Update on the difficult child's from our psychiatrist mtg 2-day

Discussion in 'General Parenting' started by gcvmom, Apr 20, 2009.

  1. gcvmom

    gcvmom Here we go again!

    Our psychiatrist is so great. I really mean it. He's totally focused on the big picture with my kids and not just the crisis-du-jour.

    He told me today that he's concerned about difficult child 1's reaction to prednisone this week, and that with his family tree, we have to watch for mania. That observation really took me by surprise. I've always looked at difficult child 1 as just your typical ADHD kid with anxiety. But I guess it's something to be mindful of as he goes through puberty. In hindsight, husband's mood issues really came to a head in his late teens, early 20's. That's when he got into fights at school, his grades in college plumeted, and he was never smiling in any family pictures. Go figure.

    psychiatrist also is wondering if all the arguing and confrontations I've had with difficult child 1 the past two years are due to Lexapro possibly disinhibiting him too much. He's on 20mg now, so the plan is to drop it to 10mg once school ends and see if there's any improvement in that area.

    He's also interested in the neuropsychologist's findings this week, so I'll be sharing that with him when I get the results on Thursday.

    difficult child 2 is doing remarkably well (finally) on his current cocktail of medications. There is some question about whether the Daytrana is actually doing anything for attention or if it's merely countering the sedation he has from the Seroquel. When he gets more than 5mg, he becomes very activated and hypomanic, and the psychiatrist thinks that 5mg is really not enough for a kid his size to have any effect on an attentional issue if that's all it was.

    So for now, he wants me to only try giving him 2.5mg to see if he's still able to concentrate and if he sleeps better. His thought is to actually reduce the Seroquel XR evening dose once school gets out to see if he can get by on a lower dose, with the possibility of increasing the Depakote ER once we determine that he's okay on a lower Seroquel dose.

    So I've got my marching orders for June :D And we'll see how the summer goes.

    Meanwhile, he said my updates on husband are very helpful because it allows him to tailor his conversation and subtly steer it in the right direction. In other words, if husband tries to snow him, he can challenge him with the right line of questioning. ;)

    Oh, and on a side note, we were almost trapped on the freeway offramp on the way to the appointment today. A dozen or more airline attendants with their little rolling suitcases had evacuated the shuttle bus they were on because it had caught fire! :surprise: We were about four cars back from the bus and it was completely engulfed in flames. Fortunately, a few of the cars ahead of us went in the right lane (through the nasty billowing smoke) and got off, while I opted to drive over the center median and get back on the freeway to head for the next exit down. Good thing I was in the Explorer!
  2. nvts

    nvts Active Member

    You mean you were in the Explorer and didn't pick up the Flight Attendants and all of their luggage and drop them at the 'port?

    This sounds like one really cool psychiatrist! I'm jealous and impressed!

    Way to go!

  3. gcvmom

    gcvmom Here we go again!

    That's so funny, that's exactly what husband said when I told him the story! Actually, I was more concerned about getting to our appointment on time, plus there were already three of us in the car... am I being too literal here? :tongue: They were all right across the road from the airport (and it's not that big of an airport) so I figured they'd work something out.
  4. nvts

    nvts Active Member

    No, you're not being too literal! But if the vehicle is that big, they could have pointed out where both the front (point point) and the rear (point point) exits are! :rofl:

  5. ML

    ML Guest

    I'm so glad you have a psychiatrist you like. He sure does sound like he's on top of things.

    Wow about the fire! I'm glad no one was seriously hurt.
  6. gcvmom

    gcvmom Here we go again!

    You are SUCH a card! :tongue:
  7. susiestar

    susiestar Roll With It

    I am glad no one was hurt in the accident and that you didn't miss your appointment because it.

    It sure sounds like your psychiatrist is excellent. I am glad husband sees the same one. Sometimes it is hard to give input to the doctor on your husband, esp if your husband is determined not to give them the info.

    It is so awesome that your psychiatrist explains all about the medications and what to look for and what the long term goals are. Very few psychiatrists will tell you this, sometimes because they can't keep it straight for each patient in their own heads. However you found this psychiatrist, he is a keeper.
  8. gcvmom

    gcvmom Here we go again!

    Susie, he certainly IS a keeper. I was told when we first tried to get in to see him 10 years ago that he had a very good reputation and a very long wait list. I think we were on a 6-month wait list and ended up waiting four months to get in. There are some years he's had to close the practice to new patients -- he's only a one-man office with one secretary, so there's only so much of a patient load he can carry. Once you are an established patient, he typically sees you four times a year, unless a crisis comes up, in which case he either consults over the phone or finds a way to squeeze you into his already packed day. He often is running late with his appointments, but that's because he will take extra time with people who clearly need it, and he's done that with us, so I don't mind waiting an extra 1/2 hour if he's running behind. He has a private voicemail for updates and simple questions. He returns phone calls when you ask him to, urgent or not, even on weekends and evenings. I once panicked over accidentally double-dosing difficult child 1 on his Concerta one year -- we were out of town for the weekend, and I even tried getting difficult child to throw up in the motel tub, I was that worried. psychiatrist called my cell phone back right away and said not to worry, that difficult child would likely just be very subdued that day. And he was!

    I guess it's all about access and communication. He's got that down pat. Anyhow, I feel very fortunate to have access to this psychiatrist.
  9. crazymama30

    crazymama30 Active Member

    Your psychiatrist sounds good, and I am glad you are able to give him updates on your husband. My husband has been either having me go with him or I write notes to psychiatrist that I am pretty sure he gives him.

    My husband had a similiar onset of sympotms, he had a very disapointing thing happen, and after that all his fighting and drinking and rebellion started. Lasted for 10yrs. As a child difficult child's age, husband was a handful, but not a difficult child.