Sunday, July 31, 2011

Medication struggles

We started Kit on Intuniv first.  The Psychiatrist (Pdoc) thought was that perhaps if we can help her to control her impulses, then she may have less mood swings and rages.  (Because she feels more control over herself) Frankly it kind of made sense to us. Knowing that Intuniv is one of the mildest medications of that kind,with very few side effects gave us satisfaction that it couldn't hurt to at least try.  We did and it seemed to help.  Some.  We decided to go ahead and continue it.

Unfortunately, it did not help her to be able to better control herself and so at our last appointment we talked in depth about the risks of giving a mood controlling medication to someone with a family history of bipolar.  For some reason, that class of medication can actually trigger Mania and cause them to be much worse.  We decided to proceed with caution.  Our reasons?

1.  It's summer and this would not interfere with school in any way.  We can fully monitor her in the comforts of our home.

2.  This will give us a big clue as to which direction her treatment should go. It's still not clear whether her behaviors are due to a Fetal Alcohol Spectrum Disorder *or* whether she is showing signs of early Bipolar Disorder.

We started her on a VERY low dose of Celexa.  (1/4 of the lowest prescribed dose)  I was comfortable with that.  Within days she seemed to be doing so much better.  We had almost a week of the wonderful, sweet side of Kit that is rarely seen.  It was awesome.  And then, it seemed to taper off.  So we increased the dose and it was as if someone flipped the switch.  She was bouncing off the walls as if she had consumed an entire can of Mt. Dew!!  She had racing thoughts, raw emotions and all but stopped sleeping.  All signs of Mania. My husband and waited and watched for signs of improvement for several more days before throwing up the white flag in defeat.  I called the Pdoc who instructed us to immediately stop the medication.  She said because Kit was already on such a low dose we didn't need to taper off.  At this very moment I am SERIOUSLY concerned that we should have anyway because things are even worse.  I'm keeping my fingers crossed that she will come down soon.

It's so scary to see her so out of control of herself.  I so badly need someone to talk to, it seems like there is no one that understands what we are going through.  

Tuesday, July 26, 2011

...a lot can change in 5 yrs

5 years ago, if you had asked me what I think about children taking psychotropic medication, without skipping a beat I would tell you that was outright crazy.  Once again, those freaking parents need to PARENT their children, not medicate them!!  5 yrs ago, my daughter was still just a baby struggling with severe developmental delays- likely attributed to the choices her birthmom made while pregnant with her.

Sure, we had taken all the classes required of us as foster parents.  You know, the classes outlining the good, the bad and the ugly that can come from these children exposed to more in utero than most of us will be in our lifetime.  But I thought our situation would be different.  We had all the best Doctors, intense therapies.  She was loved and doted on 110%.  That would make her outcome better.  She would be okay! 

5 yrs ago, I must have had my head in the sand.

So you can probably imagine the fierce inner war I had with myself as I drove to the pharmacy to drop off my daughters first prescription from her Psychiatrist.  I was literally making myself sick with anguish.  How did it come to this?  How could I allow them to prescribe her medication??  How would I let these mind altering chemicals pass through her lips???  What kind of mother had I become????

...and then from the backseat of my car, a rage began. The rages often begin in the car for reasons I have yet to understand.  Kicking, screaming and thrashing about.  Seat belts are restrictive so she always removes hers and tosses around in the backseat like a bouncy red ball.  Words cannot describe the intense feeling of helplessness when you are driving down the highway at 70mph and your child is in full hysterics in the backseat.  I immediately pull over to remedy the situation.  I grabbed her and held her firmly in her booster seat with one hand while I installed a carseat lock with the other.  I got back in the car and continued on my way, trying to keep my cool so as not to add fuel to the fire.  All the while she alternates kicking the back of my seat and slapping the back of my head with her shoe and belting a high pitched scream. I've long ago learned there is no reasoning with her during this these episodes.

At that moment, I decided I would fill that prescription.  Our daughter needed help so badly, she was out of control and we had already tried everything else humanly possible to help her. 

A lot can change in 5 yrs.

Sunday, July 24, 2011

In the land of fairytales...

                                             ...there are only perfect children.

I've always been one of those people who tend to believe that all children could be well behaved if they were just trained right.  It was simple, and all it came down to was parenting.

After all, if parents would just parent, they wouldn't have any problems with their children!  All you have to do is follow through with what you say your going to do, be consistent, firm and loving.

Yep.  In fact, I'll let you in on a little secret.  I used to think ADD should stand for ADULT DISCIPLINE DEFICIENCY.  I truly did.  I'd roll my eyes at the parent being screamed at by their own child.  I couldn't believe some would allow their children to behave the way they did.  "I" would never allow my child to act that way.  Never.

Well, let's just say that outlook changed dramatically as our daughter began to get old enough to walk, talk back and tantrum.  Suddenly and quickly I learned that there are exceptional children that do not fit the same mold.  For some reason, the same parenting techniques that had worked wonderfully for our 3 sons, didn't work with her.  In fact, they didn't even touch the surface!  Nothing we did or said made a difference in her behavior.  No amount of consistency, firmness or love helped us to parent her.  She is a beautiful little girl who happens to be wired completely different.

It was quite painful to realize that I'm "that" parent now.  You know, the one people stare at and judge in the grocery store as she is trying to control her small angelic looking child.  Little do they realize....

I suddenly found myself being a whole lot less judgmental.  No longer do I look down upon and judge every parent struggling to control their child in the store, or restaurant or swimming pool.  Instead I find myself sympathizing with them.  Wondering if perhaps they are going through the same things we are.  Is their child adopted?  Are they struggling with possible mental illness or fetal alcohol spectrum disorders too?  Have they pulled all of the tricks out of the bag and yet come out feeling helpless and hopeless like we do?

Background story

I guess some background would be good to start with.  I'm, Mo4 and you can probably guess that means mother of 4.  I have 3 biological sons and 1 girl (Kit*) who was adopted from the foster care system.

Our sweet Kit was born in 2005.  We had been Foster Parents for about 4 months and had cared for several other babies and toddlers during that time.

When I got the call from our Caseworker there wasn't much information available.  A baby girl had been born that day (a Friday).  Shortly after birth her birthmother had a "Psychotic Episode".  The baby was taken into protective custody.  They told us that birthmother had a history of drug addiction, homelessness and bipolar and she had already lost custody of several other children. The baby would likely be released over the weekend and they needed a foster family to care for.  We agreed to take her, I was excited to get another little one as our previous foster baby had gone home just 5 days earlier.

On Sunday morning I got the call to come pick her up.  I took the itty bitty, but amazingly beautiful baby girl home to my husband and children.  Our entire family promptly fell in love with her.

Alarming symptoms and developmental delays began showing themselves almost immediately.  The first few weeks she was very easily overstimulated.  She simply could not tolerate more than 1 stimuli at a time.  We spent many days and nights sitting with her swaddled up tight, in the nursery in the pitch dark. Being careful not to rock in the chair or pat her little bottom. She would have been happy to just be left in there alone but we knew how much she needed to bond and so we took turns sitting there quietly holding her close.  By 2 weeks she was in Occupational Therapy for feeding therapy due to a weak suck reflex.  By 1 month, Physical Therapy was started for poor muscle tone and one sided weakness.  At her 4 month well baby check she couldn't lift her head off the table to turn it from one side to the other, something she should have been doing by 2 weeks and she hadn't even smiled yet.  The Doctor warned us at that visit that she was showing clear signs of Fetal Alcohol Exposure and the prognosis for her was not good.  I cried the entire way home but I was not going to give up on this baby!!  We increased the services and I worked with her frequently.  Speech therapy started by 9 months and we pressed on.  Slowly, but surely, she began to catch up. 

The biological parents visits had been cancelled because they weren't working their plan by the time she was 6 weeks old and before long caseworkers were talking about adoption.  It was as if she was meant to be ours!

By 3-4 our sweet girl was completely caught up and was pretty much on target developmentally but she was clearly not a typical child.  She frequently had a black cloud over her head and an extremely short fuse.  She was extremely impulsive and didn't seem to learn from her mistakes.  We always had to go above and beyond normal child proofing measures to keep her safe.

Recently, we learned that her birthmother had drunk alcohol "almost daily" during her pregnancy to self treat her drug addiction cravings.  Now we wade through the distinct possibility that she likely has FASD *and* the mood disorder genetically passed down from her mother.

All the love and therapies in the world did not change anything.  It's something we are still coming to terms with and we're in it for the long haul.

*All names used in this blog have been changed for privacy