Over medicating

[Catsmother]

Hi there

Not sure where to put this one, but here goes. SS8 (nearly 9) has once again been prescribed an antibitic for a sore throat. Now reading all the literature, the recommendation is mostly to treat the symptoms, and not to take antibiotics. DH thinks that his ex panics, and somehow she convinces the doctor to prescribe something.

Now we have managed to get access to records re the medications. Up to the age of 7, SS has been prescribed 76 medications, 33 of which, at least, were amoxcill ( an antibiotic - penicillin). The mother doesn't really doctor shop per se, although she seems to use a lot of different pharmancies to get the medications. Now you are all probably thinking Munchausen by proxy, and believe me, I have been there as well. The mother is also giving him asthma meds, sometimes over the counter stuff. My son has asthma, and SS has never when with us, displayed any asthma symptoms. One GP tried to say we were just lucky not to see it. But given that we were seeing this child every weekend, I don't think we were lucky. He jsut doesn't have it.

Mind you, the mother is also now trying to get him diagnosed, at the age of nearly 9, as being autistic. But that's a whole other story.

Is this a common sort of trait in a BPD?

[david]

My xBPDw is an RN and that makes it even worse because she knows the lingo and can say just the right things to get what she wants from a doc. Most docs have to practice with the idea that they may be sued at some point and their malpractice insurance is a big cost. My ex could actually call a doc and get him to call in a prescription to the pharmacy without the child ever being seen. After we separated it became easier for me to challenge the doc since ex was not there to deflect my questions. I think my ex hadhas Munchausen too. She has a knack for finding the "right" doc to get what she wants.

[DreamGirl]

Is it possible that you can be in contact with the doctor(s) treating him? I think it will help you feel better about what is going on.

Munchausen by Proxy Syndrome is a very rare, very serious mental illness and accounts for .04% of the reported child abuse cases.

It is also not part of the diagnostic criteria for Borderline Personality Disorder.

I do think that a pwBPD can tend to over-react. My stepchildren go to the Doctor a lot - not always necessary in my opinion, but I think she gets scared and wants to make sure they are OK.  My youngest SD had an asthma attack in her care - Mama panicked and immediately drove her to a fire station two blocks away. She probably could have dealt with the situation more calmly - adminstering a breathing treatment and her inhaler and then going to the ER if it didn't help - however, Mama doesn't deal with that kind of crisis very well.

I don't know that she likes the attention so much that she fabricates it, but she will seize opportunities based on attention availability. She definitely tends to be overly dramatic. She's not equipped to regulate her emotions, so it all goes hand in hand. I don't know that there is intent in that kind of behavior.

I also have a son who spent the better part of two years on antibiotics for chronic ear infections, finally having tubes put in.  He also suffered from febrile seizures (brought on by a spike in body temperature from the infections) so at the first sign of a fever, I pumped him full of Tylenol and Ibuprofen. It was very frustrating and very scary but definitely was not over-medicated. Just sick.

I also understand not agreeing with the medical decisions that the other parent is making. My husband didn't really like how Mama was handling the medical care for his youngest daughter (severe allergies/asthma), so he became involved.

His being able to speak with doctors helped a lot in understanding the treatment plan. It also helped reduce the conflict that was arising when she was trying to relay to him what the Dr. was saying and he wasn't understanding.

~DreamGirl

[Matt]

Yeah, as DG says, talking directly with the doctor doing all this prescribing might be essential.

I also wonder if you could take the child to see a different doctor for a second opinion.

I'm not a doctor - maybe all this stuff is wise - but it sure sounds to me like Mom has a problem and the doctor is enabling her.

[ennie]

You are telling our story---and yes, it seems that this is common.  My SDs have a very similar medical history.  Mom loves to rush to the emergency room at the drop of a hat. The emergency room does little to explore the cause or details of health issues. Both girls (now 8 and 12) have been given antibiotics about 10 times a year since infancy.  When SD12 was 9, she missed 30 days of school--27 with mom, 3 with dad.  At that point, DH became more insistent about dealing with health issues in a more rational way.  Ironically, mom is totally opposed to vaccinations, which is a serious impediment to the girls school enrollment and activity enrollment, medical issues aside!

During the year when SD12 was almost always ill, Dh brought the girls to a naturopathic doctor, who explained that because the intestinal tract is a very important part of the immune system, exposure to lots of antibiotics at an early age (which has a negative impact on stomach flora) can cause damage to the immune system.  In addition, the kids' mom is a chain smoker, and most of the illnesses and infections they were getting is on the top ten list of diseases associated with chronic exposure to second hand smoke in childhood. 

The problem for my SDs is that mom's medical paranoia coupled with her smoking seemed to have resulted in over treatment, which in turn damaged both girls' immune systems. 

The naturopath diagnosed resulting food allergies, which then further reduced the effectiveness of the kids' digestive systems in dealing with infection and illness.  They recommended a limited diet for SD12, and lots of supplemental foods intended to repair intestinal health.  The idea was that after 6 months or a year on this diet, her intestines would be healthier, and she could return to a "normal" kid diet.  But mom will not consistently follow the diet.  We have tried just going off the diet, but then SD12 gets strep and other infections very often.  We have tried talking to mom about it, she just says that she follows the diet, but then tells the kids a host of conflicting policies from one month to the next.

It is really sad to see how mom is both negligent and over-treating illness at the same time. She loves being with the kids when they are sick, keeps them home for days longer than necessary.  SD8 explains she loves being sick with mommy, because she gets to have ice cream and lay in bed with mommy cuddling all day, and when mommy wants her to take medicine, she gets yummy chocolate bon bons if she eats the medicine.  The kids doctor reported to DH that she canceled a doctor's appointment because the kids were "too sick," and he could hear some sort of arcade or amusement park in the back ground.

At any rate, DH's involvement has resulted in much better health for both girls--they tend to miss about 7 days of school with mom, 3 with us these days. We also have an order stating that neither parent can smoke near the kids, which one would think would make no difference with BPD mom, but SD8 says mom no longer smokes in the car or around the kids, which is great.  I just wish that he had been more assertive when the girls were younger, because I fear their long-term health has been compromised.  But in general, they are ill much less often, and get many fewer secondary infections.

Though as I speak, both girls are ill at their mom's home. 

[Catsmother]

Thanks for your responses. It does make sense about the mother panicing. DH also thinks along the same lines. Just today, DH has had a series of missed calls on his mobile, and then a couple of texts (his mobile needed charging). The mother had taken SS to emergency because she thought he had a twisted testicle. Within half an hour though, she sends a text saying all good. No explanation as to the how or why of a twisted testicle.

DH had a response from the doctor who said that she has not presribed antibiotics for six months. So the doctor is now on "notice". Doctor also said she has not prescribed asthma meds. Not sure whether we should tell the doctor that the mother has sent the child over with asthma meds, one of which was given over the counter.

[Matt]

This sounds really serious to me.

A mom who is looking at or touching her nine-year-old son's testicles?  At that age, my son wouldn't have let anybody touch his testicles without a very good reason, like if he was in pain.  And then it was "all good"?  I can't imagine how that could have been an innocent mistake - it sounds really creepy to me.

And then a bunch of meds, but the doctors says she didn't prescribe them?  So Mom is getting them from somewhere else, or the doctor is lying to DH?  Neither of those sound good at all.

Maybe you guys could take him to another doctor, make sure he is OK, and tell that doctor what you've told us here, and see what you learn that way.

I might also talk to a lawyer and find out what your options are.  Like if the court could intervene to make this stop.

[Catsmother]

Hi Matt

To clarify the twisted testicle. Apparently SS was just sitting playing, and then suddenly complained of pain in his testicles. The mother took him to the doctor who told her to go to emergency. They think it was twisted, but that it corrected itself. If she was given further information about the possiblity of it happening again, or the reason it happened, if at all, then she certainly did not tell DH. Mind you, this is a child who screams like someone is sawing off his leg when you have to remove a bandaid (plaster) or when he bumps himself.

While we are on the subject of SS's nether regions. The mother moved away, 900km (550mile) when SS was 4yrs and 9 months old (she moved to live with boyfriend she had not previously lived with). Within two weeks of moving, SS apparently bruised his whole penis by playing with it. I did report it to child services (2 weeks later) and got abused by them, and they said that the bruising would have gone down by then (according to the records it hadn't) and I delayed because I know how child services treat the reportings from seperated families (poorly). He has also had an ulcer, apparently, on the end of his penis (he is not circumcised, so the end is protected naturally). He was eventually taken to a urologist, who could not see any sign of an ulcer. The mother had used the ulcer excuse as a reason for SS to have frequent toilet breaks at school, when this wasn't acutally the reason. SS has learnt avoidant behaviours at school to enable him to get out of work.

My psychologist thinks that maybe SS plays with himself as this is a form of comfort to him, and something he has control over. I have caught SS playing with himself when sitting on the lounge, he was spoken to out inappropriateness (location) and then a couple of hours later, I caught him playing with himself when standing in line at McDonalds. DH doesn't believe in psychologists, so doesn't want SS seen. Aargh.

As for the medications, the last lot she got from the country hospital where they used to live. But that had been over a year ago. She would have told them he gets asthma (because she believes this) even though the GP she was seeing actually stated that SS had never presented at the surgery with symptoms. She had got him onto asthma meds when he was about 2. DH went to the surgery (different one way back then) and saw a different GP in the surgery, woh said she could not understand why he was prescribed asthma meds. And she (the mother) has been on this kick ever since. She, apparently, aslo has asthma. BUt DH does not have any exerience of her having attacks when they were together. A bit like her being allergic to bees, but not carrying an epipen... .  

[Catsmother]

Oh and to top it all off, the mother is trying to have SS at the age of nearly 9, diagnosed with Autism, or ADHD or something. There has been nothing from the schools previously to say that they were concerned about him, and there is nothing in  the GP notes that she was concerned until about 9 months ago.

[Matt]

Touching himself like that might not be a big deal - important to correct that behavior when it's in an inappropriate place like in public, but maybe not a sign of a big problem.  But I do think SS9 is under stress and is being treated oddly, so getting professionals involved - a doctor who you can trust, and a psychologist too probably - is the best strategy, to keep Mom's twisted thinking from twisting SS9's thinking too much.

Any one of these issues, like the testicle pain, might be explained away.  All kids have some unusual problem at some point in their lives.  But there sure seems to be a pattern, and it's not get to get dealt with unless you guys deal with it somehow.

Is there anything preventing you from taking him to a GP first, for a frank, open talk about all this, and then maybe getting a referral to a psychologist who can look at those aspects?

[Catsmother]

We are EOW only. Not even a dinner visit. I agree, I think he is under stress, but DH is not willing to get him to a psychologist as he doesn't believe in the "mumbo jumbo".

And yes, there does seem to be a bit of a pattern (the bruising of the penis lasted for 6 weeks - a lot of brusing for someone who was just "playing" with himself)

Will have to work on DH about the psychologist.

[Matt]

Can you take him to the doctor on a Saturday?  Or take him out of school, or pick him up after school to take him?

I was very skeptical about psychology too - I still am, a little - I don't think it's the same as the physical sciences, where knowledge can be verified and demonstrated very clearly.  But psychologists do understand a lot of stuff, and they help a lot of people.

It would be a shame if anything prevented your stepson from getting the care he needs, both medical/physical and medical/psychological.

What about talking to a lawyer, to find out what evidence and how much would be needed to get the court to recognize that there is a problem?

[Catsmother]

Even though DH has joint legal, he would not be able to take him out of school. The mother would insist on attending as well (as well as wanting to know why). And yes, we could take him to a doctor on Saturday (sadly we get charged double to do this).

We don't have a lawyer at the moment mostly because we just can't afford $400 per hour.

Will see about putting all the medical notes we have together, and work from there. Need to follow up with one particular practitioner as we don't have notes from that surgery.

[Matt]

Are you sure you can't just pick him up and take him to the doctor?

What would happen if you did that?

Or take him on a Saturday.  Parents take kids to the doctor all the time - it's absolutely normal.  I wouldn't hesitate a minute to do that.

I think these issues are potentially very serious.  It's important to get professionals involved.

[Catsmother]

All hell would break loose if we took him out of school, or even picked him up from school. So better not to do that.

I have an appointment with my psych in just over a week, so I will run it past him. We don't need to get a doctor's referral to a psych, so no problem there. Just need one that is child focused.

And after numerous phonecalls, DH got the information from the hospital himself. Slightly different story to what the mother told him. In her email to DH she said that testicular torsion was ruled out, well the hospital said it wasn't ruled out nor was it ruled in. Problem was that SS was taken to emergency when no longer in pain. Coud have been bacterial, could have been any number of things.