Update on Family therapy

Discussion in 'General Parenting' started by crazymama30, Dec 1, 2011.

  1. crazymama30

    crazymama30 Active Member

    Well, I feel much better about things now. difficult child looks better than he did last week, he has lost about 5lbs, but that is hard to deal with as some of it is the fact he adamantly refuses to eat lunch. At this point? I think he needs to learn to eat real food, I was battling that at home too and I am tired of it. As long as he does not become skeletal? Then I am not going to push that one. He looked much better this time, no bags under his eyes and was much more engaged. psychiatrist said he seemed more wound up to her, but I thought he was better. As of yesterday they stopped the abilify and he is on 300mg of seroquel. If he seems as wound up to her next week, she will add a small dose of seroquel in the morning.

    I asked her if she thought he was more Pervasive Developmental Disorder (PDD) not otherwise specified or more bipolar not otherwise specified, and she answered more Pervasive Developmental Disorder (PDD) not otherwise specified. I agree. The more I read, the more I think that. I asked about the medication wash, and she said they do not like to do medication washes untill a pt is stable, it usually goes better than if you start when they are unstable. That makes sense. She asked me if I thought he would be better without medications, and I said no. I think without medications he would not be able to function at all. I think at the next appointment I will ask if he is doing well on the seroquel if we can start lowering the stimulant, as they increase anxiety and tics, and I think both of these are becoming increasingly problematic for him. I really don't want to stop the lamictal, it is so hard to get on. She asked if I thought the lamictal helped,and I said I think so but how would I know? He has been on it since 3rd or 4th grade(he is now in 8th). I told her he has been on Depakote with severe agression and Lithium started the same thing, but I realize that with time and the changes kiddos go through that sometimes a medication that did not work before will work.

    I think his therapist is really green. In our session difficult child started perserverating and catrasophizing, she tried to redirect him to no avail. I let her try for a while, then I took over and got him calmed down. She is supposed to be an autism specialist, but why in the world is she using words like catrasophizing with him? I asked him if he knew what that meant and then she explained it. She used the word cope and he looked at her and said I don't know what that means. He said that about a few other things too. I am going to make a list of things he needs to work on for home, that DO NOT involve us triggering him, but him not getting triggered. I am also going to write down what I want to ask psychiatrist.

    s2bx is not allowed to speak to difficult child unless his therapist is present, I guess he called and was calling the Residential Treatment Center (RTC) and f'ing prison, that if difficult child was not on the f'ing medications he would be fine. He got belligerent with the staff too. Therapist called him and talked to him about it and he says he does not remember it. That could be, he is off his medications as his psychiatrist fired him and he has not found a new one. I think it is a great idea. therapist was concerned as difficult child was trying to calm s2bx down, and difficult child has enough to deal with. Sometimes all you have to do is give a person enough rope to hang themselves with.

    I think meeting psychiatrist and having a session with therapist without easy child there was helpful. I don't deal well without meeting the person who is prescribing my son medications, and just meeting and talking to psychiatrist helped. therapist, well, I am not too sure about her.

    I am irked with the neuropsychologist, she did not mention anything about Pervasive Developmental Disorder (PDD) not otherwise specified, and that was supposed to be her specialty. difficult child's therapist here at home said that you can get another evaluation if you contest the results of the first one, and I am going to see if I can get him a neuropsychologist while he is in Residential Treatment Center (RTC). I think the one who did the other evaluation? Is not so hot. therapist at home knows another therapist at the same organization as the np who did difficult child's evaluation, and she is going to talk to her. I will talk to np's suprevisor and complain if that is what I need to do, but we do a lot of work with that organization so I don't want to tick people off. difficult child does his social skills groups there, and I think that is helpful for him.

    Thank you for all your support. This is such and awesome place, this stuff is hard for anyone to wrap their head around unless they have been in similiar circumstances.
  2. pepperidge

    pepperidge New Member

    just a few quick thoughts--

    abilify gave my son tics as well, don't know if that was a contributing factor to your son...

    I would think about getting a neuropsychologist in the area of the Residential Treatment Center (RTC), not in your home area. I am not sure there are any really good ones in the boonies, and I have heard there are some good ones in the big city....

    sorry his therapist is not so great. is she the one who interacts with him on a regular basis there?

    sounds like you are feeling ok about the place which is great.

    and I hope your s2bx gives everyone a reason to put him out of the picture.

    Hang in there. What she says about medications makes sense, maybe taking them away slowly makes more sense. Reading what you have said, maybe they have been trying Occupational Therapist (OT) medicate what can't be medicated PPD-- so adding heavy duty bipolar medications may be making things worse. Something like Seroquel or low dose of Risperdal may dampen some of the aggression and whatever and be the best you can hope for on the medication front. .. tough to sort out.

    have a relaxing evening....if possible...
  3. crazymama30

    crazymama30 Active Member

    Pepper, would coming off the abilify make the tics worse? They have certainly gotten worse as the dose goes down.

    I am hoping for a np evaluation in the big city, I am certainly not happy with the one given here in the boonies!

    yep, little miss I am new is his regular therapist. We cannot get everything. At least there they were able to document s2bx's stupidity, that will certainly be a nice thing to have.

    I am wondering if we have been trying to medicate for the wrong reasons, and we will see how he does with the seroquel. My gut is saying it won't work, but my gut could be wrong. It is hard to sort out, but I feel better and more hopeful now. I am still a bit leary of the facility, but not as much as I was.

    And yep. S2bx is hanging himself with his own rope, and it is so sad that he does it so easily.
  4. flutterby

    flutterby Fly away!

    Sounds like a good visit - and having reassurance makes it easier for you until the next visit.

    Sorry s2bx is being a tool. therapist may be green, but at least she has the sense to realize that difficult child doesn't need that koi on top of everything else.

    I'm really glad they are changing medications around. Seroquel may not be right, but just continuing to up the Abilify made me nervous. Risperdal has helped difficult child with her mood regulation - and auditory hallucinations - and she's on a low dose - only .75mg. I might not be so quick to add a dose just because psychiatrist thinks he's hyper. With all of the changes, I'd probably want to give it more time to see how he settles.
  5. crazymama30

    crazymama30 Active Member

    Flutter, they are waiting a week inbetween medication changes. with some medications that is not enough, but I think with Seroquel that is. Someone correct me if I am wrong. Upping the abilify was a bandaid, and a poor one at that. psychiatrist here was just trying to band aid him, I think she did not want to do any major medication changes here as easy child was being so badly affected by difficult child, and with medication changes it could get worse.

    Flutter, you would have to be brainless to not realize how much damage s2bx is doing to any child, and it is just worse for a kid like difficult child. I really need to start the divorce process, will have to do it on my own but I need to get it done.

    psychiatrist at Residential Treatment Center (RTC) was shocked when I told her difficult child had never been on risperdal. She said something to the effect that and he has already been on risperdal? Like it was a given. I said no, and she seemed a bit taken aback. If Seroquel does not work, then that is the next try. I would also like to lower his lamictal and see how he does, and if possible (not at the same time) lower the vyvanse.
  6. buddy

    buddy New Member

    Crazy, I am amazed at all you are having to sort thru. What blessed children you have. I can relate to all the things you are saying, just different setting and different medications. Did he say anything about the other kids, how is he doing day to day with his school work etc.? I am so glad you got to face to face see the doctor.

    I think that having gone to many many trainings for Autism Spectrum Disorders (ASD), a sorely underdiscussed topic, but one everyone discusses in real life, is the mislabeling of Pervasive Developmental Disorder (PDD)/Autism Spectrum Disorders (ASD) kids with mental health diagnoses. I was just talking to a friend who was saying (she has two Autism Spectrum Disorders (ASD) kiddos, and is a teacher for the deaf but she and I always got the deaf/Autism Spectrum Disorders (ASD) kids) and a staff person was telling her about a kid who she knows has adhd plus Autism Spectrum Disorders (ASD). She is like most of us, if it serves the child to have that added label, in order to get medications and help people understand symptoms, that is ok.... but she was just talking philosophically, can you really separate it. Most of us who work with Autism Spectrum Disorders (ASD) kids say they look like adhd, odd, anxiety, Obsessive Compulsive Disorder (OCD) kids. But put those together and often add some of the more unique social issues and vocal tone etc....(varies for different kids of course) it really is Autism Spectrum Disorders (ASD). I really agree with her. Once you have that diagnosis you need to start thinking of appropriate interventions that are known to work well with Pervasive Developmental Disorder (PDD)/Autism Spectrum Disorders (ASD) before you can really make final decisions. I believe medications are important for symptoms that interfere with being able to access or use any of the treatments, and then as you are doing...modify as new information comes along. That is what I have to do too.

    It is simply heartbreaking that the np you saw missed that. If it is one of the first things that comes to mind to parents here on the board, when that group of symptoms and behaviors is discussed in a paragaph or two....how the heck can a PROFESSIONAL miss it? I worked with a psychiatric like that and it was a huge source of stress, and since I became a threat to her by being able to help kids, she went after me with vengence. Complained about where I put a postit on OUR desk. I mean actually went to the principal and didn't like how I put my toys on my shelves. There are some crazies out there, and it is not our difficult children
  7. pepperidge

    pepperidge New Member

    CM I think trying a low dose of Risperdal is a good one. It has been helpful for aggression and mood stab for my two. Hope they go there if Seroquel doesn't work. I would certainly give it try before Depakote etc. It might useful for both diagnosis --which would be good asyou are not sure about diagnosis .

    good luck.
  8. crazymama30

    crazymama30 Active Member

    No one has mentioned how he is doing day to day with the other kids, there is one kid he hangs out with, he does not much care for the other kids. He has been paying attention in school, next week I will put it on my list to see how he is doing there. I really have no burning desire to try depakote, I would rather give the seroquel a chance and if it works? I would like to try decreasing either the stimulant or the lamictal. If the seroquel does not work? risperdal sounds good.

    We are going up to see him tomorrow. easy child's friend is coming, difficult child likes her and she likes him and is very good with him, so it should be ok. Depending on if difficult child is up for it, we would like to get him a haircut, go play minature golf, and go get some lunch. It will just depend on how he is doing, but the staff said he had a good day today so we will see. He is more likely to behave if easy child's friend is with us, as he does not want to look bad in front of her.