A Naked Picture for the New Year

That's me, around this time of year, having a nice tubby!

Happy New Year!

Med Change Failure

It's been 11 days since the med change.  The psychiatrist gave us a schedule which included a quick ramping up of the new med (the anticonvulsive) and a slow ramping down of the old med (the atypical antipsychotic). For the last 3.5 days we've been at 100% new med 50% old med.  It is NOT working.

- Sunny started having abdominal pains where he says "my waist hurts!"  It was probably gas and intestinal discomfort.  We started giving him some fiber pills and that seemed to help a lot.  We were hoping this symptom was just a temporary one that would go away when his body became adjusted to the new levels.

- He used to bedwet 1-2 times a week, now it's almost every night.  He's also been spot-wetting during the day, which used to be a fairly rare occurrence.

 - He became much more irritable and oppositional.  These last few days, it's been at least a fit every day, sometimes two. He jumps more quickly to accusing us of wanting to hurt him.  For example, when I said he had to wait until after dinner to eat a chocolate-covered pretzel, immediately, it was because I "never wanted him to have nice things, ever".

- This morning Sunny had hives all over his face and chest.  He was miserable. I gave him a benadryl. A rash is one of the rarer side effects of the anticonvulsive.

The rash sealed this. We're taking him off the new med right away. Not even one pill more. I just called and left a message with the psychiatrist.

Our only question now is whether to try and take him off the old med entirely now that we're at the halfway point. That way we could check his baseline. I have a feeling that he really needs his old med in order to regulate his emotions, and that if we raised his levels, he'd be able to regulate them even better. But then he might start drooling and ticcing because of the side effect profile.

UPDATE: The psychiatrist was out for the holidays but he just called me back shortly after I left a message on his answering service. He said we should stop the new med entirely and could go right back to the full dosage of the old med.  We'll make an appointment in a month, which should be enough time for the new med to clear his body entirely.

Fastfeet calling Coolfeet

I bought Sunny a set of fairly powerful walkie-talkies.  It's proven to be one of his favorites among the many presents he got today.  My cousin told him he needed a "handle", so he quickly decided to call himself "Fastfeet". I'm "Coolfeet". Dad is "Homebase". 

Sunny had a great time today running around outside, with my cousin's friend, testing the range of the radios, sending back various reports and yelling stuff like "THIS IS FASTFEET REPORTING ON POLICE CAR ACTIVITY".  We're still working on explaining that yelling very loudly into the walkie-talkie does not result in higher comprehension.

It's a great tech toy.  Aside from filing reports, he also uses it to pretend that he's fighting off alien invaders.  He does this from the next room, so we could really hear him without the walkie-talkie, but the walkie-talkie makes everything ten times as exciting and dramatic.

Christmas Morning On My Own Thinking about Problems

I'm spending this morning by myself, doing almost nothing, which is a pretty relaxing break. Later, we're going to meet up again at my mom's house to open most of our presents. Sunny and Guy drove to Sunny's sister's house. 

Guy just called to tell me that Sunny's little cousin is reenacting scenes from Scarface with her new Nerf gun.  Every time I hear another story like that it just boggles my mind. His cousin is 8 years old and she's watching Scarface and Saw and playing Grand Theft Auto.  It's lucky she's smart, sophisticated and has a great sense of humor, so I think she's able to keep a critical distance from all the mind-numbing media ultraviolence.

I tried to buy her an extra present for today -- a Tiana doll, since I know she would love one -- but of course all the stores around here were totally sold out of them. I'm about to order one online.

Now that I have some space to think, I'm calming down about the information I received a few days ago.  The "Merry Christmas, your son and his brother are meth-exposed!" message. I appreciate the kind comments on my last post.

I'm worried about the stigma on Sunny's behalf.  He already faces stigma for being adopted from foster care. We're open about that, because he's open about that. It's a trade-off between stigma and shame. If you don't hide something, people will pre-judge you negatively. But if you hide it, or are encouraged to hide it, you'll grow to be ashamed of something you shouldn't be ashamed of.

I feel I can be open in real life about his ADHD. It's such a commonly discussed topic. I can easily put it in a non-adoption context, since I grew up having a cousin with ADHD.  I'm going to go on telling people Sunny has ADHD.  The alternative is to say "We think he has prenatal meth exposure, which led to brain development issues including a set of behaviors which happens to include many of the same behaviors as ADHD".

But it's really not genetic ADHD. We already know that ADHD meds don't work on him well, or upset him emotionally to the point where he can't take them.  Many of his behaviors are nowhere near as severe as my cousin's were.

The scariest behavior that Sunny has -- and this scares me even more than the rages sometimes -- is his inability to be alone.  He cannot even put on his pajamas alone by himself.  He'll run out naked into the hallway putting on his pajamas so that he won't be alone by himself in the bedroom even for half a minute. It's not about attachment -- if we're not there, another adult or child  will do for an audience -- and I doubt it has anything to do with a particular past traumatic event.  He just cannot be alone with his thoughts.

We quickly realized that time-outs were pointless for Sunny, and I wish we had never tried them at all.  The idea behind a time-out is to calm yourself down, but they had the opposite effect on Sunny.  When he had time-outs, he would hurl himself against the door, beg, plead, sob, scream himself hoarse, "MOM DAD PLEASE SAY SOMETHING".

I think that being in that rage and panic state is actually much more comfortable for Sunny than being alone with his thoughts. Rages, in part, are a defensive reaction against being alone.  If he rages and panics, people will pay attention to him, and he won't be alone.  Because he can't stand to be alone, he finds it hard to calm himself down.  Usually, when people get mad, they storm off, which is often a smart tactic. Storming off means removing yourself from the presence of the person who is enraging you, and giving yourself a space to calm down, hopefully to come back later for a cooler discussion.  But when Sunny storms off, he hits the wall of being alone, snaps back like a rubber band, turns 180 degrees and comes back into the enraging presence, still enraged.  When he storms off, his storm-right-back line is about 20 feet indoors, 40 feet outdoors.

I think that his fear of being alone is very deep-seated, possibly related to the meth exposure, and I'm scared of what will happen to him as an adult if it never gets better.

1) people may be scared of him or avoid him because he won't seem to respect their physical boundaries in emotional situations.  If they draw away, he'll go into panic mode and follow them out of fear of being alone.
2) If he happens to fall in with anyone particularly manipulative -- perhaps a friend, group of friends, business partner, lover -- and they realize this tendency, they'll have him under their thumb.
3) He would be especially vulnerable to a cult or destructive religious group, which tend to create highly social environments in which people never have to be alone.

Balancing that out is the fact that he's very strong-willed and increasingly self-aware.  He isn't that vulnerable to peer pressure right now -- he's too strong-willed and argumentative -- and hopefully that will keep up as approaches the difficult teen years. So far, he's still very popular, but he's starting to get a reputation at school as a "crybaby", someone who can't control their emotions, someone who pushes when he's mad... I'm worried that if this escalates and kids are going to start leaving him alone, which would trigger a vicious cycle of panic, fear and more avoidance.  He's already become very sensitive about people thinking he's a crybaby.

Luckily, the kids at the school are very diverse, and some kids in his class have similar problem behaviors and some have different problem behaviors. He doesn't stand out as the only one, and the classroom has a strong focus on inclusion.

I wonder if a neurologist can address this in any way.  Maybe not.  Maybe we'll just have to keep working on giving him a lot of different tools that will help him handle the different symptoms of this base issue, because it's never going to go away or get better.

Also scary is the thought that when we get BB, he's going to go through the same things as Sunny.  His foster mom keeps trying to get the developmental infant people to examine BB, but they won't return her calls. Another effect of the budget crisis.


I'm definitely not going to talk to NN about this.  According to everything NN says, her daughter was practically a saint, and she died simply of a hard childbirth and a heart condition. I know she didn't really have a "heart condition". But why say anything to the contrary? NN will talk about the best parts of her daughter's life to Sunny, and the best parts are just as true as the worst parts, and if I died, that's the way I'd like to be remembered too. I don't want to talk about the meth exposure in front of NN, or anyone who isn't a professional or somehow involved in real life, because it's a huge issue with privacy.

At some point when he gets older I'll have to talk to Sunny about it.  That's not something I'm looking forward to either.  That means we have to move beyond "Your Mommy _ was very sick, which is why she couldn't take care of you, even though she wanted to" and into some of the uncomfortable details.

I feel like I worked through a lot of my stress just typing this up.

I'm going to move on and have a great Christmas Day.  I love watching Sunny open his presents, pumping his fist and syelling "YESS!"

I'm also heading somewhere warmer now.  The heating in our house failed for an unknown reason yesterday, and the probability of getting anyone to fix it this weekend is pretty low!  Luckily, we live in Georgia, not somewhere terrifying like New York or Michigan. So losing heating is an irritating inconvenience, not an emergency.

Happy Holidays! And a mini-update.

I have a lot of stuff to catch up on. 

Summing up: my cousin had another really bad breakdown, which we think is exacerbated by involvement in a particular local 12-step group that has mutated into something secretive, hierarchical and cultlike. Then we had an extended-family dispute over Thanksgiving that was very depressing to me, but I'm not going to talk about it any more.

I received some documentation on BB that states he was meth-exposed, which I half expected.  I did not expect that learning about BB's medical issues would give me so much insight into Sunny's issues. Really, it's like a lightbulb went off in my head. We don't have much medical info on Sunny beyond basic hospital stuff, because he didn't come into foster care until he was almost three.  But by all accounts, he had almost exactly the same issues as an infant that BB is having now.

On advice from Tubaville, I'm going to make an appointment with a neurologist ASAP.  This makes me really sad for Sunny. Much of his behavior must come from the fact that his brain was literally damaged by  destructive chemicals. Again, it's a possibility that was always in the back of mind, but I never really brought it to the front.  It's up there in the front right now, for sure. And unlike ADHD, which I feel confident about discussing widely, meth-exposure has a greater stigma, and so that raises huge privacy issues for me.  If this blog goes private for a while, that will probably be the reason why. On the other hand, this is really, incredibly important stuff for other parents to know about, and we stay ignorant when we don't listen AND talk... it's hard to say.

We're also halfway through a med change for Sunny.  We're switching from an atypical antipsychotic to an anticonvulsive. It's supposed to have less potential side effects, but Sunny has already been complaining of stomach pain, which is really worrying me. We're going to keep it up because so far the pains have been intermittent, haven't affected his appetite at all and there's a chance they'll go away as his body adjusts to the new medication.  He has a new diagnosis -- IED -- and if you know what that stands for, it's sort of a baloney diagnosis, but then again I take all these diagnoses with a grain of salt.

I'm mostly keeping up with my fitness plan. I'm getting burned out on Debbie Siebers but I still do Burn It Up a couple times a week and I'm exercising at least 5 days a week. 

So far Christmas is going OK.  I IMed my dad in Hawaii the other day and wished him a Mele Kalikimaka (Hawaiian for Merry Christmas).  I expected him to IM back something like "I don't believe in that garbage" or "you will burn in hellfire forever".  Instead, he wished me a Mele Kalikimaka right back!  He really has mellowed a lot in his old age.  Maybe one day he'll even buy me a present on Christmas, or let me buy one for him.

We're going to have a small Christmas, and my cousin is getting a day pass from her clinic to join us.  Sunny has been tracking Santa and making calculations about the chimney size.  I'm a bit stressed but staying in good spirits.

I'd also like to congratulate Thorn, who has a special visitor this season.