Some thoughts???

[totoro]

So prior to leaving we were talking we were talking with our therapist. She feels K is not really ADHD, and that she is not really severely Anxious.
She feels that K is classic Bipolar. That what the psychiatrist has seen is just a snapshot K and has taken the time to really see the full picture of K and that K is not comfortable with him.
She also feels when K is unstable, she exhibits more anxiety, more hyper-ness, more of all of the symptoms that he is seeing... and being confused by...
Because K is SO unstable and cycling so rapidly that is all that he sees.
SO she goes into his office and he sees, K hiding under his table, scared. Or jumping around...

Also because K is very afraid of displeasing anyone she tries desperately to hold it together until she is "safe" just with us...
We have tried to explain all of this to him. He thinks we are being over indulgent (his words) and he knows better.
He thinks he is just seeing Severe ADHD and Generalized Anxiety Disorder (GAD).
But in therapist's office were K is comfy... she let's lose... destroys the office and shows her true colors!!! LOL
I tend to side with therapist who has been with us for 2 years and really sits and listens. She knows all of our histories.

She feels if K was stable on some most likely first line MS, that most of her ADHD and Generalized Anxiety Disorder (GAD) symptoms would fade or lessen...

She questioned psychiatrist 2&3 's medication descision's all along. She wrote a pretty good letter, saying such.

What does the board think????

K can sit for hours at times calmly if she engaged with something... when she unstable noway. psychiatrist1 said she did not have ADHD... just comorbid sypmtoms... I don't really care, but it just would really burn my bottom that psychiatrist3 has spent the past 8 months trying to medicate her "severe ADHD" when we kept asking him not to!!!!
We begged him to give us a first line MS....
No I don't feel comfortable with blood draws.... or maybe lets try this first.

Just rambling... thinking with my fingers.....

 

[SRL]

FWIW, I think there are any number of disorders that could have the same results, especially given the number of unsuccessful medication trials K has been through. The wrong medications can make a child more hyper...or more anxious...or more rageful...or...or....or. A undiagnosed/untreated child with Autism Spectrum Disorders (ASD) can look BiPolar (BP). A parent just mentioned that mood disorders were missed in the initial assessment and they medicated for 4 years for ADHD with no avail, but when they medicated for mood disorders the inattentiveness dropped off. I've seen highly hyperactive children be able to engage for long periods of time provided they had high interest in the activity.

Medications can greatly muddle the diagnostic picture, especially when there have been many and/or many with side effects. When answers are elusive, go back to the early developmental history and take a long, hard look at what was happening before the medications.

 

[BusynMember]

I would see a neuropsychologist just exactly because of what SRL said. Bipolar and Autism Spectrum Disorders (ASD) can look identical sometimes, and you need somebody with more knowledge than a therapist (although NeuroPsychs are really good) to do the testing and diagnosing. I personally don't like when psychiatrists start medications because a thorough assessment is done because certain medications can make certain disorders worse. I think SRL is right on the money. Tdocs, even nice ones, are not the best diagnosticians from my long, long experience. I would use them for therapy only, not for diagnosing. I'm always suspicious of "SEVERE" ADHD. I don't trust that diagnosis. If it's beyond normal ADHD, I always think they're missing something else.

 

[flutterbee]

T -

I don't understand how psychiatrist3 could think just severe ADHD and Generalized Anxiety Disorder (GAD). Neither one of those involves hallucinations.

And I can totally understand how her anxiety would be higher when she's unstable. It just becomes the vicious cycle.

Hang in there.

((((hugs))))

 

[Steely]

My son who is BiPolar (BP), has all of the co-morbid symptoms. Anxiety, inattentiveness, etc. Those are all co-morbid symptoms - not the actual diagnosis. However, the only way we got the actual diagnosis is by extensive testing, where we identified the NonVerbal Learning Disorder (NVLD), and through years and years of watching his behavior. Up until he was 12, there was not one psychiatrist that would actually diagnosis him with BiPolar (BP) - only Mood Disorder not otherwise specified - even though I could see his moods cycle at least 3 times a day. in my opinion, he was a rapid cycler.

Finally, when he was in phosph, and manic, and a pre-teen, psychiatrists were comfortable with a BiPolar (BP) diagnosis. None the less, the medication regimen did not change much from what we were doing. We already knew stimulant ADD medications made him insane. We already knew SSRIs made him insane. So, the only options we had were mood stab., and those we had been trialing since he was 6.

At that phosph stay we tried the Lithium which changed the world around for him. However, despite the cycling slowing down, we still had to treat the anxiety and ADD, because, although to a lesser degree, they were still there.

We have finally found a regimen that works for about 70% of his symptoms, but he is still extremely impulsive, inattentive, and anxious. At this point I have decided that some of this he will just have to adapt to and accept. medications can only do so much.

All of this to say - find a psychiatrist you trust. Which you are doing. And do not worry too much about the actual diagnosis..........just treat her symptoms. As someone else mentioned, the hallucinations are certainly not indicative of ADD, and you need a psychiatrist that sees that. You also need a psychiatrist that completely respects tdocs opinions and history with her, and honors and listens to that.

I think you are on the right track with AZ.
Many hugs.
Willow

 

[tryinghard]

Hi. Because some on what you are talking about sounds like my son, could you tell me what Autism Spectrum Disorders (ASD) and Generalized Anxiety Disorder (GAD) mean? Also, what is a NeuroPhysc? Thank you

 

[totoro]

WW-
That is what therapist was saying... that once stable... on the right MS. We may still have some hyperness and some anxiety. But it will not be to the degree that it is right now! We will not need to focus on it like the psychiatrist is right now. He is acting like it is the main problem. therapist was saying, why isn't he treating the instability? Why doesn't he have her on a first line MS???
Then see how bad the ADHD "like" symptoms are... because she was saying he was too focused on his belief that she was severely ADHD... and Generalized Anxiety Disorder (GAD). ANd like you say WHO cares. She is unstable... and he seems to be making it worse, which is what the psychiatrist's here in Tucson think also.
So as she attacked me tonight... I can not wait for Thursday to come...

 

[totoro]

Autism Spectrum Disorders (ASD)- Autism Spectrum Disorder
Generalized Anxiety Disorder (GAD)- Generalized Anxiety Disorder
I think there is a list under F.A.Q???
Nuero-psychiatric is Psychologist that performs an exhaustive amount of testing on your child that not only pinpoints IQ but it narrows down learning dissabilities, possible issues, what could be going on with your child, maps out a game plan for you and your child as far as what types of therapies your child will need, what your child will need in school, you fill out tons of forms, hours of testing in office. Ours was around 10 hours. We ended up with his view of what he thought was K's diagnosis and what we needed to do for her. His suggestions. He gave us a huge packet. It was wonderful, all of his test scores, IQ scores etc. You can get one through a Hospital, through a independendt company.

 

[witzend]

Wow, hon, you sound as though you are a bit overwhelmed! Maybe I read your post wrong the other day - I thought that you were hopeful? Maybe the travel and the pressure of being on show and high expectations is throwing you for a loop today. Not to say that you aren't right to be concerned, but that it's probably not something that you can expect an answer to right now.

I hope that you will get an opportunity to hit the hot tub and/or get a glass of wine and some time to step back for a moment. You're doing so much this week, you're bound to find moments when it feels like too many opinions and too many fingers in the pot.

{{{{{{{{{{{big hugs}}}}}}}}}}}

 

[DDD]

Sending supportive hugs your way. The cumulative stress can be really overwhelming and frustrating.

This sounds a bit "way out there" but if the therapist sees your child as you see your child is there any chance the therapist would set up a cam to record the natural behaviors? Is your psychiatrist a child/adolescent specialist?

It took me four psychiatrists before I found one that I had confidence in. on the other hand
difficult children issues are not quite as severe as those you face. Good luck. DDD

 

[Steely]

What is the plan with the docs in AZ? Are you seeing them everyday that you are there? You said you are looking forward to Thursday, is their some type of finality occuring Thursday? Hopefully? A possibly solution of medications and docs?
Sending you many hugs and positive juju, that a solution will be found ASAP.

 

[totoro]

I am just frustrated... I am tired of not getting her treated for her diagnosis. I am tired of people questioning her diagnosis... the same tired old questions... If you read the charts... if you look at the history it is all there.
I am just trying to understand why psychiatrist3 medicated her the way he did.
We are in a nice house, but it is not difficult child proof, she is not doing well, the honeymoon is over, she was up last night, obsessing over Pancakes... First couple of days it was swimming... we needed to get the pool cleaned. So she needed to wait. LOL
So she is raging and locking doors and becoming violent...
So yes I am kind of hopeful about Thursday... but I still have to go home, we still have to make decisions,
I have people coming on the board making comments I should just ignore... but I am just a bundle of nerves.
I thank all of you... SRL I am going to try to implore these docs to dig deep into her past!!!
Witz I am positive... but it is tiring...

She is in my face... A LOT.

But hey I got the sun...

 

[SRL]

Hang in there, girl. I went nutty regurgitating info to the 3rd specialist and they were even on the right track.

When a child isn't doing well with any of the treatment, my thoughts are always 1) go back and really focus on those early, premedicated years --go back before the hallucinations, etc and look at behaviors and devlelopment then 2) if possible do a medication wash in a controlled environment and start over again one medication at a time. I know it's not always possible for every child though.

I know you're frustrated but I think this team of doctors wouldn't be doing their job if they didn't take into consideration that along the way a diagnosis and/or medication route could have been totally wrong. Hopefully if they do their job thoroughly and knowledgably they'll wind up with answers that seem reasonable to you.