Wednesday, December 24, 2008

Intervention: a look at dysphagia

I'm not sure how many of you watched Intervention on Monday, but it was a very interesting case with a young woman with dysphagia, a swallowing disorder. Dysphagia can occur at any age for a variety of reasons. It can be due to a congenital abnormality, a structural problem or damage, a medical condition like Parkinson's, or for a psychological problem.

In this case,
dysphagia was psychological. This episode featured Nicole, a woman who had been molested at a young age. This prompted her descent into anorexia where she became very malnourished and eventually had to have a feeding tube placed in her stomach. The feeding tube has been in her stomach for fourteen years. During this time, she got married and had two beautiful children.

Her family has become increasingly worried about her children as they feel she has neglected them. They also fear that Nicole could overdose on the many medications she's on for depression, anxiety, and I believe her heart. Since Nicole fears swallowing food so intensely, stemming from her childhood molestation, she chews and spits her food as well as mashing it up and dissolving her medications through the feeding tube. Her rationale for the feeding tube is that without it, she would not live at all,
simply starving.

Nicole has been in various treatment centers, including those specific for eating disorders but did not feel they helped her. When she reaches the point of talking about the molestation, she has much difficulty dealing with it and shuts down. Thus, she has not gotten that far in therapy. In the intervention, her family's and husband's hope was that she would accept receiving treatment at a residential eating disorders clinic. At the end of the show, it said she stayed in the treatment program for two months, and then went home. She learned to swallow baby food and had gained over 25 pounds.

What I found interesting about this episode was not only the fact that it presented
dysphagia psychologically which I've known has occurred in some abuse cases, but also the reliance of the feeding tube from an eating disorder perspective. I've personally never experienced this, but I have heard of people both refusing a feeding tube and also fearing the removal of one as well.

In the case with Nicole, she had had the feeding tube for fourteen years which is an extremely long time, especially evident by the sores around her feeding tube site. Feeding tubes' initial purpose has always been as a temporary measure to help individuals with eating disorders or any other ailment receive the nourishment they needed for a short time. After that, it was to be removed with resumed feeding/learning to eat on one's own.

The other aspect I found surprising was how forthcoming Nicole was about her feeding tube. She publicly fed herself through the feeding tube. She figured this was how she was going to eat, and if people were
repulsed by it, then they needed to not watch. In general, this goes almost completely against normal eating disorder characteristics. Eating disorders have always thrived on secrecy, but she puts hers out on display. It gives a feeling of "attention seeking" even if that is not her intention.

The show also featured the toll this swallowing disorder has taken on her family. Her oldest child felt like she did not love her, while the younger one held out hope but was still clearly hurt.

Overall, I'm glad that she accepted treatment and has found some success. I hope she continues on with recovery and will be able to overcome her abuse issues and mend her relationship with her daughters and family.

If anyone saw this episode, what were your thoughts?


Anonymous said...

I saw it. It was unlike anything I have seen in terms of eating disordered behavior. Aside from Shelly from "Thin," I haven't encountered anyone who kinda liked having a feeding tube until this episode with Nicole. I found it fascinating. I'm glad I'm not the only one who didn't think she was seeking attention by feeding in public, but I'm sure that many will see it that way. I felt bad for her husband and kids and hope she's doing much better now so she can mend these relationships. I'm looking forward to updates!

Anonymous said...

I, also saw this episode - rarely watch 'Intervention' - this caught my eye due to the oddity of the prob -

Am aware of boys who were molested having probs swallowing or vomiting -

Haven't seen many girls w/ a prob like this for so many years -

The longer this went on, the longer it will be for her to get rid of that feeding tube - it's become her friend, not unlike heroin or cigarettes -

She has a start - it will not be easy, in fact, may fail - not a postive picture - she has to be totally motivated - she does not look like person who is 'motivated'

Anonymous said...

I saw it! I love Intervention. I noticed that this particular episode was a lot different than the usual eating-disordered cases that they typically show...I've never seen anyone who -wanted- to keep their feeding tube like that, for so long, and who openly uses it in public while chewing/spitting so...openly. I felt bad for her, she was too scared to even swallow her own spit. I hope that she continues to get better, hopefully they'll update it every time the show reruns.

Tiptoe said...

Charlynn, I hope they do an update of her. I think a lot of people would want to know how she was.

Anon, you're definitely right that the longer a person has a feeding tube, the harder it it to psychologically remove it. It'll be interesting to see whether she was able to become motivated or not.

Tiptoe said...

Gutsinarut, hopefully her case is only for educational purposes for people and nothing more. Yes, the updates would be helpful.

Anonymous said...

I watched this because I have gone through it. I had a thyroid problem that went untreated and I always felt like I was choking. I couldn't drink water because I choked on it. I could only eat pudding. But the fear of choking was already ingrained in me. Even when things got settled I would still only eat chocolate pudding, and had to go to an eating disorder clinic. It has screwed up my life. I found this fascinating mostly because I thought I was crazy, but it's good to know I am not the only one that has a psychological reason for not swallowing.

Tiptoe said...

Anon, I'm glad you were able to watch this episode and feel less alone. Many people do not know about this disorder, so it was good to bring it into the light a bit. I hope treatment has been helpful for you as living that way is certainly not pleasant.

Anonymous said...

This was one of the most interesting, thought provoking Intervention episodes I've ever seen (and I'm an avid watcher). I couldn't help but think Nicole felt very alone. Her father's behavior, IMO, was horrible. Clearly Nicole feels like her mom and dad didn't protect her when she was a little girl. I hope Nicole figures this out and gets help. I really wish her ex-husband wouldn't have taken her back in and instead made her go back to that treatment center to complete her stay. Her 2 little girls need a mom, and he needs to be strong from them. May God bless Nicole and her family.

Tiptoe said...

Anon, I agree with you. I hope she gets the help she deserves.

Tucker said...

That was crazy. She actually went to intervention? Why? Nicole is a genius! She has single-handedly solved world hunger. No longer will there be commercials of African babies with distended bellies and fly-covered eyes. Down with third world countries complaining about malnutrition. Ladies and Gentlemen, do not send Nicole to intervention, send her to Washington in 2012!
Go green! Go tube!
Change the world one tube at a time!
I solemnly swear to commit myself wholly to the task of putting Nicole in contention for the presidency of the united states of America. If our country wasn't a farce when Obama was elected it will be now.

Anonymous said...

Tucker you're are clearly in need of an intervention!!!!

Anonymous said...

I was in treatment at Remuda Ranch with this girl in 2008, and I just now got around to watching her episode of Intervention. She was really frustrating to be around because she was just as she appeared on Intervention - attention, attention, attention. They said at the end of the episode that they had taught her to eat baby food, but I sat at meals with her. We are talking two tiny spoonfuls at each meal, and it would take her 30 minutes (our maximum alloted time) to eat them. I understand that her psychological and psychiatric issues are real, but there was a lot, and I mean a LOT of attention-seeking going on with her. I'm going to look back through my paperwork to see if she left me her contact info; I'm super interested to see how she is doing now!

Anonymous said...

Watching her parents was horrific!
And her husband....I have my own addiction issues and my husband is an AMAZING husband because he refused to even risk impregnating me, until I was in treatment and recovery. I am now sterilized. Because I fear I will never be truly healed. And it is WRONG of me to ever subject an innocent life ( a child) to what issues. This man not once but twice, helped participate in putting a woman with major issues through the psychological rigours of pregnancy!! Who the heck does that to someone on a feeding tube!?
And instead of making treatment a condition of being around her children, he takes her back!??
Could not even be strong for his own children.
Nicole was NOT the only one with issues in this episode.
Sadly, two innocent children are subjected to that.

Anonymous said...

And before jumping on me, both of her children were born SEVERELY underweight and had to be in the ICU. The fact that they were allowed to be on this show and so graphically interviewed is beyond disgusting!
The husband blames Nicole for how the children were born and a host of other problems.
Yet, last time I checked it takes TWO to make a child!

This is the one episode where the adults should be left to their own downfall. DOES ANYONE CARE ABOUT THE INNOCENT CHILDREN INVOLVED!??

I hope those children have some saving grace...person in their lives.