correspondence with GP

I have now heard back from the GP. I originally wrote to him:

Dear Doctor GP

thank you so much for your referral of my daughter, Waif, to the Maudsley clinic. We have been along for two sessions now and everything there is very efficient and I am reassured that she is getting the best possible treatment.

As I understand it, they agree that Waif is very underweight (77% of where she should be, whereas 84% or below is considered to be a marker of anorexia). However, on her questionnaires she does not seem to display other indicators (concern over weight, anxiety, depression). She is a clever girl who plays her cards close to her chest so it is quite possible that she has not made full disclosure on the forms, and that may come out in the weeks to come. However in the meantime she continues to lose weight, albeit not as quickly, even though she appears to be eating well at mealtimes.

The reason for my letter is that I am concerned that whilst the Maudsley are understandably pursuing the Eating Disorder route, which could well be right even if not currently indicated psychologically, perhaps there could be some underlying physical cause for Waif's weight loss? I know that you took some blood tests and wondered if there is anything more that could/should be done to exclude any physical basis for Waif's condition, either directly or through causing loss of appetite? If there is, then I will make an appointment with you and bring her in - I have not done so immediately because she is fed up with being dragged along for medical appointments and so I wanted to touch base first.

One further point: the Maudsley wanted a set of baseline blood tests done but Waif was reluctant and distressed by the idea so I thought that perhaps your surgery could please forward the results from the blood test that she had done a few weeks back - so far the only details that the Maudsley have is that the "tests proved normal" which is a little generic for their records.

I am so sorry to take up yet more of your time and very grateful for all your help.

Kind regards

Anorexia Mummy

The reply:

Dear Anorexia Mummy

Thanks for your e-mail and apologies for delay in replying due to my leave.

I have printed out all the blood results to hopefully avoid further tesing for now - as noted before they are all normal.

This makes a physical illness much less likely, reinforced by Waif's story. The results are in reception for you to collect.

Your observations on her lack of disclosure of other concerns are very apt, and probably have been considered more at the Maudsley, for further development.

The need for further investigation is something the Maudsley team might comment upon after they have seen the blood results, but is less likely to be necessary for the time being since Waif is not complaining of other symptoms and seems well in herself apart from the weight problem.

Please do bring her in if there are concerns following this note and any discussion at the Maudsley - or if new features arise you or she feel concern about otherwise.

With best wishes,

your GP