I'm Worried

Nathan is in the middle of starting a new med that we hope will break down some of the barriers that keep him from talking.  His receptive (heard) language is rapid, faster even than his two brothers-ask him to do something and he does it.  His expressive (spoken) language varies from 2-3 words to none at all.  So we started memantine in an effort to help.

However, irritability can be a side effect.

We were also trying to wean his Risperdal.  To off, if possible.  And Risperdal helps with irritability.

He has 1-2 days a week it seems that he just wakes up and doesn't go back to sleep.

But when he woke up at 3, then 2:30am, then just didn't bother going to sleep All.  Night.  Long.  we gave up and restarted the twice a day 0.5mg risperdal

Then when he started cycling up and down with irritability we increased back to where we had been - 0.5 in the morning and 1 mg at night.  He started sleeping again.

He's getting a cold.

Yesterday he woke up at 3:30, which isn't that unusual with a cold.  So Paul got up with him and then I got up at 6:30 and started getting my other two ready while Paul went back to bed.  Nathan fell back asleep.  Sam got on the bus.  I was trying to get Isaac ready and he was dragging his feet, so I was harping a little.

Suddenly, Nathan awoke enraged and went right for Isaac.  Who, thankfully, after years of training, ran out of his way.  I am grateful for his survival skills.

I put Nathan in a chair to calm and had to restrain him (crossed arms, held from behind to avoid injuring either of us), because I want him to start learning that aggression results in a time out until calm.

He fought and fought me.  He tried to bite me, repeatedly.  He got out of the chair and got between Isaac and the door.  I couldn't find my keys and terrified Isaac couldn't either but the bus would be coming soon.  I couldn't restrain him standing up because he repeatedly kicked me and got his hands free to try to hit me behind his back.  I pounded on the door to get my husband up then did a foot sweep to get Nathan onto the floor.  I was able to use my weight to restrain him there, but he continued to fight to get in position to continue hitting me.

My husband got Isaac onto the bus and relieved me on the floor.  I was soaked with sweat as I emailed Isaac's teacher to tell her he might need more support today.  I hated disclosing what happened, but I knew the extra emotional help might be needed.

Paul later found my keys on the floor where I had thrown them in my focus to get to Nathan.

This episode was all the more concerning because this is the first time in 3 years it was that bad.

When I got home last night I found out that Paul had had to restrain him several more times to keep from getting pounded.  He had been walloped in the nose hard enough to stun him momentarily.  Two therapists at our house caught glancing blows but Paul was standing ready to intervene.

And today is better.  One episode of irritation over lunch that was soothed with some (intense) deep pressure intervention from me.  But he was able to tell me what he needed and then (with prompting) tell me when to stop.  Several minutes of standing close and following him because he seemed ready to throw/drop/break something which he has also been doing recently.  But not needing to touch.

I will only restrain him when he is truly out of control, breaking things or trying to hurt people.  We haven't had to do it for 3 years, and he hasn't been an angel for all that time.  It HAS to be big.  If he is biting himself, I urge him to ask for what he needs, but I know that he is meeting his needs, even if I don't especially like it.  I want him to find a better way than having scabs and calluses on his hands, but this is the best thing he's found to deal with strong emotions.

But he is very strong.  Much stronger than when we last had to perform these restraints on him 3 years ago.  I could not have handled him much longer if Paul had not been home.  I couldn't have gotten Isaac on the bus.  I would have had to lock myself and Isaac somewhere safe.  I am going to have to figure out what I will do in that situation, because safety must come first.

I am worried about that.  And I am worried about what happens if this continues this time - if it isn't just a med side effect?  And I am worried about what happens if it happens in another year or two when he is even bigger?

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