Anorexia Nervosa

In big block letters, on Lilly's lab requisitions, the ones we had to take from the Dr's office to the lab. Dx: ANOREXIA NERVOSA

I mentioned before that Lilly's been losing a lot of weight. We went to the eating disorder specialist yesterday.

There are no magazines in the waiting room. Only that wretched upstart, Paloma Life, which is meant to be a social magazine (about Paloma!) and mostly features the stretched, chicken-skinned faces of doctors wives standing next to each other in pic after pic. There are also stacks and stacks of Neurology Today, incongruously. I have no idea why they have them. I'm a little frustrated by this, until I think, Oh, yeah, it's an eating disorder specialist. Not good to have pics of skinny models and celebs lying around.

They give me a "why you're here" sheet to fill out, which I hand immediately to Lilly. She checks off "Eating disorder/weight loss" without hesitation and hands it back to me. We don't talk. She stares right ahead. Her eyes are so huge. They look like agates.

They take us back. Get a blind weight on Lilly. 111.7 pounds. "And how are you related?" The nurse asks me, "friend? Sister?"

"Mom!" Lilly says.

"You look so young!" The nurse says, then leaves.

"We're so sick," Lilly says, after the door closes. "If we were really psycho, we'd be like, 'yay! Lilly, you've made it! You're finally skinny enough to have to go to the hospital! You go girl! And my mom looks like a teenager! Screw this psychological health shit. We win! We win!"
We start giggling, which confuses the medical student sent to do Lilly's intake.

The student is good. Slight. Indian. Mature and respectful. We like her. The doctor knocks on the door in the middle of the interview. "I'm interrupting. I'm taking over," she says, and sits down.

"She was doing really well," I offer.

"Yes, but this is very serious. I was just reviewing her chart."

Well, duh. That's why we're here.

"So, Lilly," she begins. "Why do you think you're here?"

"Well," Lilly says, and I can tell she's going into her beautiful mature interview mode. "I think I need to establish a better balance between eating and activity."

Lilly should become a campaign manager. She has spin down.

"Do you want me to leave?" I ask.

"Do you want your mom to leave?" The doctor asks.

"No. I won't tell you anything I don't tell my mom."

The interview unfolds. Lilly, for the most part, has a handle on the problem, but it's interesting to see the blind spots. For example, Lilly tells the doctor that she eats all her food. Which she never does. Ever. I interrupt to point this out.

"Yes I do."

"What about last night?"

"I ate all my pasta last night."

"No you didn't, remember? We were going to band practice and you got up to look for a CD, and then we were late, and you only ate a mouthful and threw the rest away."

"I ate it when you weren't looking."

"I don't think so..."

The doctor interrupts. "You need to trust yourself on this one, Mom."

"Ok," Lilly shrugs. "maybe I forgot."

Lilly's heart rate is 55. "she's a runner..." I offer. "I'm a runner, too."The doctor has Lilly lie down. "I'm going to leave the room. Let you rest. If your heart rate after resting a bit is below 50, I'm going to have to admit you."

So Lilly lies down. I sit next to her holding her hand. We talk quietly. Mostly jokes. I look at Lilly, and suddenly see her. I see how terrible she really looks. Skeletal.

"So this is a big deal?" Lilly says..

"Yeah."

The doctor comes back. Heart rate is 50.

"Ok, I'm not hospitalizing you. But if you haven't gained weight by next week, I am. "

We meet with a dietitian then, get labs drawn. Lilly takes the sheet, plans out all her meals for the next 4 days on a grid. Then makes a shopping list.

That's my 1/2 hour.