And just an hour ago I saw a young patient whom we will call Sean. Sean had food phobia; he is completing his course of outpatient follow up after being hospitalized here from June 11th to July 16th, followed by some work in the Kartini Day Treatment Unit (13 treatment days) to consolidate his gains and make sure he would have no problem eating at home.
Sean is now like a new boy and his parents: mother, stepfather and father, gave me permission to talk about his treatment to you.
Sean is nine years old. In late April of this year he contracted a strain of strep throat that caused him severe nausea and abdominal pain. His pain was so severe that he required a hospital stay (in another town) to control it with i.v. medication and fluids. This was very scary for Sean and on returning home he began to avoid food that he associated with his abdominal pain. His normal childhood anxieties, spurred by a very active imagination, began to “rev up”. He worried that aliens might be inside of him causing the pain (he had seen something similar on TV). As he is nine he has the cognitive ability to discuss his thoughts, something a much younger child might not. He began to complain of his throat “tightening up” and to have problems swallowing. He said his saliva tasted odd and food did not taste right either. He worried that he might die. He began to have increasing difficulty eating and drinking and began to lose weight.
Sean’s parents were naturally very concerned and took him to their pediatrician who tried to talk to the boy about the importance of eating enough. Begging, pleading, positive reinforcement for eating and drinking, negative reinforcement for not doing so…nothing helped. As he lost weight Sean became paranoid about being poisoned and his concerns about dying increased. He began to spit out his saliva and almost all fluids. He refused to play with his friends as he had before.
At the time of his admission to the hospital utilized by Kartini Clinic Sean was essentially refusing to swallow all foods and liquids. He complained of itching and stinging on his tongue. He would take small sips of 7-Up and small amounts of milk mixed with Carnation Instant Breakfast, but he was losing much more fluid than he could take in.
Can you imagine how desperate his parents were?
Fortunately, Sean’s stepfather found us on the web and learned that what their son had was something called “Food Phobia”. He read my description of other cases and told me “It was as if you had lived with us….that was Sean you were describing!”
I won’t be going into the details of Sean’s hospitalization in this blog today, suffice it to say we followed our protocol: hospitalization with an N.G. tube, the use of a neuroleptic medication (Olanzepine) and eventual behavioral support with our family therapists and the pediatric nurses we have trained over the more than ten years of working with eating disordered patients.
Does the treatment seem long to you? Consider that most patients have been sick for a month or more before we see them and that other treatments offered to families consists of months of “psychotherapy” or “behavioral therapy” (with equivocal results as far as I can tell). Our treatment begins on day one and has a beginning, a middle and an end. And—in our experience to date—once it’s over, it’s over.
Today in my office Sean was a normal, happy, active nine year old boy; he had grown a little more than an inch since we met him. He eats everything, he displays no anxiety, he wrestles with his little brother, he builds fantastic fighting aircraft out of Leggos.
In short: thank God!
