Ah yes...it was a beautiful day. After refusing to get out of bed for school, M worked himself up to a 3 hr mini-rage where he talked to himself and threw a few things in his room. He went on for about an hour about how so-and-so said if he got something for him, he'd be his friend, so he did and then he wasn't his friend and it wasn't fair! and then he'd scream and throw something...then he's start all over with something similar about how somebody said something, he told the teacher and HE got in trouble for something someone else did....over and over he went on like this for an hour! He finally calmed down and came down stairs, got dressed and took a nap on the couch. I woke him to eat lunch before his pdoc appt and he refused lunch. I had to physically drag him out the car for his appt. He raged for an hour in the dr's office where I had to restrain him to keep him there (I have several nail marks and bruises) and then after hiding in the office building for 15 minutes, I found him and we left. Then he wouldn't get in the back seat of the car, he sat in the front seat. I explained that it's against the law for me to drive with him in the front seat and he just stayed strapped in and clung to the seat belt. So, I eventually called 911 for a medical transport. The ambulance came and he started scratching and biting everyone and they had to restrain him because he kept unbuckling the safety belts on the stretcher. The entire 45 minute ride he kept screaming "I'm going to kill you! Let me go, I'm going to kill you mommy! I hate you all, I'm going to KILL YOU!" and other similar statements. When we arrived at the hospital, we were greeted by 4 security officers and it took 6 or 7 people to strap him down to the bed in the ER. Then, it took 2 shots of Ativan (they were about to give him a 3rd shot) and about 4-5 hours for him to calm down. They ended up re-admitting him.
This time around he has a new Social Worker and new Psychiatrist assigned to him, so he has a new set of eyes, which is good. Third time's a charm, right?
Thursday, May 31, 2007
First day of School- Off to a Good Start (note: sarcasm)
I never received a crucial phone call I was supposed to get from the BOE regarding the bus p/u time or the back-up plan should M refuse to go to school, so I planned my morning as best I could with little to no information. I set the alarm for 7:10 am, hoping that would give me enough time to get M up, out of bed, and ready before the bus showed up...IF he would even go.
Unfortunately, M's grandmother (my mother) had made a deal with M...a bribe if you will, that if he was "FEELING BETTER" (crucial words) and went to school today, she'd allow him to sleep over Saturday night and they'd go to Chuck E Cheese's. Without being aware of it (though I was fully aware the moment she said it), she gave M and instant out, and he knew it as he smiled and promised to go to school today, while in the back of his head he was saying, "if I'm feeling better."
Of course, low and behold, M is still feeling "sick" this morning and can not go to school. Big surprise. He's also refusing to take his meds, which is only going to make him sicker and more oppositional. So, he's laying in his bed screaming and working himself up to a rage. The only Seroquel he's had in over 36 hrs is his 100 mg dose last night.
We have a pdoc appt scheduled for 2:45 pm today. It should be fun trying to get M dressed and out the door to that after missing school, raging, and off his meds! And with our 3 yr old in tow nonetheless! Grant me the serenity...
Unfortunately, M's grandmother (my mother) had made a deal with M...a bribe if you will, that if he was "FEELING BETTER" (crucial words) and went to school today, she'd allow him to sleep over Saturday night and they'd go to Chuck E Cheese's. Without being aware of it (though I was fully aware the moment she said it), she gave M and instant out, and he knew it as he smiled and promised to go to school today, while in the back of his head he was saying, "if I'm feeling better."
Of course, low and behold, M is still feeling "sick" this morning and can not go to school. Big surprise. He's also refusing to take his meds, which is only going to make him sicker and more oppositional. So, he's laying in his bed screaming and working himself up to a rage. The only Seroquel he's had in over 36 hrs is his 100 mg dose last night.
We have a pdoc appt scheduled for 2:45 pm today. It should be fun trying to get M dressed and out the door to that after missing school, raging, and off his meds! And with our 3 yr old in tow nonetheless! Grant me the serenity...
Wednesday, May 30, 2007
Withdrawl?
So the plan to deal with the Urinary Retention was to take M off of the Seroquel for 24 hrs and then resume his original dose of 200 mg a day. Last night, M got only his Stattera and NO Seroquel (I had already titrated him down to 300 mg a day from the 400 mg). Early in the morning he woke us up saying he felt sick and we told him to bring a trash can to bed. Since then he's been vomiting all day long.
Withdrawal from going off Seroquel cold turkey? Stomach upset from being on Strattera alone? Combo of both? Either way, he can't keep ANYTHING down.
We resumed his 100 mg pills of Seroquel at 8 pm and since, no vomiting! We did hold off on the Strattera, initially, just to get one pill down at a time and accidentally forgot to give it to him before he fell asleep for the night.
Withdrawal from going off Seroquel cold turkey? Stomach upset from being on Strattera alone? Combo of both? Either way, he can't keep ANYTHING down.
We resumed his 100 mg pills of Seroquel at 8 pm and since, no vomiting! We did hold off on the Strattera, initially, just to get one pill down at a time and accidentally forgot to give it to him before he fell asleep for the night.
Monday, May 28, 2007
PPT & Can't Pee
Lovely.
We had our PPT meeting at the new school on Friday. It seems really nice. The principal and all of the staff all go by first names which seems really nice. The classes max out at 8 students and all students are at grade level or above. Surprisingly, M made it through without Melting down, though he did shutdown for a good portion of the meeting. I think our saving grace was that it apparently never dawned on him that he was going to be going there. He thought we were only "looking" at the school...he was not clear that it was more of a sure thing...he still thinks/thought he was going back to his other school.
After the PPT, we decided to spend the afternoon at a local amusement park. It was there that we found out that M is having trouble urinating. The entire time he did not pee once. On the way home, I checked online on my phone to see the side effects lists of the Seroquel and Strattera to see if difficulty urinating was on either drug list and once we were at home I called the pediatrician's office for advice. They said if he didn't pee after a warm bath, to take him to the ER. After a warm bath, he finally was able to pass some urine, so we didn't take him.
Saturday afternoon, the difficulty reared it's ugly head again and by Saturday night M complained it was painful to pee when the flow of urine started. So, on Sunday morning I placed a call to the Psychiatrist. When I didn't hear back from the Psych by the afternoon, I took M to the ER. The ER was of NO HELP at all. They just dipped the few drops he was able to grunt out over the course of the few hours we were there (literally drops!) for a UTI and it came up clean, they scanned his belly to measure the amount of urine he was storing, said it wasn't either med causing it (yeah right!), and sent us home. :::sigh:::
Today M says it hurts MORE when he pees, he seems to be having more trouble, and yes folks, if you read my other post, he's far more irritable, as we have no basis for our now 1+hour long meltdown. And, still no return call from the psychiatrist for his input on if it's a result of the increase in the Seroquel or if it's the Strattera finally reaching it's peak in his body (difficult urination is listed as a "serious side effect" for Strattera...I'm just not clear if it could take 4 weeks to get that side effect).
So...looks like I'll be making it up as I go along tonight...I'll probably titrate down the Seroquel to 300 mg a day and see if that helps. 150 mg x 2 If the psychiatrist isn't going to call me back, he's just going to have to deal with my decision.
We had our PPT meeting at the new school on Friday. It seems really nice. The principal and all of the staff all go by first names which seems really nice. The classes max out at 8 students and all students are at grade level or above. Surprisingly, M made it through without Melting down, though he did shutdown for a good portion of the meeting. I think our saving grace was that it apparently never dawned on him that he was going to be going there. He thought we were only "looking" at the school...he was not clear that it was more of a sure thing...he still thinks/thought he was going back to his other school.
After the PPT, we decided to spend the afternoon at a local amusement park. It was there that we found out that M is having trouble urinating. The entire time he did not pee once. On the way home, I checked online on my phone to see the side effects lists of the Seroquel and Strattera to see if difficulty urinating was on either drug list and once we were at home I called the pediatrician's office for advice. They said if he didn't pee after a warm bath, to take him to the ER. After a warm bath, he finally was able to pass some urine, so we didn't take him.
Saturday afternoon, the difficulty reared it's ugly head again and by Saturday night M complained it was painful to pee when the flow of urine started. So, on Sunday morning I placed a call to the Psychiatrist. When I didn't hear back from the Psych by the afternoon, I took M to the ER. The ER was of NO HELP at all. They just dipped the few drops he was able to grunt out over the course of the few hours we were there (literally drops!) for a UTI and it came up clean, they scanned his belly to measure the amount of urine he was storing, said it wasn't either med causing it (yeah right!), and sent us home. :::sigh:::
Today M says it hurts MORE when he pees, he seems to be having more trouble, and yes folks, if you read my other post, he's far more irritable, as we have no basis for our now 1+hour long meltdown. And, still no return call from the psychiatrist for his input on if it's a result of the increase in the Seroquel or if it's the Strattera finally reaching it's peak in his body (difficult urination is listed as a "serious side effect" for Strattera...I'm just not clear if it could take 4 weeks to get that side effect).
So...looks like I'll be making it up as I go along tonight...I'll probably titrate down the Seroquel to 300 mg a day and see if that helps. 150 mg x 2 If the psychiatrist isn't going to call me back, he's just going to have to deal with my decision.
Who knew today would be like this?
It stared simple enough...we had plans to attend a Memorial Day cookout at a friends house. M was up for it...even asked if there would be watermelon there and we said we'd bring some. Then when it came time to go, he didn't want to put his clothes on. I even had already picked out his clothes for him and brought them up and put them on the couch for him an hour earlier. Life had gone his way today...he got his earned Harry Potter computer game this morning, he got to play messy Moon Sand and get it all over the dining room (I cringe in the inside), and yes there would be watermelon to eat at the cookout! Why wouldn't he want to go? I even told him he could go in his pajamas if he wanted to! Segway into MELTDOWN.
M proceeded to start shoving the dining room table towards the fish tank and after I blocked the path, dh brought him up to his room when he wouldn't stop and be safe. From there, he went into TOTAL MELTDOWN, of which I have yet to survey the damage, but from the sounds of it, collateral damage is pretty substantial. He was chanting phrases such as "I have my life" "It's not fair" and "Everybody hates me so I hate everybody!" Wow. Where did THAT come from? All we did was offer to take him to a cookout! Now he's in the living room with me chanting "NO ONE GIVES ME A CHANCE!" A chance to do what, he refuses to elaborate. I'm totally clueless as to where this is coming from. There's nothing this child didn't get, nothing we took away from him, no "chances" he wasn't given...so apparently he's somewhere else in his head than we are in body.
Apparently the increased dose of Seroquel isn't doing much for us, because this came WAY out of left field. While our other meltdowns last week were well provoked by new events and anxiety caused by them, I can't find basis for this. None at all.
M proceeded to start shoving the dining room table towards the fish tank and after I blocked the path, dh brought him up to his room when he wouldn't stop and be safe. From there, he went into TOTAL MELTDOWN, of which I have yet to survey the damage, but from the sounds of it, collateral damage is pretty substantial. He was chanting phrases such as "I have my life" "It's not fair" and "Everybody hates me so I hate everybody!" Wow. Where did THAT come from? All we did was offer to take him to a cookout! Now he's in the living room with me chanting "NO ONE GIVES ME A CHANCE!" A chance to do what, he refuses to elaborate. I'm totally clueless as to where this is coming from. There's nothing this child didn't get, nothing we took away from him, no "chances" he wasn't given...so apparently he's somewhere else in his head than we are in body.
Apparently the increased dose of Seroquel isn't doing much for us, because this came WAY out of left field. While our other meltdowns last week were well provoked by new events and anxiety caused by them, I can't find basis for this. None at all.
Thursday, May 24, 2007
First Psychiatrist Appt Post-Discharge
Now that was fun. M's anxiety was in high gear and I had to bribe him out of the door with the reward of two marbles for his marble jar and eating inside McDonalds if he went without a fight. So, out the door we went. By the time we got there, he was shutting down and refused to get out of the van. I had to physically drag/push him to the Dr's office. Once in the office, he hid behind some chairs, then proceeded to try to escape the office, where he eventually did run down the hallway and I had to chase after him and bring him back and baracade the door with my body. Eventually he gave up and hid under some chairs, after which the receptionist had me sit in another room and M stayed under the chairs.
The Dr started our appt an HOUR LATE which is always wonderful when you have an unstable child. By this point, M was tipping the chairs over in the waiting room which started to make the receptionist nervous that he would hurt the other patients. I think this Dr is leaning towards BiPolar...just my guess.
He wants to discontinue the Strattera, but because M's rages have been less frequent, more manageable, and more redirectable, I asked that he remain on it. The Dr said we could leave him on it for another week. Because of the degree of meltdown he witnessed in the waiting room, he decided to raise the dose of Seroquel from 200 mg to 400 mg. We're starting that tonight.
After the appt was over, M bolted down the hallway and hid in the office building for about 10 minutes until I found him. Fun.
The Dr started our appt an HOUR LATE which is always wonderful when you have an unstable child. By this point, M was tipping the chairs over in the waiting room which started to make the receptionist nervous that he would hurt the other patients. I think this Dr is leaning towards BiPolar...just my guess.
He wants to discontinue the Strattera, but because M's rages have been less frequent, more manageable, and more redirectable, I asked that he remain on it. The Dr said we could leave him on it for another week. Because of the degree of meltdown he witnessed in the waiting room, he decided to raise the dose of Seroquel from 200 mg to 400 mg. We're starting that tonight.
After the appt was over, M bolted down the hallway and hid in the office building for about 10 minutes until I found him. Fun.
Tuesday, May 22, 2007
Ah, Just Like The Old Days!
Just took 2 weeks.
I've dialed "9, 1...." but couldn't convince myself to dial the last 1 yet. The day is young, however. I *really* don't want to go for phosp admit #3. I told him he was starting the Day Program tomorrow afternoon in the nicest, calmest, yet most happy, enthusiastic way I could and he LOST IT! He went into TOTAL RAGE and started kicking the wall, throwing things across the room, he smashed one of C's die cast metal cars (the roof the car is now smashed in), he broke one of the rungs on the staircase, he smashed his glass gumball machine lava-lamp-type-thing, he broke part of his desk chair, and he completely emptied out his toy box all over the floor. I had to tell C to lock himself in his bedroom to stay safe during the whole escapade, which is partly why I started dialing the phone. He calmed for a while, but now that C is sleeping (and safe), I told M he couldn't have a friend visit right now and he's in the process of dismantling my sectional in the livingroom....I heard a snap...I fear he may have broken my $2,000+ leather couch.
Update:
The raging continued for approx. 4 hours - 4 1/2 hours. He finally calmed down and played outside with us. It's been an exhausting day with a lot of collatoral damage. I spoke with the coordinator of the Extended Day Program and she said I can let her know up until 2 pm tomorrow if M will not be attending tomorrow, as they won't drag him on the van and *make* him go. If he wakes up and starts raging again, I'm afraid I won't have a choice but to keep him home...which is what I anticipate happening. He is so overly anxious and refusing to attend "Program" that I think we're going to end up back at square one with no Dr, no support system, no nothing. So first thing in the morning I am calling to make an appt with a psychiatrist to make up for that gap, that loss, and get that support system in place.
M doesn't know it yet, but he is being outplaced to an alternative school. Ever since his refusal to go to school last Thursday, his school decided it's in his best interest to outplace him. Luckily, there is room in what we're told is a wonderful school and our PPT is scheduled for Friday at 9:30 am...the trick will just be getting M there without incident and subsequently getting him to the new school after that.
Quite the long road ahead of us.
I've dialed "9, 1...." but couldn't convince myself to dial the last 1 yet. The day is young, however. I *really* don't want to go for phosp admit #3. I told him he was starting the Day Program tomorrow afternoon in the nicest, calmest, yet most happy, enthusiastic way I could and he LOST IT! He went into TOTAL RAGE and started kicking the wall, throwing things across the room, he smashed one of C's die cast metal cars (the roof the car is now smashed in), he broke one of the rungs on the staircase, he smashed his glass gumball machine lava-lamp-type-thing, he broke part of his desk chair, and he completely emptied out his toy box all over the floor. I had to tell C to lock himself in his bedroom to stay safe during the whole escapade, which is partly why I started dialing the phone. He calmed for a while, but now that C is sleeping (and safe), I told M he couldn't have a friend visit right now and he's in the process of dismantling my sectional in the livingroom....I heard a snap...I fear he may have broken my $2,000+ leather couch.
Update:
The raging continued for approx. 4 hours - 4 1/2 hours. He finally calmed down and played outside with us. It's been an exhausting day with a lot of collatoral damage. I spoke with the coordinator of the Extended Day Program and she said I can let her know up until 2 pm tomorrow if M will not be attending tomorrow, as they won't drag him on the van and *make* him go. If he wakes up and starts raging again, I'm afraid I won't have a choice but to keep him home...which is what I anticipate happening. He is so overly anxious and refusing to attend "Program" that I think we're going to end up back at square one with no Dr, no support system, no nothing. So first thing in the morning I am calling to make an appt with a psychiatrist to make up for that gap, that loss, and get that support system in place.
M doesn't know it yet, but he is being outplaced to an alternative school. Ever since his refusal to go to school last Thursday, his school decided it's in his best interest to outplace him. Luckily, there is room in what we're told is a wonderful school and our PPT is scheduled for Friday at 9:30 am...the trick will just be getting M there without incident and subsequently getting him to the new school after that.
Quite the long road ahead of us.
Thursday, May 17, 2007
Let the fun begin...School Day 3
Well, Monday was M's first day back to school. Most of it spent on a field trip. Easy enough.
Tuesday he was out for our in-take meeting at the Day Program. Mild, mild meltdown there.
Wednesday was M's first "work" day back at school with a substitute. M reported that it was a good day and he couldn't remember getting any "warnings" from the teacher! :) The rest of the day/evening was spent with my parents, as I was out of town for work.
Today, Thursday, has been interesting. I was woken up by M's loud voice billowing through the house as he played Monopoly at 7-something in the morning, much more hyped up than "normal." There was definately more intensity in his voice, so I could tell it was going to be a fun day. My first thought was, "Oh gosh! Did he not take his meds last night?" According to him, he did. I had DH give him his morning meds about 1/2 hr early so they'd have time to kick in before school.
The rest of the morning continued without incident...he got dressed, ate breakfast....even did his homework that he neglected to do the night before! Then, when it came time to leave, all of a sudden he keeled over on the couch and was "too tired." I put his shoes on him, lifted him up and carried him to the door, got his backpack on him, and got him all the way out on the deck, but that's as far as we ever made it. I wasn't going to force the issue and risk a major meltdown at school and have to risk another ambulance transport. So, as he stood on the deck, I laid his choices out before him..."either go up to your room and sleep and stay in your room until your school day ends at 12:30 pm (he's on a half day schedule right now) OR get in the van and we'll go to school and you are welcome to visit the nurse or Mrs. T at any time to take a break, sit in a bean bag chair, or take a nap. Those are your choices." He was upset and frustrated and he lightly punched the house a few times and stomped the deck, so I walked away and told him to let me know when he made his decision. He eventually choose to go to bed after I said that if he went to his room and slept and stayed there until 12:30 with NO ARGUMENTS, that I would still allow him to go to his friends house this afternoon. To me, I see a sick child before me and I have no reason to further prevoke him and make him sicker. School consequences will be dolled out on school time. After school is family and friend time.
I'm curious if M is really napping. The last day he was in a mood and napped, he woke up in just as bad a mood if not worse. It will be interesting to see what the rest of the day brings.
Tuesday he was out for our in-take meeting at the Day Program. Mild, mild meltdown there.
Wednesday was M's first "work" day back at school with a substitute. M reported that it was a good day and he couldn't remember getting any "warnings" from the teacher! :) The rest of the day/evening was spent with my parents, as I was out of town for work.
Today, Thursday, has been interesting. I was woken up by M's loud voice billowing through the house as he played Monopoly at 7-something in the morning, much more hyped up than "normal." There was definately more intensity in his voice, so I could tell it was going to be a fun day. My first thought was, "Oh gosh! Did he not take his meds last night?" According to him, he did. I had DH give him his morning meds about 1/2 hr early so they'd have time to kick in before school.
The rest of the morning continued without incident...he got dressed, ate breakfast....even did his homework that he neglected to do the night before! Then, when it came time to leave, all of a sudden he keeled over on the couch and was "too tired." I put his shoes on him, lifted him up and carried him to the door, got his backpack on him, and got him all the way out on the deck, but that's as far as we ever made it. I wasn't going to force the issue and risk a major meltdown at school and have to risk another ambulance transport. So, as he stood on the deck, I laid his choices out before him..."either go up to your room and sleep and stay in your room until your school day ends at 12:30 pm (he's on a half day schedule right now) OR get in the van and we'll go to school and you are welcome to visit the nurse or Mrs. T at any time to take a break, sit in a bean bag chair, or take a nap. Those are your choices." He was upset and frustrated and he lightly punched the house a few times and stomped the deck, so I walked away and told him to let me know when he made his decision. He eventually choose to go to bed after I said that if he went to his room and slept and stayed there until 12:30 with NO ARGUMENTS, that I would still allow him to go to his friends house this afternoon. To me, I see a sick child before me and I have no reason to further prevoke him and make him sicker. School consequences will be dolled out on school time. After school is family and friend time.
I'm curious if M is really napping. The last day he was in a mood and napped, he woke up in just as bad a mood if not worse. It will be interesting to see what the rest of the day brings.
Tuesday, May 15, 2007
Our In-Take Meeting for the Day Program...
I don't know if it's my gut feeling, my own anxiety, or me feeding off gfg's anxiety, but I just don't feel 100% comfortable with the Day Program M will be attending. We were originally given the paperwork for the place a little over a month ago from the Day Hospital M was attending BEFORE his re-admit to the phosp as an option for his "next step" when leaving the day hospital. Reading the paperwork felt overwhelming to me and their point system sounded very strict and of little reward. I don't know...it could be just me. So, I've just felt uneasy about this place from the begining.
Today was our in-take meeting and we went through the whole process...the guy who did our in-take was nice and easy to talk to and then he asked me for what goals I would like M to work on while at the Program and he kept bringing up the Oppositional behavior. I just couldn't get the impression out of my head that they expect M to be able to comply with rules and regs when he may not be able to. Like that they're SO "Basket A" it could destroy him. Again, it could just be me...it could be all in my head, but my stomach was in knots and my heart was in my throat and I felt like I was going to burst out crying at any moment! I just kept brining up goals like coping skills and recognizing meltdowns before they happen and reducing isolation...and I explained how M gets "stuck" and I don't want this to be a negative experience for him and I don't want him to dread coming here...I guess I was just trying to make myself feel better.
Then, it came time to leave and M was so anxious and upset about the whole Program thing (he *SO* does not want to go) that he wouldn't get out of his seat to leave...intead he bunched up his body and was hitting his head. I tried to nicely talk to him...bribe him with McDonalds...bribe him with the reminder that his grandfather was at home...nothing worked...so the guy doing our intake said, "Where did you park?" and I pointed to the side of the tiny building...and for some strange reason, he said, "Well, why don't you pull your car around to the other side?" I said, OK figuring there must be a door closer to his office and he must be thinking we can just carry M out....this tiny little building has about 10 doors...all unmarked and all apparently locked because when we got there, we had no idea where to go and couldn't get in! So, I go out, move my car, and figure this guy is going to meet me at the locked door I came in at to let me back in to get M...he doesn't! I'm locked out of the building and my upset child is inside! I knock on the door...nobody comes. I walk around the building to see if there's a marked "entrance" door....nope. I go back to the locked door and knock again....no one comes. I go back to my car...HIS OFFICE WINDOW IS RIGHT BY WHERE MY CAR IS....I'm thinking I KNOW HE CAN SEE ME....no doors open...the blinds don't part...he says nothing through the window. In fact, when I start to walk towards the window so I can yell to him, the window shuts. I heard the a/c turn on too...probably a coincidence...at least that's what I'm telling myself. He couldn't have seen me coming and shut the window on purpose. I grab my cell phone and call his office....he doesn't pick up...it goes to voice mail. I have no idea what's going on inside that office with my son. I have no idea how severe the meltdown has gotten. I have no idea what this "stranger" is doing. I can not get into the building. I called my husband who is 3 states away on business choking back tears to tell him "I don't like this place!" and DH says he's in a meeting and can't really talk, he'll have to call me back. I have no choice but to sit in my car and stare at the mans office window. FINALLY, and I have no idea how much time passed, he opens a window and tells me that M is "still in here" and I can finally say, "I CAN'T GET BACK INTO THE BUILDING!" and he tells me where to go.
I swear I was going to have a nervous breakdown. Even thinking back about it I am on the verge of tears. I probably sound like a lunatic! Yes...the door he directed me to....yup...it was unlocked. It was on the backside of the building, unmarked...one of the 10 doors...how the heck was I supposed to know?
Today was our in-take meeting and we went through the whole process...the guy who did our in-take was nice and easy to talk to and then he asked me for what goals I would like M to work on while at the Program and he kept bringing up the Oppositional behavior. I just couldn't get the impression out of my head that they expect M to be able to comply with rules and regs when he may not be able to. Like that they're SO "Basket A" it could destroy him. Again, it could just be me...it could be all in my head, but my stomach was in knots and my heart was in my throat and I felt like I was going to burst out crying at any moment! I just kept brining up goals like coping skills and recognizing meltdowns before they happen and reducing isolation...and I explained how M gets "stuck" and I don't want this to be a negative experience for him and I don't want him to dread coming here...I guess I was just trying to make myself feel better.
Then, it came time to leave and M was so anxious and upset about the whole Program thing (he *SO* does not want to go) that he wouldn't get out of his seat to leave...intead he bunched up his body and was hitting his head. I tried to nicely talk to him...bribe him with McDonalds...bribe him with the reminder that his grandfather was at home...nothing worked...so the guy doing our intake said, "Where did you park?" and I pointed to the side of the tiny building...and for some strange reason, he said, "Well, why don't you pull your car around to the other side?" I said, OK figuring there must be a door closer to his office and he must be thinking we can just carry M out....this tiny little building has about 10 doors...all unmarked and all apparently locked because when we got there, we had no idea where to go and couldn't get in! So, I go out, move my car, and figure this guy is going to meet me at the locked door I came in at to let me back in to get M...he doesn't! I'm locked out of the building and my upset child is inside! I knock on the door...nobody comes. I walk around the building to see if there's a marked "entrance" door....nope. I go back to the locked door and knock again....no one comes. I go back to my car...HIS OFFICE WINDOW IS RIGHT BY WHERE MY CAR IS....I'm thinking I KNOW HE CAN SEE ME....no doors open...the blinds don't part...he says nothing through the window. In fact, when I start to walk towards the window so I can yell to him, the window shuts. I heard the a/c turn on too...probably a coincidence...at least that's what I'm telling myself. He couldn't have seen me coming and shut the window on purpose. I grab my cell phone and call his office....he doesn't pick up...it goes to voice mail. I have no idea what's going on inside that office with my son. I have no idea how severe the meltdown has gotten. I have no idea what this "stranger" is doing. I can not get into the building. I called my husband who is 3 states away on business choking back tears to tell him "I don't like this place!" and DH says he's in a meeting and can't really talk, he'll have to call me back. I have no choice but to sit in my car and stare at the mans office window. FINALLY, and I have no idea how much time passed, he opens a window and tells me that M is "still in here" and I can finally say, "I CAN'T GET BACK INTO THE BUILDING!" and he tells me where to go.
I swear I was going to have a nervous breakdown. Even thinking back about it I am on the verge of tears. I probably sound like a lunatic! Yes...the door he directed me to....yup...it was unlocked. It was on the backside of the building, unmarked...one of the 10 doors...how the heck was I supposed to know?
Monday, May 14, 2007
Sad, Worries, Anxiety High...
Today was M's first day back at school, albeit a short one. I joined him on his field trip to my old high school's planetarium for a 1 1/2 hr presentation (how bad is my memory that I didn't even remember my school HAD a planetarium?). He begged me to stay at school and join him for lunch, but I declined. He is one a half day schedule at the moment, which he is a little anxious/upset/stressed about because he believes he is missing out on "fun" stuff like gym class, computers, and "fun work." I've tried explaining that the shortened day is to give him an easier time going back to school, but he can only focus on what he's missing.
He spent the late afternoon and evening at my parents so I could work on a presentation for work. He did NOT do his homework, in fact at this point he's not sure where he left it. He's not going to school tomorrow, since tomorrow is our in-take at the day program, so we'll worry about finding it tomorrow.
Speaking of the day program, his anxiety is very high over that! He started to go into meltdown mode this evening, refusing to take a bath/shower and almost refusing to take his meds. I got him to take his meds, which took priority over bathing, and I let the bath slide. We watched Deal or No Deal and he went to bed with no further argument. The kid is just stressed to the max over our in-take meeting tomorrow.
On a side note, I was thinking tonight about how the psychiatrist at the hospital was thinking of adding Lithium to M's meds, which can only mean she was thinking M is BiPolar (BP). During M's first admit in March, I had a phone conversation with her (Dr) and discussed my concern that M might be BP and she seemed surprised. I find it interesting how she came to what seems like a similar conclusion, yet refrained from speaking it out loud.
With that said, on the Seroquel, I haven't seen M really have any "highs." It seems to be keeping the manic episodes at bay and his rages seem, so far and knock on wood, to be more redirectable. I suppose this also could be due to the introduction of the Strattera...I'm not really sure the importance that plays in all of this. But, on the same token, M does seem more "low" than normal. I never would have described M as depressed. Could he RAGE? Oh heck yes! Chronically irritable? For sure! But sad? No. But, the past few days, M seems sad. Gonna have to keep an eye on that.
He spent the late afternoon and evening at my parents so I could work on a presentation for work. He did NOT do his homework, in fact at this point he's not sure where he left it. He's not going to school tomorrow, since tomorrow is our in-take at the day program, so we'll worry about finding it tomorrow.
Speaking of the day program, his anxiety is very high over that! He started to go into meltdown mode this evening, refusing to take a bath/shower and almost refusing to take his meds. I got him to take his meds, which took priority over bathing, and I let the bath slide. We watched Deal or No Deal and he went to bed with no further argument. The kid is just stressed to the max over our in-take meeting tomorrow.
On a side note, I was thinking tonight about how the psychiatrist at the hospital was thinking of adding Lithium to M's meds, which can only mean she was thinking M is BiPolar (BP). During M's first admit in March, I had a phone conversation with her (Dr) and discussed my concern that M might be BP and she seemed surprised. I find it interesting how she came to what seems like a similar conclusion, yet refrained from speaking it out loud.
With that said, on the Seroquel, I haven't seen M really have any "highs." It seems to be keeping the manic episodes at bay and his rages seem, so far and knock on wood, to be more redirectable. I suppose this also could be due to the introduction of the Strattera...I'm not really sure the importance that plays in all of this. But, on the same token, M does seem more "low" than normal. I never would have described M as depressed. Could he RAGE? Oh heck yes! Chronically irritable? For sure! But sad? No. But, the past few days, M seems sad. Gonna have to keep an eye on that.
Meds we've tried so far
Risperdal- made him very sleepy, yet very compliant. Caused a vocal tic & raised his prolactin levels. Blurred vision. Trialed during first phosp admit March 07.
Zyprexa- had little effect, started on very low dose when discharged from first phosp March 07. Raised dose up to 2.5 mg twice a day. Still saw no marked effect. Added Adderall XR.
Adderall XR- 5 mg had no effect OR made things worse. Zyprexa was titrated down at same time to 2.5 mg at night only. M started saying he could "See the Future" via visual hallucinations that were described to be like photographs when he blinked and during a rage one night made suicidal comments. Within 6 days he was back in the phosp! Can you believe they KEPT him on the Adderall for another week before discontinuing it?!?
Current Meds since last phosp discharge:
50 mg Strattera & 200 mg Seroquel Watching with our breath held as normal daily stresses re-enter his life post-phosp discharge. *So far* rages seem a little more redirectable. He does, however, seem a little more obsessive about wanting ("NEEDING") things. Ever since he came home he's NEEDED several material things and it was actually these needs that triggered his meltdowns yesterday. I'm unclear as to whether I can honestly say the obsessions are worse/more intense than before or if they just feel that way to me because he just came home and has been gone for so long, but I'm leaning towards worse.
Ah the joys of parenting!
Zyprexa- had little effect, started on very low dose when discharged from first phosp March 07. Raised dose up to 2.5 mg twice a day. Still saw no marked effect. Added Adderall XR.
Adderall XR- 5 mg had no effect OR made things worse. Zyprexa was titrated down at same time to 2.5 mg at night only. M started saying he could "See the Future" via visual hallucinations that were described to be like photographs when he blinked and during a rage one night made suicidal comments. Within 6 days he was back in the phosp! Can you believe they KEPT him on the Adderall for another week before discontinuing it?!?
Current Meds since last phosp discharge:
50 mg Strattera & 200 mg Seroquel Watching with our breath held as normal daily stresses re-enter his life post-phosp discharge. *So far* rages seem a little more redirectable. He does, however, seem a little more obsessive about wanting ("NEEDING") things. Ever since he came home he's NEEDED several material things and it was actually these needs that triggered his meltdowns yesterday. I'm unclear as to whether I can honestly say the obsessions are worse/more intense than before or if they just feel that way to me because he just came home and has been gone for so long, but I'm leaning towards worse.
Ah the joys of parenting!
Day 4 Post Psych-Hospital Dischage: Meltdowns Ensue
Today was interesting. M came home this morning from his friends sleepover birthday party early this morning while I slept in for Mothers Day. He's been waking really early since coming home from the hospital...must be the meds. Apparently he's been waking around 5 am, which makes for a very tired boy come mid-morning/early afternoon. I woke around 11 am and when I made it to the living room, M was asleep on the couch. He must have just fallen asleep, because dh hadn't noticed.
The report from his friends house was that he did well on the sleepover! :) It sounds like they were kept busy and there were plenty of kids to play with, which is good. He's never really had any problems over there, other than being a little obsessive over wanting to have his video games over there and inflict his video games on their low-tech household, which is good. I found out through a phone conversation with the mom earlier this week that apparently they were aware of M's emotional/mental issues and difficulties at school to some degree, as they had asked if he had stabilized and if he would be allowed to return to school. Not sure HOW they found out or HOW MUCH they know, but I was simply impressed that they were still willing to invite my son over for a sleepover! Bless their little souls.
Anyway, you would think a nap would put M in good spirits, but rather he woke up in quite a sad mood, which struck me as sort of odd. M doesn't normally present as sad. Chronically irritable, OH YES. But, sad? No. But, he woke and just laid there and pressed his face into the couch and said he had nothing to do and of course nothing I had to offer was appealing enough to motivate him to move off of the couch. He eventually fixated and OBSESSED on a few things that were simply not options that threw him into total meltdown mode. It was our first real meltdown since hospital discharge on Wednesday night. First he was telling us about a computer game that his friend has on his computer that he really wanted...some Harry Potter game. He asked us to buy it for him...many, many, many times. Then he asked if we could go to the library to see if they had that game or another game he could borrow, but our local library happens to be closed for renovations and we don't have a card for the library in the next town. He obsessed, but would drop it and come back to it. It was also lunch time. We had chosen to get lunch from Outback Steakhouse for Mother's Day...M wanted Taco Bell. They're not even in the same town. When he realized he couldn't have either of the things he wanted, he just totally melted down. Repetition, hitting himself in the head, pulling his hair, and when his father came into the room he started throwing things at our faces...stuffed animals, pillows, blankets, etc. DH ended up having to restrain his arms because he was being unsafe.
While DH was on M duty, I went upstairs to his room. I cleared out his main closet, which is of a pretty decent size, and vacuumed it and then I put a large bean bag chair in there. I got a really soft blanket and put that in there as well and the closet has its own light and light switch. Well, by the time I had finished, M was being really unstable in the living room, so DH brought M up to his room and I tried to re-direct him so we wouldn't have to restrain him and I introduced/explained the "special room" to him. In the phosp day program and in the phosp, they always advocated that the kids "take space" by basically giving themselves a time out in a separate area whenever they were angry, which M is simply not capable of doing because he really gets too worked up that he ends up in the quiet room. So, I was sort of going off a combination of the two concepts here. I told him that I created this space just for him and that he was welcome to hang out in it at any time. That it had it's own light and it's own door, so any time he needed/wanted to escape from us or his brother (his brother is a big trigger for him), he could come here. Of course, he said that his brother could just open the door, so I told him maybe we could replace the doorknob with one that would lock. I then told him that he could bring in a book or just lay down with the blanket and relax and take some space. He could have the light on or off, the door open or closed. I even told him that if he wanted to paint the walls in there a special color we could go pick out paint at the hardware store one of these days! Well, wouldn't you know he got right in there and laid down on the floor with the blanket and I asked him if he wanted the door open or shut and he said shut. I told him he was welcome to open the door and rejoin us at anytime and he came back downstairs calm and collected within minutes!!!!! IT WORKED! I think he found comfort in the close four walls. I think it may have felt safe and familiar and special. (Is it bad that all I kept thinking was "now if only the walls were padded and the door had a lock?") I just hope he continues to use the special room in the future!
He ended up having yet another meltdown later after dh left for a business trip, so I was on my own to deal with it. This time M wanted more video game time. This is a recurring trigger for him. He is very obsessive over video games. He is only allowed 1 hr on school nights and 1 1/2 hrs on weekends and we do not allow video games after 8 pm (bedtime is 9 pm). Well, he did not finish his game time today and it was almost 8 pm, so he was getting upset saying he needed more time and he wanted to play after 8 pm. MELTDOWN! Luckily, this one wasn't as bad as the first. I just ignored it and kept going on with the routine. He followed me where ever I went throughout the house to whine and rant, but he took his bath and went to bed on time. PHEW!
Tomorrow is the first day back to school since the hospital discharge. YIKES! It is, however, a field trip and I was sort of made by the principal to promise I would attend. I don't foresee any major triggers other than the lack of routine in the whole field trip thing, so it should be OK. He's looking forward to returning to school and I think bumping his return to Thursday, which the principal suggested, could have adverse affects, so we're going with the field trip. So, unless he wakes up Monday and says, "I'm not going!," we're going!
Tuesday is our in-take meeting at the Day Program. It should be interesting to find out how much it has in common and how much it has in contrast to the Day Hospital program he used to attend. I feel pretty anxious about it, so I can only imagine how he feels. I'm trying to play it really cool so my anxiety about it doesn't reflect onto him. I know how contagious that stuff can be!
Wednesday will be the first official real day of school M has with true school expectations and the surprise to him is that he will have a substitute. We already have a plan in place to have the Social Worker and Special Ed teacher check in on him throughout the day. He *is* only on a half-day schedule anyway, plus we'll know when he'll be leaving for the Day Program by Wednesday too...so hopefully Wednesday won't be too bad.
Thursday will be his first official real TRUE day of school with his teacher and true school expectations! Yeah...that should be fun. Think we'll make it? If not, we'll have to call a PPT and see if we can get a home tutor written into his IEP for the rest of the year and it looks like an Alternative School is on the docket for next school year.
Ah the joys of parenting!
The report from his friends house was that he did well on the sleepover! :) It sounds like they were kept busy and there were plenty of kids to play with, which is good. He's never really had any problems over there, other than being a little obsessive over wanting to have his video games over there and inflict his video games on their low-tech household, which is good. I found out through a phone conversation with the mom earlier this week that apparently they were aware of M's emotional/mental issues and difficulties at school to some degree, as they had asked if he had stabilized and if he would be allowed to return to school. Not sure HOW they found out or HOW MUCH they know, but I was simply impressed that they were still willing to invite my son over for a sleepover! Bless their little souls.
Anyway, you would think a nap would put M in good spirits, but rather he woke up in quite a sad mood, which struck me as sort of odd. M doesn't normally present as sad. Chronically irritable, OH YES. But, sad? No. But, he woke and just laid there and pressed his face into the couch and said he had nothing to do and of course nothing I had to offer was appealing enough to motivate him to move off of the couch. He eventually fixated and OBSESSED on a few things that were simply not options that threw him into total meltdown mode. It was our first real meltdown since hospital discharge on Wednesday night. First he was telling us about a computer game that his friend has on his computer that he really wanted...some Harry Potter game. He asked us to buy it for him...many, many, many times. Then he asked if we could go to the library to see if they had that game or another game he could borrow, but our local library happens to be closed for renovations and we don't have a card for the library in the next town. He obsessed, but would drop it and come back to it. It was also lunch time. We had chosen to get lunch from Outback Steakhouse for Mother's Day...M wanted Taco Bell. They're not even in the same town. When he realized he couldn't have either of the things he wanted, he just totally melted down. Repetition, hitting himself in the head, pulling his hair, and when his father came into the room he started throwing things at our faces...stuffed animals, pillows, blankets, etc. DH ended up having to restrain his arms because he was being unsafe.
While DH was on M duty, I went upstairs to his room. I cleared out his main closet, which is of a pretty decent size, and vacuumed it and then I put a large bean bag chair in there. I got a really soft blanket and put that in there as well and the closet has its own light and light switch. Well, by the time I had finished, M was being really unstable in the living room, so DH brought M up to his room and I tried to re-direct him so we wouldn't have to restrain him and I introduced/explained the "special room" to him. In the phosp day program and in the phosp, they always advocated that the kids "take space" by basically giving themselves a time out in a separate area whenever they were angry, which M is simply not capable of doing because he really gets too worked up that he ends up in the quiet room. So, I was sort of going off a combination of the two concepts here. I told him that I created this space just for him and that he was welcome to hang out in it at any time. That it had it's own light and it's own door, so any time he needed/wanted to escape from us or his brother (his brother is a big trigger for him), he could come here. Of course, he said that his brother could just open the door, so I told him maybe we could replace the doorknob with one that would lock. I then told him that he could bring in a book or just lay down with the blanket and relax and take some space. He could have the light on or off, the door open or closed. I even told him that if he wanted to paint the walls in there a special color we could go pick out paint at the hardware store one of these days! Well, wouldn't you know he got right in there and laid down on the floor with the blanket and I asked him if he wanted the door open or shut and he said shut. I told him he was welcome to open the door and rejoin us at anytime and he came back downstairs calm and collected within minutes!!!!! IT WORKED! I think he found comfort in the close four walls. I think it may have felt safe and familiar and special. (Is it bad that all I kept thinking was "now if only the walls were padded and the door had a lock?") I just hope he continues to use the special room in the future!
He ended up having yet another meltdown later after dh left for a business trip, so I was on my own to deal with it. This time M wanted more video game time. This is a recurring trigger for him. He is very obsessive over video games. He is only allowed 1 hr on school nights and 1 1/2 hrs on weekends and we do not allow video games after 8 pm (bedtime is 9 pm). Well, he did not finish his game time today and it was almost 8 pm, so he was getting upset saying he needed more time and he wanted to play after 8 pm. MELTDOWN! Luckily, this one wasn't as bad as the first. I just ignored it and kept going on with the routine. He followed me where ever I went throughout the house to whine and rant, but he took his bath and went to bed on time. PHEW!
Tomorrow is the first day back to school since the hospital discharge. YIKES! It is, however, a field trip and I was sort of made by the principal to promise I would attend. I don't foresee any major triggers other than the lack of routine in the whole field trip thing, so it should be OK. He's looking forward to returning to school and I think bumping his return to Thursday, which the principal suggested, could have adverse affects, so we're going with the field trip. So, unless he wakes up Monday and says, "I'm not going!," we're going!
Tuesday is our in-take meeting at the Day Program. It should be interesting to find out how much it has in common and how much it has in contrast to the Day Hospital program he used to attend. I feel pretty anxious about it, so I can only imagine how he feels. I'm trying to play it really cool so my anxiety about it doesn't reflect onto him. I know how contagious that stuff can be!
Wednesday will be the first official real day of school M has with true school expectations and the surprise to him is that he will have a substitute. We already have a plan in place to have the Social Worker and Special Ed teacher check in on him throughout the day. He *is* only on a half-day schedule anyway, plus we'll know when he'll be leaving for the Day Program by Wednesday too...so hopefully Wednesday won't be too bad.
Thursday will be his first official real TRUE day of school with his teacher and true school expectations! Yeah...that should be fun. Think we'll make it? If not, we'll have to call a PPT and see if we can get a home tutor written into his IEP for the rest of the year and it looks like an Alternative School is on the docket for next school year.
Ah the joys of parenting!
Subscribe to:
Posts (Atom)