Oh God, it’s so hard. Hard for the kids. Hard for the parents. Hard for me.
Resting an injury is not an easy concept when you don't feel direct and immediate pain if you don’t. This makes it hard to rest an injury such as a heart attack, cancer, a surgery or… anorexia nervosa. And it’s harder for some people to rest than for others.
Case in point: my partner pediatrician Dr. Naghmeh Moshtael. I know she won’t mind me revealing that she has had to undergo chemotherapy several times in her life. Man oh man, did she not want to rest! She charged around the hospital and clinic dragging an i.v. pole trying to keep up; trying to, dammit, not give in to the illness. That hard-charging personality is what makes her who she is. Rest? You must be kidding. But that was then. Now she has (reluctantly) come to understand that if she wants to live a long and healthy life and have a long and joyous motherhood, she actually has to allow herself to get enough sleep, to stop when she has to rest, and to take vacations.
Case in point: me. Oh man, I am a project person and have the work stamina of… well, Naghmeh. When my lung collapsed years ago, I chafed against the “rest” advice of my radiologist and also tore around the hospital making rounds in a wheelchair. What idiocy! What perfectly understandable idiocy. But today, I understand that even I must rest.
Case in point: a lovely girl recovering from anorexia nervosa who is tops in her sport, just like her father, whom she adores. She is finally weight-restored, but her labs are not yet in the normal range. Though she has had some bleeding, her hormones are still in the anovulatory range and her leptin is suppressed from postprandial hypoglycemia. This happens to some people who are recovering from dieting of any cause. It’s not fair and it’s not preventable. It’s not even predictable. But it is treatable with a medication (Acarbose), spreading out food to frequent meals and, you guessed it… rest.
Of course the very kids who develop this complication seem to be the ones who are most dedicated to getting back to their sport, but as Dr. Cooper has taught us, even Olympic athletes must be rested in order to compete at the top of their game. We humans are just built that way.
But you know, it’s one thing to “take the long view” when you are an older adult, and quite another when you are a kid. What long view? You mean, like, next week?
So Dr. Moshtael and I (and Dr. Emily Cooper in Seattle) spend a lot of time making ourselves very unpopular by continuing to restrict exercise (called ‘resting them’) until our patients are well and truly recovered.
It’s very hard to see the disappointment in the kids’ eyes, and the tears behind the eyes of disappointed parents, too. We are all doing our best to see that every child recovers fully and can be returned successfully to their old life, the life they had before the eating disorder robbed them of it.
To send an injured athlete back into the game too soon is to court disaster. To avoid this you must take the long view. I guess that’s why we’re grown ups.