It sound like your difficult child is having side effects from the increased medications. Can you refuse to take him home until they get his medications under control?? Speak with the Dr and explain your concerns. If he is worse now than he was, its certainly not going to get any better once he gets home.
The lip licking/eye blinking could be a dystonic reaction to the Abilify. It happened to my son on Risperdal (in the same class of medications as Abilify). My son's lip licking became so constant that he developed a staph infection around his mouth, and we had to discontinue the Risperdal. If it is a dystonic reaction, you have two choices: either add a medication like Cogentin to stop the movements or discontinue the Abilify. Talk to the psychiatrist tomorrow; it is important not to allow the movements to continue without medical attention.
Oh hun, I'm so sorry. I certainly know your fears of bringing home an unstable difficult child. Definitely voice your concerns before bringing him home tomorrow and I'd ask them to keep him until they can figure this out. But, it's time to probably start planning for the worst case scenario...which I must say has been the hardest part for me of this whole process. I've always been an optimist and to now continually have to always try to see the glass half empty to predict what can go wrong has been difficult. So, start preparing your plan...I guess what I'm basically saying is start preparing yourself mentally. Know that discharge may come no matter what fight you put up and know that you may have to face another trip to the ER in the near future.
And I'm SO sorry about your struggles with husband. I would be upset too. It's obvious your husband is struggling as well and doesn't know how else to cope...and unfortunately it leaves you unsupported and dealing with this alone. But, you're not totally alone, because you have us. :wink: ::::
I would definitely be addressing the tics and lip licking with your doctor before bringing him home.
My difficult child did have Tardive Dyskinesia, his was from Abilify and started the second day of taking it. Luckily he did not have any long term effects. His symptoms did not include tics or lick lipping (which does not mean I'm saying he doesn't have it just that my difficult child's symptoms were different). His tongues was making uncontrollable snake like movements and his jaw would move forcefully and uncontrollably. He also had trouble with his hands.
I'm sorry you don't feel he is stabilized yet. I would be sure to tell them this and why you feel he isn't stabilized yet. Hugs.
I've refused discharge for wm in the past. I was prepared to be charged with anything - however, wm was so not stable enough to be discharged & he had some of the tic's you are describing (too high a dose of risperdal). Mental health case manager backed me up the last time. wm ended up in the hospital because of my refusal for 6 weeks until the appropriate treatment setting could be found for him (Residential Treatment Center (RTC)).
Having said that, it doesn't work like this every time & many times the resources aren't available.
Whether husband is a part of this or not, it's time to get a crisis plan in place.
We have an official crisis team number we call however before we call for kt our steps are:
Redirect the behavior (we use humor, magazine ads for bling, favorite CD & dancing).
In the meantime, we administer kt's PRN medication & put away all sharps or anything she with which she can harm herself.
Next step is utilizing the self calming plan; kt loves to shower to calm herself or drink chamomile tea.
While this is going on I remain calm & keep my emotions, reactions in check. I'm very non-committal - almost comatose in my response to all this emotion.
When all this fails, I call crisis team. Keep in mind, on average crisis team is in our home 4 -5 times/month.
Put together whatever you feel will work for difficult child.
At discharge, ask for a PRN medication for the weekend. A chemical restraint, along with a break in the escalating chaos is better than surviving a 6 hour meltdown.
Keep any & all requests to a minimum this weekend - day treatment starting will help in the long run. You just want to survive the weekend.
I'll be keeping you in my thoughts this coming weekend.
spoke with psychiatrist and expressed concerns, she said she had not seen these tics, but she also did not mention when was the last time she saw difficult child II. She said insurance was being stingy which is why difficult child II was being released today. But if she saw the tics that they would push to keep him until 2morrow, and see what depakote levels read.
I already had planned on staying with my parents (their home is more isolated) even though difficult child II would rather be home, mainly because <A> d/h keeps calling out of work and binging day and night <B> we live in a townhouse developement and it is too hard to keep difficult child II from wanting to be outside to play with all the kids.
I have mixed emotions now because difficult child II is expecting to come home, although he told me last night he liked it there better then home.
*I also bought a bunch of Magic tree house books for his roomate (11), the child has been there for over 30 days (it's a 7 day program) and his parents have not visited once, not judging them , but my heart breaks for the kid, and he seem severely disturbed.
sigh I am so sad for you and yours. I know when ant was in an Residential Treatment Center (RTC) for two yrs, we were told by staff that many kids have no one visit for the whole time they are in.
I hope your family gets some peace soon.
I'm wondering if they're keeping difficult child today or not? It's been a while since you've posted. My thoughts are with you today.
I had a feeling insurance may be part of the reason they were trying to push your difficult child out the door. It's really quite sad how someone sitting behind a desk halfway across the country who has never met your child can decide what's best for your child, isn't it? :::: I fear this is what we have to look forward to on future admits when our new insurance becomes responsible for paying...that's what I've been told anyway. :frown:
I hope all goes well. I'll be thinking of you!
(oh and just to add to the no visits comments...it is sad. Thursday night is "family night" on the unit where my son is and it's "mandatory" otherwise they refuse visitation...or at least that's what they threaten in the parent handbook! They are a 20 patient unit and during the parent group on family night there are usually only about 6 sets of parents on a "good" night. It's awful. I feel so bad for a lot of those kids. One of the kids is living there for the time being because the state can't find her a foster home.)
They did manage to get the insurance company to allow him to stay for a few more days. No one can tell me how many.
But the Psychiatrist decides after hearing my concerns about difficult child II's tics to......
raise the Depakote another 125 mg!!!!!! What's worse is she did not tell me she did it, I found out from his social worker "I see she raised his dose this morning again" I was like WHAT???? SW says he was fine all day but Psychiatrist told me he was angry and defiant ever sense my visit last night (way too many versions here, which is which?)
Then his social worker calls me frantic that difficult child II thinks he's going home and it's going to be tramatic, and I should tell him he's staying. I get a knot in my stomach to have him tell us he knows because he saw his name on the board for tommorrow and there was no "goodbye" time during his last group of the day (he is a smart kid). He was not crying but was annoyed and expressed he no longer liked it there.
SO I am on the fence here, difficult child II has an evaluation 2morrow with a new psychiatrist here in town that the school is paying for. They have been kind enough to keep his appointment open, knowing he may not make it. I am feeling like yanking him 2morrow and going to the evaluation. The raise in medications really has me feeling a lack of trust for his care there.
my head is spinning and my ankle is still throbbing, it has not been a good day.
Oh (my daily chuckle) difficult child I has decided he wants to become a psychologist, I told him a HS diploma would help in that endever, LOL, hey it could happen!
My understanding is that the psychiatrists (and I could be wrong, but this is my experience) only really ask for permission to CHANGE medications, not dosages. M's dosages have increased without a phone call before, but medications won't be added or removed without permission. I guess once a medication is in the mix, the psychiatrists basically have free reign of the dose, within limits I would imagine.
The fact that she rasied the dose suggests that difficult child probably WAS more on the out of control side than the "fine" side that the SW believed he was. It sounds like they either have different ideas of what "fine" is or there are some communication rifts. But, the SW isn't there ALL the time. The other staff on the floor are more apt to really know how your son is doing on a day to day, hour to hour basis as they're the one's truly dealing with him. I assume you have the ability to call the nurses station and get updates 24/7? I'd call THEM for your updates before you speak with the SW or psychiatrist.
It's great that the SD will hold the evaluation. As much as you want to pull difficult child from psychiatric hospital...if he's not stable, he's not stable, and really that's the last thing you want...esp if your husband is not stable either.
I say call up a girlfriend and go out to dinner and a movie or something this weekend. As hard as it will be, take a break. Do something that is about YOU this weekend.
"I assume you have the ability to call the nurses station and get updates 24/7?"
I do call but all I get is he's fine not many details, when I ask for details I get put through to SW voice mail.
difficult child II actually called me at 7am this morning. He seemed calm (probably tired) said he was sad yesterday about not coming home. He is also still obsessing about his yo yo, they have it locked up there, and I suspect he's driving them nuts about wanting to have it.
Speaking of yo yo's. I also have to stay away from the stores, I am buying things left and right for difficult child II, which is terrible because when he is with me I always emphasize not buying him things, and I am buying things that if he were with me he'd be throwing a fit for me to buy them for him, oh gosh I am mental aren't I???
I have Birthday & Xmas bought for hypothetically, LOL!!!
PS difficult child I and I have a date to see Silver Surfer this afternoon.