Wednesday, August 24, 2016

ARFID: AVOIDANT/ RESTRICTIVE FOOD INTAKE DISORDER

In the current diagnostic DSM-5 manual, ARFID is detailed in the eating disorders section. ARFID is being presented as a new diagnosis as of the 2015 edition.  It is reserved for people who are clearly struggling with food and eating issues, but do not fit the criteria for anorexia, bulimia, or binge eating disorders.
Individuals might refuse to eat certain textures or colors of food, have trouble digesting certain foods, will only eat small portions at one sitting, are fearful of vomiting or choking, or have no appetite. 
In the DSM-V, ARFID is an eating or feeding disturbance that manifests as a chronic failure to satisfy energy or nutritional needs associated with at least one of the following:
  • A significant deficit in nutrition.
  • Significant loss of weight, not achieving expected weight gain, or the absence of normal physical development.
  • Disruption in psycho-social functioning.
  • Reliance on enteral feeding (e.g., feeding tube) or oral nutritional supplements.  
 The eating problem cannot be owed to the unavailability of food or to a culturally sanctioned food observance. ARFID is not accompanied by a distortion of one’s weight or body shape and is not concurrent with symptoms of anorexia or bulimia. An ARFID eating problem must be unrelated to a medical condition and not better explained by a different psychiatric disorder.
Though ARFID typically begins in childhood, it can persist into or begin during adulthood. For treatment, children and adults usually receive behavioral therapy such as gradual exposure to the avoided foods, and are also assessed for possible underlying symptoms of depression or anxiety.
It is good to be aware of ARFID, but having it is uncommon. Most children, and some adults, go through periods marked by strange eating patterns, such as only wanting hot dogs, or refusing to eat fruit. These patterns usually resolve themselves without professional intervention.   As a result of the eating problem, the person isn’t able to eat enough to get adequate calories or nutrition through their diet. There are many types of eating problems that might arise – difficulty digesting certain foods, avoiding certain colors or textures of food, eating only very small portions, having no appetite, or being afraid to eat after a frightening episode of choking or vomiting.
 As ARFID is officially still a new diagnostic category, there is little data available on its development, disease course, or prognosis. We do know that symptoms typically present in infancy or childhood, but they may also present or persist into adulthood.
Complications associated with ARFID have risks which include:
  • Cardiac complications
  • Heart
  • Kidney and liver failure
  • Bone density loss/osteoporosis
  • Anemia
  • Electrolyte imbalances
  • Low blood sugar
  • Constipation
  • Bloating and other gastrointestinal issues.
ARFID is more than just “picky eating”; children do not grow out of it and often become malnourished because of the limited variety of foods they will eat. 
ARFID (Avoidant Restrictive Food Intake Disorder) is one of the new additions to the DSM, and still has that unique strange affliction stigma attached to it. Even among the medical and psychiatric community, it is poorly understood.

I have known of my diagnosis for 3 years and it is not easy to handle. People tell me "just eat."  It is not as simple as that. I can be repulsed by everything in my house and turn to milk to substitute for food.  Sometimes it is just a color or texture, a smell or shape, or my "mind" says that nothing can be put into my mouth.  I do not know why, or how to overcome it. I am hoping to find the right help and make myself healthier, as going this way is definitely going to cause an early death.  It scares me. Right now dealing with healing from a surgery on my left knee to replace it after being laid up for 2 months is my focal, but regaining strength and handling the eating problem so my body will be healthier and the diabetes better is also a goal. I am 64 and need to do this.  One doctor told me that my body hangs on to everything bad as it does not know when I will give it the food it needs, and also overproduces the wrong chemicals in my body, like insulin.  It is all out of wack from starving.
I pray I get the right kind of help and solve this life-long problem.

Monday, August 22, 2016

FREE AT LAST!!!

I am back in my home! I was released August 20th. Being home is not as easy as I thought it would be.  The last 3 months have taken quite a toll on my body and I am quite weakened. Following my fall, I spent 2 months laid up waiting for my hip and foot to heal so I would be able to have the full knee replacement done on my left knee. The doctor cancelled the surgery 2 times due to my hip. The surgery finally happened July 20th. July 23rd I was sent to stay in a rehabilitation center.  There were some bad experiences there due to some miscommunication, and lack of communication with my surgeon. The center kept trying to call my primary care doctor instead of the surgeon, and I have yet to meet my primary care so he never responded as he did not know who I was. The lack of connecting with my surgeon despite my requests led to problems with a brace on my leg (delayed PT for a week) and problems with the catheter and its removal!  This caused me great pain and led to interventions by friends of me to make its removal finally happen! 
 Oh, and the food in the rehab place was horrible.  The cooks overcooked most of it and it was not edible. I lost 40 pounds in the full 3 months, mostly muscle.  The physical therapists were great and worked hard with me over the month there. I was told by them that it will take much longer for me to regain muscle strength and be strong again and I need to be patient.  I see the surgeon on Weds. to find out if he will release me to drive and tell me what else I need. I am going to be getting PT at home through home health care.  
It is hard for me to ask for help and everyone has been so kind and helpful. I am so touched by the loving kindness that has been shown to me.  So many took time out to care for my 2 cats, to care for my home, to get mail, to drive me to and from appointments, caring for my yard,  to shop for me, to visit me, and to show love to this old lady.  It has meant a lot.  
Not sure when I can return to work for more than 2 hours a day as after 2 hours of sitting, my left leg muscles start to spasm in pain. PT told me that is because of the loss of muscle. 
I am not sure how my work will take that when I am told I can return. That is, if they allow my return to my part-time position at even lesser hours per week.  
I am so happy to be home, though struggling with some things and finding myself tiring out way too easily.  One of my problems that is complicating things is my eating disorder that I have lived with all of my life.  I think I will tell you about that in another post. 

 

Saturday, August 13, 2016

I HAD A DREAM LAST NIGHT...

I dreamed that my husband, Clay, was stroking my hair and saying, "Be well, be well."  It seemed so real, I swear I felt his hand.
So today is bittersweet so far. I looked back on my memorial page for him, have listened to a lot of John Denver, who we both felt was an amazing poet and singer. 
One our drives or camping trips we would sing along with John.
I am missing Clay's wonderful smile, his enfolding hugs, his soothing voice and his laughing eyes so filled with love.  He was my one and only soul mate.

Friday, July 29, 2016

SO FAR STILL ALIVE

My total knee replacement surgery took place on July 20th. I was moved into a rehab center July 23rd about 2:30 pm. Being here has not been the greatest experience. Lots of miscommunication, horrible food, delays in pain meds., slow response (up to one hour) after pressing button for help, and more.  Do not want to go into details, but friends witnessed some problems and were shocked. I was in tears off and on.  The head of the place was finally notified and she came to interview me and help me.  
It is so depressing to be laid up for so long, especially since I was laid up for 58 days prior to the surgery and already weakened. I am so used to being active and on the go. Been trying to let go and let God. I am trying to take it one hour at a time more than one day at a time. 
Still accepting prayers on my behalf.  Worst is that I had to spend my 64th birthday here.

Thursday, July 7, 2016

CHANGE IN SURGERY SCHEDULE!

The orthopedic surgeon rescheduled the surgery for my left knee replacement. I was not too happy, but the concerns he had about my left hip were enough to cause this to be rescheduled to Wednesday, July 20th @ 1:30.  You know how disappointed I am that he could not just go ahead and do it Monday, but his schedule is filled. IF they do have a cancellation, I was promised I would be the first person called.  So I have to suffer a bit longer with pain.  Now I have to re-do the schedule for care for my 2 fur babies, Kala and Mooshoo.  So, keep prayers going!

Wednesday, July 6, 2016

1974: A YEAR TO REMEMBER

In 1974 I was at two historical events. The first was a huge rock concert in Ontario at the Ontario Motor Speedway in Southern California. It was called the California Jam on April 6th 1974 and the cost was $10.
The bands performing were Deep Purple, Black Oak Arkansas, Rare Earth, Earth Wind and Fire, the Eagles, Jackson Browne, Seals & Crofts, Emerson, Lake and Palmer, and Black Sabbath.
Jackson Browne came along with one of the other groups and was a surprise. All were top bands at the time and the concert rocked!  Over 200,000 people were there.  I was with 5 friends.  It was well organized, very peaceful, and fun.  No way any more could you see all those bands for only $10.
The other event was Expo 1974, the first environmentally themed world's fair held in Spokane.  Spokane was the smallest city to ever host a world's fair until Knoxville in 1982.  Peter Max designed a stamp for the event.
 
 The IMAX theater made its debut here at this event. The Expo slogan was "Celebrating Tomorrow's Fresh New Environment." For the first time since the company's beginning, General Electric did not have a fair pavilion but it sponsored the musical group Up with People that performed during the summer at the fair. Nations with an official presence at the fair included Australia, Canada, West Germany, Iran, Japan, Republic of China (Taiwan), Republic of Korea, USA and the USSR.
This world's fair was particularly notable for its large participation by the Soviet Union, the first time since World War II that they participated in a United States world's fair. It would also be the last time.
You can watch a video about the Expo here:
Forgot to mention that my brother, Jim, and friend, Cheri Simpson, were with me on this camping trip in my Gremlin! Tight but fun, and we even went to Canada!
 Now when I watched this video the first thing I noticed was how many balloons they launched at the grand opening. We all know how bad this is now and how dangerous for our wildlife!
I know my friend, Pat, will roll her eyes!
Enjoy the video! Wonder if any of you were at either event.

Sunday, July 3, 2016

PREPARING FOR EMERGENCIES

 Emergencies come in many forms: tornadoes, hurricanes, earthquakes, wildfires, utility outages, and more.The Humane Society says you should not only have a preparedness kit for you and your family but also remember your pets. They rely on you! A kit for them should have the following:
*Food and water for at least five days for each pet, bowls and a manual can opener if you are packing canned pet food. People need at least one gallon of water per person per day. While your pet may not need that much, keep an extra gallon on hand if your pet has been exposed to chemicals or flood waters and needs to be rinsed. 
*Medications and medical records stored in a waterproof container and a first aid kit. A pet first aid book is also a good idea
*Cat litter box, litter, litter scoop, garbage bags to collect all pets' waste.
* Sturdy leashes, harnesses, and carriers to transport pets safely and to ensure that your pets can't escape.  Make sure that your cat or dog is wearing a collar and identification that is up to date and visible at all times. Carriers should be large enough to allow your pet to stand comfortably, turn around, and lie down. (Your pet may have to stay in the carrier for hours at a time.) Be sure to have a secure cage with no loose objects inside it to accommodate smaller pets who may also need blankets or towels for bedding and warmth as well as special items, depending on their species. 
*Current photos of you with your pets and descriptions of your pets to help others identify them in case you and your pets become separated and to prove that they are yours once you're reunited. 
* Pet beds and toys, if you can easily take them, to reduce stress. 
* Written information about your pets' feeding schedules, medical conditions, and behavior issues along with the name and number of your veterinarian in case you have to board your pets or place them in foster care. 

Friday, June 17, 2016

YEARNING

Earlier I was sitting on the seat of my walker looking out of my bedroom window at my front garden. A hummingbird was flitting from flower to flower. I picked up my camera and took a few shots through the window as I sat. I am not sure how they look, if any came out at all, but it felt good to hold my camera. Being crippled up since end of May in excruciating pain has been depressing. I am usually active and can  hardly move now, having to use a walker in home and being pushed in a wheelchair around to doctors, tests, etc. by friends who drive me.  My knee has to be totally replaced as it is severely damaged, and surgery is scheduled July 7th. I am depressed a bit due to pain and being home bound and wish it could all be done tomorrow.  Unfortunately the surgeon went on vacation--my bad timing. Keep prayers going for me. *sigh*

Saturday, June 11, 2016

UPDATE

The MRI shows degenerative arthritis of the knee with additional tear in the cartilage.MENISCUS: There is an extensive complex tear involving the body and posterior horn of the medial meniscus. "Extensive complex" does not sound good to me.  My doctor has referred me to an orthopedic surgeon saying it was the worst he'd ever seen.  It is extremely painful. I could use prayers.

Tuesday, June 7, 2016

LAID UP

I had a fall May 25th which has left me in great pain and not able to get around. My big toe on left foot was dislocated, and left hip and knee injured. Luckily no break according to x-rays. MRI being done on left knee tomorrow as they are concerned about it.  So I am tied to home and relying on dear friends for transportation. Hope I will soon be blogging about adventures again. 

Sunday, May 22, 2016

SIMPLE PLEASURES

I am doing much better and sciatica much improved.  Now there is a small voice that repeats over and over Please do not let the sciatica return! Any of you who have suffered with it knows what it is like.
One of the things I did for physical therapy was to walk in the circular pathway in my garden. The beauty helped take my mind off the pain. Such a simple pleasure can be so healing in many ways.
So here are some more shots of the bountiful beauty God has provided me through my friend and landscaper, Lisa N. It helps me so much.  Nothing like this to get your mind off problems and pain.
 
 
 
Lovely colors to brighten any day.
 
 
 
 
 
 Wouldn't this lovely scenery life your heart? 
It certainly does mine!



Saturday, May 14, 2016

APOLOGIES FOR ABSENCE

I am so sorry I have been absent from my blog. I have been suffering with sciatica, which is very painful with pain shooting from my hip to toe down my left leg.  It inhibits my sitting, standing, and walking to limited time. I have to take short walks, and luckily my lovely garden provides a circular pathway that is enjoyable to walk on.  I have stretching exercises to do as advised by the doctor, have had chiropractor work done, have had heat and cold packs, electro-pulse work done, and use my EMPI machine, which I got last year around this time when I had sciatica down my right leg.
Pain limits activities, especially ones which require bending, kneeling, and twisting movement, which is about everything.  It definitely is a cause of feeling helpless and depressed.  I have missed 2 weeks of work because of it and my pay per month (4 weeks) is less than $1000 after taxes and all, so this hits me hard.  I am praying to be better (by Monday!) and return to work and feel better. Since I work at a computer doing database entries three days a week for 6.5 hours each day, this sciatica is problematic. I want this to end! So say a little prayer for old Rose here.

Saturday, April 30, 2016

WONDERFUL COLOR IS SURE TO DELIGHT

I love the colors and textures of my garden. In this post I am going to show some up close. Enjoy!
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Then the sun set in the west and turned the sky golden.
As the sun was setting a light rain started to fall and created this final drama to the east behind me...

 


Colorful ending to the colorful walk in my garden.