Month 4: BPD d13 in residential treatment center

[lbjnltx]

yes gamegirl...i believe that it is.  I have never once feared for her safety.  with such a complex disorder as BPD with odd and mdd piled on top I had some fears about whether or not they would know how to help her.  we have all worked together, shared information and ideas to achieve that goal.  I know that her therapist has put extra effort into my BPDd-13. husband and I decided that if the plane went down we would will our daughter to her t!   

thanks for traveling with me on this incredible journey.

lbjnltx

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[GameGirl]

yes gamegirl...i believe that it is.  I have never once feared for her safety.  with such a complex disorder as BPD with odd and mdd piled on top I had some fears about whether or not they would know how to help her.  we have all worked together, shared information and ideas to achieve that goal.  I know that her therapist has put extra effort into my BPDd-13. husband and I decided that if the plane went down we would will our daughter to her t!   

thanks for traveling with me on this incredible journey.

lbjnltx

You are a very brave woman, and listening to you gives me insight into the parents I work with and helps me to be more sensitive to their concerns and questions. 

[kj1234]

lbjnltx,

that's a great story and I am very happy for your family.  Your daughter is learning some great things that we all should should be so lucky to learn at an early age.   

[lbjnltx]

FAMILY T SESSION #14

had our session yesterday as therapist is going to be in vegas for a seminar w/dr. amen of the amen clinics.  she is still pushing for a spect scan or at least an mri for BPDd-13 because the better she gets to know my d and our family the less sense all this disordered stuff makes and especially the auditory hallucinations.  we are scheduled to have a phone conference w/her therapist and pdoc today to address the auditory hallucinations...again. therapist suggested a brain tumor  or brain trauma, or perhaps that smoking marijuana could have caused the auditory hallucinations...idk!  then again BPDd-13 tells the therapist that she has heard the voices as long as she can remember...?  I do remember her telling me that she thought our house was haunted because she was "hearing things"  this was when she was about 11 yrs. old...the same year of the whole 4th grade debacle.  the marijuana incidents(2) were just this past year...i'm not sure.  anyway I told the therapist I absolutely do not want any more dx added to my BPDd-13's record of care/diagnostics...esp. schizo affective or schizophrenia...   :'(

the therapist session:

really great. BPDd-13 so happy that she earned "necklace privilege"...that's it...getting to wear a necklace...no entitlement there!

she was really aware of how hard she had to work to get that privilege.  the therapist lead her down the path of thinking about how hard we have worked to achieved our goals of having a ranch, of having healthy boundaries, healthy marriage, having healthy lives, etc...BPDd-13 said she sees that and "i want to be a part of the ranch and my family.  it is an awesome place to live". "my family really cares about me and they are trying to help me become a better person and stop doing the things I did before I came here".  "i feel like I care for them and I can feel that they care for me too".

we talked about our trip in october and that dad couldn't come.  she was excited that I suggested my mom come w/me and would "love to see my grammy".

BPDd-13 has also been stepping up as a leader for mini study groups in Positive Peer Culture while she reads the book and has been a co leader for the main Positive Peer Culture group.  she has improved her cooperation level with the staff and tells herself "do it for my friends."  she says "i feel great.  I have accomplished much.  I have my emotions under control, I have build friendships and relationships with staff and peers.  I have also developed leadership skills and have personal happiness.  I am ready for a home visit."

t reminded her that we must first have the 3 day off campus visit in utah before she can come home for a home visit.  BPDd-13 "oh yeah"  "that will be fun too."

BPDd-13 is working on looking at past friendships and how to best deal with those when she comes home.  I emailed her therapist today a response to that dilemma...asked her if it would be a good idea for BPDd-13 to look at each friendship individually and ask herself some discerning questions before making individualized choices about her friends.  we will see what develops from there.  the issue was "tabled" during the family therapist session as husband and I let therapist handle the discussion.  therapist introduced the idea to BPDd-13 that we may be afraid of letting "old friends" back into her life.  BPDd-13's final statement on the subject was "when I am more prepared and have more tools and am more consistent and am at home I want to give them a chance."  wow!

i'm sure I will have more to add to the journey after talking to therapist and pdoc today.

thanks for reading

lbjnltx

[qcarolr]

lbj - I can see the wonderful impact your intelligent involvement in your D's therapy has. You are able to add so much more than is the usual parent involvement - IMHO. Every life you touch comes away so much better for it. Thanks for sharing.

qcr

[lbjnltx]

dear qcarol,

you are far to kind.



lbjnltx

[lbjnltx]

The conference call w/t and pdoc at the residential treatment center:

we had a discussion about why the abilify should be increased...pdoc wants to address the auditory hallucinations w/meds.  I reminded him that the abilify (higher dose) had not addressed this issue in the past and that the symptoms have decreased significantly since the dosage was decreased...doesn't make logical sense...i am not a pdoc but I do have common sense and that is the only basis for my reasoning.

he suggested we try other meds...seroquel (no!), resperadahl (no...been there done that), zyprexa...maybe.  then therapist jumps in and suggests that we stop the abilify all together to get a "base line" on my d.  pdoc didn't like it...wanted to know what plan b would be if this backfired significantly.  I asked the therapist to work w/my d from a spiritual point of view to address the auditory hallucinations...BPDd-13 doesn't see shadows anymore.  therapist agrees that would be a good plan.  BPDd-13 believed (at one point) that it was something she invited upon herself...i suggested that w/leadership and faith she could possibly uninvite it...we will see. 

so the pdoc says that BPDd-13 needs to come into the room and be part of the conversation.  they call me back 10 min. later and tell me that they spoke w/my BPDd-13 and she told them that she is "feeling angry" and would like to stay on or increase the abilify..."would rather be tired and deal w/the voices than be angry".  so the abilify will be increased...

this is all news to me.  I just got a glowing report the day before from her therapist and the Positive Peer Culture leader on how happy and well BPDd-13 is and is doing... ?

i told therapist and pdoc that I want an evaluation done to find out what is going on in her head...i need them to ask  her the specific questions to determine what is causing the voices...why these "announcements" about feelings are not being caught in therapy...what direction to take in her treatment to address any other disordered thoughts that we may not yet be aware of.  it reminds me of the situation when you ask someone "why didn't you tell me?" and they reply "you didn't ask."

from my perspective the abilify never addressed BPDd-13's anger...then again I guess it could have been worse without the abilify...?

does anyone believe their BPD has a mood disorder?  my d can go from angel to evil in the blink of an eye and back again just as quickly...i don't see that as a mood...opinions?

this will be my last post on this thread.  today we start month 5 at the residential treatment center.  getting through one step at a time.

thanks for reading

lbjnltx

[LionDreamer]

Hey don't lbjnltx,  Don't panic.   Things have been going better than anyone expected.   But healing is not a linear process and things pop up, get better, get worse.   There is so much terrific progress that even with this confusion I think things are doing pretty great.   

I'm wondering why pdoc doesn't want to stop the ability to get a baseline?  What better time to do it than when she is in a residential situation and closely monitored.   Once medicines are relied upon, its hard to know what the baselines are.   Maybe you can ask the pdoc what his fear is regarding this?

Although now that your dd has requested to stay on it, I imagine that is pretty impossible.   Still she may not want to "be tired" for too terribly long. 

[lbjnltx]

thanks for the encouraging words ld!

i wouldn't say I am in a panic...i just see this as ridiculous...3 adults, a pdoc, a therapist and a parent work through the decision in a logical and reasonable way ... reach a conclusion that makes sense ... then a disordered 13 year old comes in and makes a statement without any "evidence" to back it up and the whole plan changes...   it goes against my common sense!  anything that goes against my common sense causes me uneasiness.

the pdoc definitely has an ego in play.  he was very terse w/the therapist when she suggested the meds be cut out to get the baseline.  part of the problem w/that is the length of time she has left at the residential treatment center...would there be time to regain any lost ground (if there was any)?  I assured them that BPDd-13 would be there at least until the 1st of the year.

i talked to the Positive Peer Culture leader and asked him if BPDd-13 seemed angry.  he said no...i would describe it as a little frustration w/other girls in the group and a new intensity for her new found passion...leadership and the Positive Peer Culture process.  he told me he would work w/my BPDd-13 to help her to understand that her self proclaimed anger was a secondary emotion and try to help her identify her feelings and how to best address them.

time will tell.

lbjnltx

[LionDreamer]

i wouldn't say I am in a panic...i just see this as ridiculous...3 adults, a pdoc, a therapist and a parent work through the decision in a logical and reasonable way ... reach a conclusion that makes sense ... then a disordered 13 year old comes in and makes a statement without any "evidence" to back it up and the whole plan changes...   it goes against my common sense!  anything that goes against my common sense causes me uneasiness.

You've shown uncommon common sense through all this lbj     I know I would trust your instincts above else.  Maybe this is something to discuss with dd's therapist or even the director.

[peaceplease]

lbj,

Thank you for sharing your journey of the residential treatment center and your dd.  It appears that so much progress has been made.  God Bless you for all that you do.  It is so inspiring to read these posts. 

I am looking forward to reading month 5.


peaceplease

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[swampped]

Dear Lbj:  As others have said, your account of your dd's journey and that of your family is inspirational and instructive.  You have so much insight into all of this!  Thank you so much for sharing this with us.  I too look forward to month 5.  As for your feeling that some of this is the psydoc's ego strikes me as right on.  In another life I was a physician, caring for children, and it was only with a fair amount of experience and maturity that I learned that most important lesson:  listen to the mother!  I found if I listened to mother, and observed the child, the answer was most often in front of my nose.  But that is so threatening!  I think of your psydoc, participating in this conference call, being questioned by a very well-informed parent and a young therapist, and can imagine how much on the defensive he/she felt!  And digging in his/her heels was probably almost a reflexive action.  One could hope that after thinking about it, and perhaps listening to your dd's T, he/she (sorry, can't remember) would reconsider.  It was a very hard lesson for me to learn in my younger, insecure days---and occasionally, even at the end of a long career, the tone of voice, the day I was having, my fatigue level, whatever, nearly brought the defensiveness to the surface.  Especially with the parents of my special needs patients--- always they knew so much more about their child's condition than I ever would, despite all my training and study.  Getting over that ego was critical in learning to do my job.   Now I know, it is his/her job, to deal with complex children and their parents who have almost certainly come to him/her after many other strategies have failed.  But I wonder if you do speak with T tomorrow, and see if anything has changed, might you find that there is more flexibility about stopping the Abilify for a trial.  Your logic in all of this is excellent, and my bet would be that citing your dd's  plans for herself was simply looking for support wherever he/she could get it.  On behalf of myself and my colleagues, and all the times we have been too anxious to be right, I apologize.  Know that you are doing a wonderful thing, not only for your dd and your family, but also for those of us who follow your account and who struggle with the pwBPD in our lives.  You will be in my prayers.    Swampped

[lbjnltx]

dear friends,

thank you all so much for your votes of confidence in me...at times like these it helps to know that other people believe you are capable even though you are having some doubts.

i emailed the therapist and let her know I was "uneasy" about the turnout of the conference call w/her and the pdoc.  she emailed me back late today and stated she "needs to talk about the conference call" with me...she is going to call me tomorrow.

i also let her know that our 3 day off campus visit is only going to be for 2 days. the cost of flights pushed the trip up 2 days and the case manager only wants BPDd-13 to miss one day of school.  my mom is going because we can't afford for husband to fly up AND miss work for 2 days...also that BPDd-13 requested 3 things...trip to the best friends animal sanctuary, a trip to an amusement park, and PLEASE bring my dog...well...usairways has a policy that no dogs fly in the cargo bay to vegas or phoenix...i could buy him a 200.00 ticket but his carrier won't fit under the seat..so no dog...the amusement park is too far away for such a short trip...so no amusement park...we can go to best friends...this is all going to challenge my BPDd-13's newly acquired skills... ;p   the therapist asked me not to discuss the trip w/my BPDd-13 during our social call tomorrow...i guess she wants to be there to witness BPDd-13's reactions and help if needed. 

today I feel like I am hanging on with nubby nails  

i did get a "surprise"...the residential treatment center scholarship-ed the fees for the pdoc...that is nice...i think I might actually have resented sending him a check. 

if there was one thing I could change about the residential treatment center...i would change pdocs.

lbjnltx

[qcarolr]

It is kind of hard when the 'real' world changes our plans - like work and airline rules. Though this is a big disappointment, maybe this is a good time and place for d13 to learn to handle the inevitably unexpected nature of things. Hope you can put it all out of your mind for the social call with her.

Hang in there - thinking of you all.

qcr

[peaceplease]

lbj,

Sorry about the disappointment that your dd will have.  Maybe, she can make a list of other wishes and you can compromise with doable ones. 

Will be praying for a good outcome. 

I know that we were not very fond of our pdoc at the facility that I worked at.  He definitely had a "God " complex.  We loved the one for adults, but the adolescent pdoc was not so popular with the employees. 

You are in my thoughts and prayers. 

peaceplease