Thread by @WheatNOil

I didn’t get a chance to comment on this more the other day, but we are absolutely seeing this surge of anorexia in Saskatoon over the last 6 months or so.

In some ways, it’s almost reassuring to see it’s happening elsewhere too. Initially we were wondering if it was just us.

https://twitter.com/a_picazo/status/1353436890830168064

Anorexia is probably the deadliest mental illness you can get for children & adolescents. The mortality rate is high and since it usually hits teens, it takes out kids who shouldn’t be dying of anything at their age. So it’s serious stuff.

They mostly die from two causes:

1) Heart problems

See, if you’re really underweight, you don’t have much left to burn for energy other than muscle.

Your heart is a muscle.

So if you’re low enough in weight, your heart will literally shrink in size. You’re burning it for fuel.

So kids with anorexia often run really low heart rates. Really low. Like 30 beats per minute low.

And you wouldn’t know it by watching them.

See, old people slow down as their heart fails. They get more fatigued. They look sicker.

Not these kids. Not always.

They go on doing their thing. Getting 90s in class. Doing dance or gymnastics or whatever 7 days a week.

And then one night their heart can’t keep up. And it fails. And their blood backs up into their lungs. And they don’t wake up.

And sometimes you don’t have much warning.

I say this to emphasize why some of these kids need intensive treatment. It can’t wait. Some need to be in hospital. Sometimes with 24 hour heart monitoring. They need to gain weight or they’ll die. It may take months to get them healthy. And that’s just the initial treatment.

In Saskatoon, we don’t have a step-down unit or a day hospital for kids with eating disorders. We don’t have something in between full hospitalization and outpatient treatment.

It’s something we’ve asked for years.

This is a problem.

We know that if we treat anorexia aggressively at first presentation, kids have the best chance of success. If we half-ass it, then they are way more likely to relapse. Once you have multiple relapses, your chances of living free of anorexia go down. Your chance of death goes up.

I realize I forgot to mention the second most common cause death for anorexia. Pretty close to heart failure actually.

Suicide.

So when we admit kids to hospital for anorexia, they’re often in there for a long time. They need to gain weight. Food is treatment. If we send them home early, especially without a step-down unit, they do much worse on average.

With the pandemic and the rise in eating disorders, sometimes 33 to 50% of our child psychiatry beds are filled with kids with eating disorders. Sometimes they’re there for months.

Which means there’s less beds for every ‘other’ mental illness kids get.

It’s a low-key disaster.

(Actually not so low-key. It’s kind of my day to day disaster and very stressful for my colleagues and I, let alone these poor kids. Which is why I escape to Twitter to talk about a hockey team that lets me down and vaccines. What is wrong with me?)

We’ve looked at trying to expand beds. Have an eating disorder unit. The physicians are on board. There’s just no physical space. See, there’s this COVID thing going on and it’s taking up a lot of room in hospitals. We kind of get trumped there.

So this story doesn’t have an ending. It’s being written as we speak. If you’re a Saskatchewanian and you’ve come with me this far and you want to help?
1) Bug your MLA. Seriously. We need help in all areas of kids mental health. But Eating Disorders is one of them.

2) If you’re super rich... maybe you’re a Redditer that just made a boat load of money taking down a hedge fund... we’re getting a mental health fund set up at the Jim Pattison Children’s Hospital Foundation. Even if we find space for a unit, we’ll need the money to set it up.

(You all knew it would only be a matter of time before I leveraged all my followers I got from vaccine explainers towards kids mental health!)

But seriously, it’s not enough to have mental health awareness. We need the resources to treat it.

#BellLetsTalk