Current Med and Diagnoses Page.

I keep this one page document updated and with me at all times.  I also keep a copy in the front of the kids' 3 ring binders.  Their timelines are too detailed and long to keep printed out. I think of this as a summary.  

It's especially useful to have on hand when I need to fill out a health form for school, admittance forms for a psych hospital or residential treatment center, or new therapist or medical practitioner forms. It's also helpful to give to police officers and to child protective service workers (when we're reported for child abuse by a child who makes false allegations). I've even used it with a child's current provider as a refresher since they wouldn't have time to review my child's chart before an appointment, and that can greatly effect what they suggest/ prescribe. . 

It is amazing to me that people will usually believe information when it is in writing (doesn't seem to matter that I'm the one that wrote it!). If I verbally give the same information about my child, they often treat me like I'm overreacting, overemotional, overprotective, over controlling, have Munchhausen by Proxy...    

Another reason I like having this information in a document, is I don't have to repeat the information in front of my child, which can be a huge trigger for him/ her. 

Kitty Themom (K.) 8/8/13

Kitty Themom (K.) (birth name ___________ _________).  Born ##/##/##.  She is 18 and in 12^th grade.  Placed for adoption in Themom home with her brother, Bear (B.) on 11/06.  K. is Caucasian and Native American (_________ – not a Federally-recognized tribe and K’s father is reported to be full Native American - tribe unknown).  Adoption finalized 3/08. 

_ISD School Diagnoses (4/8/13):  (07) Emotional Disturbance; (08) Specific Learning Disability - Basic Reading skill, Written Expression, Mathematics calculation, Mathematics problem solving; (09) Other Health Impaired

Diagnoses: Neuropsych assessment (04/17/12 – The Center -Residential Treatment Facility)

Axis I:  309.81  Posttraumatic Stress Disorder, Chronic, by history

            296.80  Bipolar Disorder NOS, by history

            314.01  Attention-Deficit/Hyperactivity Disorder, Combined Type, by history

            294.9    Cognitive Disorder NOS (deficits in processing speed, working memory,

executive functioning, and visual memory) - Cerebral Dysrhythmia (TBI) – right temporal lobe. - which controls memory, hearing, understanding language (receptive language), organization, and sequencing.

            995.54  Physical Abuse of Child, Victim, by history

            995.53  Sexual Abuse of Child, Victim, by history

            995.52  Neglect of Child, Victim, by history

            307.6    Enuresis, by history, resolved

Axis II:  799.99  Diagnosis Deferred (R/O Borderline Personality Disorder - Emerging)

Axis III:             Obesity

            327.3    Circadian Rhythm Sleep Disorder / Insomnia (diagnosed 4/13)

564.0   Constipation, chronic

                        Acne

                         Esophoria – an inward deviation of the eyes, particularly when tired

                           (diagnosed 5/12)

Axis IV:   Problems with primary support group

               Social Environment

               Educational

Axis V:  GAF = 35-40 (4/17/12)

Mental Status Examination:  Mood: Stable | Thought Processes: Goal Directed   

                                                 Judgment: Significantly Impaired | Insight: Poor

K’s Emotional/ Social Developmental Age: approximately 6-10 years. 

   Previous diagnosis: 313.89 Reactive Attachment Disorder of Infancy or Early Childhood –                                                 not completely resolved.

11/16/2011 Neuropsych - ____ Center: 

Full Scale IQ -                                   ##       (4^th %ile – Well Below Average),

Verbal Comprehension –             ##    (19^th %ile – Below Average)

Perceptual Reasoning –                  ##      (25 %ile – Average)

Working Memory –                        ##       (3^rd %ile – Well Below Average)

Processing Speed –                      ##      (1^st %ile – Lower Extreme Range) 

7/26/12 Tested for Central Auditory Processing Disorder -scored within normal limits (better than 2 standard deviations below average for an adult - anyone >12 years of age) on 9 of the 11 MAPA subtests administered. She scored below (worse than) -2 SD on the Tap Test and SINCA (right ear) tests.  She is considered at risk for CAPD, but does not have it.  - All information must be presented shortly, simply and concretely in a calm, quiet, environment for Kitty to have maximum comprehension.  Kitty’s ability to handle stressful situations is low, particularly when aggravated by loud, chaotic environment, and she shuts down when overwhelmed. 

Current Psychotropic Meds:  T_____ 1800mg (mood stabilizer), S_____ XR 400mg (atypical antipsychotic), W____ XL 300mg, L____ 250 mg (mood stabilizer), I____ 4mg (regulator for ADHD), A____ 10mg (PRN sleep med), L____ 10mg (allergies).

---Page 2--- {I don't always include this page}

8/20/09 – 9/5/09  Neuropsych results from M RTC:  

P300 is absent.  (Means she has ADHD).

Cerebral dysrhythmia (brain damage/injury) in right temporal lobe.  {Temporal lobe controls your: Memory, Hearing, Organization and sequencing, Understanding language (receptive language).

Temporal lobe disorders: Exaggeration of emotions is sometimes seen with disorders of the temporal lobes.  Deep in the temporal lobes is the “limbic system,” a primitive system involved with emotions and memory (and to some extent sexuality).  Disorders here can turn anger into rage, sadness into suicidal depression, or anxiety into panic.  Electrical disorders in this area can result in atypical psychotic symptoms, inappropriate sexual behavior, and unusual fears.  Memory problems are common.  Temporal lobe patients are prone to “bad days” when their behavior is out of character.  They are unpredictable and may become depressed or explosive without provocation.

Right hemisphere disorders:The right hemisphere is important in visual spatial reasoning, visual memory, and organizational ability and pattern perception.  In addition, the right hemisphere is involved in the non-verbal aspects of communication such as facial expression, body language, gestures, and voice inflections.  Individuals who cannot express or comprehend such non verbal signals are at a social disadvantage.  Even with normal language, their lack of non-verbal signals makes their communication dull and ineffective.  If they cannot see patterns of social relationships or communicate effectively they may seem odd and be rejected by peers, resulting in problems that peak in adolescence.  Visual processing problems can produce learning impairments which impair schoolwork in math, science, and other visually learning classes. ~From Neuropsychiatry by Dan Matthew, M.D and Larry Fisher, Ph.D.

How We Keep Our Marriage Strong!

Hubby and I have been married for almost 20 years.  I had a rough childhood (not horrible, but not easy) and knew I had some pretty big men issues when I got married.  Hubby helped me through them and so I felt he would be an amazing dad to attachment challenged kids (not that we knew that's what we were getting!) - surprisingly, it didn't work out that way. He needed a lot of help figuring out how to do therapeutic parenting and his biggest contribution (huge!) was supporting me while I struggled through it. 

I think we have a very strong marriage now because he stuck with me through the early years and now I trust him.  We do still struggle with my issues somewhat, but he's super supportive.  A couple of years ago I was diagnosed with an Adult Attachment Disorder, which really surprised me.  This is NOT the same type of attachment disorder that my children have.  

One thing that I found helped a LOT was learning each other's Love Language and speaking it!  This is a lot easier when your "love tank" is full.  Which is one reason I find this post about Finding the Joy to be so important.

Men Are From Mars, Women Are From Venus
I want to comment on the book Men are from Mars, Women are from Venus that I read early on in our relationship.  This book almost ended my marriage!  Not because it didn't have a lot of basic truths in it, but because I implemented them without communicating with Hubby.
  
A basic premise of the book is that women solve problems by talking them through with others (very true of me), and men solve problems by going in their cave, only coming out when they have a solution (right or wrong).  This perfectly described Hubby (who was slightly depressed).  So, feeling guilty for chasing him around and forcing him to talk to me about what is bothering him... I backed off and let Hubby have his time in his cave to work through his troubles.  Problem was, I forgot to tell Hubby (whose primary Love Language is Quality Time), and he thought I didn't love him anymore!!

{Early on in our marriage, I felt Hubby was suffering from depression, but he's an intensely private person and hates taking meds so he would never see a therapist or doctor.  I "tricked" him into seeing a therapist, by having him come with me to support me (I was seeing a therapist to deal with my depression and anxiety - I now know I have mild bipolar disorder.). "My" therapy sessions helped him a little, but obviously couldn't be very intense or he'd have figured it out! ;) }

***

Effects of Adoption on Our Marriage
Seven years ago, when the kids came to live with us, we didn't know anything about attachment disorders (and weren't told that the kids had RAD - or bipolar or pretty much anything else!).  The kids, especially my son, targeted me, but they hid it from Hubby, who they were afraid of (just because he's big and tends to speak firmly - he's really a teddy bear). This was a HUGE issue for me for a long time. At first, Hubby didn't see the behaviors (they were usually directed at me, the female caregiver and my kids have "Charming" RAD so were highly motivated to hide this type of behavior from everyone).

It took some not so gentle, pointing out that when Hubby didn't back me up, I felt Hubby doubted me, and that he thought I was lying and/ or overreacting. Since my Love Language is Words of Affirmation, not having his approval and support, made me feel drained. It took my therapist reminding him that I'm not a liar and that the kids often lie for him to eventually get to the point where he believed me even though he didn't really see the behaviors happening.


United Front
When Bob and Ponito were little,  occasionally one child would ask me for something, I'd say, "No," and then the child would go to Hubby and ask the same question, hoping for a different answer. We discovered early on that we had to be a united front. If we thought the other parent might not approve then the child was told that no decision would be made until the parents had a chance to talk about it.

All the kids quickly learned we were a united front (even if we disagreed behind closed doors). They also discovered that Hubby and I talked about EVERYthing, and the attempts to triangulate pretty much disappeared.

Generally, Hubby and I agree on a lot of things. Probably the biggest area of dissonance for us is discipline.


Therapeutic Parenting
When Hubby did finally see the kids' behaviors, he wanted to parent the way you would a neurotypical child, which doesn't work with our kids. I tried to show him the research I'd done and the suggestions/ guidelines I'd learned from it, but I think part of the problem was that he realized how structured our lives would have to become and he did NOT want the "warden" role. So he fought me on it, and maybe subconsciously tried to stay in denial.{Structure and Caring Support}

We have had some marriage counseling in recent years, but it tends to be more focused on helping us understand the kids better so we can be on the same page (we don't always agree on what is a child's disability, and therefore out of the child's control, and what is manipulation - I tend to see manipulation in Bear and he tends to see it in Kitty).

Hubby has never done all the reading I have and doesn't have time to attend seminars, but he's willing to listen to me talk about what I'm learning, and he did watch a couple of videos with me.

I've found that if I do a quick summary, hitting the highlights of interesting things I've read recently it works better than handing him something to read or "teaching" him what I've learned as though it's part of a class/ lecture. Usually, I mention things in relation to our kids, for example. Bear did __________ today, and I so wanted to do [typical parenting consequence - grounding, time out, take away something he values...], but based on what I learned about therapeutic parenting from ________, it was suggested that we [therapeutic parenting consequence - add more structure, time in, use these calming techniques until he gets out of fight/ flight/ freeze and gets regulated....].

Hubby usually attends some of the local support group meetings too, although it is definitely not his favorite thing to do. I love that he is willing to do this for me because it is for me that he's doing it, not the kids. Maybe that should bother me, but I'm just happy he cares about our marriage enough to be a part of this.

Daddy Discipline
I finally decided to step back and let Hubby handle discipline for Bear. I hid in the bedroom or bathroom a lot and said things like, "Your dad and I will talk about that when he gets home."

Hubby didn't do things the way I would have, and I couldn't get myself to step back completely, but it helped me to realize that even though Bear's life didn't look like I wanted for him, it wasn't because we didn't do something right or we did something wrong. I reread this post every time I start to feel guilty - You Have Not Failed!

The Biggest Things That Keep Our Marriage Strong:

1. RESPECT - we both respect each other and make it a priority not to hurt each other.  Hubby tells the kids they need to respect me because I'm his wife and he enforces it! Every time I hear someone
2. Speaking each other's Love Language!!! This is HUGE! It means even more to me that he tries to speak my language even though it's different from his own, and he was willing to
3. Making US a priority.  We schedule date nights and time alone!  Remember that the kids won't live at home forever.    Eventually (hopefully) the kids will move out and it will be just the two of us for as long as we live.
4. Support each other.  We step in and give each other breaks (tag team!), and try to prioritize and ensure the other gets self-care. I hate not having Hubby home, but I encourage him to go to the gym twice a week because he needs the break.
5. Don't depend on each other to get your needs met.  I know that I need a lot of support and validation, especially when I'm stressed.  I try to get a lot of that from multiple sources (including the internet and blogging), so the burden isn't entirely on my husband.
6. Self-Care! Making sure my emotional reserves are full so I have enough energy for our marriage as well as the kids. 

Prioritizing Yourself, Your Marriage, Your Family as a Whole, and Your Child - In That Order!!