Wednesday, 8 August 2012

Update at Sweet Sixteen

It is Waif's sixteenth birthday this week.

She is happy, sunny and well nourished.

I do absolutely bear in mind the cautionary tales that some of my lovely readers have posted, but I dare to hope.  Waif now acts like a normal teen - she sneaks in chocolate bars, she picks at food on others' plates, she eats healthily at meals and enjoys eating out.  I am grateful on a daily basis that I no longer need to monitor when and how much she eats as she seems to be doing so independently.  Yes, she could hide fasting from me for weeks now as I seriously do not check up, but clearly she is doing fine on her own as her weight remains steady.  I know that part of being a mother is letting go as my job has been to train her to live her own life:  at 12 with anorexia, I believe I was right to take control of her everyday living.  At 16, and healthy, the world is hers for the taking and I take a step back.  I am going back to work in September (term time only) so she will have lots of autonomy.

Waif is still doing lots of sport:  she cycles absolutely everywhere, without a helmet, but I live with that as I live with anything else so long as she is EATING.  She has even had a go at track cycling now and may take that up seriously.

Waif has a wonderful figure - slim but not boney.  She even has some curves.  She has a lovely supportive boyfriend whom Waif has decided is too thin and is now feeding up.  BF is indeed thin but I reckon that goes with the territory of being 6ft 5 inches tall at the age of 16.

Waif is still eccentric in a delightful way.  She wanted a Segway for her birthday until someone much wiser pointed out that you cannot legally ride them on either the pavements or the road in the UK.  She is settling for an hour of all terrain Segway riding in a nearby forest.  You have to be aged over 10 and over 7 stone to do it.  Happily, she is both of those!

My heart goes out to all of you reading that are either struggling with your own demons, or supporting a loved one with an Eating Disorder.  I hope that our story can give some hope of a happy outcome (yes, I am touching lots of wood, and I will always be looking out for Waif).  Whilst you are going through it, it really can seem that there is no hope.  I wish I could help everyone.

Wednesday, 28 March 2012

Final thoughts

It is a while now since Waif was discharged from the Maudsley.  I go days without thinking about eating disorders and without worrying about my darling girl, and I feel confidence in her future.  When I remember the dark days during which she was so very thin and getting thinner,  I am overwhelmingly grateful to be here, now, with such an optimistic ending.  I wish the same for every single person battling an eating disorder and so I want to summarise my experiences and learning in case it is of any help to others.

I look back and still can't fathom what the Maudsley did that was so magical - they talked to Waif regularly, always with me there, often with her father, and sometimes with her older sister.  They probed into whether she was unhappy in any way (she always denied that she had any unhappiness other than being forced to family therapy) and whether she had suffered trauma when young (nope).  As those drew a blank, we usually simply had her weighed, she was then either praised or sharply ticked off depending on whether she had gained or lost weight, had a discussion about the negative effects of being underweight and then chatted about what she had planned for the next week.    A few times she was threatened with being hospitalised, or kept away from school, and she was banned from sport for a while, and she always put weight on after one of those sessions (I reckon the thought of compulsory feeding in hospital was pretty frightening).   But she never really talked back.

Waif never spoke easily about her motivations - in fact, Waif never spoke at all about them and they are still a mystery.  Perhaps when she is full grown she will share some insights with me.

From the outside (and with nudges from the Maudsley) I would say that she was a vulnerable child because she is such a perfectionist and so bright.  When Waif decided to lose weight, she was not one to mess about with half measures and to lose heart half way through the day and have a Mars Bar.  She does everything properly - with charts (I found those later, the ones she did aged 12 with lists of calories out and calories in, and sad or happy faces depending on how she rated herself).   She was bright enough to do calorie searches on the web and to avoid high calorie foods.  She was also at a very high pressure school which placed no value whatsoever on eating, indeed they made it difficult with their lunch pass system and the arranging of meetings, or detentions, or team practices in the short lunch hour which had long queues and much queue barging.   It was simply easier not to eat between leaving the house at 7.10am in the morning and arriving home on the school bus at 5pm or 6.45pm.

We, her parents, must also shoulder some responsibility.  I suspect we were "fattist" and  inadvertently gave the impression that anyone overweight was faintly to be despised (I don't actually believe that, incidentally).  Not that she was ever overweight, but it can't have helped as she could have extrapolated to thinking that the thinner she was, the more we would love her.  Of course, when I realised she had anorexia and was not eating properly, I emphasised how bad it is to be underweight - so much more dangerous so much more quickly than being overweight, and went to great lengths to explain that there is a broad band of healthy weight and everyone should aim to be in it, but that it does not matter if you are at the slim end or the plump end, just that you are healthy.  And with health comes beauty - clear skin, bright eyes, lustrous hair, a pink complexion.  It annoys me so much (and not much does) when people within a perfectly healthy weight range moan about wanting to lose weight, and refer to food as "naughty".   Why can't they be happy to be healthy and devote their mindspace to more interesting matters than their precise weight which, frankly, nobody else much cares about anyway?  Okay, if you are morbidly obese then you ought to address your lifestyle, but the people I know who worry about extra pounds are a long way from that.   It seems like an indulgence.

Perhaps there was also a little of Waif not wanting to grow up (this was suggested at the Maudsley, not least because Waif still slept in my bed until she was nearly 14).  The world is a frightening place and she has parents who might be seen as high achievers (it doesn't seem that way to me, really, but I can see it is how she would see us) which can pile on the pressure.

In the end, I hope what helped Waif back to health was to know that our love never swerved, that we were there every step of the way and that we were so worried about her that it was obvious to her that getting thin was not a trivial matter.  The fact I gave up my job to be with her, that I cried at night with worry, that we all changed our lives around her, that we moved her school and that I supervised all her eating must together have signalled that this was no game and possibly shocked her a little.  We were lucky that we could make all those changes.

On a practical level, we followed the Maudsley approach which was to provide a regular, compulsory menu of food.  That was the big non-negotiable.   I provided high calorie meals 4 times a day and Waif, bless her, generally ate them - I was not so rigid that I would not let her swap one thing for another (whilst trying not to allow there to be bogey monster foods - advice from the Maudsley - like chips or sauces), and I never hid from her what was in the food and that it WAS high calorie and that that was because she NEEDED to put on weight. I explained that once she was healthy she could cut back to a normal diet as long as she didn't ever become too thin again because she would probably have a life long vulnerability.

At no point did any of us lie to Waif - not about how many calories there were in her food, nor why she needed to eat, nor what would happen to her if she did not.  I feel that maintained some trust.

I also explained to her that physiologically she needed to eat a lot more calories than a normal person in order to put on weight - apparently one's body tries to maintain homeostasis and if you have been a certain weight for more than about 4 months, it resists letting that go up or down (this also explains why dieters have to bear with their diets and keep their weight off for 6 months before they can relax otherwise they will go back up to their pre diet weight).  We never banned healthy food - lots of fruit and veg are always good, although I did have to let go about worrying about her teeth as getting calories into her with sugary snacks was more important than risking some fillings.  Oddly, and happily, her teeth seem to have survived.

Waif now seems to eat normally although we will never again be fully relaxed about eating, I suspect, but we are close.  I am going back to work in September, in a new job working with teenagers, so I need to start trusting Waif to make her own packed lunch, and to be independent of me as she starts in the sixth form.  Gulp, I am just so happy to not be in that alternative universe where instead Waif was hospitalised and angry and still ill.  Thank you to good fortune.  Let me never mind about small worries.

Lastly, but certainly not least, thank you to all my lovely commenters and readers.  I started this blog as a way of recording my own feelings to help me to deal with them, but also as a way of getting advice from those who have "been there" and "done that".  I have found insights from readers who have themselves struggled with eating issues especially illuminating and, often, a good reality check.  I have felt like you are true friends and your support got me through the tough times.  Thank you.

Tuesday, 28 February 2012

Monday, 6 February 2012

Discharged from the Maudsley

We go out on a high  :-)

At nearly 16 years old, Waif had her review appointment at the Maudsley late last week.  She has grown again (1m66 now) and weighs a record 49kg.  This is still short of her ideal of 56kg but she has maintained the weight solo, with no nagging or reminders from me, and without even supervision as Waif seems to go to Costa friends' houses for most meals.  She is looking really well:  still very slim but NOT skeletal.  She has some muscle on her thighs rather than an alarmingly concave hollow. Nobody winds down their car window now and tells her to "eat more meat" , clothes bought from real grown up shops fit her snugly.  I am so proud of her.

Nor has she neglected her studies.  Waif has just been awarded a sixth form scholarship at her current school and despite being enticed by the offer of a place at one of the top girls' schools in the country, has decided to stay with her friends where she is.

The psychiatrist at the Maudsley said she was so happy to be saying goodbye.  She implied that this kind of recovery is sadly still quite rare.  The dark days of two years back where I could not look at Waif for wincing at her sharp bones and drawn skin seem so far behind.  I no longer wake in the night wondering if I am going to lose the most precious thing in my life.   I honestly don't want any more from life than that my daughters are strong, healthy and happy and at the moment they are.

I have a big thank you to say to all my followers and supporters, and to The Maudsley Hospital Teenage Eating Disorders team.  We were lucky to catch Waif young and to hit this horrid disease hard.  This is the happy ending to beat all happy endings.  Now Waif can be a normal teen and cope with normal teen stresses.  I can tell her "not to treat the house like a hotel" and her father can tell her she "can't go out dressed like that" and we will all be just fine.  I sincerely wish such a happy ending on all of you who read this blog and might be suffering yourselves.  Do it for your mum, do it for your friends but most of all do it for yourself - your body is there to be cherished and nourished for it to serve you well.  Food is so not your enemy.

Saturday, 14 January 2012

Friday 13th

If you can meet with Triumph and Disaster
And treat those two impostors just the same
...Yours is the Earth and everything that's in it

New growth springs from forest fires.  That's a thought to hang onto.

Yesterday, on Friday the thirteenth, OD got her rejection letter from Cambridge and drowned in the pool.

I am SO proud of her for giving it her best shot, and will be even more proud of the way she tackles this set back and sees it as a chance to redouble her efforts:  it was such a close run thing.  In a weird way, a year out of academia will give OD a chance to mature and to experience things she would never otherwise have done.

Also yesterday was the day that my father went into a home from which he is unlikely to ever emerge.  It was time.  My mother had been his full time carer for several years and carrying on was not an option without her endangering her health and giving up the rest of her own quality of life.  With moderate to severe dementia he will be better cared for in a residential facility.  Still, it's a heartbreaking time and incredibly difficult for my mother.  OD has gone to stay with her for the weekend so they can nurse one another's very different heartbreaks.

Meanwhile Waif is being reassuringly teenagery:  she spends a lot of time mooching in her room, which is more like a self contained flat as she has the largest bedroom in the house with a sitting part and a bedroom part.  I will put up a photo later.  The rest of her time is spent out with school friends, generally smoking in Ollie's hut.  Waif swears to me that she does not smoke but she definitely smells strongly of cigarettes and it is clear that she is at least a second hand smoker.

I am a vehement anti-smoker merely on quality of life grounds - I HATE the smell and can't imagine why anyone would want to do it - yet also on health grounds.  However, the health issues seem remote compared with anorexia which strikes so young and with such deathliness so I keep a low profile on the whole thing and hope that Waif is clever enough to make the right decision on her own.  On one visit to the Maudsley, Waif was asked what I thought of smoking (the psych was encouraging her to hang out with her friends and drink and smoke!) and Waif was very clear that I had no shade of uncertainty about my views.  So that's good.  I can't really do more than give her strong advice.  I have picked my battle and it is not the smoking one.

The Maudsley phoned me on Friday.  You may remember that Waif has a review coming up on 2 February.  Well, apparently the Head Psych (Waif's lovely, firm counsellor) is off for a good few weeks following an operation so we will be seeing someone else.  I am still glad that Waif is going as it will be a time to reweigh her, but sure that she will not like the CHANGE of psych.  I am guessing that she will be very shy and that the psych will not get a word out of her.  Head Psych couldn't believe the difference in interaction from when she first met Waif (the no speaking act) to our final few appointments where Waif was the outspoken, zingy, ascerbic, funny girl that she is with us at home.  I hope to see more and more of that girl  :-)

Tuesday, 10 January 2012

Still waiting

Firstborn Daughter is still splashing around in the Cambridge Pool.

I am not sure if the tension is telling but Waif has now gone off the whole idea of Oxbridge for herself.  And she is having doubts about changing schools.  I have told her that she should do just whatever she would like to do.  I know how hard working and perfectionist she is so I have no worries about her under achieving so much as worries about her putting too much pressure on herself.  Nor do I want to hold her back from her dreams, so I will simply support her decisions.

I am not sure if I have mentioned (and am too lazy to check) that the Maudsley have asked Waif back for a review appointment.  They wanted to see her at the end of January but as this clashes with some of her public exams I put it off to 2nd February.  I am reassured that they will confirm whether or not her weight is acceptable and/or has slipped.  Her cousins came to visit on Sunday and my oldest niece (aged 22 and a very down to earth and kind primary school teacher) ticked me off for Waif looking far too thin  :-(

Poor Waif is not well at the moment - D and V.  Two years back I lived in terror of that as any weight loss would have been life threatening.  I am so glad that we have a tiny buffer now such that I am sure she can go without food for 24 hours without compromising her health unduly.

Friday, 6 January 2012

Splashing about

We are still waiting for news on Older Daughter and her Cambridge entrance.   I am not sure Waif should ever go through this as the stress is quite enormous on her.

Meanwhile, the Maudsley telephoned to offer Waif a review appointment.  The first two days that they suggested are ones where Waif is sitting GCSE modules so were not possible.  I have plumped for the day after her exams finish.  I am not going to tell her until after the papers as I don't want her worrying about two things at once.  I am hoping that the review will go well.  I am glad that it means she will be weighed....hmmmm...that is the only reason to warn her weeks in advance as she always eats in anticipation of a weighing.   Remembering where we were with Waif 2 years back makes me relax about this Oxbridge stuff actually.  OD is healthy, happy and settled.  I can't ask for more.

Thursday, 5 January 2012

A glimpse into the future

I am sitting in the kitchen on tenterhooks:   we are waiting for my Older Daughter's decision letter from Cambridge - whether or not she has been accepted to read Medicine next year.

We have accepted the sixth form place for Waif at the central London day school at which she won a place - there were 140 applicants for 12 places so she did well.  Really it involves moving from one private London day school to another so it not too great a change BUT she will be going back to an all girls' school.  With a desire to study maths, physics and economics this seems like a sensible trade as the chances are at her current school that she might well be the only girl in the higher maths set and (having been in that sort of position myself) that is not much fun as it leaves you short of female company.   Waif is keen to remain friends with her current set, and I am sure she will as they all live locally to us and I know she will make the effort.

I have not been without qualms about the move as the only way that Waif will ever achieve any happiness in her life is to stay healthy.  I have not persuaded her to weigh herself and let me know the weight but I have seen her several times in underwear and she is nowhere near as thin as she was 2 years back when she resembled a walking skeleton  :-(   OD dug out our holiday video from Christmas 2009 and we were all pretty horrified.  She is now merely very slim which, although dangerous territory, is not in itself worrying.  Hearteningly, she tucks in to chocolates when they are on offer and always eats ice cream for pudding at supper time.  Apart from that, she eats very healthily:  usually the vegetarian options, always lots of greens and often a medium small portion but not ridiculously minuscule.  I am daring to hope that perhaps she will be one of the lucky ones to beat this thing once and for all.   If so, I don't want to hold her back unnecessarily.  At her new school she will be in a class of about 8 and they have a tremendously good Oxbridge record.

OD has just gone to the cafe round the corner and I am instructed to phone her when the letter arrives.  Gulp, any minute now.......