Posts for category ‘Diagnoses’

I like to talk about my son the inventor. Max is 9 years old and for years has always been putting things together to help him get around, across, and through obstacles. My wife and I are waiting for him to up with that one brilliant idea that will let us retire.

We joke about this a lot but we never thought it really could happen. You see, with all of his disorders we didn’t think he would be able to accomplish all the great things we know he is really intelligent enough to do. He has been diagnosed with ADHD, Bipolar Disorder, Asperger’s (sometimes PDD instead), ODD, OCD, and anxiety among other things.

With all of the medication he is on we have been afraid that it would stunt his mental growth. Michael Moore, the creator of many movies including “Roger and Me”, once said if his parents had put him on medication for his ADHD he doesn’t think he would have accomplished what he has.

We have a parenting counselor who meets with us each week. She helps us work through Max’s issues. We told her how he wants to go to MIT and become an inventor. When we mentioned that we didn’t think he would succeed she told us not to bet on that. He’s smart, has the capabilities, and will probably pleasantly surprise us. She has spent a lot of time at MIT and she told us that most, if not all, of the students had similar issues and had worked through them to accomplish great things.

And he keeps inventing. Just the other day he built a rainforest in the backyard. He didn’t start out doing it. All he wanted to do was fill a barrel from the hose. His plan was to put on his bathing suit and climb into it; relaxing as if it were a hot tub. Only thing was it was a cold day and the water was icy.

It wasn’t long before his mind spawned the idea of a rainforest. He took the hose and attached a smaller one to it that has a sprayer on one end and a shut off valve on the other. He then climbed up a tree high enough to hide the sprayer in the branches but also low enough to reach the valve.

When he tested his invention he was standing under the tree in his bathing suit. He flipped the switch and a fine mist began to spray downwards. The water dripped off the branches and formed puddles in the dirt.

Max declared it a rousing success but too cold. He disappeared into the house. A few minutes later he returned still in his bathing suit but he had added a yellow rain slicker and yellow rubber boots. After a retest he was elated that it was working so well.

Once all his testing was completed he began rounding up the neighborhood kids to show them what he had made. Several children stood in the back yard and watched him dance in and around the misty rain. He tried to convince them to join him but not only was it too cold and wet, none were dressed appropriately. But all liked what he had accomplished.

My wife and I are now rethinking our opinion of what Max will be able to accomplish when he grows up. We don’t want to sell him short. I actually know an inventor who graduated from MIT. I’m going to ask him if he would spend some time mentoring my son.

Who knows, as our counselor says, Max will probably surprise us!

Do you have children? If so, do they take any medications for an illness or disorder? What is your opinion on drugs?

So far I have met people in several categories:

• There are the ones that do not believe in drugs of any kind. They don’t know what it is like to have a child taking medications or who needs them. One mother actually told me once that if even the school tried to force her to put her children on meds she would home school them. She didn’t know what that entailed but she knew that her kids would never get drugs. She had heard about the “terrible” things that they could do to children like destroy their minds and make them nonfunctional.

• There are the ones that have given their children drugs and didn’t like the results. One little girl had taken Ritalin for 2 and a half years and her mom hated the results so much that she took her off them. She said that her children would never be put on drugs again.

• Other parents give their children medicine wholeheartedly. The doctors and schools have told them this would be the best thing for their kids and after a lot of experimentation the parents agree.

• Another group is the one where the parents don’t like giving their children this stuff. However, they see how their kids are without drugs so they give them with a lot of misgivings.

We fall into the latter camp. My son Max has been diagnosed with ADHD, ODD, Bipolar Disorder, Asperger’s Syndrome, and sensory issues. We have seen how he functions without medication. He is explosive. He rages. He is violent. He is miserable.

When he is taking his medication he is happy. He plays with other children. He can do his homework easily. He loves life. His mind is “destroyed” when he isn’t taking his meds.

I am not happy that he has to take them. I have always believed in looking for natural alternatives first before taking medicine of any kind. If I have an illness that is treatable with antibiotics and there is nothing else available I take them. I would much rather Max was happy and loving life without them but that is just not happening.

He is working with therapists and psychiatrists and special education teachers to help control his moods. We give him as much healthy food as he will eat. We are helping him learn how to play with other children.

Last night I was talking to a woman who gave me a glimmer of hope. She says her son had the same diagnoses as Max. She had him on all of the drugs; he was also taking Ritalin. She said he told her that he wanted to be taken off of them because his mind felt like mush. He couldn’t function and he couldn’t remember what was happening from one day to the next.

She said when he hit puberty everything changed. His symptoms started to disappear. Wildness turned into quiet. His exuberance became introspective. She decided to wean him off of all of his medicines. When she was done she found that he was functioning as well as any other child. She said she never told the school that he wasn’t taking the drugs anymore and they never noticed a difference.

This sounds all well and good but after she told me this she got a phone call. Her son had just shown up after having been missing for several months. It turns out this happens a lot. I don’t yet know what other problems he is having.

So what is your opinion on all of this? Would you give or do you give your child medicines for disorders? Why or why not?

My son Max and I spent the weekend at Battleship Cove with the Cub Scouts.  As its name implies it has a number of exhibits including a battleship, submarine, and destroyer on display in the water near the ocean.  And like a lot of museums nowadays you can schedule groups to sleep overnight to get the experience of living aboard them.

This is our third year doing it but Max still gets just as excited as the first time.  When he gets excited it can be expressed in many different ways.  For example:

• He can get excited when running.  Like other children that have Asperger’s this can be manifested by flapping his arms.  I used to try to teach him to hold them close to his body and pump them the way that regular kids do it.  Since I have learned about the syndrome I have backed off doing this.  However, I have noticed he will switch back and forth between flapping and pumping his arms depending on the mood he is in.

• He can get very excited when he is wrestling with his friends.  But as his anxiety levels increase it can turn to upset.  When this happens his face gets red and he looks like he is going to cry.  Then he becomes violent.  His excitement transforms into anger and he is ready to beat the other person down.  This is when we have to step in and separate them.

• At other times when he discovers things that really interest him he really, and I mean really wants to show people what he has found.  And he will harass them until they come to look.  Interestingly enough he doesn’t care how excited they get; they can even be annoyed, but at least they have witnessed what he has found.  At the Cove no one was safe.  Every time he turned around there was something else to cause excitement and there were 600 people to badger.

Through trial and error my wife and I have figured out some of the triggers for his excitement and the results to expect.  But there is always something new.  Right now he is building a ship in the backyard with his advocate.  This is his project du jour.  And as he works he keeps thinking of something new to add to it.

First was the saw.  He came running in talking very quickly.  His words fell over each other as he tried to ask if he could use it.  Why?  After much prompting I discovered that he found a long piece of wood that he wants to make into a gang plank for the ship.  Well, it is okay with me if his advocate is willing to supervise.  Upset.  He heard a “No” when I said that.  In the end she said yes and he got the saw.

After he cut the wood he wanted the drill.  What could he possibly want the drill for?  Screws.  Um, I can’t work with just one word.  What is he going to use the screws for?  To make a long story short I never really found out but we didn’t have any.  Upset.  But he finally settled for nails so I listened to hammering for quite some time.

Next he wanted our wooden flag pole.  I can’t get a straight answer why he wants it.  This time I said “No”.  Of course there was more upset.  Finally, when all was said and done he got the pole.  It turns out he wasn’t going to cut it, hammer it, or damage it in any way.  There is a hole in the center of the table on the back deck.  It holds the umbrella we use during the summer months.  This is where he put the pole after attaching the flag to it.

One thing about Max though.  Once he has completed a project or shown other people the things that excite him he forgets about them and moves on to something else.  But unfortunately, in the meantime, we can get upset or annoyed or frustrated especially if he is handling his excitement in a new way.

Asperger’s is a whole new world for us, as it is for a lot of other people.  Every time we think we understand what is going on with Max, something else appears and we learn yet a new lesson.  It can be exhausting but it is also nice when we figure out another way to help him through his excitements and upsets.

I’ve been talking a lot lately about the med changes my 8 year old son Max has been going through.  To accomplish this we needed to find a new psychiatrist.  For us this process was fairly simple.  We belong to a program recommended by our local Department of Mental Health.  We are working with a Family Therapist, Child Advocate, and Play Therapist who are all part of this group.  Since they already had a psychiatrist connected with them we decided to check him out.   However, problems can arise when psychiatrists have different philosophies.

History
When Max started showing signs that things weren’t quite right.  We saw him as a discipline problem that we had to address.  However, it wasn’t long before we realized that it was something else that was causing our issues with him.  But, like other parents, we had no idea where to look to get help.  Friends were pointing out what they thought was obvious and recommending drugs.  We did a lot of research; every time we found a symptom list we would say things like:  “He has that one but he doesn’t have this one.”  We were diagnosing him ourselves and not having a clue whether we were right or wrong.

His Pediatrician
Then it dawned on us that we should be talking to our pediatrician.  They are generally an excellent start in locating problems and how to address them.  In Max’s case, his doctor is considered one of the best in the state so we were comfortable taking his advice.

His conclusion was that Max has ADHD.  He prescribed medication that vastly improved his situation.  My son was able to go through kindergarten without any more problems.  During the summer he went to camp and was a model camper.  This was a vast improvement over the previous year when the owner kept threatening to throw him out.

We saw only wonderful things in the future.

The First Psychiatrist
During the second half of Max’s kindergarten year, at his doctor’s recommendation, we took him to see a psychiatrist to get a more clear diagnosis.  This woman observed him at play in 3 sessions over a 3 week period.  Her conclusion was that he was not only ADHD but he was also PDD/NOS, OCD and had sensory issues.  The second one, she told us, was because she believed that he fell into the autistic spectrum but she couldn’t determine exactly where.  He seemed to have bits of everything.  She decided not to change his medications because they seemed to be working well.

Hospital Psychiatrist 1
In the fall Max entered first grade.  September went very well but then everything fell apart.  He became very aggressive and uncooperative.  As a result he was suspended several times and they were threatening him with expulsion.  His pediatrician told us that his problems had progressed beyond the doctor’s expertise and he recommended we take him to a specific hospital emergency room.  The idea was that it was connected to their psychiatric ward and they could help him immediately.  Ordinarily it can take up to a year to get a child tested by a psychiatrist and we wanted to get help as soon as possible.

They suggested putting him into their psychiatric hospital for a few days so they could diagnose him properly.  So at the recommendation of Max’s doctor we agreed.  This was a horrendous experience for my boy that I hope he never has to go through again.  The psychiatrist abruptly removed him from his medications; we have since discovered that he should have been weaned off of them gradually.  Then he observed him for the next few days before coming up with an added diagnosis of Bipolar Disorder.  The new meds he recommended however were for emotional issues and didn’t really address the diagnosis.

Hospital Psychiatrist 2
The we spent next few weeks finding a new school because his old one felt that he required special help that they were unable to provide.  During that time we felt like we were in limbo;  Max wasn’t any better but he wasn’t any worse either.  Within 6 weeks however, he was behaving so poorly he needed to be hospitalized a second time.  The psychiatrist in this hospital added yet another diagnosis while agreeing with all of the others.  So not only did Max have ADHD, Bipolar Disorder, OCD, PDD/NOS, and sensory issues he now had ODD.  This doctor changed his meds and also recommended we start watching  “Super Nanny” and the “Dog Whisperer” to learn out to deal with the ODD.

And, oh by the way, all of these doctors seem to switch back and forth between calling Max PDD/NOS or Aspergers.  I’ve gotten into the habit of using them interchangeably.

Regular Psychiatrist 1
After Max was placed into a special school and was following a new recommended med plan we found him a permanent psychiatrist who, we believed, would keep an eye on him and change medications as needed.  What we got was someone who believed that there was only one protocol which was to stay on a certain medication for life.  The only deviation from this was to increase the dosage over and over again as the situations warranted it.  He did not believe in observing the child; he acted only on what the parents told him about his or her behavior.  As a result he became a “rubber stamp”, writing prescriptions based only on what he heard.

In the beginning this was enough to get Max through first grade but he had a lot of problems again in summer camp.  This time I decided he would not be going back because I did not like the treatment he was getting there.

Regular Psychiatrist 2
He did really well in second grade.  When summer rolled around we kept him in school which made him very happy.  The first half of third grade was okay but when he was moved into the fifth grade class he started doing better.  The problem we had though was with the psychiatrist.  All we ever saw was Max’s meds being increased.  The man had never spoken to him except to say “Hi”.  I was also becoming more and more convinced that Max was being overmedicated.  We needed something different.  At the recommendation of our family therapist and child advocate we decided to try their office doctor.

He initially seemed to be a good choice.  He spent more time with Max and advocated a med change;  the first step being to take him off his ADHD medication.  This doctor believes that a Bipolar child will not also have ADHD; the stimulants only aggravate the bipolar condition.

Regular Psychiatrist 3
We were in the middle of weaning Max off his stimulants when the doctor abruptly left.  Apparently he was only temporary and his contract ended.  It is this office’s policy to only keep doctors for short periods of time and then bring in new ones.  We were disappointed that this happened right in the middle of the med change but unlike any of the psychiatrists before her the new one seems to be taking a real interest in Max himself.  She will talk to him directly instead of through us so that she can see first hand where he is at.

But, yet again, we have a difference in philosophy.  She believes that ADHD and Bipolar Disorder can coexist.  As a result she is reintroducing the stimulants.

Conclusion
Whew, that’s a lot of doctors!  It wasn’t until I sat down to write this that I realized how many.  Is there any way to find a good doctor before ending up working with so many?  From my observations I’ve come up with some suggestions:

1. First thing is to find psychiatrists that your insurance will cover.

2. After compiling a list it is a good idea to find out how quickly they can see your child; if they have a good background in your child’s area; and if they are flexible in their treatments.  Your child’s pediatrician may be able to help.  Remove the ones that won’t work from your list

3. Use the first couple of visits to check out a doctor; start with ones on your shorter list.  Make sure they can work with your child.  How well do they get along with him.  Does she respect your child?

4. Start with one doctor that you like and try his treatment suggestions.  Make sure you are comfortable with the way things are proceeding.  Are you happy with the results?

5. If one doctor doesn’t work, try another one.

We can’t give up.  Maybe we need to see more than the ones we’ve gone through all ready or we might be very happy with the most recent one.  All psychiatrists are different and unless we do our research, testing, and observing we probably won’t find the best one for our child.

I had a crazy dream early this morning.  I was in a company parking lot looking for my car.  All of a sudden a man started running wildly through it; he appeared to be in his twenties.  He was attacking people at random but it didn’t appear like he was trying to hurt them.  It seemed more like he was trying to get himself noticed.

The problem was that he was hurting them and no matter how much we tried to tell him this he ignored us and kept on with his play.  It got so bad that someone called the police who arrived and took him into custody.  They stayed long enough to question us before dispersing everyone. Afterwards the police left and I found myself alone.

Well, not alone, it seemed like the man had been forgotten.  But he hadn’t stopped playing; he continued running around the parking lot.  Now you could see how much fun he was having.  He was laughing as he started smashing things in his path.  I pulled out my phone and called 911.  When it was answered I told them what was happening.  They were very interested and started asking me questions.  I answered that we needed the police and for some reason when they were here before they did not take him with them.  This surprised them and they questioned me some more.

All of a sudden I had to interrupt the conversation; the man was now lifting up windshield wipers and snapping them off as he moved from car to car.  I spoke to him several times but it was if he couldn’t even hear me.  He then started running up the street and yelling exuberantly.  I tried to get the people on the phone to commit to sending another police car but they were still interested in asking more questions.

“Are you awake?”

It was my wife coming into the bedroom.

“Um, yeah, ” I muttered.

“I’ve been up since 4:30 with that boy.  Can you take him now?  It’s 5:30.”

I struggled out of bed still groggy.  I went downstairs to find him watching a video on the computer a friend had sent him.  Max is 8 years old and has been diagnosed with, among other things: adhd, bipolar disorder, and asperger’s syndrome/pdd-nos.  He is also very high energy; but this is not surprising since each of these disorders includes this as a symptom.  And we never know when he is going to get up in the morning; it can be any time between 3 and 7:30.  But when he does we expect a wild time until his meds start working.  This can include screaming, swearing, smashing things, or just happily doing marathons in the house.  Coupled with the med change he is going through right now, this has led to some hectic times.

By the time I got up he was calm and enjoying the video.  When it was over we moved to the living room to watch a fun movie starring Jackie Chan called “The Forbidden Kingdom” before he got dressed and headed off to school.

The dream has stayed with me this morning; does it have a meaning?

Like this man, Max likes to:

• Get into people’s space.

• Smack his Mom in the butt as he passes or run at me and bounce off my stomach while saying “Fat Daddy!”

• Toss things around but doesn’t expect them to break.

• Be noticed.

• Ignore people when they are talking, as if he is deaf.

• Run exuberantly around the house or down the street while yelling.

It seems like that this man could be the future Max.  However, I was talking to Max’s therapist this morning and I told him the dream.  He says that, even though this could happen, we still have time to change things.  The frontal lobe in his brain is still forming.  In boys it doesn’t become fully developed until they are 25.  We, as parents, will be taught the skills we need by the therapist to help develop it.  We will do this by helping Max learn the coping skills he will need later on in life to survive in the world.

What is the frontal lobe?

It is the part of the brain that is at the front of the head.  Scientists believe it may control the personality, emotions, and long-term memory. If it is damaged at all it can affect problem-solving and reasoning abilities.  Disorders such as adhd and bipolar disorder appear to be symptoms of this problem.

Why is this where we concentrate our efforts?

It seems that very young healthy children learn problem-solving and reasoning through play; this in turns develops the frontal lobe.  However, this result may be inhibited in children with a disorder.  If we teach Max these skills it will help it mature more properly.

Will this cure him?

Probably not but if we do our jobs correctly then Max won’t become the man in my dream.  He will have learned to control the behaviors that can cause these outbursts.

How is this going to work?

Max’s training started several months ago with his therapist and child advocate, and we have seen some changes.  But this is our first day of training.  As we continue to learn and apply our new skills I will write more about how it is progressing.

Children that are on medication for mood disorders such as ADHD, Bipolar Disorder, or Asperger’s syndrome have to be watched to see how they are reacting to the drugs.  Each one has side effects that parents have to be aware of.  ADHD medications, for example, can cause stomach upsets, weight loss, or insomnia.  Not only that but mood changes have to be monitored.  Quite often the prescribed dose will stop working over time and will either have to be changed or a different medication must be prescribed.

When making a med change parents must be aware of the procedures that need to be followed.  Some medications cannot just be stopped; they need to be weaned slowly over a period of days or weeks.  Similarly, other drugs may have to start at a smaller dose and then be increased to the required one.  Always follow your doctor’s recommendations.

My 8 year old son Max is in the middle of getting a med change.  In his case he is being treated for both ADHD and Bipolar Disorder.  He had been having large mood swings that were interfering with his relationships so something had to be changed.  His psychiatrist does not want to make any changes to the bipolar meds until he is weaned off of the ADHD stimulants so that he can see what changes can be made.

The doctor suggested doing it slowly.  We have reduced the stimulants from 3 doses per day to 2 so far.  Consequently we are seeing much wilder behavior but another change we have noticed has been in his eating habits.  Other recommendations for his ADHD medication have been:

Before all of this started Max was a very high energy kid and thin as a rail.  He exercised constantly and was proud of his “washboard” stomach or, as he calls them, his “6-pack Abs”.  His weight has always fallen into the low end of his height and age range.  This is a result of his suppressed appetite.

But as we decreased his stimulants we noticed that he was starting to eat more.  We have also increased his bipolar meds a bit and now he can eat voraciously at meals.  Where before we were practically begging him to eat, we are now doing the reverse: “No more food Max!”.

And over the passed few weeks we have also noticed that he is filling out.  My mother says that he is starting to look like a regular kid.  But I’ve that his cheeks are becoming fuller.  We are now going to have to watch that he doesn’t put on too much weight.  He won’t want to lose those abs!

Whenever our children are taking meds like this, especially if long term, we have to watch to see how their bodies and moods react.  It is not enough to say “Okay, got them on their meds, now I can relax.”  It doesn’t work that way.  As their bodies adjust, changes may have to be made.  One here or one there can cause wild changes in moods.  It can cause obesity or weight loss.  Some meds even require blood tests on a monthly basis to watch for possible liver damage.

We always have to be vigilant.

As soon as I finish this post I will be going to the YMCA to swim with my 8 year old son Max.  Once he sinks his teeth into something we have to do it constantly until he finally gets bored.  For example, on February school vacation we spent 4 hours a day at the Y playing basketball and then cooling off in the pool.  Since then he hasn’t had any interest in it.

But a couple of weeks ago he rediscovered swimming.  As a result we have been getting into the pool any afternoon he is free.  What I mean by this is that my son has many diagnoses such as bipolar disorder, adhd, aspergers, and odd.  Several days a week someone works with him on his issues:

• Mondays he works with a counselor and other kids to learn how to interact in social groups.  Many children who have one or more of Max’s diagnoses, like him, have problems being with others their own age.  They get together to find out how get through them.  We have time to swim after the class is over.

• Tuesdays we swim.

• Every Wednesday he has a half day from school so in the early afternoon he works with a play therapist.  Later on he goes to a science/dramatics class with other kids like him.  It gets out late so there is no time to swim.

• Thursdays after school he meets with his child advocate.  After it is done we can swim for awhile.

• There is no swimming on Fridays.  He spends the afternoon with his mentor and they get done late.

As you can see this allows us 3 days.  When he is in the pool he divides his time between playing and doing laps.  He can swim the length of the pool round trip over a dozen times.  Before and afterwards he is an octopus climbing all over me.  Or perhaps “jellyfish” is a better description.  It can get annoying at times.

In the long run it doesn’t bother me.  We will keep going until this obsession wears off and he goes after something else.  And you know what?  I will keep enjoying it until the time comes because if it wasn’t for my boy I wouldn’t get any exercise.  You see, I’ve never liked to do any physical stuff.  This isn’t because I’m lazy, though I might be a little.  It is because I have multiple sclerosis; I always found it an effort to do the physical things required to keep me healthy.

That’s not to say I don’t do anything.  I found early on that if I skipped all exercise that I very quickly get to the point that I have difficulty walking.  I have also gone through periods when I cannot use my hands.  This happens when I have been ignoring what I should be doing.  So I generally make it a point to at least to walk as much as possible.

This is where Max comes in.  He has a lot of anxiety so he doesn’t like to do things alone.  He has difficulty making friends so Daddy is generally his playmate.    I have to force myself to do the things that he likes so much like biking, running, hiking, mountain climbing, and anything else that requires a lot of energy.  I cannot just stand around and watch; to be with him I have to do all of these things too.

Just like anyone else the more I keep moving, the easier it gets.  It has made me realize that what I have been doing happens to a lot of other people with MS and perhaps other diseases and disorders.  We make excuses to justify not doing what we need to.  I’m not suggesting everyone does it but certainly I’ve been doing it around exercise.

Much as I enjoy doing the cerebral stuff, like writing, physical work is fun and I have to keep doing it.  My wife is always after me for just sitting in my chair all day researching and typing.  Thankfully Max comes home from school and drags me out the door to get some fresh air.  Because of him my arms and legs are solid and my exacerbations have diminished.  Not only that I’m getting my daily dose of Vitamin D from the sun!

Though I don’t like the fact that Max has to deal with all of his disorders the upside is that we both keep physically active and are healthier because of it.

I know several people with Multiple Sclerosis that will read this and say that it is alright for me but they cannot do it for this reason, or that one, or something else.  But my answer to this is, don’t give up!  In my PCA work I have a couple of clients with MS.  Neither one can do the things that Max and I do but both have physical therapists that help them keep their muscles toned and strengthened as much as possible.  At the same time it keeps them in good spirits.  How well I know how depressing it can be when I’m not moving at all.

The bottom line is, don’t let excuses get in the way.  Don’t give up and keep moving!

My 8 year old son Max gets a lot of services through the Department of Mental Health.  He is eligible for them because of his diagnoses.  These include bipolar disorder, adhd, pdd/nos, odd, ocd, high anxiety, and sensory integration issues.  Because we have been receiving all of these services we have been trying for months to get a meeting together to make sure that everyone is working towards the same goal.   That is, improving my son’s standard of living.

I just came from that meeting and it was interesting to say the least.  Before it happened we insisted that either my wife’s counselor, Max’s play therapist, or both be present otherwise it would be a waste of time for us.  When we arrived this morning both surprisingly were there especially since it didn’t look like their schedules would match.   Also there besides us 4 were our family therapist, Max’s mentor, their supervisor, and the caseworker who was leading the meeting.

Before we started the caseworker had to make the point that he didn’t know that the play therapist was going to be there.  Apparently it was going to change the dynamics of the whole meeting, whatever that meant.   The supervisor piped in that we were there to discuss why we were dissatisfied with their services.  My wife and I looked at each other in shock; we never said we didn’t like the services, we just wanted to make sure everyone had the same goals.  To that end we had wanted the play therapist involved since she works with Max directly.

Once we got this straightened out we could then start the meeting.  The play therapist talked about how Max has a major problem with limits and the word “No”; either can set him into a tirade that can be physical and/or verbal.  She says that when this happens she sees a totally different boy than the one she is used to dealing with.  When she starting working with him in October she thought that his parents were too lenient but she finds that today in August they are stronger and more consistent.  When he explodes he must spend time on the couch until he calms down.  If he gets violent Dad will hold him until he settles down.  She sees a lot of improvement.  She has been working with him on accepting boundaries.

The family therapist talked about how she originally had intended to work with the whole family but Max wanted all the attention on himself.  It made it very difficult, so at his parents’ request she started working directly with them to help them learn to communicate with each other and become more supportive.  She believes that there has been improvement.

Max’s mentor says she goes with the flow.  They do things that he likes to do such as basketball, bike riding, or swimming.  In the process she has been working with him to accept “No” as an answer.  She will say “no” to minor things; he will grumble and may ask a second time but that’s it.

My wife’s counselor talked about how she is worried about Max’s parents.  She would not only like to see them communicate more but they also need some rest; raising Max is exhausting.  Our caseworker jumped in at this point and thanked her for bringing him to the subject he most wanted to discuss.  This is “respite”.

For months we have been talking about getting rest for Mom and Dad on the weekends so we will be more able to take care of Max during the week.   It would also help our own relationship; as the therapist said we could start dating again.   This was a timely subject since my wife and I were actually falling asleep in the meeting.

Respite is kind of a sore subject.  It was first brought up in January when our caseworker mentioned a children’s home that has kids living there permanently.  On weekends it is available for families to drop their own kids off to give everyone a chance to relax.  It is a structured environment with programs that are not only fun but teach the children how to manage their behaviors.

My wife was excited; I told the caseworker at the time I didn’t like it but I would do it for her sake.  I didn’t want to be separated from Max; I felt that we should be doing things together on weekends, if not as a family, at least as father and son.  That’s the way it was when I was growing up.  He took that to mean I wouldn’t do it at all so the idea got shelved.  It came back up in May so we went for a tour of the facility.  It had a lot of things Max loves like a weight room, basketball court, and a bike track with bicycles.

When we first mentioned it to him Max was excited especially when we took him just to see it.  What made it better for him was that one of his friends lives there so he would have someone to play with.  He was all set to stay overnight but we decided that a few hours the first time might be better to ease him in to it.

He stayed 4 hours the first time but he wasn’t too thrilled with it.   When we arrived a counselor promised him bike riding but then couldn’t find a key to the bike shed.  He agreed to a second try the next week.  That day it was raining so he ended up spending 6 hours in front of a TV set; Max doesn’t like watching for more than 10 minutes at a time.  He was very quiet and subdued when he got home and very clingy.  We scheduled 1 more trip but cancelled at the last minute when Max refused to go.   This was in June and we haven’t tried since.

So the subject came up again today at the meeting.  They insisted forcefully that we try it again.  We insisted just as forcefully that we would not drag him kicking and screaming to the place.  We have gone through this before and yes, as they pointed out, it works out sometimes.  Going to his school was initially a disaster but he grew to love it.  But you know what, his first trip to the hospital was not pretty.  He didn’t get used to it and this is where his anxiety levels initially skyrocketed.  The home gave me a little bit of the same feeling; I can only guess how he felt.

Anyway, we’ve decided to try it again.  We are going to schedule an overnight this Friday night.  This time we won’t drive him; Friday afternoons he spends with his mentor so she will get him ready to go while they are on their outing.   The family therapist will meet them and drive him there.  She will stay for an hour or so to make sure he settles in.  On Saturday his mentor will visit him and see how things are going.  At the end of the day we’ll pick him up.

My wife and I have a lot of concerns but we are willing to try it; not only for ourselves but for Max as well.  The caseworker has promised to call the home to voice our concerns.  That is, that my son is not getting what he needs. If they are going to watch television all day let him do arts and crafts at the same time, this will settle him.   Take him to the gym, he needs muscle work to relax.  If it a sunny day take him outside, he needs the sun!

With that everyone at the meeting was satisfied that everything was accomplished.  It was adjourned and we all left for home.  But as I write this my concerns about respite are resurfacing.  I’m not coming up with reasons not to do it as the caseworker suggested.  I want this to work for both Max and my wife.  And no I don’t believe that Max will not be affected by this as he also suggested.  Today is Wednesday, Friday is the big day, I will take a wait and see attitude.   If it doesn’t work out I’ll be looking for something else.  If it does it will be great for all of us.

Nervousness, shyness, social anxiety, or whatever you call this fear, people want to get over it.  Is there a drug that can stop it?  Well there are a lot of those things that can do that in the short run…at the expense of your health perhaps.  But you don’t want to stop nervousness; it is there for a reason.  It is related to our built in “fight or flight” mechanism.  It makes you aware of a potential danger and gives you an opportunity to think of a course of action.  In essence, you want to manage your nervousness.

I speak from a lot of experience here.  Up until I was about 7 years old nothing bothered me.  Being alone in a dark room was okay.  When I met people I could have easy conversations with them.  I used to see groups of kids I had never met before and I would join in their play and have a good time.

But once I hit 7 things began to change.  I remember that I noticed that a lot of kids were afraid of the dark; maybe I should be afraid.  Perhaps I was becoming afraid at that time anyway but I remember trying to will myself to fear.  Whatever the reason, I was successful.  I could never again go upstairs to my room at night or into the basement if the lights were off.

It got worse later on when I saw a movie called “The River of Blood”.  Whenever someone in the movie got into the water a bloody wave would wash across them and much like being eaten by piranha, their bones were scraped clean.  Now I couldn’t go into any room alone whether the lights were on or off.

I also lost the ability to talk to people.  I couldn’t walk up to those kids anymore and just play.  I couldn’t even go outside by myself.  And as the years progressed it got worse and worse.  I couldn’t go to the gas station or to a bank unless someone was with me.  It made it tough on my job especially since at one point I had over 30 people reporting to me.

It may seem strange to a lot of people but until I was 39 years old I needed a light on when I slept; even when I was traveling for my company.  I also found it difficult to speak in meetings.  I could handle one-on-one discussions but even they were difficult.

A couple of things changed my life.  First I went through the Sterling Men’s Weekend which is very intensive.  Once I came out of the weekend I never needed lights again.  Half the time I don’t even bother turning them on when I need to go into the basement in the middle of the night.

Oh, gas stations and banks?  Pshaw, who needs company…

I had to go a different route to be able to peak at meetings and in public.  In the mid-1970s my Dad had taken the Dale Carnegie Public Speaking course.  When he graduated he joined a group called Toastmasters.  I was amazed at the change in him.  He went from being a bookish school teacher to speaking at conferences for two and a half hours without notes.  My Mom said that if they went away on a plane trip he would disappear and she would find out later he had met everyone on the plane.

Knowing how terrified it made me to talk to people he suggested I get involved in the group.  No way!!  Just the thought of it made me break out in a cold sweat and I would shake in fear.

It took me 20 years but I finally took the Dale Carnegie course but sadly unlike my father I got nothing out of it.  This made me forget about Toastmasters altogether.  As a result I suffered for many more years in silence.  When I moved to my present home, if I was at the library at night I would hear the local toastmasters meeting.  I would shake my head and sneak by.

Then 4 years ago I read they were having an open house; so I went.  I wasn’t impressed with the guest speaker; he was jumping up and down a lot, and pretty much making a fool of himself.  But I saw something in it that could help me, so I joined.  Today, 4 years later, I have lost count of how many speeches I have made.  I am moving through the speaking levels.  I have been an officer of the club.  And I can speak in public and at meetings.

So, have I gotten rid of my nervousness, anxiety, and shyness?  No, they are still there but the important thing is they don’t rule my life anymore.  At the beginning of this post I mentioned that you want to manage your nervousness, not get rid of it.  Being anxious going into a dark room makes you aware of what is happening around you.  If you are nervous in public it makes you observe the people that are with you.

When you allow the nervousness to take over then you can either make bad choices or hide from life because your mind goes blank.  Managing these fears gives you the opportunity to think up ways to handle the things happening around you because your mind doesn’t shut off anymore.

My son Max is now 8 years old.  I have noticed him following the same pattern I did when I was his age.  My goal is to help him manage his anxiety and shyness so that he doesn’t spend the next 40 years battling them.

In a previous post I introduced my friend Rob.  He is a recovering alcoholic who a doctor discovered had bipolar disorder and had been self medicating with alcohol and drugs for years.  He started drinking at 12 years old and is now in his mid forties.

Though his new medications for his disorder had been helping him I ended that last post saying that he was back in the hospital again.  I said I didn’t know when he was coming out but when he did I hoped that he would finally be able to accomplish his goals.

He lasted in the hospital for maybe two weeks and then checked himself out.  I didn’t know you could do that when you are going through a detox program but apparently you can.

The big question is: Why did he leave early?  I thought initially it was because he was either fed up with being in all these detox centers over the years or he had done something that caused him to be kicked out.  But it turns out that neither is the case.  Apparently he has been in contact with a woman through email that he has never met.  She was originally involved with a friend of his who had moved out west.

She and the friend had broken up and Rob decided to correspond with her.  They have spoken on the phone and swapped pictures but as yet have never met.  It has been perhaps a month now and the two of them have decided to move in together.  He bought a plane ticket and will be flying out there this Wednesday.

Since he left detox he has been living with his parents in a cramped two room apartment.  When he went into the hospital he lost the place he was living in.  Last week he and I drove down to where he was living and picked up his belongings.  We then stuffed his clothes, an air conditioner, and a bike, among other things, into his parents’ place.

During the ride I planned on talking to him about his trip.  He is throwing everything away: his schooling, his sponsor, his friends, and his family for a woman he has never met.  Before I could bring up the subject though he got very angry about some very innocuous thing and I thought he was going to become violent.  I decided not to bring up the subject.

This passed Saturday I had breakfast with his dad who has been a recovering alcoholic for 37 years.  I asked him why his son hadn’t joined us.  It seems Rob was asleep on the couch when dad left.  He shook his head; Rob is drinking again.  He said that before Rob got his bike his dad had some control over what he was doing.  I’m not sure how much control he had; his son is 47 years old after all.  The drinking became more pronounced when the bike showed up.  Now he is able to get to package stores and pick up bottles whenever he wants to.  Rob doesn’t have a driver’s license.

His dad made a sad comment, “His plane leaves on Wednesday.  I can’t wait for him to be gone.  I hope he never comes back.”

Does he mean this?  I can’t speak for him but I don’t think so.  Dad has worked hard for so many years to help his son.  He even opened his apartment up to him when Rob left the hospital.  And Dad understands the disease since he has it himself.

Rob’s sister is another story.  She is very angry with him for drinking again and doesn’t want anything more to do with him.  She cannot understand why Rob is unable to stop.  Perhaps she thinks it was easy for her dad to stop so it should be just as easy for her brother.  I don’t know but I know she has written him off.

I wish him well with his new woman and whatever he does with his alcohol.  I know I’ll miss him and my 8 year old son Max will miss him too; they are buddies.