Monday, April 15, 2013

Dr. Obvious

So, my next appointment with our new psychiatrist was only two weeks after the first, since we're changing meds.  She feels that the meds Kindsay's been on since she was 5 or 6 are the culprits of her emotionally disturbed levels of anxiety.  Week by week she has been decreasing, with hopes that Kindsay will forever be changed and ready to face the world.  How's this working for you doctor?  I had to pick her up from school last week because she was threatening to "kill" herself if she had to go to the special education dance at another high school with her class.  She'd never really kill herself, but her threats are still coming, her anxiety is still through the roof, and she is getting more and more difficult with getting her to leave the house at all.

The doctor is bent on fixing this kid.  I'm all for trying, heck, but let's face it...I've been raising this kid for what....16 plus years?  I think I know her well enough to be able to move on to higher levels of treatment, whatever they may be.  At least, higher than the doc was aiming for.

To show her how very nervous Kindsay is, I tell her that Kindsay will go to lengths of nervousness by biting her toe nails.  She pulls her leg up to her mouth and chews.  She gnaws, better yet.  The doctor looks over at Kindsay.
Doctor:  Kindsay, if you need to cut your toenails, just get some clippers.
Kindsay: (nodding)
Me:  What?  We have LOTS of clippers.
D:  Do you know what you are putting in your mouth?  It isn't safe to chew on your toenails.
***Please be using a heavy Indian accent so you can feel the depth of the cultural chasm**
Me:  I don't think Kindsay is worried about what germs she is putting in her mouth.
D: (ignoring me)  Kindsay, you really need to use clippers, on your nails and toenails.
Me:  (grabbing Kindsay's hand and putting it close to the doctor's eyeballs)  See this?  See how her nails are chewed to the skin?  When she runs out of nails, she puts her foot in her mouth and starts on those.  This isn't a hygiene issue, it's a nervous issue.  We HAVE clippers.  And you should see what she puts in her mouth.  Germs from the ground are the least of her worries, in fact, they are cleaner than all the bodily stuff she picks at and sticks in her mouth.
....okay, so I was a little frustrated, and I held my tone together so as to keep the frustration in check...
Moving on, the doctor makes a couple of notes...
Then I tell her Kindsay never wears clothing either.  She walks around our house in her underwear with her queen-sized comforter over her head like a big green ghost. 
D:  Kindsay, you must wear clothing.  (Looking at me)  You must insist she wear clothing.
D:  Kindsay, it isn't polite to walk around in your underwear.
Me:  (now why didn't I think of telling her to get dressed?  that's so simple..der)
K:  (nodding furiously now and getting more nervous by the second)
Me:  Kindsay doesn't care who sees her, she walks around in front of any one like that, except perfect strangers, but even then she doesn't rush to dress.
D:  Kindsay, you cannot walk around...(yes, she did go through the do's and don'ts of walking around in front of strangers)  Why don't you give her some rewards for putting on her clothes?
Me:  (now why didn't I think of using rewards???)
D:  Kindsay, maybe your mom and dad should give you a reward for wearing clothes.  and if you don't, maybe they should take something away.
Me:  (Now this is what I get for starting parenting yesterday.)  We actually do use incentives for good behavior.  She just doesn't care after a while.  She's more interested in living how she wants, rules don't apply to her in her mind.
--Kindsay is looking at her phone and giggling.
D:  Kindsay, what is funny?  Is something funny?
M:  When Kindsay is unmedicated, she begins to think everything is funny.  It's like when a person is high on something they get this paranoid laugh, and it really stems from nothing except the nerves. 
D:  Well, clearly something is funny on her phone.  She is laughing.
--I'm looking at her phone.  I see her icons sitting neatly on her wallpaper.  Kindsay is just looking at her phone and the giggles are getting worses. 
M:  No, there's nothing on her phone that is funny.
D:  She thinks it is funny.
--I take her phone and show the doctor, again inches from her eyeballs.
M:  See?  There's nothing.
Kindsay then looks up at the clock on the wall, an ordinary school clock, and she starts giggling more and more.
D:  Kindsay, what is so funny about the clock?
Me:  Nothing is funny, she isn't laughing with humor.  This is what she does when her meds wear off, it turns to mania after a while. 
--The doctor is so perplexed.  How can her mother know her so well?  How can she know what Kindsay is doing and why?  Heaven knows how I know my own child.  If clippers and a pack of stickers was all I needed to get this kid to behave like a normal person, I would've wiped Walgreens out a long time ago.
Finally, I'm frustrated and I let her know.
M:  I don't usually bring this up, but I think it might help for you to know that I have been trained to work with kids with behavior issues.  I teach children with special needs for a living.  This isn't my first day on the job.  I'm trying to tell you that her behaviors aren't triggered by anything externally.  This is something on the inside.  This is why she struggles with sleeping, this is why she eats around the clock, this is why she won't leave the house, this is why she chews her nails clean off and digs into her skin.  We Need Meds.
D: (writing the prescription at last) Okay, Kindsay, we are going to lower your Concerta and I want to see you in 3 weeks.
--Ah, lower, great...sounds like the obvious answer.  LOWER the meds, duh.  I mean, we're on the verge of medical breakthroughs here, there's nothing to see but typical teenager and crazy mom.  Lower her meds, but increase mine...isn't that what we REALLY need to do? 
Our next appointment is Thursday night.  Can't wait.  I wonder if she'll tell me that if I just fix dinner, she won't get into the fridge at night.  If I wash her clothes, she'll wear them.  If I put her in the car, she'll leave the house.  Easy breezy!!
Problem solved.

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