This was posted by a member of the HAES UK forum and in it a doctor describes how he started to consider that maybe obesity was not the cause, but the symptom.
So after carefully negotiating with 2son that he will see the doctor if I arrange a precious home visit it is with trepidation that I put in the request for one. I had spoken to the doctor about his situation and have kept her updated, but there was never really any reason or value in having a home visit.
Naturally the doctor then proved unobtainable and it took 10 days to make the appointment. Not her fault; she’s the nicest doctor within the practice and the only one who actually listens to what you are saying.
So she came round on Friday. She was supposed to come on Thursday, but as 2son was resolutely fast asleep I thought I’d trick him and delay her for 24 hours. It didn’t work. He was asleep through her visit on Friday as well although he did hear what was said as he repeated it to his brothers.
He wouldn’t let her touch him, but I showed her his hands and she saw his hair. The marks on his hands that do seem to be diminishing are nit bites; I didn’t know they bit. She talked to him, saying that we were worried about his physical state and that he needed help. We also mentioned that he was Vitamin D deficient. Whether he would take supplements or not is another question. She was nice and sympathetic to him which is what I’d told him she would be.
We went back downstairs and had a little chat. Her first question was how do I cope with it which I appreciated. She said she’s seen scalps in worse condition but that the only option she sees is forcing him into hospital, for a short visit and assessment, including getting his hair sorted. She will talk to our consultant psychiatrist to see what’s possible.
The practical difficulties are at what point, legally speaking, does his personal neglect trump his rights to make his own decisions; at what point can social services step in and move him to hospital. In our team meeting after Christmas we decided it wasn’t yet.
The other issue of course is that if he is forced into hospital, kicking and screaming, what does that do to him? It may make him realise that he can’t do this for ever and he needs to decide to make changes in his life, or it may push him over the edge and take away his last safe refuge. It’s a horrible decision that we will have to make and the doctor did ask me whether I wanted that choice taken away from me. I said no. I’m very uneasy about the outcome of this and need to know more before I can make a decision, let alone anyone else. So another meeting is probably the next step.
I just don’t know at what point you say enough is enough and try forcing the issue. Two years is a long time to be out of circulation. He’s 14 now and missing out on so much life.
I’m skipping #15 today.
This week I went to a review meeting about 2son. We had quite a good team together, with his EWO (Education Welfare Officer), his CATE leader (Continued Access To Education) and both CBT therapist and consultant psychiatrist from CAMHS (Child and Mental Health Services). That’s a bit of a mouthful.
I talked about his behaviour over Christmas and the fact that he had perked up a little, mainly for playing games on Wii but that he had ultimately got on with visitors over Christmas. I spoke of the game I’d bought him for his birthday that he was contemplating earning game play time for. He’d said that he would see his doctor on a home visit in exchange for computer time.
This is all talk with no action but he spoke to his therapist on the phone last week for a full 50 minutes for the first time. He’s got three more sessions over the phone before she wants him to try visiting him. 2son told her that he just found the outside world too bright, big and noisy, nothing surprising there considering he hasn’t ventured out for what is now 4 months.
The only idea for moving forward is the doctor’s home visit. She’s agreed to do one but I haven’t been able to set a date despite frequent phone calls.
Other than that the bad news is that the EWO is closing the case. Not because she wants to but because she’s in a different borough, along with 2son’s original school and they took him on because my local borough EWO refused to. It all comes down to whose budget the funds come out of. She’s been ever so good, understanding and sympathetic and I am sorry to see her go. I’ve had no contact with the EWO in my borough except for a five minute visit from one who graciously told me that they wouldn’t be taking me to court for not getting 2son to school. I didn’t know whether to thank her or punch her. So I did neither.
The comment from the consultant psychiatrist who has only seen a sleeping 2son from the bedside when she tried a home visit before Christmas was that unless he’s deteriorating then there’s nothing extra they can do. If the self-neglect was worse than they could start talking to social services about getting him admitted to hospital overnight for an assessment. I’m not sure how useful that would be but there’s that terrible feeling that he has to get worse before he can get better.
He’s not clinically depressed. On the basis that he still cooks for himself at night or in the day, mostly filled pasta and packet noodles, with the occasional giant size bacon sandwich for breakfast. He does have baths and changes his pyjamas when he wants to, not just when I tell him to so he is making decisions about his self-care. He’s making choices and not ignoring the world completely. So he’s either got to decide for himself that he wants to fight this, at which point we can all step in and help him or he’s got to get to a dangerously low level such that concern for his self-care and health trumps his rights as a child to say no.
It’s painful to talk through, and despite the fact that I have got a good team on his side who are trying the best they can for the most part (I’ll except Social Services here who have done absolutely nothing), they can’t actually do anything and are tied by his refusal to participate. For that I sometimes want to just scream “Do Something” at them.
I do understand that he needs to make his own decisions in his own time and that nothing else will help. My worry is that like an addict he will need to hit rock bottom before he can decide to start climbing out of it. All I can do is watch, wait, listen and tell him that I love him.
It is bloody ridiculous that I feel so anxious about going to the GP (doctor) but I do.
I’m going to ask for anti-depressants, something that I’ve thought of, off and on, for a long time but never asked for. I did discuss it once but at the time I didn’t really feel they would do me any good and wasn’t really asking for them. My GP then said that she would prescribe them if I wanted but didn’t really feel they would do any good.
So what’s changed?
I made the appointment a month ago (necessary to get the one GP in the practice who actually listens, and she only works part-time) when 2son had stopped going to CATE or to CAMHS. I really struggled for a fortnight to get out of bed every morning. If I didn’t have the other two boys to get off to school I don’t think I would have. What’s the point was my waking thought. I’m going to spend the day chasing 2son to get up and he’s not going to. Or he is going to get out of bed, but no more than that. I’m going to expend energy and emotion and it’s all going down the pan, unused and unwanted. It’s depressing.
The sad and pathetic truth is also that I was brought up that pills and medicine were for softies (and southerners, but don’t let’s start on that), for weak people who didn’t have the strength to get better by themselves, mind over matter. Yes I know how ridiculous that sounds. But I see anti-depressants as an admission of failure to cope with life and anything less than 100% success is, according to my father, total failure. I somehow feel that I’m coping better if I don’t label myself as depressed because that puts me a step above those who are, on the ladder of life. I’m doing better than people who have that label.
And yet, maybe if I admitted that yes I am depressed, I might get some help that would be, well, helpful. Although there are moments when I slump so low I will honestly say that right now I am depressed, for the most part I won’t. Is that because I’m not depressed for 90% of the time or just because I won’t admit it? I really don’t know.
But I am worried for my sanity, and that of my children. And I’m worried that I decreasingly have the capacity to deal with any of them when there are problems or arguments. The amount of time I think “sod off, sort it out yourself, I don’t care and haven’t the patience” is increasing and that worries me.
I feel guilty and embarrassed to ask for medical assistance here. I still hear my father’s words that I ought somehow to have just got over all this. I know that attitude’s wrong but nevertheless it’s still sunk in.
I shall struggle to say it tomorrow, but I will say it.