Seeing an ED doctor for the first time..what to expect? (TW?)
Hello (:
I've been suffering from anorexia for roughly 6-8 months. A couple months ago I decided to recover on my own on 2000 calories. I am sad to say I have recently had a mini relapse, and realize that this is impossible to do without professional help. So not too long ago, my mom set up an appointment with an ED specialist at a children's hospital. A few weeks ago until this week, I had consumed 1300-1500 calories per day. This week I've been having about 830, which is terrible. I just feel like I "need" to be at a lower weight for the doctors to take me seriously and actually help. Anyways, just 2 days away now!! I was just curious to know what to expect on this first visit. Some things I am struggling with are heart palpitations, hip pain/clicking, extreme fatigue, lanugo, low body temperature, dizziness upon standing, etc. My weight is currently between 100-102 at 5"9 (could be less now, I'm not sure). Will they recommend IP? Or some other treatment? When should I expect a meal plan, and how many calories do you think it would be? ANY help would be appreciated...I'm super nervous and anxious about it all, but moreover excited that I will be getting real help this time and the push I need. Thanks in advance!
You're pretty underweight so I wouldn't be surprised if they do recommend ip, however they might try to place you in an outpatient program first. Also, you will most likely meet with a registered dietician at your first appointment as well to set up a meal plan. Anyway, it's great you're getting help so take full advantage of it be open no matter what (something I regret so much when I was a teenager) and you will recover that much faster.
Hey :)
When I was 17 I went to Childrens hospital to see a ED specialist. She was nice, and asked the typical doctor questions as well as stuff about my diet. I hide most everything her, and even without me really telling her anything she admitted me to the hospital. I weighed the same as you do now and I was an inch shorter, so there is a good change you might get admitted.
When I was admitted I was on bed rest for a week. I wasn't aloud out of bed at all because they were afraid for my heart I think. I pretty much slept for an entire week. I wasn't aloud to do anything else. They wouldn't let me watch TV or read any books until I reached certain weight goals, and even then it was like 2 hours of TV a night.. so needless to say it got pretty boring. I actually started looking forward to meal time because it was something to do. I did have to go to occupational therapy once a day... but it was super lame(like we spelled our feelings out with alphabet cereal lame)
They didn't have an IP program really so I was released a little over a week later(I was supposed to transfer into an IP program but it was to much money for my parents)
My experience was alright really. I've never slept so much in my life as I did that week. I saw the doctor there and a nutritionist from there for a few months afterwards too. I'm not sure if it would be the same at your children's hospital, but hope this helps somewhat
Hi Skyscraper,
I just wanted to post to say well done for identifying that you need more help and for keeping fighting despite having slipped backwards. That's a very mature decision.
Good luck at your appointment xx
Oh sorry, I also meant to say ....
You could phone the doctors office in advance and ask exactly what you should expect in the appointment. They will understand that you are going to be a bit anxious and I find that knowing what to expect before you go can be calming.
My EDU sent me an information sheet before my initial assessment to tell me exactly what was going to happen, it definately helped me to prepare mentally and I also had the chance to prepare some notes on what I wanted to discuss in case my mind went blank!
xx
Thank you all for helping me! You are all so wonderful!!
IP scares me a little, but I almost feel like it may be something I need. I want to see what the doctor thinks first of course though. I'm worried about this being too much for my parents, and them seeing me there would be hard for them. I feel like I've caused them so many problems because of my anorexia, and I feel hopeless sometimes because doing this alone just isn't working very well,
So you guys think with me being at a BMI of 15 or even less, they would recommend IP without me even asking?
Yes you are at a critically low body weight, more than likely if they have an IP program you will be admitted day of the first appointment, that is how most hospitalization programs work.
On your first appointment the first thing they will do is the typical physical assessment such as your vital signs ( heart rate, blood pressure, oxygen pulse oximetry ) they will also test you for orthostatic vital signs ( you did mention you are dizzy upon standing ) and they will also get your height and weight. After that a EKG is often done to check for abnormal heart rhythms and other conditions such as bradycardia. More than likely a series of blood tests will be done to rule out any intolerance such as gluten or dairy, as well to check for any deficiencies that you may have such as blood counts, vitamins, hormones, and electrolytes, glucose levels are assessed as well. The final part of the appointment is the questionnaire, you will more than likely meet with the nurse practitioner or social worker and they will review your medical history, family history, questions regarding why you are restricting, what your typical daily intake is, and other questions to better understand you.
When inpatient on day one they typically start you on the same meal plan as you are on now, everyday after that they will increase your meal plan until you are finally where they want it. I am not going to say what that is going to be, because they aren't going to tell you either. Your stay will not be discussed in the beginning because everybody is different and people progress differently. Just be cooperative, do what they ask of you, and be respectful. This is the biggest step of recovery and I wish you well!
Best of luck,
Frank
autopilotfrank: Wow, thanks so much for all the info! You're response was very thorough, and helped me understand it all a little bitter. Is IP treatment covered by insurance or does it cost a lot? Thanks for the kind words, I appreciate it!!!
Blue Cross completely covered the in patient stay, as well as all of the other follow up appointments, and lab work. Depending on your coverage you will just have the $25 co-pay but the exact amount is insurance dependent, it counts as a specialist visit. I am now under United Health care and the same services are provided, I am not sure of your provider, so I can't answer exacts.
Anymore questions about the whole experience feel free to shoot me over a message, amount of work I have just doesn't want to end so I will be at the computer ALL day it looks!
- Frank
Okay, we have UHC, so I'm pretty sure we'll be covered (: thanks, you helped tons! I'll message you if I do!
Just to let you guys know...
The appointment went pretty well for me. All the doctors were really nice and pretty helpful. The first thing they did was check my height and went, then blood pressure, heart rate, eyes/ears/nose. Then they asked my mom a lot of questions in private, then did the same with me (when did I start restricting, what I ate today, triggers, stress/anxiety, medical problems, etc.) I went to the lab after this to get blood drawn. The doctor then talked to my mother and I together. She told me I had a lot to gain, and I explained to her that I didn't feel sick enough. She set me up with a nutritionist, recommended therapists, and told me I would be going back to see her every 1-2 weeks. I was expecting her to suggest IP (my BMI is 14.9), but she wanted to see if I could get better without it, unless I fall backwards again. I was somewhat disappointed and said that I wasn't sure I could do it alone, but she assured me I wouldn't be. I was then told to include a serving of each food group in every meal (3 meals a day) and roughly two 250 calorie snacks, but that there wasn't any "limit". I asked her several times what my calorie intake should be, but she REFUSED to give me any numbers, which was disappointing. I was prescribed some Prozac to help with my anxiety/depression, and I'm hoping it works...but I've heard stories of it causing weight gain, which scares me of course. I'm a little confused, and anxiously waiting to see my new nutritionist so I can get some specifics.
Here's what I ate so far today.
Breakfast: 2 egg whites (34) 2 slices of bread (70) cottage cheese (80) pumpkin butter (40)
Lunch: Panera Bread classic cafe salad (170)
AFTER appointment..
Snack: apple (80)
Snack: Low fat frozen pb yogurt, with a little bit of strawberries, kiwi, blueberries, and a chocolate chip cookie chunk
Snack: PB&J larabar
Dinner: about 1 c. of miso soup, salmon and avocado sushi (with white rice :p) and strawberry kefir
Snack: Hopefully going to have some almond ice cream with some fresh fruit..
I don't know how many calories I had today, and honestly don't want to know. Anyways, I challenged myself a little, which is good (:
Thank you all again for your support and advice. It's helped me even more than you can imagine! With the help of this site, I'm sure I can have a healthy, happy recovery.
Well I know this is kinda late, but I just wanted to say that your 1st appointment was kinda what I would have said...I remember my first appointment back in feb. 2006 when I was diagnosed..I'd only had anorexia for like 6 months too, but I was down to like 67 lbs at 5'6', and I still wasn't admitted. I'm pretty sure that doctors like to give your your "first chance" outpatient to see if you can get better that way. Nobody likes being in the hospital, so I think maybe doctors like to give you a chance. I will say though, don't let them down if you don't want to be hospitalized. They will give you a chance, but if you keep failing they'll take that as need of hospitalization. My first go around back then I went and I was at a very critically low weight, so the doc wanted to see me twice a week at first, and as long as I showed gains, (even if it was only 1/8 lb.) she would be happy. So I complied and within 5 months I was up to 2 lbs less than what my pre-ED weight was at 102 lbs. In the beginning I tried going to a 12 hr a day ED program, but they ended up teaching me a lot more then I already knew. The program was like all adults and most of them did drugs and stuff and talked about that and sex, when my parents came on like my 3rd day they freaked out ( I was only 12) and they took me out. After that I just saw a therapist outside of the hospital weekly, and I saw the doctor and a dietician at the hospital, at first twice weekly, then once a week, then finally once every 2-3 weeks. After I reached 102 I pretty much stopped going to the doctor and dietician. Then I started going to a psyciatrist who put me on drugs. That ended really badly after a couple of months. I also still saw the therapist for a while, but then that stopped too.
After a couple months of quitting everything, I unfortunately relapsed. That time around I was hospitalized. So as you can see, they will give you a chance, but if you blow it they will hospitalize you. So keep going in the right direction and don't go back!! :)
how are you doing now by the way? are you getting any help or treatment? have you managed to pull yourself out of your relapse and get to a healthy weight?
Sky I think you need to trust your team your working with. I have been on many meds and some can really help. If they feel prozac will for you then I think you need to trust them. Many side effects dont happen and if you were ip you would not have a choice usually because they most often do a lot with meds. Also it is important to be honest with the team. Tell them you are scared of the meds or are struggling etc. This is the only way they can help you.
Over my long battle I did every type of treatment from outpatient teams,inpatient,day,hospitals I could go on. At the end of the day recovery is very hard and you have to be willing to do what ever it takes and fight. You can do this though and you are at a very sick point though the ed makes you feel not. That is why reminding yourself the facts and what others are telling you do is important
Thanks abbi333!
I don't know why I was being so stubborn about taking it, because I know I really do need it. There's certainly no point in being miserable, and hopefully this will help this ordeal go a little smoother. I've decided that I'm going to take it, and praying it works.
I (thankfully) have incredible new doctors, and the support/guidance of everyone on this site which will help me immensely to see what is right and what I need to do to restore my health. Thanks for your response..every one helps set me back on track.
Congratulations on your recovery! xx
