Terry Shiavo case and anorexia

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In a recent message Francesca Skelton wrote:

" During all this frenzy about the Terry Shiavo case, it made me wonder what

in the world happened to her during her 20's (they were calling it a " heart

attack " ) to cause such severe brain damage and terrible present

circumstances... "

Here is an article on her case from the USA TODAY:

Schiavo case highlights eating disorders

TAMPA (AP) - Before she was the severely brain-damaged patient at the center

of a legal dispute over whether she should live or die, Terri Schiavo was a

young woman who desperately wanted to be thin.

At 26, she was strikingly beautiful with delicate features. But she had

spent her childhood and high school years as a chubby and shy girl, standing

just 5-foot-3 and weighing 200 pounds at her heaviest.

When she finally lost 65 pounds in her late teens, men started to pay

attention - including the man who would become her husband, Schiavo,

who was tall and handsome.

But keeping the weight off was a struggle for Terri Schiavo, and years

later - after her heart stopped briefly, cutting off oxygen to the brain - a

malpractice case brought against a doctor on her behalf would reveal she had

been trying to survive on liquids and was making herself throw up after

meals. The Schiavos' lawyer said her 1990 collapse was caused by a potassium

imbalance brought on by an eating disorder.

It is a cruel twist lost on no one close to the case: A woman who is said to

have struggled with an eating disorder is now in the middle of a court

battle over whether her feeding tube should be removed so that she can

starve to death.

Fox, a lawyer who represented Terri and Schiavo in the

malpractice case, said the disease is the " lost lesson " in the Schiavo case.

" While there is no cure for bulimia, there were things that could and should

have been done for her that would have controlled it, " he said in a recent

interview.

Terri Schiavo, 41, is now locked in what some doctors say is a persistent

vegetative state, with no hope of recovery. In one of the nation's longest

right-to-die disputes, her husband is fighting with her parents to have the

feeding tube removed; a court order preventing its removal expires at 5 p.m.

Friday.

Like almost every element in the case, whether Schiavo really was bulimic is

in dispute. Her father, Schindler, said he does not believe his

daughter had an eating disorder and thinks her husband had something to do

with her collapse. Schiavo has denied hurting his wife.

During the malpractice case, at least one of Schiavo's friends testified

they knew she was bulimic because after meals out, she always immediately

excused herself to go to the bathroom. Her husband also knew she had

peculiar eating patterns but did not realize they were dangerous, Fox said.

Medical records from the hospital where Schiavo was treated after her

collapse note that " she apparently has been trying to keep her weight down

with dieting by herself, drinking liquids most of the time during the day

and drinking about 10-15 glasses of iced tea. "

Fox said that in the months before her collapse, Schiavo went to the doctor

because she had stopped menstruating. It was a silent " cry for help, " the

lawyer said. But the doctor did not take a complete medical history that

might have revealed an eating disorder.

The jury put the damages at $6.8 million but reduced the verdict to about $2

million because it felt Schiavo was partly at fault for her collapse.

Fox said Schiavo was a victim of medical negligence, but also a victim of

societal pressures to be thin. " She didn't want to go back to where she was

from, " he said. " This was the only way she could do this in her mind and be

able to eat as much as she did. "

Eating disorders have long been known to cause heart failure. According to

the National Eating Disorders Association, the binge-and-purge cycles of

bulimia can lead to chemical imbalances that harm major organs.

Herzog, a Harvard psychology professor and founder of the Harvard

Eating Disorders Center, said medical science is only in the early stages of

tracking the long-term effects of eating disorders and there are no good

statistics on how many people are killed or permanently disabled. Herzog

said that even when someone dies from an eating disorder, medical examiners

often do not list it on the death certificate.

Experts say the serious health risks exist long before a victim looks sick.

In Schiavo's case, Fox said, she was not excessively thin when she went to

the doctor.

Psychologist Doug Bunnell, president of the National Eating Disorders

Association, said while he could not comment on the specifics of the Schiavo

case, it is often impossible to predict which sufferers are in immediate

danger.

" Paint me a picture of an eating disorder - it's an emaciated woman, " he

said. " But that's not the reality. They don't get down that low. The face of

eating disorders is your next-door neighbor's daughter or maybe your own. "