Back From Meridell

We are back from visiting Caroline at the Meridell Achievement Center in Liberty Hill, Texas.  All in all it was a great visit and Caroline seemed much improved in every way.  She was so much more relaxed and in control of negative responses than we have seen her in a very long time, and looks great having lost about eight pounds. 

Our visit began with arriving in Austin around 11:30 on Saturday, and then driving about half an hour to Meridell in a rental car.  During the car ride, I began to feel anxiety creeping over me.  I have so enjoyed the time I have had free of the daily stress she has brought into our lives. I wasn't exactly missing her or looking forward to being with her for two days.  I love her, I just feel gun-shy around her.

We pulled into the RTC, and the campus looks like a nice camp more than a medical facility with lots of wide open spaces, and big oaks providing the only and much needed shade.  When she burst out of the door she went straight for Bill's arms, not a surprise since she is a daddy's girl, then she hugged me looking supremely happy.  The nurse had to give us her meds for the evening to take with us since we were taking her off-campus.  While she was explaining the meds to us, I felt myself beginning to feel quite anxious, and detached.  She must have noticed something, because the nurse asked me if I was OK.  I realized I probably didn't look thrilled or something.  As the afternoon unfolded, however, my fears were assuaged since she was obviously quite different than she was before she left.  Never having seen Texas, I would have to say that it is hot, dry and dusty!  I saw more wild life than I wanted to--a tarantula crawling across our hotel parking lot and a snake at the RTC.  Anyway, we picked her up and took her back toward our hotel where there was a very nice mall and restaurant complex.  We took her shopping for a few new clothes, and other items, and then we went to a nail salon where she and I got pedicures and manicures.  She needed some pampering!  We had dinner later at a great Asian place.  Throughout the afternoon and evening, she was so pleasant. We had to get her back by 9:00 for bedtime, and after dropping her, we remarked to each other how much we enjoyed that day together with her.

 On Sunday, we considered going to church, but since we didn't know where to go, we decided to just pick her up and go into downtown Austin to explore.  Initially, she seemed again relaxed and sweet.  We were a little late in picking her up and by the time we found the right streets in the city, it was lunchtime, and she began to get a little fussy about being hungry and the heat.  We found a place to eat with helpful waiters who told us where we needed to go to see the best of Austin. 

It was a very hot day, so we decided to go down to a nearby park where you can rent canoes and paddle up the blue-green river that winds around the city.  Caroline usually loves any outdoor adventure, but she seemed quite bothered by the heat and grew impatient, noticeably more so than the day before.  She became difficult during our canoe ride, and Bill said he was beginning to have flashbacks to how it was at home with her.  After letting her swim in the lake following the canoe ride,  I realized we had forgotten to give her the noon dose of the new med Amantadine.  She was three hours off schedule, and we could see that her ability to cope with distress had declined without this med in her system.  So we gave her the late dose, and within about an hour she was calm again, happy, and controlled.  Thus this affirmed that the new drug truly is the "miracle pill" that Meridell calls it.  The rest of the afternoon and evening went much more smoothly and she was happier in general.

On Monday morning we had three meetings scheduled, one with her psychologist, another with her team of teachers, and the last with her psychiatrist.  We did spend some time with Caroline, having lunch with her outside on a glorious day under one of the oaks, and playing in a game room.  We could tell she was growing increasingly sad and anxious about our leaving that day.  

The meeting with her psychologist was great.  She is very likable, obviously committed to caring for the kids she works with.  We told her about our time with Caroline over the weekend, and how well it went.  We had been given some goals for our time with her at the start, all of which we accomplished.  We had tried to implement some stronger boundaries for Caroline and reinforce the skills she was learning at the RTC while she was off campus.  Bill was better at that than I was.  I just wanted her to have fun and enjoy being with her parents, while he wanted to approach the time in a more deliberate way.  

The meeting with her teachers was very encouraging.  They all seem impressed with her natural academic ability and her work ethic, which is great to hear.  They had no complaints and all said she was working at or above grade level.  Yay!  Meridell finishes the school year June 29th, and they do have standardized testing required by the state, so we will be quite interested to see how she does.  Maybe moving on to 7th grade is more than a possibility, which would be so heartening for Caroline and for us!  Especially after reading the results of her initial neuro-psych-educational testing done after her admission.  

These tests are all ones she has had at least four times before, at the age of 5, 7, 9 and 10, and now at 13.  They measure intelligence and ability, as well as screen for learning disabilities and psychological disorders.  What has been very sad for us to read is how her general IQ scores have declined over the last eight years.  At the age of five, her IQ was in the very superior range, and now, she tests in the low average range.  What has brought her scores down has been her declining processing speed.  She demonstrates very big deficits in processing speed and executive functioning, and thus she has a definite learning disability (Not Otherwise Specified is the official label).  She had so much potential to be a high-achiever like her older sister, but a lot has slowed her down.  She still has great potential, but she is going to have to work at a slower pace with a lot of accommodations to help her achieve her goals.  If she didn't have bipolar disorder, and this brain abnormality, her life would look so different.  

We managed to track down the main psychiatrist at Meridell.  He is hard to get on the phone and in person, our only complaint so far about this RTC.  When we did sit down with him, he was quite obliging and apologetic for being hard to get catch.  We told him about the incident with forgetting the Amantadine, and how that affected her.  He was quite glad to hear that the drug worked that well.  He said that many of his patients have benefited greatly from this drug, which is so often overlooked by many psychiatrists.  It is an old med that is used generally for other things, not to enhance the electrical connections in the brain.  He also said he wants to introduce either Trileptal or Tegretol into the mix because of their anti-seizure mood stabilizing properties, and get her off of the Trazadone and Klonipin , which can be cognitively dulling.  We told him we were open to whatever he wanted to try, but that she was as stable as we have seen her in years.  She is on a lot of meds, so simplifying them would be great, as long as this doesn't set her back.  The doc said he thought Caroline would only need to stay another six weeks, which was surprising.  We kind of hoped for longer but if she is significantly better, I know our insurance won't pay for more days than necessary.  With her academic confidence restored, and this new miracle drug in her mix, she may benefit from coming home and starting at a new school from the beginning of the year, instead of coming in halfway through the fall or whatever.  

After this meeting, we made a mad dash to and through the airport because we had spent a little too much time on the campus, but we got to the gate on time and got home safely, feeling satisfied that the staff at Meridell were caring and doing a great job with our daughter.  

Speaking of a new school, we are feeling the pressure to really move fast now that this trip is behind us (and a three day trip to DC that I took with one of my other daughters just before this trip) to get our house on the market so we can get everyone settled in by September.  We have had a lot of distractions up until now, but it's full speed ahead, especially if Caroline is coming home much sooner than anticipated.