Just heard Nikki Grahame has died

[catherineofarrogance80]

What a week 😭tragic

makes many of us think “god couldn’t they just have force fed to get over this hurdle, give her enough weight to survive” and saved her life

That obviously happened time after time with poor Nikki. It's hard to accept that some conditions/people just can't be cured

We don’t know exactly what help and support she had though. It’s very dangerous to go “you can’t help some people”.

@nannybeach

Who is Nicky Graham?

There's always one

Very sad and such and far too young 🥲

For the people that wonder "why not just tube feed?", she had been tube fed, multiple times I believe, but a) that doesnt address the psychological and emotional trauma and b) it's easily reversible and doesnt educate on a sustainable eating and/or exercise plan.

Think of the all the people that very low calorie diets/cambridge diet etc. They lose a lot of weight very quickly....but lots put it back on (or more) once they stop doing it because it's not sustainable.

That is sad. I remember her now on BB probably towards the end of when I watched it.

I can’t recall if ED was generally known then. But she looked very ill in pics mentioned below. Very sad.

makes many of us think “god couldn’t they just have force fed to get over this hurdle, give her enough weight to survive” and saved her life

Nikki didn’t want this treatment so let’s break down what “force feeding” would have entailed.

She had previously ripped out nasogastric tubes so would have needed sedation for insertion and to keep it in. As people who work in hospitals know, you have to be fairly significantly sedated not to pull a tube out so sedation would need to be quite heavy. A tube pulled out mid feed in a sedated patient can increase the risk of aspiration which can be life-threatening.

Patients who are starved have low resting heart rates, with heart muscle and conduction problems worsened by years of starvation. They are at risk of sudden death, especially when asleep. Sedation would exacerbate that.

People with anorexia who are starved are at risk of something called refeeding syndrome when ng feeds are started. There can be sudden metabolic shifts which can be fatal if done too quickly - feeds need to be increased over days as well as frequent monitoring with blood tests.

It’s simply not feasible or safe to sedate someone that heavily for days and days while the feed tolerance builds up and then for the weeks it would require to actually be effective s for weight gain.

Plus, as soon as she went home the restriction would just start again, as it had many times before

@nolongersurprised

makes many of us think “god couldn’t they just have force fed to get over this hurdle, give her enough weight to survive” and saved her life

Nikki didn’t want this treatment so let’s break down what “force feeding” would have entailed.

She had previously ripped out nasogastric tubes so would have needed sedation for insertion and to keep it in. As people who work in hospitals know, you have to be fairly significantly sedated not to pull a tube out so sedation would need to be quite heavy. A tube pulled out mid feed in a sedated patient can increase the risk of aspiration which can be life-threatening.

Patients who are starved have low resting heart rates, with heart muscle and conduction problems worsened by years of starvation. They are at risk of sudden death, especially when asleep. Sedation would exacerbate that.

People with anorexia who are starved are at risk of something called refeeding syndrome when ng feeds are started. There can be sudden metabolic shifts which can be fatal if done too quickly - feeds need to be increased over days as well as frequent monitoring with blood tests.

It’s simply not feasible or safe to sedate someone that heavily for days and days while the feed tolerance builds up and then for the weeks it would require to actually be effective s for weight gain.

What about restraining her hands? So she can't pull it out. I know it is not a nice thing to do.

But I was watching a documentary about patients admitted into psychiatric hospitals for other issues. Many of them had their hands restrained to stop them from harming themselves.

Those pictures are just haunting, so so sad. Poor girl. I really hope she’s at peace now.

People with anorexia who are starved are at risk of something called refeeding syndrome when ng feeds are started. There can be sudden metabolic shifts which can be fatal if done too quickly - feeds need to be increased over days as well as frequent monitoring with blood tests.

I think this happened with some of those found in prison camps during the Holocaust didn’t it, the American soldiers who found them handed out bread / water and sadly some of them passed away due to the shock to their system

Refeeding syndrome is quite easy to treat. My dd has had it.

I don’t know for definite but let’s be frank here - the poor woman had never lived a healthy life.

It was always going to kill her.

I really feel uncomfortable with that kind of rhetoric.

Mine? I don’t mean that anorexia can never be cured and will always lead to death. Sorry if it sounded like that: totally not the intention.

But in this particular case what I mean is I don’t think a week of forcing her hands down or whatever people think should have happened would have made a difference. She was never well. Even when she was ‘healthy’ she was very very thin by most people’s standards. As her book says she was fragile.

I think this happened with some of those found in prison camps during the Holocaust didn’t it, the American soldiers who found them handed out bread / water and sadly some of them passed away due to the shock to their system

As far as I’m aware, I’m pretty sure that’s how people became aware of it. Happy to be corrected if it predates WW2 though. If definitely happens in anorexic people as well, to be fair, they are probably equally starved.

What about restraining her hands? So she can't pull it out. I know it is not a nice thing to do.

For weeks and weeks though? With the only improvement after that time her weight? And knowing that as soon as she was home the weight would be lost again.

I have no idea how long a mental health section lasts for adults but it seems unlikely one would be granted in someone who didn’t want treatment, over a period of weeks and where there was no realistic chance of meaningful improvement.

This is desperately sad. I agree that she should never have been selected for Big Brother. She was so obviously very vulnerable. And that experience of fleeting fame seems to have played into her already fragile state.

The thing is that physical restraints etc don’t solve the long term issue. It’s no different to saying “why not lock an alcoholic in a room so they can’t drink.

Refeeding syndrome is quite easy to treat. My dd has had it.

But the point is that you can’t rush the feeds. So you can’t give a just few days’ worth of high calorie, high volume feeds to a patient - it’s a big deal.

What about restraining her hands? So she can't pull it out. I know it is not a nice thing to do

It’s really not as simple as just feeding them up, it’s a hugely complex illness. You aren’t addressing the root cause.
In the same way you wouldn’t tell someone with depression to cheer up, fattening someone up isn’t the cure.

I have a relative with a life-long eating disorder. In patient, out patient, years of therapy, she was sectioned once and nearly died. She’s in her early 40s and has osteoporosis. None of it makes a difference. She has an annual check up with GP but keeps just the right side of the lowest weight limit for it and nothing happens.

What about restraining her hands?

Really no, can you imagine how someone would feel about loss of control and what would happen after release?

@SteveArnottsbeadyeyes

The thing is that physical restraints etc don’t solve the long term issue. It’s no different to saying “why not lock an alcoholic in a room so they can’t drink.

Yes I agree, but one could argue that the alcoholic in most instances, is not on the verge of death.

If you are on the verge of death, and are mentally sectioned, I personally think that the person should be physically restrained and force fed for a week.

Even feeding them for a week would save their life.

Anyway this case will bring a lot of awareness to Anorexia, which is good.

@MarshaBradyo

What about restraining her hands?

Really no, can you imagine how someone would feel about loss of control and what would happen after release?

But they physically restrain mental health patients already in the NHS, and they have done for a long time.

But they physically restrain mental health patients already in the NHS, and they have done for a long time.

You really think it would help a person with severe ED?

What are you basing your insight on - do you have knowledge / experience in it

Even feeding them for a week would save their life.

And then what?

Nikki Grahame was sedated and tube fed by the way, multiple times apparently. When she came round from sedation she pulled out her feeding tube, damaging her insides, and resolved to lose any weight she had gained, according to her book.