Kitty's summary letter

We still don't know if Kitty is coming home on Saturday. We're waiting for our funding source to get an extension approved. They'd asked for a summary letter with recommendations, this is what they received:


To Whom It May Concern:

This letter is review the progress of Kitty since entering The Center on 12/21/2011. The Center is a residential treatment center located in _______________. Kitty entered treatment in order to stabilize dangerous behaviors to self (suicidal statements, incidents of self harm) as well as dangerous behaviors to other (aggressive threats, physical aggression, property destruction). She entered our program in order to receive evidenced based treatments of Dialectical Behavior Therapy as well as Trauma Focused Cognitive Behavior Therapy as appropriate.

Kitty's engagement in treatment has fluctuated between initial readiness as evident by her willingness to comply and participate in treatment opportunities. She mentioned her preference for residential or inpatient treatments related to her comfort with less attachment expectations and avoidance of emotional cues (relationship attachments). After a time, she struggled with engagement related to group and community activities as her patterns of social struggles and emotional reactivity in response to interpersonal conflict increased. She has demonstrated increased stability in her behavior, willingness to engage in therapeutic activities, and ability to participate fully in individual and family therapy.

Kitty had positive responses to the skill set of Dialectical Behavior Therapy as well as the psyhoeducation and affect modulation focus on Trauma Focused Cognitive Behavior Therapy. Her developmental struggles and cognitive delays have interfered with her ability to fully apply skills at the pace of intensive residential. She has demonstrated awareness and understanding through individual focus and repetition.

Kitty has demonstrated positive responses to medication changes. She is currently being titrated on increasing doses of Lamict*l. She began 25 mg on 02/21/2012 and will increase after 7 days to 50 mg, 75 mg, and being at a full dose of 100 mg in the third week in April. She would benefit from maintaining consistent and stable environment during this time in order to note the effectiveness of Lamict*l. As related to past history of destabilization with change, we are recommending that Kitty remain in residential treatment until the third week in April. She has expressed anxiety and concern related to returning home due to changes in family structure (brother moved out) as well as changes in school and routine. Moving her from residential at this time would increase her environmental stress while she is adjusting to new medication.

Upon discharge from TC, the treatment team is recommending an intensive outpatient program to continue Kitty’s progress in the areas of skill acquisition and generalization as well as overall affect modulation. We are also recommending IOP due to Kitty’s vulnerabilities related to change and environmental stress and cues.

Kitty and her family have consistently participated in treatment and shown phenomenal commitment to overall wellness, recovery from Kitty’s abusive history, and attempts to focus on attachment and future aims. The treatment team recommends ongoing transitional support in order to maintain and translate her progress to her outpatient setting. We are recommending ongoing behavioral therapy related to Dialectical Behavior Therapy as well as continued work on social skills, transitional living skills, and Trauma Focused Cognitive Behavior Therapy.

For any further information or questions, please feel free to contact us.

Surprise! Kitty's coming home

OMG! Just got a call from the residential treatment center where Kitty is currently residing. She might be discharged this weekend! They'll let me know for sure sometime this week. We're sooo not ready! (Neither is she).

Apparently the Center hasn't been keeping our funding source (the state she's adopted from) updated on Kitty's progress (or lack thereof) despite repeated requests from our funding source. When the fiunding source exasperatedly reminded them that their contract is up at the end of this month, the Center hastily submitted a 200 page, mostly (poorly) handwritten document. The funding source can't review it in time to get the contract extended.

Of course the Center had already said Kitty wasn't progressing well (her cognitive and processing issues are hindering her ability to understand and use the treatment effectively) so they were going to send her home anyway, but we'd been told they would wait until a new medication had time to get up to therapeutic levels - which won't be for another few weeks.

The good news is it doesn't interfere with Hubby and my birthday plans. We were already planning on going to the city where the Center is located, visit her and go to family therapy on Friday, spend the night alone in a hotel(*woo hoo!*) , and then visit with her again on Saturday. If she comes home, the only thing that will change is instead of visiting on Saturday, we'll be picking her up and taking her home.

We can't really fight the Center sending her home before the med is at therapeutic levels, because unfortunately, she doesn't exhibit any behaviors at the Center (gotta love RAD and having a child who would "rather die" than let anyone see her problems), so they have no way of telling if the med is already working or not. Honestly they didn't see a need to add this second mood stabilizer, but we insisted because we knew she was going to need it when she came back home to the stress of family and school.

We're expecting a honeymoon period, and maybe we can count on that to get us through to Summer when things usually go a little smoother.

It should help that Bear is no longer living at home... for now. He recently decided to quit all his meds cold turkey and over the next 6 or 7 months as they wear off we can expect to see at least some of his symptoms return. Which is scary. He's already starting to skip school, although I'm sure he'll blame this on the suicide of his current roommate's father (Bear and friend lived with the mother, but the friend visited his father occasionally - Bear didn't go because he and the father didn't get along). Of course he can't move home if he's off his meds... not that he's likely to ask.

In the meantime we'll keep pushing our funding source to get partial day hospitalization (aka intensive outpatient) where Kitty can get therapy, psychiatric care, and school during the day (like being in residential or at a hospital), but still come home at night.

Not sure when we'll know for sure about Kitty coming home. Will keep y'all posted.

A new baby?

I don't know if y'all remember me talking about my pregnant 16yo niece. She was staying with my 21yo nephew as her legal guardian (because her uncle had attempted to molest her and her mother wouldn't make him stay away). Then her mom bribed my niece to come home (probably to regain access to my niece's SSI) by allowing the baby's daddy to live with them. Then biomom went to jail and niece moved in with boyfriend's family (8 people in a 3 bedroom home). I helped nephew get niece to move back home (told him to mention - contributing to the delinquency of a minor) ... anyway this is about the baby.

My niece ended up having complications (diabetes) and didn't take care of herself, endangering the life of the baby. He was born prematurely, but did get to come home after about a week. She apparently missed the baby's doctor appointment and spent a lot of time on FB... and the state took custody. I don't pretend to know all the legal stuff - this is all happening 4 states away.

Currently the state placed the baby with the boyfriend's grandmother. Our family (nephew and my MIL) are looking to Hubby and I to try to take custody as the only family members who are in a place to care for .

Part of me thinks God is planning this (Bear moved out a couple of months ago and his room is now empty, we're getting a substantial tax refund which means we can pay off some of our debt - balancing out the loss of Bear's subsidy, Hubby has been offered a full-time job so we'll finally have health insurance again...). Part of me is ambivalent, am I ready to take on a baby? I have been wanting to adopt again, but I was thinking of an older child.

Well I'm not holding my breath, we've been jerked around by this state before (we actually thought we would end up with custody of niece, nephew and other niece, but the mom kept getting them back). At this point I'm just going to keep cleaning up and remodeling the house and trying to get it back to where it would actually pass a homestudy. Will keep you posted.

Sisters

Did I just do something really stupid?

Kitty had her first overnight pass from residential treatment, and unfortunately her biomom was in town for the first time in 3 years (they live several states away). This time though she'd brought 2 of Kitty's half-sibs. One of which Kitty hadn't seen since she came to live with us 5.5yrs ago and the 3yr old she'd never met at all. (One of her sisters has been given to her biofather so she wasn't there.)

We knew from Bear that Biomom was on her way through town to head South to vist the youngest child's biofather. Last weekend she'd met with Bear for breakfast. He'd gone back and forth about whether or not he wanted to see her. He'd texted me when he first found out and I offered to be there for him and suggested he contact his therapist to act as an intermediary. (Three years ago at our "closure visit" with Biomom, we'd met with both kids' therapists right there the whole time). Apparently he decided against this.

Bear let me know Friday night that Biomom was on her way back through to go home, and that she was considering staying through the weekend so might be there when Kitty was home. (He also let me know that he was completely off all of his meds, but that's another blog post.)

We decided to let Kitty see the sisters. It had always been our intention to maintain sibling relationships, but it's hard what with them still living with biomom and so far away.

We didn't know that the biomom was traveling with an old family friend and her kids. This woman is part of my daughter's trauma story (She tried to bribe Kitty not to tell her step-dad that biomom was cheating. When Kitty refused to take the dollar and started throwing a fit, the woman slapped her and pulled her by her hair. When talking about this event, Kitty is always more upset over the woman's behavior than Biomom's. I'm guessing part of this is because she Biomom is "mommy" and Kitty can't handle having negative feelings about her since I see this in my own relationship with her. Sometimes "black and white thinking" works in my favor.).


Kitty was shaking like a leaf and obsessing about how "fat" she is now. I tried to reassure her, and managed to get her to do some breathing and tapping. I held her hand and talked her through it. The minute she saw her sisters she was just excited.


She didn't even recognize the family friend until her sister told her who it was. She was polite to the woman and talked to her a little bit, mostly about the woman's children - some of whom weren't there. At the end of the meeting, the woman gave us $20 as a gift for Kitty to "buy a shirt or something." Kitty's birthday is in a few weeks. When I told Kitty about the money later, she decided to save it to help pay for Senior prom (she's a sophomore). She was telling someone else about it and said the money had come from her biomom. I don't think she could hear that it came from the friend.

We spent an hour together at a McDonald's playscape- from 9pm until 10pm (not my first choice in time either, but they were just driving through and leaving immediately after to drive home). The 13yo seemed to be bored out of her mind, but luckily Kitty was clueless. She was hugging all over the sister who just stood there and tolerated it. The 3yo was totally sweet. She let Kitty cart her around some, and Kitty was totally in love. Biomom spent most of the time trying to get the little one to leave the playscape and get pictures taken.

Bear had been invited, but luckily didn't show. Biomom obviously wanted him there and said he'd been texting her all day (which couldn't have been totally true because he was with Hubby and Ponito at a soccer game for most of the day and had broken his phone earlier in the week). He had called me and asked if he was supposed to come. I told him to do whatever he wanted to do. Of course I was secretly hoping he wouldn't come, because Kitty very much did not need the added stress.

On the way back to the RTF, Kitty was bawling, and we realized how little she was able to process all this.

Feeling guilty, but at the same time I know she really needed to see her sisters, even if the timing stunk. Part of me knows the timing is never going to be great.

Gettin' R Done! aka Tom Sawyering

I've been working on trying to get the house ready for Kitty to come home from residential treatment, get Bear's room inhabitable again and make the kids' bathroom less of a biohazard. I’ve had family members come over and help. I’ve told them all I really need is for them to just keep me company while I work, but they’ve been very generous and helped too.

My mom allotted one hour a day for a few days and helped me paint Bear's room and do some serious cleaning on the bathroom. The younger kids got into some trouble, so as part of their restitution I had them work on moving Ponito's stuff into his new room, plus he’s been playing Tom Sawyer all week and gotten his friends to help.

I got in on this too and suggested that he and my nephew have some “fun” peeling the disgusting wall paper off the bathroom walls so I can paint it later. They had a blast and when they ran out of steam, my daughter and niece finished most of the rest (motivating me to do the final steps).
I’ve also paid Bob to help me clean Bear's room (actually I regret that because of the disgusting stuff she found).


Best part is that we’re winding down Spring Break and my sister had taken all week off work, so by Friday she was BORED. We'd been trying to get the kids together all week, so I asked them to come hang out at our house since I had to use the day to finish Kitty’s room (she was having her first overnight pass the next day).

My sister not only hung out with me while our kids played, but she helped me finish Kitty’s room! Then she washed a couple of loads of dishes!! (Our dishwasher is broken so this was by hand). Plus she got Bob (15yo) and her daughter (9yo) to dry the dishes and put them away!

Kitty's room looked amazing, and she loved it. We'd stripped out a lot of her stuff/junk that has accumulated since the last deep clean (her therapist recommends keeping it stripped and we find it really helps) and added some new furniture and reorganized so everything had a place.

Redesigning

Bear has always had issues with the shower. He used to take 45minutes to an hour long showers once or twice a day. Several years ago Bear had pulled off the soap dish so many times we finally couldn't get it to go back on, so we'd told him he could only take baths and needed to be careful not to get the wall wet. Let's just say he wasn't careful, and now 8 tiles have fallen off and the wall board has dissolved in many places. We'd hoped that limiting him to baths would save our water bill, but he started taking 45 minute to 2 hour baths (pretty sure he fell asleep), which doesn't sound so bad, except he left the water running full blast and the drain open during that time. Our water bill has dropped significantly since he left.

A big discount store had a 20% off everything in the store sale so the kids and I got almost everything we need to redecorate the kids' bathroom that had become Bear's bathroom, because no one would use it since it was so disgusting and always smelled (he SPITS in the house - all over the walls, all over carpets... plus the usual boy issues (bad aim), med side effects that he didn't clean up, his hoarding issues, and just lack of cleanliness). I've been trying for weeks to get someone to call me back about getting the tub wall retiled and let me know if there is water damage from where the linoleum is peeling up.

I plan to completely renovate the bathroom. No more cartoon fish wallpaper! Was planning on just painting directly on the wall paper, but in removing some of the decorative items I damaged the paper so I'm going to have to figure out what to do with the walls now. I'm thinking a white marble with grey stripes.

The kids picked a pretty teal shower curtain, soft purple rugs and an expensive dark mosaic glass toothbrush holder and matching bowl. We already had matching towels, but Kitty was using them and they have bleach marks all over them. We'll probably stick to each kid having their own towels and being responsible for them.

Kitty won't be using this bathroom because she is not capable of keeping it clean. She tends to leave dirty clothes everywhere, including used feminine hygeine products. I can't blame the other kids for refusing to share with her, so she'll continue to share our bathroom.

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My step-father is installing the doors for Ponito's new bedroom and he is a total perfectionist so they're still not done. As soon as they're done I'll paint the doors and since I'll have the paint out I'll repaint Bear's door (never actually painted it when we replaced it a few years ago because the primer looked so much like the builder's white on the rest of the doors and now it's covered in black smudges).

Hopefully that will get me in the mood to repaint a LOT of things. Still need to repaint the floor in the front room where we'd ripped out the disgusting carpet (until we can afford to get it replaced). Of course Bear's room needs to be completely repainted to cover all the spit stains, grafitti, patches, and of course the mural that he destroyed.

I've been so totally unmotivated about getting all the renovations done in the kids' rooms, but my mom decided to come over for one hour a day and we got more done in the hour she was here, then I've gotten done in weeks.

Luckily I had patched all the holes in Bear's room in the morning before she came over. So while my mom started priming near the ceilings (less likelihood of spit), I scrubbed the lower walls and furniture (*EEWWW!*). We completely primed over all the patches, graffiti and Mom's (formerly) beautiful mural. We even had time to drain most of the fish tank. It was all gross and depressing, but it went fast with someone to talk to. S

Finally got a contractor to call me back about fixing the tile in the kids' bath, but he couldn't come out to give me an estimate until Saturday morning so I went online and requested bids. I didn't want to do a lot in there until I knew what was going to happen with the wall (if we're going to have to rip out the whole wall, then I might just completely change the tile to something nicer than 4" white squares.

Decided to request bids for someone to give me an estimate to replace all the carpeting too. 5 or 6 decent size rooms and a long hall and stairs - over 1600 sq ft. It's 18 yrs old and looks it. If it's not too expensive then this is a good time to do it (while only one child is actually living upstairs - Ponito is moving upstairs as soon as the doors are done).

My mom came over and started painting Bear's bedroom while I scrubbed the bathroom, since a contractor was supposed to come over to give me a quote on the wall repair, and the room was disgusting. I had found 3 cans of white paint and didn't know which one actually matched the wall color (builder white). I left my mom to figure out if any matched, and frantically scrubbed the bathroom. She said it was one of the full cans and started painting. It wasn't until she'd left and I was doing touch up work on the wall she'd finished that I realized it didn't match!

We had to repaint the whole room anyway, but now have to paint the ceiling too. I havn't had any rollers for my roller, so we've been doing it all with a 3 inch brush. We picked up new rollers when we bought more paint so it will hopefully go a little faster.

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I guess the recession is over because so far only 2 of the 5 contractors so far have shown up out (one more is scheduled for Saturday morning).
The carpet and roof guy was here for 4 hours. He's with Sears, anyone here ever used them? The quote seemed high, but have no one to compare it to yet. They were the only one who answered my request for bids.

We're looking at carpeting about 1600sq ft and their $15,000 quote includes moving all the furniture in the room, the highest quality carpet (Hubby picked) and installation. I think we'll lose a $1000 discount because we didn't commit today (which upsets me a little because I'd told them this wouldn't be happening until we at least found out what our tax refund was going to be. I would have waited until we had that information before we requested a quote. He also quoted to replace the roof which was over $20K. *Yikes!*

The tile contractor says he's giving us a big discount for replacing the section of the bathroom wall that is damaged (we talked extensively about our kids - he's got a pregnant teen). (Dropped from $800 to 650).

The good news is he says we can just glue the linoleum back down and regrout (of course the flooring guy said it should be replaced). So I'll scrub the floor, glue it back down and regrout it and then all but the tub/shower will be reusable again.

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I found out on Wednesday that the Center wasn't going to let Kitty come home during the week on Spring Break next week (she'd miss too many therapy sessions which would violate their contract) so they told us to take her for the whole weekend THIS weekend. Uuuuummmmm.... NO!

For one thing, I have barely even touched her room to get it ready (there's still tupperware full of ranch dressing, piles of clothes from when I washed and sorted everything, some stuff we moved out of the playroom to get it ready for Ponito to move into - that needs to be disposed of since Kitty's room needs to be streamlined to avoid being overwhelming for her). Plus I've been focusing on cleaning Bear's room and the bathroom.

The grandparents are out of town this weekend, we're down to one vehicle because Hubby's car's transmission is dead, a contractor is coming, Bear has a dentist appointment AND most importantly, BIOMOM WILL BE IN TOWN! She's coming through on her way to visit the youngest sibling's biofather. She'll have the young sibling (my kids have never met because she was born after they moved in with us), and the older sibling (I think she's 14). The middle sister has apparently been living with her biodad for almost a year.

Bear is pretty stressed about it, but except for a few text messages to me, he hasn't asked for any support.

I was slightly tempted to let Kitty come home this weekend so she could see the siblings (it's been over 5 years), but... it's just too much. At some point I'm going to have to tell her about it. We told her about Bear moving out last weekend. Maybe this is the weekend to spring this on her.

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Making the drive to visit Kitty tomorrow. We'll take her off campus for a few hours, and then next weekend she'll come home on pass all weekend. I didn't get to work on her room at all today because I spent so much time with the contractors.

Didn't think about the fact that the carpet/roof guy would be looking at the ENTIRE house. I knew my house wasn't looking great, but hadn't realized how much I'd let everything slide until I was showing it to a stranger. The little piles of confiscated junk, outgrown/sorted clothing, pet hair, kid junk, paperwork, and overflowing trash cans... the worst was having to talk to him about all the biohazardous waste issues we have -spit and pet byproducts, but mostly the fact that we have overflowing toilets at least monthly. I think he almost vomited when he heard me talking about the carpeted bathroom that is soaked in waste, and Hubby suggesting we just replace it with new carpet even after I said the issue was going to continue).

The only good thing about the experience was he did admire the "bones" of the house. He was actually very complimentary of the design. Now I just have to completely clean the house from top to bottom.

Giving you the Finger... update

Bear told me that on a Thursday almost 3 weeks ago, he slammed his right hand in a car door fooling around in the school parking lot. He apparently skipped school that day. At some point (Thursday or Friday) he had a school athletic trainer "reset " his pinky finger. He also saw the school nurse. He claims he had someone reset it again at some point.





Sunday night he called me and told me he needed a doctor appointment because now it hurt. Monday morning I made an appointment and picked him up at school. He didn't need to leave for a couple of hours, but he was obviously exhausted (said he's not sleeping and he's staying up all night playing video games), and he said it hurt too much. I made him see the nurse to put ice on it.





A new doctor saw him, commented on the 18lb loss, told him to keep icing his pinky (which he refuses to do because it makes it hurt), to splint it (which he kept removing because it got in his way), and sent him for x-rays. The next day I was told over the phone that the x-rays showed a fracture and he needed to see an orthopedist. Honestly I assumed "fracture" meant crack in the bone, so when I was told the orthopedist is only in his local office on Mondays I didn't think twice about it.





Monday morning, Bear forgot. So I rescheduled for the following Monday, today. We were also supposed to get bloodwork for his medications, but he "lost" the paperwork and "forgot" he was supposed to be fasting (even though I'd reminded him). I'm wondering if he has something to hide (although they're not actually doing a drug test).





He gave ultimatums the whole time ("I'm not going to wear a cast."). Af first I tried to explain that a little inconvenience now was better than a lifetime of arthritis, pain and deformity. I finally told him to stop acting macho. It's OK to be nervous.





Bear had to have the doctor explain things to him several times, and he still didn't really get it. At one point the doctor just turned to me and explained, but I knew Bear had to hear it from the doctor, so when Bear asked a question that the doctor just answered I made it obvious to the doc that I expected him to answer. Then I explained it again after we left. I still don't think he gets it.





Bear apparently broke the entire tip of his pinky bone just above the joint, except for one tiny piece that the tendon was connected to. Because he didn't wear the splint, the tip of his finger had slid away from the joint, and both pieces had started healing so could no longer be jigsawed back together even with surgery so surgery is not an option. His finger will be permanently deformed and the joint immobile.





IF he wears the splint all the time, the bone and the piece might heal together (although not the way they're supposed to go) so his finger won't look deformed. If he doesn't... then the bone could continue to drift and eventually adhere to a different part of the joint. Luckily it's only his pinky.





On the way to school I asked Bear what lesson he learned from this. He said, "none." I asked him if he had learned a lesson, what lesson does he think it should be? He guessed, "See the doctor?" Yes, Bear, that's a good lesson to learn (it's even on the Murtaugh list).











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Murtaugh's List.





I like the show, How I met Your Mother. Recently I saw an episode about thier Murtaugh's list. Murtaugh is a character on Lethal Weapon, who is always saying, ""I'm too old for this $#*!".





So after suffering from a night of partying like they were 20 something, the 30 something year old guys wrote a list of things they were too old to do any more. Here's some of the ones I remember:

• Drinking and partying all night


• Spending the night on a friend's futon


• Getting something pierced


• Put off seeing the doctor


• Playing lazer tag


• TPing

What would you put on your list?