Posted by Dr. Beth Steinhauer on March 19, 2005, at 19:00:53
In reply to Steinhauer-- low weight problems and doctors, posted by CareBear04 on March 18, 2005, at 16:13:48
Dear Care Bear,
Based on what you've written, I would be very concerned about your medical status. You didn't indicate your current BMI, but a BMI of <16 is almost invariably cause for immediate hospitalization and refeeding. It sounds as though you may be experiencing many effects of starvation, including low blood pressure, postural hypotension (that means that your blood pressure drops when you sit or stand up after lying down), (possibly postural) tachycardia, dehydration, dizziness, syncope (passing out). When you write "I'm not so lightheaded", it sounds to me as though you've become desensitized to how abnormal your medical situation must be. Fainting three times in recent weeks suggests that your body is seriously underweight, malnourished, dehydrated, or all three. (There are plenty of other reasons why adults get dizzy, but I'm speculating based on your eating disorder history and your age and recent low weight.) You SHOULD NOT be driving under these circumstances, as you are endangering yourself as well as other pedestrians and drivers. When your BMI is restored to >/=18.5 and you no longer faint or feel dizzy, THEN you can safely resume driving.The fact that your treatment team is requiring this intensity and frequency of visits suggests to me that they are very concerned about your emotional and physical health. While it is common for people with A.N. to chafe against frequent weight monitoring, often believing it makes them feel worse, I agree with your team that this level of supervision is necessary. I suspect that part of your illness involves minimizing or denying the seriousness of your symptoms. This, too, is unfortunately typical of most underweight people with A.N.
For what it's worth, I worry too about your use of two stimulants, Concerta and Adderall, in light of your eating disorder history. I hope that your psychiatrist is well aware of your weight, blood pressure, etc.
Take good care of yourself, and feel free to share what I've written with your treaters. ES
poster:Dr. Beth Steinhauer
thread:472551
URL: http://www.dr-bob.org/babble/eating/20050314/msgs/472958.html