Monday, December 24, 2012

Bye Bye Abilify.... Hello Geodon~!

Honeybunches seen the pdoc this afternoon.  After looking at his most recent blood work from last week, we discussed possibly putting him on Geodon and taking him off the Abilify.  She basically let me decide if we should leave things alone or if I thought we should change.  After how concerned his primary care doc sounded on the phone and seeing his blood work for myself I thought it would be best if we did change.  She told me that Geodon is gentler on his body, especially his liver.  We are going to go up on Geodon slowly, then once he's up to where she wants him, then we will titrate him off the Abilify.  Here is her plan:

Dec 26/27
20 mg 1x day

Dec 28/29 
20 mg 2x day

Dec 30/31 
20 mg am and 40 mg pm

Jan 1/2 
40 mg 2x day

Jan 3/4 
40 mg am and 60 mg pm

Jan 5 and ongoing....
60 mg 2x day

Then we'll wait 5 days.  On January 10th, we'll begin titrating down his Abilify.  Right now he's on 5 mg 2x day.  Here's how she's going to take him off:

Jan 10-12
2.5 mg am and 5 mg pm

Jan 13-15
2.5 mg 2x day

Jan 16-18
2.5 mg once a day

Jan 19th stop Abilify

She was saying how we could go up to 160 mg on the Geodon if we have to.  She was sharing with us how she recently went to a conference where they mentioned that Geodon seems to not work with children because doctors don't go high enough on it, so she wants to get his dose up there.  So even when we get him where she wants him initially, there will still be room to go up.  The pdoc gave me her cell phone # to call her, even over the holidays, if we have to.  She is taking the nice chart/calendar she made me about his med titrations with her wherever she goes she said.  :)

I am scared to change, but the time has come.  She gave me a copy of his labs.  They did a ton of blood work, but here are the concerning #s:

D. Bili 0.3 Should be 0.0-0.2
Cholesterol 240 Should be under 200
Triglycerides 352 Should be under 150
HDL 35 (Says that is low)
AST 88 Should be 10-36
ALT 131 Should be 24-49

His Lithium level was good at .9.

I hope things go well with this med change.  Pdoc thinks Geodon would be easier on his liver as well as not cause as many issues with his triglycerides and liver enzymes. 

Friday, December 21, 2012

Sick Little Man

Today begins the Christmas break from school.  They don't go back until January 2nd.  Honeybunches has been battling a cold-like illness since November 8th.  He has a very nasty cough.  I took him to the primary care doc on Monday.  She didn't think it was anything catchy or anything that needed antibiotics.  She put him on Prilosec for what she believed to be reflux.  Well it's not doing anything.  I knew that was not his problem.  My 16 y.o now has the same cough.  I hope hers goes away quicker.  I hope they can find out what's going on with him too.  He goes back to the regular doc on the 31st, yup New Years Eve. If he's still coughing as bad as he has these past couple days, then I think I'll try to get him in to be seen next week instead.  I might get a 2nd opinion from a different doc.  That's one good thing about going to such a large practice.  There are about six other docs there I believe.

On Monday we took Honeybunches to get a bunch of fasting blood work that both his pdoc and GI doc ordered.  Today his primary care doc called me to say that his cholesterol, triglycerides and liver enzymes are all much higher than they were.  She was like "Put him back on whatever diet you had him on before".  The problem is that nothing changed.  He's still on the mostly Vegan totally Vegetarian diet.  The only exceptions are still the ranch dip and the Morningstar Farms brand meat alternatives.  They don't have cholesterol.  Thankfully we have a pdoc appointment on Monday.  Yup... That's how we plan to spend part of Christmas Eve lol. 

His 1st appointment with his new counselor got cancelled because the counselors wife had a baby.  He'll call back in a few weeks to schedule something the counseling center said.

  This morning when I dropped him off he noticed the police man standing in the front of the building.  He asked why he was there.  I said "To help keep you all safe" and left it at that.  The principal let Honeybunches be an assistant police officer today.  (They had extra police because so many people were concerned with it being 1 week after the CT tragedy, some rumors going around town that teens at the highschool might have planned on shooting the school, and many people rediculously believing today was the end of the world.)

Letting him be the assistant police man was a great way to approach things with him.  That lessened any anxiety he might have had to zero.   I went back in the afternoon for their Holiday Party.  It was great spending time with him.  I got to see how he loves helping the janitor collect the garbage in the afternoon, his friends, a gecko another classroom has which he loves to go visit, help him with his gingerbread house, and see the classroom's new Ipads.  He had a lot to show me in the 1 1/2 hours I was there.  It was a great visit!  I love seeing him at school. 

This morning when I dropped him off the teacher told me how the behavior specialist came to see him earlier in the week.  She's updating his behavior and safety plans.  She also created a new incentive plan.  They used the new plan yesterday and today.  Both were awesome days.  I guess the behaviorist changed things up a bit.  In the previous plan, he could earn things by getting enough circles for doing a good job, but if he did something that was against the rules then his chances of earning it disappeared.  Now with the new plan, I guess the chances of earning it don't go away.  He can have all day to have chances to earn whatever it is.  I will know more once the plans are complete and I get copies of them.  The new plan seems to be working, at least for now.

I am really concerned about Honeybunches health issues.  I think it's time to strongly consider changing one of his meds.  From what I am reading, Abilify is the most likely culprit for the triglycerides and liver enzymes being so high.  In the past, the pdoc has suggested that we might think about changing that for Geodon in the future.  I will read up more on that over the weekend so I can go into the pdoc appointment on Monday with some type of possible things to discuss.  I hate change.  I am terrified of changing anything with him.  I fear that he'll become aggressive and unstable like he was back in 2008 before this current med mix was put in place during his hospitalization in Feb 2009.  I don't want to go back to those days, especially now that he's stronger, older and bigger.  Maybe the med change would go okay, because he is older and more mature now.  Still I find myself worrying a lot about this since the phone call.  I'll know Monday exactly what his levels were.  The pdoc gives me copies of the lab reports. 

He's been okay here at home.  Some days he gets a bit hyper and overstimulated, but I think that's just from things related to the holidays.  He's not had any major issues though thankfully.  I'll update Monday after his pdoc appointment...

Sunday, December 16, 2012

For Sale: One Daddy on Ebay... and Thoughts On CT Tragedy

Once upon a time there was a little man who said... "Rrrr I don't like Daddy.  I'm gonna sell him on Ebay.  He should go back to New York where he came from..." Yup! Little man is not happy tonight.  We had to give him his medication an hour late because tomorrow morning we have to go to the lab.  They have to draw it 12 hours after his last dose of Lithium, but they don't open until 7:00.  Usually he has his night meds at 6, but on the evenings before blood draws, we have to change the time to seven.  Anyways, Honeybunches is hyper tonight.  There were no major incidents, just him playing around a bit too rough with his sister Princess, using not nice words with Daddy, and other small stuff like that.  Daddy has been getting frustrated easily, losing his patience and not using the best choice of words. That's caused me to be a bit frustrated with DH.  I don't believe that he's been taking his morning medications and think he needs to start again. DH's lack of patience and word choice in turn makes Honeybunches more upset.  In his words "Daddy gets me going...".  When Honeybunches said he wanted to sell Daddy, I had to make myself not laugh, because in reality it was not funny but he was so serious the way he said it was hilarious.  Honeybunches has been doing good calming his body though.  He came up with a new coping skill on his own a couple weeks ago.  He will go into his room, get in bed and either cover his head with a pillow or just lay there and read.  Sometimes he'll humm to himself. 


Reading everything about the tragedy in Connecticut has been really depressing me. As I think back to how my son was before his hospitalization back in 2009, I can honestly say my heart is filled with fright. I have so many fears about his future. He used to have very serious aggression, instability and rage. There were times that I was terrified of my six-year-old. That's something that others  would never understand, until they have a child with Bipolar who was as unstable as he was or have a child with another diagnoses which can cause the uncontrollable, unprovoked aggression. He would get this look in his eye. Then it was like something overtook his body. He was not in control anymore. It was like he was not even there. It was not my son doing these things. Yes, on his current regime of meds, he's much different now, but still sometimes I wonder about what his future will hold. Sometimes it's to hard to think about so I try to focus on each day. Could my son be capable of something like what happened on Friday? With all of my heart, I hope not, but part of me looking back at how he used to be honestly has that fear. I refuse to let that be my son's destiny. 

That's why I never let him play with toy guns and teach him guns are bad. This is why I keep advocating so strong for him to get the help he needs. This is why I don't give up. This is why I remain determined to keep fighting. This is why I don't care if people at the school like me. They can hate me all they want to. I won't shut up until my son is getting all the help he needs there. When he does, I am happy to thank them for doing a good job. When he doesn't or when things aren't right, I will make my voice heard until they fix it. This is the reason why I listen to that voice inside my heart that tells me when things just are not right and when they are. I don't think I am alone, in the world of parents who have children with mental illness as I wonder if my son could ever be capable of something like that. I am scared. No, I am terrified. I think one difference is that I am not scared to say that I am. There has to be changes in the mental health system. I will remain dedicated to making sure my son gets his needs met at home, at school and in the community with the hope that I will make a difference.
Photo: Pres. Obama: "We've endured too many of these tragedies in the past several years. I react not as a President, but as a parent. I know there's not a parent in America that does not feel the same overwhelming grief that I do." http://on.wcvb.com/Z5ZpPC

(AP Photo/Charles Dharapak)
The children, principal, other professionals, and children who died on Friday are receiving millions of prayers. I also think we should stop and pray for this man's forgiveness. Pray for his brother and the rest of his family. They lost love ones too and will have to live the rest of their lives dealing with this horrific tragedy their brother died committing. They are the forgotten ones, but I believe they are just as worthy of prayer as the families of those children. Yes, I can see how some people will say that the children were innocent and this man was not. The killer was somebody's brother, somebody's son, maybe somebody's uncle and cousin. I wonder what happened in his life that made him come to that? We shall never know because he's dead. I pray that he'll be forgiven and his family will have strength to get through this too.
There was something about seeing President Obama wipe the tears from his eyes as well as that poem/picture above that touched my heart the most.  Both of them had tears in my eyes and made my heart ache.  
Communication is really lacking with Honeybunches new 1:1 aide.  At this point, I am not liking her.  There's not much I can do, except make my voice heard about what concerns me.  She hasn't done anything that's really horrible.  I just am not too fond of her.  I know that she finds Honeybunches intimidating.  She's impossible to talk to.  I just don't feel like she's the right fit for my son.  Maybe as the year goes on, she can be molded to be a better fit.  IDK.  I guess time will tell.

Thursday, December 13, 2012

IEP + What aide said = Momma Bear Not Happy!

So Honeybunches brings me his Home-School Communication Book as he says:
"Mom Mrs T is not going to be on the bus one day.  She said either I have to do a good job or get a ride that day."  That got Momma Bear out of hybernation LOL. 

I told him I'll give him a ride that day.  Then I wrote his teacher a bitchy email.  Well, I tried to be nice lol... I said "Mrs T has not told me, but (Honeybunches) mentioned to me that "One of these days Mrs T is not going to be on the bus.  She said either I have to do a good job on the bus or get a ride."  I would rather just give him a ride that day.  Could you let me know which day she won't be there?"

Then after thinking for a few more minutes I wrote another email:
"Also his IEP states 1:1 aide will ride the bus with (Honeybunches) to and from school." If Mrs T is not going to be there on certain days, there should be a replacement or she should talk to me in advance to see if I would mind bringing and/or picking him up on that day.  She can't just expect him to do a good job without one because that is against what his IEP states.  I don't think it's fair to say that he either has to do a good job or get a ride when 1:1 aide on the bus is in his IEP.  Of course, this is coming from (Honeybunches) words, which may or may not be what was really said.  Anyways, I just wanted to clarify which day she won't be on the bus.  Whatever day it is she's not going to be there, I will bring him.  That's not my issue.  It's the principle of things.  I already told (Honeybunches) I will drive him.  I'm just writing to clarify what was said to him and let you all know that if what he said is the words she used, I have issues with that because it goes against his IEP."




Updates from school

12/10/12 Note from Communication Book:
"He had a good day.  Some testing behaviors.  Very silly at different parts of the day.  He refused to read when I asked him to.  It was nothing big.  He made a good choice in the end.  He seemed thirstier than normal.  He drank 3 bottles of water.  He had a good day overall."

12/11/12
Honeybunches woke up before 5 am this day!  He had a productive morning though.  He chose to complete a spelling sheet that came home.  That was all his idea.  He took it out of his bag, sat at the table and did it all within just a couple minutes. 

Note from Communication Book:
"Several refusals today.  He also refused to come out of the bathroom at snack because he was angry at me.  I told him he did not earn eating his snack int he meeting room because he refused to do some of his Math.  He began to crawl on the bathroom floor.  There was no reasoning with him so (Principal) came to intervene.  He came back to class fine.  He refused to complete reading, so he lost free time.  After lunch he was okay until about 2:15.  He became disruptive, so he was escorted to time out.  He went willingly."

12/12/12 Awesome day!!!!!!!!!!!!!!

12/13/12: Note from Communication Book:
"He had a good morning.  However, after lunch his behavior went downhill.  He ended up having to be restrained.  He became aggressive towards (1:1 aide), kicking and pinching her. During Word of the Day, he became very silly and disruptive.  He was given choices.  As a result, he needed to be escorted out of the room to the time out space and was engaged in a brief restraint.  He calmed quickly.  He came back to class and participated very nicely in our BINGO game.  The incident was prompted by a refusal to comply with a simple request after choices were given.  He swiped contents off the chalkboard.  He then grabbed the remote off a tv cart in the hallway and attempted to throw it down the hallway.  While being escorted, he became aggressive."

I wonder how his afternoon will go.  Right now, he went for a quick ride with Daddy to go look at the train tracks with the hope a train will pass by.  Honeybunches knows that when he is aggressive with people, he doesn't get computer privileges for the rest of the day.   I hope that doesn't cause issues.  We shall see!!!

It's hard to believe only 12 days left until Christmas.  My little man still believes in Santa.  Yesterday he was so cute.  After school he was telling me how the principal has Santa's # and told him that they've been good.  He asked if I had Santa's # too.  Then he said "Ssshhhhhhhhhh he is watching". 


Monday, December 10, 2012

Honeybunches Counseling Appointment Scheduled

Honeybunches teacher is back in school as of today.  YEAY!  He was testy, but without major issues.

We finally heard from his counseling center.  Honeybunches' will have his 1st appointment with the man counselor B next Monday.  See more about how Honeybunches intoduced himself to this man here. I was so proud of him that day!  Anyways, I am glad we finally have an appointment for him.  Crisis has called 3x since last week to check on Princess.  We are still waiting to hear about an appointment for her.

Thursday, December 6, 2012

Concerns with Princess

Yesterday morning I got a call from the school.  Interestingly, it was not from Honeybunches school.  It was from Princess' school. Princess had told a friend at school that she's been having suicidal thoughts.  The friend told a teacher, who discussed it with Princess.  She admitted it was true, so they sent her to the counselor at school.  Princess has a history of cutting herself.  They've never been deep cuts, mostly just superficial ones so light that they don't bleed.  The school counselor called me and suggested that we get her a crisis evaluation.  We have been discussing her psychological well being a lot in the past few months.  At least that counselor takes parent-school communication seriously.

So I went down to the school to talk with Princess and her counselor a bit.  The counselor and I called crisis together.  I had the counselor tell them what was happening at school because she sees that all 1st hand. They suggested that I bring Princess down to their office for a crisis eval, so I drove her there.  While there the evaluator suggested that Princess might have PTSD from the mess she went through with Shnooks and other stuff from her past. Princess told the crisis lady that she gets random thoughts of killing herself.  Nothing seems to bring them on.  They just come.  Some of them are graphic, but Princess would not talk about any specific plan.  She said those thoughts scare her.  When they asked her why she cuts herself, she said "I don't know" and refused to talk about it.  They didn't see her as needing inpatient hospitalization and put Princess on their referral list to see a counselor.  They said it should only be about a two week wait. I explained to them how we've tried counseling for her in the past, about five different times.  She has trouble opening up and talking with anybody.  Then they usually give up on her and tell me it's not working, before she can build up the trust that she needs to confide in them. Princess internalizes things a lot and it's hard for anyone to get her to talk. They are going to see if a male counselor is available.  All the ones we've tried have been females, so they think maybe a male would work better.  She agreed to try it.

With the family history of BP and mental illness being so strong on both DH and my side sometimes I wonder if there is more going on with Princess then we know about.

The tricky thing with Princess is that she doesn't seem depressed.  She present like a well spirited, happy, energetic child.  She does have a tendency to get impulsive, which they notice more at school.  She's a hard one to figure out.  

There is some other stuff going on with Princess that I found out yesterday.  She disclosed something to the crisis worker that she didn't know how I'd react to when one lady took her in another room alone.  I don't feel comfortable discussing that here, but now that she let me know maybe she'll be in a better mental place. 

"So What Do You Do All Day"?

Yesterday somebody asked me:
"Do you work"?
I said:
"I have a son with Autism and other special needs who gets SSI so I stay home".
Person said:
"So what do you do all day"?

I had to think quick, so I said "Housework".  Later on today at home I was thinking of all the smart responses I could have come up with. Seriously?  What do I do all day? Well besides the added responsibilities of nurse, counselor, referee, self defense trainer, butt wiper, clothing dresser, housekeeper, janitor, therapist, medication runner, appointment taxi driver, pharmacist, short order cook, dish washer, laundry cleaner/dryer/folder/sorter/put-a-way-er, educational advocate, lawyer, civil rights worker, secretary, security guard and whatever else should come with being the parent of a child with Autism, BP and other special needs, I found this:
A Mother's Job Description

I thought that was pretty awesome!  I love how she said ""I'm a Research Associate in the field of Child Development and Human Relations."
I was also impressed by her comment "I have a continuing program of research, (what mother doesn't) in the laboratory and in the field, (normally I would have said indoors and out). I'm working for my Masters, (first the Lord and then the whole family) and already have four credits (all daughters). Of course, the job is one of the most demanding in the humanities, (any mother care to disagree?) and I often work 14 hours a day, (24 is more like it). But the job is more challenging than most run-of-the-mill careers and the rewards are more of a satisfaction rather than just money."

LOL That's one of the best examples of what we do that I've found yet!  Doesn't it sound professional?

Honeybunches Snooping and Goodness

Things with Honeybunches have been going awesome.  Although his teacher has been out of school since the Tuesday before Thanksgiving because of a serious back injury (Where she herniated and slipped some discs) and won't be in until at least next week, Honeybunches has been doing awesome.  Of course there has been a bit of testing, but nothing major.  At home things have been going well with him too.  The worst thing that happened is that he snooped at what I bought him for Christmas, but that's a typical childhood thing.  This generation has it easier.  Here is how it works:
  1. Wait for Mommy to get in her morning bath.
  2. When Daddy goes into the room rush to the computer. 
  3. Check what is in Mommy's Ebay Purchase History. 
  4. When you hear Mommy coming, close the windows real quick, tell her "I was not doing anything... I didn't see anything, only the thing I ordered." 
Okay, maybe the telling on himself gave it away lol.  I had a bad Mommy moment and told him I should cancel all those things I bought him.  I had told him not to go on my Ebay.  He usually does to look for stuff and to track where the things he orders are.  He gets $5 for helping Gramma put the garbage cans out to the curb each week.  That's how he spends it 99% of the time. Now I am more careful, locking the computer or switching user before I walk away. I've been making him go on his own user name. I'll just be sure to mark those presents as "From: Mom and Dad" lol.

My little man, at 10 years old, still believes in Santa.  I say let him believe as long as he wants to.  I love the Christmas season and Christmas music.  This is my favorite month of the year.

I had Honeybunches parent-teacher conference over the phone yesterday.  His teacher is so impressed with all the progress he's making.  She talked more about his transition to the new school next year.  She thinks we should arrange for him to go to the new school about 4-5x before the end of this school year.  She said maybe beginning in April or May we'll bring him there for about an hour or so a few different times so he can sit in on what will be his new class, meet his teacher, see the school, etc. 

Honeybunches has been a loving boy with lots of hugs lately.  The past few weeks have been smooth with him. (Knock on wood!)