Is this normal pre-teen awareness/self consciousness?

[Phasmid]

My son, 12, is doing really well now. He's on a prophylactic dose of penicillin vk, after one more relapse from school exposure. His eyebrows and eyelashes are starting to grow in.... again. He says he's picking less. Overall, he's doing great. HOWEVER....

now his dysmorphia is persistent and pretty strong. He's a medium-build kid, on the taller side. He is very athletic, so he's "stocky." He is muscular and so is definitely not the skinny, super lean boy he was pre-PANDAS. He is by no means fat. He sees himself as fat, looks in the mirror sideways to see if his stomach sticks out, squeezes his arm to check the amount of fat he has, and constantly pulls his shirt down in front as well as in back. He comments on his "fatness" about six times per day. He asks me if he is fat about two to four times. He looks at his neck in the mirror to see if he has a double chin. He bends his head down and makes the skin bulge out, but it's not just fat there. But when he does that it does come over his chin. It wouldn't if he DIDN'T do this.

 

Having only one child, I have no idea if this is normal pre-teen body consciousness, or if this is over the top due to some remaining mild ocd which he does have, but you would never know it. What d'ya think?

 

Thanks in advance...

[EAMom]

Well, I vote for NOT normal...esp. since he is a boy.

 

He is by no means fat. He sees himself as fat, looks in the mirror sideways to see if his stomach sticks out, squeezes his arm to check the amount of fat he has, and constantly pulls his shirt down in front as well as in back. He comments on his "fatness" about six times per day. He asks me if he is fat about two to four times.

 

 

This description totally reminds me of PANDAS dd when she was 7.5 years (she actually got A LOT worse than that when her PANDAS anorexia was full-blown)...but the squeezing the arms, checking in the mirror, comments about fatness...eek, deja vu.

 

PS I only have girls, so comments from others, esp. those with boys are certainly welcome.

[MomWithOCDSon]

Phasmid --

 

Our DS13 was very similar, especially last year when the PANDAS and its OCD went off the charts. He was a very skinny . . . almost petite . . . kid up until about age 7, which was when the really harsh OCD first hit. But it wasn't until 12 that he started asking to see the old "skinny" pictures of himself and complaining that he was fat now, etc.

 

I do think it's probably a little dysmorphia and a little standard teenage self-awareness kicking in. Probably, too, kids at school are less "politically correct" and can say some things . . . even to or about an average-sized kid . . . that makes them self-conscious. All that grade school "warm and fuzzy, be nice to everyone" stuff starts to wear off in junior high, in our experience. And how else to say it: some kids are just jerks who get their jollies out of picking on the quieter, less self-assured among them.

 

Our DS didn't really take it any further than a mild concern about making sure his shirts were larger and loser (nothing "hugging" his body), and it also helped encourage him to take on a little more exercise, which is never a bad thing. But nothing extreme: no restrictive eating or anything like that.

 

So long as your DS doesn't stop eating or start exercising in excess, I think it'll probably ease up as he gets used to his growing body and the way his junior high peers see themselves and treat him.

[peglem]

Well, I have 4, the oldest is a boy, then 2 girls, then my PANDAS girl. I have to go with not normal. Once or twice a month, maybe, but as often as your son is doing it- not even my girls did that. Watch for eating, or compulsive exercising...

It sounds though, like your gut is telling you this is something to be concerned about, and you're trying not to overreact because of your PANDAS worries. I know I've second guessed myself a lot too.

[thereishope]

I'm sorry, but it doesn't seem like the expected teenage self conscious stage. He's obsessing, he's looking for reassurance, etc.

 

My son, 12, is doing really well now. He's on a prophylactic dose of penicillin vk, after one more relapse from school exposure. His eyebrows and eyelashes are starting to grow in.... again. He says he's picking less. Overall, he's doing great. HOWEVER....

now his dysmorphia is persistent and pretty strong. He's a medium-build kid, on the taller side. He is very athletic, so he's "stocky." He is muscular and so is definitely not the skinny, super lean boy he was pre-PANDAS. He is by no means fat. He sees himself as fat, looks in the mirror sideways to see if his stomach sticks out, squeezes his arm to check the amount of fat he has, and constantly pulls his shirt down in front as well as in back. He comments on his "fatness" about six times per day. He asks me if he is fat about two to four times. He looks at his neck in the mirror to see if he has a double chin. He bends his head down and makes the skin bulge out, but it's not just fat there. But when he does that it does come over his chin. It wouldn't if he DIDN'T do this.

 

Having only one child, I have no idea if this is normal pre-teen body consciousness, or if this is over the top due to some remaining mild ocd which he does have, but you would never know it. What d'ya think?

 

Thanks in advance...

[Phasmid]

okay... so... if we have done all we can do in terms of antibiotics, prednisone, do I assume that this is OCD outside of PANDAS? Do I move ahead with IVIG? Our doc, McGhee at UCLA, said he would have better luck getting insurance to cover ivig if the boy is presently on antibiotics. He is presently on pen. vk as already mentioned. So... can we expect this to go away without ivig? I know I am asking questions that there may be no known answer for. It is not something that we can't live with (the eyebrow/lash pulling we CANNOT live with), but it is annoying to us and he doesn't need that worry consuming him.

 

I just dunno....

[airial95]

It is not something that we can't live with (the eyebrow/lash pulling we CANNOT live with), but it is annoying to us and he doesn't need that worry consuming him.

 

 

I would be cautious about this. I agree with the others, that it does sound like something's up - this focus is unusual for a teenage boy. But while it might be something that is just annoying to you now, this type of obsession can very easily lead to eating disorders, purging, sefl starvation, overexercising and a whole slew of other unhealthy behaviors.

 

I wish you the best!!!

[EAMom]

okay... so... if we have done all we can do in terms of antibiotics, prednisone, do I assume that this is OCD outside of PANDAS? Do I move ahead with IVIG? Our doc, McGhee at UCLA, said he would have better luck getting insurance to cover ivig if the boy is presently on antibiotics. He is presently on pen. vk as already mentioned. So... can we expect this to go away without ivig? I know I am asking questions that there may be no known answer for. It is not something that we can't live with (the eyebrow/lash pulling we CANNOT live with), but it is annoying to us and he doesn't need that worry consuming him.

 

I just dunno....

 

Since your son is just on Pen, it would seem reasonable to try full-strength Augmentin (XR?) and/or Azithromycin before IVIG...but it is entirely possible that you will still need IVIG.

[thereishope]

Was the dysmorphia always present during this exacerbation? At what point did it start?

 

 

okay... so... if we have done all we can do in terms of antibiotics, prednisone, do I assume that this is OCD outside of PANDAS? Do I move ahead with IVIG? Our doc, McGhee at UCLA, said he would have better luck getting insurance to cover ivig if the boy is presently on antibiotics. He is presently on pen. vk as already mentioned. So... can we expect this to go away without ivig? I know I am asking questions that there may be no known answer for. It is not something that we can't live with (the eyebrow/lash pulling we CANNOT live with), but it is annoying to us and he doesn't need that worry consuming him.

 

I just dunno....

[Phasmid]

He was on azithromycin for two months, biaxin (clarithromycin) prior to that, prednisone twice, (30 days taper then 5 day burst)

 

the excessive concern with "fatness" started this summer, after we had started aggressive treatment which began in March.

 

Interesting that the plucking has diminished ( I think) and the night time stuff like having to tuck in covers just right is gone right now, only to add this in? Like I said, I can live with this, but I just hope that it doesn't last. He isn't showing sign of eating disorder, but has been choosing to skip the more fatty foods for the fruits and veggies. He does say he doesn't want to eat a particular thing because he doesn't want to "get fat."

 

So, sounds like you parents with more experience think that this is outside normal consciousness with appearance. I was afraid of that...

 

thanks-

 

 

[EAMom]

Sometimes PANDAS symptoms can "morph"....some symptoms fade and new ones appear.

[Kayanne]

Sometimes PANDAS symptoms can "morph"....some symptoms fade and new ones appear.

Yes, I was thinking the same thing...even during the healing process this can happen.

[wornoutmom]

Our ds14 has been through the same thing as yours and it has not developed into an eating disorder, so I wanted to put that out there for you as a more moderate viewpoint. Ds was always a skinny as a rail boy until 12, when a combination of puberty, depressive overeating and psych meds saw him gain 25 pounds in just a few months. My formerly athletic, active boy was suddenly very uncomfortable in his body. He didn't want to go swimming any more because he didn't want to show his tummy. As he entered jr high he became/remained very self conscious, but it always struck me as a teen thing. All young teens - boys and girls - are acutely aware of how they compare to others. This summer, post IVIG, he decided he wanted to try and lose weight and began working out with a personal trainer and watching what he ate. Spent lots of time pulling his shirt up and checking his stomach, looking at his arms, commenting on others eating habits, calculating if he had eaten too much in one day or could still have a bed time snack. I have to say I was a little worried about the new compulsions. But we just watch and wait and be aware. He has lost 10 pounds, looks great, it has raised his self esteem and has not morphed into anything more serious. In fact, once the weight was lost, the compulsions' frequency died down to a slow trickle. I think with these kids there is a tendency to latch onto thoughts/things more obsessively period, but it doesn't mean it's definitively going to develop into disorder proportions. Just my 2 cents.

[Iowadawn]

I vote: Note normal. Dawn

[Phasmid]

Okay, now I am officially worried. This morning he got up and seemed despondent. He was quiet. He came and sat for breakfast, which was a bowl of fresh fruit and a couple hard boiled eggs. He wasn't eating... he was looking at his belly. Then he asked if I thought he was fat. We talked about his feelings, and he got up without eating. Then he went to the candy basket. I explained that if he was worried, he should not be eating candy for breakfast. He said "candy can't make you fat." I think he thinks if it has fat in it, like fries, those are fattening foods. I explained the calories in-calories out situation, and that the eggs and fruit have more nutrtion than fat calories. He refused his food.

 

NOW WHAT????