Viewing blog posts categorized under "ARFID"

Game Plan For The Holidays

posted by Julie O'Toole on December 18, 2014 at 8:05am
Christmas is not just one single holiday at Kartini Clinic, it is several. In fact it’s a season involving many celebrations and special events. Some of our patients’ families do not celebrate Christmas as such, of course, but for those who do, some “highlights”: Baking… baking… baking. It’s a problem in many ways. And the truth is, no matter how appealing the picture of doing so may be, or how often it’s been done before in your family, probably not everyone should… Read More

What To Do With An Affected Parent?

posted by Julie O'Toole on November 5, 2014 at 9:15am
This blog is asking for help from those of you who have a child with anorexia nervosa but who may have experienced an eating disorder yourself. Any clinic or provider who treats pediatric eating disorders will sooner or later see children whose families have more than one affected (or partially affected) family member. This is the fancy way of saying that when you do a careful history you are likely to find other family members who have eating disorders in addition to the child.… Read More

Can I speak to the chef, please?

posted by Julie O'Toole on October 22, 2014 at 7:33am
It’s not very common for me to hear things out of the mouths of our patients that I have not heard before—I have heard most things many, many times. For example: “exercise (insert dance, soccer, cheer, ballet, etc) is my only social life, I don’t have any friends without it,” or “school is the most important thing to me. I can’t get behind because of treatment,” or “I don’t care abut how much weight I gain, as long as it’s muscle,” or “I don’t tolerate… Read More

The Promise of Personalized Medicine

posted by Julie O'Toole on September 3, 2014 at 8:15pm

Advances in medicine come in all shapes and sizes: vaccines, antibiotics, anti-virals, immune system boosters and reducers, technological changes and recently, the hope that faster, cheaper and more accurate genetic analysis can bring us the new approach to medicine and medications: personalized medicine.

As I have mentioned in a previous blog, a leading proponent of personalized medicine has been Dr Eric Topol, editor-in-chief of Medscape and director the Scripps Translational…

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Save Yourself First

posted by Julie O'Toole on August 28, 2014 at 1:18am

It has become almost trite to advise parents struggling with the “severe pushback” of doing battle with their child’s eating disorder to remember that flight attendants caution parents travelling with small children to “first place the oxygen mask on yourself (really counter-intuitive for parents) and then place it on your child.” When I first heard this advice on a plane (astonishingly not what would have come naturally to me) I thought “of course! If I am unconscious then my…

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Making ‘em Mad

posted by Julie O'Toole on August 13, 2014 at 10:43pm

I’m sometimes not sure whom I make madder: some kids, some parents, or some insurance companies!

Making kids mad:

Me:  “Jill, help me understand why your weight would be way down this week?”

Jill (shrugging):  “I don’t know.  I actually exercised less and ate exactly what I was supposed to.”

Me:  “OK. I guess your body is just telling us you need more food.”

Jill:  “What!!?? No way!  I refuse to have more food.”

Me:  “Well…. unless you can think of something that didn’t go…

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Parental Supervision

posted by Julie O'Toole on August 7, 2014 at 1:45am

Eating disorders strike children at virtually all stages of development. Sometimes we think it’s most difficult when they strike a very young child, sometimes it seems the most difficult when a “child” is about to go off to college, or a student exchange program, or start a new school. Personally I think mid adolescence is one of the most difficult times for an eating disorder to strike a child.

Childhood and early adolescence are characterized by learning new skills, but also by…

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Do Parents Cause Eating Disorders?

posted by Julie O'Toole on June 19, 2014 at 12:59am

Sometimes things happen to me that cause me to wonder what planet I have landed on.  Five years ago -- to say nothing of ten or fifteen -- whenever I insisted that parents didn’t cause eating disorders, any more than they cause schizophrenia or bipolar disorder or autism, I was treated like I hadn’t done my homework.  Thankfully, that has changed. Virtually no responsible eating disorder professional of any stature believes that parents cause severe mental illnesses, of which…

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Treatment Fatigue

posted by Julie O'Toole on April 23, 2014 at 11:37pm

I feel so weary writing this, I almost can’t start.  And I am not talking about provider fatigue, for that is a different subject altogether.  No, I mean the fatigue I have watched parents feel over all these years of treating children with eating disorders.

Parents are human, even when they can do inhumanly difficult things for the sake of their children. None are saints, of course, but they can come close to one when circumstances require. At least some of them can (and do).

Do you…

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Levels of Care

posted by Julie O'Toole on April 17, 2014 at 2:49am

At Kartini Clinic our evolution to the current levels of care we offer has been a long one.  In the first days of the clinic we offered only inpatient (hospital rounds for medical stabilization) and outpatient care.  In 2000 we developed the day treatment (partial hospital) level of care.  This was a big step forward and allowed us to “gently land” patients, who required brief medical stabilization in hospital, to a lower level of care. In day treatment, such patients could get a lot…

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