Have you ever watched a puppy learn an agility course? If you have, you'll know exactly what I'm feeling right now. I'm at that - "Ah ha! You want me to jump over these hurdles one after another, then run back and forth between these poles really fast, then run up this ramp and down the other side!" -moment. I'm catching on to how this plays out. I just hope I get a treat at the end somewhere.
I suppose this post might make sense if I start at the beginning. I got a call from the new PNP a few days back and she had some news that was really disheartening. She's not comfortable seeing Natasha long term as she feels like her issues are outside of the scope of what she's capable of treating. She is very concerned that while she may be bipolar, she also may have conduct disorder, oppositional defiant disorder and possibly ADHD. She mentioned that we should try to get her in to see a specialist (I thought that's what she was!) as Children's hospital in Seattle and the only thing she's comfortable trying in the meantime is a stimulant. If it helps then it must be ADHD, if Natasha is bipolar then it may send her into a manic rage and we could all die a horrible death at the hands of our twelve year old. Ok, she didn't actually say that last part but she might as well have. I know my daughter and she does NOT have ADHD, she does NOT have conduct disorder and she is NOT going to be put on a stimulant to "see what happens". Jeez. What a crock!
After this lovely conversation I called her original psychiatrist back (I will refer to him as DrJ from now on) and it was like he knew what I was thinking before I even called. He said that if she is bipolar that we definitely need to ease up on the Sertraline and he's glad the upped dose of Risperdal is helping. He has always seemed to trust my opinion and I guess I just needed to be really adamant about what I'm seeing in her. He's a genuinely great guy. I was just hoping that there would be someone out there who would see her and say "Hey, that kid's bipolar! Let me tell you what to do!" No such luck. When I talked to DrJ he said that we might try Lamactil but he really wants to get a second opinion before he diagnoses her as bipolar. I appreciate his restraint and cautious approach as long as he's willing to address it. He gave me that name and contact info. for several top specialists, a Dr. Karen Myers at the University of Washington, Dr. Kiki Chang at Stanford, Dr. Judith Rapoport at the NIMH in Maryland and a Dr. Karen Dineen Wagner in Texas. I called them all and unfortunately none of them are seeing new patients. Dr. Chang's office did say to call back in about a month to check again. *sigh* Oh well. We have another appt. with DrJ on April 9th so maybe by then he'll have more ideas. Actually, I should mention that I didn't hear back from NIMH yet so that is still an option until I hear otherwise. They have a bipolar research study going on and we would have to fly across the nation every couple months but they pay for everything. Pretty dramatic but evidently diagnosing this is very complicated and since it's rare and such a big deal, the good psychiatrists aren't going to jump to any conclusions.
I feel good though. Partly because Natasha is much easier to deal with now and is at school AGAIN.. and partly because I'm like that pup who gets the light bulb over it's head. "Ohhhh... I thought I was done after that first jump but really there's a whole course I have to do!" Tougher than I expected and it will take a lot longer but at least I know what's going on now.
I did forget to mention to DrJ during our last conversation that Natasha is gaining weight like crazy now that we've upped the Risperdal so I'm waiting for another call back from him. I've read that Abilify is less apt to cause weight gain but is crazy expensive and since we don't have health insurance (or money at the moment) I guess I should check in with the pharmacist before I even ask DrJ if we should change it. I read up on Lamactil (Lamotrigine) after he mentioned it and I think it sounds like a good place to start, although I have moments when it absolutely shocks me that I am giving stuff like this to my daughter. I don't even give my kids antibiotics! What kind of idiot am I!?! Anti-depressants, anti-psychotics, mood stabilizers?!? To a child??? Yeah. Risk and benefit weighing aside, it makes me feel physically sick to my stomach when I think of what I might be doing to her body. But I spent 7 years trying other things first so.. here we are. The hurdles keep coming and I'll just keep jumping.
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