Mom's Thoughts:
It's been a while since my last post. A lot of things have been happening, and time slips away quickly.
After our last visit to Elizabeth's pediatrician Dr. G., I broke down and scheduled her an appointment with a child psychiatrist. We do have an appointment coming up next week with a psychiatrist that
is on our insurance plan, but we've already waited 4 months for that
appointment. I just couldn't wait any longer. We found Dr. S. in a psychology group that had been recommended along with several others by her therapist. Of course, none of the psychiatrists we have been able to get appointments with take insurance, but I decided to bite the bullet and pay out of pocket. And it ain't cheap, I'll tell you. Makes me really think about all those people out there who don't have the insurance or the money to pay for their own care... but that's a topic for another day.
Dr. S took control of things right away. She's an odd sort, and Elizabeth was a little put off at first. But she seems to really know what she's doing, so I'm on her team. She immediately began taking her off of Paxil (Elizabeth was taking the max dose of 60mg.) She said that using high doses of SSRI anti-depressants to treat anxiety can cause a hyper-manic response - inattention & inability to focus, racing thoughts, inability to sleep, very strange "panic attacks" that lasted sometimes several hours, hyperactivity. She also says that Paxil is one of the worst SSRI for treating OCD. After several weeks, she is down to just 20mg of Paxil and is doing much better. She is still having some of these residual side effects, but much reduced in intensity and frequency.
She is now cross-transitioning her onto Luvox, which I've heard from several therapists is much better for OCD. The jury is still out for that medication, since she has just started on a very low dose and the doctor says it although it will help with the anxiety and depression soon, it will take 12-14 weeks to see any improvement with the OCD.
She is still taking a couple of other medications to help with the "breakthrough anxiety" and panic attacks, but Dr. S says we should be able to reduce and eliminate those once she is stabilized.
Elizabeth is back in school full time now after a few weeks of coming home in the middle of the day and even not being able to go at all. Her therapist says she must continue to go to school no matter how hard it is - and not all me. It is part of her exposure therapy, and continuing to skip school (that is, giving into anxiety) can create much bigger problems. I'm so glad she gave me that permission - it's hard to know how to help your child when they are suffering. Do you bring them home to momma, or make them tough it out? Will you make things worse or better? My instinct was to make her go, but that is easier said than done. And with her therapist giving the order, Elizabeth was more open to following it. I just had to be "the enforcer."
She is a bit behind in school, but we've been working on an official 504 Plan with the school counselor to give her the accommodations she needs at school - extra time on assignments and tests, the ability to leave class to see the counselor whenever needed, and even the ability to do classwork at home. This is a great plan (check the website link below for info on this) and is helping her stay on track with her grades. The teachers have essentially been giving her those accommodations anyway, but the 504 plan makes it "official" and is easier than going to each teacher individually to put out various academic fires. I'm very grateful to her school for being so accommodating and to her teachers and counselor for being so kind. I am so moved when I think of how amazing they have all been. Traditional thinking has told us once kids get to high school, they're "on their own" and are going to have to "sink or swim." My experience with her high school couldn't be further from the truth. I feel blessed to have such a great school to support my daughter.
I'm not a medication person (I don't even take vitamins,) but I can see that medication, along with Cognitive Behavior Therapy, is necessary for Elizabeth. I am just glad we seem to be on the right track and can hopefully get things under control over the summer.
Info on the 504 Plan:
http://www.greatschools.org/special-education/legal-rights/868-section-504.gs
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