The facility is an adolescent unit. It seems to be primarily servicing teenage girls likely with eating disorders. My son is one of a couple of boys. The patients are easily identifiable owing to their lack of shoes. Two reasons for that - to prevent fleeing and because of shoelaces (get it?).
The presence of girls is irrelevant to my son as he is quite wrapped up in his own situation. He has been hospitalized for about 5 days so far. The first 3 were more or less uneventful. He was pretty well-behaved. He sounded a little over medicated as they were feeding him a lot of Haldol. Much more than he was getting before. They decided to switch to Navane and that seemed to go OK.
During one visit my wife off-handedly indicated that my son was likely to be home by the end of the week. That appeared to give him ideas and he seemed to decide that if he really misbehaved he would get home even sooner. Of course, that logic only makes sense to him. But the net result was an 18 hour period during which he attempted to flee, attacked staff and other patients and acted out in many ways. He was restrained and put in isolation. They don't mess around there. He was given more Navane, benadryl and Adavan all in an effort to calm him.
We spoke with him and made clear that he would be there as long as needed. That we did not know when he would be released. That it was all up to him and his behavior. Maybe that helped, maybe not.
He was back to being somewhat calmer next time we visited. Now they are thinking about trying Risperdol again. I'm thinking if they want to experiment then that's the place to do it. They are also looking into non-stimulant-based ADHD drugs.
Monday, April 2, 2012
More of the Same but Different
The initial period after Haldol resulted in greatly increased engagement. My son spoke more and was more lucid. The doctor realized that Haldol was limiting in the the types of anti-depressants that might be used so she decided to taper off the Haldol and switch him to Perphenazine. His initial reaction to Perphenazine seems to be violent aggression. He was out of control, attacking others and being oppositional. Since this was his initial reaction to Haldol as well we kept going. The dosage was increased and the aggressiveness continued unabated.
After a couple of weeks, we switched back to only Haldol. In this period his school decided he was unmanageable and was building the case for placing him elsewhere. At home things were unsettled as well as he decided that attacking his mother was acceptable behavior. He would not attack me and he would not attack my wife when I was present. This meant that when I was at work I was on edge constantly fearing that my wife would be hurt or driven to the edge.
An emergency trip to the psychiatrists office led to such a high level of aggression towards my wife and the staff that the police were called. The psychiatrist suggested that my son be taken the emergency room. The police were not allowed to take him to the local hospital (about a block away) and could only transport him to the county psychiatric emergency facility.
He stayed there about 8 hours until the attending psychiatrist could see him. When the psychiatrist did see him, he was unhelpful. But he held my son overnight.
The facility was not new and had the look of a bunker from the outside. Visiting my son was allowed in a doubly-locked private area not unlike a prison visiting room. Staff were in attendance at all times. My son was scared and upset.
After an overnight stay, we were duped into taking him home. Duped because apparently if you leave the emergency room, the search for placement is halted. They wanted him out because he was needy, bored and lonely and required a full-time attendant and they were going into the week-end with a skeletal staff.
We found out about this con after we brought him home. We decided to try the weekend at home. The results were basically unchanged. He was sort of manageable but would go after my wife unprovoked. On Monday I had to work late and the evening was eventful as my wife fought off unprovoked aggression from my son. She eventually wrestled him into his room were he remained until I returned.
The evening was peaceful but tense as my wife was upset and nervous around him. Sensing this, he was on his best behavior and was sweet and helpful. This was the usual post-aggression behavior.
In the morning, he got in the bus to go to school and moments after he left a phone call from the driver indicated that my son had undone his seat belt and lunged at the driver. I told the driver to bring my son home and I took my son to the local emergency room.
We stayed there about 14 hours until a placement was found in an adolescent psychiatric unit about 50 miles from our home. The entire 14 hours was trying because my son wanted to go home, wanted to walk around, was bored and finally when the ambulance came to transport him - was afraid that he was never coming back. We were not allowed to accompany him during the transfer.
After a couple of weeks, we switched back to only Haldol. In this period his school decided he was unmanageable and was building the case for placing him elsewhere. At home things were unsettled as well as he decided that attacking his mother was acceptable behavior. He would not attack me and he would not attack my wife when I was present. This meant that when I was at work I was on edge constantly fearing that my wife would be hurt or driven to the edge.
An emergency trip to the psychiatrists office led to such a high level of aggression towards my wife and the staff that the police were called. The psychiatrist suggested that my son be taken the emergency room. The police were not allowed to take him to the local hospital (about a block away) and could only transport him to the county psychiatric emergency facility.
He stayed there about 8 hours until the attending psychiatrist could see him. When the psychiatrist did see him, he was unhelpful. But he held my son overnight.
The facility was not new and had the look of a bunker from the outside. Visiting my son was allowed in a doubly-locked private area not unlike a prison visiting room. Staff were in attendance at all times. My son was scared and upset.
After an overnight stay, we were duped into taking him home. Duped because apparently if you leave the emergency room, the search for placement is halted. They wanted him out because he was needy, bored and lonely and required a full-time attendant and they were going into the week-end with a skeletal staff.
We found out about this con after we brought him home. We decided to try the weekend at home. The results were basically unchanged. He was sort of manageable but would go after my wife unprovoked. On Monday I had to work late and the evening was eventful as my wife fought off unprovoked aggression from my son. She eventually wrestled him into his room were he remained until I returned.
The evening was peaceful but tense as my wife was upset and nervous around him. Sensing this, he was on his best behavior and was sweet and helpful. This was the usual post-aggression behavior.
In the morning, he got in the bus to go to school and moments after he left a phone call from the driver indicated that my son had undone his seat belt and lunged at the driver. I told the driver to bring my son home and I took my son to the local emergency room.
We stayed there about 14 hours until a placement was found in an adolescent psychiatric unit about 50 miles from our home. The entire 14 hours was trying because my son wanted to go home, wanted to walk around, was bored and finally when the ambulance came to transport him - was afraid that he was never coming back. We were not allowed to accompany him during the transfer.
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