Archive for November, 2009

Partial Program/Full Disaster

November 30, 2009

A tells my mom he really liked program. He made an “anger” poster about what makes him angry- “LIFE”

All this therapy and anger management strikes me as bullshit. I would love to see A spending his day doing yoga, painting, music therapy, swimming…doing physical things to stay calm and keep active while we give the meds a chance to work. In my next life I will start a day treatment program that focuses on nature and serenity instead of  anger and frustration.

We hang his anger poster in downstairs shower– his new “quiet room.” we lined to bottom of the stall with a dog bed. A likes it in there.

There is acting out, but I don’t back down. “You will NOT misbehave. You WILL live in this family. Daddy and I love you and WILL NOT allow this type of behavior.” But too many consequences seem to push him over the edge. I wonder if love alone and a strong desire to keep him home will be enough. Consequences sound like such a good idea but I have to back off.

We do notice a few hours during the day where A seems pretty stable and has much better impulse control, but there are 24 hours in a day…

D works on Thanksgiving. His dad wants to help so he delivers a Thanksgiving meal to our house early in the morning. I never know what to do when he is so kind. He seems to get mad when I thank him.

I invite my step sister E over for the feast. She too is bipolar. She too is overwhelmed by large family gatherings. H joins the rest of the family at my sister’s for the “real meal.”

A hates all the food. Nothing is  making him happy. He wants to be alone, but with me. He hates turkey today. He hates stuffing. He wants pasta but it’s too cold. Now its too hot and has no butter. “Why the hell did you put butter on my pasta!?!?” he screams next. I know he has to eat. This is how he has always been. Grumpy and then when he eats he is an angel. I am a pro at discreetly putting food next to him and distracting him with tv or a story and before you know it he is asking for seconds.

Only not this time. He is a mess. I try to encourage him to come outside so we can get fresh air– it’s a good coping skill I tell him. He won’t open the door because he is afraid the dog will run away.

After bedtime E and I talk about things. She says I have a lot of patience. I cry. She tells me that she only feels angry when her meds are off. She is so honest and so caring. I’m so glad she can give me her point of view because I am just guessing. She is living it.

Friday morning we are off to the partial program. A wants to go. We have a nice car ride there. I enjoy the extra time we have together now in the car. He seems more “available” lately and we can connect.

As we approach the parking lot A says he doesn’t want to go in. I coax him out of the car and we make it in the door. I give Nurse J a report of behaviors– no aggressive behaviors to report, but some acting act. I wonder about focusing on the  positive.  We are supposed to walk in everyday and report all his transgressions in front of him? And everyone else too?

I go to leave and A flips out. He grabs me and won’t stay. I feel helpless. Staff tells me they aren’t allowed to touch him. I feel more helpless. I tell A he is strong and he can do this. I will be back at 2:30. I trust the staff and he will be safe. A grabs tighter. I look to Nurse J for help. She asks what the alternatives are. I say I guess hospital– but I don’t want to go there– I don’t want to threaten with the hospital. A and I both know that the third time means residential and I know he can function- more than function- at home with the right meds and supports.

Nurse J says not to make a threat unless I will follow through. I tell A it is the partial program or hospital. He clings to me. I am lost. He is having such separation anxiety and I am threatening with the ultimate separation–residential treatment. I stay strong and walk out. A is attached to me.

We get in the car and I am mad. I am sad. I am frustrated. I am worried. My baby.

You are going to go to this program. I get out. He follows. I get him int he door and I shove him in before he can grab me. I run to the car and drive away. I come back and sneak upstairs to docs office. I wait a long time but do eventually see him. I tell Dr. R about A’s anxiety and behavior.

Serequol. 25 mgs. Start tonight at 6. Don’t worry if he is very sleepy.

I am relieved. I didn’t get nonsense about family structure and discipline. I got a prescription. And I think I remember Dr. G saying she wanted to start A on Serequol. All is good.

6pm and I give A the new meds. He does get very sleepy.

Up at 5:30 Saturday morning. So needy. So agitated. Nothing is making him happy. He gets physically aggressive. I call Dr. R and leave a message. Something isn’t right and we need help.

We do have a few moments of good times. It is decided A needs his own room so we go to Home Depot and he picks out colors. Its fun. A and I are alone but H calls and wants to come. I’m torn but I agree. On the way home she and A fight. He hits her. I feel so bad.

I take a leap and suggest the whole family paint the room together. I worry D is going to get mad if the kids make a mess. I take him aside and remind him its the process not the product. I think he gets it.

I tell the kids that if they do a neat job with minimal mess they will get a prize. They each pick something I was planning on getting anyway– H wants a cover for her itouch. B wants _____ and A wants a lizard. I explain they can earn the prize by being very careful where and how they paint and keeping their clothes clean. I also explain they will have to wait until I am able to get to a store to get the prizes- it may mean waiting for a few days. All agree it is a reasonable plan and we set to work.

WOW! It is fun! The kids were great painters. Minimal mess and we all had fun together! Prizes all around–in a few days.

Back to major irritability. This is bad. I leave second message for Dr. R.

Second night of serequol. Musical beds all night. B makes his nightly pilgrimage into our bed. I eventually fall back asleep in his bed. I am awakened by a punch to my gut. “I WANT MY LIZARD NOW!” I don’t even know where I am or what is going on. Okay I get it now.

“You will not hurt me. You will learn to live in this family without hurting people.” He is crazed- cursing and violent. I tell him no lizard till Tuesday. He gets worse. But i am supposed to give him consequences for his behavior, right?

The day doesn’t get better. A is so agitated and irritable. Third message for Dr. R.

Nothing is interesting. A is bored. Bedtime can’t come fast enough.

I lay with him. He is crying,”I KNOW YOU HATE ME MOMMY!” He looks weird. His eyes are faraway. I promise him I can never hate him. I love him. Nothing you do will ever make me hate you. He is far gone. “Hmmm I KNOW someone hates me. It must be daddy. He wants to kill me.”

“Problem with new meds,” I text David in the other room.

Fourth message for Dr. R.

I cry myself to sleep. D holds me tight. “Don’t let go,” I plead. “I will never let go.” It’s what I need to hear  and I fall asleep.

A and I get up and get ready for our long drive. D takes B to school. I drop off H. I desperately want our old life back. How did this happen to us? We used to be such a cute family with a tough kid. Now we are a torn apart family with a psychopath. But my boy is in there somewhere. I know he is.

A chats away in the car. He is excited about his new program. I am surprised when we pull in that he won’t get out of the car. I take a deep breath and remain cool and calm. “I need to talk to the doctor. I can walk you in, or you can come out when you are ready and go in by yourself. But you MUST go in. If you don’t then  you don’t get your lizard.”

I check in with Nurse J and tell her about our weekend. I tell her A has locked himself in the car. She tells me he needs consequences because it has to feel better to come to program than face the consequences. I stare blankly. I don’t know what they expect from me.

I head upstairs to see Dr. R. I tell him A had a psychotic reaction to the serequol. He says it is impossible. I tell him about the paranoid reaction to the risperdol. He says he can’t go on what he hasn’t seen. Wow, really? So all of A’s atypical reactions to meds don’t count here because Dr. R hasn’t been witness to it? That’s scaring me.

I tell Dr. R I don’t feel comfortable giving A the serequol anymore. He tells me that I must continue it or A can’t be in the program. He says the psychosis is A’s sick mind and he needs the serequol to stop the psychotic thinking.

“I am a doctor with years of experience and expertise. You must believe in me if you want to help your son.”

I don’t know what to think. Maybe he is right I am just a mom. I don’t have years of experience with psychotropic medication. But I know my boy. And I will fight for him.

Dr. R. recommends offering A candy if he gets out of the car. Confirmed. Dr. R. you are an idiot.

I head back down to see if A has gotten out of the car. No dice. It is raining so I sit in the waiting room of the partial program. Nurse J tries to coach me into getting A out of the car. A therapist comes out to talk to me as well.

“He had two very good days here. You aren’t giving him enough consequences for his behavior–obviously this is environmental because he does well here and is oppositional to you.”

I cry. Tell me what to do to get him in here. “That is really up to you, but not getting his lizard is not enough of a consequence.” I explain that A could care less about anything else- other than his dog. “Maybe get rid of his dog. That will teach him who is boss.”

Is this really happening?

“You have to trust in our program.” I ask the therapist what it would look like if I trusted the program. “A would be in here right now.” My head is spinning. I don’t even understand this.

They bottom line me and tell me to take him to the ER.

I leave.

I stand outside in the rain and call my secret weapon. Dr J.

Dr. J. is a friend of my aunt and uncle in Atlanta. He is a child psychiatrist and has been helpful through out this process. He keeps reminding me that A isn’t stable yet so no amount of excellent parenting or consequences is going to help.

“Get to the airport. I will admit him and put him on the right meds. He will be okay. They are running you around in circles up there and no one will take responsibility for him.  you need to get down here.”

I go to the car and hug A. “We are going to Atalanta and getting you the right help. You will feel better. I promise you.”

I call D, I call my mom. I call Dr. G. It always feels better if Dr. G is behind these big decisions. She tells me she is not a miracle worker and can’t do this outpatient. “If you have someone who will admit him and thinks they have the meds that will help, do it.”

We do it.

A and I embark on our adventure down south.

Second Time Around

November 25, 2009

Poor H. Today I was suppossed to pick her up early from school and have some special time with her. Instead I called school and told them we were taking A to the hospital, please tell H I can’t come get her. I make arrangements for her to go home with a friend.

We head to St. Clare’s. A seems relieved. We go through the emergency room. They eventually put us in the psych ER. We have our own room. It is barren. There is a tv, a bed and a chair. There are restraints on the bed. We amuse ourselves with them for a long time. We are in there for 4 hours waiting. A is playing with chap stick. He impulsively decides to poke me in the nose with it and instead jabs me in the eye. Staff see it on the camera and come running. He cries. he is so sorry. Later a nurse tells me we have to be so careful because he can do damage accidently and then feel so sorry for it that he wants to hurt himself. this sounds right.

A is transported to psych hospital via ambulance. I get to go in and D follows in our car. A is very excited about ambulance. He “talks shop” along the way.

A is taken into unit by stretcher. This place is very different than Four Winds. It is an actual hospital. Not so homey. A cries when we leave. I am heart broken. How many times can you do this to a kid without changing him forever.

We are only 45 minutes from home this time- it seems like a much closer place. We hear from the therapist in the morning and arrange a family session for the next day. D can’t make visits or sessions because he has to work– he missed so much when A was at Four Winds. I am alone in this now. It feels cold. D has been confirming my reality–yes A is really out of control. No we didn’t cause this. Yes we need help.

Now its all me.

Hospital doc wants A on clonodine. Dr G agrees. So A starts on .05 at night.

Having A closer to home is actually a little harder — I am trying to keep things normal for B and H and still make it to A. It’s a crazy rush all day long back and forth. But if I just do it and do what the docs all say A will be okay and then the rest of us will be alright too.

I decide to be a little savvy this time and not trust the therapeutic staff off the bat. I ask our therapist if she believes in Early Onset Bipolar. YES! She does! And she goes on to describe how it would play itself out in a family. I am thrilled. She understands us. She knows we are good parents. She realizes A is working hard at this too.

I get a phone call from her. “Dr. M says this is learned behavior. A needs to start making better choices.” I am confused. I thought she got it.

Visits aren’t too bad. A holds it together most of the time. His mood seems pretty good. He is loving his new found skill of oragami. He says he likes the unit because they keep him distracted.

We are told a boy is being mean to A. He twisted his arm and also threw his food tray at him. Staff wants A to take some responsibility. A is telling on the other kid. Therapist tells me that A is having a hard time udnerstanding that what makes adults really like him –like telling when a kid is doing the wrong thing– will make other kids beat him up. I feel bad for A. He never really got that. But, maybe he needs to hear it.

We get a pass for Saturday. H,B, D and the dog come. We go to the dog park. A is great in the car. He is participating and playful. Maybe he is talking too much? Is he manic? He’s happy to e around the dogs. B annoys him, but A tells me instead of hurting B. I’m impressed. Later we walk the dog on the leash outside of the fenced in area and A gets worried about dog running away. A get really worried. A shuts down. He can’t move. Then he gets mad. Really mad. And he cries and he apologizes. I try to get him to take deep breaths and explain what is happening. He says he can’t be with us he has to live in a hospital it is too much for him. I tell him he had an anxity attack. Not a big deal- easily taken care of. He begs me to help him.

We go back to hospital and D and company wait in the car. I tell A that we will talk to the dr about the anxiety. I am convinced that his mood had been stable but the anxiety threw it off. We return to the unit where they tell us A needs to have a body search and then can come wait with me while I wait for doctor. He hesitates but I tell him to do it– he’ll be right back. 5 minutes later they come out and tell me that he had the body search, but as it turns out, he isn’t allowed back out and now A is hysterical and in the quiet room. I am horrified. I don’t trust them anymore.

Dr. M comes out but is very rushed she doesn’t have time. I tell her about the anxiety and she tells me A is trying to show us who is in charge. I think about punching her. I am so mad. Then I wonder if she is right. Nope -wrong . Definately wrong. I stand my ground and tell her A has a documented anxiety disorder. She tells me we should have told him to breath deeply and next time don’t bring the dog. I firmly tell her I need her to hear that we have to start treating the anxiety if A is going to get stable. She says she will increase the clonodine at night. Hmmmm I think I remember the colonodine has a short half life– no, she says, taking it at night will help with anxiety in the morning.

I hate that everytime A enters a new program we have a new psychiatrist. It seems like a bad system.

I get 10 minutes to sit with A in his room. he cries. He is scared of the meanboy. He is scared of everything.

We are told A is going to be coming home on Tuesday. Just before Thanksgiving. D and I think this is a bad idea. A never does well at family functions. In fact we stopped attending them years ago. Dr. M says this is learned behavior. I don’t even know what that means anymore. She says he does fine eating with 25 kids in the dining room there is no reason why he can’t go to thanksgiving. D and I think she is nuts. A thinks she is nuts. I say we won’t do Thanksgiving. Dr. M questions who is in charge in our house.

I call Dr. G. She says no way — stay home for thanksgiving. No malls either.

A is discharged. I pick him up and he says he feels better than ever! We stop for a bite to eat at Panerra. He tells me he is worried that he can’t live in a family. My broken heart breaks even more. Didn’t know it was possible. I tell him not to worry. I am worried. He tells me he thinks residential is a good idea, but makes me promise not to tell Dr. G.

We make it to Dr. G’s who seems surprised we are there so soon after the hospital. I am taking no chances this time.ANd I think the meds are wrong. The lithium is getting closer to therapeutic lever (.88,) but the clonodine at night just doesn’t sound right.

A tells Dr. G he really like the hospital and he thinks he can’t behave outside of one. Dr. G tells him not to be so hard on himself. All kids feel this way when they first come home. A is happy to hear that. He is scared to go to residential.

He tells her that he is having trouble remembering certain words. “Its not that I lose my train of thought or get distracted. I just forget the word I need.” Dr. G pulls me aside and tells me to keep an eye on this- word finding issues are a known side effect of lithium and we may need to try a different med. Oh my god. We are so close to mood stablization I don’t care if he is forgetting words!

I tell Dr. G I am terrified about residential and that I am going to make sure that A gets the message that he is capable living in a family and he doesn’t have to be in an institution to function. “He’s only 9, ” I tell her. “I’m not done cooking him.” “But you may not have all the ingredients,” she replies.

A is now going to take the clonodine in the morning too. We leave and prepare for our morning appointment at the new partial program.

A is excited. Me too. I have new strength in telling him he is going to behave at home. He can do this. He will not go to another hospital. With the right meds, the right changes at home and a lot of hard work on his part we can do this.

My mom comes with us to the partial program. We talk with a counselor. A cries. he doesn’t want to stay. Then he laughs and gets giggly. His moods are all over the place. A hears there is someone who knows oragami and then can’t wait to stay without me.

We leave and by the time we get home its time to turn around and come back. My momoffers to get him and I get a nice afternoon with H and B.

In the hospital, out of the hospital, in again.

November 11, 2009

We visit again on Sunday. A still is crying and pretty miserable. Says he still thinks someone is watching him.

Finally Monday and the docs and therapists are in. We speak with both. The hospital doc consults with Dr. g and A is started on lithium. I am pretty surprised. Seems so heavy-duty for a baby. Aren’t only crazy adults on that stuff? I remember reading a little about it and am concerned because it sounded like a hard med to manage– there is a small therapeutic window and toxicity is an issue. Docs tell me that A can’t take a lot of the other meds because he had elevated liver enzymes most likely from the risperdol. An EKG reveals a cardiac issue that will resolve after the risperdol is out of his system.

Wow, we are on our way! The meds take some time to work, but then he’ll be okay! It’s starting to get exciting!

We visit throughout the week. A says he doesn;t think people are watching him…”Well, I mean, they are watching– the staff is always watching me!” I think of “Just because you are paranoid doesn’t mean they aren’t watching you!”

Staff reports A is very compliant and happy now. He is a model patient. We have family sessions. Therapist tells us we need to set the bar higher for what we expect from A. I’m confused. Don’t we do this already? I listen and I swear I will do whatever it takes. I guess I haven’t been the parent he has needed but I will now. D too. We set up schedules and rules and rewards and consequences. A can’t wait to get home and we discuss how we will do things differently. D is a little pessimistic and tells therapist that the techniques aren’t new. “We’ll post this chart right on top pf the others,” he says sarcastically. I’m more willing to do what they say– after all, they are the professionals.

A comes home on Tuesday night and is scheduled for am intake with a partial hospitalization program on Friday. The plan is to keep to the rigid schedule and show Abe who is in charge by rewarding his good behaviors and having consequences for the bad.

A and I watch tv together before bed on his first night home. He doesn’t want me to turn it off at bedtime so he pushes me. I remind him of the rules and remind myself that this must be the bad habits everyone keeps talking about.

I bring B and H to school in the morning. Wow, it feels good to have the old routine back. D calls to say they are at the dog park but A is melting down and wants to leave. We have to stick to the schedule like they told us. We are in charge. D doesn’t give me much detail about what is happening and I don’t ask. I don’t really want to know. We are empowered now and D can handle it.

Thursday morning I arrive at RS’ office for our scheduled 10 am session– just me– she doesn’t want to meet with A yet. The door is locked. I call and she answers. “I am so sorry – I overslept!” Did she just say she overslept? RS apologizes and promises to be there in 20 minutes. 45 pass and she comes in and we have our session. She understands that A isn’t as stable as hospital believed. Says we will meet again and revamp routine, etc. to where he can deal with it.

I go home and catch the tail end of a therapy session A and D are having with MH. I think to myself how nice it is that D can handle this stuff– I am not the only one who can do it anymore. YAY! They are discussing the continuum of anger. A says he is never calm so thats not on his continuum. But the continuum ends with “wanting to kill someone,” A says.

A and D go into the kitchen for a snack while MH and I talk. A melts down suddenly. A huge rage ensues and D restrains A. I want to help. I know I can calm A down. MH discourages me and coaches D through it. It lasts a long time and A curses at MH. A comes over and tries to punch me in the face. D stops him. I cry and lock myself in the bedroom. MH reports this is what eventually gets A to stop raging.

MH is the first non-family member to see A rage. She confirms that this isn’t him being willful or bad or us not parenting him properly. This is inside him. I ask if she ever saw a child like this and she says yes, but not a child who comes from a home with two loving parents.

I am confused, sad, mad, lonely, and tired. Tomorrow we have his intake at the partial program. We made it!

A is excited to start the program. I think he is looking forward to getting back to a normal routine. It’s far–45 minutes each way, but we think its worth it so he can get stable and eventually start back at school.

We sign lots of papers and forms. Lots of consents. I sign a limited consent to school and ask that they only send educational information. It doesn’t seem to be a problem and I assure them that if it is a problem I can speak to our lawyer and make sure it is okay. They reassure me its fine.

A, D and I meet with psychiatrist. He is a big, Eastern European man. I can’t tell if he is warm and friendly or very stand offish. He asks A to step out so D and I can speak with doc alone, but A says he is scared, so D waits in the waiting room with him.

I give doc a brief history and doc asks if I have ever taken a parenting class. It feels like he just punched me in the stomach. I was feeling so confident –MH confirmed what I believed. It’s not about parenting–and anyway, H and B are okay. I told doc I’ve actually taught parenting classes, but would be more than happy to attend if it would help A get better.

We hear crying and I suspect it is A. Doc goes out and confirms it is. D is restraining him. Doc comes back in and tells me he wouldn’t have believed it if he hadn’t seen it for himself. “Your son is so charming! I can’t believe this!” REALLY!!?? I thought it was a hallmark characteristic of bipolar kids to be so charming to strangers and lose it with family. Didn’t he know that?

Doc tells me that A is too unstable for the program. Maybe they shouldn’t have let him out of the hospital just yet, he speculates. I feel defeated. We are doing just what the “experts” are telling us to and its wrong. I know it. A knows it. I think D knows it too.

I cry. Doc tells me that we have tried all the meds there are and we need to start researching residential placement for him. But, there is still a small chance he can come to their program. The “team” will meet Monday and decide. In the meantime there is more paperwork to sign “just in case.” I sign and sign and sign. One paper is for “rescue meds” in case A has a rage there. I tell doc I don’t want them to give A seroquel because of his response to Risperdol. He says that is fine and he has me sign for a different rescue med.

We leave. D tells me A started kicking him and when he tried to put his foot out to stop him D accidently bumped A’s leg into the table and A flew off the handle. D feels so bad–thinks its his fault that A won’t be accepted into program. I reassure him that accidents happen and its A’s reaction that is the problem, not what D did. Not sure he believes me. But I’m tired. D drives off to work. A and I start to drive home.

I call Dr G and tell her. She can get us in Monday. Keep him busy and apart from sibs this weekend she suggests. I drop A off at my mom’s for the weekend. He is calm there. She is enjoying him. We have all missed him.

A is invited to a “therapeutic” birthday party at a special needs school for a friend of his. He is really looking forward to going. I pick him up Saturday midday to take him. We arrive and he worries I will leave. I promise to stay. I am so gald we are there- it’s the first back-to-normal activity A has participated in since the hospital. We are making progress!

The teacher discusses with the children what appropriate behavior is at a party and what they can expect in the two hours. I wonder if A thinks this is below him? But it looks like he is soaking in each word and trying to understand it. So, maybe it is what he needs? She then asks, “are you ready to have some fun?” YES! They all scream. except for A. He cries and runs to me and buries his head in my chest. He tells me he ahs to leave. We leave.

In the car he says he doesn’t know what happened. Says he didn’t even feel sad. Just cried and had to leave. I assure him it is okay and we will do something else for the afternoon.

We have chinese at his favorite place and he orders his “usual.”

We decide on a movie-“Where The Wild Things Are.” Terrible choice. A decides Alex is bipolar– I think he is right. During the runaway scene A whispers to me that he will never run away from me. I tell him when he is feeling so bad like Alex I can help him feel better. If he runs away I can’t. He nods.

He sleeps at my mom’s house that night. On our way to Dr g’s I get a phone call from the partial program saying they won’t accept A because he had a meltdown there. They recommend a therapeutic school and in home services from the state. I ask them if they can send it to me in writing for my records. The letter comes later in the week– A wasn’t accepted because I refused to sign consent for school and wouldn’t allow rescue meds to be administered…

Dr G is concerned. A is in bad shape. He tells her he feels his moods changing almost constantly for no reason. She is shocked that Four Winds discharged him with no appointments and with no stable meds. She wants blood work done. I get flashbacks from our last trip to Toys R Us. I can’t do it. I tell her I want him back in the hospital. D agrees.

Paranoia

November 1, 2009

Its Thursday and D and I have an appointment with a therapist recommended by Dr. G. Its blurry but I think A went to school. We tell her what is going on and she says Dr. G needs to know –but Dr G is in Hawaii and we can’t reach her. But the therapist can. She tells us to go home and wait for her call at 3:30. D goes to work I pick kids up and have a sitter with me. RS, the therapist calls me back and says Dr. g wants Dr C to give A med and if they don’t help by morning we need to go to the hospital.

Dr C says risperdol .50 mgs. I give it to A and keep him apart from B and H. I am frazzled. I don’t know what the right thing to do is. I am exhausted and putting A in the hospital seems like a an easy way out so I can get rest and that feels so self fish. I wish I read the hospitalization chapters in the books!

A half an hour after takes the risperdol he asks me if I ever have ever felt like someone is watching me. I say no, but ask if he feels that way. He says he does feel like that and he knows someone is watching, but he can’t figure out where they are. I panic but don’t let him know.

Its 11 o;clock at night and I start calling hospitals to see who has a bed for a 9 year old that takes our insurance. I speak to a very kind woman name Marilyn at Four Winds Hospital in Ketonah. I cry a lot. I tell her the whole story and she makes us a 4 pm appointment for the following day. I tell her that I am pretty sure we will make it, but maybe A will be better and he won’t need to go.

I decide that night, while David sleeps beside me, that we are going to hospitalize A. The next day is the Halloween Parade and ironically A wants to go to school. We wake up and I am trying to go about business as usual. I don’t tell A. The kids sit at the table for breakfast and A is aggressive. I have to wake D up to stay with them so I can go to the bathroom. I am convinced I am making the right decision.

A goes to school excite about Halloween parade. I tell him if he starts feeling badly or scared he can tell teacher and I will bring him home. He thinks I am ridiculous.

D and I rendevous at my office– which I haven’t been to lately. We discuss our options. He convinces me that we can make t till Monday when Dr. G gets back. I have a call out to the Child and Adolescnet bipolar Foundation Parent Support group– I speak with J and he tells me he can send an email out to parents who have had their children at Four Winds and they can tell us more. We start getting phone calls almost immediately and its all good. Their children got the help they needed at Four Winds. I told one mom that I had no idea how we could possibly make the 1.5 hour trip to Ketonah with him and how I felt like my heart might break. She told me she would stay on the phone with me the whole ride if need be.

D spoke to one of the parents also. Now he is convinced we need to go to the hospital. We go home and pack and make arrangements for the other kids and the dog. We pick A up early from school and don’t tell him where we are going until we get in the car. He is oddly okay with it. I tell him we are going to check out a hospital that is really good at getting kids to feel better. I explain it is faraway in the county and he asks if it is because they know kids like him need peace and quiet to relax. Oh my sweet boy.

We make the with no major problems and pull up to the sprawling campus. A sees the full parking lot and says he sees it is not just him that needs help and says that is a comfort. we find the admissions building– I meet Marilya nd give her a hug. We wait and wait and answer various questions, fill out forms, etc. We see people being brought in by ambulance. A is impressed.

After many hours it is time to bring A to the unit. He is told that we will walk him and then we will say good-bye. He cries and screams. I hug him and cry too. When he refuses to stand up to go, the lady speaking with us mutters a few words into her walky talky and in less than a minute there are 5 people standing over him. “Abe is having a hard time agreeing to walk to the unit. Mom is upset too.” Huh? Was I suppossed to be something other than upset? Are there really moms who don’t cry? I tell him he can do this– its hard but he can do hard things. I repeat myself over and ver and with the help of the staff we are able to get him to start walking. He throws up on the way. We keep going. He stopsand they remind him he has to keep walking or D and I will have to leave. He goes. I am trying to stay strong and to remember that he is uncontrollable and can’t be at home. They give us a tour of the unit– they show A the school room and he falls to the ground hysterical. I laugh to myself. We say a very tearful goodbye and A is physically removed from me. D and I leave. I cry very little. I am so relieved. A staff member comes out to give us info on phone calls etc. and then D and I drive away. We find a hotel in nearby Mt. Kisco. We are alone. We are all safe. I cry a little. D tells me he almost told the staff to take their hands off of A but realized they ahd to do it. Says he was sad. We fall asleep.

D and I take a huge walk in the morning. It feels so good. I am not as upset as I thought I would be. We have a nice breakfast together. I realize how much I miss this and D.

We visit A at 11. He sees me and cries and cries. They make us leave until he is calm. We come back and visit him. We color, play cards, etc. He cries on and off.