Tuesday, 1 September 2009

Pre doctor thoughts

Phew, the last four days have been quite tricky: having guests and yet concentrating on Waif eating properly is tough and I am not sure we fully succeeded. There have been many tears.

Last night we had drinks with some good friends, including Anna. Anna is the borough child psychiatrist. She thinks that the Waif looks far too thin and also ill. She advises that we get an immediate referral to the Maudsley. She said we "didn't necessarily have to go privately". I do not care greatly - if we have to pay, then we will pay. We are fortunate that we can. OTOH if the NHS and/or BUPA will stump up then I shall gratefully accept but really that is a secondary issue that I am happy to address after treatment commences.

This morning, Waif had a small bowl of bran flakes. At 10.30am I made her a snack of a chipolata toasted sandwich. Waif carefully picked out one chipolata and ate half of it. She then negotiated down to a swap for a quarter bowl of yoghurt and sugar.

She ate a medium lunch (some chicken pie and ratatouille - no potatoes, no bread and the pie crust cut off and left), and says that she ate a large mars bar in the cinema this afternoon.
Sigh, I hope this proves to be a storm in a teacup.

I am worried that if Waif gets a stomach upset (as her older sister has had for the last couple of days) or swine flu, then she will not have sufficient strength to fight it off without becoming seriously ill. This is one of the questions I want the GP to answer for me tomorrow.

I have made a prebooked appointment for the Waif tomorrow afternoon at the GP surgery. I will phone in the morning and get an on-the-day appointment for the morning to discuss issues in the morning with the doc. I shall tell him that as far as I can tell (and I am not wholly incompetent) Waif has a BMI of about 14.5, is in the bottom first weight centile for her age and height, and is reluctant to eat properly. I shall ask him for a referral. If he is still reluctant I shall point out that Waif has lost over 15% of her body weight since Christmas and at what weight exactly would he make a referral? I shall point out that again, as far as I can tell, early intervention is much more effective than late.

To my utter surprise, my husband has agreed to go to work late tomorrow so that he can attend the morning GP appointment. I am really pleased about this as he will need to be on board with any treatment approach, and I also can't help believing that a 6ft 4, besuited city lawyer will be taken more seriously than a middle aged neurotic housewife.

School is the next big hurdle: do I allow Waif to choose her own school lunch (and possibly skip it) or do I turn up every lunch hour to supervise the eating of sandwiches in the carpark, or do I send her in to school only for half days? I need some advice as to how seriously to treat this. Luckily as Waif is entering Year 9, this is not a big exam year giving us some leeway to miss lessons.

I have not weighed Waif for 7 days as it upsets her so, and weighing a pig does nothing to fatten it. I trust the doctor will do so tomorrow.

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