Viewing blog posts categorized under "Recovery"

Our First Teaching Webinar

posted by Julie O'Toole on January 7, 2016 at 2:36pm

Today we did our first webinar on a site called ReelDX, specifically created as a teaching tool for providers and students, offering lifelong learning for a variety of other specialists and, eventually, for parents as well.  When we signed on to do teaching thorough ReelDX, we were especially thrilled at the prospect that parents could also access actionable medical information on health conditions that affected them personally.

To participate in these teaching vignettes, “case…

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Goodbye, Bryan

posted by Julie O'Toole on November 4, 2015 at 11:59am

Anyone who knows me knows that I am no longer young. Yet I have teachers. My patients are my teachers and some of my colleagues are (still) my teachers. At this stage in the student/teacher relationship we often teach each other: we debate, we discuss, we disagree, we commiserate, we laugh.  As one of my general pediatrics colleagues told me the other day “what you do is hard; not everyone can love your patients”.  But I know someone who can and does -- now, sadly, past tense could…

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Why We Ban Cell Phones at Kartini Clinic

posted by Julie O'Toole on September 9, 2015 at 4:36pm

All our kids know it: at Kartini Clinic there are no cell phones allowed on the unit.

But why not?

Well, treatment takes focus and it takes interaction with the therapists, doctors and other patients.  Today I walked in on a group therapist talking with the high school-aged kids about the difficulties one of them was experiencing with concentration.  The supportive comments and suggestions given from one patient to another were nothing short of amazing.  The kids are amazing, but…

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Helping Parents, Together

posted by Julie O'Toole on August 26, 2015 at 6:04pm

Mother nature built us to protect our offspring and, where necessary, the offspring of other members of our “tribe”.  Elephants and non-human primates have been reported to foster or adopt motherless infants and raise them as their own.  Few adults can bear to see the suffering of a child.

Life can throw some of us a lot of pain.  But perhaps the worst kind of pain we endure is the kind we experience when our own small children are suffering.  We are supposed to be able to protect…

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What Real Mental Health Parity Looks Like

posted by Julie O'Toole on July 30, 2015 at 1:21pm

According to a June 29th article by Sam PK Collins for, “last week, Missouri Gov. Jay Nixon (D) signed a bill that explicitly states the types of eating disorder treatments insurance providers must cover. The new law builds on the mental health parity law by expanding the definition of “medically necessary” to include mental health treatment. It will also ensure that weight no longer serves as the sole determinant for whether someone may continues treatment.…

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Traveling with ED

posted by Julie O'Toole on May 28, 2015 at 1:48pm

I am writing to you from Berlin tonight and thinking about a recent article written by Dr. Bulik on the challenges of international travel for those with an eating disorder, in particular anorexia nervosa. In the article Dr. Bulik talked about time changes and irregular meals, of long distance transportation being a danger to those whose brain chemistry is less anxious when they don’t eat and more anxious when they do. It's how a person’s weight may slide down inadvertently, because…

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The Suffering of Others

posted by Julie O'Toole on May 8, 2015 at 10:04am

“With what incredible courage we are able to endure the suffering of others” -- My favorite quote from English garden writer Christopher Lloyd.  And nowhere does it apply more than in medicine.  And within the world of medicine, nowhere more than in the world of mental health.

When my neighbor is poor, he deserves it for his sloth and lack of thrift.  When I am poor, I am the victim of unfairness and persecution.  When a young man medicates his abdominal pain with narcotics, he just…

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Very Early Onset Anorexia Nervosa

posted by Julie O'Toole on April 3, 2015 at 3:20pm

For the purposes of this discussion I am somewhat arbitrarily defining “very early onset” as 12 years and younger.  Despite what you might think, this is not synonymous with “pre-pubertal onset” as Caucasian girls on average begin breast development - and the hormonal changes associated with this - at about 10 ½ years of age. Boys on average begin to go through pubertal changes about two years later.  And for girls and boys of African and Hispanic heritage average ages for these…

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Avoiding negative energy balance

posted by Julie O'Toole on February 26, 2015 at 5:01pm

Last week I was pleased to discuss a paper by Walt Kaye and colleagues that I felt strongly supported ordered eating for people with anorexia nervosa.  Ordered eating on our Kartini meal plan has always been the cornerstone of our weight restoration strategy for children and young adults who suffer from this condition. It works and Dr Kaye’s research tells us why.

This week I would like to refer you to a blog written by Cindy Bulik of the University of North Carolina. Cindy is a…

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Connecting the Dots

posted by Julie O'Toole on February 6, 2015 at 4:33pm

Two current Kartini parents handed me an excellent article the other day whose lead author, Walter Kaye, is likely well known to our readers.  The article, Temperament-based Treatment for Anorexia Nervosa, appeared in the European Eating Disorders Review.

I was especially pleased to see this article, although many of us have heard Walt speak about meal planning and the latest neuro-biological and neuro-radiological evidence before.  Neuro-biological and neuro-psychological evidence…

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