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.