Archive for December, 2009

Good Day

December 30, 2009

I’m almost afraid if I write it down, I will jinx myself, but A had a pretty good day. The best part of today was that he is starting to see his improvement. He had his last art therapy session today and when T asked if he thought he would fight with H and B he said ‘no!’ It was so much better than hearing say he is scared he is going to hurt them. 

Today he had 6.25 mgs of zoloft, and he wasn’t as calm as yesterday, when he had none– I’m not even sure if zoloft works that way, but I will tell Dr J. It was if A was ALMOST oppossitional, ALMOST talkative, ALMOST fidgety. 

People have been asking me to post information on making donations to The House: 

  

Please make out check to Ronald McDonald House, and remember to include your name and address so you will get a receipt and acknowledgement. 

 Mail to: 

Ronald McDonald House Atlanta 

c/o C. Olson, House Manager 

5420 Peachtree Dunwoody Road 

Atlanta, GA 30342 

Please indicate that your donation is in memory of Lloyd Temes. That is how the manager will know to put it towards the TV and DVD player and the family fund. Thank you for remembering my Dad. 

Normal

December 30, 2009

I was so afraid of what I would wake up to today. I should have predicted that A would be up early– 5 am actually. A tells me it was important that we both get up pre-dawn. “Mom! We have to get to work on my logo!”

Last night I spoke with D and cried. I told him that every attempt at bring A back to reality and telling him we couldn’t possibly buy him a building to house the animals he essentially stole from other people was met with anger. D is a man of few words, but when he does speak he is right on. “You couldn’t just agree?  I mean, I’m not there, so I don’t know what it’s really like, but what if you just go with it. Look up properties with him online.”

So, I take D’s advice this morning and help A get the computer up and running and help him design his logo in Microsoft Paint– which I think is pretty darn cute. He makes a picture of a sad-faced dog that says, “Save me.”  Although his “business” is still top priority, A isn’t as agitated or angry as he was last night. I watch him work intently on his logo and think about the flip side– his depression days. His tear streamed, pale face during visiting hours at whatever hospital it was that month, of him lying in his bed telling me he should just be dead. Him sitting, with no interest in anything, except for a thumb tack– repeatedly poking his arm watching the little balls of blood rise to the surface.

This morning is better than that. Much better. It is hard to compare last night though. Agitated mania and depression seem tied in how disturbing they can be. I think last night was particularly disturbing because it was an obvious break in reality– again.

Off to the hospital early for lithium level. I’ve already been up with A for 3 hours. I had told him I would go with him to the blood work, but after waiting for a few minutes, I decide I need a nap and tell A I am going to go. Just then J comes along smiling, “It’s fine. Come A, we’ll wait together.” I almost sense A would have been okay even if J didn’t help out. Huh, progress.

I remember a friend telling me her son had to go to the doctor this summer while he was away at sleep away camp. My stomach turned thinking about a child going to a doctor’s appointment without his mother. Ironic. Now I leave A at hospitals for EEGs, EKGs, blood work, all by himself. And today I don’t even think twice. I just want my pillow.

I nap. I count the days left of my napping life of luxury. I really only have two days. There is no program on Friday and D is coming that afternoon. Then a weekend full of activity and then we head home!

I meet R for a quick bite and we make plans for the weekend. We are going to work on parenting skills and also work with A on how he is feeling about going home. Her parenting program intrigues me. It is specifically for parents of difficult children and seems to spend a great deal of time on healing the parent-child relationship. Originally I thought we didn’t need something so hokey, but I now realize that I spent a lot of time avoiding being with A. It was too hard. Too painful. I think D needs some healing too.

Pickup A. Usual afternoon of dogs and tuna sandwich. He’s not super hungry today, but not completely refusing to eat either. He’s very calm. Doesn’t mention his business once. When A was a baby I used to believe he and I were so connected that I could judge his hunger or tiredness by how I felt. Now I feel like that with his mood. If I am feeling calm in his presence I think he is calm. If I am agitated and on edge, it’s him. I’m calm. I’m calmer than I’ve been in a long, long time. He still is having bouts of talkativeness, and I have to admit it is difficult to follow his stories today, but there is an underlying calmness.

No zoloft today and increase in the keppra. Better living through modern medicine.

A does mention his business when we get back to The House. “Mom, I am going to switch my idea to the first one- I am going to collect donations and deliver then to the shelters.”  I smile and softly tell A I think it is a good idea. On the inside, however, I am having a parade! THANK GOD! I could almost see the progression of A’s thoughts travel from unreal to real tonight. He’s back– again.

We spend the evening working on his business, “A’s Animal Mission,” creating a purpose: “To collect and deliver supplies for animal shelters across the US,” (okay, a little grandiosity never hurts!) We design a business card and start the very beginnings of his website. He is so happy. “Maybe I’ll be in the newspaper. ‘Young boy starts own business and helps save animals.'” He makes me laugh. I am loving being with him tonight. He’s sweet, funny and compliant.

We lay in bed together and A tells me that he isn’t really sure what it is like to feel normal. “I only know what I feel so how do I know when I feel normal like I am supposed to?” He never fails to amaze me. What a brain he has in that head. “Well,” I say, “Normal people feel calm. Do you feel calm?”

He does. He says he feels calm tonight.

“Remember when you told a therapist that you never felt calm before? Well, now you do! It’s big news, A!”  I realize that I don’t want him to judge his normalcy on other people though. I back pedal a little. “You know what, normal is when you feel okay. Do you feel ok?”

“I felt okay for part of tonight. And I feel okay now.”

Oh my. It’s too good to be true.

The Kindness of Strangers

December 29, 2009

I felt exhilarated when we woke up this morning (albeit late) gave A benadryl in the middle of the night because he was sniffling and snuffling.) Everything was smooth as could be – maybe A was talking a little much.

My sister, K, sent an email to P and me. “People are going to want to make donations in Daddy’s memory. What charity should we choose? Maybe something with diabetes?” Ultimately, my dad died from complications from type II diabetes. Somehow, still, a diabetes charity didn’t sound right to me. My dad would want something that helped people– people in need. The answer was clear to me — The Ronald McDonald House! Surprisingly K and P agree and it is decided that contributions will go to The House.

I speak with Kerri and arrange that the donations will go directly to this house. I ask what is needed the most. Kerri tells me a small tv and dvd player for the kitchen would be very appreciated. And, if there is money after that, it could go in the Family Fund. It costs $20 a day per family to stay at The House and that includes meals. It doesn’t sound like a lot of money, except many families are here for 4,5,6 months at a time. It adds up quickly. My dad would be proud to know that he helped these families provide for their children. The money will help families that A and I have befriended while we’ve been here and that makes me very happy.

Kerri calls me back into the office and I worry there is a problem with setting up the donations. She hands me an envelope. “A woman dropped this off – she says she reads your blog.” It’s a card. A sympathy card. I am so touched. It is such a simple gesture. So kind. I feel so loved and taken care of — and by a stranger. Thank you, E!

I glance at the clock and it’s exactly 12:30 pm. My heart skips a beat. My dad’s funeral. I’m sitting in the living room at the house and suddenly I panic. I run to my room and cry. I have a sudden sense of being so alone. I call Aunt. She’s not at the funeral and we’ve developed such a nice friendship since I’ve been down here. She stays on the phone with me the entire length of the service.

I pick A up and he tells me he had a terrible day. “It was Miss MaryAnn. We played a memory game and I had such a hard time at it and she didn’t believe me.” The story continues to unfold all afternoon. Not only does it unfold, but A can’t let go of it. He perseverates about it all afternoon and evening. He retells the story, but he also keeps making sure I notice his memory problems. “What was I saying?” “I was just about to do something- what was it?” He is almost believable. I am glad we are leaving soon- I know the staff is well-meaning, but I don’t think they always do the right thing. A tells me the day program stresses him just like school does, and I think he is right. The immediate focus needs to be to get A to recognize how far he has come and that now he can handle some stress. I tell him it must have been hard to listen to Miss Mary Ann all afternoon and I make sure to let him know that he ended up being okay in spite of her.

He doesn’t really hear me– he is too wrapped up in his new business. It started this morning. A told me he wants to start a business- just like a girl he met at the hospital- he is most impressed that she has business cards and a website. She collects handmade cards and distributes them to veterans. Taking a close look at the website reveals the probable cause of her hospitalization- Jesus told her to start the business.

This morning I thought A’s idea of a business was great- he wants to raise money and supplies for animal shelters. I think of all the valuable skills and lessons he will learn from designing a logo and a website, from writing letters to shelters, from organizing the donations and mapping out a delivery route. As I listen to him talk, I am reminded of “goal-oriented behavior.” A symptom, I have read, that a child is in a manic state. This still doesn’t seem too bad though.

But it gets worse. By the afternoon A no longer wants to pickup dog food and cat litter. He wants to hire a staff to go into people’s homes and remove their animals that they have been abusing. He definitely needs a website and business cards, but more pressing, we need to buy a building to house the animals in. Any attempt I make at trying to refocus him on the original idea is met with anger. “There are millions of animals being abused! I have to save them!” I remind him that the ASPCA already exists. “I will hire educated people who can handle this.”

The only remedy I know for ending this conversation is sleep. I manage to get him to take his melatonin and we go to bed. “Mom, you know I love you even if you get me mad, but you really have to stop getting me so mad, okay?” “Okay,” and I kiss his cheek.

As soon as A is asleep I send Dr J an email explaining A’s behavior tonight. “Most kids are content with a lemonade stand. I think he’s manic.” Dr J calls and confirms that A is most definitely manic. “We probably overshot with the zoloft. Skip tomorrow and restart with half of his dose. And, increase the keppra in the morning.”

I love this. I love the definativeness of Dr J’s answers. He makes me realize this is temporary. We’ll make it through this too. Dr J gives R the phone and she gives me good, practical advice. “Look back to when you came down here. He has come so far.”

I catch Dr J and R up on our plans to leave in a week and to start seeing Dr. Galanter. We all agree her willingness to consult with Dr J is a good sign, and we all love her comment when I asked her if she would want to change A’s meds. “If it is working, I wouldn’t touch them with a 10-foot pole.”

The card from E, the support from people at The House, the help from Dr J and R, the contributions in my father’s memory– all kindness of people who were once strangers.

My New Theory

December 27, 2009

There are lots of terms that I have become familiar with to describe the moods of a bipolar person. One is “hypomanic.” It’s a precursor to full-blown mania. I didn’t quite understand what hypomanic was- what it looked like, but today I think I do. I think A is hypomanic. He is talking a lot, but not to the point of being completely inappropriate– and he still makes sense for the most part. He gets angry, but bounces back pretty quickly. He curses–on his good days he never does. On days like this they roll off his tongue so easily.

A is up early – 7am and wants to play monopoly. I lay on the floor with my blanket and pillow and I play with one eye closed. A tells me his is sorry about his behavior last night. I tell him I forgive him and I let him in on an idea I’ve been thinking about.

“What if we call your moods ‘seizures,'” I ask. “When you have an angry outburst we’ll say you’re having a seizure and we will keep you safe until you feel better- just like a regular seizure.” A tells me he likes the idea. “Then everyone would stop blaming me.”

I feel like I am entering dangerous territory. I’m taking away any responsibility he has for his behaviors. But I have a plan. I think with this new framework, A can understand what is going on better, and I think he can actually start taking more responsibility. I will continue the analogy and start talking about “auras,” what it feels like before a seizure. They are working on this in the day program, but A just can’t seem to get it using the hospital’s terminology. They talk about what his body feels like before he gets angry. “It doesn’t feel like anything. I just go from okay to angry with nothing in between.”

Initially I am going to praise A for not having a “seizure.” I plan to comment on why I thought he was going to have one–maybe this will give him some insight as to what is going on physically with his body and hopefully he will start noticing it and then can begin to use his coping skills that have been drilled into his every cell.

Last night I was doing some not-so-light reading on the internet and came across a blog about a teenager who had epilepsy as a young child, and as a teen was diagnosed as bipolar. Her mom made parallels between the two and I was intrigued. Imagine, I thought to myself, if in twenty years people say things like, “Could you believe we used to punish kids who were bipolar because  they would rage. Ha, we had no idea then that it was a seizure.” Much like today how we no longer blame the “refrigerator mother” for her autistic offspring or for causing asthma. Keppra, which I think is working, is an anti-seizure medicaiton. So, there is some scientific basis for my latest idea, but, like usual, it’s 99 percent gut.

I think it will give H and B a good way to understand A’s behaviors. I am constantly thinking about what life back on earth will be like when we return home. Maybe hearing that A is having a “seizure” and mommy needs to be in his room with him until it’s over will help them deal with their brother. 

Today we have tickets to see the Nutcracker! A woman staying at The House got them from her baby’s hospital and she gave them to us! A is excited. He has seen the Nutcracker before, with my mom, so he knows what he is getting himself into. We are going to an Atlanta landmark, The Fox Theater. It’s just as amazing as Aunt said it was. We have great seats. Just as the show was about to start, two of the tallest people in the world plop down right in front of us. I believe even the most even-keeled  kids would have been upset. A wants to leave. We wind up in seats in the back of the theater, but we can see much better.  I say to A, “I thought you were going to have a seizure. Your face looked mad and you spoke in an angry voice. I’m really glad you didn’t cause now we can stay and watch the show.” A agrees and I think I may be on to something.

A really likes the ballet. I am somewhat surprised, but when he was younger he loved this kind of stuff. As he got older, it wasn’t that he thought it was “girly,” but it would have been too hard for him to sit still or too crowded. Today he is good- great actually. He is humming along with the music. We are quietly talking about what the dance is about. I am surprised he gets it. A has a non-verbal learning disability, which means he doesn’t always get non verbal cues and body language, etc. No words are spoken in the ballet and A is getting it.

I don’t notice that A is tapping his foot on the back of the empty chair in front of him, but a lady in that row does. She barks at him to stop. He stops and I worry he is going to cry. He doesn’t, but he isn’t happy.  He hangs in there. Intermission comes and goes and A continues watching and understanding– and tapping. And she yells again. He gets mad, but doesn’t let her see it. We are two scenes from the end and A says he wants to go. So we do. “I left early with Bubbie too.” I tell him that he sat for a long time and he really was great – two scenes don’t matter and it means there are no crowds on the way out.

We eat at Varsity- another Atlanta Landmark- A knows about it from the Atlanta Monopoly we have been playing non stop for two days. I have to admit it is fun to see all these places in person after seeing them on the game board.

We stop at the drug store to pick up Zoloft Dr J has called in for him. I worry about giving it to him today when he seems hypomanic, but I do and I hope I didn’t do the wrong thing.

Dinner is pizza and salad and A says the pizza tastes different. He thinks its one of his medications. Yet, he eats it. He’s back to eating a lot. I can only deal with so much at once and I have decided his food issues will have to wait. I’m not going to start limiting or restricting or pushing all the food groups yet. His “seizures” need to be in better control first.

The evening is okay-  not the best, but not the worst.  He has some hypersexual behaviors, he is talking a lot, he is silly. His saving grace is that he falls asleep at 7:45. I use my free time to book our tickets home! We leave a week from tomorrow. I am so scared.

Mourning

December 27, 2009

A wakes up with what I decide is too much energy. Ugh. Here we go again.

He wants to play Monopoly. We left the game unfinished and now, the boy who was so distractable and so hyper that he couldn’t even sit still long enough to roll dice,  has gone the opposite way and is completely focused on the game. We can play, but first A has to get dressed. I have grown accustomed to being able to say “get dressed,” and A doing just that. Today I am reminded of the way it used to be. “You need to get dressed. Here’s your shirt. Please turn off the sink. Your shirt, honey…you need to put on your shirt. No, don’t throw it on the ceiling fan. Now your pants- oops they’re backwards. A you’re going to fall if you run around with one leg in the pants and the other out. Sweety, get dressed. You were getting dressed when you noticed the bird outside– just put your leg in and you’re done. No! Don’t take your shirt off! You’re getting dressed- not undressed.” He is a space cadet. He finally gets dressed and we play monopoly. But even during the game, “Yoo Hoo- it’s your turn. Hey, A! Roll already…”

We head to IHOP for breakfast. Uneventful, except his large appetite is back.

Today we are going to Rabbi Fred’s shul so we can say The Mourner’s Kadish. I’m a little worried that A won’t be able to tolerate sitting still for so long- I am hoping to catch the tail end of the service.

Turns out Rabbi Fred is away. The Cantor is leading the service and we try to sneak in quietly. A likes it here. It’s so familiar. I always love that no matter where you go, Jews around the world pray the same way. It’s time for the prayer for healing and I cry. I can’t give my father’s name. He’s gone. A hugs me and we hold hands. It’s a weird feeling– A always needs me and now I need him. He seems like a big kid. He’s almost teen-aged like. Our hands are almost the same size. His hugs actually feel strong.

I like being there. I love the rhythm of the psalms and prayers. Some tunes are familiar, so are not. Then it’s time for Kaddish– the Mourner’s Prayer. A looks at me– “This is it, Mom.” I stand and say my dad’s name so he will be amongst the people included in the prayer. I start to cry. A cries too. We cry a lot. Someone brings us a box of tissues. Part of me wants to hide under the pew. We make it through the prayer and walk out of the chapel into the reception hall to break bread with strangers. But it doesn’t feel too much like being amongst strangers. It’s all very familiar ritual and they are all familiar looking semites.

People ask where we are from. I try to give them the brief run down without getting too dramatic. “Well, we are actually down here because A is receiving medical treatment here and we are staying at the Ronald McDonald House. Sadly, my dad recently died so we wanted to come and say Kaddish.” A adds the drama “I’m on the psych ward and her dad died yesterday.” People look a little horror-stricken. I get up to get a drink and a woman follows me. “You didn’t say what was wrong with you son.” REALLY? Wow. I am shocked. So, I tell her. She seems content with her new knowledge. A and I finish our food, we thank everyone and wish the a Shabbat Shalom.

We are off to the zoo. A is complaining about the long ride. He is threatening what he is going to do because he can’t handle it. But, he ends up lying down and fiddling with something. All talk, no action. Thank God.

The zoo is a lot of fun. A is like a man on a mission- it’s the ADHD trip to the zoo, I decide. He doesn’t stop to look at anything- just walks past and says a brief, “Ooh, I like those,” or “I saw a show on that once.”  We watch a gorilla at a training session. I love it. I could stay all day. A loves it, A can stay 3 minutes. Brief stop at the gift shop. I give A a $10 limit and although it takes a long time, he stays well within it and doesn’t complain. I praise him for it.

Our whirlwind tour of the zoo is over and we leave.

We decide to go to the Cyclorama– a Civil War Museum with a huge, circular mural depicting the Battle of Atlanta. Viewers sit in the middle of the room and the chairs slowly move so you see every part of the mural. It’s really pretty amazing.

We head to The House. A is okay, but seems “on edge.” A lot of times I get a sense of his mood by how I am feeling. I notice my anxiety is getting higher- it’s the feeling of walking on egg shells– a feeling I know all too well from childhood and parenthood. It feels like something is brewing.

More Monopoly. A finally agrees that the game is over. There are lots of people at the house today. Colby’s family is here to celebrate Christmas. Colby is the boy who was in a car accident and A has become friends with. We’ve all become friends. Colby’s sister-in-law is A’s tutor. A is restless. He complains he is bored. I am so exhausted. Physically from all the activity today and emotionally from my crazy life.

A interacts so well with Colby’s family. I wish he could do it with our own. There are no young children in the family, I wonder if that is the difference. A sits and watches tv with them.

Shower time. Uneventful except I worry about A’s “rituals” in the shower. He picks 3 shampoos from the shampoo basket full of hotel-sized shampoos. 3 conditioners. 2 soaps. His been doing this for a few days. He has a specific way of applying them all and then slides them down the edge of the shower stall. It seems too strict. Too planned out and I worry about OCD. I worry about everything. The behaviors today- were they from too much prozac? Not enough prozac? The keppra, the intuniv. Sometimes i am so sure I know the answer, but really I have no idea. My theories are just that. Theories. Tentatively correct until proved otherwise. It’s a crappy way to live.

I call Dr J and he says its time to switch to Zoloft– the prozac is just too hard to manage because of it’s interaction with the intuniv.

A’s behavior detioriates tonight. I hear Aunt’s voice reminding me to expect it. It won’t always be smooth sailing. We hit a lot of waves tonight. A was hungry before bed, but nothing sounded good, except for spaghetti and meatballs. “GET SOME!” I calmly explain that he can pick something else and A tells me to shut up. Off to bed I tell him. He goes to our room and cries. “Mom, I can’t go home. I don’t want to hurt H and B.” In between sobs he is also cursing at me and getting angry. He quickly turns back to crying. “Shhh… go to sleep. You’ll feel so much better in the morning.” “I’m not fucking tired!” He rolls over and begins to snore.

H calls. “MOM! I wrote a song about you! It’s called, ‘Mommy, Come Back, Please.'” I think one day I will look back at this and wonder how I didn’t just sit down and crumble to the ground.

My father died yesterday. As real as I know it is, it seems like just another chapter in this crazy book I am living right now. My nine-year old son has been hospitalized three times for a variety of psychiatric issues. Another chapter. I have lived away from my other two children and my husband for over a month. Another. Yet, I am such an idealist that I really believe we will live happily ever after.

And to all a good night…

December 26, 2009

I was awakened at 3:15 am by my cell phone ringing. It startled me out of my sleep and took a minute for me to realize what was going on. “Is this Lucy? This is Ethel from the nursing home. I am sorry to tell you, but your father has passed.” Just like that. I have spent weeks wondering how I would find out. What the voice on the other end of the phone would say.

Ethel continues, “Would you like us to prepare the body? Would you like to see him one last time? Who is picking him up?” So many questions for the middle of the night. And I have no answers. I tell her we will call her back in a few hours.

A wakes up and asks, “Is he dead?” Yes, he is I tell him. A checks to see if I am crying. I’m not. We hug and he rolls over and goes back to sleep. I can’t figure out what to do or who to call. I am the first to know. I decide to do what I do whenever there is a crisis– I call my mom. I once saw a woman on Oprah who was kidnapped and instead of calling 911 from her cell in the trunk of the car she called her mother. I would too.

“Hi Mom, it’s me. Um.” Yikes. How do I say this. I always hated saying someone has “passed away.” They are dead. Dead. “They just called Mom. Dad died.” I think about how long she and my dad have known each other. Since my mom was 16. We decide I should call my dad’s brother on the West Coast, as he is the only way who may still be up. I speak with his wife and I tell her. She is sweet and comforting. I think that there are wonderful women in my family. We agree that they will call the other siblings in a few more hours.

I am worried I won’t be able to go back to sleep and then I will be so tired all day with A. But, I eventually drift off. I awaken at 7 and call my sister and my brother. I still don’t cry. They do. K, my sister, wants me to come up for the funeral. I try to explain that I need to finish here. I can’t take the chance of stressing out A right now. I know she doesn’t understand  but I insist that I must stay here.

I call D. I cry. He is worried about me, but really I am ok. It’s just something about hearing his voice.

A wakes up to discover a big bag of gifts left for him by Santa at The House. He is excited, but concerned that he shouldn’t be too happy. I give him permission to open the presents and enjoy: $50 gift card to Target, Coca Cola memorabilia (he is now a collector!) candy, a blanket with his name embroidered on it and a wrapped gift with a card: “Hi, I am sorry you aren’t feeling well and have to be here for Christmas. I saved my own money to buy you this. I think you will like it. It is something I really like too.” It is a webkin an A is so touched. “You know that boy could have saved up and bought something for himself, but instead he got me something. That’s really special.”

I’m able to be in the moment with A this morning, although my mind drifts to my dad a lot. I picture what he looked like a few weeks ago, I recall holding his hand. I still not overcome by emotion. I If anything I feel peace. I don’t think my dad ever felt peace, and now, finally, he does.

I need to make calls- it’s the least I can do considering I am 700+ miles from my family. I call my dad’s (other) ex wife. I am surprised that it is a helpful phone call. “Donna, my dad died this morning.” She is sorry to hear that and wants to know about funeral arrangements, but warns me that she probably can’t go. I am glad. I never understood their relationship and never found her very endearing. I tell her not to worry about the funeral- I actually won’t be there either. “One of my kids has been sick– he will be okay– and we are in Atlanta getting treatment.” She asks for more details. “He’s actually a lot like my Dad, Donna. We are here to get him stable on psychiatric meds.” She surprises me with her unspoken understanding. She and my dad were married for a few years before he had a major stroke and a fall that left him with a head injury- there was always speculation that the head injury brought about underlying mental illness, but I remember incidents before that seemed to point towards bipolar. She confirms it. “If  he is like your dad, stay there and get him on the right path. There is so much hope these days with the right medication. Your dad never had that.”

My mom agrees with me that I should stay here. It’s not the funeral that matters. It’s what happened while Daddy was alive. She is right.

Aunt helps too. “If you had a newborn baby no one would expect you to be there. It’s like A is brand new. You should stay.”

A is getting annoyed I am on the phone so much today. He understands I need to be, but doesn’t want to give up my attention. He plays with his legos while I call people. He has been building a lego tower– adding to it each day. I find his “play” fascinating. He doesn’t try to build a house or a car. He methodically makes a tower. He builds one layer. Then he measures the tower and marks the height. He repeats this a few more times and then declares he has added the maximum for the day. For a very creative kid his play lacks imagination. It is very rigid and controlled. I think it must be anxiety, but don’t really know if it is true. I do know that for the last 9 years he has NEVER had an interest in legos or any other building toys, except for two times. I literally remember the two times he played with legos- it was during a failed stimulant trial. He was aggressive and agitated, but twice during those two weeks he took legos out and played for a few minutes. Today he played for over half an hour– and has been doing that each day.

The lego tower has begun to get too big and has broken a few times. He doesn’t mind. He works to piece it back together. I comment on this and let him know he’s different now. It backfires, he starts to get upset and cry- almost throws the legos. I  manage to work him through it, but we have about another hour of irritability, frustration, “I’m bored.” It goes away when we go to the movies, but it feels like a narrowly averted crisis. Today is a prozac day (he has been getting it every other day,) and it’s probably the prozac making him irritable.

He loves the movie (Alvin and the Chipmunks The Squeakal.) He’s fun and appropriate in the car on the way home. I set A up with some crafts and am able to take a shower. He is socializing with another family staying at The House. Grandparents have come to spend Christmas with one of the car accident boys. I expect A to knock on the bathroom door, but he doesn’t. As a matter of fact, he stays occupied the entire afternoon.

Volunteers have dropped off a traditional Christmas dinner. A prefers pizza, so I let him have it. He wants more and goes to get it himself. One of the visiting Grandma’s tells him she is proud of him. We’ve become friendly- even close- with this other family. Their boy is making so much progress- he’s walking with a walker, with prompting he is saying words, he is typing what he is thinking. They tell me A is making progress too. His attention, his patience, he seems happier. I feel like I just won a million dollars!

We have a very successful family dinner- the first family dinner A had ever made it through without incident– except it’s not our family! I guess it is good practice.

As happy as I am, I am brought back when I think of my Dad. I like having A with me. I’m not alone. He is a source of comfort today. I tell him that we won’t go home for the funeral and he is sad. I remind him how much progress he has made and we only have a week left. He agrees and the rest of the day is spent watching videos, doing schoolwork (an hour!) and playing Monopoly. A has never been able to play board games. It was always so frustrating. He would make up rules that were so hard to follow– and he would spend so much time organizing the pieces that you never actually got to play the game.

Tonight was different. He set it up, he rolled the dice. He played! He followed the rules! We played for so long I finally started bending the rules to help end the game. I give him a public service announcement,”If you were playing with friends, they wouldn’t like it if you bend the rules.” “DUH MOM.” When did he gain so much social awareness?

No leg pain tonight. He goes to bed easily.

My best friend from childhood calls. She had heard about my dad. She is crying on the phone. Ironically, I have to calm her down. She remembers her own father’s funeral and how my dad and I went to it. Funny, one of my sister-in-law’s fond memories of my dad is how he went to great lengths to be at her father’s funeral too.

When I let my mind drift to him I cry. I just don’t have the huge overwhelming feelings that other people are having. My sister calls and tells me she is so distraught and feels so completely helpless. I can relate, but not about my dad. My dad was sick. He would have suffered. He has peace. My son is young and sick  and suffered. He had no peace. I have cried about that for months. That felt like horrible, horrible overwhelming helplessness. 

 The same day my dad found peace, I saw peace in A’s face. My dad’s peace is eternal. I pray for A’s to last too.

No News is Good News!

December 24, 2009

From wake up until almost asleep, A had a plain old day- no super highs, no super lows. No opposition, no anger.

Wow!

We have an appointment January 22nd with the new doctor– I debated about staying down here for an additional week or two just to get us closer to that appointment, but I really want to go home. I am not so sure the day program here is even so good for A, considering what J told me yesterday. If we do a new day program at home, we will have to switch to their psychiatrist and I am not willing to do that either. So, it looks like I will start homeschooling A! It’s what he has wanted his entire school career. The plan is to be very hands-on– more like go out and do activities in the neighborhood than sit at home and complete workbook pages. The school will, hopefully, be sending a home bound tutor for two hours a day also. We have an IEP meeting mid-January and should have an idea of when and where A will be going to school after that.

The day was uneventful up until bedtime. Just as he was falling asleep, A started to cry- really cry- that his leg was hurting. He said it felt like “Charlie’s Horse.” I tried ice, I had him walk on it, I rubbed it. Nothing helped– he just eventually fell asleep crying about it. I googled ‘leg pain and keppra’ and sure enough, some people have leg pain when they increase the dose. I emailed Dr J and we’ll see if he says to bring the dose up slower.

Merry Christmas to All and To All, A Good Night!

December 23, 2009

A was oppositional before he even got out of his bed. I was so disappointed. I slept lightly last night, giddy with the excitement of how well A did earlier in the evening. Now, barely opening his eyes, A was cursing, mad, not going to the hospital.

It’s hard to explain all the things that go on in my head when he gets like this. There are a cast of characters telling me how to handle it. I quickly evaluate what they have to say. I remind myself to trust my gut. Today my gut tells me to get him fed, meds and off to the hospital.

Only A doesn’t agree. “I am not hungry. My meds aren’t working and I will not go to the hospital.”

I want to be firm, but I also want him to know that I realize he feels crappy. I want him to know I am doing everything I know to make him better. “You have 5 minutes to get into the car.” I tell him if he doesn’t I will call the hospital and they will come get him.

We get in. I drive off with his medicine in a baggy since he is refusing to take it. We make it to the unit and speak with Dr. Co. A tells him he was angry yesterday but doesn’t remember what happened. “Stop it right there. You cannot blame this on your disease. You have to fight it and you have to remember what happened.”

I just watch. I don’t know if this is good or if this is bad. Dr. Co turns to me and says, “Sometimes when children have a parent who is…” he pauses. “Who is very involved, they tend to take less responsibility for their anger. It just means progress will be slower.”

Eventually A takes his medication, but still won’t eat. I walk out of the unit, tears running down my face. It is so hard to be A’s mother. It doesn’t seem like anyone “gets it.”

I want to call someone. I run through a list of people and decide to call S who’s house A and I went to last week. She gets it. We chat. I tell her how bad the morning was. She’s been there. We make plans for next week.

I feel like there is a piece to the puzzle that we are missing. Not only is A having blood sugar problems, but he doesn’t ever feel hungry. What has changed? I run through the med changes in my head. I got it! I call Dr. Co and tell him. “I don’t want to sound like an overinvolved mother,” I begin. He assures me that I an “appropriately involved mother.” I continue, “We lowered the lithium, but A is still taking the synthroid. Is it possible we have now made him hyperthyroid and that’s why he isn’t hungry?” “BRILLIANT!” Ha! Dr Co says I’m brilliant. I am so relieved that A’s hunger strike isn’t defiance- it’s chemcial.

I resist the urge to nap today. My sweet cozy bed is calling my name, but I have work to do. I am feeling so much better about A’s appetite, now i have to tackle my to-do list. I need to find a psychiatrist back home. First I need to call Dr. Greenberg. I feel like I am breaking up with a boyfriend. I update her on A’s meds and progress. “Lucy, he is too hands on for me, I am sorry to tell you, but I can’t take him back.” I’m glad she was honest and I’m glad she dumped me first.

I have kept notes of names and numbers people have mentioned over the last few weeks. Dr. Gallanter was recommended by Aunt’s friend at NIH, and was a name I recently heard of through a support group.

I call her and we spend a great deal on the phone together. She has just opened a new clinic in Manhattan for Early Onset Bipolar Disorder and she can see us Mid January for an evaluation. She even takes our insurance- which is a big deal. We don’t have out of network coverage, and any of the “good” docs aren’t in our network. The only catch is that if A truly isn’t bipolar, he won’t be eligible for the clinic. I guess that would be bittersweet news.

It’s exciting. It means we can go home!

Dr J calls to discuss an emai I sent last night. I cut and pasted information I found regarding one of the meds A is on- Intuniv can increase the blood levels of prozac. That’s why he is responding to such a low dose and it may be why he is still having manic episodes. Dr J says we may switch to zoloft, but we agree to give it a few days and see how A does without the synthroid. I feel brilliant again!

Befoe heading out to pick up A, I stock a lunch bag full of snacks — Dr J says it doesn’t matter for now if it is healthy- just get him to eat. I agree. I know that if A eats a cookie, it is usually what he needs to stimulate his appetite for something healthy. I keep the food cold with a frozen rag. I feel invincible. I a backpack full of “devices”- an itouch, a laptop and A’s camera. I hope it works.

I get to the unit and A is asleep. Not sure what that is about, but he fell asleep a few times there today. While he naps I get a chance to speak with J, A’s favorite staff member. She tells me she doesn’t know what it is, but she just loves A. It’s the kind of thing every mother wants to hear-not necessarily on the psych ward, but hey, I’ll take a compliment anywhere I can get it!

I go on to tell her about the issues we have been having and she says he is an angel with her. This use to really bother me. A saves his worst behaviors for me- its clearly something I am doing or not doing then. I know now that it isn’t that simple. I have relieved myself of that guilt.

I mention that I thought W saw some of it a few days ago- and I add that W may have pushed too hard. She tells me in confidence that she doesn’t think that is such a good thing. She adds that yesterday he was with an inexperienced clinician who seemed to provoke A.

Breathe mama breathe. That would help explain A’s resistance to going the last few days. I don’t know what to do with the information, but I store it away and have more sympathy for A.

We head to the dogs and then head home. No traffic!

A is tired. He eats dinner without a fuss and watches tv. It’s sweet and cozy. Next it’s shower time and I am glad it’s just A and me- he can take his time and splash and squirt to his hearts content.

All’s Well That Ends Well

December 22, 2009

A sleeps through the night and awakens at the usual time. He seems fine. His thoughts don’t seem to be racing, he isn’t talking a mile a minute. He gives no indication that he is going to be oppositional. The only thing that is ‘off’ scares me:

A and I are standing next to one another in the kitchen making breakfast. A opens a drawer and its the knife drawer. “Oooh, look at this one! This one would be good at cutting meat. This one isn’t very serrated. Huh, this looks like the first one.” He is caressing the handles of the knives and occasionally touching the seration or the tip. I quickly shut the drawer and tell him not to do that. “You can hurt yourself accidently!” “Or not so accidently,” he replies with a menacing smile. He is quick to tell me he is just kidding.

When I was in college a guy down the hall from me had a knife collection- in retrospect, I can’t understand how he was allowed to have it. He would sit in his room polishing the knives, sharpening them, arranging them. He wasn’t trying to hurt himself, but he was fascinated with them. A was fascinated  today.

At the hospital A reminds me that he wants to speak to Dr Co. We manage to get him on the phone and I tell him about the events last night. I am getting the feeling A wants to be back in the hospital. Dr Co asks me if I would be more comfortable if A was an inpatient for a few days. I tell him I think I can handle things outpatient. I ask A and he says he doesn’t want inpatient.

I don’t completely understand what is going on with A. He is telling me he thinks its “better” if he stays as an inpatient, but says he will be more scared and doesn’t want to go. I want him to see the progress he has made. I think inpatient would set him back a lot. Maybe he is scared. I remember him feeling similar after his second hospitalization and Dr G telling him being nervous about going home is normal.  I need to remember to tell him this again.

This morning I do some grocery shopping for The House. Kerri has given me a gift card that was donated and a grocery list. I am so glad to do something to help out. All day long people are dropping off beautifully decorated cakes and candies, new toys and books. A and I keep our room neat and clean up after ourselves in the kitchen, but there isn’t much opportunity to do more. This feels good.

I take a delicious nap in the afternoon. I am storing up my energy for the afternoon with A. I could have an anxiety attack thinking about what lies ahead for me from 3-8. It’s only 5 hours, but it has been known to be the longest 5 hours of my life.

I arrive for pick up and I don’t need to ask staff how A’s day was. He looks terrible. He tells me he wants to speak with a therapist before we go home. No one is available, but one of the nursing staff says she can help us. I tell A I was worried about the knife drawer this morning and I want him to promise not to open it anymore. “I can’t promise you that. I mean, what if I go to open a different drawer and I accidently open that one.” This continues for 5 minutes. I ask for a promise and he gives me a debate about why it’s not possible to promise. I finally say I need to know he will not use the knives to hurt himself or anyone else. He agrees. We can leave.

We leave the unit and walk down the hall. I need to stop and use the bathroom before we go and A begins to meltdown. He is upset that if we wait to long we will sit in traffic “and then I will really hurt someone.” I manage to get away from him and use the bathroom. When I come out he grabs my arm and pinches me and then tries to bend my fingers. This is exactly how he was after school a few months ago.

“We cannot go home if you are going to hurt me.” A social worker overhears us and brings us into our office. A is so oppositional. He won’t agree on any sort of safety plan. The social worker tells me the unit was very hectic and overwhelming this afternoon. This leads me to decide that he needs less of it, not more and I won’t put him inpatient. “Come, we’ll go play with the dogs at the pet store and then we are having chinese food.” A growls at me (an old behavior I haven’t seen in months,) and we head out the door.

We barely make it to the parking lot and A starts cursing and kicking and screaming. “If there is one god damn car in our way I swear I will fucking throw a rock through the window.”

I turn around, walk back inside and A follows me crying. I tell the receptionist we need to speak with someone on the unit. They give me the phone and I speak with someone who’s name I don’t recognize. “I’m sorry we are so short staffed that I can’t help you. Tell A to use his coping skills.” I think I may have laughed out loud. I’m told we can go through assessment if I am really worried.

We leave. I ignore A’s outlandishness and stay calm. “I will never come back here tomorrow. You can call the police, the doctor. I don’t care. I WILL NOT GO.” There is no traffic and we make it to the pet store without incident, other than A’s verbal ridiculousness about what he would do should there be traffic, or a person who he doesn’t like, etc. As we are about to get out of the car I offer A some popcorn. He grabs a handful and takes a deep breath. Two more handfuls and his whole face has changed. He is smiling. He tells me he is looking forward to having chinese food back at The House. We walk into the pet store arm in arm and I feel like the most neglectful mother– I have the food in the car and I can’t even remember to give it to him!

We play with dogs and birds and then A asks to go to the deli for a tuna sandwich. I offer to buy him an extra sandwich to bring home and eat after the hospital tomorrow- its’ s test and he passes with flying colors. “Sure,” he says. He didn’t say he wasn’t going and that he would break my neck if I tried to make him. He’s back.

He calmly eats  and I break the news that we have to go to Walmart to pick up meds. He doesn’t flinch. It’s like oppositional, defiant, crazy behavior would never even occur to him.

Got meds, get into car and hit so much traffic. But A is busy making finger pictures on the steamy windows. We sit in traffic for 45 more minutes without so much as a bad word out of his mouth.

Dr J calls to check in and I mention the knife drawer incident. “Fascination with knives is a known behavior during a manic episode.” Did this kid read the book on how to behave when you are manic, or what?

A tells me he hates the way the prozac tastes. “And anyway, it’s not helping- I’m still scared all over.” I tell him he doesn’t seem to be so scared anymore. “I still feel it, I’m just not reacting to it.” I think this is great news. BIG news. I tell A that’s the next step and eventually we will get the meds right to the point he doesn’t even feel scared. I am excited.

A isn’t  hungry when we arrive. The woman who I have asked to be his tutor is home and she engages him right away. I stick around, out of sight, because I know he won’t last. I warned her that 15 minutes would be all he can handle. I am ready to help redirect him at any minute…but it never happens. He sits and does his math work for 55 minutes uninterrupted. I don’t think he has ever sat still for so long. Ever.

We chat with a dad who just moved into The House. His 16-year-old son was in a car accident and has a head injury. (Note to self, my children will never be allowed to drive until they are old enough to drink—only that doesn’t right either.)  A relates to what the man is telling us about his son’s lack of memory. “When I get mad I don’t remember what I did when I was mad, just that I was mad.” Huh. I wonder if that is true. He had an EEG at St Clare’s and they never said anything to me about it. I assume that meant it was normal–certainly worth looking into.

I tell A he can stay up and watch extra tv tonight because he worked so hard during tutoring. He choices Star Wars and asks me to sit with him because some of it is scary. Occasionally he tells me he sees someone watching us. I tell him its his disease and his healthy mind has to not let him stay- “tell him to leave us alone and he will go away.” I really have no idea what I am talking about. First, I don’t even know if he is telling me the truth and, second, I have no idea what you are supposed to do about hallucinations. I do know we want him to stay in reality and he needs to know a big part of him is healthy and can do that.

I give him a ten minute bedtime warning. He says okay and I go back to watching the movie. “MOM! You didn’t say, ‘Thank you for being so agreeable, A!'” He is so cute and sweet right now I wish I could freeze time.

I think about the days events and I am reminded of sage advice about toddlers. If they are hungry, feed them. Tired, sleep them. You can’t reason with a tired, hungry baby. Just like I can’t talk about coping skills to A when he wants to run me over with a truck.

When A is doing as well as he did tonight it doesn’t even seem like his crazy behaviors are even in his repetoire. My job now is to make him available (thanks Aunt!) as much as possible to learn what to do before he gets upset, so we don’t even have to go there.

Tempting Fate

December 22, 2009

I got a call from my dad’s nursing home late last night- he has a skin tear on his leg- it’s standard protocol to call the family, the nurse says. I ask how he is doing otherwise and resist the urge to explain why I am not at his bedside. “He’s comfortable. He’s not eating and he’s not talking anymore. I will pray.” I don’t want to ask what she is praying for. I know it’s not that he get better.

Somehow my mind knows I can’t deal with two major crisis at once and I am able to put thoughts of my dad aside and not be upset by his situation.

Nice morning today- maybe A was slightly manic- but if he was, it wasn’t too bad. I am learning not to react to every slight mood change and to have patience to see the big picture.

W was there when I dropped A off at the hospital. I ask him what works for A in the hospital, but W says they don’t really see the behaviors, so it’s hard to say. What they do see is A getting distracted and then distracting other kids during school time – “He’s looking for an easy way out of schoolwork.” I try to take it lightly. I really do think if A is taught the way he learns, he will flourish in school.  I don’t think W is right, but there is no school this week at the hospital because they follow the school calendar and schools are out for winter break. No use to try to get my point across.

W asks how the weekend went. I tell him it was mixed- Saturday I almost readmitted him, but yesterday was fantastic. “Great to hear how well yesterday went. It means today we will hold him more responsible for his behavior.”

I should have kept my big mouth closed. The scales are starting to tip favorably and I don’t want anything to push it in the other direction. Of course I want A to be responsible for his behavior. I back pedal a little. “He even told me what coping skills he used yesterday when he was about to get upset,” I lie.  Maybe they can skip the holding responsible step if he is already doing it. I already hear the comments  friends, family, therapists would make if they heard the dialogue in my head. “He’s much stronger than you are giving him credit for.” “It’s safe to do in the hospital setting.” “He’s resilient.” But, not only is A not there yet, neither am I.

I am only loosely feeling like a good parent right now.  I’ve been shot down so many times. I’ve never had the opportunity to parent a “normal” kid (with the exception of B and H, but that was under the shadow of the dysfunction in our home.)

Am I being overprotective by wishing they wait until we have more successes under our  belt? Maybe W will forget. I keep my fingers crossed and walk out of the hospital.

Today I am optimistic and start making plans to go home. I decide it’s best to have A come back when H and B are back in school from Winter Break. That’s a solid two weeks more. It sounds so long. I make lists. Doctors to interview. Therapists to call. Music therapy. I want to come home and have a plan.

I have lunch with R and she offers to help with parenting. I’m all for it, although I’m not sure what someone can teach us that we haven’t already tried, but now that A will be available to our family rules and structure it will come in really handy to have someone helping us stick to a system.

I get to the hospital and W tells me A had a difficult time today. He threatened another child (someone fell off a chair and another child laughed. A asked the laugher if he wanted A to push him off the chair to see how it felt.) He refused to answer questions about coping skills.

A looks like he is going to cry. He’s angry at W and tells him that. W talks to A about using coping skills and the need to have more than one. A doesn’t really care. I don’t flinch. I can’t let A know that I think this is stupid and too much already. It seems like it was W’s mission to push A’s buttons today. 

W tells me A is worried about a “family member who probably died today.” I tell W that A isn’t far off, that my dad is dying any day. W tells me he knows, but that A needs to learn to live in reality and not get upset about something that didn’t happen yet and not create a reality in which it did.

I am surprised A is upset about my dad. A is surprised I am surprised. But A talks so nonchalantly about Zaydie dying, and they never got along. I tell A that it is going to happen soon, but I will be okay when it does. I wonder if he is more worried about me. I tell him I think it is weird that someone can be here one day and then the next they aren’t. He agrees that this is baffling.

A doesn’t want to see the dogs today- he wants to go play with the legos I bought. He tells me not to buy anymore (I wasn’t going to,) because he won’t be into legos for very long. I tell him to enjoy it while he can. I read a book, he plays with legos. We are normal! I like this! I don’t have to dread picking him up in the afternoons because there is still space for me when he is around now.

A hears me on the phone with MH, our at-home-therapist. I tell her things are going well and we are going to be home in two weeks. She tells me she has arranged to have a Behavioral Therapist come to the house for 3 hours a week to help us with parenting. She agrees to speak with R about the parenting work we are going to be doing down here.

We head to art therapy and A tells me he wants to tell me something about his brain. “I see people pointing guns at me.” He says he knows they aren’t really there. I tell him not to worry- just your mind playing tricks on you, I reassure him. I don’t let him know I am panicking.

I call my mother while he is in his session. Together we wonder if A is pulling my leg. “Maybe he wants to stay in Atlanta with you and get all the attention to himself, ” suggests Mom. I hate when people think he is so manipulative, but it is a possibility.

We make it to The House and A tells me someone is watching him. Shit. Here we go again. He knows they really aren’t, but he says it’s a feeling. I call Dr J who tells me as long as he has a sense of reality that people really aren’t watching him, then its okay.

Time for bed. Can’t wait for him to sleep. He’ll forget about it all in the morning.

We step into our room and A starts to cry. He tells me he doesn’t know why he is crying. I hug him and tell him this happens to everyone at some point, even though I’m not so sure it does. “I’m scared I’m going to hurt B and H when we get home.” I tell him D and I won’t allow it. I tell him his new bedroom will have a lock on it and if he gets violent he will go in his room and stay there until he is calm for 10 minutes.

He tells me he wants to go back to the hospital. I hold him and he cries. I convince him to go to sleep and we’ll talk to Dr. Co in the morning, but I don’t think he will need to be an inpatient. I need him to know I can handle whatever he throws at me.

Suddenly he’s mad. He tries to bite me and I hold him. He is unrelenting. Just as quickly as he was raging, he is suddenly dancing madly around the room– he pulls his pants up to his chest and starts his manical laughter “I’m Steve Urkel! Look Mom! I’m fucking Steve Urkel! I’m fucking Steve Urkel!”

What happened? Where did this come from? I manage to get A to take his night-time meds despite his protests. He is calmer now. He is oppositional though and I know if I tell him to, he will refuse to lay down–so I tell him we can watch tv together.  I zip off an email to Dr J and wait for A to conk out.

A is wide awake. He’s not dancing, biting or crying, but he isn’t tired. Dr J calls and helps me keep things in perspective. He’s had episodes like this before, it really isn’t anything new. We have to get him to sleep. Give him benadryl. Do you have valium? I think he means for me– but he doesn’t- we have no valium anyway, but if we did, I certainly wouldn’t have shared it.

2 teaspoons of benadryl and A and I wait some more. We watch Jay Leno. He is right up A’s alley- A gets the innuendos and thinks its the best show. We watch animal planet. I worry that he is never going to bed and I know that poor “sleep hygiene” can bring on manic episodes, so I assume it can make them worse, too. I give A another mg of melatonin.

We lay together in his bed and snuggle. He’s great now. But he’s still talking. His eyes are closed and his mouth is still going. Finally, he stops mid sentence and he is asleep.

I want D here with me. I need someone to witness this. I need a reality check. I need him to hold my hand. But D can’t come. Last we spoke, he was worried about B. “He’s got a fever, his legs hurt and he has a headache.” I know what D is thinking- 4 years ago A had similar symptoms and it turned out to be meningitis. Poor D. It’s so scary. But, I know B and how he gets with a fever. I tell D those are  B’s usual symptoms. Motrin should help, and it does. Fever is down, no more headache. B is a sweet boy again.

I think about Texas. I want to go home so badly. I want to be with my other kids, with D. I want to make my own bed, do my own dishes. Maybe Texas is the answer. I can fly us there, check A in, stay for a few days and then go home. We could fly down on weekends.

I have to keep reminding myself that it was only a brief episode– maybe an hour at most. Tomorrow we increase the keppra. Dr J says to do prozac every other day. There are still answers here.