I learned something about me today.... I should be ashamed of myself. I am judgmental. I really didn't' think I was...but it seems I am.
Zack and I checked into the office to see Dr. M. We went and sat down in the lobby waiting area. I sat on an end seat and Zack wouldn't sit next to me.... He sat a seat away. That's one of his current hang ups....he thinks it's not "cool" or appropriate to be seen with family members. He doesn't go anywhere with us. He won't go out to eat or shopping or even to a movie in the dark. He's worried about what people will think. So he couldn't be seen sitting with his mom in a psychiatrist's office....
While we were sitting there, I read. He did nothing. A woman stepped out of the office area and I heard somebody address her as "Dr. M"...I didn't know what to expect Dr. M to be like, so it was nice to get an idea of who she was prior to meeting with her. I thought to myself how hard edged she looks. She had on leopard print shoes and a linen suit, glasses with thick frames and dark hair with a severe cut. She appeared harsh to me.....
Then I went back to my reading, telling myself... no worries if I don't like her..it's just a second opinion. I looked up as a woman was approaching Zack...she quietly addressed him and asked, "Is this your mom?" And then she shook my hand and introduced herself as "Alaina".... Oh my... she was the crabby, overtired case manager that left the sigh filled message yesterday. Only...she was very sweet. Very. Maybe she IS overworked...and had had a long day .... or like me, just doesn't do messages well. I was kicking myself for being so rash in my conclusion yesterday that she wasn't all I had hoped she'd be. Still not sure if that's the situation (my hopes are high out of desperation) but she was very nice in person, and did seem willing to help. I was glad I sucked it up and left a friendly, sunny message for her yesterday.
A few more minutes and we were called in to see Dr. M. She turned out to be very soft spoken, calm, and knowledgeable. I really like her. I admire the way she treated my son with kind understanding. She gently interviewed Zack, asked him some questions about his goals, how he feels, how Dr. K has been treating him... to which he answered "well". Regarding his goals - he "wants to get a job". He feels "fine"...and doesn't see any need for any of this - including the TAPS group. That was expected....He doesn't perceive that there is any problem, that he is any different than he used to be, or needs any help or coping skills. It was funny - last night at dinner I asked Zack what he did in the group....he told me "stupid games to teach relaxation skills". I said, "Hey! I could use some relaxation skills...tell me what you learned." And he said "Toss some Frisbees". OK... maybe I'll give that a try. Then Lucy asked Zack if he was making any friends in the group. He told us that he wouldn't want any of them for friends. Those people are "half in half out"... Lucy looked at me, suppressing a laugh, and I winked at her... keep it hush hush... He just doesn't get it. He is one of those "half in half outs".... So odd he sees it in others, but not himself.
I talked to the doctor about medication options.... she suggested that clozapine might be where we end up. She said often patients that have not responded to other anti psychotics do really well on clozapine....but then she brought up all the nasty possible side effects. Why it's usually reserved as a last ditch effort. We are staying on the Saphris for at least six weeks. She told me it usually takes six weeks to see the benefit.
I spoke with Dr. K's office after I met with Dr. M. We are adjusting the Saphris down to one 10 mg dose in the evening, versus the two daily 10 mg doses. Maybe that will help with the daytime drowsiness. Dr. M also mentioned that for now we may not be able to "fix" the positive side effects Zack is experiencing (the voices).... and she also reminded me of what I already knew...that there aren't medications available that help with the negative side effects of Schizophrenia (the apathetic attitude..and more, "the four As") Those negative symptoms MAY be relieved with clozapine. She said it's the only anti psychotic out there that has shown some improvement with these symptoms.
Dr. M also tried to get Zack to open up about his love for substances.... he said, through his hand, that he didn't really want to talk about it. She tried to impart on him the need for him to stop all substance abuse as he is taking strong meds right now and we're trying to help him. He always agrees....seems to understand... but then as soon as he can, he drugs himself up.
At the end of the conversation, she recommended a group home. Another subject Zack wasn't open to discuss. I was. I want that.... I need that. It would take so much burden off of me. I know that sounds selfish and cold....but from where I am, I see that realistically I cannot give my son the help he needs. We have tried. We supply him a place to sleep, a room to spend his day, buy him food, necessities, and cigarettes....that's all we are capable of. He is not getting better with our care. As much as I hate to admit defeat...and remembering back to how hopeful I was at Christmas, when he came home to us, it hurts to know we have reached an end. Really, not an end... a new beginning for all of us. It's time to let somebody else try and help. The group home would be local and the goal there would be to teach him to live independently. Zack was very angry and upset about the possibility of a group home.
Dr.M also told us to get going on the SSI paperwork. People usually have to apply three times before it goes through....
I am at a cross roads. Do I stay with Dr K or switch to Dr. M? I really like Dr. M. I like that she's a woman...I feel that connection with her....more "equal" with her somehow than the male doctors we've seen.
I have a high regard for Dr. K, but I often feel that he looks at me with pity...and expects me to break down any moment - fall to pieces in his office. That's not me. I don't want to be treated like I am bordering on weak...even if I have been. Maybe I'm being judgmental again in some twisty way, but I've seen him since January and I feel that every time we talk...like he's just waiting for me to have my own breakdown. Something I respect about him, though, is that he very recently shared that his daughter is also schizophrenic. She is even worse off than my son and has spent the past ten years in state mental hospitals. Hearing that broke my heart...I did cry when he told me about his daughter. I never would have guessed...but maybe that's why he assumes I'm going to come unglued....he's been where I am....desperate and on the edge. When he told me about his daughter, it pointed out to me that yes...we do all have something. Something secret dragging us down.....and you'd never know it about most people....
To Be Continued......
Acting "half in half out"...back when it was acceptable to be silly
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