Disappointed with 2nd psychiatric opinion today...

Discussion in 'General Parenting' started by gcvmom, Jul 6, 2007.

  1. gcvmom

    gcvmom Here we go again!

    I guess I had unrealistic expectations for today's 2nd opinion at our local university hospital. I was not very impressed with the doctor we saw, and for someone who deals with kids all day he was not very patient with difficult child 2.

    Why do we bother to fill out stacks of forms with clinical history when the doctor doesn't take time to read them before the appointment? We spent most of the hour going over information I already provided so that he could write it all down again. He didn't spend any time with difficult child 2, just listened to the history and then asked a few questions (that were already on the history form).

    His advice is to continue with the Depakote and just see what happens -- so basically our current psychiatrist is doing nothing different than he would do (confirmation is always good, I guess). He says difficult child 2 appears to have signs of ADHD (duh!), and it's possible that BiPolar (BP) is emerging, but it's too soon to say for sure (did I say duh yet?).

    Did I want a magic bullet? Yes. I know, that's stupid of me. I am just feeling so desperate and tired of it all. And if things don't improve dramatically soon, the (expensive) two-week day camp difficult child 2 is signed up to attend will have to be cancelled (with no refund, I'm sure, because of the late date), and that's really going to be sad for him (it's a fort-building adventure camp with hammers, saws, nails, etc. -- too risky for him to attend with his impulse control and anger issues) :sad:

    And don't even get me started on the soccer practice he's supposed to start in August, let alone SCHOOL! Ugh.
     
  2. Janna

    Janna New Member

    Hi there,

    I'm sorry, I was gone for a while, so I'm not really familiar with you. So, if I say something someone has said before, I apologize ahead.

    My son, Dylan, is 10, and Bipolar. He's got other stuff too (see signature). Anyway ~ hate to break it to you, hon, no magic bullet :crying: I'm really sorry.

    Anyway ~ you can find medicine that can tame some of the behaviors. You can find medicine to help calm, help with focus, help with some things. You won't find a pill that is going to make your child "normal".

    We have found an AWESOME mix for my son. It took away rages and changed him from a difficult child to an almost easy child for about 15 months. It was great. In hindsight, he really wasn't almost a easy child though. I'm lucky, my son isn't defiant, he's not problematic, but he is Bipolar, and he is emotionally unstable. Always will be.

    With that being said, he needs interventions. He needs aides. He needs therapy. He needs to learn how to handle his emotions, how to deal with anger, how to relate to peers, how to get along, how to do things medications are NEVER going to get him to do. These are all things that must be done aside from medicine.

    I hope the Depakote helps. We started Dylan last week, and discontinued already because it was giving him tummy aches. Remember, Depakote needs a good, full 8 weeks to see effects, and it must be at a theraputic level.

    Maybe you could call your local Mental Health/Mental Retardation (MH/MR) agency. What about Wrap Around Services/TSS? Someone to help, like a Big Brother/Big Sister? Call around, see what your child qualifies for, find resources, start bugging people. Get help.
     
  3. Wiped Out

    Wiped Out Well-Known Member Staff Member

    Sweetie,
    I know how you feel. We would all love that magic bullet. Have you called the camp to see if they have aides available. Our son's day camp does and it has been very helpful. Hugs.
     
  4. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    My advice is (and, yes, I know how you feel) if you aren't happy with the psychiatrist, then hang in there and if your child doesn't improve, get still another opinion. I hate when they hem and haw and say, "ADHD, maybe emerging bipolar" then act like it's bipolar by prescribing Depakote. I want to scream, "Say it, ok???" :smile: I went thru a lot of bad apples with my son.
    Bipolar is not curable, but you CAN live a pretty normal life as an adult with bipolar. Many people who have it, your friends and neighbors, are undetectable because they are stable and taking their medications and not drinking or using other recreational drugs. It is harder to stabilize in some than in others, but it is not hopeless. I know that first hand. I have not had bipolar symptoms for fifteen long, wonderful years. I don't have Bipolar I (I have Bipolar II) and in ten years or so maybe Bipolar II will have a different name, but it is still a raging mood disorder which has caused raging and problems into my adulthood that only the right medications helped. But they DID help. I can live a normal life as long as I stay on them, but it took me a long time to find a combo that worked for me. I had debilitating symptoms in the past. I urge you to think good thoughts and everyone remember that they will know a lot more when your kids grow up than they do now--they are learning of better ways to treat bipolar every day. And God knows if it will still be known as "bipolar!" It used to be manic-depression. We are understanding these things more and more--this is not a death sentence to hang on your child. I do believe in stability, maybe it is easier to stabilize an adult who is willing not to drink than a child who is still growing and dealing with raging hormones. There is hope.
     
  5. gcvmom

    gcvmom Here we go again!

    Thank you, Sharon -- I will call Monday to find out if the camp can somehow work with him so he can still go and have a good time. If not, my choices are probably either to pull him out or shadow him myself the entire day for two weeks (neither solution is attractive to me).
     
  6. gcvmom

    gcvmom Here we go again!

    Janna and Midwest Mom....

    Thanks so much for your replies.

    I know nothing about mental health services in our community, let alone at our school. We've only had a 504 plan until now. I've got my work cut out for me this summer to find out more about these things.

    As for difficult child 2's future, in the long run, I know things will eventually work out -- I feel pretty confident about that. It's the short term that I'm struggling with because I don't really know what to expect having never been here before. I got my arms around the ADHD thing pretty well over the past eight years, so this is all new. And his behavior issues are all new, in a sense, because we've always been able to just switch stimulants or add another "this" or "that", but now we've run out of choices in the usual bag of tricks and are having to look at other medications which I know nothing about (well, very little anyway).

    Having to start over again with his school administration and asking for a possible IEP is daunting to me, but I know it's something I'm going to have to address. He's such a smart kid, I don't want him to lose any ground academically, and I want him to have an easier time with his peers than he has in the last year but I don't know if that's going to be possible.

    I guess that on the bright side, it's summer, we have a little bit of time to work on this, and he's young. It's not like he's falling apart in highschool when college is just around the corner.

    So, I am resolved to count my blessings, to limit my freak-outs to one per day, and to work as hard as I can to ensure difficult child 2's got the supports in place for the Fall. The rest of my worries can wait.
     
  7. Hound dog

    Hound dog Nana's are Beautiful

    I have to echo MWM. If you don't feel you're getting your money's worth from the psychiatrist find another. We also went thru several before finding one that was worth a darn. Most we went to were little more than revolving doors with prescription pads. ARGH! And I have no patience for psychiatrists who are afraid to give a bipolar diagnosis to a child for fear of the "stigma" involved. Stigma or not, label or not, if a child is bipolar then their bipolar. Not giving the diagnosis doesn't change anything and prevents the child from receiving appropriate medications and treatment.

    I'm bipolar. I am stable. There are members of my own family who have no clue that I have bipolar. Actually there are only a handful of people who do know I have the disorder. It is possible to reach stability and stay there. The getting there is the hardest part, especially for a child who's body is growing and developing.

    You are your child's best advocate. No one will fight for him harder than you will. Ask questions, call up agencies and ask what services are available, educate yourself, be that squeaky wheel. We all had to start somewhere. Knowledge is powerful.

    Hugs

     
  8. flutterbee

    flutterbee Guest

    I understand how you feel. Everyday I wish I could snap my fingers and make it all better.

    I agree with the others; if you're not satisfied with the answers you are receiving, keep looking. And, if along the way, you find that elusive magic bullet let us know what it is.

    (((hugs)))
     
  9. smallworld

    smallworld Moderator

    I'm sorry if you've covered this at another point, but are you taking your difficult child for a neuropsychological evaluation? It makes a lot of sense given that you're struggling with diagnosis and medications.

    Another question: Has your difficult child ever been on an SSRI antidepressant without any other medications on board? If so, what was his reaction?

    I ask the latter question because I co-moderate a listserv of parents of BiPolar (BP) children. One of the kids in the group tried just about every combo of mood stabilizer/atypical antipsychotic over the last 3 years and was still raging. It got so bad that she was hospitalized about 10 days ago. After testing and observation, the psychiatrists now believe she has severe Obsessive Compulsive Disorder (OCD) and not BiPolar (BP). She has started a trial of Prozac and is doing much better.

    My point is that the symptoms can look like a lot of different disorders, and treatment is based on diagnosis. ADHD is treated one way. Anxiety and unipolar depression are treated another way. The medications for ADHD and anxiety/depression can make a child with BiPolar (BP) worse. The medications for BiPolar (BP) will likely do nothing for a child with anxiety.

    This is all my long way of saying that a differential diagnosis is frequently not reached without a lot of testing and observation over time. Both my older children J and A have had extensive neuropyschological testing over the last several years, and they both see psychiatrists weekly for medication management and psychotherapy (no tdocs involved). M also sees a psychiatrist weekly for medication management and psychotherapy. She has not had neuropsychologist testing because hers is a more straightforward case of anxiety. Only through this systematic approach to mental health care have we been able to make any progress at all.

    Good luck. Believe me, I know through my own experiences with my kids that this stuff is not easy.
     
  10. SRL

    SRL Active Member

    Every specialist I have seen has spent time going over the history...even if they've read in advance what I've turned in.
     
  11. nvts

    nvts Active Member

    Just a thought: has anyone considered Asbergers Syndrome? I agree with the thought of a neuropsychologist evaluation. We're trying to get one scheduled, but everyone on this board seems to feel like it's key to get one done, even if it's to brainstorm problems, issues and diagnosis!

    Beth
     
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