Out of Control Stress

Now Caroline has really gone into a full-blown manic state, which we now see she has been ramping up to for weeks now.  We may have to admit her to an acute psych unit until she is more stable to go to RTC.  In which case, neither she or my husband get to go on the SeaWorld/Disneyland vacation we have planned and paid for much of it beforehand.  We did get travel insurance on the airline tickets, which we will always do now.  I am really really stressed out about Caroline's crazy behavior, and my youngest is really acting out, and my oldest is running a 102 degree fever.   This is so very hard.  I was filling out Caroline's  Merridell application today and there was a section to check off previously tried meds.  I checked so many boxes.  About 14 actually.  Then there are the seven psychotrophic drugs she is on now, plus a few others for asthma and severe eczema.  And the boxes I checked for anger and agitation, plus lack of focus were numerous.  I sure hope the RTC things happens soon.

Moving a Step Closer to an RTC

Today we met with Caroline's psychiatrist's P.A. who had gotten the health insurance paperwork, and agreed that an RTC would be a good move for Caroline.  Her psychologist sent over her evaluation to add to the documents needed.  I think we have a good case for approval, but we'll see what happens.  We have decided that the RTC in Texas, the Merridell Achievement Center, is our top choice based on their neurobiological-based psychiatric approach, using brain imagery and scans to guide choices of medications.  I would love for them to do a med wash where they basically start all over again from scratch, because she is on ten different medications.  We leave for a big vacation on Saturday and I am just hoping she will be able to handle it.  She's acting a little too happy/irritable right now (rapid cycling?) so are bringing things to calm her down if we need too.

Health Insurance: The Other Necessary Evil

I am venting here.  We are trying to find the very best Residential Treatment Center (RTC) for Caroline that we can possibly find, one that has specific criteria that are important to her health and to us.  Some of the best ones are far from us, like in Texas, and Colorado, Wisconsin or Georgia.  We are willing to fly out there if that is the best scenario for our daughter.  Tricare, our health insurer, has an approved list of RTCs that they will pay for.  Some of our preferred RTCs are on the list, but our psychologist just told us, having dealt with Tricare before, that they will probably only approve the one closest to us, which we had already struck down based on what we saw on the website.  We really would like to take her to a place that has brain-based therapies such as neurofeedback and brain imaging based therapies, and equine therapy, which is so helpful to her and calming.  I am just mad that we are bound by someone else's opinion in some office somewhere who doesn't know our child.  The one in our state doesn't have horses and looks undesirable compared to some other RTCs.  I guess we'lll see.  This will be about a two week process now.  And we don't want to see her once a week actually, which Tricare requires, because we now feel that she will make better progress if she realizes we are not able to take her home every time we go up there (big problem before).  One great RTC in Texas only wants family visits every 8 weeks, which sounds  about right to us.  I mean, WE need a break too.  Her family is tired and exhausted and we need her to be cared for by others for a spell.  

The Scarcity of Connection

One of the things I have struggled a lot with in the last few years is that fact that when we are going through a hard time with Caroline (pretty much all the time), I can always count on my sisters, my mom, my neighborhood friends, and our pastors to call us, bring us meals, ask me out to coffee, or for a glass of wine, but the people that you would think would reach out to you, don't.  My closest friends in town seem silent, but my more "fringe" buddies are the ones lending a hand, doing my laundry, calling, sending emails.  Some of them may be reading this and wondering which group they are in.  It's not that all of my closest friends avoid me, it's just that a lot of them do.   Let me just say, don't be afraid to call me, or send a note, or invite me to coffee.  I would love to spend time with you or chat briefly.  Even just knowing that my close friends at least read my blog once in a while would be comforting.  I guess this is what a lot of people experience when they have cancer or something.  No one knows what to say, or are afraid of saying the wrong thing, or they feel completely inadequate to help so they shrink back, hoping maybe that the suffering one won't notice.  I've done that to other people myself.  I have two huge regrets regarding two friends who both died of cancer, well, three actually.  I was so busy with four little ones at the time, that I felt unable to be of great help, so I kept a low profile and hated myself for doing it (still haunts me).   I know this post is kind of brutally honest, but I am speaking not only for myself, but for anyone out there who is going through the valley and feels like people fade away.  Suffering is hard, but loneliness through suffering is harder.  

Residential Treatment Center

Bill said last night he could see the wisdom of sending Caroline away to an RTC for a period of time.  I have been online researching and also asking other moms of bp kids about their experiences with long-term RTC stays.  I've gotten some good recommendations.  Nothing in our state looks that great, so we are looking at ones in Utah, Georgia, Texas and Vermont.  We have specific criteria for what we want, including equine and occupational therapy and lots of true professionals running the place, not a boot-camp type of a place where anyone could work there.  She doesn't need to be yelled at, she needs structure and affirmation and caring people.  We have to contact our insurance company to get pre-approval and also get her doctor to sign off on this.  We may be taking her as early as this week, so I have a lot of phone calls to make.  She knows we are looking at this and she actually isn't put off. She feels pretty helpless right now.  I really don't want her to miss our CA trip, but we will just have to see.

This May Be a Wash, or Worse

I don't know where to start because a lot has happened in the last 24 hours.  I'll just say that Caroline has already decided she doesn't like this school, or any school for that matter.  She has given up hope that she will ever be able to go to any school because of the fear that she will embarrass herself and have to leave, lose friends, etc .  She in general is acting hopeless about her future and gets angry when we try to assure her that she does have a hope and a future.  The school has offered for her to go only half days next week with no homework, but she says she has already been making up stories about herself to the other kids, and feels like a fool (tall tales a very much a part of bipolar disorder).  

Yesterday culminated, after I had to pick her up after only being at school for about 45 min, in her packing her bags and running away.  She took pics of our family, her med box (she knows that they are very important), and took off on foot and walked down through a very bad part of town (murders and shootings daily) for several miles, traipsed around the coffee shop area on the other side, make her way over to another part of town after visiting the zoo.  She was gone for about an hour and a half.  We had called the police, but thankfully someone spotted her before they did and I was able to get her in the car and take her immediately to her psychologist.  We tried to process what was going on in her head but it was hard--she seemed not to understand or care about the danger she was in. The psychologist said when Caroline left the room that she felt strongly it was time to consider a long-term residential treatment program.  I actually agree this time.  If she refuses to do school, there isn't much else we can do. 

I was completely nauseated when we couldn't find her, just numb as I printed out photos for the police to help find her.  I think I've had the last straw.  She is just driving everyone crazy and we are losing time.  Bill believes the school could still work for her, but I think she is convinced it won't.  

In the mean time, my husband's dad has been deathly ill, in and out of the ICU and rehab facilities for 8 weeks now.  The stress of Bill being gone a lot during these weeks of Caroline doing poorly has pushed me to the edge.  I begged him not to go this weekend.  He agreed, but of course if his dad takes a sudden turn for the worse again, he will go up there with my blessing.  

We are going to CA next week to see both family, Sea World, and Disneyland.  We so need a vacation.  Just to play together and swim with the dolphins.  Caroline may not be at her best, but I'll just give her Ativan if I have to.  If she goes to an RTC, it would be right after that, after we line up funding because it is about 11,000 to 20,000 a month!  Insurance would pay for maybe 90-120 days of it, but we would have to find the rest.  An ideal stay is 6 to 12 months. There are some groups that you can finance through .  We'll do anything to help her get back on the right track so we don't lose her to despair, drugs, whatever.  She is at a critical juncture and we have to act.

Third Day...better

Bill decided to let Caroline sleep until she woke today.  I was not so sure about that, because I was afraid she would wake up mad that she wasn't on time.  He went off to work, and Caroline woke up a half hour before school started, and she was furious indeed.  Thanks honey.  I knew she needed more time to wake up, so I told her I would take her to breakfast.  We went to a coffee shop, she ate, and then said she really needed to go back to bed.  It is so hard to know sometimes what is fear and what is real need.  But knowing she can't function well tired--she didn't fall asleep last night until 10:45 apparently even with her sleep meds--I decided not to risk having to pick her up again.  She did go back at 11:00 and stayed til 3:00 without incident.  She was just fine when I picked her up.  

She must be anxious or something, because normally her sleep meds knock her out and keep her asleep all night.  She is trying to do her homework now after lacrosse practice and she is freaking out again over the work load, even though her teacher said not to worry, just finish what you can.  Her teacher had called me last night to find out how she could help Caroline to have a successful time there.  She was great, very compassionate and understanding.  Today, I dropped off a brochure from the Child and Adolescent Bipolar Foundation which was penned just for educators on the types of accommodations these kids need in class, one for her teachers, and one for the principal.  I hope they read them because I think they will be helpful.