S05.E16: Where are the now? Brittani and Sean

[okerry]

15 hours ago, MrsClaus said:

Am I the only one wondering what Sean's mom is carrying around in a backpack?  Just me?  Okay.

1. Several pounds of medication.

2. Turkey legs.

3. Her son's manhood.

[okerry]

1 hour ago, Pondlass1 said:

Sean's story reminded me of a TV show I watched years ago.  Same situation.  Overweight teenage boy and doting dangerous mother.  When the boy got help and started losing weight she didn't like it.  She wanted to keep him bedridden and dependent. 'How can one slice of pizza hurt?' she would say holding it out to him.  That's not love.

Oh, yes, that was Billy Robbins, the Half-Ton Teen. I'm almost sure he was a patient of Dr. Now's, too. Would like to see an update on those two. I think the universe would explode if Billy and his mom were ever in the same room with Sean and his mudder.

[Complexity]

20 minutes ago, okerry said:

Billy Robbins, the Half-Ton Teen

I didn't see this, and everywhere I look, I cannot find it (youtube, netflix, hulu, amazon, itunes). Does anyone know how to find this so I can see it? I searched for "half ton teen" and then for "billy robbins." Neither search worked. Is there another name I should try?

[notyrmomma]

17 minutes ago, Complexity said:

I didn't see this, and everywhere I look, I cannot find it (youtube, netflix, hulu, amazon, itunes). Does anyone know how to find this so I can see it? I searched for "half ton teen" and then for "billy robbins." Neither search worked. Is there another name I should try?

BodyShock - Half ton Son part 1https://www.youtube.com/watch?v=jzktJYFkEJ0 I think there are like 5 parts to this series

[bethster2000]

15 hours ago, gonecrackers said:

Dr. Now could've made his point with Sean's mom without the yelling & ego trip. He didn't even yell at Steven that way for abusing hospital staff. I get his annoyance but it really didn't help much except she stopped bothering him about Sean's 'care'.

Of course, we don't have all of the history with Sean and his mother here, but Dr. Now really upset me with his nastiness and yelling.  Yes, the dynamic between Sean and Mom is all shades of fucked up.  On the other hand, Mom had a point...that's her son lying there sick, he has a long history of health problems, and this wasn't her first time at the rodeo.  I think it's a very dangerous thing for a doctor to holler and yell about a person advocating for a loved one in the hospital (or in any healthcare setting).  As smothering as the Mom may be, I would hate to think that Sean would suffer or die because of medical arrogance and a refusal to take a patient's history seriously, no matter what the professional opinions are about the person doing the advocating.

[notyrmomma]

15 minutes ago, bethster2000 said:

Of course, we don't have all of the history with Sean and his mother here, but Dr. Now really upset me with his nastiness and yelling.  Yes, the dynamic between Sean and Mom is all shades of fucked up.  On the other hand, Mom had a point...that's her son lying there sick, he has a long history of health problems, and this wasn't her first time at the rodeo.  I think it's a very dangerous thing for a doctor to holler and yell about a person advocating for a loved one in the hospital (or in any healthcare setting).  As smothering as the Mom may be, I would hate to think that Sean would suffer or die because of medical arrogance and a refusal to take a patient's history seriously, no matter what the professional opinions are about the person doing the advocating.

I said the same thing a couple of pages back.  Dr Now has been consistently belittling his patients about their health concerns.  I was beyond shocked that he let Brittney get her knee surgery.

[Kellyee]

All I could focus on during this episode was how Sean kept getting naked to get into bed. Every single time. With no underwear. With his mother sitting only a few feet away. Sometimes he would wear a hospital gown in the bed in the apartment. Yet we saw him wearing regular clothes. So he had regular clothes that fit him, but he chose to lay in bed naked, covered by just a blanket. So bizarre and disturbing. Like either he himself or his mother was keeping him in an infantile or severely disabled state of being. I agree with whoever up-thread said Adult Protective Services should be involved.

Plus, he's laying in a bed all day when at the very least, he is capable of sitting in a chair, working on the computer or something.

At first I really thought Sean might be developmentally delayed. But then he could do things if he had to. So now I don't really know if he is just emotionally stunted by his mother.

I like Dr. Paradise. I think this is the second time we've seen him? I don't like how Dr. Now deals with his patients. If you think the mother is harming her adult son, Dr. Paradise should be doing the confrontation, not the gastric bypass doctor. I feel like some of Dr. Now's yelling is just drama for the show, which is awful since these people have a real mental illness.

[LeeAnn]

Just watched the first 10 mins of Sean's original episode.  When he was a senior in high school he fell down some steps, twisted his ankle and tore ligaments. He's been n bed ever since. And as has been said already, he also was born with clubbed feet (in the pop ups last night). So you may thank me now for clearing up the original injury so no one else has to go back and watch his mudder trying to clean between his folds and calling him kiddo.  I'm sorry, but that is one weird relationship. It's creepy actually.

[bethster2000]

3 hours ago, notyrmomma said:

I said the same thing a couple of pages back.

Your comment triggered my comment :-)  Great minds, and all that!

The more I think about it, the more turned off I am about Dr. Now.  What the mother was asking about, the lactic acid levels, would have been a very real concern if Sean was running a fever and sliding into sepsis.  Bacteria feed on lactic acid, and bacteria can cause lactic acid buildup to the point of toxicity.  I think the mother has more than a few screws loose, but what she was asking about was valid.  No doctor had better ever yell at me for advocating for my loved ones.  I am invariably polite and respectful to medical professionals, but that's my loved one you are dealing with there.  You better believe I am going to ask as many questions as I want to and give you as much history that I can to make sure loved one gets what they need.

2 hours ago, Kellyee said:

I like Dr. Paradise.

I do, too.

[chopperchopperbell]

I thought Brittani was adorable with her dimples.  What a positive and bubbly person.  Good for her.  I don't understand why her husband is so big.  He should be eating the same foods she is, if for nothing else, to show his support.   He looked over 400-450 lbs to me.

Sean was just a mess.  I agree with the Munchausen by Proxy diagnosis.  I also think Sean has some kind of developmental disability.  I thought at first maybe he was r*******, but then I saw him crocheting the afghan and I thought, maybe not?  Although you would think he would express some sort of interest in the internet or reading or doing something besides crafting.  His soft spoken voice, his perpetual confusion (he doesn't know what a mango is?  He doesn't know how to find out how his mom is doing?) had me suspecting an autism spectrum disorder.  But I don't think it's just his Mom.  I think a normal person would say NO MOM and find a way out of that prison.  I figured sooner or later his mother would no longer be able to care for him, and he would have to learn to survive on his own.  I hope he makes it, because I think the situation is tragic, and Sean looks really depressed.  Who wouldn't be?

Edited April 21, 2017 by chopperchopperbell

[Calicocats]

What is the mom farting in the backpack?  Tacos (per Lupe)

taking the rest to small talk

[xwordfanatik]

On 4/19/2017 at 8:44 PM, Christina said:

Storms knocked my electricity out so I'm just now caught up. I really liked Nikki so if they are showing an update for her, I will watch it, too, further setting back my plan to no longer watch this show. By next year, my resolve will probably dissipate completely. Sigh...

Brittani did great and the only negative comment I have about her process is that she lost just a bit too much weight in her face at the end. Throughout the episode, I thought to myself how pretty she looked since she hadn't become drawn in the face like a lot of the patients of this surgery. She looked ill and she was pretty before that last few pounds. Hopefully, her husband will get on track with her, since this couple really seems to love each other, which I noticed on the original show because it was surrounded by husbands who had sexual fetishes as opposed to actual love for the person they married.

There were several interventions for Sean and his mother before Dr. Now, but I can't remember the details at this moment. There was an article way back when the episode aired. I've never understood why APS wasn't involved, but suspect that they would take a step like calling a nutritionist or a doctor to make it look like they were trying. They clearly both need help, but don't see why or how Dr. Paradise can treat both of them. That doesn't seem right or productive. Hopefully I'm wrong. Sean didn't bother me as much this time as he did in the original episode, so perhaps there is some growth in him, even if it is just maturity based on age.

You are right about the aging showing in the face after weight loss.  It happened to me when I got my weight under control, although I am over 60 now.  For me, it's worth it not to have the knee pain I had before.  I'm happy that I was able to do it without surgery of any kind.  Eat less and move more continues to be my mantra.  

It's unfortunate for overweight/obese people that one can't choose where the weight will fall off first, and that skin may not shrink enough to keep up with it.  I lost close to 100 pounds over one year, and since I was older, my skin is a bit loose in a few areas.  The increased mobility is worth it for me.  When I'm dressed, I think I look good for an old lady :)

[DC Gal in VA]

I really don't have any issue with Dr. Now going off on this woman in particular. She really has her poor, befuddled little old lady routine down pat. I remember from the first episode on Sean when, after she and Sean showed up to his office and Sean had gained 84 pounds in two months, she pulled her confused bullshit on Dr. Now and softly asked "should he be eating more protein?" and some other crap. Dr. Now said with a frustrated tone, but didn't yell, that he had given them a diet and explained everything to both of them. How many countless frustrating and infuriating conversations must he have had with this woman?

If your loved one is literally dying before your eyes, at your own hands no less, then I think you should buckle up and get ready to be yelled at a lot! Obviously Dr. Now gives a damn way more than his own "mudder" about whether or not Sean lives or dies.

My only complaint about Dr. Now as concerns Seanmom--thanks again for that one Toaster Strudel!--is that, as a physician, he is a mandatory reporter and is legally required to report even a mere suspicion of abuse. In this case, he has directly stated that he believes there is Munchausen's By Proxy afoot here so, as many here have already said, APS should be contacted asap.

As for her requesting very specific labs on him, "check his lactic acid levels" and so forth, coming from a normal concerned parent, such requests might not seem to be unreasonable. But coming from Munchausen Mom, well.............. The hair stood up on the back of my neck because she handles all his food so if she indeed has this syndrome, who the Hell knows what she might be putting in mama's "secret" recipe?

Edited April 22, 2017 by DC Gal in VA
To correct typo.

[fonfereksglen]

7 minutes ago, DC Gal in VA said:

I really don't have any issue with Dr. Now going off on this woman in particular. She really has her poor, befuddled little old lady routine down pat. I remember from the first episode on Sean when, after she and Sean showed up to his office and Sean had gained 84 pounds in two months, she pulled her confused bullshit on Dr. Now and softly asked "should he be eating more protein?" and some other crap. Dr. Now said with a frustrated tone, but didn't yell, that he had given them a diet and explained everything to both of them. How many countless frustrating and infuriating conversations must he have had with this woman?

If your loved one is literally dying before your eyes, at your own hands no less, then I think you should buckle up and get ready to be yelled at a lot! Obviously Dr. Now gives a damn way more than his own "mudder" about whether or not Sean lives or dies.

My only complaint about Dr. Now as concerns Seanmom--thanks again for that one Toaster Strudel!--is that, as a physician, he a mandatory reporter and is legally required to report even a mere suspicion of abuse. In this case, he has directly stated that he believes there is Munchausen's By Proxy afoot here so, as many here have already said, APS should be contacted asap.

As for her requesting very specific labs on him, "check his lactic acid levels" and so forth, coming from a normal concerned parent, such requests might not seem to be unreasonable. But coming from Munchausen Mom, well.............. The hair stood up on the back of my neck because she handles all his food so if she indeed has this syndrome, who the Hell knows what she might be putting in mama's "secret" recipe?

Didn't his bloodwork drawn at that visit indicate he was extremely protein deficient?  So mudder was the cause of that  hospitalization  since she controls the food!

[crazycatlady58]

24 minutes ago, DC Gal in VA said:

25 minutes ago, DC Gal in VA said:

I really don't have any issue with Dr. Now going off on this woman in particular. She really has her poor, befuddled little old lady routine down pat. I remember from the first episode on Sean when, after she and Sean showed up to his office and Sean had gained 84 pounds in two months, she pulled her confused bullshit on Dr. Now and softly asked "should he be eating more protein?" and some other crap. Dr. Now said with a frustrated tone, but didn't yell, that he had given them a diet and explained everything to both of them. How many countless frustrating and infuriating conversations must he have had with this woman?

If your loved one is literally dying before your eyes, at your own hands no less, then I think you should buckle up and get ready to be yelled at a lot! Obviously Dr. Now gives a damn way more than his own "mudder" about whether or not Sean lives or dies.

My only complaint about Dr. Now as concerns Seanmom--thanks again for that one Toaster Strudel!--is that, as a physician, he a mandatory reporter and is legally required to report even a mere suspicion of abuse. In this case, he has directly stated that he believes there is Munchausen's By Proxy afoot here so, as many here have already said, APS should be contacted asap.

As for her requesting very specific labs on him, "check his lactic acid levels" and so forth, coming from a normal concerned parent, such requests might not seem to be unreasonable. But coming from Munchausen Mom, well.............. The hair stood up on the back of my neck because she handles all his food so if she indeed has this syndrome, who the Hell knows what she might be putting in mama's "secret" recipe?

And maybe  that is what happened  to Mom, APS was contacted  it was just said she was in the hospital ,  maybe a mental  hospital . 

[auntjess]

7 hours ago, LeeAnn said:

Just watched the first 10 mins of Sean's original episode.  When he was a senior in high school he fell down some steps, twisted his ankle and tore ligaments. He's been n bed ever since. And as has been said already, he also was born with clubbed feet (in the pop ups last night).

Thank you for taking the hit.
So for anyone who knows about this, does it sound at all reasonable that an injury like that would cripple you for life?   Guess Dad was already gone by this time, and she wasn't about to let Sean escape.
 

[Showthyme]

Dr. Now did the right thing by putting Seanmom in her place. Where was her concern when she allowed her son to drop out of school for an injury? She could have tutored him instead of feeding him. As a mother, I would have many conversations with my son before I enabled him to gain all that weight. How can someone watch a loved one gain so much weight that they are confined to their bed just to complain about them not getting the proper standard of care? Some people just like to complain and Seanmom is one of them. She may have complained her way off the show when she disappeared from our screen at the end. 

Sean did sound developmental delayed but it simply could be because he didn't get out and no one required him to know more or do better.

Since I am on the bus to Hell with some of y'all, what is up with all of the morbidly obese enablers and the dirty, cluttered homes? Denial is huge in these families. Pun intended.

[aliya]

2 hours ago, auntjess said:

Thank you for taking the hit.
So for anyone who knows about this, does it sound at all reasonable that an injury like that would cripple you for life?   Guess Dad was already gone by this time, and she wasn't about to let Sean escape.
 

Go back to his original episode. I asked about that and someone provided a medical explanation. Basically, he needed the problem to be looked at at the time. The issue to me was, if your kid is injured like that, wouldn't you move heaven and earth to get him the care he needed? I don't know why she didn't. 

[Pondlass1]

The enablers are just as sick as the bedridden obese.  If I lounged in bed all day yelling for my family to bring me food - I'd die of starvation.  There's something in it for the enablers.  Either welfare or the need to keep the person under control and not leaving or having a life.  A person living alone would have a hard time getting to be 600+ pounds and bedridden.  They could phone for food to be delivered, they could pay for a care-giver... but I doubt it happens ever. This scenario is a two-person deal. The obese and the enabler both getting something out of the deal. 

The by-pass surgery is the focus of this particular show.  But it's such a small part of the recovery. Maybe they should shake up the format for a new season and include  scenes of the obese learning to actually cook a healthy meal and any therapy follow up.  Otherwise it seems kind of an empty journey and we're left wondering if they made it.

There's a British series called Fat Doctor (episodes on YouTube) that's somewhat similar and quite interesting. Not only is the doctor good-looking, he actually has a personality and empathy - two things Dr. Now appears to be missing.  Why they chose him as the focus for the show I'll never know. Lots of doctors out there doing this surgery.  Still, every once in a while he does make me smile.  Like the one time an enabler said 'she gets angry if I don't give her the food she wants' and Dr. Now replied 'What are you scared of? She can't get out of bed and hit you'.

[QueBueno]

15 hours ago, Showthyme said:

Since I am on the bus to Hell with some of y'all, what is up with all of the morbidly obese enablers and the dirty, cluttered homes?

There was a book a few years back that associated cluttered homes with weight gain.  Not sure it was exactly scholarly research, but anecdotally I see the correlation on the Hoarders show.  Maybe a general lack of self-discipline?  (looking around in shame at my own clutter)

[auntjess]

35 minutes ago, QueBueno said:

There was a book a few years back that associated cluttered homes with weight gain.  Not sure it was exactly scholarly research, but anecdotally I see the correlation on the Hoarders show.  Maybe a general lack of self-discipline?  (looking around in shame at my own clutter)

But this isn't always the case, because some of those people, I'm thinking of a Valerie, and some others, are agile by necessity, because of the way they have to navigate through their homes, climbing piles of junk, ducking under the ceilings.

[Hockeymom]

If this has been adressed, forgive me. Where is Sean's dad? 

If I remember correctly, mom and dad divorced. I feel for Sean. He has had this seemingly caring, but secretly manipulative mother controlling his life for so long. Of course, he needs to grab his independence. I just worry about his being alone in the world. I don't think he's savvy enough to navigate without some guidance. I mean, the kid had never seen a Mango! Never been in a supermarket!

Who even knows at this point what his diagnosis really is?  Mom may have pushed for the ADHD drugs. Without her interference, perhaps Dr. Paradise can find out what's going on and get him the correct treatment. 

Sean actually has a sense of humor. When his PCA left him by the candy, Sean was funny with the wry "this isn't fair". 

Maybe dad can have some influence now. He must have some common sense - he left Mommie Dearest!

[KateHearts]

On 4/21/2017 at 1:51 PM, bethster2000 said:

As smothering as the Mom may be, I would hate to think that Sean would suffer or die because of medical arrogance and a refusal to take a patient's history seriously

I think the annoying thing wasn't that Dr. Now wasn't taking his history seriously. He knows Sean's history- he knows the history given that he's been treating Sean and operated on him. It's the demand that he order a specific test that set my alarm bells off as a medical provider. As his mother/family member, she saw signs that he might have a problem; she notified his doctor and he was admitted to the hospital. But to act, as Dr. Now said, as if she was a doctor, was overstepping her boundaries.

22 hours ago, bethster2000 said:

 What the mother was asking about, the lactic acid levels, would have been a very real concern if Sean was running a fever and sliding into sepsis.

Sepsis is kind of the "zebra" in the room in terms of suspicion when a person has a fever.  Most people have febrile illness without becoming septic. An infection (strep throat, etc) can manifest in fever but rarely develops into a life-threatening sepsis (infection that spreads into the bloodstream and threatens life).

[ChristmasJones]

My sense, based on the comments Dr. Now made when he was giving mom her smack-down, was that this incident was one of many, and that he finally blew his lid. I did not get the sense this was the very first time she had acted like that.  JMO

I also thought it was very on-point for him to have the same psychologist work with both of them. Dr. Now accurately determined that he was dealing with a family problem in this case. Given that it is a family problem, it would be far more effective for the therapist to see both of them rather than having two completely different therapists seeing them individually.  Of course, in the real world, when there are two adult family members, each would have to consent to this type of arrangement before participating in it.

Edited April 22, 2017 by ChristmasJones

[Momof2boyz]

On 4/20/2017 at 9:46 PM, Miss Chevious said:

The pop up said Sean was working on getting his GED. What? Did Mommie Dearest pull him out of high school too? What else has she ruined for him?

Yes I recall from the original episode that the falling down the stairs accident happened while he was in high school so he never graduated 

[Ocean Chick]

One of the signs of Munchausen's by Proxy is that the care taker always suggests specific tests/diagnoses, which reinforces in their victims the idea that the care taker knows better than doctors, and also is supposed to make others (doctors, nurses, and the general public) seek care taker's "wisdom" and praise them.  Attention, attention, attention.  Praise, sympathy, adulation.  That's what they crave.

[gardendiva]

I am probably giving away my age here, but there was a 1976 movie with Sally Field called "Sybil", where she played a multiple personality disorder patient. Her mom was a total whackadoo. Sean's mom reminded me of Hattie Dorset, Sybil's mentally ill mother in the movie.

 

[Complexity]

Here is the criteria for Factitious Disorder Imposed on Another (formerly known as Factitious Disorder by Proxy or Munchausen by Proxy) according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5):

• A. Falsification of physical or psychological signs or symptoms, or induction of injury or disease, in another, associated with identified deception.
• B. The individual presents another individual (victim) to others as ill, impaired, or injured.
• C. The deceptive behavior is evident even in the absence of obvious external rewards.
• D. The behavior is not better explained by another mental disorder, such as delusional disorder or another psychotic disorder.

The part about falsification is a key criteria for the diagnosis. Did Sean's mother lie about his fever? Did she lie about his medical history? I didn't see any mentioned of lies or falsification in the show. I think Dr. Now may have the wrong mental health diagnosis for her (maybe because that's not his specialty).

ETA: Merck Manuals: Factitious Disorder Imposed on Another (scroll up on that page for more information about the disorder).

Edited April 23, 2017 by Complexity

[auntjess]

1 hour ago, Complexity said:

or induction of injury or disease

Yes, but I think she induced the injury or disease, but failing to get proper care in a timely manner, and feeding him to the point where he was bed bound.

[Complexity]

33 minutes ago, auntjess said:

Yes, but I think she induced the injury or disease, but failing to get proper care in a timely manner, and feeding him to the point where he was bed bound.

I'm not saying there isn't a mental disorder involved, just that she did not meet the criteria* for Factitious Disorder (aka Munchausen by Proxy).

* Based on the information given by the show.

[Calicocats]

I think she lied about the seriousness of his knee injury.  I've known a bunch of people (paramedics, military people from deployments, athletes, overweight people who have had replacements, etc) who have had different corrective knee surgeries and now can live normal lives.  I find it hard to believe, in this day and age (and he is only 26, so this was only 8-9 years ago) that he injured his knee walking down steps in a way that's unfixable.  

[LeeAnn]

I'm not going to try to diagnose Sean's mom, but just from what aired in his two episodes, this is what we know:

From a senior in high school, at 400 pounds, he gained another 500-600 pounds over the next eight years living with mom.

After his fall, why couldn't he go to school in a wheelchair?   Crutches?  I guarantee no orthopedist would say to keep him bedbound.  Was there more to this story than a fall?   (speculation - was there an issue with Sean's mom and the school?) 

Why didn't mom home-school him or get his assignments or tests to be able to complete his senior year so he would at least have the diploma that most employers want to see.  Or he could have done the GED then.  Why hasn't he in all these years?   Why, Mom??

Why is he on 30 different meds that Dr. Now doesn't believe he needs?  How did he get them?  How does he maintain prescriptions for that many meds without seeing a provider on a regular basis?  How, Mom???

Why did Sean gain 100 pounds over a couple of months after the initial visit with Dr. Now?  I remember Dr.  Now asking her how it happened and she pretended to be clueless.   Let's just say he wasn't given a prescribed diet (unlikely).   What the hell was she feeding that boy?  It wasn't Lean Cuisine, I guarantee you.

Why does Mom think it's always best to bump up his calories?  Really? 

Why does Mom think Sean is pushing himself too much walking from the living room to the bedroom?   Sheeeesh!!!!

Sean wouldn't be at the hospital with Mom directing orders to Dr. Now if not for her continuing to feed Sean.  He's there BECAUSE OF MOM!!!!

So I've repeated things already said by others and left out some, but I'll stop my rant now.

As for Sean, I felt sorry for him this episode.  I hate what she has done to him.  But I don't think it's too late for Sean to be rehabilitated with the right programs and counseling as long as Mom stays away. 

The End.

[Calicocats]

I'm trying to say this as nicely as possible.  I don't think Sean has all the mental abilities that most of us have.  How much of that he was born with, and how much is just stunted development is hard to tell.  But I don't think it would be hard for her to convince him he has a certain medical condition, or "has" to stay in bed, take certain drugs, etc.

She brought him the food and he chose to eat it, can't argue that.  But it was really a poor choice on both of their behalf(s?  Can it be plural?)

[Whyyouneedaname]

I was wondering the same thing about where dad was, & how long he's been gone. Did mom have this obsession with him his whole life and dad just felt ignored. We all know this is not a healthy mom/son relationship.

[Pondlass1]

In the show Half Ton Teen the mother had lost a baby as an infant.  When she had another son she kept him an infant totally dependent, changing his diaper, washing him, feeding him, etc., as a mother would a baby.

There has to be a name for it in the mental health books.

I feel bad for Sean. I don't think he possesses the steely determination to lose all his weight, but I hope he gets to a point where he can at least walk and have some kind of a life.  Life is short and we only get one shot at it.

[Complexity]

54 minutes ago, Pondlass1 said:

In the show Half Ton Teen the mother had lost a baby as an infant.  When she had another son she kept him an infant totally dependent, changing his diaper, washing him, feeding him, etc., as a mother would a baby.

There has to be a name for it in the mental health books.

Fear of losing someone might be considered fear of abandonment. Running a search in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) for "abandon" turned up two personality disorders (among other things): Borderline Personality Disorder and Dependent Personality Disorder. I think the latter is very interesting when considering what we've seen on the show for both Sean and the "Half Ton Teen." However, it is equally interesting to consider the criteria for Dependent Personality Disorder for either of their mothers. Also take note of the section for Child Neglect. There are other areas in the DSM-5 that might apply, but these are the ones that came to my mind first.

Borderline Personality Disorder - Diagnostic Criteria 301.83 (F60.3)

• A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

1. Frantic efforts to avoid real or imagined abandonment. (Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.)
2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
3. Identity disturbance: markedly and persistently unstable self-image or sense of self.
4. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). (Note: Do not include suicidal or selfmutilating behavior covered in Criterion 5.)
5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
6. Affective [emotional] instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
7. Chronic feelings of emptiness.
8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
9. Transient, stress-related paranoid ideation or severe dissociative symptoms.

Dependent Personality Disorder - Diagnostic Criteria 301.6 (F60.7)

• A pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

1. Has difficulty making everyday decisions without an excessive amount of advice and reassurance from others.
2. Needs others to assume responsibility for most major areas of his or her life.
3. Has difficulty expressing disagreement with others because of fear of loss of support or approval. (Note: Do not include realistic fears of retribution.)
4. Has difficulty initiating projects or doing things on his or her own (because of a lack of self-confidence in judgment or abilities rather than a lack of motivation or energy).
5. Goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant.
6. Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for himself or herself.
7. Urgently seeks another relationship as a source of care and support when a close relationship ends.
8. Is unrealistically preoccupied with fears of being left to take care of himself or herself.

Child Maltreatment and Neglect Problems - Child Neglect

• Child neglect is defined as any confirmed or suspected egregious act or omission by a child’s parent or other caregiver that deprives the child of basic age-appropriate needs and thereby results, or has reasonable potential to result, in physical or psychological harm to the child. Child neglect encompasses abandonment; lack of appropriate supervision; failure to attend to necessary emotional or psychological needs; and failure to provide necessary education, medical care, nourishment, shelter, and/or clothing.

Disclaimer: I am not attempting to diagnose anyone on the show as I have not seen any of the people in person or otherwise in a professional capacity. I am merely discussing the criteria for these disorders as specified in the DSM-5.

Edited April 23, 2017 by Complexity

[notyrmomma]

12 hours ago, Complexity said:

Here is the criteria for Factitious Disorder Imposed on Another (formerly known as Factitious Disorder by Proxy or Munchausen by Proxy) according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5):

• A. Falsification of physical or psychological signs or symptoms, or induction of injury or disease, in another, associated with identified deception.
• B. The individual presents another individual (victim) to others as ill, impaired, or injured.
• C. The deceptive behavior is evident even in the absence of obvious external rewards.
• D. The behavior is not better explained by another mental disorder, such as delusional disorder or another psychotic disorder.

The part about falsification is a key criteria for the diagnosis. Did Sean's mother lie about his fever? Did she lie about his medical history? I didn't see any mentioned of lies or falsification in the show. I think Dr. Now may have the wrong mental health diagnosis for her (maybe because that's not his specialty).

ETA: Merck Manuals: Factitious Disorder Imposed on Another (scroll up on that page for more information about the disorder).

I think he was labeling her as Munchausen because she kept consistently feeding him the wrong things - which I agree that loosely, a case could be made for that.  Asking for specific tests, eh, maybe - but it could be because she has gone through this with him many times and that's the specific test they always give him.  I dunno.

I am learning so much about mental illness from this thread!

[gonecrackers]

I would love to hear Dr. Paradise's take on what's going on between Sean & mom, & if he has a specific diagnosis for the mom. He would most likely be the qualified opinion on all of it.

[Complexity]

1 minute ago, gonecrackers said:

I would love to hear Dr. Paradise's take on what's going on between Sean & mom, & if he has a specific diagnosis for the mom. He would most likely be the qualified opinion on all of it.

Me too, but he cannot do it without breaking confidentiality... unless Sean and Mom signed a release of confidentiality. But even if they did, he would be sabotaging his practice since his other patients will have troubles trusting him to keep their information confidential. Confidentiality is paramount for therapy.

[okerry]

13 hours ago, Complexity said:

Falsification of physical or psychological signs or symptoms, or induction of injury or disease, in another, associated with identified deception.

MBP is either lying about someone in your care being sick so you can get attention and sympathy for caring for them - that's usually how it starts - OR actually causing them illness or injury by poisoning them, for example, or starving or horribly overfeeding them, or keeping them from medical care until it's a serious problem. Sean's ankle is a perfect example of that. 

His mother is a sick, sick woman, just like Billy Robbins' mother, and they are both textbook examples of Munchausen's Syndrome by Proxy.

[gonecrackers]

1 hour ago, Complexity said:

Me too, but he cannot do it without breaking confidentiality... unless Sean and Mom signed a release of confidentiality. But even if they did, he would be sabotaging his practice since his other patients will have troubles trusting him to keep their information confidential. Confidentiality is paramount for therapy.

I realize that, but was just saying his opinion would be of the most interest. I don't expect to ever know exactly what is happening though.

[ChristmasJones]

In the comments in Sean's original episode, I said that I believe his mother is very invested in keeping him dependent on her because it gives her a purpose, an accepted social role, and someone to provide companionship.

By remaining the caregiver to a dependent adult child, she doesn't have to do things like make friend with people her own age, or go on dates, or establish her own identity, or face the loneliness she would be feeling due to lacking friends, activities/hobbies,  and/or a partner. She also doesn't have to face her own obesity and how it is impacting her life and health.

When you look at it in terms of what she will gain versus what she will lose, it is clear that Sean remaining obese and dependent is far better for her than him becoming healthy and independent.

Edited April 23, 2017 by ChristmasJones

[okerry]

52 minutes ago, ChristmasJones said:

In the comments in Sean's original episode, I said that I believe his mother is very invested in keeping him dependent on her because it gives her a purpose, an accepted social role, and someone to provide companionship.

By remaining the caregiver to a dependent adult child, she doesn't have to do things like make friend with people her own age, or go on dates, or establish her own identity, or face the loneliness she would be feeling due to lacking friends, activities/hobbies,  and/or a partner. She also doesn't have to face her own obesity and how it is impacting her life and health.

When you look at it in terms of what she will gain versus what she will lose, it is clear that Sean remaining obese and dependent is far better for her than him becoming healthy and independent.

Not to mention the disability checks he gets and the checks she gets for being his caretaker.

[Hockeymom]

5 minutes ago, okerry said:

58 minutes ago, ChristmasJones said:

 

Not to mention the disability checks he gets and the checks she gets for being his caretaker.

And maybe there was some lawsuit from the fall. 

[kgg]

On 4/21/2017 at 1:51 PM, bethster2000 said:

On the other hand, Mom had a point...that's her son lying there sick, he has a long history of health problems, and this wasn't her first time at the rodeo.  I think it's a very dangerous thing for a doctor to holler and yell about a person advocating for a loved one in the hospital (or in any healthcare setting).  As smothering as the Mom may be, I would hate to think that Sean would suffer or die because of medical arrogance and a refusal to take a patient's history seriously, no matter what the professional opinions are about the person doing the advocating.

I think what set Dr. Now off was the fact that his mother was escalating everything and diagnosing him with sepsis.  She labels him as sick, he believes it, and then it sets his progress back.  I'm a doctor, and I've never yelled at a lay family member of a patient for suggesting labs, etc., but I understand his frustration.  I've seen sepsis many, many, many times.  It can start out subtlety and go downhill quickly, so it's important to look for it.  Dr. Now and his team seem to act quickly enough for patients who are ill.  I'm assuming the team who initially evaluated Sean found him to have a normal blood pressure, no fever, no obvious nidus of infection.  His complaints of aching all over make me think he had a viral infection causing some myalgias (the aches and pains we feel when we get sick).  We don't have a timeline from when he was admitted until when Dr. Now saw him, but ideally for those you fear have sepsis, it's important to have fluids and antibiotics going sooner rather than later.  It seems like they did a "rule out," meaning they grabbed blood cultures and started antibiotics pending those blood cultures.

[auntjess]

10 hours ago, LeeAnn said:

Why didn't mom home-school him or get his assignments or tests to be able to complete his senior year so he would at least have the diploma that most employers want to see.  Or he could have done the GED then.  Why hasn't he in all these years?   Why, Mom??

I wonder if she said she'd home school him, then made an excuse that he wasn't up to it.

7 hours ago, Pondlass1 said:

I feel bad for Sean. I don't think he possesses the steely determination to lose all his weight, but I hope he gets to a point where he can at least walk and have some kind of a life.

He seemed to enjoy the grocery store outing, so maybe the more he's able to do, the more he'll strive for.  I hope he can be kept apart from his mother for long enough to realize that she's poison.

[Honey]

On 4/19/2017 at 10:17 PM, aliya said:

I wonder if the store let Sean in barefoot because he was in a wheelchair and wasn't going to walk on the floors. I live in a university town where the Walmart backs up onto cornfields. I'm pretty sure the stuff on the bottom of the farmers' shoes is worse than Sean's bare feet, and they let the farmers in. 

It's not so you won't bring dirt into the store.  It's so you won't step on something and cut your foot.

[Snarkasm]

11 hours ago, ChristmasJones said:

In the comments in Sean's original episode, I said that I believe his mother is very invested in keeping him dependent on her because it gives her a purpose, an accepted social role, and someone to provide companionship.

 

Even if Sean lost most of the weight and was able to get around pretty good, momma doesn't need to worry about some woman swooping in to take away her baby boy.   Ain't gonna happen. 

[Barb23]

Sean needs some friends of his own but I don't see that happening. IIRC, he had at least one in his old home.  Sean was telling him how to move things when they packed up.  He probably had a few high school ones that dwindled away.  He doesn't seem comfortable with anyone so I don't see any new friends in his future. What a shame.  

[Granny58]

because mention had been made of Sean's first episode and I didn't remember it, I watched it last night (on Discovery Life I think).  Anyway, I have a different view of him and her now.  I think he is a big brat, has always been, and she doesn't have Munchausen's but is very weak.  He was a bratty kid who was a handful, daddy yelled at him (wah, wah, wah) and so he ate to comfort himself.  Mom, being weak, gives him whatever he wants.  In fact, I suspect her interaction with Dr. Now (agreeing but not changing) is also due to weakness.