Emma Carter

Introduction

“Her heart could give up at any minute.”

That was the most terrifying news they gave me.

I only had Poppy in my life for fourteen years. That was not long enough. Selfishly, I wanted more.

Waves of emotion flooded me and brought me to my knees. My heart was pounding, my hands were clammy, and my tummy was churning. I started to sob quietly before uncontrollable tears pooled out of my eyes.

My mind raced for my poor Poppy.

Why?

How did this happen?

Why didn’t I notice?

What am I going to do?

What are they going to do?

What do I tell her brother?

What do I say to her?

I didn’t see that coming, and then it was too late. I was petrified that she was going to die. No one expects a child to die before them.

My head pounded with fear. Fear of losing the future with my daughter, fear of missing out on watching and nurturing her as she grew, and fear of missing seeing her develop into a young woman.

I wouldn’t witness her accomplishments. I wouldn’t see her achieving her hopes and dreams. I wouldn’t be able to celebrate any more birthdays with her. I would miss meeting her first love, her graduation and her wedding day.

I was scared of the life in front of me, without her.

How can I live without her?

How can we live without her?

How had we got here?

Where had it gone wrong?

Was it too late for her?

Could she pull through?

Chapter 1: Hold on Poppy

Poppy was lying in the hospital. She was alone. It still hadn’t sunk in but seeing her body so frail brought it all back to me. It was real. She could die at any minute.

They told us that her heart was incompatible with life. What! Fear didn’t come close to describing the emotions I felt.

I couldn’t get my head around it, as she had only been on the ward a week and it was only two weeks since she had first seen the eating disorder team. Within a short space of time, she had deteriorated so quickly to the point where her life was on the line.

“Her heart could give up at any minute,” they said. That phrase kept going around and around in my head.

I could lose my daughter.

Never in my wildest nightmares did I think that would happen to us. I always assumed that I would die first. Even though, as a parent, you know there are no guarantees in life, it still doesn't prepare you for the fact that your child could die. I knew life was fragile, but I never really gave it much thought.

Nearly every single moment of my day was taken up thinking about her, willing her to keep living, hoping that she would make it out alive. I didn’t want to be another statistic. I didn’t want to be another parent who had lost their child to anorexia.

Each morning, I opened my eyes with trepidation. Had she made it through the night? What will today bring?

I dreaded the phone ringing, hoping that it wasn’t the hospital with bad news.

My mind was constantly bombarded by an avalanche of thoughts of memories, conversations, what-ifs and shoulds. I couldn’t silence the constant babble in my head.

I should have spotted the signs.

I should have been able to turn this around quickly.

I should have been a better mum.

I should have been more present in her life.

I should have eaten with her more.

My days were flooded with feelings of guilt, disbelief, and anger at myself for missing the illness, as well as inconsolable fear of losing my daughter, my baby. My eyes were constantly sore due to all the tears I shed, worrying that she wouldn’t make it through another night.

I couldn’t stop the questions forever repeating in my mind:

When did it start?

Why did it start?

How did I miss it?

What did I do wrong?

Why didn’t I see it?

Was I too focused on myself?

Family members would unhelpfully add to my feelings of inadequacy, and I used that as a stick to beat myself further.

I felt helpless and useless. There was nothing I could do. We were in the hands of the hospital and it was going to take time. Time for her body to hopefully get stronger and time for her brain to repair.

Out of fear, out of desperation, and out of other options, I prayed.

I prayed that she would live.

Hold on, Poppy.

Please hold on.

Chapter 2: Knocked sideways

Saying it out loud didn’t make it any easier.

“Poppy has anorexia.”

I never imagined that we would be in that situation. It wasn’t something that was on my radar. No one I knew had an eating disorder, and I wasn’t aware of any of Poppy’s friends having eating issues. It wasn’t a topic that had ever come up in the house. The only time I was aware of anorexia was when, as a child, I watched the story of Karen Carpenter. Then, as a teenager, I remembered reflecting on her talent and thinking how awful it was that her life had ended so tragically short.

I didn’t expect it at all. I didn’t look for it, as I didn’t think I needed to. I just didn’t think about it at all.

I wish I had. I wish I had seen the signs more clearly and quickly. If I had, maybe we wouldn’t have been in this situation.

How did it go so wrong, so quickly?

Fourteen years had flown by, and it seemed so long ago since she was a baby. Nothing prepares you for the love you feel when they are placed into your arms for the first time. That precious little bundle was ours to look after, to protect, to show her what was right and wrong, to guide her and always be there for her.

How I wish I could go back to those younger years and start all over again, and somehow do it differently so that I would have done a better job of looking out for her. If only I could change things. But I couldn’t. Nothing was going to change where she was at.

I replayed event after event in my mind, looking for clues that I had missed. Each year, she would stop eating chocolate and biscuits for Lent, but that was nothing new. What was new was the fact that her Easter eggs remained untouched, which was unusual as Poppy loved eating sweets and biscuits. She had a sweet tooth, just like me. Poppy and I enjoyed puddings when we went out for food; that was the norm for us.

When the Covid pandemic struck, Poppy found it hard being at home all the time. It didn’t help that I was working full-time from home. Work was hectic, and my online meetings usually started at 8 am and often finished around 6 pm, with little breaks for lunch and little time to grab a drink. Eating together was impossible but, unknown to me, this gave Poppy the perfect opportunity to restrict herself.

I didn’t see it until it was too late. I saw her anxiety increase, which seemed to relate to the amount of homework. She was fixated on the fact that each piece of homework had to be perfect and nothing less would do. She was overwhelmed with the deadlines and being at home rather than at school. She was taking longer to complete the homework, which ultimately added more pressure. No amount of teachers' support enabled her to budge from her perfectionism, and the pressure she put on herself.

As life continued to be busy for both of us, mealtimes gradually got later and, before we knew it, it would be 7 - 8 pm before we had our tea. On the odd occasion it was after this and Poppy would tell me it was too late to have a big meal, as she was going to bed. I didn't think much about it, I just put it down to us being busy, and made a mental note to get back into a better routine.

It was a refreshing change to see Poppy spend time with her friends, as she seemed brighter and more like herself. Everything seemed better. I hadn’t realised it, at the time, but I had made it worse. I was encouraging her to spend time with her friends and, unknown to me, she was eating very little and what she ate had not fuelled the amount of energy she needed to walk to her friends and back. She admitted much later that she didn't know how she had walked that distance, as she would often feel weak, exhausted, and faint. How did I not see that? It was too scary to consider that her heart could have given up whilst she was walking.

I had no reason to consider anything was wrong with her eating, as sitting down for a family meal at the weekend was still part of our routine, and she was still eating puddings with me. Eating meat began to be more of an issue but I could relate to that, as I was not much older than her when I stopped eating red meat. I didn’t give that much thought.

She would tell me that she had eaten. She left her dirty bowls and cutlery out on the side, and crumbs were still on the table, so there was nothing new there. I still didn't consider anything to be wrong.

Little did I know that she has been taking every opportunity to skip or restrict meals whenever she could. I always felt lucky that Poppy and I had an honest relationship and I had no reason to think otherwise.

One day I noticed that she was upset because she had eaten too many biscuits. There were also a few occasions when I picked her up from school early and she hadn’t eaten all her lunch, and there were times when she began to talk about trying to be good and not eat many sweet things. I didn't think much about it at the time. I stressed the importance of eating her lunch and told her that no food was good or bad.

During Covid, everyone seemed to be talking about, and joining in with the online fitness classes that had started. It was a nice thing for us to do together. Poppy was more dedicated than me and would exercise two or three times a week, which seemed reasonable. I did question her when that increased to four or five times a week. I spent time explaining the importance of resting your body, and the need to not exercise too much. I began to feel uneasy when I noticed she was exercising every day, and I asked her not to do any more as she needed to rest. She agreed.

By then, my instinct was too loud to ignore. Something was not right. No one should exercise every day.

Disagreements started with what she wanted to eat, as she no longer fancied any of her favourite foods, preferring salads. More noticeable was her increasing anxiety around mealtimes.

I couldn’t put my finger on it. Her moods were getting worse, and I found myself having to walk on eggshells. When it came to preparing meals, she wouldn't leave the kitchen, and she would question every ingredient, and reason with me about the portion sizes, telling me that she was not hungry, or was feeling poorly. That was so unlike her.

Something didn’t add up.

Too many times she had eaten on her own rather than wait for me.

Too many times she had left some food saying she was full.

Too many times she had pushed her food around the plate and got grumpier if I asked her to eat more.

I began to be more vigilant, more to reassure myself that everything was OK, rather than to confirm it.

I couldn't shake the nagging doubt that she was staging things to throw me off. The knife looked as if it had been dipped in butter, the cereal bowl was too clean for her to have eaten her breakfast, and the crumbs looked as if they had been strategically placed on the plate.

Mealtimes were getting more upsetting for her and she kept refusing to eat all her food, saying that she was too full or felt unwell. For a while, I rarely saw her eating crisps or puddings.

Did she have an eating disorder?

I didn’t want to believe it but she was more stressed with eating, her portion sizes were getting smaller and she continued to make excuses. Something was wrong, and I couldn’t think what else it could be. It had to be an eating disorder.

I then noticed she had a pear-drop odour. I used to smell it when she was poorly as a young girl, so I put it down to the fact that she must be coming down with something and thought nothing more of it.

My head was in a spin worrying about her, so I rang the doctor’s surgery and was given a telephone appointment that day. I expressed my concerns. Poppy’s anxiety was worsening, and I was worried about her eating and level of distress. I asked if it could be an eating disorder.

The doctor didn’t confirm or deny that she had. She dismissed my query about being referred to Child and Adolescent Mental Health Services (CAMHS) by saying that there was a long waiting list, and it would be months before she could be seen. Instead, she advised me to look at several websites and contact a local number that might help. I was advised to take Poppy to the clinic in three months.

I was bewildered, as she didn’t even offer to check her at the clinic. She didn't seem concerned about her at all.

Was I being overprotective? Maybe there was nothing wrong, but my feelings told me differently.

The referral form was sent off that day, as the quicker we got help the better. They were quick to respond but said that they couldn’t see Poppy as her BMI was too low. I suggested that, before they rejected the referral, I would check her weight and height at the surgery as my scales were not accurate. The nurse worked out her BMI and confirmed that it was too low for them to see her. Her urine had ketones present, which explained the pear-drop smell. She explained that Poppy’s body was eating its fat reserves for energy due to the lack of nutrition, confirming that she had been restricting food for some time. She had complained of feeling cold during the previous few days, which was unlike Poppy. I did not know it at the time but that was her body’s way of protecting her main organs.

That knocked me sideways.

I was in denial, hoping that I was wrong, but the facts were clear to see. The low weight, the distress at mealtimes, the excessive exercise, the mood changes, the coldness and the ketones in her urine. It takes time for a body to use up its reserves, so it was clear that she had been restricting her food intake for some time.

I hadn’t realised, although I had an inkling. I had looked at the events in isolation but unfortunately had failed to join the dots. It wasn't helpful that she hid her body under baggy clothes, making any weight loss difficult to spot until it was too late. It can be a manipulative and deceitful illness, which makes it very difficult to see the whole picture.

When we were given the diagnosis of anorexia, I read anything and everything I could. I joined groups and attended workshops. I immersed myself in finding anything that could help. There was not one day where I didn’t read something, or attend something, and my days were consumed with information about eating disorders.

Within a week, the CAMHS eating disorder team contacted us to gain some insight into where Poppy was at. I held back my tears as I heard Poppy share some of the details. They were going to discuss her case at their weekly meeting and would get back to us. Meanwhile, they advised her to stop walking and to rest as much as possible. Her eyes filled with tears when she heard that. I didn’t know, at that time, how deep she was in the illness then.

It went from bad to worse. I knew we were in trouble when I saw her sobbing inconsolably, and no amount of encouragement or hugs could get her to eat one satsuma segment. Normally she would have devoured a bowl of fruit in minutes and asked for more, whereas then it was as if I was trying to get her to eat something poisonous.

I tried everything I could think of, and explained that our bodies need a certain amount of energy. I spoke about the analogy of a car needing the right fuel, otherwise it would stop in its tracks. I pleaded with her. I tried distracting her with videos, clips, and anything I could think of.

Nothing worked.

No longer was there any joy or fun in Poppy. The happiness had been drained out of her and was replaced with sadness, anxiety, anger, frustration, denial and guilt. Her life was consumed by calorie counting, excessive exercise, excessive standing, bodychecking, and self-loathing. She had an insatiable focus on losing more weight and checking to see her ribs.

That wasn’t the Poppy we knew.

I was scared.