Saturday, July 21, 2012

When Hungry Kids Don't Eat

Hungry kids eat.  This is the premise of most articles on picky eating.  It's the premise that any good pediatrician works with when they discuss picky eating, and it's the one that nutritionists start with when they begin working with a new patient on how to create better eating habits in their children.
While this is an excellent premise, it isn't always true.  Oh, normal kids will eat if they get hungry enough.  But there are a few stubborn children who don't.
My oldest was the former.  She seemed picky at times.  There was the ball phase...where she would only eat food that was ball shaped.  Since this included grapes, peas and a full blown temper tantrum in the produce department over a bag of brussel sprouts (which she won; they were brussel sprouts after all) her pediatrician was more amused than concerned.  But the phases passed, and over the course of a month at any given time, her diet was relatively balanced.
Enter the youngest member of the family.  From the start, she had a cagey relationship with food.  She'd hungrily latch on and midway through a meal, arch her back and start screaming.  It took a few months and a bit of a rash to discover that she was allergic to the almonds and nut products in my diet.  As a toddler, she seemed to eat a varied diet.  Of course, it was limited in that we avoided anything with nuts.  But she ate squash, tofu, apples and cheese with relish.  She even tasted the lemon in a box of sushi we once purchased.  Somewhere along the way, she started getting pickier though.  Food couldn't touch any other food on the plate.  If a cookie or breadstick broke in two, she'd collapse into inconsolible tears.  'She's tired', we told ourselves.  Even if she'd slept well.
Then there came a variety of diagnosis for the rest of us.  Our family diet became more limited, and it seemed logical that she would balk.  We've been juggling this attitude for years now.  I don't want to be a short order cook.  But she needs calories.
Some nutritionists suggest using pediatric 'milk shakes' similar to ensure.  Unfortunately, I've taught the child to read and some logic skills.  She won't touch a chocolate shake for breakfast, and the ingredient list just makes her think I'm trying to hurt her.  They suggest occasional trips out, fast food is affordable and it's high in calories.  But it's never been in our diet so she gives me a squinty eyed suspicious look.  Besides, her sister can't eat most fast food.  Why would I treat bumblebee to a dinner out when she's been incorrigible?  Right.  I wouldn't.  Scratch that idea.  What about soda with her meals?  She won't touch it with a ten foot pole.
After talking to a nutritionist and doctor, I find myself wondering if by serving veggies and water when the kids were little I somehow set up a junk food deficiency.  Wouldn't that be a good thing?  I suppose that depends on if the kids eat.
What happens when I decide I can be as stubborn as she is?  Recently I stopped worrying too much about what she ate.  She was pulling these tantrums over food, where she'd sit at the table with a plate of food in front of her and crying because she was hungry.  I took my cue from her newest therapist and shrugged.  There was food, tasty food.  There was food available.  I saw some of it enter her mouth.  If she was going to cry about it, I wasn't going to stay in the same room. 
She lost 10 pounds.  And then was hospitalized. 
Hungry kids don't always eat.  At least, not enough to keep themselves going and healthy, even if you make sure the foods they need are readily available. 
Several thousand dollars later, we're no closer to an answer to picky eating.  Our recommendation is to feed her anything at all she's willing to eat, even if I have to go out at 2am.  But, don't become a short order cook.  Make one meal and if she eats, great.  Hungry kids, after all, eventually eat. 
Please tell me I'm not the only one who thinks that's conflicting information?

Tuesday, July 10, 2012

The Power of "Can't"

Today, my daughter concluded her current extracurricular activity.  She worked behind the scenes to keep a performance running smoothly.  The reward was a small, supervised party followed by an unofficial trip to the local snack shop.  I heard about the unofficial part when making arrangements to carpool and the other mother asked if my child was going to the second party.  You see, the younger kids usually don't.  But Penguin isn't a younger child anymore.  She crossed the barrier into 'big kid'.  In fact, soon her friends will include a series of licensed drivers.  Yikes.
I weighed the question carefully.  The main question being why hadn't my daughter been the one to ask if she could go?  Did she want to?  Did I want her to?
"I'll have to get back to you," I told the other mom.  
Honestly, it would have been easier not to worry about it.  How would she get there?  How long would she stay?  As an unofficially supervised outing, what sort of adult influence would be present?  I could just pick her up at the proscribed time and bring her home.
Ironically, most of my concerns vanished as soon as I asked Penguin if she wanted to go and she answered no, with a shrug.  "I mean, I do want to.  But I can't and that's okay."  She left the words between us with a smile and turned back to her drawing.
"What do you mean, you can't?" I asked carefully.  In my head were a number of scenarios, the 'mean girls' attitude that is common among her peers being forefront.  Up until now, this group of kids has been friendly and embracing; clamoring for her attention.
She frowned at me.  "Food?  They're going there for ice cream, and it's just easier if I don't go.  I can't eat anything."
She said it flippantly.  Off handed.  Accepting.  Like she'd come to the brick wall in a maze and instead of feeling around to see if it were an illusion, she turned around and continued on her way.  But it felt like someone had just knocked the wind out of my sails.  Food allergies.  The brick wall we've been telling her doesn't exist for the past 5 years.  Yes, you have to avoid certain food.  But we'll find a way.  We'll make arrangements.  We'll make it work.
And now?
"Yes, you can!" I told her.  I pushed logistics and carpooling aside.  I told her she didn't have to eat, that just going could be fun.  I told her that she could ask for just a fruit bowl.  That they might sell juice (Overpriced and under-filling, but it's something).  I found myself selling an outing most parents were probably on the fence about.  Suddenly this outing, this little social sidestep became important to me.  And the way her face lit up with a slow, dawning smile of hope makes me think it was important to her, too.
I've realized over the past year or so that food allergies have really created a barrier for us, as well as a handy excuse.  There are a multitude of reasons we don't go to a movie theater, the primary ones being both physical and financial.  But it's that airborne corn allergy that I cite.  Even though I can't afford to spend nearly $10 a ticket on a 90 minute escape from reality (that may or may not be worth watching on a big screen), it feels horrible to state it out loud.  And the two facts are both perfectly valid and completely honest.  If I were given 2 free tickets to the movies, I'd send my child with a friend or relative because physically, it's not safe for me to go (just as it's not safe for me to eat in a restaurant; although I occasionally brave the atmosphere)  If they were to purge the theater of popcorn and air it out thoroughly, I'd still not go because of the cost.  And there are so many other things on my plate right now that a trip to the movies isn't even something I'm missing.
But, my children may see that as a barrier.  Food allergies = I can't.
I can't eat out.  I can't go to a theater.  I can't participate in birthday parties.  I can't be normal.
Like every other food allergy parent out there, my definitions of 'normal' changed the moment that food allergies came on the scene.  At first, it was for my kids.  When I was diagnosed, the lines of normal and martyr and sacrifice and safety got murky.  But we're redrawing them.  Normal isn't eating out nightly.  It doesn't have to be something we hide or are ashamed of.  Food allergies aren't something to be ashamed of.  They simply are a part if who we are. 

Tuesday, July 03, 2012

Anxiety Vs Food Allergy

A long time ago I was told I 'just' had anxiety.  My symptoms were in my head.  This confused me, since I wasn't scared.  After being reassured that there was nothing wrong, my symptoms irritated me more than anything else.  I would give myself stern talkings to and force myself to go participate, do something when I was feeling ick.  I indulged the avoidance only in two ways...I wasn't crazy about movie theaters (at least, going there with family members who generously treated me to what I now know was actually causing those anxiety symptoms) and restaurants, where the 'anxiety' symptoms sometimes became unbearable and once or twice crossed a line to embarrassing.
Once upon a time, I believed that what I felt was anxiety of some sort.  I learned what I could, applied what I read to my symptoms and carried on.  Until discovering that I had food allergies, of course, and eliminating nearly all of those nasty 'anxiety' symptoms.

My daughter is 10.  She was diagnosed with anxiety issues (The original diagnosis was 'some sort of anxiety disorder') 5 years ago, when she was in kindergarten.  Since then, we've worked with multiple doctors and a large handful of therapists/psychiatrists.
I've had to relearn everything.  When they called my nausea and cramping a 'nervous stomach' and the hot flashes and faint feelings 'nerves' and the hives and racing heart a 'panic attack'; they did a grave disservice to those who really and truly deal with anxiety.
I know what it's like to experience these symtpoms.  But my daughter experiences them along with the sensation that her very life is in danger.  She doesn't just feel 'scared'.  She goes into fight or flight mode.  She doesn't strike out in anger, she strikes out in self defense.  It's us who 'don't get it'.
When I look into her eyes during certain 'temper tantrums' I don't see a kid who wants her way.  I see a trapped animal, who is looking for a way out.
She's a normal kid.  She has real, honest to goodness temper tantrums and breaks down into 'I want my way!' kind of tears.  But that doesn't make the other kind, the ones that sent us looking for help, any less real.

I'm also learning that real, full blown, actual clinical "Anxiety" can coexist with something else.  I don't know what's going on in her little body, because when we or the professionals try to ask more questions to help clarify, her anxiety takes off.  It interferes with her ability to communicate.  It interferes with her ability to rationally interpret the signals her body sends out.  It might worsen headaches or stomach issues, but it isn't the cause of random fevers.  And I really don't know if it's the sole cause of those headaches and stomach issues.

Eight or so years ago, I went corn free and gluten free.  I thought that was hard.  I thought it was overwhelming.  I thought it was the most challenging thing I'd face.  But I was wrong.  Food allergies are a known target.  They are something that you can identify, and work around.  They are something you can at least understand and educate others about.  Anxiety?  That one's still a mystery.