Wednesday, February 20, 2008

Imagination

The Boy has an amazing imagination. Despite all our struggles with him, his imagination constantly charms and entertains us.

Last night he was very excited knowing the tooth fairy was coming. He went upstairs on his own after dinner. When he came down he told us "I was telling all my animals about my tooth and the tooth fairy. They are upstairs discussing it now."

This morning when Amazing Daddy went in to get him up, he told him "the tooth fairy came and she gave me a big hug and kiss!".

He regularly has conversations with Baby
Brother and isn't the least bit put off that BB doesn't answer him. TB just answers for him. It is so freaking adorable!

Tuesday, February 19, 2008

Before and after

Before (edited to add he has fake "ugly" teeth in his mouth people!)and After



and a gratuitous butt shot.


Saturday, February 16, 2008

He's a five boy....from hell that is.

Yeah, so much for posting a couple times a week...

I've been working a lot the last few weeks. Kind of funny...I'm still officially on maternity leave but I'm putting in more hours from home than I did before I had the baby. It's all good though as I'm enjoying what I am working on.

The Boy turned five on Monday. Unbelievable! He's a five boy as he says.

My parents were in town for a few days and we had family photos taken. I'll post some when I get the online link for them. It was two hours of craziness with the photographer, and getting both boys to smile was a challenge. It was tough for The Boy since he was in all the pictures, and as usual full cooperation from him was pretty much impossible for him to do. We made it through though.

Monday we took him to the Star Wars exhibit at the Franklin Institute. It was pretty cool. Lots of hands on stuff to do. It was kind of funny as we were walking through the hallways, which were kind of dark and bare, to get to the exhibit, The Boy turned to Amazing Daddy and said "I'm not so very sure this is a very great idea." AD had started to watch the movie with him over the weekend and it scared him pretty much right from the start. Even though we had assured him the exhibit was not going to have shooting and loud noises like the movie, he wasn't sure he was ready to believe us.

He had fun though and handled himself very well through the exhibit. After that we went to see the giant heart. It was pretty cool too. The Boy walked/climbed through it more times than AD and I could count. He was doing fairly well in it too, until several school groups came in. They were noisy and moving very fast. It was just too much for TB and he quickly became over stimulated. At one point AD lost sight of him so all four of us (my parents were with us) were looking. I wasn't so much concerned that someone would take him (hell, if they did they would soon be paying us to take him back) but that he would do something destructive. At one point I heard a couple different kids saying something about there being a boy in the heart doing something. I never heard exactly what "the boy" was doing, but I did know right away that it had to be TB.

We got him out and tried to take him to the cafeteria to get him to calm down. He ran away from us into the caf and was very wild. We cornered him at a table and tried to calm him. By this time he was yelling, pushing and knocking over chairs, etc. My parents were pretty much horrified, as they have never seen him like this out in public, and it has been over a year since they have seen it at home too. I was hopeful that we would be able to calm him and get him back in control, but it just didn't happen. My mom tried to talk sternly to him, and I had to tell her to leave him alone. Of course this pissed her and my dad off and they left. When TB gets like that talking to him just aggravates it, especially if it sounds like you are yelling or mad at him. He just acts out more in response.

We spent a good twenty minutes trying to get him to regain control, but he just couldn't do it. AD was trying to hold him so he couldn't push the chairs and tables around, but it was quite a struggle. He's 40 pounds of muscle this kid; very strong. We finally calmed him down enough that we could carry him out. As we were leaving the cafeteria I realized there was a museum employee (in a suit, looked very official) watching us. He left the cafeteria with us and walked towards the exit with us. He never said anything, but it was pretty clear he was watching us and making sure we were handling things appropriately.

We took TB out to the van and got him in his car seat, still somewhat hopeful he'd regain control, but he just couldn't. He was so worked up and angry about being strapped in that he tried to make himself throw up. When that didn't work he started blowing snot out his nose. The anger was so intense. Scary to see.

At this point I went to find my parents and asked them to please not say anything to him or talk about it.

TB never really did get himself back that day. I thought he would fall asleep on the ride home since he is usually emotionally exhausted after one of these outbursts, but he didn't. The rest of the day he was very bratty. Lots of talking back and demanding behavior. Great birthday memories for all of us.

Of course my mother couldn't keep her opinion to herself, and later had to give me her assvice. She read a book recently about difficult children which she brought for me to read. She seems to think all the answers to his problems are in there and he'll be "cured" if I read it. I will certainly read the book, but there is no book out there that is going to cure TB. I'm sure the book has some useful information in it, but TB needs more help than a book is going to give him or us. My mom thinks that a firm hand and some discipline is all he needs. I wish it was that easy.

We had started a new medication (Strattera) the week before, to try and get better ADHD control in the evening and early morning. Some of the side effects are irritability, mood swings and aggressiveness. We had hoped that they wouldn't effect TB, but clearly they did. We stopped the medication that day and he seems to be handling himself better as the week has gone on.

Tuesday, February 05, 2008

Saturday, February 02, 2008

frustration

Thursday we had The Boy's six month check in with the developmental pediatrician (Dr. B). I always dread these appointments. All we do is focus on the negative (which I know is why we are there...but still, it is depressing). Amazing Daddy and I always leave there feeling very down; asking ourselves if The Boy is really that fucked up...

This appointment was no different than the ones before it, even though in many ways The Boy has made huge strides forward. At one point I was in tears during the appointment, and after it was all I could do not to start sobbing.

Two appointments ago The Boy was taking Adderal for his ADHD. It was helping him in some ways, but it was also causing him to be very emotional. And he was having pretty intense episodes of anger and rage. He was also talking about some pretty serious things, like blood, killing, knives, etc. It was quite scary for us, as we started to worry if we were raising a serial killer. The Boy's regular pediatrician had prescribed the Adderal after TB had showed some adverse reactions* to Metadate (Ritalin by a different company). At this appointment with Dr. B she explained that she didn't like to use Adderal, that it was too harsh, and often caused the type of rage we were seeing with TB. She also expressed concern about his talk of knives, blood, etc. and called them "ideations." She wanted us to see a colleague of hers, a forensic psychiatrist (Dr. S). And we decided to give the Metadate another try.

I contacted Dr. S., who was now in practice by herself, and we spoke on the phone and via email several times. An evaluation by her was going to cost us approximately $2500. And she was about a two hour drive away. She works with seriuosly disturbed children. She wasn't that concerned about TB, and felt that we didn't need her services...at least not yet.

I checked in with Dr. B via phone and told her this. I also told her that another therapist (Dr. W) she had recommended (to help with behavior management) we see was not taking new patients and they told us to call back in three months, but we were going to go back to our attachment therapist who was willing to work with us even though attachment wasn't his main concern now. So Dr. B told me she thought that would be fine and not to worry about Dr. W.

At our last appointment (in June I think) we tweaked the dose of his medication and added a short acting Ritalin dose in the afternoon. Fortunately the eye tic didn't return when we retried the Metadate. And the "ideations" were no longer an issue. TB had a great summer, and was even able to go several weeks at daycare without a TSS.

In September he started to show some of his old behaviors again (but not the aggresive talk/ideations). So we increased his dose from 1 1/2 capsules to two capsules, which seemed to help him. Again, he was doing fairly well.

Some where around this time we were supposed to go back and see Dr. B., but when I called to make the appointment I was never able to get ahold of anyone. I was either on hold for extended periods of time, or I would leave a voice mail but no one would return my call. Since he was doing so well I just gave up on trying to get the appointment. Not to mention this was around the time my pregnancy was really exhausting me, physically and emotionally. I admit that I wasn't as on top of things with TB as I had been in the past, with all aspects of his life.

Well, at Thursdays appointment she reamed me out for not being back to see her earlier. What could I say? I told her I wasn't making excuses, but getting an appointment was practically impossible, and that he was doing great, so it just didn't seem that important.

So she let that drop and we started talking about our concerns. I told her that I thought his medication needed to be tweaked a bit, and she jumped on me that he was already taking a large dose for his age and why did I think he needed more. I responded that I wasn't saying he needed more, but that I thought he needed something adjusted...and then told her what I was seeing to make me think that. Things like how rough our evenings were, and that it was obvious the medication had worn off by about dinner time. And about how he often wakes up in the middle of the night and won't go back to sleep. And, how wild he is in the morning...like a caged animal in some ways. So she suggested we try him on Strattera, in addition to what he is already taking. Since that was one of my thoughts going in to the appointment, I agreed.

Then, she starts talking about his "ideations." I had to tell her several times that they weren't a concern anymore. That I felt very confident in contributing that to the Adderal. She had a hard time dropping it though. And then started back on why we didn't see Dr. S. So I had to tell her the reasons, which I had already told her last summer. And also, why we hadn't seen Dr. W, but were seeing the attachment therapist.

And then she wants to know why we saw an attachment therapist. By then I was getting pissed...and confused. So I reminded her that The Boy was adopted, and was in an orphanage, and we saw an attachment therapist because he had problems with attachment. I think I may have been a bit condescending in my tone by that point.

Is it too much for me to expect her to remember, or if she can't remember, at least look through his chart before she see's us, some of the major factors that impact The Boy ? Come on...his adoption and time in the orphanage is a major part of his history.

I came out of there feeling like she thinks AD and I aren't doing enough (or maybe anything) to help TB. I don't think she understands just how much therapy/help he is getting. But because we didn't see the doctors she recommended, we aren't compliant.

I'm going to start looking for a new doctor. Unfortunately it is not easy to change to another doctor in that practice. I actually have to get permission from Dr. B. to see someone else. And since I'm a wimp when it comes to conflict like that, I'm dreading having to tell her I don't like her.


* TB developed an eye tick (basically he was frequently closing his eyes...kind of between a blink and a deliberate close and open of his lids). It was beginning to bother him and he was unable to control it.