General Questions about Hospital Treatment What is medical stabilization? Medical stabilization refers to the evaluation and treatment of medical complications that are present as a result of an eating disorder, or that are likely to occur during the process of nutritional rehabilitation. How do I know if I need medical stabilization? You may need medical stabilization if you have experienced any of the following: Weight loss to the point that you, your friends, or your family are becoming concerned. Medical complications related to an eating disorder, such as abnormal blood tests or very low heart rate. Rejection from an eating disorders program because your weight is too low or you don’t meet other admissions criteria. Pain or discomfort interfering with eating. Confusion regarding your diagnosis; uncertainty about whether your weight loss or other symptoms are being caused by an eating disorder, a medical condition, or both. Still not sure? Schedule a comprehensive office or telehealth evaluation with one of our adolescent/young adult medicine specialists. Contact Dr. Linda Schack or visit www.DrSchack.com Contact Dr. Lindsey Brucker What is refeeding syndrome? Patients who are very malnourished and/or underweight because of low food intake are at risk for this set of medical complications when the refeeding process begins. Increasing the amount of food given to a nutritionally depleted person even when done carefully places stress on the body. Essential minerals, blood sugar, and body salts can drop to dangerously low levels and need to be monitored and supplemented in a hospital setting. Patients also frequently experience edema (swelling), hepatitis (liver stress), and muscle weakness. Refeeding syndrome is a potentially fatal condition. This is why patients with eating disorders who are sick enough to be in a hospital need treatment in a specialized eating disorders unit, supervised by physicians experienced in the care of eating disorders patients. If all we're doing is having our daughter eat regular food, why can't we do that at home? I'm a nurse/doctor and can check her blood pressure and pulse. The hospital is providing much more than food. Round-the-clock observation enables us to see facets of the eating disorder that may be otherwise hidden and begin to address them in treatment. Accurate and continual measurements of body weight, fluid intake, urine output and calories consumed also enable the physician and dietitian to assess calorie needs much more accurately. The hospital is also the safest place for your teen to be right now. It is important to allow yourself room to be a parent, and it is asking too much of a parent to provide medical treatment for their child. It is also confusing for adolescents and their parents when parents act as medical providers. Why would a hospital setting be better for my child psychologically than being in her home? Many patients feel relief when they enter the hospital because the constant internal dilemma that they have about which foods to choose and eat are removed. In addition, the power struggles which sometimes happen at home, with parents trying to get their son or daughter to eat or prevent them from purging, are not present in the hospital. Questions about Our Eating Disorders Medical Unit: How do I start the admissions process? Complete an application. You will hear back from our admissions coordinator, generally within 1 business day, confirming receipt. After initial review, most applicants will have an in-person interview with one of our psychologists. This is also a good opportunity to ask questions about any aspect of the program. If accepted for admission, you will be contacted to schedule your admissions appointment. Download an Application Do I need a doctor’s referral to get an assessment? No. You or a family member can make an appointment with us for an assessment without a physician’s referral. Will my insurance pay for medical stabilization? Yes, if your insurance plan is with a Preferred Provider Organization (PPO). TMMC has contracts with most PPO plans. Because our Eating Disorders Program is located in an acute care facility, your stay will be covered through your medical benefits, rather than your behavioral health benefits. This means that after discharge you will be able to use your behavioral health benefits for further treatment. Can I bring supplements with me to the hospital? Though you may want to bring your supplements with you, it is our policy to provide you with the appropriate supplements ourselves while you are a patient under our care. Your supplement regimen will be based on the results of tests and examinations we perform when you are admitted. Can I bring my own food? We understand that you may prefer a home-cooked meal prepared by your family over hospital food. However, for the recovery process to begin you need to use the services provided by the treatment team, including food. Dietary services include meal planning, education and food consumption monitoring. Later, when you can consistently eat the meals provided by the dietary staff, your family or friends will be able to bring some meals and snacks to be incorporated into your treatment. Can my family stay during mealtime? Meals are an essential part of your treatment (we view them as a medical intervention) and require monitoring by the nursing staff. You need to begin to trust the staff during meals, which is more difficult if family members are present. Similarly, patients may be self-conscious about eating in front of friends and family. How long will I have to stay in the hospital? Patients stay in the hospital until they are medically stable. Most patients with orthostatic hypotension (unstable pulse or blood pressure) and patients with bradycardia (slow heart rate) can expect to stay two to three weeks, as these conditions generally take a long time to improve. Patients who are at extremely low weights often stay four to five weeks. We do not have a discharge "weight goal" for underweight patients, except in cases of extremely low weight. If a patient is underweight, they may be discharged when they are medically stable, gaining two to four pounds (1-2 kilograms) per week and eating 100% of their meals (without nutritional supplement liquids). Most patients transfer to residential eating disorders treatment programs after becoming medically stable. I’m concerned that I (my son/daughter) will have to repeat a grade in school/not graduate on time due to the relatively long hospital stay. We have found that middle and high schools, colleges, and graduate programs are very willing to work with students who are in the hospital. We can provide you with a letter, if needed, to verify your hospitalization (we do not discuss the reason for hospitalization or any medical details, as this is protected confidential information). Once you are admitted, you or a parent should contact your teachers, vice principal, or academic advisor and arrange to have work sent to you and plan next steps. It is helpful to state that the expected hospital stay will be at least 2 weeks. As far as we are aware, none of our patients have had to repeat an academic year or been unable to graduate on time after being in the hospital. Some college students elect to take a medical leave of one or two semesters after hospital discharge in order to devote more time to the recovery process. Can I participate in online classes while I am in the hospital? While technically this is not prohibited, it is not recommended. Meals/snacks, doctor visits, and therapy sessions have to take priority over online activities. This means that you would be asked to turn off your computer when your tray arrives, or if a doctor is making rounds, for example. Meetings with your dietitian and therapist usually occur at regular times but may be changed on short notice. Meals and snacks are served at 8:30 a.m., 10:30 a.m., 12:30 p.m., 2:30 p.m., 5:30 p.m., and 8:30 p.m. We adhere very closely to this schedule but at times there may be a delay of up to 10 minutes for the tray to be delivered to your room. Patients have 30 minutes to complete each meal and 20 minutes for snacks. It is best to make arrangements to view recorded rather than live online classes. If you would like to discuss your particular situation, please bring it up during your individual therapy session. Can I bring my guitar (keyboard/flute/online voice lessons etc.)? Musical instruments should be left at home. We will assist you in finding other opportunities for creative expression. (See also: “Can I participate in online classes ....” FAQ). Why do I have to get up out of bed during meals? Even though you are in the hospital, it is important for your recovery that you remain as functional as possible. People tend to feel more helpless and tired if they stay in bed all the time. Meals are an active, important part of your recovery, and it is helpful for you to be alert and aware of your reactions to the process of eating. Why do the nurses have to search my belonging? Eating disorders sometimes lead to behaviors you otherwise would not engage in. Going into the hospital is a big step, and it can be difficult to give up the use of artificial sweeteners, laxatives or other substances when you may not feel ready. Also, sometimes items are inadvertently brought in by visitors. Having these things in your room could interfere with your recovery and may pose a threat to your safety. Why can't I be told my child's weight? People with eating disorders tend to dwell on their weight and body appearance, and it is easy for significant others to get pulled into this. We know you are concerned about your child's health, which may be threatened by an unhealthy body weight. However, we recommend that parents stay out of weight discussions that can trigger arguments, comments and dynamics that impede recovery. The easiest way to avoid this problem is to have no knowledge of the number on the scale. We also want to avoid situations in which a parent has information that the patient is not allowed to have, which can erode trust. Why can't parents stay in the hospital overnight? Adolescents need space to begin to trust the treatment team, which is more difficult if parents are always available to meet their needs. Teens are also better able to experience their emotions when they have some time alone. This is very important for the recovery process. Nurses are always available to patients if they need something or if they are having a hard time. Parents also need an opportunity to get adequate rest and to get in touch with their reactions to what is happening in the family. Parents who are well-rested and allow time for themselves are better able to provide support for their adolescent. Parents of some preteens may need to stay in the hospital for a few nights, to help ease transition into the program. Please let us know ahead of time if you think this may be necessary. Click here for hotels in the area with a discounted Torrance Memorial rate. What hotels are nearby with a special Torrance Memorial rate? 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For more information on Torrance, visit www.DiscoverTorrance.com What should I bring with me? We recommend that you bring a bathrobe, slippers and two or three sets of pajamas. You also need to pack a seven- to ten-day supply of comfortable clothing to wear during the day (shorts, jeans, sweatpants, T-shirts, socks, tennis shoes, etc.) We do not have laundry facilities, so please arrange for someone to take your laundry home and bring you fresh clothing at regular intervals. If this is not possible, we can provide you with information about local laundry pick up and delivery service. Bring whatever toiletry items you'd like. We do have basics such as shampoo and toothpaste. If you like, you are welcome to bring your own pillow and blanket or comforter. Items for decorating your room, such as framed photographs, posters, twinkle lights and artwork, are fine. You may also bring devices such as a phone, laptop, etc.; Torrance Memorial Medical Center has free Wi-Fi available. Some other items you might like to have with you are books, a journal or art supplies, crossword or jigsaw puzzles. We also have art supplies, puzzles and board games on the unit. Please do not bring items which could be a fire hazard, such as hair dryers, heating pads, electric blankets or space heaters. There is a hair dryer on the unit that can be used by request.