Today we had our first practice snack with L in the unit. Before we have a home visit we have to spend snack time with L and learn the clinic routines. It feels as if we are being inducted into the dark arts of how to make an anorexic child eat. On Friday we will share a meal with L in the clinic, along with their staff.
So what is their secret? Timing. Each meal or snack has a set time. Twenty minutes for both meals and snacks, with a possible ten minute extension for main meals. After the time the plate is removed. If the patient hasn’t eaten, they go on bed rest. If they don’t eat consistently then a nasogastric tube is considered and they move to the acute hospital. There is no urging or cajoling. After the meal, in a separate room the ED patients and staff then talk for up to ten minutes about how they felt. They then have supervision for an hour.
And that is it. Of course there is an intensive therapy programme, but at mealtimes, that is it. And we watched as L munched her way through a cereal bar, apple and milk. No resistance, no distress. And this is what we will do at home this weekend. I will write about how it goes.
And in other news, tomorrow is my 46th birthday. If L were at home, she would make breakfast and be as excited as me. Last year she baked a lemon and poppyseed cake as well as a blueberry cake to take to work. This year that won’t happen. But tonight she gave me a bunch of origami flowers, a hat she knitted with wool from the unit and a home made card. Tomorrow, I am sure I will have lovely presents from the family. C is taking me away for a couple of days. But no gift will be as precious as my paper flowers and knitted hat.