Viewing blog posts tagged with "Hospitalization"

Ronald McDonald House

posted by Julie O'Toole on October 2, 2013 at 9:50pm

There are a lot of worthwhile charities in this world, many of them founded by successful business entrepreneurs or their heirs.  This blog is about one such charity that has made a huge difference in the lives of our young patients with eating disorders: the Ronald McDonald House Portland (East).  

The very first Ronald McDonald House was opened in 1974 in Philadelphia at the impetus of a pro football player (who was also a parent of a sick child), a physician, a professional…

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Portrait of a Nurse

posted by Julie O'Toole on August 28, 2013 at 8:10pm

Depictions of nurses and of the relationship between nurses and doctors have been the subject of many films and books and stories.  Doctors are usually portrayed as leading and demanding, telling the nurses what to do.  Nurses are usually portrayed as carrying out the doctor’s orders, and occasionally talking back or standing up to them.  My mother and one of my favorite aunts were both nurses in the old mold, largely deferential to doctors, they wore uniform dresses of modest length…

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The Eleventh Hour

posted by Julie O'Toole on July 25, 2013 at 7:36pm

I’m sure all specialties have their frustrations, but here is a major one of mine: patients who come to Kartini Clinic needing -- indeed deserving -- help but at the “eleventh hour.”


What do I mean by this?  I mean families who come in seeking help for a condition which is characterized by anosognosia, having waited for a variety of reasons, until shortly before their child’s 18th birthday, at which age their child will be able to refuse treatment, and often will do.  Even in…

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The Day Treatment Model for Pediatric Patients

posted by Julie O'Toole on May 9, 2013 at 7:21am

With the publication of results for models of family-based home treatments, the treatment of children with eating disorders has changed a lot in the past five or six years, or at least it has in many communities.  In some places,however, it is still the “same ol’, same ol’” of individual eclectic therapy, nutritional advice and a doctor’s infrequent monitoring - a combination known for some time to give substandard results.  

For some patients  “Maudsley” and other forms of newer…

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Judgement and consequences: where to hospitalize an eating disordered child

posted by Julie O'Toole on April 28, 2012 at 1:50am

It is understandable for parents to hope treatment for their ill child could be as close to home as possible - and to wish for as little disruption to family life and work as could be managed - but I for one am very unhappy about what I see as a lack of judgment on the part of many physicians when it comes to hospitalization for a very ill eating disordered child.

Hospitalists, who would under any other circumstances adamantly decline to do surgery for which they were not trained - or…

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Re-training the brain and modifying behavior in eating disorder treatment

posted by Julie O'Toole on March 18, 2012 at 1:11am

Ah the brain, it's so complex; we are so complex!  What of our behavior is under our control?  What is amenable to cajoling, influence and even coercion? Does this change with age?  How is general willingness and ability to learn affected by a specific brain disorder, or can we generalize?

These issues quite frequently come to the fore during the treatment of food phobia, and even infrequently in the treatment of early onset anorexia nervosa.

Some percentage of our young food phobia…

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Inpatient Eating Disorder Treatment Checklist for Parents

posted by Julie O'Toole on December 2, 2011 at 2:00pm

If your child or adolescent is admitted to a hospital for the medical complications of an eating disorder, you need to carefully assess adequacy of care at that hospital.  

Common sense would dictate that we not become aggressive, belittling or demanding of professionals on whom our child is temporarily dependent for medical intervention, however you should not hesitate to inform yourself, rely on your intuition and experience and ask questions.  The days of “because I said so and I…

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