Friday, July 23, 2010
And Hope Comes Screeching to a Halt
Everything was looking up. The treatment plan, the doctors, the behavioral program, hope was the sweet smell filling the air I breathed (poetic right?). Then yesterday it came screeching to a halt.
It started when the psychiatrist intern (we'll call him Dr. Dork cause, well, he is one) called to say he spoke with our outpatient psych Dr. S. He agreed to start the Intuniv (and ADHD drug used that works well for kids born addicted to drugs as it inhibits impulse) so they started a small dose yesterday. He happened to slip into the conversation that Dr. S wasn't confident in the bipolar diagnosis, which is news to me because he never mentioned that. He has always referred to Taz as bipolar.
Why do doctors do that to us? It's so confusing.
Anyway, I said, "you're not planning to change his diagnosis right?" To which Dr. Dork replied, "nothing has been changed as of yet." Which is a round about way of saying "we're considering changing it". I felt a little suspicious so I went to the wonderful and knowledgeable world wide web and looked up everything I could find on Intuniv, especially on how it relates to bipolar disorder.
Well, imagine my surprise when most reports say it works to control ADHD symptoms when used in adjunction with mood stabilizers and when the bipolar mood swings are under control. Many kids get irritable or depressed after several weeks of taking it. So, in a nervous panic (because I thought we were going to the hospital for bipolar meds or a mood stabilizer) I called back Dr. Dork and voiced my concerns. He said they are trying the Intuniv because it is used to treat the types of symptoms Taz is showing. I said I would go along with it but I'm concerned we'll end up back there when it wears off and what he really needs is a mood stabilizer.
Then Dr. Dork asked why I thought he was bipolar (alarm bells started going off in my head). I said,
well, if you give me a list of symptoms of bipolar, Taz has all of them. And I didn't just put my kid in a psychiatric hospital for ADHD (cause I know that's where they're going). Last I knew kids with ADHD don't threaten to cut their parents fingers off, blow up the house, shoot their sister to make her dead, and threaten to cut all our heads off. They don't cry for long periods of time for no reason. They don't throw themselves in front of traffic then laugh about almost getting hit my a car.
He said that yes, there does appear to be more going on than ADHD but that many kids have comorbid disorders.
So...basically....like all professionals, they don't want to use the big bad "B" word. They are going to tiptoe around it labeling every other condition they can other than bipolar. He's ADHD, ODD, GAD, Explosive Disorder...oh, and he also has mood swings. But not bipolar. No, of course not. We don't want to put that label on a kid. Just another five hundred labels instead.
Seriously, does this make sense to anyone else?
But Dr. Dork did make sure to tell me he's not saying that Taz doesn't have bipolar. They are just thinking about it very carefully.
Whatever.
Then he stressed a behavior management program at home and that Taz isn't have any behavior problems at the hospital. Yeah, well great. It's been 3 days!
I told him very firmly that I didn't just put my kid in a hospital to have him labeled ADHD and then tell me it's my parenting. I have done everything every professional has told me to do with him. I have a background in special ed. We are smart resourceful people. We have already fought with professionals who've told us it was our fault. I'm not playing the blame game anymore and I will take him home if that's what's going to happen.
I can get any doctor to prescribe an ADHD medication. One look at Taz and no one would deny ADHD.
Well I don't think Dr. Dork has ever dealt with a parent like me. He backed right up and assured me that's not what's going on and they just want to try Intuniv because we haven't tried anything like that yet and it's the simplest to try. If it doesn't work they will consider other options, maybe mood stabilizers.
Which brings me to my next issue. Behavior management.
Sigh.
Next post I'll continue my rant.
Oh, and I miss my son immensely. I have had multiple emotional breakdowns these last couple days. More on that next post too.
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Doctors can be idiots. ADHD is a comorbid diagnosis with bp, and at this age it is almost a guarantee.
ReplyDeleteI had a doctor once tell me that these meds are not only to help/cure the issues, they also help diagnose. He told me that by gauging the reactions they have they can eliminate and refine the diagnosis. Every time we try stuff like this we refine more.
I tell myself this is the refiner's fire. If there wasn't some purpose I would go mad. Hang in there.
God I hate July--its the start of the new residents. That's all I have to say--just remember--the nurses have to train them. Brand new graduate know it alls that need a serious kick in the ass. Stick to your guns. Talk to the nurses. The doctors see the kids for just brief periods of time and the think they have all the answers (yeah right whatever!). You were the one with him for 24/7--you know what was going on. Again--July. If it wasn't for my birthday it would be a huge sucky month!
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