🪦 Deceased Ashley Isaacs / Hamtaro-chan - The Lich Queen; Might Have Fallen Victim to Turn Undead

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Treasure Champs said:
Doesn't @cuddle striker dissect dead people? No offense, Chicken, but I'm gonna ask for a second opinion on this one. Cuddles, how easily do anorexic intestines come apart?
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it's fan fiction, or the person was in stage 2 decomp when found. It's pretty bad- I've autopsied an anorexic. It's not like that though.

System by system:
bones are brittle and exhibit loss of marrow.
muscle is banded, withered, dessicated and flaccid. to include the heart
nerves are exposed.
cartilage, tendons and connective tissue often is extremely tensile and contracted.
joints show lack of synovial fluid and wear on the adjacent areas to movement.
blood vessels are distended.
brain and glands are smaller than anticipated with excess fluid.
the digestive system is always a disaster but usually atrophied, not "friable". intestine will be narrow, there will be strictures and a general lack of tone to the peristaltic musculature.
prolapse is guaranteed, there's no "hole on the tailbone", the anus protrudes.

The state of the liver, kidneys, mouth, teeth, sinuses, esophagus and stomach will depend on whether they were also bulimic.

my patients are all dead. I address one like ash by saying "patient Isaacs died of heart failure related to an eating disorder on (date). external examination shows multiple hematoma and lesions with little sign of healing." then we start to cut.

most doctors will be blunt with someone at this point; eating will not "fix" her and they'll be talking about hospice.
 
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cuddle striker said:
it's fan fiction, or the person was in stage 2 decomp when found. It's pretty bad- I've autopsied an anorexic. It's not like that though.

System by system:
bones are brittle and exhibit loss of marrow.
muscle is banded, withered, dessicated and flaccid. to include the heart
nerves are exposed.
cartilage, tendons and connective tissue often is extremely tensile and contracted.
joints show lack of synovial fluid and wear on the adjacent areas to movement.
blood vessels are distended.
brain and glands are smaller than anticipated with excess fluid.
the digestive system is always a disaster but usually atrophied, not "friable". intestine will be narrow, there will be strictures and a general lack of tone to the peristaltic musculature.
prolapse is guaranteed, there's no "hole on the tailbone", the anus protrudes.

The state of the liver, kidneys, mouth, teeth, sinuses, esophagus and stomach will depend on whether they were also bulimic.

my patients are all dead. I address one like ash by saying "patient Isaacs died of heart failure related to an eating disorder on (date). external examination shows multiple hematoma and lesions with little sign of healing." then we start to cut.

most doctors will be blunt with someone at this point; eating will not "fix" her and they'll be talking about hospice.
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my thanks for correcting that other post with correct info
 
cuddle striker said:
banded, withered, dessicated and flaccid
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That's a quality set of descriptors, there.

What causes the strictures in the intestines? I just finished the FVG thread and it's not clear to me what the mechanism is for intestinal damage other than laxative abuse. Or does it really depend on the ana-chan in question?
 
LoveYouLongTime said:
Any medical Kiwis around? How do you address a patient like Ashley? Do you just ignore the obvious and just address the symptoms? Or is there an attempt to refer them into therapy to actually try and help them recover?
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If she showed up in the clinic we'd be liable if we did not immediately have her medically and psychologically checked out. Being that she clearly is a danger to herself it would not be hard to get a 72 hour hold, but thats where it gets tricky. There just aren't enough long term beds anymore and someone like her would require a long term hospitalization with 1:1 support. Also at her level of anorexia she'd be deemed medically fragile and that is not always something that can be dealt with to the degree she may need in many psychiatric setttings. Thing is though most anorexicswon't seek out help its a disorder of control and seeking help is giving control over to another.

Heres an idea of how bad off she probly is:
 
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That's a great chart-- accurate breakdown of the treatment necessary depending on where the patient is at with their ED. Ash's options are hospice or Denver ACUTE, but the latter isn't happening because she doesn't want to recover. At her stage in the game, it's not even a matter of will power or needing to understand and accept that being so underweight will kill you. That's for BMI 15 patients.

Regarding referring them to a therapist, based on personal experience, many outpatient therapists will not treat you if your symptoms or BMI is low enough. It's not just the liability factor. You can't engage in therapy when you're malnourished. There's a level where you can function and have a job, etc. but you don't cognitively grasp how bad things are (how slow or out of it you are, how miserable the ED makes you and no number is ever good enough) until you're on the other side. Ash is obviously no where near this point and she will never be.
 
I wonder if there's a point where being starved makes you so out of it that it's like being on dope or something. Whereas every time they have a good meal, they get lucid enough to freak out about the state they're in, and they don't like it.
 
KiwiFuzz said:
I wonder if there's a point where being starved makes you so out of it that it's like being on dope or something. Whereas every time they have a good meal, they get lucid enough to freak out about the state they're in, and they don't like it.
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Starvation “high” is definitely a phenomena often referenced in ED world, though some might characterize it as numbness rather than euphoria. As others in this thread have pointed out, after a certain point you just don’t even feel hunger signals anymore, much less higher emotional/cognitive functions.

I think you’re definitely on to something there though - a big part of ED recovery is learning how to deal with actually feeling shit again, both physically and emotionally, when you restore weight. Getting a taste of lucidity and true self-awareness in this skelly’s state would be terrifying.
 
KiwiFuzz said:
That's a quality set of descriptors, there.

What causes the strictures in the intestines? I just finished the FVG thread and it's not clear to me what the mechanism is for intestinal damage other than laxative abuse. Or does it really depend on the ana-chan in question?
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Usually the strictures are because the peristaltic muscles- long muscles that move your food along- keep trying even if it's empty. Combined with laxative abuse and ipecac, those muscles atrophy, but some will keep trying for a while. They'll tighten up around sections, other areas are flabby and loose.
AnOminous said:
I think she's actually off that chart in some "just plain doomed" category they don't list.
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She's "recommend to hospice". There's no treatment plan for this.
GenociderSyo said:
Rather sure she lives off the souls of dead anorexics and pure spite.
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She lives off people on the internet speculating about it.
KiwiFuzz said:
I wonder if there's a point where being starved makes you so out of it that it's like being on dope or something. Whereas every time they have a good meal, they get lucid enough to freak out about the state they're in, and they don't like it.
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She'll never be lucid again. Refeeding syndrome is a real thing- a normal meal would kill her. Any chance of recovering would mean monitored, long term hospital treatment with tube feeding, slowly building up in caloric content. It would be suicide for her to sit down to a regular meal and eat it without vomiting it up immediately. I'm curious if she's got the physical strength to vomit, actually.
 
cuddle striker said:
I'm curious if she's got the physical strength to vomit, actually.
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She has been that way for a while. Krispy Kreme donuts used to be one of her favorite binge/purge foods but she had to give those up because she couldn't throw them up anymore. What I'm less sure of is whether she's that physically weak or if long-term bulimia destroys one's gag reflex.
 
cuddle striker said:
She'll never be lucid again. Refeeding syndrome is a real thing- a normal meal would kill her. Any chance of recovering would mean monitored, long term hospital treatment with tube feeding, slowly building up in caloric content. It would be suicide for her to sit down to a regular meal and eat it without vomiting it up immediately. I'm curious if she's got the physical strength to vomit, actually.
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For that to happen, someone would have to force her to because she's not remotely interested on getting better and she "enjoys" her state.

It's very morbid to think about it, but we're just following the "life" of a ghoul. There is a minor character in Harry Potter (yeah, yeah, I read other books, ok?) who was a very old teacher and one day he died in his sleep and never realised, Next day, he woke up as a ghost and carried on teaching. There is a reason why we say Ashley feeds of spite because it could well be that case.
 
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I'd have mixed feelings about Halloween too if I was her. Imagine, it's November 1st and you're walking back home after a day of haunting the kids and then, someone puts you inside a "Halloween deco" labelled box until next year. I'd be terrified!
 
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