Wrapped in the warmth of a blanket as she lay still in bed, a then 14-year-old Hannah McDonnell barely had the energy to shiver, her skin blue to her elbows and knees and with a heart rate and blood pressure so low a doctor couldn’t even check her radial pulse without cutting off the circulation.
“For weeks at that point I slept with her every night with my hand on her chest to make sure she was still breathing,” said her mother Tara McDonnell.
Hannah had been diagnosed with an eating disorder months earlier and was being supported at home through family-based treatment while on a waitlist to see a team of experts at the BC Children’s Hospital.
But when Tara took Hannah to their family doctor on Feb. 8, 2013 it was in a state of desperation to save her daughter’s life.
“I almost lost her that day. We were at the doctor and her body was completely shutting down,” she said with now 19-year-old Hannah by her side at a local coffee shop.
“I call it Living Day because that’s when we dug our heels in and I just grabbed her by the hand and said I know you don’t have the energy but I do, follow my lead.”
Ladysmith has joined other municipalities across B.C. in marking Feb. 1-9 as Provincial Eating Disorders Awareness Week.
As a young girl, Hannah was health conscious but also had a sweet tooth for the occasional cupcake. Over time, however, she started to become obsessed with fruits, vegetables and low-carb diets.
Her earliest memory of an eating disorder starting to manifest itself was at an improv camp on Gabriola Island when she obstained from eating and only drank tea.
By early in Grade 9 the teen was starting to miss school and was officially diagnosed with having an eating disorder in November 2012.
“It wasn’t just trying to lose some weight or shed some baby fat, that was detrimental to my overall health in every way, shape and form - in no way was that healthy,” she said, reflecting back.
Her mom adds that early intervention can be the difference between life and death and the mortality rate is reduced from 20 to 10 per cent with evidence-based treatment.
“What we didn’t always recognize was that she could hide that she hadn’t eaten breakfast or that the lunches were going in the garbage can,” said Tara, who cut back time at work to support her daughter. “There was this negative energy balance in her life.”
A 2014 report on eating disorders among Canadian girls and women produced by the Standing Committee on the Status of Women found that as many as 600,000 to 990,000 Canadians could meet the “diagnostic criteria for an eating disorder, primarily anorexia nervosa, bulimia nervosa or binge eating disorder.”
Almost everyone who struggles with eating disorders also suffers from what’s known as anosognosia, a condition that doesn’t allow the affected individual to understand they are ill.
For Hannah, there are lapses in her memory about those dark days when she stopped eating altogether and lost her will to live. Or that Living Day in 2013 when her mother sat beside her “begging” for her to take a sip of Gatorade or Boost after the family doctor ordered Hannah not to risk any movement by getting up.
“I remember certain things but never to the extent or extreme that people tell me something happened because my brain was just shutting down,” she said. “I remember the day that they couldn’t take any blood from me mostly because I hate needles.”
Early on in the illness she also recalls fainting frequently and the impact it had on both her friendships and others who were quick to judge.
“A lot of the stuff freaked out a lot of my friends because they were the same age as me,” she said. “There were a lot of things that different people said to me that were myth-based and downright rude.”
Family-based treatment for eating disorders has been shown to be the most effective form of treatment for adolescences, but may also seem radical for anyone on the outside looking in. For the McDonnell family, it meant banishing Hannah from the kitchen and serving meals already plated and cut into portions.
“Feeding your child should be easy but it’s not with an eating disorder,” said Tara, explaining how many with eating disorders also suffer from food rituals. “It did make her upset to eat so you need to learn to separate the eating disorder and your child and you have to learn how to be OK with their distress.”
The family also started eating calorie-dense meals packed with heavy cream, butter, oil and hemp hearts.
“I was blessed with a mother who is a fantastic cook because she’d cook something in the kitchen and throw so much extra stuff in there,” said Hannah, explaining how she had to consume upwards of 5,000 calories a day to rebuild her body.
Tara also found a parent support group on Facebook and information on websites such as the National Eating Disorder Information Centre to help in her quest to restore her daughter’s health.
She learned that “every bite needed to count” and most of all that the brain required nutrition before any amount of therapy would be effective.
“All food is not created equal when you’re feeding a person with an eating disorder, you need lots of calories to rebuild the organs that are literally shutting down in their body,” Tara said. “One of the hardest things I ever did was looking at the bottle of oil and dumping it into the smoothie.”
With only a dozen beds at BC Children’s Hospital for inpatient care, when Hannah did come up on the list they travelled weekly to Vancouver for eight months in order to receive treatment.
“It took me a long time to realize that just because you aren’t in the hospital doesn’t mean you aren’t sick and I know a lot of people who feel that way,” she said. “You can still be a ‘normal’ weight and still be very, very sick and that’s something people don’t understand…their minds and inside of their body isn’t working properly.”
Hannah also started attending a summer camp in Maple Ridge in 2013 where she met others who had silently battled eating disorders and formed lasting friendships.
“The connections that we made with each other were incredible and it was a big breaking point for anxiety because I had to branch out and talk to people,” she said.
“It’s nice to have people that back you and see you go from your worst to your best, encouraging you for your future and who really want to see you live a life and be part of it.”
Tara and Hannah feel that sharing their story is as much about educating others on early warning signs of eating disorders as it is busting many of the myths that perpetuate around the illness.
Last December, Tara presented at a BC Centres for Excellence in Eating Disorders conference and sat on an advisory committee with Island Health for four years.
“I don’t want it to happen to anyone else. Little pieces of awareness here and there will make a difference,” Tara said. “I feel so strongly that our carers need training of what to do better. Right away, empower them, because ultimately it’s the carers that are going to carry that person through their recovery.”
Hannah also wants people to understand that early detection of an eating disorder can make all the difference in reducing stigma.
“I wish that more people knew how to recognize warning signs and how to deal with things because it’s more prominent than people realize,” she said. “I’m fantastically lucky to have such a strong mom because I wouldn’t be where I am today without her, and I’m not even sure if I would be here today at all without her.”
Tara adds that now every day she can see her daughter’s zest for life again.
“You look into Hannah’s eyes now and you see the bright, shine in them,” she said. “I used to say, I love you to death. No, I don’t love you to death, I am going to love you to life.”