The Kid started going to the 'hospital school' on Tuesday this week, and I must say that after three days, I'm honestly starting to feel optimistic again. More good things have happened in the last three days than have happened for The Kid and his mental illness in the last year. Or shoot, ever.
That said, he's still had some tough days. They have a 'safe room' where kids can safely rage and completely lose it. He's spent a majority of his days in that room. His first day was disastrous. But we're seeing signs of hope, he's using his words to describe his feelings a little better. He's not dreading leaving the house in the morning, despite his bad days.
One of the benefits of a day treatment program for kids like The Kid is that school is completely centered around their needs. There is no, "I don't have time to ______" from the teacher. There is a fully accredited teacher in the classroom, at least two nurses, several social workers, and a team of psychologists and a team of doctors rotating around the classrooms like satellites. Well, satellites that would jump back to earth whenever they are needed to fix things. Okay, bad analogy I suppose. Anyway, there are academics taught and worked on, but a great deal of the day is spent working on the more expressive aspects of academics: art, music, playing games in the gym or on the lawn. Don't discount gym... The Kid has such a hard time with the disappointment of losing or the careful science of social interaction within sports, especially just being a good sport. That kind of social interaction is one of his biggest difficulties. He needs more training in sports than reading right now, probably. I can work on his reading, and while I can play games with him to teach him about losing and being a good sport, what he really needs is to learn how to do that with his peers. One of the most amazing things I've seen this week was a ball game the kids were playing on Wednesday, and when The Kid was "out," he simply went and sat on the concrete wall with the other kids that were "out."No fight. I was amazed. Normally, that would be a trigger for rage.
But it's all baby steps. He's still having a really difficult time in the classroom. Like, I said, he's having meltdowns about 6 to 10 times per day. That's hours and hours of the day. We're currently in a wait and see time to see if they want to hospitalize him, inpatient, for a few days before they spend much more time in the classroom. The hospitalization would act as a chance to really stabilize him and work with him more intensively (out of the school environment) to get him on the right meds, really investigate root causes, etc, before the continued attempt to get him to function better in the classroom. I understand. I don't want him hospitalized, but I'm also cynical enough to know that I've got thirty days per calendar year through my insurance for mental 'inpatient' services. Each day of day treatment is equal to 12 hours of inpatient. Each day he's there, my countdown clock of time at this hospital ticks down. If he needs to be inpatient for a few days to help the classroom setting be more effective, rather than the contstant struggle he's currently having in the 'safe room,' then I'll be happy to give it a try. Nothing would be worse than to struggle for the next 15 or more days with only a little improvement, only to THEN have him hospitalized, and eventually run out of options when my insurance company pulls the plug.
Other things that encourage me:
1. He is going to get a neurologic work up next week. This includes a sleep-deprived EEG, and probably an MRI. Because of his frequent vomiting and the physical tics that he's developed, they want to rule out a seizure disorder. A friend of my sister's brought this to my attention a while ago, and we actually have an appointment to meet with a neurologist in January (the first appointment available when I made the appointment in September!). Because of this program, we get to do this next week. The EEG is 'sleep deprived,' I have to keep him up until midnight the night before the test, and then wake him up at four the morning of. This means I get to go all fraternity pledge hazing on The Kid. We'll call the frat Mu Gamma. Just for fun, I was thinking about instituting other frat-house hazing staples, like running naked around the house, cleaning the bathroom with a toothbrush, speaking only to his pledge mom (me) and learning the greek alphabet. I suppose we'll refrain from obligitory shots of Jaegermeister. I'm totally kidding, you know. (we'll definitely be doing the jaeger)
2. Right before we started this program, our regular psychiatrist took The Kid off of all of the meds he'd been taking previously and started him on Depakote. Depakote is a med that only works if it has an optimum level in the blood stream. It takes a long time to adjust and lots of blood testing to know when that optimum or therapuetic level has been reached. Because of the start of day treatment, we never got that blood level taken. The hospital did take it yesterday. I guess the therapuetic level is between 75 and 100 [whatever units of whatever to whatever in his blood]. The Kid's blood profile from yesterday only showed 37 units. He's essentially unmedicated right now. I've basically known this without the blood test, but knowing how off the mark he is, this just shows me how un-mitigated by meds his behavior currently is.
3. He's in a great mood. He's doing better with his anxiety. He's talking about his feelings. Ultimately, I think The Kid is encouraged. Which is the best news of all.