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Input about school vs. home behavior - long
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<blockquote data-quote="rlsnights" data-source="post: 311236" data-attributes="member: 7948"><p>Read the Explosive Child several years ago and still have it on the shelf. Gave us a lot of good ideas that have helped us get this far.</p><p></p><p>We are working on medication adjustments. It's been a see-saw the past several months.</p><p></p><p>He became manic on SSRI 2 yrs ago which then led to starting Abilify. Early this year when he had seemed to be fairly stable we tried withdrawing the Abilify to see if the mania was AD induced or what. Got manic again so back on the Abilify which helped but wasn't perfect.</p><p></p><p>We had also started seeing metabolic SE's from the Abilify - weight gain, higher fasting glucose. So we started him on Lamictal - the slow titration so that took several weeks. When he reached 100 mg we dropped his Abilify from 7.5 to 5 mg. Well his liver enzymes went way up about 4 weeks after reaching 100 mg Lamictal. So we had to hold steady and re-checked labs. Everything went back to normal so we increased Lamictal again to 150 mg about 1 week before school started. Once school started he began major melt downs at home on the weekend.</p><p></p><p>After the last one where he was clearly going through a manic episode we doubled his Abilify to 10 mg and increased the Lamictal to 200 mg. That was roughly 10 days ago. So too soon to see much change except maybe from the Abilify.</p><p></p><p>We re-check labs again in 2 weeks to see how his liver is doing. Not sure what will happen then.</p><p></p><p>At psychiatrist appointment last week we discussed adding Geodon to help with his anxiety but decided to wait a while and see if the Lamictal and Abilify dose increases helped. Trying to avoid too much muddying of the waters by changing a lot of things all at once.</p><p></p><p>So we are definitely still tweaking medications.</p><p></p><p>Homework with Badger ... well he's not melting down over homework because he's racing through it with no regard for accuracy, spelling or following the directions, etc. Most days he brings nothing home - says he's completed it all in class and turned it in</p><p></p><p>I guess I'm relieved that we are not battling over homework. But I feel nervous - like I'm waiting for the other shoe to drop. I wonder when his lousy efforts are going to catch up with him or the workload is going to go up and he'll start to fall apart under it.</p><p></p><p>I think that's already happening in science - thus the teacher's request for the 2nd meeting in 3 weeks.</p><p></p><p>Cannot get the history teacher to respond to any of my e-mails, which is really starting to bug me since he told me e-mail was the best way to confer with him. Perhaps he thinks no news is good news but to me no news is just that - no news.</p><p></p><p>And the poor Special Education teacher is 15 kids over her limit and looks more harried every day. Badger has her for math and language arts. I can't bear to even ask her how he's doing because she is just so earnest she will bend herself into a pretzel to try to give me a comprehensive update.</p><p></p><p>I wouldn't be so concerned about it but Badger's IEP is scheduled for 10/20 and I worry that they will want to take all the services away except Special Education math because he's doing "so well". I can always call for another IEP meeting if things change dramatically but it would be much better for everyone if we didn't have to do that.</p><p></p><p>And I'm not convinced that the school is really meeting Badger's needs on any front. But it's hard to pin that down because Badger often looks like he's doing fine and like he gets what's going on. But when you test him or demand meaningful output, especially written, it becomes clear that he doesn't understand nearly as much as he ( or you) thinks he does.</p><p></p><p>The school has one counselor for 620 students. The police officer assigned to the school is more accessible than the school counselor. There's no social skills program or any other real support for the students except what they get from the VP who handles discipline. </p><p></p><p>Since he's not throwing things, being incredibly defiant, or getting into fights and trying to attack other students with any weapon at hand while screaming death threats (all things happening at home) there's no obvious connection between what's going on at school and what's going on outside of school. So, even if the school were willing to make changes, it's difficult to know what changes to make.</p><p></p><p>He started with a new therapist the week before school started. The guy is good but Badger is very good at imitating a kid who is just going through a streak of adolescent rebellion. It took last weekend's mania and my blow-by-blow updates to the psychiatrist and him for therapist to get on the right bandwagon and stop telling me to just send Badger for a walk when he started getting upset.</p><p></p><p>So I'm hoping that will be a productive change. Only time will tell.</p><p></p><p>Got to go to bed. Thanks for the replies - guess I'm just going to have to give it time.</p></blockquote><p></p>
[QUOTE="rlsnights, post: 311236, member: 7948"] Read the Explosive Child several years ago and still have it on the shelf. Gave us a lot of good ideas that have helped us get this far. We are working on medication adjustments. It's been a see-saw the past several months. He became manic on SSRI 2 yrs ago which then led to starting Abilify. Early this year when he had seemed to be fairly stable we tried withdrawing the Abilify to see if the mania was AD induced or what. Got manic again so back on the Abilify which helped but wasn't perfect. We had also started seeing metabolic SE's from the Abilify - weight gain, higher fasting glucose. So we started him on Lamictal - the slow titration so that took several weeks. When he reached 100 mg we dropped his Abilify from 7.5 to 5 mg. Well his liver enzymes went way up about 4 weeks after reaching 100 mg Lamictal. So we had to hold steady and re-checked labs. Everything went back to normal so we increased Lamictal again to 150 mg about 1 week before school started. Once school started he began major melt downs at home on the weekend. After the last one where he was clearly going through a manic episode we doubled his Abilify to 10 mg and increased the Lamictal to 200 mg. That was roughly 10 days ago. So too soon to see much change except maybe from the Abilify. We re-check labs again in 2 weeks to see how his liver is doing. Not sure what will happen then. At psychiatrist appointment last week we discussed adding Geodon to help with his anxiety but decided to wait a while and see if the Lamictal and Abilify dose increases helped. Trying to avoid too much muddying of the waters by changing a lot of things all at once. So we are definitely still tweaking medications. Homework with Badger ... well he's not melting down over homework because he's racing through it with no regard for accuracy, spelling or following the directions, etc. Most days he brings nothing home - says he's completed it all in class and turned it in I guess I'm relieved that we are not battling over homework. But I feel nervous - like I'm waiting for the other shoe to drop. I wonder when his lousy efforts are going to catch up with him or the workload is going to go up and he'll start to fall apart under it. I think that's already happening in science - thus the teacher's request for the 2nd meeting in 3 weeks. Cannot get the history teacher to respond to any of my e-mails, which is really starting to bug me since he told me e-mail was the best way to confer with him. Perhaps he thinks no news is good news but to me no news is just that - no news. And the poor Special Education teacher is 15 kids over her limit and looks more harried every day. Badger has her for math and language arts. I can't bear to even ask her how he's doing because she is just so earnest she will bend herself into a pretzel to try to give me a comprehensive update. I wouldn't be so concerned about it but Badger's IEP is scheduled for 10/20 and I worry that they will want to take all the services away except Special Education math because he's doing "so well". I can always call for another IEP meeting if things change dramatically but it would be much better for everyone if we didn't have to do that. And I'm not convinced that the school is really meeting Badger's needs on any front. But it's hard to pin that down because Badger often looks like he's doing fine and like he gets what's going on. But when you test him or demand meaningful output, especially written, it becomes clear that he doesn't understand nearly as much as he ( or you) thinks he does. The school has one counselor for 620 students. The police officer assigned to the school is more accessible than the school counselor. There's no social skills program or any other real support for the students except what they get from the VP who handles discipline. Since he's not throwing things, being incredibly defiant, or getting into fights and trying to attack other students with any weapon at hand while screaming death threats (all things happening at home) there's no obvious connection between what's going on at school and what's going on outside of school. So, even if the school were willing to make changes, it's difficult to know what changes to make. He started with a new therapist the week before school started. The guy is good but Badger is very good at imitating a kid who is just going through a streak of adolescent rebellion. It took last weekend's mania and my blow-by-blow updates to the psychiatrist and him for therapist to get on the right bandwagon and stop telling me to just send Badger for a walk when he started getting upset. So I'm hoping that will be a productive change. Only time will tell. Got to go to bed. Thanks for the replies - guess I'm just going to have to give it time. [/QUOTE]
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