How time flies... Yesterday my daughter was discharged from IOP (Intensive Outpatient Program). What normally should have taken six to eight weeks barely lasted four, and she went only a few times those last couple of weeks. A couple of major things took place that brought IOP to an abrupt end.
First, school started at the end of September. My daughter is doing an online high school program that was supposed to be totally flexible and allowed her to move at her own pace. It is not and it does not. There are online sessions that she needs to attend each day and if she misses, she has to watch a recording of the session, which is considerably less fun than actually participating. So once classes started, my daughter was totally stressed about having to spend four to five hours each day in IOP and falling further and further behind.
Then she came down with bronchitis - most decidedly caused by stress - and so she stayed home for almost an entire week.
But the clincher was IOP itself. In a Partial Hospitalization Program (PHP), clients (aka patients) go to the program for eight hours a day where they eat two meals and two snacks and participate in group therapy. For IOP, clients are there from 10 a.m. to 2 p.m. where they have lunch and eat the two snacks and participate in one group therapy session with the PHP kids. So in IOP, you are with kids who are in the early stages of their recovery.
My daughter has come so far in these short few months that it was extremely frustrating for her to have to sit there for four hours a day, doing therapeutic exercises that she had already done, listening to people talk about problems she feels she has overcome. Especially since it meant that she was falling further behind in school. On Monday, as we were driving home that first day (after she had been off a week for illness and school had already started), she burst into tears and begged me not to make her go back.
As a parent, I agreed that she had progressed way beyond what she was getting in IOP and understood her frustration. But as a former nurse, I also know that mental health patients often stop treatment as soon as they start feeling better, which in most cases is detrimental to their healing. And so, in that moment, I told her she had to go back until the therapist told her she would be discharged. This released what I can only call a rant, a non-stop stream of irrational talking where she could not hear anything I said to her. It was the kind of thing that preceded her hurting herself in the past.
So I asked her, told her, "I need to know, when we get home, are you going to do something to hurt yourself?" And to her credit, my daughter answered honestly: "I don't know. I want to" and then she resumed her rant. I tried to talk to her, but she would not hear me so I turned the car around to head back to the hospital. When she realized what I was doing, she stopped talking, promised she would not do anything to hurt herself. It took several minutes but we finally got to the point where we could talk about her frustration and constructive ways to deal with it.
In the end, she decided to call M, her Narcotics Anonymous sponsor (I'll write more about her another time). Unfortunately M was at work and could not talk right then but she gave my daughter the phone number of another one of her sponsees and encouraged her to call. My daughter called and 20 minutes later, she was calm and back to her usual self.
I called her therapist the next day and we decided that this would be her last week of IOP and she would only have to come in one more day (Friday, which was yesterday) so that she could be officially discharged from the program.
I feel like we have been in a maze, finding our way in the dark, but we turned a corner and suddenly, I can see the light shining through the exit.
Showing posts with label Eating Disorder. Show all posts
Showing posts with label Eating Disorder. Show all posts
Saturday, October 8, 2011
Wednesday, August 31, 2011
all quiet on the home front
Hard to believe it's been more than a week since I posted last. School has started and my son is living with his dad during the week, coming to my house only on the weekends. My daughter is finishing up her second week at the Eating Disorder house. I haven't gone to any Al-anon meetings lately and have not read the daily devotionals for several days now. It's like I am in limbo, waiting for whatever comes next.
Last Sunday I went to visit my daughter and since she was allowed to leave the house for the afternoon, we saw the movie, "The Help." Charming film. Weird though, in a way, because we couldn't go out to eat. She plans out her menu everyday and is not allowed to stray from it. I never realized how integral eating out was to our relationship.
Today I'm headed over there to have lunch with her and the therapist. The therapeutic purpose of this meal is to learn to recognize the symptoms of eating disorders. (She'll eat off her meal plan, I need to bring a lunch. Again, very weird that we will not be sharing the same food.)
I have no idea how long insurance will continue to approve her stay at this house. I am toying with the idea of pulling her out of residential and into a day program but not sure why. I guess I am reaching the point where I am ready to move out of limbo.
Last Sunday I went to visit my daughter and since she was allowed to leave the house for the afternoon, we saw the movie, "The Help." Charming film. Weird though, in a way, because we couldn't go out to eat. She plans out her menu everyday and is not allowed to stray from it. I never realized how integral eating out was to our relationship.
Today I'm headed over there to have lunch with her and the therapist. The therapeutic purpose of this meal is to learn to recognize the symptoms of eating disorders. (She'll eat off her meal plan, I need to bring a lunch. Again, very weird that we will not be sharing the same food.)
I have no idea how long insurance will continue to approve her stay at this house. I am toying with the idea of pulling her out of residential and into a day program but not sure why. I guess I am reaching the point where I am ready to move out of limbo.
Saturday, August 20, 2011
sigh...
Yesterday we moved my daughter out of the Dual Diagnosis program and into the Eating Disorder program. I had hoped that her ED was in early enough stages that DD would be enough to address her issues but sadly, that is not the case.
More uncertainty on the horizon...
More uncertainty on the horizon...
Thursday, August 18, 2011
a word (or 900) about shame
On Sunday I went to visit my daughter for the first time since she was admitted to Rehab. She is so full of hope, it was wonderful to see. She was talking about finishing up high school in two years, maybe taking some college classes and working on a singing career. She told me things she had learned about drug addiction, particularly to hard drugs like cocaine and heroine. She had experienced things that she was afraid to tell me about before (like having visual and auditory hallucinations during withdrawal) but that she learned were normal. And she never wants to go through those things again.
She is also learning about eating disorders. Her therapist told her that kids who develop ED have had control issues starting from a very young age, things that happen when they were so young and are buried so deep that sometimes they never uncover them. My daughter talked about when we first moved into our own home without her father (she was just a couple of months shy of turning nine). I used to travel about one week a month for work and my daughter would call me several times a day when I was gone. She told me that she used to be so afraid when I travelled that I wouldn't come home, that I would die in an accident or plane crash.
I suppose I should have realized how stressed my daughter was when she was younger, but I was wrapped up in my own issues and did not see what was happening. I thought that, because I was leaving her in the care of her father and her grandparents whenever I went out of town, that she was fine. Plus, she was always such an easy child, even as a baby. I used to joke about how she would switch so easily between breastfeeding and bottle, as compared to her brother who was much more difficult. He refused to go back and forth between feeding methods so we switched to just bottle-feeding when he was just two weeks.
My daughter was not a child who threw tantrums; the "terrible twos" never happened with her. But during those last few years of my marriage, when things were at their absolute worst, she threw a couple of major, screaming, throwing herself on the floor, kicking tantrums. The first was when she was in first grade, at school (while I was on a business trip). When her teacher asked her why she was so upset (she was probably 5 at the time), my daughter replied that she was "afraid her mom wasn't going to come home." When the teacher asked if she was afraid something would happen to me, my daughter replied, no, that she was just afraid I wouldn't come home. The second tantrum happened about a year later, when the kids and I took a trip at Christmastime without their father for the first time. She had no recollection of either of these incidents.
We talked about what happened and I explained that I didn't think the problem was that I was gone so much but that I was so unhappy during her early years. When she was about 5 or 6, she overheard me talking with a friend on the phone and I laughed out loud at something the other person said. When I hung up, my daughter marveled at hearing me laugh out loud; she had never heard that before. And when I watch videos of myself from when the kids were young, I am mainly a solemn presence in the background, interacting only when someone speaks to me directly.
At the last Al-Anon meeting that I went to, the leader chose shame as the topic for the evening. A few parents (who have young children) shared what life was like before they came to Al-Anon, when they were consumed with trying to control the adult alcoholic in their life. They spoke with great shame and regret about how they were not present and available for their children emotionally. On the flip side, when adult children of alcoholics talk, they often share about how they felt like everything that went wrong was their own fault. That if they had just behaved better, their parent would not have drunk or (or did drugs or let life spiral out of control).
I think that shame and guilt are useless feelings, tools of the devil to keep us from where we could be. They lead to embarassment and the need to keep secrets. As my daughter told me about her fears and wondered aloud why she had control issues, I suppose I could have stayed silent. Let shame and embarrassment about being such a sad and absent mother (both physically and emotionallly) keep me from telling her what she needed to hear. But truthfully, since I am neither ashamed nor do I feel guilty, it came out very naturally, very matter-of-factly. It's just how things were back then and there is nothing I can do to go back and change them.
I think I saw a light come on in my daughter's eyes when she realized that there were things going on that she didn't understand, that had nothing to do with her, but that she took responsibility for and internalized at that young age.
We're having our first therapy session together on Friday and my daughter asked that I tell the therapist all that we talked about, in case she didn't remember to bring them up herself. And I will.
She is also learning about eating disorders. Her therapist told her that kids who develop ED have had control issues starting from a very young age, things that happen when they were so young and are buried so deep that sometimes they never uncover them. My daughter talked about when we first moved into our own home without her father (she was just a couple of months shy of turning nine). I used to travel about one week a month for work and my daughter would call me several times a day when I was gone. She told me that she used to be so afraid when I travelled that I wouldn't come home, that I would die in an accident or plane crash.
I suppose I should have realized how stressed my daughter was when she was younger, but I was wrapped up in my own issues and did not see what was happening. I thought that, because I was leaving her in the care of her father and her grandparents whenever I went out of town, that she was fine. Plus, she was always such an easy child, even as a baby. I used to joke about how she would switch so easily between breastfeeding and bottle, as compared to her brother who was much more difficult. He refused to go back and forth between feeding methods so we switched to just bottle-feeding when he was just two weeks.
My daughter was not a child who threw tantrums; the "terrible twos" never happened with her. But during those last few years of my marriage, when things were at their absolute worst, she threw a couple of major, screaming, throwing herself on the floor, kicking tantrums. The first was when she was in first grade, at school (while I was on a business trip). When her teacher asked her why she was so upset (she was probably 5 at the time), my daughter replied that she was "afraid her mom wasn't going to come home." When the teacher asked if she was afraid something would happen to me, my daughter replied, no, that she was just afraid I wouldn't come home. The second tantrum happened about a year later, when the kids and I took a trip at Christmastime without their father for the first time. She had no recollection of either of these incidents.
We talked about what happened and I explained that I didn't think the problem was that I was gone so much but that I was so unhappy during her early years. When she was about 5 or 6, she overheard me talking with a friend on the phone and I laughed out loud at something the other person said. When I hung up, my daughter marveled at hearing me laugh out loud; she had never heard that before. And when I watch videos of myself from when the kids were young, I am mainly a solemn presence in the background, interacting only when someone speaks to me directly.
At the last Al-Anon meeting that I went to, the leader chose shame as the topic for the evening. A few parents (who have young children) shared what life was like before they came to Al-Anon, when they were consumed with trying to control the adult alcoholic in their life. They spoke with great shame and regret about how they were not present and available for their children emotionally. On the flip side, when adult children of alcoholics talk, they often share about how they felt like everything that went wrong was their own fault. That if they had just behaved better, their parent would not have drunk or (or did drugs or let life spiral out of control).
I think that shame and guilt are useless feelings, tools of the devil to keep us from where we could be. They lead to embarassment and the need to keep secrets. As my daughter told me about her fears and wondered aloud why she had control issues, I suppose I could have stayed silent. Let shame and embarrassment about being such a sad and absent mother (both physically and emotionallly) keep me from telling her what she needed to hear. But truthfully, since I am neither ashamed nor do I feel guilty, it came out very naturally, very matter-of-factly. It's just how things were back then and there is nothing I can do to go back and change them.
I think I saw a light come on in my daughter's eyes when she realized that there were things going on that she didn't understand, that had nothing to do with her, but that she took responsibility for and internalized at that young age.
We're having our first therapy session together on Friday and my daughter asked that I tell the therapist all that we talked about, in case she didn't remember to bring them up herself. And I will.
Monday, August 8, 2011
e d
I woke up this morning with the memory of a college friend. Our families had known each other forever but were not particularly close so I hadn't seen her for years before we re-connected my sophomore year.
I was rooming with my sister that year. We first learned that our friend was bulemic the night she overdosed on laxatives and something that made her extremely drowsy. She called our suite asking for help and so we drove her to the ER and stayed with her all night and most of the next day. For several weeks after that, I tried to be supportive but she was so needy, so insecure, so all-consuming. I had school and so many other commitments. I ended our friendship a few months later and she did not return to college the next year.
I've also been thinking a lot about a high school girlfriend who was anorexic. This was the early 80s and eating disorders were unheard of then, at least to kids growing up in small, midwestern towns. I remember standing behind her in the cafeteria line at breakfast and seeing her take nothing but a small bowl of granola as her food for the day. She used to exercise for hours at a time. She was literally down to skin and bones by the time her parents withdrew her from our boarding academy.
Eating disorders are scary.For me it's easier to focus on the drug addiction because the path is clear. Stop using drugs. Go to meetings. Work the 12 steps. If you relapse, start again. "It works if you work it." But there is no clear path for ED. You cannot stop eating food. There are no meetings. This is not a problem so common that the mantras have entered the common vernacular. There are no mantras. And the issues that fuel an ED are so deep, so painful that they may never be uncovered and food and body image issues can dominate for a lifetime.
As the parent of a child with ED, I see no middle ground. I am either consumed by it or I have to let go. I have chosen the latter route, preferring to watch and worry in silence. Refusing to try to get her to eat more or to ask if she has thrown up today. Talking myself down off the proverbial ledge in the privacy of my bedroom when my frustration and anger get to be too much. Focusing on the disease that I understand.
So this is my other reason for being grateful for residential treatment. The professionals will deal with this, figure it out. And once they have, they will tell me what I should be doing, how best to help my daughter.
I was rooming with my sister that year. We first learned that our friend was bulemic the night she overdosed on laxatives and something that made her extremely drowsy. She called our suite asking for help and so we drove her to the ER and stayed with her all night and most of the next day. For several weeks after that, I tried to be supportive but she was so needy, so insecure, so all-consuming. I had school and so many other commitments. I ended our friendship a few months later and she did not return to college the next year.
I've also been thinking a lot about a high school girlfriend who was anorexic. This was the early 80s and eating disorders were unheard of then, at least to kids growing up in small, midwestern towns. I remember standing behind her in the cafeteria line at breakfast and seeing her take nothing but a small bowl of granola as her food for the day. She used to exercise for hours at a time. She was literally down to skin and bones by the time her parents withdrew her from our boarding academy.
Eating disorders are scary.For me it's easier to focus on the drug addiction because the path is clear. Stop using drugs. Go to meetings. Work the 12 steps. If you relapse, start again. "It works if you work it." But there is no clear path for ED. You cannot stop eating food. There are no meetings. This is not a problem so common that the mantras have entered the common vernacular. There are no mantras. And the issues that fuel an ED are so deep, so painful that they may never be uncovered and food and body image issues can dominate for a lifetime.
As the parent of a child with ED, I see no middle ground. I am either consumed by it or I have to let go. I have chosen the latter route, preferring to watch and worry in silence. Refusing to try to get her to eat more or to ask if she has thrown up today. Talking myself down off the proverbial ledge in the privacy of my bedroom when my frustration and anger get to be too much. Focusing on the disease that I understand.
So this is my other reason for being grateful for residential treatment. The professionals will deal with this, figure it out. And once they have, they will tell me what I should be doing, how best to help my daughter.
Sunday, August 7, 2011
don't bother me i'm watching people's court
Tonight it is beginning to dawn on me how tired I am. Part of it may be due to the extraordinarily busy weekend but I think that the stress of being "on" these past four weeks is finally getting to me.
My daughter is packing to go to the residential treatment facility tomorrow. Even though the facility has thoroughly reviewed her history and medical records and accepted her, and we have preliminary insurance approval, there is no guarantee that she will actually be admitted. And we have no idea how long she will stay - it could be just a few days, it could be up to a month. I am looking forward to, hoping for, at least a few days of at-home solitude.
On the one hand, life with my daughter has been blissfully peaceful the last week. The medication is working and helping her sleep and keeping her mood steady. She has resumed some of her favorite hobbies (much to our family's benefit) such as playing piano and singing, cooking, and crocheting. We have actually enjoyed the last few NA meetings and had good conversations when they were over.
But it has also been incredibly stressful... Monitoring what she is eating; wondering if she is throwing up when I am busy in another part of the house. Checking several times during the day to see what she is doing when she is too quiet and occasionally making sure she is still in bed in the middle of the night. Ensuring she is not too bored for any length of time (which is usually how trouble begins). Trying to not overreact when she does something stupid, like spilling a half gallon of blue latex paint on the tan carpeting. Giving her the medication, planning our lives around NA and Al Anon meetings, constantly checking to make sure that I have my phone (so she cannot use it), and that all medications and other dangerous substances are locked up.
And fighting the desire to believe that she is fine now, that today it is ok for me to go back to living my normal, oblivious life.
So tomorrow, after I get back from the residential center, don't be worried if you don't hear from me for a while. Hopefully I will be in my room, the door locked, phone turned off, curled up in bed, mindlessly catching up on four week's worth of People's Court and Matlock reruns (yes, I DVR those shows).
My daughter is packing to go to the residential treatment facility tomorrow. Even though the facility has thoroughly reviewed her history and medical records and accepted her, and we have preliminary insurance approval, there is no guarantee that she will actually be admitted. And we have no idea how long she will stay - it could be just a few days, it could be up to a month. I am looking forward to, hoping for, at least a few days of at-home solitude.
On the one hand, life with my daughter has been blissfully peaceful the last week. The medication is working and helping her sleep and keeping her mood steady. She has resumed some of her favorite hobbies (much to our family's benefit) such as playing piano and singing, cooking, and crocheting. We have actually enjoyed the last few NA meetings and had good conversations when they were over.
But it has also been incredibly stressful... Monitoring what she is eating; wondering if she is throwing up when I am busy in another part of the house. Checking several times during the day to see what she is doing when she is too quiet and occasionally making sure she is still in bed in the middle of the night. Ensuring she is not too bored for any length of time (which is usually how trouble begins). Trying to not overreact when she does something stupid, like spilling a half gallon of blue latex paint on the tan carpeting. Giving her the medication, planning our lives around NA and Al Anon meetings, constantly checking to make sure that I have my phone (so she cannot use it), and that all medications and other dangerous substances are locked up.
And fighting the desire to believe that she is fine now, that today it is ok for me to go back to living my normal, oblivious life.
So tomorrow, after I get back from the residential center, don't be worried if you don't hear from me for a while. Hopefully I will be in my room, the door locked, phone turned off, curled up in bed, mindlessly catching up on four week's worth of People's Court and Matlock reruns (yes, I DVR those shows).
Thursday, August 4, 2011
keeping my fingers crossed
I'm feeling hopeful. It looks like we might be able to get my daughter started in an outpatient treatment program as early as tomorrow. She should have started a week ago but we weren't ready.
It's a long story.... She was in the behavioral med unit for two weeks initially after the suicide attempt. Then she went into outpatient Partial hospitalization the first day after she was discharged. Partial means you spend 7 hours a day in an outpatient treatment program and that typically lasts a week or two. (I use that word, "typically," loosely. How the patient responds determines how long they stay.) In Partial, they were assessing my daughter to determine if she should go to the Eating Disorder Partial program or to what they refer to as Dual Diagnosis, which is for patients who have two or more problems such as drug use and depression. They decided Eating Disorder (ED) was more appropriate so they discharged her on a Wednesday with the plan that she would start ED the next day.
ED is eight hours a day, five days a week, and lasts typically six to eight weeks, longer if the patient is not responding. It is held at the hospital which is 25 miles from my home (and 50+ miles from my ex-husband's house), but the commute can easily take 30 - 60 minutes one way during rush hour traffic for me (and 3 hours for him). It is also expensive. I have very good health insurance and they were going to cover the bulk of the cost, but even the daily co-pay was more than I could afford without going into serious debt. When they told me about the decision to go with ED and what all it entailed, I shut down. Literally. I refused and took my daughter home.
To their credit, the people at the hospital were very kind. They told me they might be able to work out transportation with a van service. That they might be able to work out a program where she would come in fewer days in the week, maybe even shorter hours, and all these things would bring the cost down. But as I said, I shut down and could not begin to discuss options. I remember telling the staff, "I really can't afford the ED program" and the nurse asking me, "How much can you afford?" The first thought that went through my mind was, What are you? A used car salesman? Fortunately I did not express that thought out loud.
It's amazing what a good night's sleep can do. I woke up in the morning and was able to think clearly; I was able to verbalize the fears that were paralyzing me.
I talked that morning with my sister on the phone, and was complaining that I could not afford the cost of treatment. She was very encouraging and supportive and said, "These things always come to an end. Don't feel like you will be paying that money forever. It's just for a set time." But my fear was that this might never end. Most addicts relapse. A woman in Al Anon told me she had sent her son to rehab 20+ times between the time he was 14 and 21. She mortgaged her house to send him to a camp in Utah for a year and when he came home, he was using again within two days. I said to my sister, "I feel like I am in this for the long haul and I can't afford to go with luxury treatment programs. This hospital ED program feels like a luxury. I feel like I have to be economical about this. It's the not-knowing what the future will be like that is killing me."
And as far as the driving issue, I realized that a treatment program that was closer to my ex-husband's house would work better for us all around. I could set up shop at his house while my daughter was in treatment and he would be able to help drive. If we drove together, it would give us time to talk not only to her but to each other. It would also be more convenient for him to participate in therapy.
I began looking online for treatment programs and found one that sounded really good. (The Parents' support group that we went to a couple of days ago was for this program.) It has taken us a week to get to the place where we are emotionally and psychologically ready to send her. Now we're working on paperwork and insurance.
This may not work out and I'm ok with that. I know now what I am looking for and that I will eventually find the solution that is best for my daughter AND that is within our means and abilities.
It's a long story.... She was in the behavioral med unit for two weeks initially after the suicide attempt. Then she went into outpatient Partial hospitalization the first day after she was discharged. Partial means you spend 7 hours a day in an outpatient treatment program and that typically lasts a week or two. (I use that word, "typically," loosely. How the patient responds determines how long they stay.) In Partial, they were assessing my daughter to determine if she should go to the Eating Disorder Partial program or to what they refer to as Dual Diagnosis, which is for patients who have two or more problems such as drug use and depression. They decided Eating Disorder (ED) was more appropriate so they discharged her on a Wednesday with the plan that she would start ED the next day.
ED is eight hours a day, five days a week, and lasts typically six to eight weeks, longer if the patient is not responding. It is held at the hospital which is 25 miles from my home (and 50+ miles from my ex-husband's house), but the commute can easily take 30 - 60 minutes one way during rush hour traffic for me (and 3 hours for him). It is also expensive. I have very good health insurance and they were going to cover the bulk of the cost, but even the daily co-pay was more than I could afford without going into serious debt. When they told me about the decision to go with ED and what all it entailed, I shut down. Literally. I refused and took my daughter home.
To their credit, the people at the hospital were very kind. They told me they might be able to work out transportation with a van service. That they might be able to work out a program where she would come in fewer days in the week, maybe even shorter hours, and all these things would bring the cost down. But as I said, I shut down and could not begin to discuss options. I remember telling the staff, "I really can't afford the ED program" and the nurse asking me, "How much can you afford?" The first thought that went through my mind was, What are you? A used car salesman? Fortunately I did not express that thought out loud.
It's amazing what a good night's sleep can do. I woke up in the morning and was able to think clearly; I was able to verbalize the fears that were paralyzing me.
I talked that morning with my sister on the phone, and was complaining that I could not afford the cost of treatment. She was very encouraging and supportive and said, "These things always come to an end. Don't feel like you will be paying that money forever. It's just for a set time." But my fear was that this might never end. Most addicts relapse. A woman in Al Anon told me she had sent her son to rehab 20+ times between the time he was 14 and 21. She mortgaged her house to send him to a camp in Utah for a year and when he came home, he was using again within two days. I said to my sister, "I feel like I am in this for the long haul and I can't afford to go with luxury treatment programs. This hospital ED program feels like a luxury. I feel like I have to be economical about this. It's the not-knowing what the future will be like that is killing me."
And as far as the driving issue, I realized that a treatment program that was closer to my ex-husband's house would work better for us all around. I could set up shop at his house while my daughter was in treatment and he would be able to help drive. If we drove together, it would give us time to talk not only to her but to each other. It would also be more convenient for him to participate in therapy.
I began looking online for treatment programs and found one that sounded really good. (The Parents' support group that we went to a couple of days ago was for this program.) It has taken us a week to get to the place where we are emotionally and psychologically ready to send her. Now we're working on paperwork and insurance.
This may not work out and I'm ok with that. I know now what I am looking for and that I will eventually find the solution that is best for my daughter AND that is within our means and abilities.
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