My daughter spent three weeks in an eating disorder medical stabilization unit in Phoenix, Arizona, for restrictive purging anorexia. She deteriorated physically as she intractably vomited everything she was encouraged to eat. She was refusing fluids as well. She fainted frequently with a resting heart rate between 35 and 45; they told me they could not help her. They would not place a life-sustaining NG-tube for fear of aspiration from her vomiting.
After my daughter spent almost two weeks in another hospital in Sacramento, vomiting NG-tubes out 7 or 8 times, the very desperate decision was made to surgically place a gastrostomy tube for life-saving nutrition. I was terrified at this aggressive measure, but I was also aware of the fact that my daughter was slipping away. The G-tube was placed, and nutrition was given completely via the G-tube for 4 days.
Guess what? It broke the cycle of vomiting. She began to eat 100 percent without vomiting. The tube was used for a total of 5 days. Next, we began the hard work of refeeding together, FBT style. With the support of the doctors, nurses, aides, clerks, and therapists, we nursed my daughter back to physical stability. After almost 6 weeks, her G-tube was removed. She is weight restored and is fighting for her life now. She continues eating 100 percent of her three meals and her snack, and she shares more and more about how her anxiety rules her life.
1) What are your thoughts on the treatment approach taken with the patient? What are the pros and cons of this approach? Explain.
2) As a follow-up to this treatment, you are assigned to work with the patient and her family. What behavior modification techniques would you use and why?