Dr. O'Toole's Blog

Scene:  hospital bedside, the doctor is making rounds.  The patient, a 16 year old boy, is in his hospital bed having been admitted earlier that day.  His mother is next to him.  In tears.  He is angry and tearful himself.  He is well groomed, clean and tidy, good-looking but very, very thin with obvious muscle-wasting.  His heart rate, although he is angry, is in the 40’s, at night it drops to the low 30’s.  He is too orthostatic to stand.

“Jacob,” the doctor says, “I’m here to answer your questions.”

On July 8th The Oregonian ran an article about eating disorders featuring a large, glamorous photo of a “recovered patient”: a beautiful young woman in a slim dark dress and long blondish hair leaning against a leather couch in a well-appointed home.

Were her parents proud of her? You bet! Should they have been? Absolutely!

I am a gardener when I am not in the clinic. It used to be that I did all my best thinking in the shower. Now I do it in the garden. So some musings from there.

Thinking about stress today. Stress and our patients. What does the word stress mean for all of us?

As we all know, weakening of bones is one of the most concerning effects of the malnutrition associated with anorexia nervosa (AN) in girls and boys.

What is the problem?

Osteopenia (“weak bones”) is a precursor to osteoporosis (“bones full of holes”). It is not uncommon for a young patient with anorexia nervosa to present to their doctor with a stress fracture as the first manifestation of their illness. And sometimes even that gets ignored.