Monday, February 24, 2014

Decisions: When the head knows, but the heart is saying "la la la...shut up bitch, I can't hear you."

We find ourselves in the unenviable position of having to make a very difficult decision regarding Noah. The most difficult decision we have faced yet.  It's not that we haven't made difficult decisions about his care in the past, and I know we will likely face even more difficult decisions in the future, but this one just sucks. It means we have taken that next step forward on the path of mental illness.

Noah has been spiraling downward for several months. We've watched it happen, but kept hoping with every doctor appointment, medication change, and relatively good day scattered amongst the difficult, that maybe it would get better.

It isn't though. It isn't getting better. He is getting worse. The line is getting thinner, and more and more often I see him leaning perilously close to the edge of reality.

There are times that I am not sure if he's walking in the same world that the rest of us are. 

He needs to be admitted to a psychiatric hospital. He needs his medications changed and we can't do that safely at home. He needs a set of eyes on him 24/7 that aren't mine or Rich's. 

My head and gut know what needs to be done. My heart though is fighting me and fighting me hard.

I'm scared. I'm scared to leave my little boy somewhere that I can only visit twice a day for an hour at a time. 

I'm scared because he has never been away from home without us.

I'm scared that he will be scared.

I'm scared he won't be able to take GG's blanket. Or worse, that he will and it will get lost.

I'm scared that he will hate me for doing this.

I'm scared that something bad will happen to him there.

I'm scared the other kids will teach him things, or behaviors, that he doesn't need to know.

I'm scared if we don't do it he will keep getting worse.

I'm scared if we do that they won't be able to help him. 

I'm scared that I'm going to feel relief when he isn't here.

I'm scared that if we have a few days of normalcy and peace in our house, days where we aren't constantly dealing with behaviors and meltdowns, that it is going to be even harder to go back to it when he comes home. And yes, I do want to throw up after writing that because I know it is awful. I also know it is true. I don't doubt my love for him, but I am so tired. What does that say about me? 

I expected the psychiatrist to tell me today that he needs to go. Instead he left it very much up to us. He didn't say it was the wrong thing, but he also didn't say "yes, you need to do this now." He did remind me though, that I'm the grown up and that I need to look at the bigger picture, because Noah can't.

The psychologist thinks we should, and he's spent more time with Noah than the psychiatrist.

His teacher is concerned, and said today that Noah isn't the same kid he was last fall.

I know what needs to be done.

I know.

I hate it, but I know.

I'm just not sure I'm ready yet to tell my heart to shut up and let my head lead the way.

I'm scared for what is and what is yet to come.


  1. I'm so sorry to hear that you're in the position having to make this hard, hard decision regarding your boy. He's clearly sick and in need of treatment and the pediatric psych ward probably won't be as awful as you think.

    My baby sister and I inherited a boatload of mental illness from both sides of the family -- the kind that warranted psychiatrists, meds and the odd in-patient stay in grade school. We both made it to adulthood as a result of timely, appropriate medical intervention (our mom wasn't quite so lucky, commuting suicide when K was a few months old).

    K spent a lot of time in-patient, six or seven stints (longest was 8 wks; shortest closer to 4 wks) at big teaching hospital with a pediatric psych unit. She's alive because of that amazing, amazing hospital -- and me, dad and grandparents were able to call / visit / stay overnight a lot of the time. Most of her rooms were singles, with a pullout bed for a parent, visiting hours were lunch and after school/therapy (12-1 + 4.30-9) on weekdays and anytime on weekends. The hospital encouraged parents/siblings/friends to visit -- and K in-patient really wasn't all that different from a kid with, say, cancer in-patient for a month. (Somewhat easier, as she wasn't immunosuppressed). K's awesome, late 20s, happily married and a social worker who takes meds daily, I do too.

    I hope your boy gets the treatment he needs -- and if he's sick enough to require in-patient treatment, so be it. You will likely be able to spend lots of time with him while he's in hospital. It'll likely take a few stays to get his meds sorted out but they *will * be sorted eventually. Hang in there.

  2. Kris,
    First of all you and the family are in my prayers. You and Rich can make it thru this, I am sure. And you are probably correct in that this might not be the most difficult decision you will make. You just make the best decision you can. And your thoughts are not awful, and not the only parent that has had them. You are human,

  3. My dear Kristine - I have to agree with Cayte, who responded before me, that a peds psych unit is not how it is portrayed in fictionalized movies or in allegedly "true" documentaries. I have worked in peds psych units and yes it is difficult - but it is a means to a critical end that Noah deserves and needs. The symptoms of mental illness are exhausting and excruciating. To get the best help It is important for him to be closely supervised during med changes on a GOOD peds psych unit. Even though these units are probably different than when I worked on them many years ago - he deserves the opportunities that this type of treatment plan can offer - when the time is right. Treatment recommendations based on the unique perspective that comes from an opportunity to be observed by trained staff as he functions in his moment to moment life is a unique experience. Unfortunately the only place for that to happen is away from home. You will do what ever you feel is best for your whole family. And I know you will make the "right" choice - regardless of the emotional price for you. It isn't easy ... it never is ...

  4. I want to offer my hugs and to let you know that you have readers that care and support you in whatever choices you need to make to help Noah.

  5. I'm so sorry, Kristine. You are in a place that none of us want to be in or even consider. I remember these decisions vividly and the heartbreak and exhaustion that come with living it 24/7. I'm so sorry, but you know you're not alone.