Lack of Structure on Break a Problem

Without the structure of school, homework, and sports practice, Caroline feels a little lost. She complains about being bored a lot, and so we are doing a lot of taking her to the gym, and to the basketball court, or just out of the house. Today she forgot to take her morning meds, which we didn't discover until 2 in the afternoon! I am mad that she lost her watch which was programmed to remind her. We must get a new one for her immediately. We usually check and remind her, but everyone was so crazy today getting ready for company. Bill was mad and she was mad, and I was mad. Stress!!! I have a love/hate relationship with Christmas.

Interesting New Approach to Psychiatry

Caroline's psychiatrist is really into a new approach to psychiatry looking at all of the neurotransmitters, not just serotonin, norepinephrine, and epinephrine. He uses a lab called NeuroScience, Inc, and their website is www.neurorelief.com. Check them out. He found that many of her neurotransmitters were awry, and her cortisol was off, and her progesterone was too low, making her estrogen dominant. He prescribes all natural supplements as well as traditional psych meds. He is hoping we can reduce the amount of meds she is on, and the dosages if possible. We shall see. I am initially a little skeptical, but if it works, that will be wonderful.

Let the Grousing Begin

Christmas is over, the presents unwrapped, the day cloudy, and all four of my kids are at each other's throats. Another week to go. At least Caroline is mostly behaving herself. Her older sister has no patience for anything, or anyone, right now. I am counting the days until school starts....

Merry Christmas to All!

I am wishing you a Merry Christmas and a great New Year! May this year be filled with peace, as much as it can be, while you care for your challenging child. I am grateful that this Christmas is a much better one this year for our family now that we have a mostly stable child, so unlike last year when hope seemed so far away. I pray that if you are struggling this year with a child who isn't doing well at all, that you may find hope and help in the coming year, and time for yourself. Take care and hold your loved ones close, and remember that God holds us and our children in the palm of His Hand! "He shall be called Wonderful, Counselor, Prince of Peace...." Isaiah 9:6.

A Tragic Passing

I am overcome by emotion tonight as we have learned that an old friend took her own life this past week. She had suffered many miscarriages, but she had finally carried a baby to seven months, only to learn that the had baby died. Without telling her husband about the baby's death, she checked into a hotel and committed suicide. Such a shocking and sad end to a beautiful life. The last time I saw her was at her wedding ten years ago. Now they are preparing for her funeral at the same church she was married in. We will miss her. She was such a gentle, kind soul. Depression sometimes wins, but she is still victorious, united with her Savior and her precious baby. We pray for her husband.

Christmas Coming

I was kind of harsh about those two girls in my last post. They are just middle school girls, I know. Sometimes when our children are threatened, especially the ones who are most vulnerable, we become harsh judges of other children. I did write them very nice Christmas cards, just to speak some grace to them because they surely need it, as do I.

Now that the Nutcracker is over, I can focus on preparing for this special holiday. We can lose focus so easily. As one of my three year old Sunday Schoolers said when asked what they were looking forward to this Christmas, "I can't wait to see the Son of God! But I haven't seen him yet!" We need to be looking for the One whose abundant grace is there always, to embrace our brokenness! As we remember that wonderful Gift this week, let's rest in knowing He came to give us hope and peace and to bridge that gap between His holiness and our great need for His holiness! Only He can supply that grace! The Giver of all good gifts speaks through the darkness of our hearts bringing us the light of His Glory in His precious Son. I am so very grateful for His mercies, new every morning! I cling to the Promise in a very broken world.

A Lot Happens in Ten Days

I am sorry to all who follow my blog for the long hiatus. Between Nutcracker rehearsals f0r my ballerina, and Christmas shopping, and one of mine sick with mono, I have been truly too busy to blog the last week and a half or so. Finally it is Saturday morning and I can sit down and write. Several significant things have happened in that time period, but I will start with a follow-up to the last blog about Caroline's "school troubles."

The boy that was the cause of so much anxiety and stress for Caroline was expelled. We are glad he is gone, but very concerned that he has a major mental disorder that is not yet diagnosed or misdiagnosed, because he was acting simply manic, really out of control. I really hope that his parents get the right help for him before it is too late. Caroline is much relieved about this as well as are her teachers. I knew that everyone was overwhelmed trying to teach him and care for him. Having been in the place where your daughter is asked to leave ("maybe this isn't a good fit for her") I know how painful this is for his parents, so I do sympathize.

With that situation behind us, another one reared its ugly head. There is only one other girl in the 7th/8th grade class with Caroline and seven boys. In the adjoining classroom of 5th/6th graders, there are two girls, one who is very young for her grade (skipped grades I think) and another one who is about eleven. They were at this private school prior to Caroline's arrival this year, and two of them were best friends, the one in Caroline's class and the eleven year old. Well, during the first few weeks of school, all was fine, with Caroline declaring that "Sarah" was her new best friend, and that "Lacey" was also fast becoming a good friend. But in the last two months, Caroline has come home with story after story of these two girls, really her only choice of friends, treating her very unkindly, saying cruel things to her, snubbing her regularly, to the point that Caroline has been sitting all by herself at a lunch table separate from anyone else. Of course, we are very concerned and upset about their behavior, and have been talking to her teachers and to the administrators of the school. They said they were trying to deal with this, but nothing was changing, only getting worse.

Finally, when they called her an outcast, and one said that they"didn't talk to strangers, " I had it. I called the administrators two days ago and basically said they MUST do something NOW!!! We were on the verge of looking for another school, which I think they picked up on. They sat these two girls down and asked them why they were abusing Caroline. They said it was because of an incident that occurred when I took all three of them to the mall three months ago, and let them go off together, with cell phones, while I shopped in other stores. They said that Caroline instigated a plan that the older girl and she would run away from the younger one and play cat and mouse.

I had no knowledge that this had happened, and when I pressed Caroline, she was adamant that she did not concoct that plan and that she only followed along because she wanted the older girl to like her. I didn't think that Caroline would come up with that idea on her own, and I called the administrator back, this time shaking with emotion, and told her that I was tempted to call "Sarah" myself and give her a tongue-lashing. I didn't of course. I am disappointed that Caroline followed her, and that I trusted this girl whom I was told was a "nice" girl. Never was I aware that this "game" had been going on--they had all seemed perfectly happy, having a great time. I figured since I was in close proximity and frequently checked on them that it was OK to let them shop by themselves. I was wrong. Caroline just wanted to be liked so much that she made a poor choices in a social situation when she knew better.

But the story that these girls gave as the "reason" they were being mean to her doesn't really add up. I think they are jealous of her, to be honest. She comes from a loving, intact home, is greatly loved by her teachers and coaches, is highly athletic, very pretty, slender, and is privileged to live in a very nice neighborhood. These girls come from very difficult home situations, are sadly obese, live in neighborhoods on the "other side of the track" so to speak, and probably pretty insecure.

Anyway, Caroline came home yesterday on the last day before Christmas break and said that she and the two girls had a pow-wow with the administrators, apologized to each other, and that everything was fine now. We shall see. I truly hope that things will change, but the older girl seems to be a schemer, and I don't trust her. We would hate to pull Caroline out of a school that seems so perfect for her academically. We will give it one more month, prior to the start of the next semester to see if these girls decide to be kind to her. She doesn't deserve such treatment. My mama bear claws came out!!

Oh, and Caroline's grades really plummeted these past two weeks. Wonder why. She was having trouble sleeping at night, and was dragging her feet every morning about going to school. I am hoping that enough has been resolved that she will be back to her A's and B's.

I have some interesting testing results to share with you done by a rogue neuro lab, but that will take a whole other blog.

School Troubles

I wish I could say that everything at Caroline's school is simply wonderful, and that every day is smooth sailing. Unfortunately, that is not the case, and of course not realistic, although we always hope for the best. She likes her private school a lot, as do we, and her teachers love her. Well, four out of five of her teachers love her. We are having issues with her Spanish teacher, who seems to be a very bright young woman, from Spain, who speaks several languages, and can't be older than 25. I am remembering that just because you are good with languages doesn't make you a good teacher of a foreign language. Her assignments are completely frustrating to Caroline, and the rest of the class, because she is moving entirely too fast for a first year Spanish class and assigns work that is just too hard given their abilities. I know, because I myself took several foreign languages in high school and college, gaining proficiency in one and fluency in another. To top it off, there are a shortage of Spanish textbooks, so my daughter didn't receive one, which I only found out last week. They are on order, I have been told, but no wonder she is doing poorly! That news really irked me.

Also, the two other girls in her class have decided to be really mean towards Caroline, why, I am not sure, except that they are probably very insecure. Caroline has received a lot of attention for her academic and athletic abilities there, and she comes from an intact loving home, which neither of them have. The things they are saying to her are just awful, and I think it is time for a conference with her teachers to discuss this growing problem, as well as that of a boy in her class that they keep threatening to expel and don't. He sounds like he is either severely ADHD and unmedicated, or has conduct disorder, and that he isn't getting the help he needs outside of school. I don't know exactly, but Caroline says that when he is in school, he is so disruptive it brings her to tears, and that when he is absent, the whole class is relaxed and productive. I know what it is like to have a child that a school doesn't feel is a "good fit" and suggests you find another place, so I am somewhat sympathetic to the parents. But he is obviously not changing his behaviors and disrespectfulness. We have finally found a great school for our daughter, and if he is going to ruin it every day, something must be done. I think that he needs special services that this school can't provide. When you are paying money for your kid's education, you want to know that you are getting your money's worth.

Anyway, I am venting but I need to act on my frustration by picking up the phone and asking for a conference. I did send a letter to her Spanish teacher explaining Caroline's, and our, frustrations with the class and asked to discuss it further, but I want to talk to the principal about this too.

Medicine Mistakes

You would think I would have this down by now, making sure that Caroline is getting the right medicine and the right dose every time. But somehow I am still catching myself making mistakes! I realized this morning that her morning pill box was missing the one of the two lithium and the 100 mg of seroquel wasn't there at all! For the whole week! I filled the boxes on Saturday, so my guess is that I mistook the lithium pills for the 100 mg of Seroquel, which is the same round shape and size, and both look the same color in the box. So I put in one "Seroquel" in each morning box, and then thought I had put in the lithium because I saw the seroquel in there and thought it was the lithium. That means that for about two or three days she has had half of her morning lithium dose and no seroquel in the morning at all!!

No wonder she texted me from school today and begged me to pick her up because she couldn't stand the way everyone was treating her! Yes, she was getting picked on, but normally she can handle it. I did pick her up early when I put two and two together. I am not a detail person AT ALL so I should just let my husband fill the boxes. He is so particular that it takes him FOREVER to do any task because it has to be perfect and checked over several times. So now it is his job, and I will just stick to writing in my blog.....

Intuniv Dosing

Someone asked me about what dose of Intuniv my youngest is on, and I forgot to respond. She is at the 4mg dose, the highest, without ill effects.

First Team Sport Since Residential

Caroline's first basketball game with her school team on Friday night went relatively well. She got kind of over-heated over one opposing player's attitude, and had to sit out most of the second half to cool off, but she wasn't too fazed over it and continued to happily cheer for her team. We are just thankful she can play on a team and have fun doing it, so unlike the attempt last spring at club lacrosse when she was too unstable to deal with the pressure. She is looking forward to spring lacrosse again, and hopefully this time she will be able to hang with it. I remember telling her third grade school PE coach who saw her amazing athletic ability that she would never be able to play a team sport because her bipolar disorder made her so intense that every competition was seen as war to the death, and she would have horrible sportsmanship. So much has changed and we are seeing her not only able to play on a team, but being a great team player. Again, thank you God.

Oops! I accidentally deleted some comments!

Sorry, Meg, if your last comment did not appear. I was trying to manage comments from my blackberry and I pushed the wrong button! Caroline has been a tough gal to keep stable, and yes she does tend towards very bad depression. We used to see much more of the mixed states, but I think she is outgrowing that manifestation. It is amazing that you can manage your child's bipolar disorder without medication. Is he on any all natural substances?

Caroline Gets Creative Writing Recognition

This is truly wonderful because this is the girl who nearly failed the sixth grade last year, refusing to write anything. She was assigned in English to write several pages of an alternate ending for a historical fiction novel. Her book was "Anacaona" from the The Royal Diaries series. Her teachers said that her piece was the best they had seen in years. They published it in the school newspaper, the only one out of the middle school! Here is a sample:

"Filled with fury and terror, my mind whirling faster than the strongest hurricane, we fled from our stronghold, Maguana, my home. We have run quietly, but swiftly, all through the night. I fear for my people more than myself. We have not made camp because of the wolf-like pack of pale-skinned men and their lightning metal rods, firing every now and then, jarring us back from our excruciating pain and weariness from this long journey. Even I am beginning to tire."

I just had to brag on her, because she has come so very far. We have to thank Meridell again for restoring her academic confidence.

Extended Release Lithium Works Better

We were right about needing the extended release Lithium, and Caroline is getting through the afternoon and evening much more smoothly since switching. This is good because the afternoon and evening are when everyone is trying to do homework, get ready for some activity, etc., and having a hypomanic Caroline isn't helpful. She has her first basketball game this Friday, and is pretty excited.

"I'm the Only Normal One, I Guess"

This is what Jane, my twelve year old said to me the other day, noting that she is the only child in our home not taking any medications. Well, normal is relative, and truthfully, I often think she needs to take something for her OCD problem, maybe an anti-depressant or the like. I am holding out because she is certainly functional, just really annoying when she cleans up everything while you are still trying to use it, or continually asks if the kitchen is still clean, or dumps out your coffee when you were still drinking it, or when she melts down, crying and stomping around, when you place something foreign on her perfectly made-up bed. Yes, she is just a little obsessive. We talked to the psychologist about it yesterday, about her need for control because life has felt so out of control for so long. She sees it but doesn't really know how to stop freaking out over everything when things don't go her way. Teaching her to be flexible and to be okay with imperfection is going to take some time. She will be very unhappy in life if she doesn't learn that life doesn't go the way you plan it most of the time. God has a way of interrupting our plans with His.

Intuniv Continues to Make a Big Difference

Mae's general disposition continues to improve dramatically. The Intuniv ADHD med is a miracle drug, I've decided! I don't think we had a single meltdown yesterday, which is a record. She wakes up pleasant and happy, gets dressed without being told, packs her bag for school, and when I pick her up from school she is again pleasant and happy, so unlike what these two scenarios were like for years, when she has been snappy and ugly, yelling at the drop of a hat. Her brain is obviously getting what it needs now to function. I feel myself relaxing more around her. Hopefully this will have the desired effect on all of us, instead of that walking-on-eggshells feeling. Thank you, God.

(I have put the link to this med website in my "Great Resources" tab below)

Christmas Cards

Do you send Christmas cards, with an annual letter, maybe including a family photo every year? We used to, until our lives became so chaotic starting back around the time Caroline was four years old or so that I would start the task, and never finish it. I have several boxes upstairs of hundreds of prints of annual family photos, in envelopes, never addressed, some with stamps, some with the family letter, but all never sent. My dear friend Wendy who also has a bipolar/Aspergers child said she has the same stack of years of Christmas cards and photos, also never sent. We laughed and said we should send them all out this year with each of the old photos so everyone could see our good intentions. Last year I finally had it with my own lack of communication with my close friends of years past and individually wrote to each of them, with the most recent family photo enclosed. It felt SO GOOD to finally accomplish something that had been just too hard to do. And honestly, I was reaching out because we had experienced one nightmare after another regarding Caroline that year, and I was at such a low point. I received some wonderful replies and was thankful that my friends were forgiving of my silence over the last seven years. I wonder if I will be able to accomplish this task this year. We still need that family photo, which no one ever thinks is a good picture of them. Who cares, it is just a way of saying "Hey, look, we are still alive, the kids are growing, and we love you!"

The Holidays Are Always Hard

We love Christmas in our house, but we welcome it with a little trepidation. I remember the Christmas, before she was diagnosed, when she was obsessed with lighting candles and would run all around the downstairs, blowing out flames and relighting them, much to our horror, since she was all of seven. Over the last six years, we have learned to lower our expectations of what our family can do during the holidays, or at least we are working on it.

My husband and the three youngest kids went out to the country yesterday to pick out a fresh Frasier. Now that this prized tree is up, I am reminding myself about how disastrous it was last year when we tried to do a "family tree trimming night." with all of the ornaments down at once and not having pre-planned the whole thing. Between Caroline's total lack of patience with noise and chaos, and Mae's insistence on perfection, I seem to recall that we had to bring everything to a screeching halt. We decided to try again the next night, with only one child at a time hanging up their own ornaments. This was a much better strategy than the confusion over whose ornaments were where and who got to put up what when. Again, something simple for other families is far from easy when you have a child with Aspergers, or bipolar disorder, or severe ADHD (or all three for that matter.) Accommodations must be made or you will hate this holiday so much you may refuse to decorate at all, as I was close to doing last year!

Oh, and we do not make Caroline sit through one of our other daughter's Nutcracker ballets, like we did in years past. She hates watching ballet, so why make her endure, or make us endure, her discomfort? Without the normal amount of self-control that other thirteen year olds have, she would get claustrophobic and agitated with each passing minute of the ballet. Some things are just not worth the pain. So we will do our best to enjoy this wonderful season celebrating God's gift to the world of His precious Son, while keeping it as low key as possible. Now, ice skating as a family is something everyone seems to tolerate just fine, as well as seeing the display of lights at the botanical gardens. You just have to find what works and what doesn't. Decorating one gingerbread house at the same time doesn't work. Letting each child do one side by themselves, bingo. Taking all four kids shopping for presents for each other together: bad idea. Taking one at a time, magic. Be kind to yourself. Drop the idea of a perfect Normal Rockwell Christmas, and embrace one that is rich in meaning, if not in activities.

Seasonal Blog Change

We never get snow where we live--it will get very cold, but it seems the line between rain and snow is just to our north. I long to see snowflakes all winter. So I picked a cooler template wishing for the white stuff to fall. Maybe it will work.

Thanksgiving

I am so grateful that Thanksgiving went very smoothly this year. Caroline did great, even with the noise and chaos of four little cousins added to the mix. So proud of her! Such a contrast from last year when she was inpatient for a month and we had to drive an hour and a half north to bring Thanksgiving dinner to her, all of us sitting around a table in a very drab room in the hospital. I tried to dress up the table as best I could, but it was a hard day. Leaving her was painful, knowing she probably had another few weeks to go. Last fall was simply awful.

I am thankful that a year has passed since then, and for many other things: I am thankful that she was able to go to the fantastic residential program at Meridell that changed the direction of her life; for the wonderful private school that accepted her afterwards knowing she might be difficult; for our church family that has been so supportive and caring; for my own family and their acceptance of our bp child, and their constant encouragement; for my many, many friends who love us unconditionally; for my fellow bloggers and followers who remind me I am not alone; and most of all for our faithful God, who has held us close every step of the way, carrying us when we could not lift our heads, "...being confident of this, that He who began a good work in you will carry it on to completion..." Philippians 1:6

A Nice Sight to Come Home To...

The sight of my two youngest girls folding laundry in the living room and sorting the piles. I really needed that !!! Thank you!!

Caroline doesn't have meningitis, always a concern when your kid has a bad headache and stiff neck. She pulled a muscle in her shoulder doing hip hop moves. Glad we have a four day weekend and no basketball practice!

Sick Again

I feel like this kid gets sick much more often than my other kids. Off to the doctor again today, this time for bad headache and fatigue. I think that in one week I have been to a doctor's office about eight times. Four kids would mean a lot of appointments by nature, but Caroline kind of triples that number. Once I heard someone say they wish they would invent a van with a washer and dryer in the rear because she spends so much time in the car. I was kind of offended by that, thinking the last thing a woman need is to be tied to her laundry everywhere she goes. Now, I get it. My laundry piles up because I AM ALWAYS GONE!! My neighbor across the street is kind of in awe of how many times I am in and out of my driveway in one day. Between basketball practice, three different school pick up and drop-offs, ballet and Nutcracker practice, dentist and doctor appointments, social activities, church activities, vet visits, and grocery shopping, I probably leave my house a dozen times a day. I need a laundress, or a washer and dryer in my van.

Great Psychiatrist Appointment

Caroline's psychiatrist agreed that her late afternoon/evening hypomania could be caused by a dip in her Lithium level since we are not using the extended release form. So we got a prescription for Lithobid, the ER form of lithium, and we shall see if it works. Also she needs to get a bunch of blood drawn for lithium and Trileptal levels as well as thyroid and liver panels. Lithium can damage your thyroid, and the anti-psychotics can harm the liver. Poor kids. If their disorder doesn't kill them, their medications can. Not to be flippant and callous, it is just the sad reality of what we live with every day.

Something's Amiss

We are taking Caroline back to the psychiatrist tomorrow because she just hasn't been doing as well as she had been doing, really since mid-October. It seems that something is wearing off in the late afternoon, making the time from about 4 to bedtime more difficult. She had been on extended release Lithium (Lithobid) at Meridell, but when we got back her doc gave her the regular kind, which may be the problem. We don't know, but she gets hypomanic and then quite irritable. Hopefully we will be able to get this fixed quickly. Her grades are not as good now either. And her room is getting really messy again, which happens when she is "off." We parents of bp kids have to become experts at reading all the "signs" portending mania or depression, don't we?

Parades Join the List of Over Stimulation

We went to our city's wonderful Grand Illumination Parade tonight, where all of the downtown buildings light up at the same time to welcome the holiday season, thinking it would be a fun, family event. We forgot one thing: Caroline hates crowds, and too much noise. Parades are pretty much defined by crowds and noise, so this was not a nice family event, but something I would rather forget. She became so agitated and mean, even punching one of her sisters! We went to watch our youngest march with her school's float, but next time we will let Caroline watch it at home on the TV. We forget that things that are normal situations for most kids, are simply not for her or any bipolar child. Lesson learned. Again.

We Think It's Working!!!

The Intuniv, that is! In the last few days Mae has shown a definite change in her moods. She is focused, and much more in control of her emotions. In particular, we have noted that she is better able to handle "no's" and irritating situations without meltdowns. We are so grateful! This is her third week on the new ADHD med and the literature did say it would take three to four weeks to see results. Thank you God! Even her sisters have noticed the change. How wonderful it would be if her sisters would actually like her again. One more step in the direction of a "normal" family life (we all know the normal is relative.) I am so glad we didn't give up finding the right med for her, and thankful for the pharmaceutical companies that work hard to make better drugs.

Soap Box Postscript

I just wanted to add to my rant last night that my husband and I are well aware that we are highly imperfect parents. We have made mistakes, and will make mistakes, with our kids. The last post may have sounded a bit arrogant, as if we are expert authorities in the matter of medicating vs. not medicating. Actually, we have so much to learn, and our kids know it too! We most certainly have had bad parenting moments when you think your kids will never forgive or forget, but we know that in the grand scheme of things, as we continue to admit our weaknesses and ask forgiveness, our children will learn that life isn't about perfection, or hiding our issues. Life is o only lived at its fullest when we live authentically. Hopefully they will see that we need grace as much as they do, and that our deep love for them keeps us seeking the best we can provide for them as they are growing up, not so much materially, but rather emotionally, educationally, and spiritually. I think they call it character building.

Medications Aren't the Panacea

Some of you may be thinking that we are awfully quick to medicate our kids, as if we have a knee-jerk reaction when any one of them is acting out: they are misbehaving, so they must need a medication to keep them in line. Let me reassure you that we do not believe that the first answer to any behavioral problem is medication. Consistent discipline, loving rebuke, and lots of boundaries are the foundation for solid parenting. To throw a drug at a child but not address their behavioral and heart issues adds up to poor parenting. But if a child meets the criteria for a mood disorder, or an attention-deficit disorder, then to not provide that child with the right medication so their brain can do what it is supposed to be doing is but can't because it is lacking in certain brain chemicals, is in my mind, a type of child abuse. Unmedicated kids with ADHD, bipolar disorder, Asperger's often come to be viewed as the trouble makers at school and at home, their relationships marred by behavior which is neurological and chemical in origin. A child who is constantly receiving rebuke at home and in the classroom because they can't focus, can't sit still, can't act with appropriate manners in different situations, will soon be a discouraged, defeated child who decides early on he or she can't succeed in anything, and will have few friends, and fewer opportunities to excel in life.

I do highly tout the use of natural brain-boosters like the Omega 3s and 6s found in fish and flax oils, and exploring vitamin deficiencies, protein deficiencies, and the like, because we are organic beings who are greatly affected by what goes into our bodies. And good psychological counseling is a MUST for any family dealing with a severely challenging child because the strain of caring for them can be overwhelming, and the child also needs to be able to work on his attitudes and behaviors in a safe environment. Great parenting gurus are out there with wonderful books offering sound advice for correcting negative attitudes and behaviors--I couldn't list them all. We have certainly read many of them ourselves, and taken many parenting classes, some good, some not so good.

But as much as some would like to think that strong-willed kids just needs more discipline from likely over-permissive parents, I would ask you to withhold judgement if you do not walk in our shoes. And if you have a child with whom you are struggling beyond the norm, please do not refuse to consider medication because so many kids are "over-diagnosed" and "over-medicated." Think about the fact that many children have diabetes and you would not withhold medications from a child whose pancreas wasn't functioning --that would be abuse outright. You are not doing your child any favors by withholding what may a huge part of the answer to his problems. Read up on neurology and how the different areas of the brain interact and control many of our emotions and behaviors, and how abnormalities in certain areas affect outward behavior. We can control many of our decisions and actions, but there are reactions and states of mind that are outside of our control if our brains aren't functioning properly. Sometimes you have to undergo a lot trial and error with medications (we have done years of this), but if you love your child, you won't stop trying until you have found what works so he or she can fulfill their God-given potential.

We live in a fallen world, and this means that we are frail humans living in a messed up world, with often messed up bodies and minds. The good news is that we have the gift of wonderful medicines and doctors that humans for centuries past have not had the privilege of using, so be thankful, and do what is best for your child!

I'll get off my soap box now.

It's That Obvious, Huh?

Yesterday, I met with my therapist to discuss our youngest's behavioral issues. If you recall, she is the one who is stirring up the pot these days. She has the type of ADHD that includes explosivity, defiance, meltdowns, and the like. Now she is on Intuniv, the newest non-stimulant ADHD med, and showing some signs of improvement, which, we were told, would happen after about three to four weeks. We have taken her off of the Methlyn, after seeing that it just made her angrier, though focused.

Anyway, the therapist said that last week when Mae and I were in her office, that she noticed how differently I was breathing when I was in the room without Mae, and then when she joined us. She said that when it was just me, I was calm, relaxed, and breathing normally. But as soon as Mae was asked to come into the room, she saw me tense up and my breathing changed to basically holding my breath, and then exhaling in big sighs. Anxious breathing, she called it. My husband has certainly noticed it, and I thought I breathed like that all of the time because the kids were always noticing it too, but I guess that there are times when I don't breathe anxiously, apparently when I am not with my kids. Hmm....(breathing, breathing)

Moms with Combat Stress

An article appeared recently in the news stating that moms of autistic kids have the same amount of stress as soldiers in combat. No kidding. I think that moms of bipolar kids must have at least that amount of stress and possibly more. I mean we are living with a frequently violent child when they are unstable, which is often much of the time, save for the rare times when all medicines are just right, the school situation is just right, and the rest of the family is doing ok. I wake up every morning since Caroline has come back from the RTC in August with a clenched jaw, muscles in my back and neck in tight knots, and a sense of tension and anxiety following horrible nightmares every night. I think it is PTSD from so many years living in chaos and fear. I need to renew our YMCA membership so I get back into yoga and pilates, which bring healing for us living this sort of life. Combat would definitely describe our daily lives, fighting to keep our children, and ourselves, sane.

Interesting New ADHD Med

Our psychiatrist just prescribed a very new ADHD drug called Intuniv for our youngest daughter. This drug is derived from Tenex, often used in bipolar kids as a calming drug (originally a blood pressure med). Intuniv is designed to address the type of ADHD our daughter has, which is the lack of focusing ability accompanied by extreme irritability, explosiveness, and meltdowns. Some have called this the "ring of fire" ADHD because of the circular pattern that lights up on brain scans of people diagnosed with this subtype. The doc said that the medicine would take about three to four weeks to really work, as we increase the dose by 1 mg each week, up to 4mg. We sure hope this med works for her, because at present the Methlyn helps her to focus, but doesn't address the irritability and explosions we deal with all of the time with her. She acts so much like Caroline that we have wondered many times if she is bipolar, but she doesn't meet the long checklist, and her explosiveness is never violent. We shall see. Peace is a valuable commodity here, and we rarely have it. Behaviorally therapy is the second part of the answer but a good med is so helpful!

November

When I posted about the annual period of mania, I am referring not just to the fall, but to November. Last November was when everything went to hell in a hand basket. Caroline had the worst fall of her life last year (and ours too), ending up with spending over a month in the hospital. I have seen other parents struggle with November as well with their bipolar child.

November means Thanksgiving, which is a whole other issue. Where do we have Thanksgiving? Do we travel three hours up to see my husband's family and risk having it all ruined by an unpredictable child? Or do we stay here and host Thanksgiving, still not knowing how Caroline might be on that day? I think we are staying here, although the kids would much rather travel. We'll see...

Mania Making Annual Appearance

Unfortunately, Caroline has been acting manic this past week. Not completely out of control, not so seriously that we need to take her to the hospital, but enough that we are watching her very carefully. We haven't seen this since before she went to Meridell back in May, so we have been feeling a lot more stress. She has a psychiatrist appointment on Wednesday, so that is good, but I was wondering yesterday if I needed to push it up to today. I guess we will see how she does today at school. I thought about keeping her home from school, but my husband said she seemed okay this morning. I am concerned about what medicine we could go up on because she is at the maximum dosages on all of her meds, I believe. I don't want to see anything changed because she has been doing so great. How I hate this stupid disorder!! Just when you think you have a reprieve, something changes.

Date Night a Success!

I can't believe we actually went on a date and didn't get a single phone call! Miraculous, really! We are very grateful. We tried not to talk about the kids, although they have a way of sneaking in, and just reminisced and laughed, and ate great Mediterranean food. Dessert too, yum. Of course now we have to put the youngest two to bed, but that is a small price to pay. I hope we can do this a lot more.

Date Night!

I am so excited that my husband and I are going on our first date in several years! Some may ask why the long wait, but for those familiar with pediatric bipolar disorder, you know that going on a date is no small thing. For years we could not go out because we couldn't leave Caroline at home without a parent. She had been in such an unstable state for so long that we knew if we were gone, something would happen that would ruin our time. But with Caroline so remarkably stable after coming back from Meridell, I realized we could actually go on a date now and not worry about leaving her home with her two younger sisters (who will be engrossed in a movie.) We just haven't been able to do a lot of things "normal" families do, like go in one car on vacations. We still take two cars on any trip over an hour because Caroline does so much better without the noise of her sisters irritating her to explosion.

Hopefully nothing will go wrong tonight--we know there is always that chance, but we will be close by if we have to head home quickly.

Thank you, Meridell, for doing wonders with our child!! Brandi, I hope you still read this!

I'm Back

My Apple laptop came back better than new, so I am up and blogging again. Things have been going pretty well here since my last posting. Caroline continues to do well in school and is enjoying basketball. The only minor mishap last week was my forgetting to put in the smaller 50 mg Lamictal dose in her med box in addition to the 150mg for about five days. I figured this out when one morning she woke up and was extremely depressed, so unlike how she had been. I immediately checked her med box, and yes, I had left out the smaller pill of the anti-depressant-like Lamictal for days. So I kept her home from school that day, knowing that nothing would go well if she went. She was able to go back the next day, and has been much better since except for Sunday. We found that on either Saturday night or Sunday morning she must have dropped one of her Lithium pills while taking her myriad of drugs, because I found one under the kitchen table Sunday afternoon. She had been acting way too "up" so that must have been the cause. It is amazing what one little pill can do.

I taped the bottle containing the smaller dose of Lamictal to the larger bottle of the bigger dose of Lamictal so I can't forget.

Tonight a new friend of mine shared about her battle with breast cancer, in detail. I haven't ever met anyone before close to me who has gone through this, so I was really in awe of her strength and faith. Bipolar disorder does have a mortality rate (about 18%), but I wonder if breast cancer tops it. I am reminded that I am overdue for a mammogram. I am calling the doctor tomorrow.

Computer Problems

Just wanted to let those who follow my blog that I won't be posting much this week because my laptop is in the shop. The only big news is that Caroline started basketball at her school and is thrilled to be on a team again. No back pain either. She continues to do remarkably well as far as stability goes. We are so very grateful.

Song/Lyrics Up

I managed to finally get the lyrics and song up, but I can't reduce it to just one recording, so choose your favorite!

Oops

Sorry to those who tried to listen to the song/video I posted. It didn't work for some reason I can't figure out. I'll try again later.

When Storms Come

"He comes to us in the brokenness of our health, in the shipwreck of our family lives, in the loss of all possible peace of mind, even in the very thick of our sins. He saves us in our disasters, not from them. He emphatically does not promise to meet only the odd winner of the self-improvement lottery; he meets us in all our endless and inescapable losing." Robert Capon, The Astonished Heart.

I love that quote, especially the part about "the shipwreck of our family lives." I have certainly experienced that and I know of other dear ones who are feeling that sort of desperation right now. There is hope, unseen now, but coming. Sometimes we need others to hope for us when we are despairing.

I have a new challenge thrust upon me. My youngest child seems to have developed a food allergy and we don't know yet what is the culprit, but now we have to carry an epi-pen for her all the time, and at school. Hopefully we will find out what the offending food is quickly.

With the swine flu here threatening the health of our kids, and now a scary food allergy, you would think I would be feeling pretty anxious. Actually, I have, but honestly, if I had to choose between my child having the swine flu, a severe food allergy, or bipolar disorder, I would choose the first two without hesitation. Why? Well, because a child with early-onset bipolar disorder has problems that can break the spirit of a child: the loss of friends, going from school to school, admissions to psychiatric hospitals, doing embarrassing or illegal things that bring a bad reputation, and having to swallow dozens of pills each day, and always there is for the parent the anxious thought of a future suicide (I think the rate is 20%).

I downloaded a song that I find a lot of meaning in today. Hope you enjoy it! It is by the David Crowder Band.

Great Parent-Teacher Conference

On Friday we met with Caroline's two teachers for the first parent-teacher conference. We didn't think there would be any surprises, and there weren't, thankfully. Her mid-quarter progress report was good: three As, three Bs, and one C, in Spanish, which we are not too concerned about. The teachers both had glowing remarks about Caroline's behavior and work effort. They said she is a wonderful example to the other kids with her attention to detail and her seriousness about her assignments. One even said they wish they could take a piece of her and put it in every kid! So we are not only relieved that she is doing so well, we are overjoyed with her experience at this school. They are seeing the real Caroline, not the bipolar-distorted Caroline. We have warned them that she may have a period of time where she isn't so great, and to let us know if they see a patterning developing of either mania or depression/anger. They had no idea that she takes seven bp meds right now, which, along with her supplements, adds up to 22 pills a day!

I can't believe how good I am feeling now with the stress of homeschooling our youngest off the table. I really felt like I was completely falling apart. I guess I can only handle so much stress--Caroline would be enough, and I have three others kids to care for! I know what my limit is now, and I am promising myself that I will be kind to myself and not stretch myself that thin again. Lesson learned.

Our pastor puts these amazing quotes in our bulletin each Sunday. They are often truly gripping and poignant. I thought I would share one of them with you:

"Circumstances may appear to wreck our lives and God's plans, but God is not helpless among the ruins. Our broken lives are not lost or useless. God's love is still working. He comes in and takes the calamity and uses it victoriously, working out his wonderful plan of love." Eric Liddell (1902-1945) Olympic gold medalist, missionary to China, subject of Chariots of Fire.

Time to Come Come, Honey

You know it's time for your husband to come home from a business trip when you suddenly lack any vestige of patience with your kids. Caroline got upset over Mae's bossy behavior, while I was chiding (loudly) Caroline for picking fights with her. Caroline then became very upset, burst into tears and wanted to call her daddy. She was acting much more moody yesterday and today, which may very well be signs that she is missing him. I am not her favorite parent, and if I lose it at her, she takes its pretty personally. Mae is dragging out homework again, as usual. She's doing it, at least, just at a snail's pace. Bother.

I just read that Seroquel XR has less of a weight gain reputation than its regular form. And apparently the XR version is less sedating. I looked at Caroline's prescriptions and realized she is not getting the XR version, so I will be calling her pdoc about that because why use a form of a med that isn't as great as an XR type? Every little bit helps.

A Milestone

Last night, while wrestling with my nine-year old over homework, Caroline came downstairs and asked if she could talk to me. I went into the living room, where she held out her cell phone and told me she wanted me to take it from her because she realized she couldn't handle the temptations that came with it. Crying, she explained that she couldn't resist talking to a boy from school and that the conversations were going in the wrong direction. She would rather not have a cell phone than fall into the trap she fell into last fall. What a moment! I hugged her and told her how proud of her I was and how mature she was. I certainly wouldn't have had that kind of self-control at her age. She said she felt like the youth group retreat really helped her to remember what life was all about and her commitment to purity. This was a shining moment in an otherwise dark day for me. The homework battle with Mae has begun, adding a lot of stress to my afternoon and evening, but at least I am not battling her ALL day.

Whew!

Caroline and Jane went on a church middle school retreat this weekend and thankfully Caroline handled herself just fine. We sent her with a little fear and trepidation knowing that in the past she hasn't done very well with that kind of over-stimulation and lack of sleep. Of course, we sent her with a lot of instructions for her leaders and with all of her medications labeled morning, noon, and night, assembled in little ziploc bags. The leaders said she had a great time and there were no incidents. We were very relieved to hear that and happy that she could feel like a normal teen for once, and do things that other kids do without mishap.

My husband is gone for four days which means it's just me holding down the fort. Oh boy. I slept badly last night, getting woken up by Caroline who couldn't fall asleep again after waking up at 2:00. I woke up with a migraine for Mae's first day at school. I wasn't a very nice Mommy this morning. I dropped everyone but Jane at their respective schools, then went back to bed for three hours while Jane worked on her schoolwork. I am so glad she is a self-starter! After school, we sorted through the fall clothes, which reeked of moth balls, making my migraine much worse. Stupid of me. Oh well.

We Are Making the Move

Mae is starting back at the private school she was at last year on Monday. You don't know how much relief this has brought me. We have a lot of work to do with her, but having her home all day was exhausting me to the point of panic attacks at the start of each morning. Jane will be my homeschool buddy. That will be fun, I know. She like to be at home with me and is so easy to school.

Caroline is having a hard time at school with her Spanish class. The teacher seems to have anger issues, and poor teaching methods. I normally side with teachers because I think a lot of parents take their kids' side when they need to support the teacher. But Caroline has told me this teacher curses at them, tells them to shut up, and has some pretty unrealistic ideas of how fast a kid can memorize foreign words in five minutes, and then be quizzed. Caroline has very low processing speed and a poor working memory, so this is impossible for her. She has failed the same quiz twice and was crying over the fact that she would likely fail tomorrow. I decided this was not acceptable, and called the principal to share my concerns, nicely of course. He was quite surprised and apologetic and said he would look into this right away. I really like this guy a lot. If Caroline starts to dread going to school because of this Spanish teacher, that would be awful. I will request that she do Rosetta stone on her own if they don't remove this teacher (if she doesn't change her ways).

Might Change Plans

We are seriously considering putting our youngest, Mae, back in school. My eleven year old is a dream to homeschool, eager to please, wants to get everything done on time, does more than she needs to, and I enjoy teaching her. Mae, on the other hand, is giving us a major run for our money. We are trying the ADHD med Focalin, but I am not seeing a big difference in the meltdowns. She is more focused, but still much too emotional over everything. She is very rigid in her thinking, and demanding, crying a lot. Working with her feels like torture, so we are trying to find a way to put her back in private school. I am much too stressed out everyday to the point that I think I am getting an ulcer, and I feel frozen with anxiety. With all we have gone through with Caroline, I just can't put myself through the ringer again. Mae was fine in school last year behaviorally, but she would bring home a lot of undone schoolwork if she wasn't on the ADHD med. I guess I need to give myself a break. Maddie cleans the kitchen for me all day long, so she is a balm to my sould. I hate the thought of giving up only three weeks into the school year, but I was willing to try it, and she was excited about it, but the honeymoon has work off and the writing is on the wall. I can only take on so many commitments and the accompanying stressors.

Raging All Day, and it's Not Caroline!

Glad we have a psychology appointment today for our youngest, who has severe ADHD. Besides being incredibly distractable, she is now raging over everything and nothing, all day long. I don't like this, because this is what Caroline did a lot at this age. I am so stressed out I feel like I am having a panic attack right now. We have been secretly filming her so the psychologist and psychiatrist can see how bad she is. I am suspicious of the purely ADHD diagnosis. I hope she isn't bipolar. I don't see the ADHD meds working to reduce her rages at all. I told Bill I may not be able to homeschool her if this continues, because it is unfair to Jane and to me.

Ooops! Don't take with Orange Juice!

Just read the most ADHD meds should not be taken within an hour of drinking citrus juices or anything with vitamin C, because the acid reduces the absorption of the medicine! Note to self...

Now For You Guys!

With Caroline in school all day (hooray!) I have plenty of time until she and Elizabeth get home in the afternoon to focus on Jane and Mae. Their behavior with us and with each other and their older two sisters has deteriorated to the point that I have determined to bring them in line as quickly as I can. Homeschooling doesn't work if the kids aren't going to listen to you. Actually Jane listens fairly well and is eager to get her work done each day. She is a hard-working students and loves to write so she is not the big problem.

Mae, on the other hand, is severely ADHD, and we have struggled with her behaviors for a long time. She is overly perfectionistic, constantly daydreams, doesn't want to do what she is told, and would rather create her own project of the moment. She is incredibly smart, so she often makes up for her lack of diligence with her high IQ. However, this won't carry her forever. Yesterday, I took her to see our old counselor at Eden who has known Mae since she was three. I was looking for help on how to tame this wild beast. I was starting to worry that she is bipolar too. She doesn't meet the checklist, so I knew she probably wasn't, but possibly some other mood disorder? The counselor said no, we just really have to get her ADHD med in her consistently, which we were and then weren't. Then, we can work on the behaviors which would likely be considerably lessened.

So today I gave her the full dose of her Focalin, dissolved in orange juice, and told her enough messing around, take it or else. She did, after I had to make it very clear that this wasn't optional. The result: when it kicked in she was remarkably calmer, and got all of her subjects done in the proper time without my cajoling. During the previous homeschooling days she was still on subject number two at three in the afternoon.

Okay, the counselor is right, and most of her problem is an under-stimulated brain. And yes, I just need to enforce the rule of taking her medicine every morning. Yesterday she exploded or melted down eight times before noon. Today, she had about four major outbursts before the medicine kicked in then only a few hiccups after that. Why am I so stubborn?

She will be seeing this counselor once a week to work on some of the behaviors that have developed out of having a chaotic home life living with a bipolar sister, as will Jane for her OCD problem. Jane has declared that the kitchen is her kitchen and starts freaking out if I start cooking and leave something on the counter, like measuring spoons. I mean a full blown temper tantrum. First it was her room, now my kitchen. Poor kid. I know this is a reaction to feeling like life was out of control when Caroline has been unstable (a lot), and she is grasping for a sense of control over what she can control. Unfortunately, this isn't helpful to her and drives us all crazy.

Caroline has been feeling less depressed yesterday and today, which is a relief. I think it is going off of the Flexeril for her back (can cause depression), and maybe the increase in Lamictal. Who knows. I find it funny that presently she is the most stable-acting kid in our home. Her sister's are more difficult to deal with right now than she is! I hope that continues, although I would like to see her sisters dealing with their issues so we can all just RELAX!

Maybe then I will sleep better and stop waking up with migraines.

Postscript

On Friday Caroline stayed home with back pain, but then spent the morning throwing up a little while after taking her morning meds, possibly because she took them on an empty stomach, or maybe a stomach virus. As a result, she probably got very little of those meds, which has now thrown her into instability yesterday and today, with bad depression showing its ugly head. We are preemptively increasing her Lamictal, which has anti-depressive properties, because she does tend toward depression in the fall anyway (so do I). I love fall weather, but fall means mood lability in a bipolar child. So discouraging!

(Yes, we are getting her doctor's approval for increasing the Lamictal--very important.

If It's Not One Thing....

This week with Caroline was challenging. She is doing very well academically and behaviorally in school, but she is being plagued by a new recurrence of severe back pain. She experienced her first problem with this last fall, in the middle of a run, when she abruptly quit and said her back hurt her terribly. I had to help her hobble back home, and one thing led to another, until she was in such severe pain that she landed in the hospital for three days. The docs did one test after another and couldn't find the reason for her pain. They released her and she was sent to a pain management doctor, who correctly diagnosed her with muscle spasms caused by a pelvic joint problem. He injected her trigger points with lidocaine, which helped a lot, and then she had physical therapy for a few months, which alleviated her pain by about 75%, not completely.

Because she left for the RTC in early May, and didn't really run all summer, her back issue went unnoticed, until she returned and started running again. She immediately had to stop and now can't do PE either because any physical activity sends her into spasms. You can only imagine how frustrating this is for her and for us. She can't run fall cross-country, and she has missed school because of the intense pain, only two weeks into the year.

We took her back to the pediatrician, but we ended up at the pain management doctor again, who again injected her with lidocaine, addressing the symptoms, but not the underlying problem. The physical therapist she is now seeing pointed out an abnormality in her spine about mid-way down, as did the massage therapist, and the physician assistant at the pain clinic. Now we are going to take her to a friend who is a pediatric orthopedic surgeon to get his opinion. I want to take her to a chiropractor, but that isn't covered by our insurance at all.

Poor kid! She comes back ready to jump into life and school and sports, and is immediately set back by this mystery problem! She is sick of this and so am I. Can't she just for once have smooth sailing for more than a week? Aaaargh! (It's National Talk Like a Pirate Day) Nothing seems fair for her.

No Local Support Group Yet

Back in March, I said I was forming a local Tidewater Area support group for parents of kids with early-onset bipolar disorder. I never got it off the ground, because I saw that there are NAMI support groups here. However, I really wanted to form one associated with CABP because I think that would be much more suited to the specifics of EOBD. Adult-onset bipolar disorder is so different from what our kids experience that I want to be under the CABF umbrella with all of their expertise from which to borrow. I received a survey just recently from CABF asking if I wanted local CABF groups to start forming, and I checked yes of course.

Seeing Real Change

I must say I do see real change in Caroline since coming back from the RTC. She is much more mature acting, much more quick to calm down if upset, and just much more pleasant to be around. I am grateful. She is stressing me out far less than my younger two right now, who need major discipline. Can you say basic training?

Second Week of School and Still Looking Good

We have finished the second week and Caroline has continued to thrive at her school. No big homework meltdowns, no anxieties about getting up and going to school. Yay! She has one new good friend she has made, and the teachers say she seems to be quite able academically. Couldn't ask for a better report.

Yesterday was my oldest's sixteenth birthday. We were able to give her a really nice party at a pizza place which made up for last year's birthday which got railroaded by a meltdown by Caroline. Whew! I think she feels like all is amended for after last night's success. I am so glad because she kind of held that grudge against Caroline for a year. Now we can move on.

To Sleep, Perchance to Sleep Some More

One thing I have definitely noticed is that unlike how I slept all summer, which was great, so much so that I dropped two of the sleep meds I was taking, I am now back to needing three sleep meds and having lots of nightmares. I wake up and I can tell I have been grinding my teeth. Subconsciously, I must be more stressed out than I feel. When Caroline was away, we all felt so relaxed, and so sleep came easily. Now, just her presence brings on anxiety. She is better yes, but she will always be bipolar, and always have struggles greater than the average kid.

Right now she wants texting back, which we had taken away last fall after some unfortunate texting that got her dismissed from the homeschool coop she was in. She wants to feel like a normal teen who does normal teen things. I wish that for her too, but the but the boundaries will always be tighter for her. She said that she always feels like she is in Elizabeth's shadow, which I am sure must be very hard. For that reason I am especially glad that she will not be in high school at the same time as her older sister. Holding her back in the fourth grade was a good idea just for that reason. Caroline will need her own space.

First Week of School

I haven't written in a while because instead of getting up in the morning and grabbing time on the computer before my kids are up, I have been trying to get into the "school routine" which means computer time comes later, and sometimes that's at night when I am toast, and I just want to collapse into bed, instead of writing on my blog.

But this week has been a good one as far as Caroline's first week of school goes. We had a smooth transition to the new routine, and she seems to be just fine with everything. Of course, that could change, but we sure hope it won't. She has already made a new friend, who I have been told by the principal is a good choice for a friend. Her class is made up of ten kids, and only three of them are girls, including Caroline. They are doing some placement testing to determine where everyone is at in writing, reading, spelling and math. I like the fact that they ability group each major subject.

The only hiccup was that this morning my husband, who normally makes sure Caroline is up for school on time, slept in because he didn't have to go to work today. For some reason, Caroline forgot to set her alarm, and so it was about 7:00 before he woke her up, and school starts at 8:00, so she kind of freaked out and was ranting and raving about how she would never be ready in time. This is our kid who never spends time in front of the mirror primping, or straightening her hair, or fussing over what she is going to wear. She just normally throws her clothes on, which she picked out the night before, eats a quick breakfast, and she's off. Bill was having a very hard time reasoning with her about how she was creating a crisis for nothing. I came downstairs and could see that he was losing it with her tantrum, and I told him I would handle it. She went to lay down on the living room couch, and I sat down and told her she was being completely self-centered and needed to straighten up and stop torturing everyone. I left the room, and she came into the kitchen a moment later, completely calm and apologetic. Sometimes this works, sometimes it doesn't.

So she went off to school and had a great day, except for the fact that her back is really giving her a problem again, and she has been complaining about it enough this week that I did take her to the pediatrician. He said to take her to a chiropractor and a massage therapist. We took her to get a massage, and the therapist said that her back was the tightest one she had worked on in a long time. She said her muscles up and down were all in tight knots and she could hardly do anything because it hurt Caroline too much. Her recommendation was to take her to a chiropractor the next day, and to come back for another massage session in a few days. Only problem: our insurance doesn't cover chiropractic or massage, so we would be looking at five or six hundred dollars a month out of pocket. We are not in the position to do this, so we called the pediatrician back and said we wanted a referral for the physical therapy place she went to before almost a year ago when this problem first occurred. They gave us a referral, but it wasn't to the same doctor, but to a p.t. place unknown to us. My husband got really mad, because I did ask for this doctor specifically (the pediatrician had given us the original referral last year) and they didn't get this part, even though I left a detailed message twice. He drove down to the pediatrician's office and stood there until he got the right referral. What a pain! At this point, her back is too messed up (again) for her to engage in fall sports, which is such a disappointment. If it's not one thing, it's another.

Yesterday a woman tried to frame me for "damage" done to her car in a Costco parking lot. There were two tiny specks of paint missing from her rear bumper, specks the size of these letter I am typing, which she said I was responsible for because my front bumper was touching her back bumper. I knew I didn't bump her car when I pulled in (she was backed two feet into my space and the Costco video of the parking lot showed that I didn't move her car) and later when I looked at the pictures I took, it was obvious that my license plate wasn't high enough to have chipped those two tiny bits of paint from the bumper. She was just looking for money I think, and I was convenient. I was sooooo upset that she wasted an hour of my time accusing me of something that I didn't do. I don't get people like that at all. No sense of grace or priorities.

I just had to vent about that.

I am gearing up to homeschool my two youngest starting on Tuesday. One of our subjects will be "communication skills." They have developed terrible habits of relating to each other and to us, and we are determined to "retrain their brains." With Caroline having so much more self-control, we now turn our attention to the two imps who have gone under the radar so long. My oldest is finishing her third novel for her AP Language class, and she also starts on Tuesday. I can't wait until everyone is in their routine so I can feel like I am in control again. Yes, I am a control freak of sorts, and there is something about a daily schedule that makes me feel much more secure inside.

Speaking of daily routine, before Caroline went back to school, I was having to write out her daily schedule on a big white board in the kitchen because it was driving her crazy not to know what she had going on every hour. Once I had everything written down, her mood improved a lot.

We are having to decide whether to pick up with seeing Caroline's previous psychologist, whom she saw for six years, or stay with the one she has had through the summer via phone conferences, and now in person. We love them both, and so we are quite torn. I think we will still with the present psychologist because our family saw her over the summer and she has been doing some great work with our other three kids in family therapy. However, I am thinking that I still want to have her previous psychologist involved somehow, because she is such a dear friend to us, did an amazing job, and has gone the extra mile for us time and again. Perhaps I will see her just for myself.

I just remembered that we had another hiccup this week with Caroline refusing to go to the social skills therapy group again because she declares she has learned all the social skills she needs to know, and just wants to be a "normal" middle schooler, not one that has to go to these "therapies." We can't force her to go by throwing her in the car and making her go in, but hopefully she will change her mind. I think she was a little turned off by the fact that she was the only girl there, and the only one that talked. Maybe I should have asked earlier if there would be any other girls in the group, and waited to sign up Caroline until there was.

Off to bed!

Social Skills Group Therapy

Caroline had her first social skills therapy group meeting last night. There are three or four boys in the group, and Caroline. She seems fine with that. All of the boys have Aspergers Disorder. She has two male cousins with Aspergers so this is not new to her. She is definitely the highest functioning in the group as far as being outgoing and chatty. The boys were pretty quiet, apparently, and to be expected really. Two of them seem pretty brilliant, one of the common characteristics of many with this disorder. I think Caroline will be helpful in drawing them out in conversation. She is mainly there to work on socially appropriate ways of relating. Making friends isn't an issue for her, it is the keeping of friends. School starts on Tuesday and we are all hoping for a great start.

Too Many Appointments!

Now that Caroline is back, I am back to playing chauffeur to her many doctor/therapy appointments. I forgot how much I time I spent in the car with her prior to her RTC stay. Her back problem from the fall and spring has reappeared and after seeing the pediatrician yesterday, he said she needed to go to a chiropractor and a massage therapist to work out all of the knots in her back. Today she had an hour long massage ($75!) and the massage therapist said her back was the tightest one she had worked on in a long time, and that one of her vertebrae was sticking out weirdly. I could see what she meant. She wanted her to see a chiropractor ASAP and come back for more massage. Caroline really can't start running with this spasm thing going on, so we do have to pursue a solution.

My husband is mad that the pediatrician didn't give us a referral to the pain management group she was at before for physical therapy, because our insurance doesn't cover massage therapy or chiropractic. I got mad because I was just following directions. I think we are both stressed out at the end of a long week.

The family was supposed to go up to the annual Crab Feast tomorrow put on at Bill's aunt's house, which is about a two hour drive away. Caroline can't sit in the car that long because of her back, and that means I am staying here, which is probably best since the laundry is out of control again and the frig needs a major cleaning. I need "catch-up" time. My other kids will be mad at me for not going, but with school starting so soon, I feel like I need time to myself to prepare for the hard work to come.

Caroline has been much better without the dexedrine. She has been using her coping skills and has been very helpful and sweet. I think those first couple of days that made me so anxious were just a combination of the ADHD med and the shock of coming home. She has shown the person we saw at Meridell for the most part. She just came in and used an "I feel" statement about how she is feeling Bill and I griping at each other over several things this evening. No meltdown, just a simple explanation of why she was feeling what she was feeling. So refreshing.

Anxiety Creeping Back In

The anxiety that I struggled with constantly before Caroline went to the RTC has come back. I find myself tense and snappy. She is better, but will always be bipolar, and there are things about bipolar kids that are so draining. Like the constant struggle with boredom. I know from email by other MOBPKS (moms of bipolar kids) that their kids also lack self-direction and are always complaining about being bored. They crave structure and a "plan" and if they don't feel they have enough, they feel very anxious and lost, which can lead to meltdowns. Last night she had her first real "meltdown" over this very issue.

She had gone the entire day without a "mission" and it drove her crazy. I had a busy day yesterday and was also seriously sleep deprived (I am definitely not sleeping as well as I did all summer) and so had no energy to go anywhere and do anything. I resorted to an old way of deflecting the situation by distracting her from her downward spiral with "let's go out to eat" which was not in the budget. I did it out of desperation because I felt paralyzed myself. I realized today I need to have a plan of action written down and posted somewhere so if my brain is foggy I can remember what I can do to help her that doesn't involve taking her out of the house and spending money, which really put a drag on our finances. At least this time I took the other ones with us so that they wouldn't feel like they were being left behind because of Caroline all over again. Today I planned a trip to the beach and Caroline was quite happy to spend hours boogey-boarding in the surf.

As for a daily plan, we are buying her a white board so that she can write down her daily schedule in her room every night and not be bugging me constantly about "what's next." My younger two entertain themselves far better than she does. School starts in less than a week! Yay!

Laying off of the Stimulant

My husband and I decided after the first two days that Caroline was home, to hold off on the dexedrine because she seemed very "up" to the point that we were concerned that maybe the ADHD med was too much. We always worry about stimulants inducing mania, and after all she has been through these last four months, we don't want to take a chance of destabilizing her. We may try reintroducing it in a smaller dosage next week to see if she was just excited about being home, or ramping up. So complicated!

The Letdown

As would be expected, Caroline is experiencing a letdown of sorts about being out of the routine she was in for almost four months, and back in the noisy realm of our home. She's been kind of down and grumpy, which hasn't alarmed me but definitely is a contrast from how she was during our visits with her in Texas. Gone is the spunkiness. She kind of mopes around, looking lost. I am also aware that she is back to trying to eat whatever whenever, which isn't good. I told her yesterday we were starting a strict meal/snack schedule that we would all be following. She was fine with that since she craves structure anyhow. I would hate to see her gain back the twenty pounds she lost, now that cross country season is upon us. She says she is out of shape, which I guess she means stamina and conditioning, because she looks fabulous. She hasn't run for four months so she will have some work to do.

I got mad at her yesterday when we were in Wal-Mart school supply shopping. She got agitated as soon as we entered the store. I need to remember that Wal-Mart is overstimulating, noisy, crowded, and too big for her. Target would have been a better choice, or even Walgreens. She becomes quickly frustrated by the confusion (and the messiness of the store shelves since there has been a stampede there apparently.) She kept snapping at me, showing no patience at all. I called her on it rather angrily myself. I don't think it is back to things as they were before, but I do think that she's going through a lot internally.

So Far All Good

We are almost at the end of Caroline's second day home, and so far she has remained calm for the most part and is showing a lot of maturity. The noise of our family has bothered her, and she will have some adjusting to do to her little sister's frequent squabbles. But really I feel so relaxed around her, so un-stressed, a huge contrast to how I felt four months ago. We will just have to see how she continues to adjust to being home.

Successful Addition of an ADHD Med

Much to our surprise, the psychiatrist at Meridell was able to add in an ADHD med to Caroline's mix without negative side effects. When we tried to do this previously at home, she always became very agitated or manic. So when he said early on during her stay at the RTC, that he was going to try adding a stimulant after she was completely stabilized, we had our doubts. Dr. Stone said that they had found that if they could get all of the other meds just right, they were often successful in treating the comorbid ADHD so many bipolar kids have. I didn't think it would be tolerated, but so far Caroline is doing great with the stimulant and not having the agitation or signs of mania she had shown in the past. This is great news since she has always had a focusing issue. Hooray!

She Arrives Late Tonight

Tonight is the night and I must say I have so much to do. I want to get the house all in order so that she can come home to an organized place. We have a final meeting with Brandi to sum up her stay there and talk about her at-home treatment plan. Our lives are going to change again shortly. The break is over but hopefully this will be a new chapter for all of us.

Three More Days!

In three days, Caroline will return home. I am truly looking forward to hugging her and making her feel at home again. Her little sisters are quite excited about this, the older one not so much, but we'll work through it. Caroline sounds so amazingly normal whenever we talk to her: no baby talk, no whining, so blame shifting, just a normal, happy teenager. We are just wondering if she can keep up the good work. The social skills group she starts through Southeastern Skill Builders should help a lot with this. See the link on the sidebar if you are interested in finding a group like this for your child. I wish we would have found this earlier.

My husband is still painting her room. He is a real perfectionist so he takes a bit longer than a contractor probably would, but the end result will be nice.

Off-topic: my youngest is pretty severely ADHD and we have been experimenting with her meds a little. Result: when she takes her stimulant in the morning, she is sweet and pleasant all day, very few explosions or meltdowns. When she doesn't take it, we have meltdowns all day. So the lesson is: she really needs her Focalin everyday even if it is not during the school year. Nice to finally figure it out. I had resisted giving this to her but it was to our detriment, not just her own. Sometimes we just need to medicate our kids if we want them to succeed in school, relationships, their futures. Not every kids needs medication, but there is no shame if they do.

Yes!

Today my husband and I met with the Principal of the private school that Caroline attended for three days in April of this year. She was not in a good place then, and basically freaked out to the point that we knew she needed to go to a residential treatment center. Now that she is coming home after four months, we have to find a school for her, having ruled out the public middle schools in our area. We weren't sure if they would really take her back, even though it sounded like they would. I had to hear it in person. So, I am very glad to report that he was more than glad to have Caroline back. He was not fazed at all by the bad start last spring. So she will start on September 1st with her classmates, in a combined class of 7th and 8th graders, a total of thirteen students in the class including her. Perfect size, and hopefully it will be a perfect fit. We shall see. I just wish we could get back the $800 we put down last spring for one month of school and fees. Three days of classes is not a great ratio of education to cost.

We Broke the News

We just told Caroline that she will be discharged from the RTC in ten days. She was ecstatic of course. Brandi told us she was grinning from ear to ear. We also broke the news to her about her gerbils no longer being with us thanks to her dogs. She handled that better than expected, even with the revelation that her older sister was at fault for leaving the cage on the floor. She said all was forgiven, no hard feelings. Whew! I guess that she is so glad about coming home soon that the gerbils were not such a big deal. Now we have a lot to do before she comes home, including meeting with the private school she was at for a week last spring to see if they are still amenable to her coming back. Hopefully this will work out. We find out tomorrow.

"It will be soon!"

Tonight during Caroline's phone call, she was quite down because she is very tired of being there and sick of having no idea when she is coming home. I could tell she really needed some hope that she wouldn't be there forever, so I told her it would be soon, that we have an actual date. She brightened up at that thought right away. We will tell her exactly when on Tuesday. I know she will go crazy.

Not Everyone is Happy

My husband and I sat down with our oldest daughter last night to discuss the timeline of our impending move, including talking about the real possibility that she may have to switch schools mid-year. She is not thrilled with that idea at all. All spring, she kept telling me how she couldn't wait to move out to another school district, that she was so tired of her school where the majority of kids didn't care about their education, were lazy, and enmeshed in a culture of purposeful underachievement. She said she wanted to go to a high school where there were more kids to whom she could relate. But over the summer her opinion changed, because after she got her fall schedule, she became quite excited about her classes, especially two that are not offered in the district we are moving to. And she wants to remain involved in Young Life where she is now one of the only student leaders at her school after a bunch of seniors graduated.

We completely feel for her. Moving half-way through your junior year, and to a school that doesn't offer what you want must be really stressful and disappointing at the outset. I wish it didn't have to be this way. But the needs of our family as a whole outweigh the consideration of her desire to stay where she is. We want her to understand that this is not all about Caroline. She wants to blame Caroline for any of her problems. Caroline's needs are only one factor. We have about four other major factors leading us to move. I think it is hard for her to understand the big picture.

In addition, we talked about Caroline coming home in two weeks. This news got the biggest reaction. She became very upset at the thought of having her at home again. She began to cry and become very angry, relating how she feels that Caroline's absence has really improved our family life and her own life, and that she doesn't want her to come home ever. She brought up how her birthday last year was ruined by one of Caroline's meltdowns, and she can't forget that. We tried to help her understand that Caroline has changed, but she won't believe that she will ever be different. She thinks that as soon as she comes home, it will be just like it has been the last six years.

I feel her pain. I can understand why she is fearful and angry. But she doesn't seem to see Caroline's great suffering as equal and greater than her own. Unfortunately, she can't be talked into a change of opinion right now. She will just have to see how Caroline has grown for herself. We have asked her to be kind to her, because she is her sister, but also because Caroline really wants to have a relationship with her. Elizabeth needs a lot of affirmation of her own pain, as well as to be challenged to put away bitterness.

I agree that the break from her has been healing and necessary. But now we need to bring her back into the fold and resume our family life with her in it. She has a place here and always will. Someday Elizabeth may hopefully understand why we made the decisions we did.