What Happened?

I’m at a loss as to what happened today and how to explain it. Maybe it was just a really bad day. More likely, it was an increased continuation of the slight aggression we had already been seeing in the last few days. If the aggression keeps increasing daily at this quick rate…sigh.

The morning started out ok, but I was already seeing some defiance and aggression toward the dogs and myself. Since we’d be driving 45 minutes to Tyler to visit the psychiatrist’s office, I asked him if he’d like to have lunch with Auntie Darya, my best friend who lives there. He said sure, he’d like to see her. Then when it was time to get dressed, he started experiencing a lot of anxiety over making sure he picked out the right outfit. “It has to be perfect!” he insisted. Apparently that meant no words or pictures on the shirt and he finally found one that satisfied him. He knew that after lunch we’d be heading to the school to answer some simple questions, so he got a backpack to fill with “knowledge stuff” in case they asked him questions about whatever random topics he’d be studying in the car. I assured him the questions would be about easy things he already knew, but he brought some books along anyways.

I often repeat the order of events for the day many times throughout the day so that he’s as prepared as possible and doesn’t get any surprises. So on our drive I repeated that we’d be seeing Dr. Fulsom, then having lunch with Auntie Darya, and then going to the school and answering questions. He got super angry and said that we were NOT going to lunch with Auntie Darya. He had absolutely no recollection of agreeing to lunch and insisted that I had misheard him. He said, “If you don’t cancel lunch, I’ll kill you.” I said, “Kill me? You mean like, I’d be dead?” He was exasperated. “NO, I’d kill you with pain! Gah, it’s just a saying, Mom!” I firmly reminded him that threatening mom was not acceptable and said we’d talk about lunch after we saw the doctor.

We arrived at Dr. Fulsom’s and he went right in. He hissed at the receptionist who had greeted him warmly. Then he went to the restroom and when he came out, he had wet himself. He said he just “missed,” but it looked for all the world like he’d just gone in his pants. Well, we were keeping our appointment anyway. Remember yesterday how I thought this visit would be so positive? Yeah, that didn’t happen. He was waiting by the door where the doctor would come out to call us in and ended up nearly swinging at the previous patient who came out when the door opened. He then ran into the doctor’s room shouting along the way, “I’M NOT SITTING DOWN!” I showed the doctor the list of meds he was on and asked if we could consolidate any dosage times so he’d be taking meds less often. He brought us down from taking meds four times a day to two. He’s still getting the same amount of everything though. The doctor turned on the scale to weigh him and he said, “NO WAY!” to which the doctor laughed and said, “OK, no weigh.” Good grief,  he’s good.

Javan then got extremely aggressive towards me and started turning off all the lights in the room and trying to escape. He punched me in the stomach a few times, tried to bite me several times, and threw my extremely large, heavy purse across the doctor’s desk, intending for it to hit the doctor. Luckily, he’s a really bad aim and he only nearly knocked over the doctor’s coffee. I had to stay leaning against the door to prevent him from escaping. The doctor was sitting in one of those computer chairs with the levers for raising and lowering, so of course Javan lowered it. When the doctor got up to raise it, Javan rolled the chair away and didn’t want to give it back. He finally did get the chair back and I’m not sure what Javan did, but Dr. Fulsom had to tell him firmly not to hurt him. As I’m leaning against the door I’m telling him how great Javan was doing and he said that was because Javan had been in the hospital. He said everything we’re seeing now is behavioral and that the progress couldn’t have been due to the medications because he hasn’t been on them long enough for them to make a difference. Well, damn. I asked him if he thought we need to place him in residential treatment and he immediately said, “Yes. I’m sorry. But yes. And soon.” Damn again. I asked him about what the insurance lady had said about residential placements in children this young causing abandonment and attachment issues and he said, “Honestly, I don’t think that’s a problem in this case because he doesn’t appear to be attached.” “You mean he’s not attached to me?” “You or anybody else.” Ok, that one stung. And I disagree with his opinion. I do think Javan is very attached to me and his father and to his grandparents as well. But I know without a doubt that he didn’t mean that as a blow to me. He was giving his honest clinical opinion.

I canceled lunch plans in lieu of returning home for a change if clothes. We watched some TV and then headed out for the school.  We got into the school and signed in. We both desperately needed a bathroom. The lady in the office said we could use the nurse’s bathroom. He went first and then I had him wait in a chair in the nurses office while I went as fast as I could. I hate it when I have to pee in public when he’s like this, but sometimes it’s unavoidable. I come out thirty seconds later to see the nurse’s mouth hanging open as she stared in horror at my child, who did stay in the chair but was hissing and growling at her for all he was worth. I smiled and cheerily introduced myself and my son. I really didn’t know what to do with how he was acting or the appalled look on her face. I told her he was just scared because he had an evaluation today and explained that he wasn’t a student yet. She said, “I was just worried. I didn’t know if he was ok.” You and me both, lady.

Just then the diagnostician and school psychologist arrived and he began giving them the same treatment. Until they told him they’d be asking all their questions in the sensory room that he’d liked so much last time. He immediately gasped and gave a wide-mouthed grin of excitement. We walked down to the sensory room and he immediately jumped on the tricycle that you pedal with both your hands and feet and started riding around the room in circles. The diagnostician started in with some questions about synonyms like, “What’s another word for good?” He rode around and answered questions. He got frustrated or refused to answer when he didn’t know some. He got bored by the time we were on antonyms and started chucking things at the diagnostician and trying to bump her with his bike. I suggested we pause her questions and take a break and then maybe move on to the psychologist’s questions. After his break, the psychologist asked questions that were rating statements on a scale of “always, often, sometimes, or never.” As you can imagine, that was harder for him. Then she moved on to yes or no questions which were easier, but he got uglier and uglier as it went on. Throwing things at everyone, trying to turn off the lights or run out the the door, trying to run people over with the bike. Oh, yeah, and at some point the principal came in and observed all this. Since this was only the first part of the assessments, and we didn’t even get done what they thought they could today, I brought it to everyone’s attention that the behaviors they were seeing are the behaviors he will display in the classroom and that obviously isn’t doable. I asked in a non-confrontational way if they thought since even just the evaluations were this difficult if we could just skip to outpatient or residential treatment, especially since that’s what his psychiatrist was recommending. They said they’d actually already discussed that with the school’s lawyers and it can’t be done that way. They have to have documented enough trial and error to be able to justify placement outside the school. They did tell me that all of the behavior we saw today during testing would be documented and asked me to get Dr. Fulsom to write a letter detailing why he was recommending residential placement so they could add that to their records.

We were in and out in 45 minutes or less and back home to relax. We played toys which, just as this morning’s toy time, turned out to be pretty disturbing. His cars were wanting to rob a jewelry store and my cars were supposed to try and stop them. But his toys always turn out to be quite undefeatable. His cars knocked my cars out and when they inconveniently revived, his cars made all my cars blind. When my cars were still trying to stop his cars from thieving by using their sense of hearing, he deafened them also. His cars successfully completed the robbery and then, because my cars had tried to stop them, they were tortured with snake stings, set on fire, and exploded. Aaaaand then we were done playing. Even in play, when he’s happy, his thoughts are turning so dark.

This evening, Daddy was asking him why he was so aggressive today. He said, “I just don’t know how to control it. I’m just mad for ten minutes and then happy for the next ten seconds.” He then proceeded to be absolutely perfect for the entire evening. Ate a good dinner, asked to be excused from the table, played a game of Pokemon, visited with Grammy who was over for the evening, took meds, brushed teeth, and went to bed with no fighting.

Ugh. It’s not that I’m ungrateful for the relief and happiness of the evening. It’s just very hard to discuss our options when my husband isn’t seeing the bad behavior and aggression first hand. I mean, he believes me about what the day was like, but being told about it and experiencing it are not comparable.  I don’t even know what residential placements are available or if insurance covers them or where to even begin with all that. Because of Thanksgiving coming up, the school can’t resume testing for nearly two weeks. Testing will probably take a week or so, then they have to put together a plan, then begin transitioning him into the classroom starting with only an hour a day. Then if it isn’t working at the school, they can consider residential placement. And what if things continue getting worse? How do we survive that long? I wanted the hope to stretch a little further, a little longer.

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