> > getting shorter, do something.

> >

> > I don't know if I was any help. I want you to know that you are not

> > alone!!

> >

> > Take care,

> > Dawn

> >

>

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Thanks for your input Bonnie, I see your point about hospitals that

do not have protocol or services for psychiatric care and the risks

involved.

About administrators, when my dd was transferred and I realized we

were entering a locked psychiatric ward (not the adjacent medical

hospital) I asked for the administrator, but it was close to midnight

and he was supposedly unavailable until morning. When I asked to

return my dd to the hospital so I could stay with her as planned, I

was told she was on a 72 hr hold in state custody and I had no legal

recourse.

My concern too, was that her heart rate and blood pressure were very

low- but apparently low " normal " range. Couldn't this have presented

a danger when she was being restrained and dealing with severe

fright? I do understand about a hospital not having expert care for

medical conditions that arise from psychiatric concerns, but they

should have a safe temporary protocol for dealing with this when

there is no local facility for it. Sending a 12 yr old to the

psychiatric ward may not be the most beneficial option. (We do have

UCLA with ED unit about 3 hour drive-but they were contacted and had

a 4 week wait for beds).

I have since learned re heart rate that a continuous monitor needs

to be placed overnight to get an accurate assessment b/c heart rate

can drop precipitously in anorexic patients during sleep. Maybe they

could have kept her for observation at least overnight (I would have

stayed with her as needed) until we learned whether the medical

danger were severe or not, and we could have used the time to plan

for a facility that we approved of, or to discuss ramifications of

taking her home, or maybe seeing if she coud be persuaded to eat in

hospital setting (with a caring attitude). Maybe it could have

served as a deterrent (she would not want to be hospitalized again so

would be motivated to work at the problem at home) but the psych

treatment just terrorized and panicked her to degree that she was

hearing condemning frightening voices daily and felt she was being

grabbed and smothered every night in her sleep and that she had

comitted a crime that merited punishment and isolation. She blamed

me and could no longer trust me or any medical personnel, total panic

ensued wrt to seeing a doctor.

If I had known that a 12.5 bmi (and we were referred by pediatrician

and psychiatrist for emergency admission b/c of this) and the

potential complications arising from that, would merit transfer to a

non-medical residential locked psychiatric ward rather than emcgy

medical monitoring overnight, I would not have taken her to the

emergency room.

I guess my point is when you have a child with illness where medical

and psychiatric concerns overlap, you are in a tricky place wrt

receiving medical treatment per insurance considerations ect. But, a

medical danger is no less dangerous or less 'medical' when

associated with a psychiatric condition than when acssociated with a

purely medical condition, and so kids who need to be rehydrated or

monitored with flu symptoms or food poisoning or food allergy crisis

etc are not passed over or passed on (like passing the buck, I

guess).

BTW insurance denied coverage for our emgcy visit b/c it

was " psychiatric " and b/c she was not clinically an " emcgy " case-so

if a 12.5 bmi is considered a medical emgcy, and you are told to rush

to the hospital, but your child does not subsequently present with

clinically dangerous symptoms-you should then be denied coverage? (We

did appeal and won).

The upshot of this has been that I will not take her to the local

Childrens Hospital, but it is quite an insecure feeling to know that

one does not have access to emgcy care when dealing with the ups and

downs of an eating disorder. I have since managed to keep her weight

up by using her rituals (rather than challenging them-we tried with

erp therapy but she could not really handle even a single missed meal

that resulted from attempting the exposures). I'm hoping when she

gets to healthy enough weight we can pursue additional treatment to

overcome the rituals.

nancy grace

> > >

> > > Dear Leanne,

> > >

> > > When I was reading your post, I thought I was re-reading

something I

> > > wrote!! Especially about the eating!! My daughter was

diagnosed

> > at 8

> > > (she is now 10) with OCD. She was hospitalized for a few days

> > because

> > > she basically stopped eating. The doctors initially thought

eating

> > > disorder but I knew it was OCD. Her list of " safe " foods were

> > slowly

> > > dwindling to nothing which lead to her hospitalization.

> > >

> > > Your daughters diet and my daughters diet are very similar.

She

> > will

> > > eat chicken Mcnuggets but only if it looks a certain way. She

will

> > > eat cheese pizza but only if her OCD/anxiety level is low

enough.

> > She

> > > will eat scrambled eggs but only if my mother makes it. You

get the

> > > picture ... ?

> > >

> > > " She would rather not eat than try anything new or eat

something

> > that

> > > isn't the brand that she likes. "

> > >

> > > My daugher is also like this but now if she says something

looks

> > good

> > > or she wants to try something, I give her only a tiny bit and

not

> > make

> > > a big deal out of it. I tell her if she doesn't like it,

that's ok

> > > and I praise her for trying. I tell her that eventhough it's

not

> > > something she likes now, her taste buds will remember it and

may

> > like

> > > it later.

> > >

> > > I used to get overly excited when she wanted to try something

and

> > give

> > > her a normal sized amount of the food but then I would be upset

at

> > her

> > > for not eating it. Obviously, this didn't work so now I do the

tiny

> > > bit and praise.

> > >

> > > " And slowly but surely the few foods that she will eat are

> > > disappearing from her list of things that she'll eat for

reasons she

> > > can't explain other than to say that she just doesn't want to

eat

> > them

> > > anymore. "

> > >

> > > I am so sorry that you are going through this. <<<<<big

hug>>>>>

> > I've

> > > been there and continue to be there. Reading your post is

bringing

> > > tears to my eyes ... I know how you are feeling.

> > >

> > > If she starts losing weight or is basically eating next to

nothing,

> > > take her to the doctor. If your doctor doesn't do anything,

have

> > her

> > > admitted to the hospital.

> > >

> > > At first, my doctor did nothing. I felt helpless. I felt I

> > shouldn't

> > > go to the hospital then I realized it hasn't/wasn't going to get

> > > better at home. So I took her to the hospital. She was so

> > dehydrated

> > > ... she just slept and I cried. I'm getting off track. I

guess I

> > > just wanted you to learn from my mistake. You know your

daughter

> > best

> > > and if she is not getting better and the list of " safe " foods

are

> > > getting shorter, do something.

> > >

> > > I don't know if I was any help. I want you to know that you

are not

> > > alone!!

> > >

> > > Take care,

> > > Dawn

> > >

> >

>

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Thanks for your input Bonnie, I see your point about hospitals that

do not have protocol or services for psychiatric care and the risks

involved.

About administrators, when my dd was transferred and I realized we

were entering a locked psychiatric ward (not the adjacent medical

hospital) I asked for the administrator, but it was close to midnight

and he was supposedly unavailable until morning. When I asked to

return my dd to the hospital so I could stay with her as planned, I

was told she was on a 72 hr hold in state custody and I had no legal

recourse.

My concern too, was that her heart rate and blood pressure were very

low- but apparently low " normal " range. Couldn't this have presented

a danger when she was being restrained and dealing with severe

fright? I do understand about a hospital not having expert care for

medical conditions that arise from psychiatric concerns, but they

should have a safe temporary protocol for dealing with this when

there is no local facility for it. Sending a 12 yr old to the

psychiatric ward may not be the most beneficial option. (We do have

UCLA with ED unit about 3 hour drive-but they were contacted and had

a 4 week wait for beds).

I have since learned re heart rate that a continuous monitor needs

to be placed overnight to get an accurate assessment b/c heart rate

can drop precipitously in anorexic patients during sleep. Maybe they

could have kept her for observation at least overnight (I would have

stayed with her as needed) until we learned whether the medical

danger were severe or not, and we could have used the time to plan

for a facility that we approved of, or to discuss ramifications of

taking her home, or maybe seeing if she coud be persuaded to eat in

hospital setting (with a caring attitude). Maybe it could have

served as a deterrent (she would not want to be hospitalized again so

would be motivated to work at the problem at home) but the psych

treatment just terrorized and panicked her to degree that she was

hearing condemning frightening voices daily and felt she was being

grabbed and smothered every night in her sleep and that she had

comitted a crime that merited punishment and isolation. She blamed

me and could no longer trust me or any medical personnel, total panic

ensued wrt to seeing a doctor.

If I had known that a 12.5 bmi (and we were referred by pediatrician

and psychiatrist for emergency admission b/c of this) and the

potential complications arising from that, would merit transfer to a

non-medical residential locked psychiatric ward rather than emcgy

medical monitoring overnight, I would not have taken her to the

emergency room.

I guess my point is when you have a child with illness where medical

and psychiatric concerns overlap, you are in a tricky place wrt

receiving medical treatment per insurance considerations ect. But, a

medical danger is no less dangerous or less 'medical' when

associated with a psychiatric condition than when acssociated with a

purely medical condition, and so kids who need to be rehydrated or

monitored with flu symptoms or food poisoning or food allergy crisis

etc are not passed over or passed on (like passing the buck, I

guess).

BTW insurance denied coverage for our emgcy visit b/c it

was " psychiatric " and b/c she was not clinically an " emcgy " case-so

if a 12.5 bmi is considered a medical emgcy, and you are told to rush

to the hospital, but your child does not subsequently present with

clinically dangerous symptoms-you should then be denied coverage? (We

did appeal and won).

The upshot of this has been that I will not take her to the local

Childrens Hospital, but it is quite an insecure feeling to know that

one does not have access to emgcy care when dealing with the ups and

downs of an eating disorder. I have since managed to keep her weight

up by using her rituals (rather than challenging them-we tried with

erp therapy but she could not really handle even a single missed meal

that resulted from attempting the exposures). I'm hoping when she

gets to healthy enough weight we can pursue additional treatment to

overcome the rituals.

nancy grace

> > >

> > > Dear Leanne,

> > >

> > > When I was reading your post, I thought I was re-reading

something I

> > > wrote!! Especially about the eating!! My daughter was

diagnosed

> > at 8

> > > (she is now 10) with OCD. She was hospitalized for a few days

> > because

> > > she basically stopped eating. The doctors initially thought

eating

> > > disorder but I knew it was OCD. Her list of " safe " foods were

> > slowly

> > > dwindling to nothing which lead to her hospitalization.

> > >

> > > Your daughters diet and my daughters diet are very similar.

She

> > will

> > > eat chicken Mcnuggets but only if it looks a certain way. She

will

> > > eat cheese pizza but only if her OCD/anxiety level is low

enough.

> > She

> > > will eat scrambled eggs but only if my mother makes it. You

get the

> > > picture ... ?

> > >

> > > " She would rather not eat than try anything new or eat

something

> > that

> > > isn't the brand that she likes. "

> > >

> > > My daugher is also like this but now if she says something

looks

> > good

> > > or she wants to try something, I give her only a tiny bit and

not

> > make

> > > a big deal out of it. I tell her if she doesn't like it,

that's ok

> > > and I praise her for trying. I tell her that eventhough it's

not

> > > something she likes now, her taste buds will remember it and

may

> > like

> > > it later.

> > >

> > > I used to get overly excited when she wanted to try something

and

> > give

> > > her a normal sized amount of the food but then I would be upset

at

> > her

> > > for not eating it. Obviously, this didn't work so now I do the

tiny

> > > bit and praise.

> > >

> > > " And slowly but surely the few foods that she will eat are

> > > disappearing from her list of things that she'll eat for

reasons she

> > > can't explain other than to say that she just doesn't want to

eat

> > them

> > > anymore. "

> > >

> > > I am so sorry that you are going through this. <<<<<big

hug>>>>>

> > I've

> > > been there and continue to be there. Reading your post is

bringing

> > > tears to my eyes ... I know how you are feeling.

> > >

> > > If she starts losing weight or is basically eating next to

nothing,

> > > take her to the doctor. If your doctor doesn't do anything,

have

> > her

> > > admitted to the hospital.

> > >

> > > At first, my doctor did nothing. I felt helpless. I felt I

> > shouldn't

> > > go to the hospital then I realized it hasn't/wasn't going to get

> > > better at home. So I took her to the hospital. She was so

> > dehydrated

> > > ... she just slept and I cried. I'm getting off track. I

guess I

> > > just wanted you to learn from my mistake. You know your

daughter

> > best

> > > and if she is not getting better and the list of " safe " foods

are

> > > getting shorter, do something.

> > >

> > > I don't know if I was any help. I want you to know that you

are not

> > > alone!!

> > >

> > > Take care,

> > > Dawn

> > >

> >

>

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There is always someone on-call for administration. Perhpas the

staff did not want to call that person. The hospital has an

administrator as well. If ever you go to a local ER and they want to

transfer your daughter, you have the right to know what kind of place

she is going to (and know that they have the proper services). You

can refuse voluntary transfer if you disagree and ask to speak with a

case manager or administrator and that would keep you in the ER.

Last week I placed a teenager in our pediatric unit with a patient

sitter because she was suicidal and I had no facility available to

take her.

It gets tricky with involuntary admissions. An involuntary admission

to a psychiatric facility requires a mental health committment (based

on imminent danger to oneself or another) - this is done by a

psychiatrist (at least in my state). Involuntary admission or

voluntary admission with a 72 hr hold in lieu of committment is proof

enough that the initial ER visit was warranted (your insurance

company really should pay for that). FYI: sometimes a hospital will

seek a voluntary admission so that they have a better chance of

placing a patient (involuntary patient slots are harder to come by)

and to save the time required to have a psychiatrist do the

committment for involuntary admission.

Yes, anorexics can develop abnormal heart rhythms associated with

dehydration and/or resultant kidney problems. This risk can be

evaluated in the ER by physical exam and labwork. The vital signs

associated with moderate to severe dehydration would be a low blood

pressure and a fast heart rate.

I know it is scary. Before my son first went on meds, he lost a lot

of weight and I was really frightened. I couldn't get him out of

the house (agoraphobic). He has also threatened to hurt himself in

the past. I was afraid to take him to the hospital because I wasn't

sure what they would want to do. My husband and I stayed with him

and slept with him until that dreadful time passed.

It sounds like your daughter is too unstable to participate in ERP.

Perhaps she needs more meds or a different kind before therapy can

proceed. This was the case with my son.

I wish you all the best.

Bonnie

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Hi Bonnie, I think the problem was that supposedly my dd was being

transferred to a HOSPITAL (the adjacent all-purpose hospital as

opposed to remaining at Children's Hospital) this is what they told

me, not that she was being transferred to a locked psychiatric ward.

When we met in the lobby (she brought by ambulance) I saw we were in

a facility separate from the nearby hospital, but it had no name over

the door. (Actually both places have the same name, but something

like adolescent services attached to the name of the psychiatric

facility).

I then saw it was automatically locked behind us and the armed

security officer. I was then told that my d was being admitted on a

72 hour hold, which I had no idea what that was. I was told I could

not take her out if I wanted to. I still did not realize, until we

got upstairs, that it was residential facilty (and very dingy btw)

not a medical facility. I believe the the admission had to do with

her breaking a small glass vial in the hospital examining room post

ekg, which was so stressful for her b/c of ocd sensory issues (I was

briefly away from her examining room at the time- they chose to wake

her for the EKG in my absence, although I had requested to be present

and for her to place the electrodes, which has worked in past).

Well, at home she has an infrequent compulsion to break a light

bulb (she actually did this when the doctor who is conducting the

genetic ocd reserch study we are partcipating in was present-this

doctor was not phased by it at all). She has no intention to hurt

anyone, and sweeps it up herself, and actually keeps one in her

dresser drawer for that purpose. So she was not a danger to self imo,

and had not indicated any suicidality to me at all. Maybe they

thought broken glass indicated a plan to cut herself. They should

have discussed the matter with me, rather than making their own

assumptions. (They never told me about this glass incident, my d told

me later). I think that I was viewed as potentially recalcitrant and

so needing to be " pushed along " by means of not providing me with

explicit information, so the psych admission could take place.

I think the fact is that Children's Hospital does not understand ocd

and spectrums, and views behaviors in a 12 yr old as teen rebellion

or potentially dangerous etc. Maybe b/c it was very late, there was

not a social worker on hand who could have helped sort matters out.

Well sorry to be belaboring this, and getting O/T for this board.

Maybe it is a bit cathartic for me to discuss it- so thanks for your

input. I do think the hospital sitter would have been preferable to

the psych admission, and I would have been willing to sit with her

all night as well.

nancy grace

>

> There is always someone on-call for administration. Perhpas the

> staff did not want to call that person. The hospital has an

> administrator as well. If ever you go to a local ER and they want

to

> transfer your daughter, you have the right to know what kind of

place

> she is going to (and know that they have the proper services). You

> can refuse voluntary transfer if you disagree and ask to speak with

a

> case manager or administrator and that would keep you in the ER.

> Last week I placed a teenager in our pediatric unit with a patient

> sitter because she was suicidal and I had no facility available to

> take her.

>

> It gets tricky with involuntary admissions. An involuntary

admission

> to a psychiatric facility requires a mental health committment

(based

> on imminent danger to oneself or another) - this is done by a

> psychiatrist (at least in my state). Involuntary admission or

> voluntary admission with a 72 hr hold in lieu of committment is

proof

> enough that the initial ER visit was warranted (your insurance

> company really should pay for that). FYI: sometimes a hospital

will

> seek a voluntary admission so that they have a better chance of

> placing a patient (involuntary patient slots are harder to come by)

> and to save the time required to have a psychiatrist do the

> committment for involuntary admission.

>

> Yes, anorexics can develop abnormal heart rhythms associated with

> dehydration and/or resultant kidney problems. This risk can be

> evaluated in the ER by physical exam and labwork. The vital signs

> associated with moderate to severe dehydration would be a low blood

> pressure and a fast heart rate.

>

> I know it is scary. Before my son first went on meds, he lost a

lot

> of weight and I was really frightened. I couldn't get him out of

> the house (agoraphobic). He has also threatened to hurt himself in

> the past. I was afraid to take him to the hospital because I

wasn't

> sure what they would want to do. My husband and I stayed with him

> and slept with him until that dreadful time passed.

>

> It sounds like your daughter is too unstable to participate in

ERP.

> Perhaps she needs more meds or a different kind before therapy can

> proceed. This was the case with my son.

>

> I wish you all the best.

> Bonnie

>

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