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.
Showing posts with label haldol. Show all posts
Showing posts with label haldol. Show all posts
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.
Wednesday, February 1, 2012
Changes, Events, Happenings
Starting the first of January, we were forced to change health insurance providers. We were moved from an open system to a closed network provider. This meant that we had to change doctors. This also meant my son had to change doctors. It took a few weeks to get "plugged in" to the new network so we continued with the Remeron (45mg) and I arbitrarily decided to tail off the Neurotin (as many as 3 x 600mg). Neither drug appeared to to much but make my son sleepy. The Remeron alone accomplished that. So much of the month was spent listening to my son perseverate. Nothing much else happened. He didn't get better and he didn't get worse. When he finally found himself asleep, I felt respite as well as he did (I assume) for he finally stopped repeating the oft-said phrases. Usually, the moment he awoke, it all started again. Sometimes, I overheard him muttering as he drifted off to sleep.
Last week, we met with the new psychiatrist. After hearing our story and even seeing my son in action (he attacked my wife and then me during the appointment), she decided to try Haldol. She too believes in the go low and slow approach. He started at 1mg once a day while keeping the Remeron as is and adding Cogentin because of reaction he had to Abilify.
Haldol, being an old anti-psychotic, fell out of favor because it could compromise liver function. It is still used but usually teamed with occasional blood tests. So it is with us.
After the first day on Haldol, my son came home from school quiet and agitated. He marched into his room and had a tantrum. His babysitter called me in a panic. I told her to lock him in his room and let him work it out. I called the psychiatrist fearful that he was having a reaction to the Haldol similar to what we had seen before with other drugs. The psychiatrist called the babysitter and got more detail and decided it may just been an unrelated mood thing.
So we kept on. We started to see slight differences. He began to speak to us more. He began to ask if he was sick. He started to ask some the same old questions of a few months ago. ("Am I going to die?", "Will I have a heart attack?") and some new ones ("Where has Oprah gone?", "I used to ride my bike a lot, didn't I?").
After about 4 days at 1mg, the doctor got back to us to see how things were going and because there was some change, she suggested going to 2 mg. We have seen my son pick up the phone and talk to people (something he has not done for several months). We have seen him try to color a little. He still perseverates. He is still anxious and depressed. He still has some OCD-like behaviors but he is more communicative.
We'll have to see where this goes...
Last week, we met with the new psychiatrist. After hearing our story and even seeing my son in action (he attacked my wife and then me during the appointment), she decided to try Haldol. She too believes in the go low and slow approach. He started at 1mg once a day while keeping the Remeron as is and adding Cogentin because of reaction he had to Abilify.
Haldol, being an old anti-psychotic, fell out of favor because it could compromise liver function. It is still used but usually teamed with occasional blood tests. So it is with us.
After the first day on Haldol, my son came home from school quiet and agitated. He marched into his room and had a tantrum. His babysitter called me in a panic. I told her to lock him in his room and let him work it out. I called the psychiatrist fearful that he was having a reaction to the Haldol similar to what we had seen before with other drugs. The psychiatrist called the babysitter and got more detail and decided it may just been an unrelated mood thing.
So we kept on. We started to see slight differences. He began to speak to us more. He began to ask if he was sick. He started to ask some the same old questions of a few months ago. ("Am I going to die?", "Will I have a heart attack?") and some new ones ("Where has Oprah gone?", "I used to ride my bike a lot, didn't I?").
After about 4 days at 1mg, the doctor got back to us to see how things were going and because there was some change, she suggested going to 2 mg. We have seen my son pick up the phone and talk to people (something he has not done for several months). We have seen him try to color a little. He still perseverates. He is still anxious and depressed. He still has some OCD-like behaviors but he is more communicative.
We'll have to see where this goes...
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