This past week has been interesting to say the least. First the positive - Carter is positively doing beautifully on his tiny dose of Risperdal. No tantrums since he started this med. He has better control of his anger so even when something does upset him he is able to let us help him move on and he moves on quickly. Good stuff!
Miss M? Not so much. We met with her psychiatrist yesterday and the CBA attended also. It was a really good appointment. The CBA was able to share what we are doing at home and how "consistent the family is". That was good to hear. He also said how intense Miss M's rages are and the psychiatrist said "yes I know I can hear her on the phone". He also said we need a rubber room when she is at that point. He was sort of joking but he said that the only thing that can be done is CPI restraint to keep her from hurting herself or someone else.
We are clearly going down hill on the current meds so he has changed the meds. It will take a few weeks to know how she is going to do on this new med. The psychiatrist did give us some hope for the future. I guess he could see distress on my face. He said that he treated a boy 10 years ago who was 12 years old at the time. He said when he came to him he was on 7 meds to help him stay calm. He said any one of these meds would lay you or I out for 2 days and this kid needed 7 of them. That same young man is now 22 and on NO MEDS. He explained that these meds are actually helping to reorganize Miss M's brain function as she matures. He said that he can't tell us that she will be as fortunate as this young man but that he can't tell us she won't.
Is it chemical or is it behavioral? It's both. The CBA agreed. The psychiatrist pointed out that all kids are behavioral, they're kids. They do things to test boundries and so forth. With Miss M her reaction to normal situations is often extreme and she clearly loses touch with reality and can not bring herself back under control no matter who is trying to help her. That part is chemical. Her brain chemistry is screwy due to inherited biology and negative life experiences in her first 2 years of life. 80 % of our brain is formed in the first 2 years of life. This is when trust, our personality and most everything that is important to being a successful human is being formed.
Carter has a similar background (screwy biology and maltreatment) but we brought him home at 12 months of age, not 2 and a half years of age as with Miss M. Vivian, well I can't say there is no screwy biology going on for her since she is genetically related to us (a little humor) but she never experience maltreatment. Evan may be the only one here with out screwy biology and he received loving care and was well bonded with his primary caregivers from day 2 of his little life when his foster family took him into their care. We simply picked up where they left off when we took him into custody at 14 months of age. We were blessed to be able to form a bond with him from 5 months old by visiting him every few months in Guatemala.
The psychiatrist pointed out that Miss M is showing clear signs of attachment to her family, especially Mom. I am really thankful that we got direction on how to help her attach. It is definitely an on going process and difficult for a child like Miss M. We find her regularly testing our love especially when her brain chemicals seem to be off. Other times she clearly expresses that she knows she is loved. For example:
Last week Miss M got into some trouble at school. Twice in one week. Last Wednesday she got into a food fight with another student in the lunch room. She was written up for that and had to sit out of recess. Friday she "used hands for hurting" and pushed another student when she got angry. She was written up for that and missed recess. When she came home she was upset that she "got on yellow at school". I learned early on with the manipulation feature to Miss M that I stay neutral regarding problems at school. If I seem upset by what when on I am VERY likely so see LOTS more of that behavior. This is pretty typical with RAD kids. So I acknowledge what happened and express my confidence in the teacher/school to handle it appropriately. When she showed me the yellow ticket that I had to sign and professed to be upset ... why do I say professed? Well the performance was a good one. I almost believed there was a tear with the fake crying but ... no. I just said, "Well babe everyone makes mistakes. You got on yellow today but tomorrow will be better I am sure of it. And you know that Mom and Dad love you anyway." She had that well duh look and said "I know that."
This journey of ours certainly is complex. No one professional has had the be all cure all answer for us with Miss M because she is an individual. Yes she fits the RAD profile and yes she fits the Bipolar Child profile but it takes not only a village to raise this child it also takes a whole team of professionals. And frankly she has kicked all their butts! But together we seem to be moving in the right direction, forward. Like her psychiatrist pointed out yesterday, she has a lot of problems for sure but in that we are seeing progress.
This child at age 4 was a danger to animals. Now at age 6 my MIL's sheepish chihuahua Chico is so bonded to Miss M that he is a wonderful gage as to how her chemicals are functioning. When they are off, he runs in the opposite direction of her and will not come anywhere near her. Otherwise he runs to give her kisses and will sleep in her bed with her.
Although we never give her the opportunity to be alone with her little brother we no longer see her seeking the opportunity to be inappropriate towards him. They have lots of supervised play together and more and more, little by little her behavior seems more typical with him.
Now in a fit of rage did she try to kill her grandmother Sunday? Why yes she did. Hey I said we still have problems. Her chemicals were clearly off Sunday, Chico the chihuahua confirmed this. We don't need no stinking doctor. Hey man we got the ch-E-wah-wah. (I am using my best accent right now.)
We are still working on the chemical part. Which is REALLY hard when this dynamic duo of ours both grew 1 inch and gained 4 pounds between visits to the psychiatrist. Their bodies, their chemistry is constantly changing because they are growing. Kids tend to do that. But the bottom line is I think the loo-loo's are on our way to success, whatever that may be!