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I've been off the computer for several days, because my power supply failed...
We had "Family therapy" with the SW at the hospital where David had been from 04/27/04, last thursday, 05/06/04. He was doing much better, to the extent that he was no longer making homicidal threats, and was showing some ability to avoid conflict by stating his opinion or upset, but walking away from the situation. They allowed us to bring him home. By this time, he was on 80mg Geodon BID, and they had titrated his clozaril dose up to 75mg/day. they increased the dose to 50mgBID for friday. I had an appt scheduled already with Dr Robertson for Friday morning.
Dr Fletcher, the hospital pdoc, would have been more confortable keeping him a few days longer, but agreed to let him come home since we had good outpatient services in place and he was not exhibiting violent behavior any longer.
David was pretty sedated over the weekend. We did see Dr Robertson, and got a RX for the Clozaril. This medication requires weekly blood monitoring of White blood Cell count. We have to provide proof of the lab results weekly to the pharmacy before they will fill 1 week worth of medication. Very strictly regulated for this medication. David's pdoc is being more aggressive in titrating his dose up to a more theraputic level.
At present he is up to 200mg/day, and by the end of this next week he will be up to 400mg, the target for now. Dr Fletcher had also recommended that we consider adding Wellbutrin to the mix to help to counter remaining symptoms after we get the Clozaril stable.
A note on the Haldol shots that David received during crisis at the hospital, he had a pretty painful Dystonic reaction (full body muscle cramps).
David still has done ZERO homework all this week. Gene and i fly out to Vegas for a business trip tomorrow. My mother came up Monday to stay with the boys while we are gone. David had a very rough blow-up on Monday evening after she got here. We had a very blunt talk with him, over the tirade and paranoia, blaming and name calling that if he was behaving like this before we left, we would have no choice but to rehospitalize him before we left. We would not leave him with his Grandmother, if he was unsafe.
Yesterday, I managed to talk to his pdoc and got a PRN of Thorazine rx'd in the meantime to take the edge off the irritability while we are gone. he took 25mg last evening and almost immediately had a dystonic muscle reation in his neck. Today, I cut the 25mg pill in half, and he is getting half when he is home from school, and the other half with his dinner/eve meds.
Tonight he was upset again, but not as difficult to pull back.
I hope and pray that the increase of clozaril will take effect soon.
Since David has been home, he has done little of anything, however, he did visit with a friend twice this weekend. It is rough, but he is barely manageable for the time being. He did admit at one point that the hospital was less stressful, but he wanted to be home.
Disbelief...
When I became a mother,
I never thought to dream
of days that ended with my breaking heart.
I never pictured blame,
oozing from your face,
and spewing from your mouth into my ears.
You could not predict
the agony I breathe,
when viewing the destruction of your path.
You drive away all help,
and spurn each reaching hand,
striking out in fear of living death.
I stand amazed, and shocked,
at the power of your pain,
erupting in a fiery, flaming mass.
Pouring rivers of destruction,
decimating dreams,
incinerating hope and tendered peace.
As thunderheads have gathered
striking claim within our home,
the lightning knives slice through our proffered love,
And blazes turn to ash
all yearning unmet needs,
and melt my stricken eyes deluged with tears.
Homicidal, hailing stones
batter living from my soul
and bruised and weary I collapse in pain.
My heart is withering
upon the tattered vine,
which, ripped and torn, lies shorn beneath your feet.
Refusing to relinquish
treasured portraits of desire,
I continue to do battle though I fail.
Shattered panes of glass,
break on cliffs of throbbing ache,
praying that one day they'll wear a trail.
A thread of consolation,
reuniting bonds,
which fallen down have shriveled from the bone.
If only I could find
a tactic to deflect
your lips of poisoned breath engulfing home.