New uniform

Waif and I went to buy her new school uniform this morning. It was heart tugging......the skirt was okay because she was able to buy a tiny size (20 inch waist adjusted to its minimum) and it merely came out very short which she was more than happy with, saving her the need to roll it up at the waist as is customary amongst the others, but tracksuit trousers were a nightmare. The ones that vaguely fitted around her waist stopped just below her knees. The ones that were lon enough were so enormously big that there was no way she could sensibly wear them and no way they would stay up. We compromised and got some that looked quite a lot too baggy and quite a lot too short, but not too much of either.

Meanwhile, we have booked for the Maudsley on Christmas Eve. We are going at 10am because the psych said that 9.30 was a bit early for him as his trains are a bit unreliable. I thought it was only solicitors who had such late starts! My husband has decided to go along with the Waif but I am driving them as I know the back routes and the roads will be choc-a-bloc the day before Christmas. I have not yet told Waif that her father is coming. She will be very cross and I am delaying her fury as there is nothing I can do to change the situation.

Meanwhile, lots of people are saying to me that OD looks too thin. Well, compared to Waif, she's not, but I guess compared with all her friends, she is :-( Ho hum, we are a slim family.

Academic success

I have accepted Waif's place at her new school. In a surprise and very human move, her current school are waiving their fees in lieu of notice thus saving us a welcome £5,000. The Headmistress was incredibly kind saying that Waif could return any time if her new school didn't work out. This is a fantastic backstop.

The HM at Waif's new school told me that Waif had scored scholarship level on her entrance papers and is going straight into all the top sets. Waif was a bit daunted by that news but I reassured her that she would be fine. This means however that she will share no classes with her best friend who is already there and is far from academic. They can still meet up after school :-)

He also asked me about her thinness. I told him that I too was worried and that it was under investigation at The Maudsley, and we were hoping that a change of school would help.

Meanwhile, my husband has surprised me with the news that he is taking Christmas Eve off work and so is free to come with us to our next Maudsley appointment. Waif has confided in me that she does not want him there. When pressed, she said it was because she "could not relax" when he was around. Hmmmmm... I am not sure what to do about that one. Probably, he won't want to come anyway on his day off. Perhaps though he should come precisely because it challenges Waif.

This morning, Waif told me that she has 14 "outstandings" in her report. Older Daughter has only ever managed 3 at most.

There are 2 grades for each subject - one for effort and one for achievement. OD does not get"outstanding" even when she has come top in exams because she forgets to hand in homeworks.

Waif is a very different child; a perfectionist. When my husband arrived at the breakfast table I told him, and he asked Waif (jokingly, naturally) why she didn't have outstanding in "all" her subjects and which result was her worst. Poor Waif confessed that she had ony "good" and "very good" in maths. I was surprised as she is remarkably talented at maths. She said it was because she had missed so many lessons (through going to the new school and visiting the Maudsley). Husband told her it was because she is so poor at mental arithmetic (another joke - Waif's favourite game is a mental arithmetic competition which she always wins and I have maths "A" level!) Poor Waif. I am so impressed by the 14 outstandings that she did get. And yet also a little worried - she pushes herself so hard to be perfect at everything.

Being good enough does not satisfy Waif. She sets herself incredibly high standards. She has written A4 sized fold out cards of goodbye for her two best friends at her current school. In each case, she has assembled and printed out photographs from the past few years and pasted these in with comments and jokes.

Ho hum, today is her last day at her current school. It will be good to have her home for 3 weeks to feed her up, although I suspect it will be relentless work.

Meanwhile, I am hoping for her blood test results soon. I will keep you posted.

Back to THe Maudsley

Waif weighed in at The Maudsley today at 37.4kg (dressed) which is 400g more than a fortnight ago, and 900g more than her first visit in late September. She has also grown a cm. Hmmmm....... this is so much better than losing weight but I feel that we are swimming against the tide and have only just been making headway through supreme effort which can't last for ever. I guess I have to put that thought aside and we have to keep battling. We had fajitas tonight but Waif refused the sour cream and the guacamole, and had only the pancake, red pepper and chicken. She basically will not eat any food with a high fat content. She managed some cake and a strawberry yoghurt for pudding, and I will make her a hot chocolate and kitkat later in the evening.

Oh, Waif also had her blood taken today for the tests - fbc, kidney function and coeliac disease screen. I bet they will come back as normal, which will mean we can really concentrate on the eating.

I had lunch with one of my oldest friends earlier in the week. I had known her mother was psychiatrist from when I was 11 years old, but my old friend told me that her mother was actually a psych at The Maudsley specialising in children and families, including eating disorders. It was thus interesting to listen to her perspective as we watched Anish Kapoor's red wax cannonball strike the walls of the Royal Acadamy and splatter blood coloured drops. Perhaps this is out of date but Old Friend reckoned that something must be deeply upsetting Waif and that the reason she refuses to talk about it is because it is so painful to her. I can't fo the life of me imagine what it could be. OF wondered if there was any tension between me and my husband but there isn't really (the normal jaded been- married- 17 -years- stuff - and- wondering-whether- there -should- be -more- to -it - mid- life-crisis, that's about it).

The psych now wants to see Waif weekly and is firm about wanting progress. He has also asked her to keep a permanent food diary, which is something I mentioned to him by email as being very helpful when we have done it.

Meanwhile, I tried but failed to see Waif's Headmistress today (it turned out that the long call I assumed the school was on turned out to be a day long power cut), and am seeing her instead first thing tomorrow to discuss leaving arrangements for Waif. I am also aiming to ask her professional opinion about how much to disclose/ involve Waif's new Headmaster - this was OF's suggestion, and a good one.

Waif has only 2 more days left at her old school. I have told her that she doesn't have to go in if she doesn't want to, but she does. I hope that is a good sign.

New school!!

Waif has been accepted at her new school!!!! I am so relieved as the news took a long time to reach us and I was worried how she might cope with rejection.

I am now not quite sure how to deal with the situation: whilst I had mentioned to the new Headmaster that I was worried about how thin the Waif was, I did not out and tell him immediately that she is being treated at the Maudsley. That's not really a first date topic.

So before I accept the place, I guess I need to put all my cards on the table and ensure that there will be flexibility for Waif to attend medical appointments and for me, if necessary, to come in and supervise her lunch - as the school is much nearer home, and as I am on sabbatical, that would now be a feasible option. OTOH I don't want them to take fright and withdraw the place!

I am even wondering whether I can persuade Waif onto the scales tonight and tell her that she is not starting at ANY school next term unless she is over, say, 39kg - she has 4 weeks to get there so that is an achievable goal (she was 37.2kg when last weighed clothed a fortnight ago). I am hopeful that the lure of the new school and the embarrassment of not being able to start on the first day will prove to be sufficient persuasion for her to really give it a go, and will also ensure that she has the energy to cope when she is actually there.

I also need to talk to the HM of her current school - about notice payments and about leaving the door open for her to return if matters don't improve at the new school.

So I have a few logistical problems but, in the round, I am overjoyed, and hopeful that this will prove to be a turning point. I certainly hope so - last night the Waif was up on stage reading out a poem at Poetry Evening at school and looked so emaciated next to her healthy weight classmates. It makes me realise that even Older Daughter is too thin (hmmm...... not helped by Waif following her round the house with snacks and drinks and trying to persuade her to eat all the time ad telling me that OD has not finished her meals which has the opposite effect).

Photos

I was looking through photos of our Summer holiday 2008. There was Waif looking happy and healthy - a beautiful little girl (then aged 11 going on 12). It brought a lump to my throat to wonder why she has starved herself between then and now, and now looks wan and thin, and several years older :-(

I saw a picture of an emaciated dog in an RSPCA advert. I thought of cutting it out and showing it to Waif and seeing if she thought the dog looked better than a dog of normal weight or whether it just looked ill and boney. She loves dogs and would be very worried about the skeletal one. I thought perhaps this might make her think again about how she wants to look, and what others might find attractive. I haven't done it yet.

Water Aid

Te Waif sat her entrance examination for the new school on Thursday. It seemed to go okay so fingers crossed......I was a little disappointed not to have heard from the Headmaster yesterday (Friday) but perhaps it takes longer than that to mark papers and to get hold of the Head at Waif's current school for references.

The psychiatrist from The Maudsley phoned yesterday but my husband took the call so I had no chance to add my tuppence worth - I want to let him know that, whatever she claims, Waif is calorie counting and calorie restricting. I also want to ask him about the change of school. I will call him on Monday.

Meanwhile, Waif announced to me that next week is Water Aid at school. This means that the girls are encouraged to drink only water (?????in solidarity with Africans who have not enough water) and not, Waif says, hot chocolate or juices. I have told her in no uncertain terms that that does NOT include her. I explained how the school would fully understand and even looked up the following about Ramadan as an analogy:

* A sick person: may break his fast which, if continued, would only aggravate the illness or delay its cure. Similar is the case of a the person who is overcome by hunger and/or thirst and fears that he may die because of it, even if he is resident and healthy.

I am tempted to follow this up with a mail to Waif's school to ask them to make clear that they are NOT asking the girls not to drink the milk that they need for strong bones and healthy teeth; that they are only asking the girls to give up sweet, fizzy drinks. I suspect that they are indeed asking the girls to give up ALL drinks but hope that such a mail might make them reconsider exactly what they are saying. On the other hand, I don't want to come across as the difficult parent from hell....

Addendum: it gets worse! On the school website it is urging the girls to get "sponsored" to give up hot chocolate and other drinks for a week!!!!! I am afraid that I will write.

New book

I was amazed to find this in my inbox today as I have never looked at eating disorder books on Amazon:

As someone who has purchased or rated The Oxford Companion to the Mind (Oxford Companions) by Richard L. Gregory, you might like to know that The Treatment of Eating Disorders will be released on 8 December 2009. You can pre-order yours for just £41.33 by following the link below.

	The Treatment of Eating Disorders Carlos M. Grilo RRP: £43.50 Price: £41.33 You Save: £2.17 (5%) Release Date: 8 December 2009
I clicked through and read the title pages and the first part of Chapter 1. It seems spot on and I have pre-ordered the tome. THe differential diagnoses for weight loss were somewhat alarming - brain tumour, AIDS, and gastro-intestinal disorders :-o But the next page stating that the best prognosis was for those caught young (yes) and early (yes) without the full spectrum of symptoms (yes). This group can be in remission within a year and then make steady recovery. This has given me hope and prompted me to spend the £42 if only so that I can read that paragraph regularly :-) Waif seems much more cheerful at the moment even though the late night snack last night was a little traumatic as we had an argument over what size hot chocolate she should have (she wanted tiny, I was gunning for the 1/2 pint cup).