Thursday, 29 April 2010

The Road Home

Waif and I stopped in the park for an ice cream on the way home from school yesterday  :-)  Yes, this is on our route home - we are very lucky!

Wednesday, 28 April 2010


The comments I have received recently have been very supportive and heartening.  Thank you.  I feel slightly unworthy as I know that I could always be doing better - about once a week I go out for the evening when I could be home supervising supper and I am inclined to be soft on ED.

Another instance is that I did not mention at the last Maudsley meeting that Waif has been back doing sport - well, not Saturday morning training, but over the hols she came on walks, went riding, went cycling and played tennis.  Now she is back at school, she is cycling in (3.5 miles there and the same back).   That's the trouble with having given her a carbon fibre bike last birthday, she wants to use it  :-)   Actually the journey is great with the first 2.5 miles being on traffic free bike paths across the park and heath.  The last mile is a little more hairy as it involves the A20 and then a couple of back roads that are used as cut throughs by commuters trying to dodge the lights on the South Circular.  They drive very fast and weave in and out.  Meanwhile harried mothers are randomly stopping to drop off school children and then pulling back out again also, astonishingly, careless of school children cycling (there are actually only about 10 bikes in the school bike shed in a school of 800, according to Waif and I guess that is why).

This is fine in principle as long as she is not losing weight but somehow Waif is unwilling to eat more to make up for the exercise.  Indeed, she has already asked me if she can start to eat "healthily" again when she reaches 43kg.  She is supposed to get to about 47kg but I checked 43kg on BMI charts and it is about a quarter of the way up the normal range for her age and height, so I said possibly.....I am not trying to make her plump!  Not that I would mind that.  NO, it is that I want her to have autonomy BUT, and this is a big but, the research shows that the higher the target weight set and achieved then the less likely is relapse.  Had she never been below 43kg then I would have been content for her to maintain 43kg, but given how thin she was late last year, I guess I we need to aim higher.  I talked all this through with her and she seems on board.  Luckily OD is now 50kg and looking gorgeous so that makes any number starting with forty seem less frightening to Waif.

Anyway, yesterday Waif cycled to school, had games all afternoon, played in a rounders match, then cycled home.  This makes a total of over 4 hours exercise. She was tearful on the way home.  Ostensibly this was as she had been subbed in the rounders team but really I suspect she was exhausted.  Next week I am going to make her choose between cycling and rounders on Tuesday, but not both.

I suggested that Waif try out for the school tennis team - she has coaching and is quite good at tennis.  She said that only the boys can use the courts at school.    Hmmm... unfortunately I can believe this is true as it used to be a boys only school and I can quite see how when the first girls arrived there was a discussion about how the courts were already fully used.  Obviously, if anyone sat down, ab initio, and looked at a limited number of courts in a fully mixed school and decided how to allocate them, not a single person would suggest that the boys should play tennis and the girls rounders.  Boys even have cricket too in the Summer where the girls have no particular summer sport in most schools (athletics being unisex) other than tennis.  Sigh, I can feel a call to the school coming up to discuss:

a)  whether Waif is likely to be back in the rounders team next week (just for my info);
b)  to check whether it is really correct that only the boys can play tennis and to ask for the thinking behind it; and
c) to ask the school to join with me in lobbying he local council for a small section of cycle lane between the A20 and the school, and asking whether children might have permission to use the back entrance (behind the playing fields) when on their bicycles to cut out a large section of dangerous road.

Perhaps I should just leave well alone.  I am never sure when to back off.

All in all though, it is wonderful to see Waif looking so much healthier and with more energy than for most of last year.  That and the wonderful blossom and sunshine we are having at the moment, makes me joyful and optimistic.

Wednesday, 21 April 2010

Steady as she goes

Waif topped the scales at 41.4kg.  This is 6kg above her weight at her second visit in October so we have made steady progress I am pleased to say.  The psych said that she is no longer "dangerously" thin  :-)  :-)  :-) and we are down to 3 weekly appointments.

OD was more cynical, reckoning that Waif had in fact lost weight since her last appointment 2.5 weeks ago as she was "holding a lot in".  Waif did indeed have a visit to the Ladies as soon as the appointment finished and the psych had disappeared down the corridor.  Regardless, she is still a stone heavier than a few months ago and that makes all the difference in the world.  She is still skinny, and too thin to look or feel her best, but not looking as if she might be about to expire.

I saw a friend last night and she said that she knew a woman who had had anorexia when she was young and that she now walks with a permanent limp because her hip did not form properly due to a calcium deficiency.  She was the daughter of a chef.  She says that if only she had known the damage she was doing her body at the time.  I wish that people like that, with experience, would go and talk to girls (for it is usually girls) at schools with rampant eating disorder problems (many of the high achieving, private London day schools) and show them the lasting effects.

Basically, Waif has begun to recover since she changed schools.  OD is still at the school that Waif used to attend.  Their attitude towards food is very odd.  Older Daughter was to have a lunchtime detention yesterday, the upshot of which is that she would not be able to have lunch (admittedly, this is the combination of her losing her pass AND having as detention, but IMHO the consequences of mislaying your pass should not be starvation).  The detention did not happen in the end (the teacher was away, perhaps trapped abroad by volcanic ash) but by then it was too late to have lunch.  This means that OD will no doubt miss another lunch on the day of the replacement detention.  She will therefore not eat between 6,30am (breakfast) and arriving home at 5pm (or 6.45pm if she has an after school activity).  This does not send out the right message on the importance of nutrition and, personally, I think is a disgraceful position for a school with an acknowledged reputation for having girls with anorexia.  When I tackle the school on the subject, they claim there is time between lessons and detention to get food.  If you talk to the girls at the school, they say that due to queuing and queue barging, there is not time, and that if you have forgotten your pass the teachers send you to the back of the queue anyway and you cannot eat before 1.15pm which is after when the detention starts.

This causes me to remember a conversation I had 6 years ago with my psychiatrist friend about schools.  She advised me against sending my girls to this school because, she said, she spent too much time counselling girls at the school with anorexia.  I had forgotten that.  How right she was.  I am glad tha Waif is out of there and that OD is leaving at the end of term.

Monday, 19 April 2010

The Maudsley again

We are off to the Maudsley Hospital again in 10 minutes after an extended Easter break of almost 3 weeks.  My husband and I both agree that Waif has continued to put on a little weight.  I am expecting her to be a kilogramme heavier at 42kg.  H is betting on 43kg.

H phoned me from work to tell me where the food diary was as he has been keeping it since the last appointment.  I opened the second drawer down in the kitchen and was slightly shocked to see it was only a scrap of folded A4 with some printing on the back, filled in with tiny pencil writing.  It is extraordinarily scruffy and difficult to read, but nonetheless comprehensive.  It is a big contrast to the immaculately laid out one that Waif and I first did together, together with beautiful illustrations.  That time, as Waif had put on weight, the previous psych merely flicked through it without really reading it, and without much attention.  That was therefore the last time that Waif was prepared to put in that effort - she is prepared to work hard but expects praise and recognition in return.

Waif is currently dressed in home clothes ( a light t-shirt and cotton leggings) as school doesn't begin again until tomorrow.  I will not say anything about changing but merely see if she chooses to don her heavy school's really up to her completely.

Wish us luck.  Gulp.

Update:  Waif just appeared in school uniform.  All four of us - Waif, Older daughter, H and I - are going to be at today's session.  I wonder what the psych will want to talk about today......

Saturday, 17 April 2010

Our week in Somerset

Waif's engineering course started on Tuesday at 11am and was scheduled to finish at a similar time on the Friday.  She phoned me on the Thursday morning to ask if I could pick her up that day as she was exhausted.  Whilst I don't approve of bailing out of commitments half way through, this seemed like a good idea on all sorts of levels - it gave me a chance to ensure she ate on the Thursday night, and we were in any case driving nearly past her course venue on our way to Somerset so, trivially, it saved me a 5 hour round drive on the Friday.  This in turn meant that Waif was able to spend all day Friday at Longleat with her cousins.

Waif said she had had a good time on her course but that they had kept  the children up very late (to keep them out of trouble, no doubt);  they had not returned from bowling until 11.30pm and were due at breakfast the next morning at 7.30am.  The next night was DVD night and again it went on late and had no opt out to go to bed.  She looked thinner to both my husband and me when we picked her up after the 48 hours so I suspect she had not eaten much. which would magnify the tiring effect of not enough sleep.

Waif had been roomed next to 2 girls from her old school.  To be friendly, I guess, but Waif told me that one of the girls was a bully.  I suspect there is stuff about her old school that she still hasn't told is since she left that she has gradually begun to get better.  Still, she survived.

Somerset was wonderful - the sun shone for the whole time and the weather was warm on our first 3 days there.  We visited 3 National Trust properties, went on a family walk, went to Longleat for the day, played over competitive board games well into the nights and the girls went on two horse rides.  Waif consistently won both Cluedo (where she is methodical at recording all information and permutations) and Pictionary (where she is quick and clear in drawing).  That was nice for her although possibly not as good for her friend who is a lovely girl but not as quick or confident.

On the last night, we lit the log fire.  Older Daughter claimed it was only the third time in her life she had seen a real fire.  Ooops, we are very London parents where log and coal fires are illegal.

Confession time:  H and I messed up big time.  When the psych suggested that Waif keep a food diary over the hols, Waif had the ab dabs saying that she didn't want her friend and relatives to know.  I said that we would keep it private and do it in our bedroom.  I am not sure I fully made this clear to H.

On the first breakfast in Somerset, feeling relaxed and amongst friends, H started quizzing Waif on her food intake and writing in her food diary in front of everyone.

Waif was mortified and ran away in tears.  She took a long time to recover.  I am not sure whether or not it was helpful for me to point out to her that others only had to look at her to know that she had an eating disorder and that it would be no surprise to any of them.  I decided it was a subtle(ish) way of making it plain to her that she does not look good so thin (she doesn't) and that other people point at her and are shocked by her appearance in the same way that she was shocked by another over thin girl in the waiting room at The Maudsley.   Poor thing, though, we also apologised a lot.......we messed up utterly on that front.

On one beautiful morning, H and I decided to walk Cheddar Gorge.

This involved 3 steep climbs and over 3 hours of walking.  Waif and friend were game to come, OD and her friend was to stay home to revise.  That was fine by us but we said Waif had to eat extra for breakfast.  She refused and so didn't come......there was a bit of a stand off as H wanted her to eat a waffle (185 calories in one go) in addition to her usual breakfast and Waif said she didn't like waffles.  I would have compromised at this point and said that she could choose what she wanted as long as it had at least as many calories as the waffle.  H doesn't compromise.  Perhaps this is where he is showing tougher love than I can.  Actually, having done it, I realise that the walk would have been too far for her so it worked out well in the end that she stayed home and played in the gardens.

Her grandparents, who were staying with us for the second half of the holiday went out for the day as H and I were not to be around.  Sigh, I did say to them that the girls would be home (a kind of hint that they could spend some time together) and my mother-in-law took it the wrong way and simply replied "oh, but they are fineo n their own, aren't they?"   which of course they were.  I gave the 4 girls (my daughters and their 2 friends) £80 to go to the beautiful country pub opposite (The Crown and Victoria Inn)

and have lunch in the garden so actually I suspect they had a great adult free morning and lunchtime.  OD reported that Waif had eaten cottage pie.

Our next appointment at The Maudsley is on Monday afternoon.  I am hopeful that Waif has put on a little weight over the last 2 1/2 weeks although pretty sure that she has not put on as much as 1kg a week.  I am, guessing she will come in at 41.5kg.  I will be content with that increase, and delighted with more.

Meanwhile, my brother in law (who stayed with us for the weekend) told me about an incident that occurred a year ago.  He said that I had served the children supper (including my niece) and said that it was a dish that my children always liked - my home made lasagne.  He said that when I briefly left the room, Waif scraped all of hers into the bin whilst looking him defiantly in the eyes.  He didn't mention it to me at the time as he was confused by the whole incident.  Hmmm.......Waif can be naughty.

Tuesday, 6 April 2010

The course begins

Yesterday, I drove Waif to Wiltshire for a night at my parents en route to her engineering course in Gloucestershire.  We were going to stop for lunch on the way down but when Waif discovered that there was to be a roast dinner at her grandparents, she only wanted a sandwich for lunch.  We identified a pretty village half way there and found this bar/cafe:

where Waif had a large ciabatta sandwich with salad, and I had a vegetable curry with rice.  I couldn't persuade Waif to order chips as a side order but, back in the car, she agreed to eat a packet of crisps and drink a juice to bulk up the meal.  Sigh, she is still watching what she eats. She also refused roast potatoes with her chicken in the evening although ate the crumble for pudding happily enough.

My father suffers from Alzheimers and there was an awkward moment when he told Waif off (and the rest of us) when he found Waif eating toast at 10pm in the kitchen.  We calmed him down, he doesn't understand.  He is tricky to mollify at the best of times. Whenever I take the girls there I feel guilty imposing such an atmosphere on them but OTOH know that my mother really appreciates our company.

Also on the way, we stopped at Stourhead:

Remarkably luckily, there was a special Easter Monday bell ringing session in the church and Waif had a go.  She also played the piano in Stourhead House to compliments all round.
Sigh, I realise that we also went for a small walk and that on Sunday I allowed Waif to have 20 minutes on a pedalo in Greenwich park.
Perhaps this means that I indeed don't take Waif's ED seriously :-(   My idea of leisure time does often  involve walks, boat trips (not often), swimming and riding....I have booked a hack or two for next week BUT I am prepared to cancel them if Waif has lost weight on her course.
I can't help believing that the ED should not prevent Waif from living a full life - life is short, and every day and every month counts and should be embraced.

Anyway, Waif is now staying on her course.  They eat supper at 6pm and then go bowling until 11pm!!!  I have stuffed money in Waif's pockets and told her to make sure she buys plenty of snacks.  I doubt she will. There will also be no chance for her to have her 2 cups of hot chocolate a day.  I hope that between now and Friday lunchtime she can't lose too much weight - she is really looking better at the moment; rosy cheeked and infused with a new energy since she has gained 10% of her bodyweight since just before Christmas.  If only she can get to 45kg by the summer then she will be able to go on her french exchange - time in Paris and in the family's country chateau which is stunning and set in acres and acres of rolling parkland.  Lucky girl!!  Something to aim at I hope.  Oh, Waif is also hoping to cycle to school next term which I will need to square with The Maudsley.  It's not too far, just 3 miles.

Friday, 2 April 2010

Daily Mail article

My older daughter mailed me this article, saying it reminded her of Waif.

My husband has the bit between his teeth on taking control of Waif's dietary intake and diary.  He is approaching it with military precision.

On the one hand this is a good thing as he makes her eat more than I do.  OTOH I have had to gently remind him that we are not trying to make Waif's life miserable and that actually she has put on nearly 3kg in the past 3 months (since she started at her new school come to think of it) whilst maintaining a generally cheerful outlook and social life.  I am acutely aware of all the stats linking AN to depression and suicide and don't want to go near that.  Mental health is important too.

Sigh, I quite like handing over responsibility for 4 days - I take Waif off to Wiltshire on Monday afternoon to stay with my mother for the night before Waif's course begins in Somerset.

Thursday, 1 April 2010

Maudsley again

Waif came in at 40.8kg.  Whilst that is disappointingly not the 42kg target, it is nonetheless 400g more than last week - a pound in a week is not too bad.  I was so worried that Waif would not be allowed on her course.  So was Waif I reckon.  She was quite hysterically sad before we left for the appointment.  She said that she found the psych intimidating.  Waif made me promise not to tell the psych about her sadness and I did although I told Waif that it would be best to be open with the psych about everything as she is trying to help and it is difficult for her if Waif isn't open.

I suspect Waif was worried about not having gained weight - she was right as last week's reading was more like an average of 40.8kg if you ask me and so she has simply maintained this week.  That's okay though as it is consolidating an earlier gain.  She has put on nearly over 2.5kg since Christmas.  If she can keep that up then she will be nearly 44kg by the Summer which is still thin but much less frightening.

Anyway, when I explained that Waif's course was something for which she had had to supply a personal statement and references to attend and was an academic course not a jaunt, the psych agreed that Waif could go .  She said she didn't ever want Waif to feel like she was being punished. BUT she said that in future we would have to be consistent and stick to targets we set.  As Waif is on her course next week, and the whole family is in Somerset the week after (yay!!), our next appointment is not for nearly 3 weeks.  The psych said that if Waif had not put on weight (or very little) then that would be it - every meal would have to be supervised and all forms of sport would be banned (I confessed that I had taken Waif on a 90 minute cycle ride and a climb on Sunday, and that she often walks across our local park to meet friends etc).

As Waif and I disagreed over exactly how much she had eaten, the psych wants us to go back to having  a meal plan.  She opined that I was too soft on ED so, as it is the holidays and my husband will be with us, she wants him to keep the diary.  Waif was reluctant about the idea of doing it in Somerset as there will be friends and relations present but we assured her that it would be done in private in our bedroom.

Poor Waif was very tearful on our return home. She complained that the psych talks about her as if she is not there.  I pointed out that it was very difficult for the psych if she (Waif) refuses to say anything at all.

Waif did indeed wear her school uniform btw (her decision totally) together with various items of heavy jewellery that would never be allowed at school, maybe 300g in total, so we will have to make that much extra up for next time.

The bad mother part of me looks forward to Waif being away for 4 days as a break from the tyranny of mealtimes, even though obviously getting Waif better is my topmost priority in life at the moment.  I will miss her in many other ways.  She is a darling child.  Tonight, she put away all my grocery shopping.  She has phenomenal energy:  this morning must have been emotionally tiring and yet she still managed to walk across to Blackheath to meet a friend, go shopping in Lewisham, wrap Easter eggs, handprint Easter cards, put away the groceries, cook supper for the family and learn to play Kelly Clarkson's "because of you" on the piano.  She could easily have just sat and read a book all afternoon.