More feedback on communication threshold

[kells76]

Continued from https://bpdfamily.com/message_board/index.php?topic=339873.0

SD13 hit her head on Friday and then puked. I was at work; this was with Mom and then the puking was when Mom dropped kids off at our house with DH. We'd had plans for the kids to play w / friends but DH canceled & kept them home.

SD13 had a soccer game Saturday; I texted Mom Fri night that I planned to tell SD13 no headers; Mom agreed. By this point DH and I were thinking it had been a concussion. I don't know a lot about head injuries so DH & I were OK with SD13 playing as long as she told her coach and had no head contact. She told the coach who said Absolutely no playing today, so we backed him up on that. SD13 watched & cheered & we went home.

The coach filled me in on a lot about policies & how seriously people are taking head impact now, so I learned a lot and went from "it was a little serious" to "let's be completely 110% safe". I decided to tell the school so I let SD13 know "just so you're in the loop, I'm going to call the school on Monday and let them know about your head impact". Learned from last time I called the school! She was a little complain-y but not for long. I called/emailed school this a.m. and they were great.

Then... this was maybe where I... IDK... took a wrong turn? I texted Mom "You've probably already thought of this, but have you let SD13's doctor know? Coach X was saying at the game that it's really important to record concussions. Just a thought!"

Mom texted back that she hadn't, did not plan on it, and it was really not as bad as the other concussions that SD13 had gotten back in Other Activity. Then she asked if SD13 had shown other symptoms.

I tried not to JADE so just said "No external symptoms"

...

I need a reality check as I go down this new path of "Decide, act, tell Mom later if at all".

I don't know a ton about concussions, but I'm pretty sure that you can have a concussion and "feel OK". Right? So: no symptoms doesn't necessarily equal no problems. True? Or am I missing something?

I am thinking it would be best for SD13 to have this in her medical record. Mom is not going to do it. How far do I "step" to make it happen? DH was a little frustrated/shut down and went to  "It's Mom's job to do medical" but then also said "If you want to do it, go for it".

At this point my plan is to call the dr's office with a "hypothetical" question: "If you think your kiddo may have had a concussion (i.e., head impact followed by vomiting), is that important to get recorded? How bad is bad enough to record? How "OK" is OK enough to not?"

Any other ideas from the group?

I think Mom was probably feeling shamed or inadequate. And Mom kind of has a track record of not taking SD13 in for serious stuff. So I'm not sure if engaging more would be helpful, and I don't know if I'm ready to take a posture of "We're in this together, you're doing great" to get stuff done.

I also let the coach know that Mom would be taking SD13 to practice as usual this week, and he said he was fine with sidelining her for certain stuff if needed. So I'm glad the coach is in "safety first" mode.

Just not really sure where to go from here.

[CoherentMoose]

Hello.  Head impact followed by vomiting could be serious.  It is a sign of a concussion and should be evaluated by a doctor.  If there were no other symptoms (headache, blurred vision, dilated pupils, sensitivity to light) then it may be a minor concussion, but with any head injury, best to play it safe.  Good luck.  jdc

[Grady]

I agree.  You have to take this seriously.  One of my D's got a concussion and then healed from it and got another one a month later.  The second one took a couple of months for her to be okay and she wasn't allowed any physical activity at all until she was released from the doctor.  The school knew this and she had to sit out the season for her sport as well as PE.  My other D's play soccer and there are very strict guidelines to follow for any impact with the head.  I think you are right for the doctor to be called to at least get a baseline test. 

[david]

I would contact her doc. They are learning a lot about head injuries today.

[kells76]

Thanks for the feedback.

I plan to call the doctor (or, at least, what I'm pretty sure is the dr's office... not in a mood to ask Mom) and see what they'd recommend. That I feel like I can do.

I do feel scared, though, and I think I am afraid that the dr will say "you need to bring SD13 in". Because of the path that then opens up, where I "have to" get DH on board, and "have to" figure out if/how to tell Mom, and "have to" figure out getting SD13 to the Dr, and "have to" field however SD13 is feeling about it -- and part of me is scared that we'll have a redo of the times when SD13 (at age 10) would run away from DH, say "I'm not going", have Mom "try to convince her, but it's just not working"... all that stuff. I feel myself bracing for that... and I haven't even called the dr yet. I have a lot of fear of "going back to the dark days" tied up in this -- because it's doing something that Mom doesn't want. Yowch.

And it's the fear that SD13 will struggle with seeing me or DH take her in and Mom not do it; her MO in the past has been to side with Mom: "I feel FINE, I'm COMPLETELY OK, it's no big deal, I dealt with it, it doesn't hurt any more" -- probably in order to avoid what it would mean if she weren't OK (that Mom didn't see/didn't care).

OK... off to the phone. Wish me luck. Still feeling queasy.

[Panda39]

Glad you're checking in with the doctor.  You got this!
Panda39

[kells76]

I am apparently "not on the list" to share any info with. The receptionist said she'd have a nurse call back, but the nurse might not be able to say anything specific. I said it's fine just to get general information. Fingers crossed.

[kells76]

Learned a lot; hope this helps other parents:

At least at SD13's dr office, their threshold for coming in for a visit is ≥2x vomiting in 24hrs, &/or headache that lasts ≥3 days. We were at 1x vomiting, no headache, so we're good. Whew.

It is telling that this episode raised a LOT of fear/anxiety for me.

[ForeverDad]

When we are questioned by the children, we can say "I have to follow the order."  It's the truth and allows us to divert attention from ourselves.

When we are questioned by the ex, we can say, "I have to follow the order and my lawyer has to approve too."  Determine which professionals you can divert attention to.

In cases like this, the doctor may say, "Bring in the child, I can't give an answer without observing the child."  If that happens then the blame for taking action can be diverted to the doctor.  And the child gets seen, if appropriate.

One aspect of the professionals and their responsibilities - and why we pay them - is that they're there to bear the brunt of us getting pressured or conflicted on what to do and how to do it.  Does that make sense?

[livednlearned]

You're not on the list for them to share health info with?

 

Sometimes I just.

With BPD mom, I wonder if asking her questions might help her get on the same page with you. I grind my teeth thinking about all the footwork we have to do in these situations but I guess the end game is better care for the kids so it's worth it.

"Do you think the concussion warrants a trip to the doctor?"

Letting her be the expert might be the crucial piece. She may be more likely to take on the role of caring mom if she considers it her idea  

[kells76]

If I'm reading your suggestion right, the subtle difference between

"You've probably already thought of this, but have you let SD13's doctor know? Coach X was saying at the game that it's really important to record concussions. Just a thought!"

and

"Do you think the concussion warrants a trip to the doctor?"

is that when I ask "have you let SD13's doctor know", then I've been the one to already decide that it merits medical attention. Therefore, I was the expert -- the one on top -- telling Mom, below me, the information.

In your example, I position myself below Mom, so that she is above me with the information, being the expert on top.

Emotionally, Mom is probably more regulated when she is "above", and probably more reactive/dysregulated when she is "below". So, if she feels "below", then regardless of what the kids need, because she is such a needy person, she needs to get her emotional needs met first. And the easiest way for her to get her emotional needs met in that situation was to role reverse with me -- I was no longer the expert suggesting taking SD13 in, SHE was the expert suggesting that it was no big deal. Back on top.

Ahhhh... makes sense.

I even thought my text would be non-inflammatory... but I missed the nuance then.

[worriedStepmom]

I think that's a really interesting way to look at it, and to rephrase.

In my situation, even a more neutral "do you think that this warrants a trip to the doctor?" would cause a meltdown because it is interpreted as me or H second-guessing her parenting.  ("Do you think might have allergies and need allergy testing?" resulted in mom calling the Domestic Violence Hotline to report H for ? and mom threatening to call 911)   If mom thought it was worth a trip to the doctor, mom already would have taken her, so H bringing it up is just a jab at her.

That may not be the case for you.  Even if that rephrasing keeps matters on an even emotional keel, there's still the possibility mom says "no".  And at that point you'd still have to decide how to handle it.  I think you did a good job this time.

[kells76]

I remember last time DH & I chatted with the kids' (former) C, she said something really interesting.

I was kind of kvetching about how I would try to work together with Mom for the kids, but it felt like something weird was happening in the dynamic; i.e. when SD13 started her period, I texted Mom to see if she already knew, and Mom came back with "Of course I know, and I'm sending supplies along, and SD13 told me she didn't want me to tell you". And then I talked about how the kids wanted to try some different activities, so I put together some spreadsheets of options/prices and emailed it to Mom, and didn't get back a blamey/experty email.

C asked me "so what's the difference between how things went in those situations", and it seemed like things went better when I just went ahead and DID what I thought should be done.

C said that she believes Mom responds better to... shoot, I forget the exact words, but basically Mom responds cooperatively to overt power and authority.

I wonder if Mom can't handle ambiguity very well. So, this could be why she hasn't reacted at ALL to me calling the school about the kid doing suspicious stuff around SD13 (https://bpdfamily.com/message_board/index.php?topic=339873.0), which I'd imagine SD13 told her about. I just did stuff, and it's done, and there's no ambiguity.

Whereas "I think you should let the doctor know about the concussion" leaves a lot of doors open -- kells76 hasn't done it yet so there's a "stage" available for performing some pushback.

Even if that rephrasing keeps matters on an even emotional keel, there's still the possibility mom says "no".  And at that point you'd still have to decide how to handle it.

Yup, and that's a live question here -- how much do we manage our phrasing in order to get stuff done for the kids. It helps to get other perspectives and learn how statements I thought were low-intensity actually were open doors with neon signs inviting conflict. And yet, I can't keep micromanaging text statements hoping that "this time" things go well. Radical acceptance and private decision first, communicate after...  if at all...

[livednlearned]

Can you take SD13 to the doctor without mom's permission?

If not, I guess it depends on what you feel comfortable doing.

I'm working my way through the third significant BPD relationship in my life (brother, ex, stepdaughter) and I am just about done messing around, so that's probably a factor in what I say.

If you can take SD13 to a doctor about concussions without needing permission, go for it. If you're super worried, it's better to ask for forgiveness than beg for permission. My two cents.

The point for me is to give SD22 the illusion that she has control. Most of my work with her is to set up invisible boundaries that she cannot breach without a degree of effort she is not willing to make obvious.

"I didn't want to regret not having someone check SD13 out immediately so I took her to see a doctor, just to be safe. I ask for your forgiveness -- sometimes my anxiety and concern overrides everything else. Thanks for your understanding. Like H suspected, SD13 was completely fine, thankfully. I'm glad we are all so invested in SD13's well-being."

Or something like that?

You get to be in the one-up position while pretending she is.

I assume that SD22 is always, and I mean always trying to be in a one-up position. It's life or death to her. Even when she's asking me how I'm doing, I assume we're in a match.

The new thing I do is to make sure that I work out every small detail I can before she starts a match. I pick the courts, I pick the side, I pick the rackets and the balls, I log some hours looking at her strengths and have an answer ready for anything she tries to hit.

It is exhausting, yes. It is also the first time I have felt like I am not losing all the time with SD22. In that sense, the exhausting work has felt worth it. I'm hoping this new feeling of being fed the hell up is because I have done the leg work and now it's just a matter of putting that stuff into practice.

"Took SD13 to the doctor because it was the right thing to do, kthxbai."

Don't you wish? 

[kells76]

Can you take SD13 to the doctor without mom's permission?

Weeellllll... that's an interesting question.

As stepparent, I would absolutely take her to urgent care/ER if needed, and I suspect the "We are GETTING THIS DONE" side of me would take over. As, every now and then in a crisis, it does. WATCH OUT 

Regular doctor? Hmmm... well, I'd probably try to ask/convince DH to take her, first. So... there's the "working with spouse" variable at play. DH still has a lot of "don't rock the boat" responses, and some deep feelings of regret at how custody played out, so that gets complicated. AFAIK he has taken SD11 to the doctor before.

If I genuinely thought that SD13 needed to be seen personally by her doctor during our time with the kids, but it wasn't urgent enough for UC/ER, and DH said something like "Well, I don't think she needs to go, but if you really want to you can take her", then... that would be tricky. I'd probably bypass the PCP doc altogether and take SD13 to UC.

It's kind of quantized/binary, you know, and this last weekend, it felt like I was getting REEEALLLYYYY close to hitting that level of "screw it, we're taking SD13 in somewhere". It did help to talk to the nurse and hear their very criteria for when a concussion merits an office visit, when it doesn't, and when it's severe enough to bypass the office & go to UC/ER.

Interestingly, this sort of reminds me of the discussion on mama-wolf's thread about "who's the target of blame/anger". I think I'd rather be the "bad guy" to Mom, who takes SD13 to the dr "even though she doesn't need it", versus DH being the "bad guy". Kind of feels like I have more emotional distance from her than DH. It's getting a lot easier to let her upsets and blaming and bizarre mental contortions be what they are -- empty balloons drifting by, I guess, really no substance -- instead of getting tied up in appeasing her and making sure not to do something "she won't like".

You get to be in the one-up position while pretending she is.

I can't remember if it was here or elsewhere that I read that "the person asking the questions is the person controlling the conversation". Interesting and somewhat related. It's not the person convincing others, or demanding, or making it about themselves who's in control.

It is exhausting, yes. It is also the first time I have felt like I am not losing all the time with SD22. In that sense, the exhausting work has felt worth it. I'm hoping this new feeling of being fed the hell up is because I have done the leg work and now it's just a matter of putting that stuff into practice.

It feels... nice  and I think there's something healthy about it. It is appropriate to be fed up with inappropriate behavior.

"Took SD13 to the doctor because it was the right thing to do, kthxbai."

Don't you wish?

Sigh... if I ever figure out how to make it to Everyone's A Functional Adult Island, I'll send you directions.

[ForeverDad]

I wonder if Mom can't handle ambiguity very well.

Here was one educational experience I had.

I found that giving my ex choices triggered her.  For example, at one exchange I mentioned an upcoming exchange problem.  I think it was that a holiday and an exchange were almost side-by-side and we'd be at the exchange twice in just a matter of hours.  I had a brainstorm, offer her two favorable options, more favorable to her than what she was rolling around in her head.  Ouch, she replied, "Then I just won't bring him!"  It eventually worked out but I've always remembered that she can trigger/object just because I suggested something logical.  My common sense logic usually doesn't win over her emotional perceptions and triggers.

For that reason I like LnL's approach.  Do your research and tell ex which one you picked.  Yes, you have your list of reasons but if you make it clear This Is The One then it might very well work, um, even if not at first.