shocked at on-call psychiatrist's 'solution'.

Discussion in 'General Parenting' started by maxeygirls, Jun 13, 2010.

  1. maxeygirls

    maxeygirls New Member

    Sorry I've been absent for so long, we've been super busy and handling lots of changes. Recently we changed difficult child's medications from risperdal and depakote to abilify and a slightly higher dosage of depakote. The risperdal just wasn't working. Changing over took just under a month and we have been doing just the abilify and depakote for two weeks now. What I have noticed is that difficult child no longer gives any warning when she is going to turn violent. She is still cycling, although it is much easier for her to handle. Over the last week though, I can see her slipping. She can be whining for something, just like any other 3.5 year old kid and all of a sudden she snaps, bites me, claws me, hits me, etc. No two instances are the same. Over the last few days her outbursts have included easy child, who just turned a year old last week. Today she scratched three 8" gashes into easy child's bare back. She never raised her voice, changed her body language or even changed her facial expression before, during or after. I had no warning and was only 2' away when it happened. Within minutes after the entire ordeal was over, difficult child was back to semi-normal until the next whining fit began. Thankfully she went after me that time.
    Unsure of how to communicate with difficult child, and being concerned for easy child's safety I called the on-call psychiatrist at her psychiatrists office to get some advice. He listened to me as I explained how difficult child is fine for 90% of the day but 3-10 times a day she has very violent outbursts and acts as if nothing happened scant minutes later. Instantly he told me his solution; they have these helmets with a mouth guard which would prevent her from biting (which she has only done a time or two recently and I explained that) and I can tape winter gloves onto her hands to prevent scratching (once again, very unusual behavior for her). He then asked if I had a playpen. I thought he'd suggest putting easy child in there for safety but no, he wanted me to put difficult child in it for the majority of the day. I supressed a laugh at this, difficult child is 44" tall and weighs close to 50lbs. She could practically flatten a playpen in seconds.
    I was shocked at his 'solutions' as well as the way he kept comparing difficult child, who is diagnosed with bipolar disorder and tests at a 1st grade level in math and reading, with mentally challenged children who are stuck at being 2 years old and with severely autistic children. Now I mean no offense to anyone with children such as those he mentioned, but each kid has to be treated differently and I was outraged at his suggestions. He even told me I could come to the hospital and pick up a helmet this afternoon and got a bit peeved when I told him I refused to try his methods.
    He even went as far as to ask if I could put difficult child in a crib to restrain her... she turns 4 in September, is fully potty trained, incredibly smart and taller than almost every 5 year old. I wouldnt even us a crib to try to restrain her when she was 2 years old.
    Sorry, I guess I needed to rant about that, I'm just in shock with his attitude and 'solution' to this issue.
    Does anyone have any suggestions as to how I can get through to difficult child before we hit the point of exploding? I've tried being super gentle, being firm, indifferent, harsh. I've even tried ignoring her, which results in immediate violence.
    Should I express my outrage at the on-call psychiatrist's solutions when difficult child's psychiatrist calls tomorrow?
    The little faith I had left for our childrens hospital is dwindling very fast, thanks to this guy.
  2. SRL

    SRL Active Member

    I'm definitely shocked by this "solution". Helmet and mouthguard and taped hands....I'm suprised he didn't want you to tie up her legs so she couldn't kick anyone either.

    Mind you, I understand there are appropriate times for appropriate restraint, but taping her hands and guarding her mouth--how is that supposed to help her gain self control over the problem?

    I'd definitely be talking to her own psychiatrist about it.
  3. maxeygirls

    maxeygirls New Member

    Exactly SRL, I do have to restrain her at times and can do so with a little bit of a struggle by using my own body. At times I end up with a scratch or two but it calms her down, allows her to think clearly. But he was talking about an all day, every day solution. If difficult child was unable to understand her actions I may feel differently but she does understand, it just takes more time. Im still so angry.
  4. nvts

    nvts Active Member

    Hi! I hopped on the NAMI website and checked to see how long it takes for both medications to "work". Depacote showed 6-8 weeks and Abilify was 4-6. These are some serious medications for a little one, so I'd make super sure that I let her regular psychiatrist know of these outbursts. It's got to be some frightening stuff! The other clown sounds like a real brain! I'd run screaming away from that guy!

    Big hugs to you! This isn't easy stuff to deal with.

  5. maxeygirls

    maxeygirls New Member

    Beth, thanks for the info. She's been on the depakote for about 6 or so months now, we just increased her dosage by 50mg twice daily. We started the gradual process of changing the risperdal over for the abilify about 4 weeks ago. Ive also noticed that with her, it seems to take just a little bit longer than they tell me for her to adjust. She gets monthly blood tests, so we keep a close eye on the medications. Her psychiatrist should be calling me tomorrow, this psycho said he'd pass the message along. My husband is in the field and called to check in tonight, lets just say he isn't happy with the advice given today.
  6. smallworld

    smallworld Moderator

    One thing you have to know about Abilify is that it is not as sedating as the other atypical antipsychotics. In fact, it can be activating. I'm wondering if that's what you're seeing. What dose Abilify is she taking?
  7. maxeygirls

    maxeygirls New Member

    Well that would explain the issue with not sleeping... She's taking 2mg total per day, 1/2 pill in the morning, 1/2 at night. She goes to sleep just fine but wakes up within 4 hours, sometimes I get her back to sleep, sometimes I don't. Since Thursday night I've gotten about 7 hours of sleep and considering how tonight is going, I'm going to guess I'm pulling another all-nighter like Friday night.
    I feel so stuck. We tried different doses of Risperdal for months, and a slight change had a drastic change in her. One dose did nearly nothing but adding only a few drops turned her into a zombie. She's so much better focused on the Abilify, able to speak clearer, talk through her problems for the most part and acts more her age than I've ever seen. Now I'm starting to worry due to the lack of sleep and the odd violent outbursts with no warning. And of course, this all has to happen while husband is field training. Thank God he'll be back next week, I need reinforcements and I'm almost out of coffee and sanity.
  8. SRL

    SRL Active Member

    I'd be sure to mention not having any warning to when she's going to turn violent, because it's impossible to keep her or others safe with that going on.
  9. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    I'm in a therapy group with a woman who takes Abiify and she has to take it in the morning or she can't sleep. It helps here (she has hallucinations) but it also makes her jumpy. Several adults have gone off of it because it made them jumpy.

    If the medications are not helping, it is possible she was misdiagnosed. She's so young that most of the time the diagnoses change when the kids get older. You may want to take her to a neuropsychologist for another evaluation if the mood stabilizers aren't evening out her moods. Good luck ;)