By Debra Jasper
and Spencer Hunt
Enquirer Columbus Bureau

Hooked to a feeding tube in her bedroom, Erica takes in a mixture of nutrients through her nose. She was hospitalized last month with an ailment that keeps her from eating solid food. (Michael E. Keating photo)

When Erika turned 11, she refused to eat more than a kiwi for lunch.

At 12, she would only chew on a plastic spoon.

At 13, doctors put a feeding tube down her throat to keep her alive. She was 5'5" tall and weighed 85 pounds.

"It was like a stranger had taken over my daughter, like she wasn't even in her own body anymore," says her mom, Linda Groden. "She had been my little tomboy. A natural athlete, a great basketball player. I was terrified by what was happening to her."

Frantic to keep Erika from slowly starving to death, Groden spent her life savings and her children's $50,000 college fund to send the girl into treatment. When the cash ran out last year, she pleaded with Summit County officials to step in and pay for her daughter's care.

They agreed - but only if they could send Erika, then 16, to Parmadale, a Cleveland center where six workers had just been indicted on sex abuse charges.

"They told me, if you don't take our offer, you are dead in the water. We won't offer to help you again," the 44-year-old Akron mom says. "But I said, 'I just can't do that to her. It's not an option.' "

Groden is among thousands of Ohio parents who must decide each year whether to allow their kids to go to troubled treatment centers. She was adamant to keep Erika out of Parmadale in part because her daughter was starting to write poems about her fear of being abused. Groden pulled out one neatly scrawled page, where Erika wrote that she wanted to kill herself or at least stay so skinny she would never again make a man grin.

"Parmadale was on the news at night, and there was all the talk about the worker who had been molesting boys," Groden says. "And I was thinking, 'There's just no way Erika's going there.' "

Bonnie Pitzer, director of Family and Children First of Summit County, an umbrella group of child-care agencies, says officials were aware of Groden's concerns. But they insisted on Parmadale because the county had already paid for a spot.

"We purchase the beds ahead of time," Pitzer explains. "When a child meets the requirements of the unit, that's where the child is going to go, whether it's Linda's daughter or anyone else. Money was certainly an issue. It's always an issue."

She says county officials assured Groden that they were satisfied the problems at Parmadale, a 48-bed treatment center run by Catholic Charities, had been resolved. The center had changed its policies and moved administrators into buildings to keep a closer eye on children.

"We said, 'Look, Parmadale is not unique, this has come up in a lot of agencies,' " Pitzer explains. "This was an unfortunate, horrible thing at Parmadale, but they are not alone."

Groden was too afraid to take the risk. Instead, she applied for a low-interest credit card and ran up $9,500 a month in charges to pay for Erika to move into Bellefaire, a 115-bed Jewish treatment center in Cleveland. The money paid for room and board. Medicaid covered treatment costs.

"What other choice did I have?" says Groden, who earns $20,000 a year working at a nonprofit Jewish social services agency. "This is my daughter we're talking about. I was determined not to let anything happen to her."

When Erika was first hospitalized in 2000, Groden says insurance stopped paying for treatment and her daughter was sent home even though she was dumping liquid from her feeding tube into towels so she wouldn't put on weight.

"She was fed through a syringe and would try to use the syringe to suck the liquid back out. It was that deranged," Groden explains. "You really start to realize then that she's mentally ill. But even though you know it, those are the hardest words to ever come out of a parent's mouth."

At home, Erika also slit her wrists and wrote her initials in blood on her pillow, surrounded by a tombstone and the dates. "She was crying. This was at her most malnourished time," Groden recalls. "She had gone over 100 days without real food."

Eating disorders like Erika's are pervasive in the United States, affecting an estimated 5 million to 10 million girls and women. With Erika, a pattern developed.

Groden paid part of the $20,000 or more a month it cost to send her daughter to treatment centers in three different states. Erika would put on weight, only to come home again and throw up as many as 25 times a day to lose it.

When Groden's last credit card finally maxed out in October, she finally brought Erika home for what she hoped would be the final time.

"I wanted to bring her home earlier, but it would have been impossible to hide everything she could hurt herself with," Groden says. "At Bellefaire, she started doing better, so I hoped she'd be OK."

Instead, Erika was hospitalized on Feb. 5, and doctors think she has a virus that her weakened immune system is struggling to fight. She went home last month, but is still being fed with a tube.

Groden has divided her time between the hospital, her job and fixing up her suburban home so she and her husband, Jerry, can sell it to pay off their debts. They owe more than $23,000 to creditors, and thousands more to relatives.

"We keep on transferring the balance to zero percent credit cards, but you can only go for so long like this," she says. "We'll be paying off these bills until the day I die."

Trying to keep her daughter alive and stave off bankruptcy the past three years has weakened Groden's own health and strained her marriage and her relationship with her son. But it's Erika's health and eating disorder that worries her the most. She has no idea where the money will come from if her daughter needs to go into treatment yet again.

"She's been so sick she can barely stand up, and I don't know what we're going to do," Groden says.

"I keep hoping that some official is going to step up and say, 'There is money here, we're going to spend it to help these children who really need it. But no one ever does."