Posts Tagged ‘child psychiatrist’

Snow’s sprinkling fine sugar upon this first full day of spring, but we all know its shaker is almost empty, so what the hell.  You’ve lost, cold and snow.  Spring’ll be here soon, like it or don’t. 

It is also M’s birthday and the 10th anniversary of the day I quit smoking cigarettes. 

Today Andy and I take Jonah to his pediatrician, the one we switched to because his specialty is autism.  I’ve got my spare pair of glasses on in case Jonah  flips out (like he did last week when we took him to the psychiatrist and switched his meds from rispersdal to trileptal in yet another attempt to get the right drug to help him).

Jonah drums in his sleep sometimes. 

And he’s been limping on and off, to add to the myriad of mysteries to solve, and I’m hoping they can figure that out too.  

Onward we push, into spring, into the unknown, into another decade of no cigarettes…

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Yesterday Jonah had another appointment at the child psychiatrist.  Andy and I tried to time it so I’d get there first to check him in, meet the social worker from Wildwood, and then Andy and Jonah would meet us there so Jonah wouldn’t have to wait (thus hopefully decreasing the chances of him flipping out).  It worked out pretty well.  Jonah did a very good job of staying relatively calm for the small amount of time the doc and a med student observed him- then Jonah and Andy left and I stayed behind with the social worker to talk to the doc. 

Doc wanted to change Jonah’s meds a bit – increase the risperdal by a little and remove the atavan PRN (as needed) and replace it with klonopin PRN.  When Andy and Jonah left, he wrote the scripts up and I explained that we were going on a tour of Tradewinds on Thursday.  Then I asked a “what if” question I’d been thinking about:

“What if we find the magical mix of meds and the aggression goes away?  Do we still place him?  Does he still need residential care?  Do you ever hit upon the right cocktail of meds and fix the problem?”

“Occasionally,” he answered, “but I wouldn’t get your hopes up.  Usually we can mitigate the symptoms for a short time.  But the decision is up to you.  Remember, the choice is yours.  If you place him, you can always take him back home.” 


I don’t like this kind of decision-making.  This ‘playing around’ with the course of my child’s whole life.  When I dropped the scripts off at the pharmacy and stopped at the house, I talked to Andy about this.

“He definitely needs to be placed,” Andy asserted. “I can’t even handle him anymore.”  At least he isn’t arguing with me – we are on the same page about doing the best for our son.  But how can we really know what that is?

Jonah’s log book from school reads like a roller coaster.  On Monday he had 6 aggressions.  On Tuesday he had only one.  Wednesday he scratched a peer.  Thursday he threw a toy at a teacher.  Friday he tried to throw a computer. 

I hate the inscrutability of it all. 

I hate the way my mother is falling apart over this; she doesn’t eat right, isn’t sleeping, and some days she just cries all the time.  She refuses my help to find her a therapist or get on some medication.  I can’t help her accept this and I feel like I have become her scapegoat and I hate that too.

Both she and Andy have indicated that they want to pack up and move to wherever Jonah is placed, when it happens.  I don’t know if they just said that, if they really meant it, but I must stay here.  I have a good job that pays well – much more than I could ever make in Oneonta or Utica.  I carry the health insurance for all of us.  I am the one who has the means to set up a special needs trust for our son, to draft a will, to set up life insurance, to afford a mediator for our separation, to maintain a home Jonah can come back to if and when he is able to do so. 

It all makes me feel abandoned.  I lose my child, my mother, my child’s father. 

I lose.  (Not that there are any winners).

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Since he’s been on Atavan, Jonah’s had long periods of drowsiness punctuated by his personality shining through, complete with talk of train and moneycoin.  (Was there a time when I actually was exasperated by his innocuous obsessions?)

Two doctors today – the eye doc, and Jonah’s first visit with a child psychiatrist.  The good news is that the eye doc said the pressure in his left eye was much lower and better, though they had to come out to the waiting room to give Jonah the eye pressure test.  Jonah had flipped out, attacking Andy, and Andy restrained him in a waiting room chair so they could get a quick pressure read.  Then Andy and Jonah left, and I stayed behind to talk to the doc.

After that they picked me up and we went home to wait for our next appointment.  Jonah seemed confused, first asking for one thing and then another.  “Museum?”  he asked.  “Toon-fish-sanwich?”  He remembers that when we go to the museum, we usually stop at Subway for a tuna fish sandwich.  He rotated through the list of things he wanted and then settled on bath.  After a few minutes in the bath, he attacked me, and Andy held him in his room until we could calm him down.  He’s on all three of his meds at this point and I’m thinking why are the meds simultaneously doping him and not really mitigating the aggression?

Finally we calmed him, mimicking taking deep breaths (let it out through a straw, bunny, breathe deep through your nose) and talking him into another car ride to the psych doc, where the social worker from Wildwood met us.  Jonah had an aggression in the waiting room and then another almost as soon as he went in to the doc’s office.  Andy ended up taking him out to the car while I spoke to the doc – which turns out to have not been the most ideal plan, as necessary as it seemed at the time, because the doc’s got to interact with Jonah.  So I spoke at length with the doc about Jonah; I asked a ton of questions, he suggested both Jonah and I likely had post traumatic stress disorder (which I always thought was for war-scarred soldiers and natural disaster survivors; when I asked what they did for that, he told me generally, not much), he doubled the dose of Jonah’s Risperdal while weaning off the Clonodine and warning us to use the Atavan sparingly, and we made another appointment in 3 weeks.

Before I left, though, I learned a hard lesson or two.  One is about judgment.  For instance, Andy and I had always been anti-meds – but for us that was like being 22 and saying you’ll never dye your hair – easy to say at 22 because you haven’t got any greys.   We never needed to medicate Jonah, so it was easy for us to be anti-med; Jonah clearly had autism but we thought we had done all the “right” things – early intervention, a variety of therapies, specialized schooling, etc. and so he was doing well…until the aggressions began.  Then we were no longer 22 year olds with nary a grey hair — we were rapidly aging, fast-greying, hair-dyeing champions.  I don’t mean to imply that we’ve suddenly become pro-medication, but it’s certainly become something we needed desperately – at least temporarily – in order to stop what was happening.  As a result, I’ve ceased judging others’ decisions about pretty much anything.  What works for one will not work for all, and that’s just the way it is.  We clearly have to try and try and try until we find the right mix of therapies and medications and whatever else until we have our lively, happy little boy back.

“Have you seen this kind of thing before?” I asked the doc naively after relating some of the more violent incidents.  He nodded in that deliberately-patient way you do when someone asks an incredibly innocent question.  “All the time,” he answered.  He told me two or three stories of parents beaten badly by their children before the families could get help – of situations far worse than ours.  When I asked what is done for these people in emergencies, he said unfortunately, not much.  When I asked why nobody could help us, he told me the system is essentially broken.

Then I stopped asking.

Andy had gone home with Jonah so K from Wildwood generously offered me a ride home. I thought a lot today about how there doesn’t seem to be any clear plan to fix any of these broken things.

How dangerous a position so many people are in.

How somebody needs to do something so there is a place for people in unquestionably dangerous emergency situations – a facility to immediately accommodate children who are non-verbal, or violent, or mentally ill, whether or not they are toilet trained, or have a high enough IQ, or are the right age, or carry the right insurance.

How I should become an advocate for better care, once the smoke clears on my own mess.

How, as frustrated and passionate as I am about this, there realistically is little hope of me making any difference.

It’s also beginning to look more and more like residential educational placement is the best option for Jonah, with the goal of getting him back home as soon as possible.  The reality is still far enough away to be an abstraction in my mind, though it is beginning to enter my consciousness in a way that feels like 90% horror and 10% relief.

That’s assuming there is a place for him, and Wildwood can present a strong case to the school district for its necessity.  I used to think we had the strongest case on the planet; now I know they’ve probably seen it all.   But the folks at Wildwood are stating that the quality of Jonah’s education, where once excellent, has deteriorated into basic behavior management and sensory input (riding him around on a scooter with a weighted blanket on it) with very little participation on Jonah’s part.  I don’t want that for my child.  I want him to enjoy activities and benefit from academics, play and sing and do all the things he did such a short time ago.   We’ll try the different dosages and hope for the best outcome, so we can keep him home where I want him.

I want Jonah to shine.

If that means we need to place him in a facility, then I best start coming to terms with that.  God help me come to terms with it.  I don’t know if I can.  Maybe I can.

But not today.

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