In a fraught week, the highlight was always going to be the long awaited day on which L is discharged as a day patient from hospital. It is eight months since she was admitted, one of the longest stays. A patient who was admitted after her was discharged back in January – and was readmitted as an inpatient last week. This makes the difficulty of recovery so much more real to L.
We assemble for her final review meeting. As L will be passed back to CAMHS, they have been present at each one and have also been attending therapy sessions with L and her team in the unit so that there is some continuity of care. As usual we discuss weight changes. This is still a problem. Despite a stated determination to gain the weight needed to be discharged at a healthy weight, L has in fact gained only half a pound over six weeks. She seems so frustrated by this,but I am not surprised. Even though she religiously eats her three meals and four snacks each day, there is a constant pull to limit or reduce the amount. Juice is not recommended by her orthodontist so has been removed from snacks and replaced by water. She is back at school and more active, although still banned from PE due to her low weight.
But there is still much to celebrate. She is able to eat without a battle. She can recognise the anorexic voice and has tools to defeat it. Purging is no longer a regular feature of her life. She has gained the confidence to speak up for herself and to challenge friends when they behave thoughtlessly without worrying that they won’t like her any more. She has made brave choices, such as the cream on the milkshake or the trip to Patisseries Valerie, the scene of our first disastrous outing when she was an inpatient. Her education reports are read out and each teacher ends by saying what a pleasure it has been to teach her. I smile, this is what every teacher since reception has said about her.
That afternoon, there is a send off. L bakes cake – lemon and poppyseed cake, her signature dish. Everyone eats it, including her and other ED patients who call her an inspiration. She receives cards and presents, including a travel journal for her future life. She is so, so pleased.
And then life returns to the way it was, with L at school, but also a patient at CAMHS. On Thursday we go to her first appointment, with her CAMHS team and a psychologist from her hospital team to complete the handover. We climb the stairs to the clinic, and we sit in the familiar waiting room. I look at the posters on the wall, cringe at the Healthy Eating ones with their helpful advice about smaller portions and cutting out fatty foods. We both look at the other patients waiting there and as usual wonder what they are ‘in’ for. A fidgety girl stands up by the wall and hops from one foot to another. Later, L and I will compare notes and agree it was probably ADHD. I am equally sure that L is scrutinised and while it may be less obvious now, will still probably be rightly assessed as having an ED. This is judging without being judgmental – every parent in the CAMHS waiting room does this.
While we are ‘back’ at CAMHS, this is still progress. While it has been a hobbling, stumbling, limping kind of week, at least we are heading in the right direction.