What is medical stabilization? Some people with severe eating disorders have additional medical complications caused by the effect of the eating disorders on their bodies. These medical complications can be very dangerous-sometimes fatal-and include heart arrhythmias, heart failure, electrolyte imbalances and gastrointestinal disorders. Medical stabilization in a hospital setting is the medical management of these conditions so the patient is out of danger and can take the next step on the road to recovery and health. 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 test results or a very low heart rate. Rejection from an eating disorders program because your weight is too low or you don’t meet other admission criteria. Trouble eating because of stomach pain. Worry that you may have another condition instead of, or in addition to, an eating disorder that makes it difficult for you to eat. What is refeeding? Refeeding is the process of gradually increasing the food intake of a person who is starving or malnourished, stopping and eventually reversing weight loss. Refeeding a person who has a severe eating disorder requires careful medical management and supervision to prevent refeeding syndrome. What is refeeding syndrome? Restoring weight is a critical part of medical stabilization. That means that patients need to begin consuming enough calories to reverse their weight loss. However, patients who are malnourished or starved may experience potentially severe physical reactions when they suddenly increase their food intake. These physical reactions, known as refeeding syndrome, include severe electrolyte and fluid shifts that may happen during the early stages of nutritional rehabilitation. These shifts occur as a result of what happens at the cellular level to the body during starvation. Specifically, starvation causes the starved body to be depleted of crucially important minerals which are stored inside of the cells. When those minerals are initially restored to the body, the patient needs careful medical supervision and blood tests at the cellular level to reduce the risk of cardiac arrhythmias. This is especially important since standard blood tests-that only look at serum and not cellular levels-may incorrectly show “normal” results. How do I start the admissions process? The first step is to call our office at 310-325-4353 to make an appointment for an assessment. Someone is available to speak with you 24 hours a day. Our office staff will discuss the appointment and other details with the patient, family or a referring provider. 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 Medical Stabilization 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. Meals with family members can be planned further into the treatment process. How long will I have to stay in the hospital? Patients stay in the hospital until they are medically stable. For a few patients, this will take several days. 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. 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 one to three lbs./week and obtaining 100 percent of calories by eating meals (no supplement use). Some patients may be able to leave the hospital earlier if accepted for direct transfer by a residential eating disorders treatment program. 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. If all we're doing is having our daughter eat regular food, why can't we do that at home? I'm a nurse 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 daughter to be right now. 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. 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 do the nurses have to search my belongings? 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. In most cases, the physician will review weights periodically (every five to seven days) with the patient. 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. 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.) Bring a light jacket or sweatshirt as you may be able to spend some time outdoors when your condition improves. We do not have laundry facilities, so please arrange for someone to take your laundry home and bring you fresh clothing at regular intervals. Bring whatever toiletry items you'd like, or we can provide you with 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 and artwork, are fine. You may also bring a cell phone and a laptop computer; Torrance Memorial Medical Center has free Wi-Fi available. Some other items you might like to have with you are DVD movies, books, a journal or art paper, crossword or jigsaw puzzles and a music player.