Week 6 Eating Disorder Recovery Update (Wendy)

Week 6 Goals/Activities

• Dietitian appointment

• Weigh in appointment

• ACT worksheets

• Playtime

• Put in Practice

  • Recognizing thoughts and feelings

  • Building positive thinking skills

Dietitian/Meal plan

Monday morning we met with our Dietitian. Sam was still having difficulty completing all her meals. Breakfast and snacks there have been no issues, however some lunches and supper there have been just a fork full or two left. Due to this we did not go forward with any additions. The challenge for Sam for week 6 was to continue to push forward and complete that last little bit, and she did well even completing the addition of ½ cup of carbs for supper. Also we discussed with our dietitian Sam’s eating behavours. Depending what Sam is eating she picks, separates, or tears apart her food. Some of these behavours can be caused by ED or autism. ED behavours are supposed to be corrected and autistic behavours should be tolerated or food served should be done in a way that is more acceptable. With this in mind we have started to serve some of her food differently. An example is that she does not like the crunchiness of lettuce on her sandwich so now the lettuce is served on the side.

The last few days of the week we went off our meal plan due to it being Thanksgiving weekend and our local fall fair going on. Sam had a friend over on Saturday, stayed the night and we headed to the fair right after breakfast on Sunday. Two things happened during Saturday’s supper that I am pretty happy with. One is that Sam did not “mask” the way she autistically eats in front of her friend. The 2nd thing she did was have a second piece of pie with whip cream. Sunday’s food plan was breakfast at home, snack and lunch at the fair. We decided to figure out what we were going to have at the fair on the go. This led us to having a fresh out of the oven apple dumpling with caramel sauce for a snack and a falafel wrap for lunch. Supper ended up being pasta. Quick and easy for us to enjoy after a long fun filled day.

Weigh-in

Well what can I say. We were not expecting any gains as we didn’t have any increases to the diet and we know the current diet only maintains Sam’s weight. So, the results were as expected. Along with the weigh-in Sam has her heart rate and blood pressure done. They are on the low side, better than they have been in the past, but still low. These are all important to monitor as there are risks when they are too low. Anorexia Nervosa is a serious illness that does need monitoring especially since we chose to work on recovery at home. Also, we recently had bloodwork done. We do blood work every couple of months. Again bloodwork is important to do regularly as it can point out malnutrition and nutrient deficiencies that are common with ED and restrictive eating. Her blood work came back okay. No major concerns. Currently Sam does take a few vitamin supplements. Until her weight is restored these are important for her overall health.

ACT worksheets, thoughts and feelings, and building positive thinking skills

Sam did have a bit of homework to do in these areas. As week-end plans changed we did not review the progress of these activities and will be doing so in week 7. One area that we did spend time on that was not originally on our schedule was to explore autism eating sensitivities. I found insightful information on a website that is all about autism and an eating disorder. I printed and reviewed information from this link Supporting Eating Difficulties and then passed it along to Sam where she provided very useful information on her perspective around eating. We will also use this in our next dietitian meeting.

Playtime

My favourite time. We have been having great weather which gives us many opportunities to go outside for walks and talks. The maple trees around our property are turning amazingly colourful. The camera does not capture their beauty. We spent one day taking a lot of photos not only of the trees but of the weeds. All are unique this time of year as they die off and leave their seeds for spring growth.

Besides enjoying our own backyard, we spent a day at the fair. We knew a few people that were showing in some horse events. Of course they were located at opposite ends of the fair grounds so back and forth we went checking in to see what time they would be performing. We also checked out all the entries of the local talent in the main agricultural building. From the tallest sunflowers, hand made quilts, baked goods to woodworking, fine art, photography, and antique treasures, there was so much to see. On the grounds there were cows and sheep of all kinds being judged. There were petting pens set up as well with camels, alpacas, goats, and rabbits. We saw many friends that we stopped and chatted with. Sam and her friend went on some rides while I held purses and took pictures.

Breakdowns and Boundaries

Not everything went smoothly this week. We had what I am calling “a learning day”. With so much information, and pushing Sam to put what we have been learning into practice this week, and then adding one more thing on top of it all overwhelmed her. She had a decision to make in which she asked me what to do. I pushed her to make this decision on her own. She did not know all the details about the situation she was deciding about and this on it’s own causes anxiety around making a decision. She needed some time to process everything and I did not give her that time. This resulted in Sam’s flight response turning into a breakdown. This is the first time I have seen Sam in this state and I realized right away I made a mistake. I stayed with her, talked a bit and then was quiet, giving her space. After 15 minutes went by we went outside with paper, pen and pencil. We had a written discussion and worked out our issues. This is the second time we have taken to writing questions and answers back and forth. We find this type of communication very helpful as it takes out emotions that are expressed when vocalizing. It also helps in taking the time to focus on appropriate questions and helpful direct answers. Lastly, I want to mention that I have an autistic male coworker at my job and I can recognize when he is becoming overwhelmed. I usually know how to help as I can see and know what put him into this state. With Sam, she masks or has been able to manage well at home so this was my first time experiencing a complete breakdown with her. What I learned from this experience was how to recognize signs when Sam needs time to process her thoughts and to give her the space to do so.

Week 7 Goals/Activities

• Thanksgiving dinner

• Review

  • ACT worksheets

  • Recognizing thoughts and feelings

  • Building positive thinking skills

• Cooking/Baking Baking to replenish snacks and cooking to use leftover turkey