Viewing blog posts tagged with "Weight Restoration"

When The Smile Comes Back

posted by Julie O'Toole on December 3, 2014 at 8:29am
Re-feeding has its own rewards, though there can be misery and challenge to get there.  I know that some of you who have been through this, either at home or with a team not at home, will be able to relate to what I am talking about.  It’s when the smile comes back. It’s hard to predict when the tipping point will come.  For some it’s within the first 48 hours of beginning to eat: the circulation improves, the cheeks fill with more color, the eyes brighten and they just feel… 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

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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Hard News About Exercise And Recovery

posted by Julie O'Toole on June 5, 2014 at 12:37am

I was recently sent an article from which I will be quoting extensively here (it’s also included in this newsletter - ed.). The article is by Heidi Mills, writing for Outside magazine and features the work of Dr. Emily Cooper of Seattle Performance Medicine. Dr. Cooper has consulted with Kartini Clinic on metabolic health and weight balancing for some time.  Originally, we worked together to try and solve the conundrum of patients with AN who appear to be weight restored but who…

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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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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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Refeeding at Home

posted by Julie O'Toole on March 20, 2014 at 5:22pm

I was recently asked by a professional skeptic, a parent & friend of mine, “why can’t parents re-feed their own children at home without the stamp of approval of the ‘professionals’”?

Well, they can, they DO, they SHOULD!  

Home re-feeding is ideal when it works, as virtually any intervention that can be done at home is preferable to one that requires the input of (even caring) strangers.  BUT -- and there are several buts-- it does not always work for several reasons:

  1. Example:…

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Weight Restoration 2.0

posted by Julie O'Toole on February 20, 2014 at 2:59am

At Kartini Clinic we have been embarking on something we call “weight restoration 2.0”.  In other words we are trying to move beyond mere weight restoration (as critical as that is) towards a deeper assessment of each patient’s full physical recovery.  We have noticed, over the years of faithfully weight restoring each and every patient, that people respond differently to recovery from starvation, depending no doubt on their genetics and on the duration of their illness. Just one…

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