Tourette's you say???

[buddy]

Ok so I told you guys I would ask about the Tourette's. Basically the psychiatrist said, yup, he meets criteria... except for the fact that we know it is from not only the brain injury but probably the prozac and concerta add to it...

We are going off of the prozac! I am glad, it never really did what we wanted it to do becasue it turned out to be seizures. She said it is especially notorious for causing aggression in teenagers. so we will go off very very slowly because of his issues.

We are switching back to short acting Ritalin...she said sometimes the Concerta can add aggression, not supposed to and that it is not as even a medication as another formula so we can try that during Christmas break, which ..by the way they said they may put him in their partial program for that. THey have low numbers during that time.

She said there may come a time when becasue he is so sensitive to medications we need to put him in for a medication wash....she thought I'd have up to 45 days witout losing pay.... I think she is thinking of SSI not MA health insurance waiver money. I told her I got NO pay for while he was in the hospital and the PHN confirmed it with her supervisor. Can't double bill And besides, I am ok with going slow. I dont want him off concerta so it is not necessary to do that. We just will go much much slower in future. NO option for the seizure medication this time but now that we know....

I told her I dont think the lithium is working but she said it is not enough time at the current dose to tell for sure.

And for the Tourettes...she said, just tell people that is what it is when you need to say it. How reasonable is that? So, when people dont understand what is going on...we can say that... when we dont want to muck up the system then we will just not bring it up.

 

[TeDo]

That all sounds like great stuff. I am very happy that things are gong somewhere. As you know, the Prozac caused SEVERE aggression in difficult child 1. That could explain some of it.

 

[confuzzled]

and concerta made mine nuttier that a fruitcake.

(maybe the not best joke to make here, but its the most accurate description i can come up with--it was horrific beyond words)

it does all sound like good stuff, and i know it might not be financially possible for you, but i think an extended stay to re-evaluate medications sounds like a great plan.

tell me again why they dont want to try trileptal with him?

 

[Steely]

SOooo glad he is going off Prozac - I think that will help a lot. I also think going off Concerta will help, but what do I know! Sounds like a good psychiatrist!

 

[lovelyboy]

Wow...this is alot of info to absorb! How do you feel about all this?
I was absent for a few days.....don't want you to double post....but what made you suspect Tourette?

 

[InsaneCdn]

Lovelyboy... basically, she had a raft of us on the board TELLING her to suspect it...

Its part of the friendliness of the board... sometimes we are wrong. But the power of multiple perspectives often provides clues that aren't necessarily obvious to the person in the middle of it all...

 

[buddy]

to be clear, he is not going off Ritalin....just switching back from Concerta to Ritalin because she said sometimes, even though it is the same molecule, the way the concerta is made and the way it is released may be an issue. He can't be safely off ritalin. we had neuropsychologist testing to check him on and off while inpatient and even those who thought he should be off it said it was unsafe. He had to be restrained four times. He never needs restraint. He can always be talked down and except for this past month with the medication changes, he had been doing fine on it. We only started exploring other medications to be proactive for when these dont work as well... nothing terrible was going wrong. remember when I started here we were coming off a high...best summer ever. he was doing great socially, behaviorally etc. (I mean he will always be Q, always blurt, always have issues, but he has only had big problems when medications have been wrong).

I would not want him inpatient anywhere just as I would not want him in a special needs only school. HE is too imitative and then we have years of behaviors taht could make any further placements in schools or residences for living not work. By how he reacted this past hospitalization, I would not risk it unless it was a medical emergency. There is no reason to rush anything when I have support with Integrated Listening Systems (ILS) and I am not feeling burned out nor unsafe. I would rather be planful and do it little by little.

Even school during that meeting had to say they have never had to restrain him, he has never seriously hurt anyone or been dangerous to anyone. Just dont like the blurting/swearing etc.


The tourettes I asked about because for years we have said what I said when he was little about autism. I would say autistic-like. But eventually had to face it was autism for sure, not just the brain injury. But with the tourette's idea, there were some reasons, like some people might understand the blurting part easier.... that made it worth looking at.... but for other reasons, like some people think that the behaviors that come with Tourette's are manipulative etc. I have been there and had to fight for kids. IT also would make no difference in educational programming except to slant things toward ebd programming which does not work for him.

So, after talking about that (never was a doubt he has tics, that was never a question, just if you could call it Tourette's legitamately) she basically said yeah, I could say that when it benefits him, because except for the cause of it being a brain injury (and medications that can add to it) he would meet criteria. It would not be added to his diagnosis in a record anywhere...just that if anyone asked her she would back it up to show it is tics. It just might help some people understand that the blurts are not personal.

 

[Hound dog]

So, after talking about that (never was a doubt he has tics, that was never a question, just if you could call it Tourette's legitamately) she basically said yeah, I could say that when it benefits him, because except for the cause of it being a brain injury (and medications that can add to it) he would meet criteria. It would not be added to his diagnosis in a record anywhere...just that if anyone asked her she would back it up to show it is tics. It just might help some people understand that the blurts are not personal.

Good. Because it's important for them to understand it is NOT personal.

Travis has the actual diagnosis of tourettes, but his is due to the brain injury like your difficult child's. It did make it so teachers would have to stop riding him over the verbal and nonverbal tics he couldn't control and would actually get worse if they brought attention to them. Which was nice.

 

[ksm]

We are going off of the prozac! I am glad, it never really did what we wanted it to do becasue it turned out to be seizures. She said it is especially notorious for causing aggression in teenagers. so we will go off very very slowly because of his issues..

Our difficult child was especially irritable on prozac too. Stratera made her go in to rages. It seems like she is better off of medications than when we tried them! Of course, it is not that good with out medications, either. But some of the over the top behavior is toned down. KSM

 

[pepperidge]

Interesting on Prozac. I have a young teenager that got much more aggressive/disinhibited on Zoloft but psychiatrist poo poohed any suggestion that the Zoloft was responsible. I will tell you that when we stopped it the behavior was significantly less.

On Tourettes I like the approach of your doctor. diagnosis's should be used to our kids' advantage. There is so much overlap in symptoms etc and medications are so blunt for most of the problems that alot of it is just trial and error. diagnosis's are just gateways to getting services, medications etc more than they are precise roadmaps on what to do.

We did have issues with both of my sons on more aggression with stimulants, but basically the trade-offs are worth it.

 

[BusynMember]

Buddy, I just want to add that my son is also very sensitive to medication and every stimulant, Ritalin included, made him mean and aggressive and he isn't like that at all.

 

[buddy]

Well things are sure changing... I am getting emails instead of phone calls...that is fine. Now the sp ed director and teacher want to go over the plan we revised tomorrow at 8:30. the email she sent me said he had sexual talk and swearing today. Called some kids names (which I have to say they are ugly to him , I witnessed it again, one of the kids has picked on him since 3rd grade and so the fact that he gets caught being mean to this kid??? ) But I tell you, even though I know they just need to pull up their granny big girl panties and deal with it, I am feeling like I dont have tough enough skin yet for every single day feeling like my kid is the one ruining their days.

I asked for an incident report for why they cleared the classroom for his sitting there. the administrator said it wasn't really an incident. he was just sitting there, and wouldn't move or talk. he got the girl with the issue and they solved the problem.

Then why the hell clear the room? I just forwarded the email to the psychologist. he is the one who asked for the report and I dont have any fight. Q spit in my face today (he is itchy and out of control again) and that was my birthday present from him I guess. yuck. I went to buy pink today for my young friend's funeral tomorrow, just not a happy day.

 

[TerryJ2]

I'm glad you're making progress with-the Tourette's diagnosis and getting off of Prozac.
So sorry about the spitting and your birthday.
And the death and funeral. So sad.