Follow Up on Lamictal Problem

The blurred vision and other weird visual disturbances, as well as the dizziness and nausea, were caused by the higher dose of Lamictal after all. So she is back down to 400mg a day. If her moods shift downward, we won't be able to an increas in Lamictal to help, so I guess we will cross that bridge when we come to it. She has previously been on Welbutrin, and I think some other AD, but with bad results (mania.) We will just have to see what happens in the fall especially. I am hearing that some women are being prescribed super high doses of Vitamin D, like 20,000 mgs, to fight seasonal affective disorder. We are giving her 2000 presently. Might need to look into the mega doses. Lifeguards get something like 50,000 mgs of Vit D from the sun in the summer, so I guess it is safe. Does anyone out there know about this?

Growing out of the "Mixed-State?"

I do believe that our daughter has grown out of the "mixed-state" as it is called, when a bp child exhibits both depression and extreme agitation and energy at the same time. This is the most dangerous stage for these kids, because their energy level combined with their negative and angry thoughts combine to cause them to lash out physically against themselves and others. When an adult experiences depression, they usually become listless, lack energy to care for themselves or others, and withdraw. But a bp child can be quite depressed, even suicidal, and have a huge amount of energy creating havoc in their homes and schools if not treated quickly with the right meds.

As Caroline has moved into the teen years, we have seen less and less of these "mixed-states" and much more of the classic swing between mania and depression. This has been easier to deal with by far. I don't know if this would be true for every bp child as they move into the teen years, but I do think that many of them become more classic BP I or II. As awful as it is to have bipolar disorder, I will take the adult version over the child version any day. I hope that if your child is experiencing the rages that cause so much damage to your home, to their relationships, and to themselves, that you will hang in there and know that there is hope that these rages can lessen over time.

College Should Be A Break

I am looking forward to the time my oldest leaves for college, not because I won't miss her like crazy, but because it will be so much better for she and Caroline to have more space from each other. Caroline is intensely jealous of Elizabeth's freedoms and friends, and I think high school will be easier for her without the comparison right there in front of her. We visited James Madison University this weekend, and Elizabeth just loved it. When we came home, Elizabeth was retelling the adventures she had hanging out with one of her good friends who is a freshman at JMU, I could tell that Caroline was really listening and wondering about what her own college experience would be like. She knows that we want her to stay here, live at home, and go to one of the four universities within a few miles of us. I just couldn't imagine her living far away and trying to manage her medications and the stress of college at the same time. That would be a recipe for disaster in my opinion. But we have five more years before she will be going to college, so we won't have to deal with that until Elizabeth is out of college! Holding Caroline back a year has certainly given her the advantage of being a little older when she graduates from high school, at age 19 instead of 17 like her older sister.

Busy Week, New Stressor

I have been incredibly busy this past week with doctor appointments, sports activities, school stuff, ballet stuff, prom shopping, church, etc, and so I have been remiss in replying to some of your questions. This evening I will steal the laptop away from my kids and try to answer everyone. We are taking Caroline to her psych doc today for a med adjustment, but he has also just published a new book on ADHD meds, originally entitled What to do When Nothing is Working. That certainly describes a lot of our lives, doesn't it? He changed it to some other title, which now I forget. I will get the title, read the book, and post a link to it on my website ASAP. Should be quite interesting.

I am stressed today. This whole school decision is wigging me out. We always want to make the best decision for our bp kids and sometimes the picture isn't entirely clear, is it? I just pray for clear leading. And the younger two are in limbo two because we may just try to put all three in the same (new) place.

Oh, and we just found out that Caroline's fantastic therapist is moving to Oregon! My answer to that was "Crap!" You know how important it is to find someone who is the right fit and we have been blessed for the last eight years with two wonderful counselors. Now the search begins. If it is not one thing....

New Crisis--Long

Oh, how I hate this disorder! It always seems that just when a bp child is doing quite well, their mood shifts, the season changes, a new med is needed, or another problem arises that throws a wrench in everything, doesn't it?

If you recall, Caroline was struggling with mania from about the end of February to mid March, not full-blown, completely out of control, but enough to be significantly disruptive to her studies and ability to go to school. She became obsessed during that time with writing a novel, which she is still working on. At that same time there was a very big, school wide, independent project that all of the kids were working on everyday in class (not allowed to do the writing or research at home, go figure). Since Caroline missed so much school during those weeks, she fell considerably behind in this project, and seemed to lack the executive function skills she needed to make up for it, as will happen when she isn't completely balanced and is under stress.

When we increased the Lamictal by another 25mg, to 425mg total, she quickly went back to "normal," but then got blurred vision. So we had to drop her down again, and she again started to have mood swings, so we bumped her up again. Aargh! To make a long story short, she didn't get the IP project completely done by the due date, and we found out on Thursday that she had failed it. When she saw her grade, a 67, she was devastated. I actually didn't realize that she hadn't finished the final draft of her paper. Neither did Bill. How this slipped past us I don't know. Normally she is so good about getting her work done, quite conscientious, but I guess the instability was enough to make her disorganized to the point of failure. We are kicking ourselves for assuming she had made it all up (she was defensive at the time when we were trying to help her finish.)

So Thursday evening, after I had a day to myself, relaxing, feeling great, all hell broke loose around 4:30 with this revelation. We spent the evening trying to reassure a bawling Caroline that she wasn't going to fail the seventh grade, that she could still do well the fourth quarter, that she was a capable student, and this wasn't the end of the world. I must say I was honestly freaking out myself, overwhelmed by crushing anxiety and guilt. I didn't think she was even close to failing that project. I was thinking she would get a C at the worst. I feel so bad that I was so out of touch with how behind she really was. We expect our bp kids to need extra help from us, so I don't know what we were thinking by letting her turn in everything without making her show us the final product!! Live and learn, I guess, but I feel that we failed her.

This whole experience, the pressure of this project from January to March, which went across subjects for grading, and was so difficult for her to manage during the seasonal mood change, makes me question even more putting her back there next year. This girl wasn't made for big, high pressure projects. She needs to learn in smaller chunks. A quarter long project, or less, would be just right. The magnitude of it overwhelmed her from the beginning. Now they are saying there will be an IP project in the fall and in the spring. Great. Yep, it is time to do some serious looking around for a better fit. Plus she was so traumatized by this that she would probably completely freak out at hearing the word IP again and develop total brain lock.

And then another big problem cropped up this week: the blurred vision, but now with other visual disturbances, like seeing stars, headaches, nausea, fatigue, insomnia, and dizziness. It was bad enough that on Friday she couldn't go to school. We took her to the pediatrician, who felt her peripheral vision wasn't right, and he ordered a CT scan and an EEG to rule out non-medication related problems, which we did right away. Then the psych doc ordered a bunch of blood work done to check Lithium, Trileptal and Lamictal levels. We did take out the 25mg Lamictal increase Thursday night. My guess is that it is too much Lamictal. I looked up the side effects, which she hadn't experienced even up to 400mg, and she had most of them now. So if mania pops up again, we may have to look at some other mood stabilizer. We have loved Lamictal for its ability to stave off depression, so if we have to drop it altogether, we will be bummed.

Oh, and yes we are in contact with her psychiatrist about all of the med adjustments. We aren't just doing this on our own, as we shouldn't.

So this spring has been such a let-down for Caroline: a broken ankle, no lacrosse, a poor report card, big failed project, and troublesome side effects. On the bright side, no hospitalizations, no behavior problems at school. I hope the summer will be a good one for her. I have three lacrosse camps lined up and a marine conservation camp too. I think she should just have school during the summer. Spring and fall are so unpredictable.

Thanks for reading. This is how I keep sane, poring out all of these frustrations to whoever will listen. Thanks.

School Choice Agony Again

With public school being out for our Caroline in our district (much too rough) we are looking at the fall again and trying to decided if we should keep her at the private school she is at (doing fine academically, but hates it socially), or if we move her. But if we move her, what other private school would that be, or do we look at homeschooling her with a lot of extra help (core classes taught by someone else?) There is a university model school about 15 minutes away, and I visited it today, loved it, think it would be perfect, but the application says they do not accept kids with "behavioral" problems. Thing is, she doesn't have behavioral problems at school, the teachers love her. She only has issues at home with her sisters. Do I try to apply? Should I call and ask? I am totally unsure. I am interested in trying to get my three youngest on one school schedule because this year I am juggling three different school schedules and homeschooling the other, which has been hard. I just don't know what is best, and what we can afford too. I really need lots of wisdom and to move beyond fear.

Reply to Question on NeuroScience, Inc.

I am having trouble finding some of the recent comments while we were away. I do remember someone asking if we are using the NeuroScience supplements. Yes, and no. We started to a few months ago, starting four different supplements at once, then Caroline got off balance, but it was during a season change and so we weren't sure if it was the usual seasonal mood shift, or if the supplements were causing the change. So we stopped them, but recently we restarted with one at a time, starting with Progon, an all natural progesterone replacement because she is so low on that hormone that it makes her estrogen dominant. The next one we will use in a month or so will be the Calm PRT, to address her cortisol imbalance (way too high in the am.) So the jury is out on the effects. I will let you all know as soon as we see a change, for better or worse.

Best Family Vacation in Years

We got back from Hilton Head last night, and I must say that we had a great time, with no big meltdowns from Caroline at all. The kids said it was their favorite vacation since Young Life's family camp at Trail West in Colorado about seven years ago. We rented a nice time share townhouse right on a golf course with plenty of room (three and a half bathrooms!) and the kids loved being able to bike everywhere. Between the beach, the pool, the gorgeous harbors, and kayaking, golf, the petting zoo, and alligator sightings, we all had a blast. I felt so relaxed the whole time and I could tell that Bill was too. Nobody wanted to come home! We are so grateful to the Lord for this respite. To us it is so obvious that Caroline's meds are just right because our more recent past vacations, especially last year's, were frought with difficulty due to her fluctuating moods and explosive irritability. She wasn't perfect, but had normal irritations like any teenager would. Her little sisters were more of an issue most of the time!

The only bad part of the vacation was the fact that my husband and Caroline wouldn't listen to me (or the doc) about not getting saltwater on the waterproof cast. They rigged up an external covering with a plastic bag and duct tape, but her cast still got wet and I think it needs to be replaced because it began to fall apart. Oh well! If that was the worst thing that happened, I'm ok with that!

Oh, and taking both minivans certainly helped immensely. Nothing better than divide and conquer with movies on an eight hour drive!

So many of you posted while I was on vacation, and I will try to respond tomorrow. I appreciate all that you have to share! Thank you!

HAPPY EASTER!!

Through exhausted eyes I am writing to wish you a truly joyous Easter, and a peaceful day (or week!) After three ballet performances this weekend, and shopping for our trip today, driving all over the place transporting kids here and there, I am trying to remember that this holiday is the most important one for those who believe that Christ proved what He promised: that He would conquer death and sin for all who would believe. This is my hope, and that of our whole family, that one day we will be free not only of the chains of death, disease, and mental illness, but free to be forever with Him, without shame or fear, celebrating life forever. He is risen indeed!