Med­i­cal limbo forces move

A Kurow mother is plead­ing for the new Dunedin Hos­pi­tal to in­clude space for a pae­di­atric eat­ing dis­or­ders unit. Mike Houla­han talks to her about how she hopes her daugh­ter’s strug­gle can help oth­ers.

Otago Daily Times - - REGIONS - Mike.houla­[email protected]

MANY peo­ple move to Auck­land to change their lives . . . Sarah Row­land is mov­ing to save one.

The Kurow woman this week packed her bags af­ter her 14­year­old daugh­ter was ac­cepted into Auck­land’s Star­ship Hos­pi­tal’s spe­cial­ist treat­ment pro­gramme for pae­di­atric eat­ing dis­or­ders.

She did not want to move north, but felt she had no choice.

Star­ship has the only such pro­gramme in New Zealand — one Ms Row­land be­lieves is the best hope for her daugh­ter, who has bat­tled eat­ing dis­or­ders for years.

‘‘She re­quires this treat­ment. Other­wise it will turn into a life­long strug­gle, or death,’’ Ms Row­land, a writer and for­mer am­bu­lance of­fi­cer, said.

‘‘The re­al­ity is that al­most one­third of anorex­ics die — I am not go­ing to watch my child die.’’

Jes­sica (now 14) was di­ag­nosed with re­stric­tive anorexia three and a­half years ago.

Ms Row­land knew some­thing was dras­ti­cally wrong with her child, but did not re­alise the na­ture and ex­tent of Jes­sica’s plight un­til she was 10.

She col­lapsed af­ter three days of gas­troen­teri­tis and was flown by he­li­copter to Dunedin Hos­pi­tal.

‘‘The doc­tor said that she was the youngest per­son she had ever seen with anorexia,’’ Ms Row­land re­called.

‘‘That re­ally shocked me, be­cause I had never been told that in those terms be­fore, and we had been to doc­tors three times be­fore.’’

The over­ar­ch­ing term

‘‘eat­ing dis­or­ders’’ spans a wide range of med­i­cal con­di­tions.

Some are psy­cho­log­i­cal, but many are ge­netic — as is Jes­sica’s con­di­tion.

How­ever, Ms Row­land be­lieves many in the New Zealand med­i­cal pro­fes­sion have been slow to draw that dis­tinc­tion — which has meant her daugh­ter of­ten be­ing treated as a psy­cho­log­i­cal pa­tient when it was her body rather than her mind which needed ur­gent treat­ment.

‘‘Anorexia does dam­age the brain mat­ter; it is akin to suf­fer­ing a trau­matic head in­jury,’’ Ms Row­land said.

‘‘You need to re­pair that dam­age, which re­quires weight restora­tion, as the body starts re­cov­er­ing be­fore the brain starts heal­ing.

‘‘Once the brain starts heal­ing, ther­apy be­comes ef­fec­tive.’’

It is the lack of ac­cess to ap­pro­pri­ate treat­ment which has drive Ms Row­land to de­spair — and to Auck­land.

There are cen­tres which treat eat­ing dis­or­ders in the South, but they are for adults and older ado­les­cents, not chil­dren.

There are psy­chi­atric ser­vices for chil­dren in the South, but Jes­sica’s ill­ness ini­tially re­quires food as her medicine rather than ther­apy, so the re­sults have not been sat­is­fac­tory.

‘‘It has been widely recog­nised around the world that psy­chi­atric units are not ap­pro­pri­ate to treat eat­ing dis­or­ders, as they are not trained in them.’’

Star­ship, Ms Row­land be­lieves, of­fers Jes­sica her best chance for sur­vival, but it is far away in Auck­land, has just six beds and does not take out­oftown pa­tients.

‘‘I com­pletely un­der­stand why they put those pro­to­cols in place — it’s be­cause they are over­whelmed.’’

In Oc­to­ber, af­ter sev­eral months of relapse, Jes­sica was read­mit­ted to Dunedin Hos­pi­tal af­ter an­other col­lapse.

She was even­tu­ally dis­charged, but was back again three nights later af­ter a mas­sive spike in her heart rate and near col­lapse.

Gas­tric feed­ing was re­sumed, but that high­lights the limbo pa­tients such as Jes­sica fall into.

She refuses to eat; gas­tric feed­ing re­quires Jes­sica to be re­strained; but for re­straint to be per­mit­ted the Mental

Health Act comes into play — and Jes­sica’s con­di­tion is ge­netic, rather than be­ing a mental ill­ness.

Faced with this catch­22 sit­u­a­tion, Ms Row­land felt she had no op­tion but to move her­self and Jes­sica to

Auck­land for spe­cial­ist treat­ment.

‘‘I have no choice — but re­ally, it should not be like this.

‘‘We should not have to go to the other end of the coun­try to treat an ill­ness which could be suc­cess­fully treated else­where.’’

With the forth­com­ing re­build­ing of Dunedin Hos­pi­tal, Ms Row­land sees an op­por­tu­nity for fam­i­lies such as hers — a ded­i­cated pro­gramme for the treat­ment of pae­di­atric eat­ing dis­or­ders for the South Is­land.

It would not take mil­lions to in­cor­po­rate this into the Dunedin Hos­pi­tal plan, Ms Row­land be­lieved, but there was an op­por­tu­nity for Dunedin to es­tab­lish a cen­tre of ex­cel­lence in pae­di­atric eat­ing dis­or­ders.

With an es­ti­mated 1 in 10 peo­ple hav­ing been af­fected by an eat­ing dis­or­der and 1 in 100 suf­fer­ing from anorexia, Ms Row­land’s fam­ily is surely not the only one in the South Is­land which faces this dilemma.

She has started a pe­ti­tion call­ing for such treat­ment fa­cil­i­ties to be part of the new hos­pi­tal, and has more than 5000 sig­na­tures al­ready.

‘‘If we had spe­cial­ists and nurses avail­able down here for chil­dren, peo­ple would not be strug­gling; if we had early in­ter­ven­tion avail­able, we would not be strug­gling,’’ she said.

‘‘If we had ed­u­ca­tion avail­able at ground level for med­i­cal stu­dents and re­train­ing for doc­tors, this would not be hap­pen­ing . . . the tim­ing is per­fect, with the con­struc­tion of the new hos­pi­tal, to do some­thing sim­i­lar to Star­ship.’’

❛ The re­al­ity is that al­most one­third of anorex­ics die — I am not go­ing to watch my child die

Sarah Row­land

PHOTO: GER­ARD O’BRIEN

Re­luc­tant trav­eller . . . Sarah Row­land has now packed her bags and moved to Auck­land to get spe­cial­ist help to treat her daugh­ter’s eat­ing dis­or­der.

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