"Unpleasant scenes at A&E......" - a post from 8th October 2010 on the ATDT parents' forum.

October 2010 was a pivotal moment in both the CAMHS eating disorder treatment and Ben's attitude towards recovery. But it began badly. One morning the (other) school nurse called me to say that Ben had fainted in the sixth form common room and his pulse was abnormally low (again). There followed a massive battle for me to get Ben to A&E because he refused to go, claiming he had faked the fainting.


Eventually I got him there only for him to flee out of the building before being restrained by security staff and the police. It was not a good day. But the end result was that CAMHS were as serious as I've ever seen them; with this being Ben's second heart scare I think they were almost as worried as I was. With threats of hospitalisation if Ben didn't put on weight, Ben's attitude to recovery underwent a transformation. The down side was that, although he might 'want to recover', the eating disorder and exercise addiction were too strong for him. But I definitely see this event as a definite watershed in both CAMHS treatment and Ben's drive towards recovery. I posted the following on the Around The Dinner Table Forum.

Yesterday was one of those days when I was in need of a seriously stiff drink by the end. My son's still not been sleeping and was in a terrible state (as usual) when he went to school: tearful, etc. The school nurse rang mid morning to say he had fainted and his pulse was only 37, so could I come and get him. I did, rang CAMHS who recommended ringing our GP who said to take him to A&E so I did. (Back in March a similar thing happened and he was in A&E followed by overnight observation in cardiac ward due to heart rate of 29bpm. Discharged following morning, heart sound and heart rate higher.)

Doc at A&E did tests, was worried (heart down to 31), wanted to take blood. Ben went crazy, screaming, tears, etc... claimed his fainting had just been a fake to attract attention ("to make people take notice of me for once")... walked out... doc chased after him saying he couldn't discharge him because he was high risk and if he didn't willingly do the blood tests he'd have to be forced to do it (explained this very calmly and nicely, a wonderful doc!!!). Security personnel ran over, then the police arrived who accused Ben of behaving like a 6-year old and if he didn't they'd call for reinforcements!. In the end they persuaded him to do the bloods...

3 hours later cardiac doc came down and said they wanted to keep him in for observation overnight again. Ben threw another wobbly, swearing and kicking trolleys, refusing to comply. Had to be restrained by staff. Cardiac bloke went off to ask the Consultant what to do. Fortunately by the time he came back Ben's heart rate had gone back up to 65 (and bloods were OK) so he was discharged and we went home, but they said ben has to get the 'once over' from our GP in 2 weeks.

What a day!!!!!!

And today we see CAMHS so I shall relay it all to them. Hopefully they will take serious intervention action today or else I will be the one throwing the wobbly.

And...

CAMHS did take it very seriously and also the fact that he had lost 0.9kg this week. We are now on a strict, monitored eating regime to be re-evaluated on Friday subject to what happens this week, weight-wise. If he doesn't gain, then things will be stepped up. The psychiatrist said that basically if Ben didn't cooperate and put on weight and 'trod water' for yet another week or so then, because of all the nasty stuff that happened yesterday, she would consider sectioning him for hospitalisation which, she said, wasn't a nice prospect for him. She also wants him to have regular ECG and blood tests with our GP. As you know from above, Ben has a pathological fear of blood tests and everything that goes with them, so this in itself was sufficient to motivate him. I've never seen him so motivated and keen to cooperate!! He and I have set up a no-negotiation plan for this week. Also if school meals don't work, then they will be closely monitored too. Also, he's going in only part-time to school on some days now rather than full time.

The decision for the time being was made for him to continue PE at school which I'm not too happy about but their logic was that if we forbid it then he's more likely to go underground and do potentially more dangerous exercises. However I have emailed the school to ask them to make PE staff aware of EVERYTHING that's been going on. It may be that they feel he shouldn't do games at all.

Also CAMHS say school would have done better calling an ambulance rather than calling me to pick him up and then me having to fight with him for nearly 3 hours to get him to go to A&E in the first place (in the end I had to call his Dad who's working away and Dad had to threaten to drive home if he didn't go).

CAMHS were about as serious and pro-active as I've seen them... ever.

And...

Thanks, everyone. So far Ben is very keen to stick to our eating plan. Fingers crossed it lasts more than a few days... I think the idea of early hospitalisation frightened him ("No way will I ever get bad enough to be an in-patient", he would say...). That, and the fact he lost 0.9kg in a week when he was convinced he would put on weight. (He was 'proving' to us that he had the amount of calories he needed sussed...)

I've made school aware of everything that's happened; the Head of 6th form even replied today (Saturday)... and replied to my second email.

She says Ben's friends were really scared and freaked out when he fainted on Friday. Ben claimed in A&E that the fainting was faked. Me, well, I'm not sure whether it was or not. I do know he was totally knackered from a week of lost sleep. The A&E doctor didn't believe his "faking it" story and kept asking questions about what happened when he passed out.

And...

Just to update you...

The GP won't prescribe any sleeping tabs as Ben is under 18 and also tabs could open up a whole new can of worms re. potential addiction and the "hangover effect", acc. to GP.

Ben has been into school Monday morning (came home because he was too tired).

Tuesday morning (we've agreed Tues mornings only for the time being and he just made this, even though he was knackered)

Wed morning (for the first time he slept and he was like a different person - and he got on well with his friends / peers for the first time for AGES!)

Today (Thurs), no sleep again, so off school.

Friday is CAMHS followed hopefully by some school. But we're not doing too well on the school front... and the sleeping is TERRIBLE.

A 'plus' is that he's stuck to this week's XXXX calories every single day without much resistance. How much he weighs tomorrow will tell us what we need to do next - increase it by 100 a day or whatever.

A 'minus' is that so far he hasn't had to eat his packed lunch in school as he's been at home for each lunch. 'Plus' because that's easier and he always eats up, 'minus' because successful pack lunches (and the new increased quantity) is as yet untested - and Ben says he'll find it really difficult to eat in school. Any probs, and he'll be monitored in the medical centre.

The school nurse, who is positively saintly, is doing everything she can to help - and CAMHS are coming in to school to talk to the year group about eating disorders (subject to asking Ben how they'd prefer him to approach this so there's no stress or embarrassment).

PS his pulse is back within the 60s but the plan is for school to call an ambulance if it dips to the low 30s again.