Sunday 20 March 2011

Big Plans are underway...

So I went into CAMHS on Friday where we were seeing the nurse (psych is on holiday for 2 weeks), armed with a load of paperwork 'ammo' and a PLAN for the next few months. I went through it, point by point, and on the whole the nurse thought it was all a good idea. Also it follows on from their suggestion last week to start blind weighing or weighing less frequently.

I asked the nurse to look back over the past 6 months and especially over the last 2 months to see what the weight gain pattern has been. Unfortunately it showed a weight maintenance more than anything else, so I said that, although we have experienced massive improvements on many fronts (which we indeed have!!!), the weight gain plan is clearly not working.

I also insisted we examine EXACTLY what a boy of his age and height should be weighing - min / mid / max, mentioning the WHO BMI guidelines. The nurse had a chart on her which showed that he should be weighing 64-68kg minimum (BMI 20-25-ish), but is currently around 54.5kg / 18.4BMI and has hovered around this level since September. I said this isn't OK for a 17 year old boy and former rugby player.

I insisted we move to fortnightly / blind weighing from now onwards. This way all of us gets a wider picture of what is going on, preferably starting to analyse weight gain over a month - and aim at an average of 0.5kg a week, as per the NICE guidelines. If we are not achieving this very shortly, then adjustments will be made to food intake.

Anyway, the Good News is that Ben agreed to all these changes.

The only idea he refuses point blank to entertain is the concept of being over 59kg. At this stage there is no point arguing the case because of the Ed thinking, so I've just left it for the time being, hoping that weight gain will reduce the Ed effect on the logic / brain and he will naturally come round to the idea. So I've left this on a back-burner for the time being...

Re. exercise... this is being rigidly monitored and reduced. Obviously if you're going to do things like nice walks in the countryside / park, etc then you can't stop all exercise; it's impossible. Ben has agreed to this, too, and I am monitoring this very carefully to make sure he does.

Hopefully the above will achieve some progress, get us out of Limboland and also enable the CAMHS sessions to be put to better use because the team won't spend most of the session allaying his fears about the "huge amount of weight" he's just gained.

Now I need to wait for the psych to get back from her hols and have a private meeting with her to reinforce this and set up a Plan for the next few months.

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