So, Mike went for chemo Thursday.. He broke out in a rash again after 6 days on the lowest dose of Revlimid. He wants to continue the medication anyway, and for now, that is the plan. The dexamethasone that they gave him as a component of his chemo has helped, and he has a prescription for a medrol dosepak which he will take, if necessary, next week. Yesterday morning he saw an eye surgeon who did a minor procedure on his right upper eyelid, which hopefully will take care of the stye. He goes back in 2 weeks, and if the stye in the left lower lid persists he will treat that one as well. Mike still thinks he is getting off very easy when it comes to chemo side effects. Nothing serious, and no nausea. Your continued prayers are appreciated.
So, I think I told you that we have a weekly AA meeting at the Happy Meadows clubhouse. Sometimes I go with Mike, not because I need an AA meeting, but because I am both friendly and nosy. When I came home yesterday afternoon one of the ladies who attends the meeting was there, along with her husband. They had asked to come over and ask Mike’s advice about their 10 year-old daughter, Sydney. Sydney has severe behavioral problems and they were at a loss about where to turn. Mike was just getting them some coffee when I got there.
“Here you are, Cindy,” said Mike, “skim milk and Sweet and Low.”
“Thank you”, she replied, setting the cup and saucer on the coffee table. She sat on the couch. James selected a chair across the room from her.
“This is yours, James,” said Mike, “Black coffee.”
“Thanks, Mike,” said James.
Mike sat in his chair where Jackson immediately jumped up on him. Shayna Maidel jumped up on the arm of his chair, maneuvered Jackson out of the way, and started making biscuits on his tummy. “So what is going on?” Mike asked. “How can I help you?”
They both hesitated momentarily, but James spoke up.
“It’s about our daughter, Sydney,” he said. “We’re having terrible problems with her.”
He stopped and took a sip on his coffee. Cindy sat holding her cup, trembling.
“What kind of problems?” Mike asked.
“Well,” said James, “she has always been somewhat slow in her development. She does poorly in school as far as her grades are concerned. She has trouble making friends and getting along with the other children. And for several months her temper tantrums have been wearing us out. You just never know when she is going to lose it. It can be at school, but more often when she gets home. And we are taking a chance when we go to a store or go out to eat with her. She can throw herself on the floor and start howling like a banshee, kicking and screaming, and she can throw things. You should see the looks we get. And, she is making life miserable for our son, James Junior. He is 13. He isn’t getting nearly the attention he needs from us, and he avoids coming home as much as possible. After dinner he retreats to his room and doesn’t come out unless he is hungry.”
“Have you discussed this with your pediatrician?” asked Mike.
“Yes, we have,” replied James. “She referred us to a child psychologist who met with us, examined her, and did some testing. “Dr. Simmons is her name. She said she thought she had attention deficit hyperactivity disorder, and suggested a few things for us to try. And she sent us back to Dr. Fahey for a prescription for ritalin.”
“So, did you get the prescription for her?” asked Mike.
“Yes, we did,” he replied.
“And,” Mike asked, “did the medication help?”
James paused and sighed. “Well,” he said, “In some ways it did. She did concentrate better on her school work. It had been impossible to get her to focus on her homework when she got home from school. That improved. On the other hand, she was up much of the night at times, and her behavior was sometimes more difficult to deal with. She was destructive of property, left the refrigerator door open, and left the front door open after she decided to take a walk at 2 in the morning. She let our cat out.” He glanced over at me, and I returned the stare.
“Did you call Dr. Fahey and let her know about this?” asked Mike.
“Of course,” James replied. “She tried a different medication. It was Focalin, I think.” He glanced at Cindy who nodded her head. She was on the verge of a meltdown herself. “That was no improvement at all. So, she referred us to a child psychiatrist, Dr. Jablonski.”
“I know him,” said Mike. “He is a good doctor. What did he say?”
“He called Dr. Simmons and asked about the test results. Then he sent us back to Dr. Simmons for more testing. Then we met with him again. He had stopped all medications until he could get a better fix on what was wrong.” James paused and looked at Cindy for a few seconds. “Then he said he thought Sydney was bipolar. He said this would explain her meltdowns and mood swings. He put her on some different medication.”
And?” asked Mike.
“And, she had trouble staying awake at school. And, her behavior didn’t improve noticeably.” James stood up for a minute, paced around for a few seconds, looked out the window, and then sat back down again. “We love Sydney so much, but she is wrecking our lives. I am not getting enough sleep. I have a stressful job. When I am work Cindy calls me in distress almost on a daily basis. Thank God she hasn’t started drinking again. I don’t know how much longer she can take this.”
Cindy spoke up for the first time. “James, I am not going to start drinking. I wish you would trust me.” She looked down again.
“Cindy,” Mike asked, “if you don’t mind my asking you this, when did you last drink?”
She continued to look down, hesitating, but then she replied without looking up. “It was about 3 months ago. I drank some vodka for 2 or 3 days. Before that it was probably 6 or 7 months.”
Mike looked at James. “Did you know about this?”, he asked.
“No,” he said. “I suspected it, and I asked her if she had drank, but she denied it and I let it go. I guess I should have insisted she tell me if something had happened.”
Mike looked back at Cindy. “I know Sarah is your sponsor. Does she know about this?”
“Yes,” said Cindy. “I tell her everything.” She glared at James, who met her glance briefly and looked away.
Mike continued. “Are you on any medication?” he asked.
“I get Prozac from Dr. Hayes, my gynecologist. And he gives me Xanax,” she answered.
“Xanax could become a real problem,” said Mike, “if it hasn’t become one already. I strongly suggest you see an addiction psychiatrist and get properly medicated. Do you know of Doctor Rasmussen?”
“I know several people in the program who see her,” said Cindy. “They say she is very nice. I just didn’t think my problems were that bad that I needed to see a psychiatrist.”
James made a sound that was somewhere between a groan and a snort. Cindy glared at him again. Mike continued.
“Cindy, were you drinking when you were pregnant with Sydney?” he asked in his gentlest voice. He looked directly at her, but took a couple of quick glances at James. Cindy started to cry, and nodded her head quickly a couple of times.
“I tried to stop, and I did cut back some,” she said. “I have always been afraid that Sydney’s problems are all my fault.” She sobbed uncontrollably. Then she looked at Mike. “Do you think it is possible that I have done this to her? I could never forgive myself, and I don’t think James could ever forgive me.” Now her head was moving from side to side, and James got up and sat next to her on the couch. He took her hands in his.
“Come on now Cindy,” he said. “Whatever the problem, we need to face it together.”
Mike took a bit of a deep breath, and said to them both, “While it is important to make a proper diagnosis, the reason is to prescribe the proper treatment. There is no value to assigning blame. What happened in the past is in the past. Let’s proceed one step at a time. Have you ever heard of the Marcus Autism Center? It is affiliated with Emory University.”
“Do you think Sydney might be autistic?” asked James. “I have wondered that myself. In fact, I had asked Dr. Jablonski that very question, and he didn’t have a definite yes or no.”
“I don’t know what the diagnosis is,” said Mike. “She could be autistic, bipolar, ADHD, or she might have a disorder they are calling FASD, or Fetal Alcohol Spectrum Disorders. This is something that not too many people know how to differentiate from the other things we have talked about. Or she may have some combination of disorders, including autism. The best approach would be to get an expert evaluation.”
“Would they be able to make a diagnosis of FASD at the Autism Center,? asked James. “Or do they just treat autism?”
“I think they have the expertise to make a correct diagnosis, ” said Mike. “And they have the resources to put together a plan of care that should get things moving in the right direction in your home. You are being challenged by a child who needs your help in a big way. I’m glad you came to talk to me. Help is available, and you can’t let your fear, anger, guilt, or any negativity get in your way. Blaming is out of the question. There is no place for blame in relationships.”
“Thank you,” said Cindy. She had stopped crying. She looked around the room. “You have nice cats.” By now Ladybug had joined us, and had jumped up on the couch next to her.
“We do love our cats,” said Mike. “They improve the quality of our lives. You mentioned that you have a cat.”
“Yes,” said Cindy, “we have Molly. She is very sweet, but she is afraid of Sydney right now. It breaks my heart.”
James stood up. “Come on Cindy,” he said. “We have taken up enough of the doctor’s time”
“Mike,” said Mike. “Please call me Mike.”
“Mike it is then,” James replied. He extended his hand and Mike took it in his grasp. “I will let you know how it is going with us. Thanks for your advice, and for the coffee.”
“You are more than welcome, said Mike. “I have some other ideas, but we can talk later after you have taken these first steps.”
Cindy gave Mike a hug, and she and James left. I went upstairs, relieved myself, and had some kibble. Then, it was time for a nap. After my nap, Mike and I put this blogpost together. This one is a milestone blog, the 100th since I started almost 3 years ago. It has been fun, and I am not even close to running out of things to talk about. I hope you are enjoying the time we spend together. Stay tuned for more from Happy Meadows.