My First Experience with Acupuncture

 

Holistic medicine has been something that has captured my interest since I can remember being interested in health.  The “old time” remedies that were spelled out in books and old TV shows always captured my interest.  I have raised honey bees and loved doing things with the beeswax, essential oils and, of course, the honey.  The honey turned out to be very helpful in reducing my allergy symptoms.  I had horrible seasonal allergies to tree pollen and would spend two months every spring since I was in diapers sneezing, coughing, and sniffling.  I had allergy shots as a kid and took every allergy medication peole getting acupunctureknown to man with very little relief.  When I read that honey, with its natural mix of pollens, was more effective in relieving allergies than most medications, I was hooked and had to give it a try.  It took about one year of using honey on foods or drinks like waffles, pancakes, crackers, smoothies, tea, etc., but it worked.  I have not required allergy medicine during tree pollen season in over 5 years.  No one believed that it was the honey and I must say I got my share of teasing about it.  The fact that my little nay-sayers knew the information came from mom’s “weird” natural magazines was the kiss of death for it. That was until several allergists in my area started recommending this.  In fact, my son’s asthma specialist told me one day that she wanted him to use honey because she preferred this to allergy shots now.  I almost laughed out loud because not one of my children believed that the honey had anything at all to do with my own allergy relief.  After the endorsement from the asthma doctor, honey suddenly became not only tolerated, but sought after.  The bees, which were certainly not being treated with the respect that their hard work deserved, enjoyed an increase in popularity. Continue reading My First Experience with Acupuncture

Help For the Holidays……again

The holidays are upon us again and I thought that reposting last year’s “Help for the Holidays” might provide some reminders about how to help your loved one, your family, and yourself negotiate what is often a very difficult time.  Remember to have that all important family meeting first.  This can be very helpful in setting the stage for less stress as all involved know what to expect.  Sometimes having this meeting with your treatment team in a family therapy setting is beneficial also.  Try not to allow yourself and your family to feel pressured into celebrating the holiday in a way that makes you feel uncomfortable.  If it is causing a lot of anxiety just thinking about traveling to very large family gathering, maybe this year isn’t the right year.  It is OK to put the needs of your family first and low-key or high-key, do what is going to be the least stressful for all of you.  With that said………….. Continue reading Help For the Holidays……again

Isolation

I can think of many illnesses that are isolating. Illness, by nature, is isolating because we simply don’t feel well.  The person suffering from an illness, whether it is physical or mental, often spends at least some of their time isolated when the symptoms are most severe.  What stood out to me as a mom and a caregiver was how incredibly isolating our son’s eating disorder was for, not only him, but the entire family.  Surely, there are other illnesses that render entire families isolated as well, but for the purposes of this post I will stick to eating disorders.

When I look back over the progression of his illness, isolation really could have and should have been a red flag that we were all sinking with the ship and intervention was badly needed.  Instead, the isolation became a coping strategy for us all.  It helped us to keep things confined; it was an excuse not to have to talk about it; it was a way to avoid and to hide; and it was a way to ignore and talk ourselves into believing it really wasn’t that bad. We could delude ourselves into believing that one good day meant things were turning around; we had a handle on it.  The isolation left us without that reality check of the shock and concern of others outside of our family who would have been putting a mirror up to us, so to   speak.  Someone would have laid it on the line with honesty.

As I have described in other posts, his illness really began with an obsession around exercising.  Even before that began though, the OCD was quite prominent just after entering college.  There was no convincing him that he had studied enough.  The exercise was, at first, intended to relieve the stress of all the studying.  It didn’t, of course.  The intense need to study was isolating in and of itself.  It left time for little else (except exercise).  As things progressed, the isolation progressed too.

Eating disorders often encompass so many other mental health issues as well.  There is often depression, anxiety, and certainly OCD is present in a very high percentage of cases.  Those things are isolating for sure.  You really can’t see those things though (with the possible exception of OCD where compulsions might be visible sometimes).  Eating disorders are visible.  In the case of anorexia, the weight loss is very visible and frightening in many cases.  Often, there are rituals around food preparation and the sufferer may be unwilling to eat outside of the house or in the presence of anyone other than immediate family.

As the family member with the eating disorder becomes more and more symptomatic, the family often stops having guests over.  At first it may be just not having guests over to the house for dinner.  The family may continue to accept invitations to holiday meals, etc. with family and friends, but make an excuse to leave the child/loved one with the eating disorder at home (sometimes a parent also has to stay behind if the child is young).

Soon no one is invited to the house at all, except perhaps family, and that slows to a stop as well.  Holiday meals start taking place with only the immediate family and at home.  This is the way it was with our family anyway.  Excuses were made so that we didn’t have to have meals with anyone outside of our own family.  We would meet at a separate time to celebrate the holiday and we always managed to see to it that a meal wasn’t included.  We couldn’t stay too long would be the excuse.

Other children in the home stop having friends to the house.  Our own children began making any excuse that they could find to go to a friend’s house rather than have that friend come to our home and see the shape that their brother was in.  No more sleepovers in our house, no friends for dinner, no birthday at home.  We all managed to meet people elsewhere, as if we didn’t have a home of our own.  We were like nomads of sorts, always traveling, but never settled even though we had a permanent residence.

It didn’t take long for people to notice the changes in the way we behaved.  We practically barred the doors and the excuses for declined invitations were suspect.  Soon we were not having contact with anyone unless we absolutely had to.  Even trips to the ballgames to watch our other children play were isolating.  We sat alone and when approached by other team parents, the conversation was quick and nervous because we didn’t want any undesired questions.

We even became isolated inside our home amongst ourselves.  We nervously waited for what would happen next.  What argument would break out over food and exercise?  How many times would an OP evaluation be offered and refused?  How many times would forced treatment be threatened?  How much more weight would be lost this week?  We waited and worried and argued, but didn’t communicate.

The eating disorder loves nothing more than isolation.  It feeds on that isolation to deceive, to divide, and to distort.  The more isolated the family becomes, the more the eating disorder weaves its web of confusion.  Everyone starts hearing its voice in one way or another.  The eating disorder gains power over the entire family.

It is so important for families to seek help right from the beginning; as soon as that caregiver role begins.  The more power taken from the hands of the eating disorder the better are the chances for recovery for the entire family.  (See “A Crisis Plan for Caregivers”).  It is so important not to let the family become isolated.

Figuring out how to talk about the eating disorder and who to talk with about it can be difficult.  I am not suggesting going to the other extreme and that everyone should be informed or that everyone has a right to know.  You and your family have a right to your privacy.  The decision should be yours and made based on what feels right for all members of the family.  A certain amount of isolation and privacy might be welcome.  The important thing is that it shouldn’t be an isolation “imposed” on you and your family by the eating disorder.  It shouldn’t be borne out of embarrassment, fear, and feeling the need to hide.

We did recover, but the isolation delayed that recovery and it did a lot of collateral damage.  It has taken work to repair the damage to the rest of the family.   Had I to do it over again (and I pray I never will!) I would take charge from the very beginning and the decisions would be ours to make, not the eating disorders.  We would set boundaries and would decide where to seek support and we would choose with whom to share the details of the eating disorder. The eating disorder would not be invited to participate in decision making.

It is important to find support to relieve the isolation.  The truth is that most of the family and friends that are close to you likely want to help.  Being informed of what is going on and what they can do to help you might be a welcome relief for them as well.  Seek the support of those who are going through what you are going through.  Support groups are a wonderful relief from the isolation.  Most of all, it is important that the eating disorder is challenged from the very beginning.  Make it clear that it will not be allowed the power it craves.  Don’t allow it to isolate you or your family.  Assume control in the form of a plan right at the start.  Get help developing that plan and make sure that a plan to deal with isolation is included.

Triggers

In my reading through support groups, articles, and just listening to the “chatter”, so to speak, in eating disorder circles, I hear more and more about advocacy.  I think that advocacy is very beneficial and I am in full support of most types of eating disorder advocacy.  I support advocacy for improved education, the elimination of the calculation of BMI’s, and certainly the overall advocacy of the elimination of the stigma of mental illness to name a few.

What I have been reading lately is advocacy in the form of yelling at store clerks for making a suggestion to use a product with less sugar to restore electrolytes, at a healthcare professional for using the term “empty calories”, at a waitress for asking if dessert would be desired after the meal or commenting that the meal must have been good because the plate is “clean”.   I have also recently seen a push to have restaurants stop posting nutrition information in the menu section and also on the labels of food packages.

It is easy to understand where this is coming from and in certain cases I agree with the action taken.  It is coming from the fact that a very stressed out caregiver is scared to death that the comment, nutrition information, etc., might trigger their child or loved one and start a relapse or simply speed up the relapse already in progress.  The reality is also that the caregiver doing the admonishing was as triggered as the person suffering from the eating disorder.  I have been there many times.

Triggers are those things that remind us of something unpleasant, and in many cases, make us feel as if we are right back in that time and place again.  They are things that we see or hear (sometimes other senses can be involved as well) which causes us to, in the case of eating disorders, have doubts about our methods of recovery or even if we should recover, cause an increase in urges to act on eating disorder behaviors, negatively impact our body image, etc.  They focus the minds of eating disorder sufferers back to thoughts and behaviors which were/are harmful.  They are similar in some ways to a flashback.  Sometimes this can catalyze a relapse.

Triggers are not unique to those suffering from eating disorders.  Caregivers can be triggered as well.  Seeing someone dressed in running clothes or driving by where a 5K is in progress makes my entire body tense.  My daughter has a medical illness that has caused her to have difficulty maintaining her weight (see “I am not my Brother”) and when she tells me that she is having difficulty eating due to nausea, etc., my anxiety level soars before I ever realize it has left the ground.  All reason seems to leave my mind without so much as a wave or even a whisper that it is going; my first clue comes simply when it is gone and I am pouncing on her about an eating disorder she doesn’t have.

There are really few of us in this world that don’t have “triggers” related to something.  There are triggers for those suffering from trauma, PTSD, addiction, physical illness, care-giving to elderly parents, spouses, or other relatives with other medical conditions.  There is no limit to the number of reasons a person could be “triggered” by something.

As caregivers we have to be in tune with those things that might trigger our child with the eating disorder, but we also need to be in touch with what triggers us as well.   My approach to triggers, especially with my son, was to panic, try to avoid whatever that trigger was, and wring my hands……….hardly an effective strategy for either of us. I quickly decided that this wasn’t going to work out well and had to think about how I wanted to handle this; what was going to work best for our family?  I thought about advocacy.  There was a real push, at that time, to get certain restaurants to stop publishing the nutrition information on their menu right as you walk through the door.  Not a bad thing to advocate for, but what was I going to do about the comments from doctors, relatives, restaurant staff, pharmacists, and the literally hundreds of comments he would hear and things he would see.  Was I going to follow him around for the rest of his life chastising everyone with whom he came in contact for saying the “wrong thing” to him?  Was I going to teach him that erasing every possible trigger related to eating disorders from this earth would make everything alright and make him recover?  Aside from the ridiculousness of that idea, it also wouldn’t solve anything.  Eating disorders are like germs.  Every time we think that we have them defeated, they find new ways to defeat the antibiotics we are using to kill them.  The eating disorder will always find a way to remind our loved ones that it is still there.  Taking away any and all possible triggers isn’t going to stop the eating disorder.  Oh, there are definitely some things that should and could be done to minimize some of the suffering that those afflicted with eating disorders endure.  We can do that, but my point is that we can never eradicate all of the possible triggers that are out there no matter how many times we yell at the store clerk, pharmacist, insensitive relative, etc.  We can remove all nutrition information from every restaurant and every piece of packaged food, but I am not sure that we should or even that it would make very much difference.  There are people that need that information.  Some changes could be made in how we present the calorie portion, but heart patients may need to know how much saturated fat is in their food and the sugar and carbohydrate portions are relevant to diabetics.

So what did I decide to do? I realized that it was impossible to eliminate triggers.  If he was going to go to college, get a job, and eventually go out and live on his own or have a family, he was going to have to learn to deal with triggers.  I wouldn’t be there to follow him around and handle it for him forever. I also realized that having both of us anticipating them and terrified of them all the time was far from a winning strategy.  It was becoming somewhat of a self fulfilling prophecy.  We needed to face this head-on and take the power out of the hands of the eating disorder and place it back into our own.  I decided to talk about it with my son, our family, and our outpatient therapist.  I decided that what I wanted and hoped for him was that he developed a sense of self (I know I use that phrase often, but it is so important to learn at an early age) so that he could identify what triggers were individual to him and a strategy to cope with them.  That is just what we did.  With the help of our outpatient team we were able to explore what things were big triggers, medium triggers, and small triggers.  The big triggers for our son generally revolved around exercise:  gyms, running, excessive talk at work, school, or parties about getting in shape or working out, and feeling he didn’t work hard enough.  He also had a difficult time with calorie information right in his face.  Strategies were developed for him which included avoiding gyms altogether.  He also avoided those restaurants where calorie information was prominently displayed.  He worked with his therapist about politely changing the subject surrounding uncomfortable subjects or avoiding those situations where he knew they would occur.  Because his OCD factored into this heavily, he was referred to an OCD specialist where he learned some tools to improve his distress tolerance and to manage the OCD symptoms.  They worked on ways to avoid, for now, those big triggers, and how best to manage encountering those medium and small triggers.  Most of all, the plan was individual to his circumstances and needs.  He learned how to anticipate triggers and prepare for them and to advocate for himself.  He practiced how to speak up in a way that was comfortable for him and in keeping with his personality style.  This helped him to be more in tune with his own needs and feelings and also empowered him to reduce the intensity of the reaction to the particular trigger.  We have a plan in place for when things do become overwhelming and he needs someone to help him regain perspective.  It isn’t perfect, but is helping.

For caregivers, we need to do many of the same things.  We need to be able to identify our own personal triggers.  It can be helpful for us to work with a therapist as well to identify what triggers high rates of anxiety and depression for us.  Caregivers often experience those triggers as a “flashback” of sorts or maybe not of sorts, just plain flashback.  It is important that we learn ways to cope with these experiences also.  Caregivers also need that “sense of self” and the ability to identify what will “trigger” us and what tools we can use to help ourselves through it.  We also need to be able to anticipate and prepare for those times when we know we will be overwhelmed by memories of a horribly frightening and depressing time in our life and, not only what coping skills we can use to help us through, but who we can call or what to do when we can’t.  What is the crisis plan?  (See “Crisis Plan for Caregivers”).  We need to take that element of surprise and fear right out of the hands of the eating disorder, who plays it so well, and face it head-on and equipped with our plan, not the eating disorders.  It won’t be perfect, but nothing is and it doesn’t have to be perfect to be effective.
 

Then and Now

I guess every generation looks back at the time in which they grew up and compares it to the generation of today and the challenges that their children face growing up in the here and now.  Many look back with nostalgia and see their time as a better time.  Each generation generally sees the one before it as more simple and a “better” time.  I don’t really look back on my generation as necessarily better or worse than any other generation.  I guess that is really an individual assessment.  Each generation has its challenges and wouldn’t it be nice if we could pull only the good things from every generation and the advancement in technologies that it brings and leave the bad behind?  That isn’t the reality, though; we take the good with the bad. Continue reading Then and Now

A Crisis Plan for Caregivers

Have you ever found yourself unable to get out of bed or going back to bed once your husband and kids have left for work and school, not getting up again until they return?  Are you crying all the time and finding the smallest tasks completely overwhelming?  Do you find little very little enjoyment and even more difficult to laugh?  Are you having thoughts that your family would be better off if you were just not here anymore?  These are the thoughts and symptoms of someone who is in crisis.  There are many more that could be added to this list, but you get the point.  At this moment the crisis is happening whether realized or not.  There were many warning signs that a crisis was coming though; signs that probably were going on for a long time and either ignored, pushed aside, or maybe just thought of as normal, but they weren’t. Those signs could have come in many forms.  It may have been sleeplessness, high anxiety, or irritability.  It may have been that you lost pleasure in things you used to look forward to doing.  Perhaps you started refusing opportunities to get together with friends or relatives.  Or maybe you noticed that your body ached all the time.  Frequent headaches and stomachaches may have left you unable to go to work and you have used a lot of sick time.  Maybe nothing looked the same to you anymore; colors didn’t seem as bright and nothing in your landscape seemed inviting or interesting any longer.  Does it feel like your situation simply has no end? This is by no means an exhaustive list, but they are all warning signs that you are becoming depleted or even depressed.  They are all red flags that a crisis may be coming. Continue reading A Crisis Plan for Caregivers

Summer

I remember that first Memorial Day weekend when we were recognizing that our son had something seriously wrong.  The weather was beautiful and I had bought flowers for the garden.  My anxiety level was high that morning as it had been for quite some time.  In my heart I had known for a very long time that a problem existed, but there was always an explanation and, for a long time, the symptoms waxed and waned. Food wasn’t really involved yet either, just exercise.  I was still at that point where I thought logical arguments would win the day.  That morning, though, I remember how edgy I felt.  Despite the beautiful colors of the flowers, they just didn’t look very bright to me.  The sun didn’t look the same to me and even the warmth of the sun felt different.   Continue reading Summer

Support Groups: In-Person, On-Line, or Both?

Support groups have become much more available for eating disorder sufferers and their families.  Most families can find a support group within a reasonable driving distance from their home and, of course, with technology exploding as it is, they are available on-line too.  I am an advocate of support groups because I think that they are a very valuable addition to the care of the entire family.  I am focusing my attention primarily on the groups for caregivers of eating disorder sufferers in this post. Continue reading Support Groups: In-Person, On-Line, or Both?

Factoring the Internet into Your Self-Care Plan

You wake up to the sound of the birds chirping and the morning air smells fresh and clean.  As the cobwebs clear the anxiety builds. Will he eat today?  Will there be a constant fight about food?

Your heart is racing.  Your mind is racing.  That headache you have has been there for nearly a week and nothing seems to completely relieve it.   Your stomach is in knots every time you sit down to a meal.  You feel sick to your stomach when you wake up in the morning and that feeling starts building; that feeling that something is wrong, something bad is about to happen.  Every muscle in your body seems to just ache and you didn’t do anything strenuous.  You can’t stop thinking about that article you read last night.  It was about…..you guessed it….eating disorders.  It wasn’t reassuring either.  The one that you read several days ago made you feel guilty because it was critical of something that you were doing and actually had found helpful.  The one you read last week gave some great ideas based on some new research, but how will you incorporate them and how will you ever keep up with all of the new information out there.   And then there was my poor support group member; what if what happened to her child happens to mine?  What if I don’t respond quickly enough and she thinks that I don’t care? The chest pain builds again and this time you feel dizzy too.  Should you tell someone? Could this really be a heart attack this time?  Continue reading Factoring the Internet into Your Self-Care Plan

Why I Don’t Feel Guilty About Being Different Anymore

Those relatives and friends that know me well also know that I do not subscribe to the philosophy of one size fits all or that there is only one approach to treatment or that following the latest trend or research is the only right thing to do.  I don’t believe that with regard to most areas of my life and I didn’t believe it or follow it when dealing with my son’s eating disorder. 

Does that mean that I am a maverick and don’t follow any of it?  Definitely not!  Certainly there are standards and absolutes.  The latest research has clearly defined that strep throat is a bacterial infection and antibiotics are the cure.  This has been pretty well demonstrated and when my doctor tells me that my children have strep throat and prescribes penicillin or some other antibiotic I don’t argue for something different. That is only one example of many. Continue reading Why I Don’t Feel Guilty About Being Different Anymore