difficult child psychiatric hospital update

[Wiped Out]

We had a meeting with the psychiatrist and the sw at the hospital today. difficult child has been having some side effects from the Depakote. He's been on it before but not with the combo of medications. He has been walking with a shuffle and drooling quite a bit. They have lowered some of his other medications and are now adding a medication (that I can't remember the name of) to try to counteract the side effects. Today when we visited we didn't notice any drooling and the shuffle wasn't noticeable so it may actually be working.

Tomorrow and Sunday we will be taking him out of the hospital for a few hours on a pass. Depending on how he does with that we will bring him home Monday night so he can try school on Tuesday. If he does o.k. at school he will stay home if not he will return to the hospital. They want to be sure he can maintain outside of the structure of the psychiatric hospital.

When we take him home on Monday they want us to take him home as if we are discharging him because they don't want him to be stressed worried he might have to go back. They want to see how he does at school with-out the pressure of wondering if he will go back or not. I totally understand but am going to feel really bad if he has to return, I feel like he will think we tricked him.

I do like that the hospital seems to be taking their time. They have been really nice with us. They have talked with difficult child's psychiatrist and therapist who have really given them a lot of info about difficult child. They have told us they think we have been doing a good job with difficult child. They seem impressed he has not been in the hospital for two years.

It's nice not to feel like the last time when the psychiatrist in the hospital made us feel like it was all our fault. I'm glad she is no longer there (I had heard lots of not so good things about her from people in the know).

On another note the principal at difficult child's school was at husband's school today. She said they have applied for an emergency aide for difficult child (she doesn't know if they will get it or not but at least she is trying).

I'm hoping we see some positive changes when difficult child comes home. It's hard to know if he will be able to maintain outside the structure of the hospital. It will be interesting because last night he started getting very upset while playing a game because he didn't want to follow the directions. Even so, he didn't physically threaten and didn't stay upset long.

 

[tiredmommy]

It sounds like things are moving along and you have a plan in hand. I hope he is able to maintain too but don't be too disappointed if he needs to be re-admitted. I'm sure you and husband will let him know in a loving way that he needs a little more time to be stabilized. {{{Hugs}}}.

 

[crazymama30]

Is the medication Cogentin, or something like that?

 

[GoingNorth]

According to my psychiatrist, Cogentin (benzatropine), isn't usually used for Depakote tremor. It is used for tremor and other side effects of anty-psychotic medications. I think the drooling and shuffling gait are from the APs, or at least that's what my experience has shown. Depakote makes me shake, the AP makes it worse, but I've never experienced drooling from Depakote, just tremor and the inevitable weight gain.

 

[totoro]

It does sound like they are trying to make a positive plan for the whole family and for his stability.
I think this may give him a chance to gain stability and gently re-enter the "real" world safely.

Continue to take care of yourself during this time.

 

[klmno]

You're doing the very best you can and have held up thru a lot so don't be too hard on yourself if he does need to be readmitted. As you know, getting a long term plan that is more effective is the most important thing for him as well as the rest of the family. He knows you love him and I doubt that could ever change. I'm glad you have a more understanding psychiatrist and a team that is trying hard.

 

[LittleDudesMom]

Sharon,

just wondering what the definition of success is? Is the line violence? What criteria is the team is using that defines a "good" day at school.

Sharon

 

[gcvmom]

Don't stress too much about the possibility of him going back and that he might feel "tricked". Maybe the way to approach it with him is to just not make any promises if he asks whether he ever has to go back. psychiatric hospital is a place to go for help, it's not a punishment. If you have to go back, it just means they didn't get a chance to finish helping you with everything. They want to make sure they do the best job possible for him.

I've never been in your shoes, but this is how I imagine I'd deal with it -- and I could be completely off. I do hope that he's truly stable enough at discharge to be successfully functioning at home and school.

How are you doing during this break from him?

 

[KTMom91]

Glad he's doing well, and the district is making an effort for him. Hugs to you.

 

[Wiped Out]

Thanks everyone for your support. I think the medication is Cogentin.
Sharon-Good question, I will be sure to find out.

We took difficult child out on a 3 hour pass today. We took him to a movie. It wasn't a great visit. When he got in the car he was immediately demanding and disrespectful. On the way in he punched two handicapped parking signs. After the movie we took him to Arbys. He was very rude and disrespectful and kept gently kicking my feet but not in a nice way (hard to explain). At one point I left to go sit in the car. I was trying to hold back tears but really his meanness was getting to me. In the car on the way back to the hospital he was escalating. Asking us to stay longer, then demanding, and then he threw something down in the back of the car.

I was really hoping for a better visit. Feeling kind of down this evening.

 

[klmno]

I'm so sorry to hear that. I'm starting to form an opinion though that there is more to his behavior then needing medications. - Not that he sstill doesn't need them- but maybe he's of an age where's he's trying to manipulate a little and so forth on top of dealing with his own issues. I know this must be extrememly difficult for you- I hope the team really can help determine what is what and get him some help so this doesn't just turn into a respite situation and he's sent back home with nothing more in place except a medication change that isn't improving things.

 

[tiredmommy]

{{{Sharon}}} I'm sorry the pass went so poorly... you must feel so let-down.

 

[smallworld]

Sharon, just know that it's too soon to judge whether the new medications are working or not. Depakote takes 6 to 8 weeks at a therapeutic level to become fully effective. I wish the pass had gone more smoothly, but I hope you know it's no reflection on you or anything you're doing. Your difficult child has been dealt a tough hand, and his challenges are going to take a lot of interventions. Gentle hugs going out to you tonight.

 

[barneysmom]

Sharon, thinking of you tonight. It's so true, like smallworld said, that what your difficult child is doing is not a reflection on you in any way. I myself am trying to de-personalize gfg16's behavior. I'm not there yet. So I understand what it's like to be hurt and down.

I recently have realized that I haven't yet accepted gfg16's limitations. I'm in the grieving process. I think I'm pretty much in the anger stage. Well I guess I'd have to call it rage. Underneath my rage and fear is the deep, deep grieving.

I think when I can gain a better acceptance of who he is, I'll be more free.

Well, this thread isn't about me. Hang in there -- sometimes it's very tough, even with the rhino skin on. He's lucky to have you as a mom. Seriously.

hugs

 

[Usha]

The meanness and disrespect are I think the hardest to endure or understand. The 'depersonalization' process barney's mom mentioned is something I am working on too. Sharon, sorry for what you are going through and you are in my thoughts too.

 

[LittleDudesMom]

Sharon,
so sorry that your visit with difficult child was just more of the same. I believe, and you know I am no expert, that it is ever-so-soon for the new medications to really be making difference. I'm thinking the team's expectation that "should he do well at school he can continue home" was way too high. It is clear that difficult child is not really stabilized yet. I'm thinking you said there was another visit off premises today.....Not sure that should really be an option Sharon. difficult child sounds wired up, disrespectful, and pretty much the same as when he left.

Hugs to you.
Sharon

 

[klmno]

I think I would be concerned about leaving the psychiatric hospital with him, too, at this point. Can it be changed to a pass to allow him off the unit but not psychiatric hospital grounds? Do they have a restaurant or sitting area that would allow some time alone together to talk and eat but still leave him officially on their grounds? I'm concerned that he's going to run and you might need their staff to help retrieve him. ((HUGS)) Try to look at this current behavior as confirmation that you did the right thing by taking him and admitting him.

 

[ML]

I am just adding my support here. As I read about the day pass I felt your disappointment to my core. I definitely feel that he's just not ready yet to come home. I wish they would give him a little more time. I mean if he struggles on a 3 hours visit how can they expect him to do the demands of school. My prayers and good thoughts are with you. Love, ML

 

[Wiped Out]

Again, thank you all for your support, it means so much.

I was really surprised today that when we talked to the psychiatrist and told her we didn't think difficult child was ready for school yet she canceled the pass for tomorrow night. We did take him out today and he did fine but we only took him for an hour and for ice cream so there were no stressors put on him at all. My guess is he'll probably be discharged Tuesday or Wednesday but I was glad the psychiatrist listened to us today.

 

[Fran]

Hugs.