Worried we're approaching crisis time

[rlsnights]

difficult child 2 has started having major melt downs after months without any. He's almost constantly anxious, defiant and at times getting physical. We've had to threaten to call the police several times in the past 2 weeks to get him to back off and take himself outside to cool down.

Saturday he got in a fight with a neighborhood kid at the park. His first ever physical fight. A group of 8 boys were playing a game of pick up football and M. got hurt you know where. He's rolling on the ground while his helpful companions, including difficult child 2, are laughing.

From there the story gets murky and doesn't really hang together. The group of boys sort of split into 2 camps - for M or for difficult child 2. Looks like M and difficult child 2 had been needling each other before the game started. They've had an uneasy relationship for a couple years but kept out of each other's way up til now.

difficult child 2's group says the other boy challenged difficult child 2 "for no reason" - said you want a piece of this? - and then lunged at difficult child 2 who then defended himself by threatening to hit M with his skateboard. difficult child 2's pals say it was obvious difficult child 2 wasn't really going to hit M but M slugged him in the stomach and then in the face with his fist.

M's group (and M) agrees M got mad but that difficult child 2 was calling him names and saying mean things and that's why M said what he did. M agrees he challenged difficult child 2 for calling him names but that difficult child 2 tried to hit him in the neck with the skateboard, pulled his hair and tried to hurt him so M was just defending himself when he hit difficult child 2. M's pals also say that difficult child 2 was screaming that he was going to kill M and his whole family before M hit him.

First we knew was when difficult child 2 came slamming into the house barely able to breathe screaming that M. had slugged him in the face and he wanted the phone to call the police and then he was going to go kill M. His asthma is triggered by extreme anger and fear and our first concern was that he was going to go into a full blown attack and stop breathing.

We managed to get him to do one puff on his inhaler and then he went back to screaming for us to call the police. We said we needed more information and he said it was enough that M. had hit him, why weren't we doing something?

difficult child 2 rampaged through the house and yard, screaming about killing M and his family and that he needed a weapon. He picked up a painter's stick and tried to leave the yard with it but we sort of herded him from a distance while telling him to give us the stick or put it down. Then he saw the sledge hammer (we've been doing some major work in the yard) and picked that up and again tried to leave the yard.

At that point we told him we would call the police on him if he left the yard with the sledge hammer. After some blustering he threw it down and shoved his way past us out of the yard. Found another stick - a tool handle this time - and stormed off in search of M.

My partner followed while I went inside for my cell phone and car keys. By the time I found them a couple blocks away all the kids were standing around with Lea herding difficult child 2 and his stick away from the group of boys. After I arrived difficult child 2 backed off a little but not much. He and M exchanged curse-laden threats from a distance and we persuaded difficult child 2 to get in the car and come home so we could put ice on his face which was swelling up.

difficult child 2 was combative and defiant the rest of the afternoon and things were touch and go. He continued to swear and talk about killing M and his family. We had to threaten to call the cops once more late in the afternoon but never actually called.

A couple times during the late afternoon his thinking and speech got a little odd. He'd go off on a rant about something that seemed disconnected from the conversation and you'd be left saying - huh? How does that connect with what we were just talking about?

After dinner we suggested we all play a board game together and difficult child 2 thought that was a great idea. He chose LIFE and we were a little relieved because LIFE is not intensely competitive like Monopoly, the game he chose at first. But once we started getting the game out he became hypomanic.

When he got what he wanted he giggled or crowed and sang bits of song over and over at the top of his lungs. He didn't stay seated for more than a minute at a time, even during his own turn. He complained about how long the game was taking and tried to rush everyone else through their turn. If he didn't get the card or the space that he wanted he crumbled into tears only to be crowing again in 2 minutes.

It was bizarre and gave me a sinking sensation in the pit of my stomach. He hasn't been like that for almost a year and a half. My partner Lea had never seen him this way because she's working full time + and by evening he's usually defiant and morose when he's in mood swing mode. The hypomania is usually a daytime phenomenon.

Anyway, I'm taking him for a blood draw this morning if I can persuade him to go. I plan to take him to school after that but we'll see. We have an appointment with the psychiatrist at 1 and with the therapist at 2:30 that were already on the books.

 

[crazymama30]

Sounds like a good day for those appts. Sorry all this is going on. Maybe psychiatrist can tweak medications and therapist can help get to the bottom of itall.

I think this is just a bad time of year. My husband is BiPolar (BP) and not doing well, and difficult child was a handful this morning.

 

[Star*]

May I make a suggestion rls?

Don't pursuade him to go have blood draws. It's not your job as his parent to beg him to go or coerce him to go or plead with him to go. It's your job as a parent to say "We have an appointment tomorrow for the doctor." END of conversation.

Of course it's HIS job as a kid to say "But I don't want to go."

and at that point you can engage in conversation with him if you choose, but...bottom line - You're going. And you don't have to be militant like that either because that doesn't help one bit.

If you like to read I can suggest a really great book about effective communication that you and your partner can benefit from. It's about the best thing I've ever read on how to communicate with kids ever. I wish someone would have handed it to me when I was pregnant. Really.

I hope your time at the doctors today went well and I hope you get some answers. Do you think maybe since your partner works a lot your son is having problems with that? Do you think maybe the kids are giving him grief when they aren't in your earshot about his/your lifestyle and he's just not conveying that to you and maybe its causing frustration?

I dunno - he could just be a slow cycler. I'm really grasping at straws here. My son is 19 now and OMG there was NEVER a pattern to his cycles.....UGH....I think I'd just about get him figured out and WHAM......let's go the other way ------and wham.....no this ......no this.....no this......way......other......this.....and as a result I was mostly just too tired to think every day.

Let us know how it went today. Hugs Star

 

[totoro]

Hope it went well. Maybe next time he can sit on his Skateboard during his blood draw. Help him relax.

 

[smallworld]

It does sound as if his medications aren't right so I hope the psychiatrist is able to make some adjustments that help simmer him down.

What is the purpose of threatening to call the cops? We never make any threat that we aren't willing to follow through on. In the situation you describe, it sounds as if he could have used an evaluation at the ER so maybe calling the cops for transport there would have been warranted.

Hang in there. Please update us when you can.

 

[rlsnights]

Thanks for all the ideas and well wishes.

Fortunately, the psychiatrist, therapist and I are all on the same page. difficult child 2 was clearly close to manic if not all the way by last night. I think the psychiatrist is now ready to call him rapid cycling and get more aggressive in treating him as bipolar. Up til now she's been kind of on the fence about a bipolar diagnosis.

We are waiting on the blood test results and, if they're OK, will be increasing his Lamictal to 200 and his Abilify to 10 possibly adding Geodon if that's not enough pretty quick.

One good thing from all this has been a real reversal with his new therapist. The guy told me today that he feels very strongly that difficult child 2 is bipolar based on the events of the past 3 weeks and that needs to be addressed ASAP. No more advice to send him for a walk to calm down so he can do his chores. Today he said that behavioral approaches weren't appropriate with difficult child 2 and we won't know if they are until we get him stabilized. My thoughts precisely.

I guess I wouldn't describe what we do as threatening to call the cops. Rather we apply the house rules to a given situation and then say to him "if this happens/doesn't happen then calling the cops is what will happen after that." We don't treat it as a threat but rather as a reminder to him and a strange sort of lifeline for him to grab.

We have called the cops in the past and will call them again under certain conditions and he knows it. So we are very willing and able to follow through if it is clear to us that calling the cops is necessary. I guess you could say it's our way of asking him to show us if that's what really needs to happen.

We can count on one hand the number of times we have used that phrase to reach him in a rage. The one time it didn't work he was taken to ER in the back of a squad car. For us it is a way to measure just how far gone he is - if he can't respond to that then he absolutely needs psychiatric hospital.

One of the things that's scary is that we have had to use that reminder with him 3 times in the past 2 weeks. So far it has worked to break through to him. All the professionals we are working with (2 tdocs who specialize in working with adolescents, 1 case manager from the psychosis early intervention program, and our child psychiatrist) have told us what we are doing is appropriate and they feel we are handling him really well. None of us want to see him in the psychiatric hospital unless it's absolutely necessary.

About the blood draws. I understand your perspective on this and many times that is exactly the approach I take. But my son has a serious chronic autoimmune disorder that requires frequent (as in 20+ times a year) blood draws. That's when things are going well. The repeated trauma of this over the past 3 years means that there are times when he is simply too emotionally fragile to handle a blood draw - not so much because of that day's blood draw but because of the accumulated trauma of years of blood draws.

Because we must do this (and other invasive medical procedures like sub-cutaneous injections at home) so often I have found that I cannot do battle with him or issue ultimatums too often. Instead I must sometimes work with him at a more adult level and use persuasion or logic to get him on board.

 

[smallworld]

Patricia, glad the psychiatrist is being proactive in adding medications. Sounds like it's definitely warranted.

Has anyone suggested a PRN like Ativan for blood draws? We've had to use that for my son who is needle-phobic.

Hang in there. We're here for you.

 

[Marguerite]

A couple of quick thoughts here.

1) Boys will be boys. When they have a diagnosis we tend to blame that diagnosis, but often - boys will be boys. Not acceptable of course and you have to take action, but don't be too fast to read anything sinister into it. What you describe - it sounds exactly like some of the things that have happened with difficult child 3. And when he gets roused, he also would be behaving exactly as you describe. The extreme emotion of it in difficult child 3 can have him running a fever, from the degree of anger in him. And yes, threats.

2) With the "who's in the wrong" stuff, I would fall back on Judge Judy's line. "Who started it by making physical contact first?" It's one thing to throw verbal insults. You can always walk away. There is no need to make physical contact unless physical contact has already been made to you and/or you feel that unless you DO make physical contact, you are in greater danger. But if at any time you could have walked away, and did not - then you are in the wrong. Even if someone else is also in the wrong. it is possible for EVERYBODY to be in the wrong. And him wanting to call the police - he clearly didn't see that he had to own some part in the confrontation. My serious suggestion, if you can set it up (maybe with the help of the local police youth liaison, if you have one - we do) is to request mediation between difficult child 2 and M. Have a cop sit down with them both and talk it through. Sometimes kids behave this way even when they're good friends.

3) Blood draws. I hear ya. difficult child 3 HATES blood draws but cooperates. However, his body does not, not readily. He has been lying there (after fainting) so anxious even though he has his arm out ready, that his blood vessels have clamped down so tight the technician can't get a drop out of him. I remember one time the technician had to move to the other arm (a second venepuncture) and even then, only a drop would come out, whenever difficult child 3 breathed out. So we sat there coaching him to breathe, like he was a woman in labour, so eventually they got about 1 ml of blood to do the cross-match needed before surgery.
Since then we have used emla cream to lower his anxiety. Technicians don't like emla because it can interfere with the blood vessels (they get too floppy). But if he knows that the emla should stop it hurting (just make sure you put it on an hour ahead of time) then it should make it a more painless event.
I also have explained to difficult child 3 that the doctor doesn't ask for blood draws unless there is a very good reason - our national health insurance will penalise doctors who ask for too many tests, so the doctor isn't asking for the tests just to justify his/her existence.

One more thing - whenever there are injuries, make good notes and take photos. You may never need them; but you never know.

Marg

 

[rlsnights]

Thanks for the replies.

yes, that was exactly our thought = boys will be boys. To some extent this stuff is normal. It's one of the main things boys have to do during adolescence - harness their aggression in effective and appropriate ways.

what's over the top is threatening to kill people while waving a weapon around.

figuring out who hit who first was not in the cards on Saturday. accusations flew fast and furious and we figured it didn't matter. Both boys got physical when either could have walked away. So both are in the wrong. But difficult child 2 is still way too fragile for me to even bring Saturday up - it triggers him right back into the rage. So we will have to wait a while to address some of this stuff. Hopefully the medications will kick in quickly and give him back his frontal lobe.

We don't have anything like the kind of police service you are describing. Cuts and more cuts to our police force mean that interventions like that are a luxury. So I'm keeping him home for now as much as possible and counting on the medication fairy to lend a helping hand ASAP.

We know EMLA well. But my son has not found it helpful and as you say, it definitely has it's draw backs. For difficult child 2 taking off the bandaging covering it is more painful to him than the blood draw usually ends up being. It's just sometimes we find ourselves skating on thin ice and have to tread gently. I also have a 2 strikes rule. If the tech can't get him in 2 tries (or 1 if they went digging) a new tech needs to be called. We only allow the new tech one try unless it's practically life or death that the blood draw be done that day.

Having these rules has helped my son manage his anxiety a lot.

 

[Star*]

Okay -

I have 2 Auto Immuine Disorders and know about blood draws...Sorry did not know he has that. My apologies. Since I also have vasculitis & I have a mental block for some reason about blood draws are never fun. Here are a few suggestions that may help him. One worn out blood giver to another.

Butterfly - with a pediatric needle in the back of his hand. Sounds more hideous than it is - doesn't hurt NEAR as much. They put the rubber thing around your wrist and not your upper arm. THAT rubber thing kills me, and I think 1/2 of it is mental for me. The next thing a nurse taught me is to hold my nose when they do the alcohol rub. Most times when I have to get blood work done it's on a fasting and the smell of the isopropol alcohol makes me nauseated. Tell him to hold his nose. This also keeps his mind busy. The veins in the top of your hand are easier to see and there are less chances for digging around or mis-pokes too. (at least with me they are).

The final thing is to have him lay flat on his back when they do this with his arms at his side for about 20 minutes BEFORE they come to take his blood. It relaxes me - and for a child it would probably help to relax him. To have someone be 'lower' than him sitting on a stool next to him rather than lord over him with a needle and him not really be able to see - helps.

These things seem to help a lot. SQ fluids at home? Ugh..not fun. Hugs for him and you Mom.

As far as the comment about your lifestyle - it was not in anyway meant as a poke. This is a very open and accepting board. Couldn't care less if the child had 3 space aliens for parents. Just asking if maybe the friends he has are not understanding and taunting and pushed him so to speak. Hard to tell with kids today. They aren't the same in any way like when we were growing up. Some ways better - but some not. Hope you didn't think it was a prying question in that way. My thought was for your son - nothing else. And mostly because I have a friend here who has a partner and she and her partner have raised her daughter with some outside issues from the daughters classmates and friends when they are introduced as "Meet my two Moms." it's caused her to loose some friends and been tough on her. So was just thinking like that. Thats' all.

Hope today was better for him and you can get a medications tweak and get him stable. Poor fella - Give him a huge hug from his invisible auntie.

Hugs & Love
Star

 

[Marguerite]

I'd missed the two moms thing. It should be far less of an issue these days I would think, kids are likely to be more tolerant than parents. but in a certain age group, kids WILL repeat nasty stuff some parents might say (carelessly in front of their kids).

Hopefully it's not a factor. Because frankly, it's far more important in my book for a kid's family home to be harmonious with happy parents, than for there to be conflict for whatever reason. And Patricia, if you and your SO are happy together and work as a team (as much as possible) with the kids, then frankly, that should be more than enough to insulate the kids from any slings and arrows cast by those who are expressing their ignorance inappropriately.

I'm in a heterosexual relationship but we still draw comment from people, comments our kids have at times heard. husband & I do the uforgivable - we hold hands in public. We even kiss in public. And at our age, people comment unfavourably. Especially if we do it in church (hold hands, that is). I've been told about those comments by others, very few people have voiced them to me or to husband. WHich frankly, I find more offensive. I mean, I'm glad my friends have told me (as well as told me what they said to those making the comments).

But people WILL pass comment (often more than you realise) and if in any way there is something different about your family, even if it's simply having a difficult child for a kid, people WILL be judgmental. It makes me very angry, and it DOES affect our kids. The best defence is to teach our kids to value themselves for who they are. Self-respect can never be underestimated.

Marg

 

[gcvmom]

Just wanted to throw in our experience with the whole blood draw issue, because as you know we are in a boat, too, though not as often as Badger. difficult child 1 tolerated Ativan for a bit -- it really, really took the nasty edge off his anxiety and allowed him to get through blood draws without having a full blown panic attack. Not saying it will help Badger for certain, but it might be worth trying if you haven't already.

difficult child 1 eventually refused the Ativan (after we got the general anxiety under control with daily medications) because he didn't like feeling loopy (guess that's a good thing!). Now he doesn't even ask for the Emla either. Just tells me to wait in the lobby and saunters in on his own.

I hope the medication adjustments work quickly for Badger -- I can appreciate how you must be feeling through all this. It can be very hard, even for warrior mom's like you

Hang in there and keep us posted on how things are going.

(((Hugs)))

 

[rlsnights]

Thanks Jean. We stay away from the benzo's cause Badger had a paradoxical reaction to Valium and we're pretty sure it's part of what landed him in the psychiatric hospital back when he was 10. Don't want to find out the hard way it applies to all the benzo's.

Thanks to everyone for your kind words of support. Our children sometimes complain about the heavy burden of being a child with two moms. But mostly it's because they have 2 MOM's if you know what I mean. One mom is plenty from their perspective.

They do and have gotten some hassle from other kids who are repeating what their elders should know better than to say even in private. But that's life. There's always someone ready to say nasty things about people who are different don't you think?

Badger is more likely to have trouble being teased for his weight actually. I'm certain that's what M was taunting him about at the park on Saturday.

Going to bed now. Thanks again and I'll keep you posted on how things go with the medication changes.

 

[gcvmom]

Yes, that would be a reaction I'd try to avoid repeating as well! Keeping my fingers crossed the next few weeks show improvement for him with the medication changes. It's no fun living on a tightrope...