Figured out why I'm nervous about Lithium

Discussion in 'General Parenting' started by nvts, Mar 2, 2011.

  1. nvts

    nvts Active Member

    Yay! I know what was bugging me.

    Now, try and follow my logic (sometimes I confuse myself - I swear, running in cricles does that to me!).

    difficult child 1 goes into psychiatric hospital for medication assessment two Thurs. ago.

    They add tenex, increase trileptal and start lowering risperdal.

    They call me the following Wed and tell me that they're considering discharging him on Friday. I was shocked. His counselor and psychiatrist are both going to be on vacation Thurs,. Friday, and Monday, so I'll get a call from a supervisor after they make arrangements with difficult child 1's community residence director.

    I call the comm. res. and she's as surprised as I am, and proceeds to tell me that she's out on Friday as well, so not to worry no one can authorize a discharge to the residence except her.

    I go see him on Saturday and spend about 4 hours with him. He's calm, easily redirected and pleasant.

    I get a call on Monday saying that they're considering lithium.


    Now remember, psychiatrist and therapist are on vacation still. These are covering professionals. I ask "what happened?" We were preparing for him to come back to the comm. res.?

    He's acting hyposexually - inappropriate conversation and gestures. They called the comm. residence for a historical behaviors and decided that lithium was necessary.

    difficult child 1 called Monday night and I asked him what happened. He said that the guys were hanging out in the common room (he's the youngest - the age in the dorm is 12-16 years old), and the guys were talking about what they're doing with their girlfriends/"ho's" that they pick up. As usual, he chimed in trying to fit in. He said that he stopped when the adults told him it was inappropriate.

    His normal therapist called me yesterday and I told her that something was bugging me and I couldn't put my finger on it. I asked her to tell me what had gone on over the weekend. She said that the report was very vague, but she asked around on the floor and that he apologized as soon as the adults called it to his attention. No meltdown, no cycling, no manic reaction. Nothing. She explained that when the CR (comm. res.) was called, they explained that those types of sexual conversations/gestures occured, mania and meltdowns and mayhem always ensued. So that's what they're basing their decision on.

    So...I asked for 48 hour observation. Here's my reasoning: As an aspie, difficult child 1 has always tried to "play to the room". He visually sweeps a room and tries to identify the "type of group" and assumes the personna of the group. When we had a meeting to discuss going to the psychiatric hospital. he showed up in a suit with a "briefcase" (his empty poker set) with envelopes and paper clips and asked the secretary to make copies of his report card to hand out. Other times, he's walked into rooms with teenagers and gotten a foul mouth, room full of little kids and become a role model, kids his age-bossy. You get my drift.

    I need them to watch and see. Was he showing off or was he "cycling"? She admitted that she wasn't sure because no one that had worked with him was there or was able to get a full report on the occurance. I explained that my fear is that in the past, no mood disorder medications had done any good. Nothing. Abilify, seroquel, risperdal - nothing. I told her that I'm not resisting a diagnosis or medication change, I just don't feel comfortable that this was a good idea based on the fact that nothing was documented and that it was all "covering" professionals that were going with an incomplete report based on 1 incident.

    She agreed to the 48 hour observation and was going to let the psychiatrist know. He was supposed to call me (I left a message with her AND on his voicemail) but never did.

    I'll keep you posted! And again, thanks for all of the support on this one!

  2. smallworld

    smallworld Moderator

    Beth, you may be on to something. Unless he's a danger to himself or others (and it doesn't sound like he is), there's no need to rush into this medication decision. Good work, mom.
  3. nvts

    nvts Active Member

    You know what it is? They've upped the trileptal and added the tenex and there's been a serious change. He's redirecting himself - if something is stressing him out, he'll put himself into the quiet room with a book. No outbursts, no running - just self-redirection. Something just isn't clicking here. Could he be honeymooning? Sure. But so far, no one can answer that for certain. So, I want them to wait.

    Thanks for the back-up - I think I'm basically ticking off the free world with this "stop, look and listen" strategy! :sigh::imok:

  4. AnnieO

    AnnieO Shooting from the Hip

    Tick off the entire free world. You know him better than ANYONE else.
  5. kfmewes

    kfmewes New Member

    I do the same thing when they want to mess with my son's medications. They get really irritated when I refuse to let them change anything without doing my own research. Not to mention, they absolutely hate the site I use to research side effects but, personally I like to know from people who take it what the most common/severe side effects of the medications. It's ok to tick them off, they should just be happy that you care enough to be so careful.
  6. rlsnights

    rlsnights New Member

    That's a lot of medication changes in a short period.

    My rule and my psychiatrist is totally on board with this - one medication change at a time. Otherwise how do you know which medication/change is the one causing/contributing to any change in behavior/mood? Or causing new side effects? This even applies (perhaps especially applies) to hospitalizations.

    I agree - now that you've been able to share the bigger picture. If he's not a danger to self or others (or acting like Charlie Sheen who sounds totally manic with a dash of delusion/psychosis thrown in) then I would wait and see.

    Good call Warrior Mom.

  7. susiestar

    susiestar Roll With It

    Stick to your guns. Adding lithium in the situation you are describing is nuts. There is NO WAY that covering docs and staff should try to substantially change medications unless a major crisis is happening - they barely know the child and you can be super-dooper-double-darn-sure that they are NOT going to read his chart to see if you have tried this already or if there is another plan that has a different medication being changed for the same reason in a day or two.

    For all that they insist that we fill out all those forms and don't skip any of their little boxes, I haven't found many docs who will stop and really read the chart at even one point while we are their patient. It isn't just that they ask the same questions that the nurses and the receptionist ask. They don't even bother to make sure that they know what THEY planned to do when you discussed medication changes and made a plan for gradual changes to be made over a couple of weeks/months at one time!!!!!!!!

    So there is almost no way a covering doctor can make an intelligent and accurate medication change - they just do not have enough info. That doesn't stop many of them from going ahead and doing it anyway!!1

    I am glad you put all of the info together and didn't let them go ahead and start him on it.

    I hope his behavior is a sign that he is willing and able to make better choices and choose safer actions.
  8. shellyd67

    shellyd67 Active Member

    Great Mommy gut Beth ! We do know our kids best ....
  9. HaoZi

    HaoZi Guest

    I *shudder* at the thought of covering docs. When Kiddo was in psychiatric hospital I got a call that one of the covering docs wanted to try her on Celexa. I almost hit the roof - that's one of the medications that landed her in there and it's right there in her chart!
    I totally back you on the wait and see thing, since it does sound more like he was trying to play the room. I bet he has no idea what they were talking about in any real sense. Heck, at those ages I bet the guys he was agreeing with hardly know what they're talking about!