L has now been in formal CAMHS treatment for five weeks. Initially they said after three or four weeks if no progress was made, she would be referred as an in patient. The first week she gained weight – but nowhere near as much as we thought as the doctor did the sums wrongly. A misplaced decimal point meant L was told she had gained 2.5kg when in reality it was .25kg. Ten times more weight than she had really gained. Of course, the anorexic backlash happened and within four weeks, L had lost weight overall.
I don’t want her to go into hospital – although some mornings I think it might be best, but that is my exhaustion, not L’s illness. In a few weeks time they will make a decision on referral, but have agreed that admission should wait until the end of the school holidays.
Nine weeks, then for L to gain weight and to be able to eat, to challenge some of the controlling behaviour. There is very little advice about how to do this from CAMHS. Three meals and three snacks. I know what kind of food she should eat and I know roughly how many calories she should eat. We had a tough start to the week, but L often tries to turn things round after meltdown and she told me she was ready to get better. She said if she had more control over what she ate, she would find it easier.
But the problem, you see, is I don’t know if that is L or anorexia speaking. On the one hand it sounds just like the bargaining process we go through when we are ready to think about change, on the other it may be that by controlling her eating, it is limited and weight will not be gained. For example, we agreed she would eat a sandwich each lunchtime of a certain bread with Laughing cow cheese. I added 20 more calories worth of Laughing Cow cheese and she fell apart. She cried and told me she couldn’t eat it, it didn’t ‘fit’. That doesn’t sound like someone in recovery. On the other hand she has eaten small meals regularly, just not enough to gain weight. She also ate a cake, a small fairy cake, but still, that’s an achievement. But is it enough?
Is it ok to build on these small steps and take things at her pace, even though this means she will not gain enough weight and may have to be admitted to hospital? I am worried that by allowing her this level of control, she will not be able to make the small increases needed. Can I or should I make a decision that we will do this our way, at home, without hospital, even if it takes years? Once again, I am beset by so many questions and worry that by getting it wrong, she will become worse. I am also fighting my own exhaustion and depression which feels overwhelming.
If you read this and know the answers or even just have a view, I’d love to hear. I know I am impatient and always want things now rather than waiting. But it does feel as if the time is slipping away and more than anything I want to do the right thing for her.