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Viewing blog posts tagged with "Inpatient Treatment"

Tolerating our own children’s distress

posted by Julie O'Toole on October 20, 2016 at 8:32am

This post was originally published on November 13, 2013.

Until I lived in the world of therapists and mental health professionals as part of the Kartini multidisciplinary team treating children with eating disorders, I had never actually heard the phrase “tolerating distress”, particularly as it pertained to parents.  Like most parents, I have a very difficult time tolerating pain in my own children, either physical or emotional and, when put in that situation, I immediately get…

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Kartini Clinic’s New Food Phobia Program

posted by Julie O'Toole on April 22, 2015 at 6:04pm

Kartini Clinic has a new home, and we are excited for a number of reasons. For starters, this time around we were able to design our units especially for our kids; they’re full of light and air and space to do art, a new classroom, a roof deck, not to mention our very own commercial kitchen - designed to provide space for parent cooking class as well - from which we serve all of our meals. Our food is sourced from the neighborhood’s New Season’s Market, conveniently located across…

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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

Food phobia, the Kartini Clinic recipe

posted by Julie O'Toole on April 9, 2014 at 10:50pm

Talking to a mother whose son has just entered our Food Phobia treatment program I realized that I may not have done a very good job stating clearly what our “recipe” for success with this illness has been.  What can a parent expect?  What can a child look forward to?  What if a provider is forced to treat a child with food phobia in an outlying hospital; how might they proceed?

First, a bit about the diagnosis.

Food phobia is the term Kartini Clinic uses for the sudden onset of…

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Mixed Symptoms

posted by Julie O'Toole on April 2, 2014 at 9:10pm

Recently I was making our daily rounds at Randall Children’s Hospital and received a lesson from a very young patient of ours.  I say it over and over: “your patients are your teachers”, and it is really true.  I was first told this by Dr. Mizuo Tottori, pediatrician and mentor to many other pediatricians in Hawaii. And life itself has borne out the truth of it, again and again.

This particular little patient has anorexia nervosa and has done very well.  Her parents are competent and…

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The Locked Psychiatric Unit

posted by Julie O'Toole on November 20, 2013 at 9:46pm

No doubt I will make myself unpopular (again) with some of our psychiatric colleagues by speaking out in this way about the use of locked psychiatric units in the treatment of children with eating disorders, but we have had several recent transfers to Kartini Clinic instigated by parents who disagreed with their treatment team’s insistence that their child be admitted to their regional locked psychiatric unit.  The parents visited the unit and were scared by what they saw.

There is…

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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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