Medical limbo forces move

Sarah Rowland has now packed her bags and moved to Auckland to get specialist help to treat her...
Sarah Rowland has now packed her bags and moved to Auckland to get specialist help to treat her daughter’s eating disorder. Photo: Gerard O'Brien
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.

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 14-year-old 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 one-third of anorexics die — I am not going to watch my child die."

Jessica (now 14) was diagnosed with restrictive anorexia three and a-half 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 out-of-town 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 catch-22 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."

mike.houlahan@odt.co.nz

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