Category Archives: The Captain

Status of the new order

Day one, the boys did mostly well with the lack of electronics and the increased focus on schoolwork.   They were, however, in different places, and thus didn’t have a chance to fight, and had serious one-on-one focus.  Still, neither finished their work completely.

Day two (Friday) went less well.   The Captain called me at work twice to complain about having to do “so much work”.   Frustrated, I allowed them to stop where they were at 1pm or so, and said I would work with them later.

Friday night, The Admiral took them out for a board game / card game night at the library, which apparently went well until The Captain did not win a match and thought he was being ganged up on in the game by the other kids.  He called and asked me to pick him up, an hour before the end.   He was frustrated and angry, but it didn’t last too long. 

Saturday, both boys were very good in the morning, very cooperative and positive.  We had a cousin’s birthday party to attend, and they both were rather well behaved, save for one small moment of fighting. 

When we got home, instead of rushing home to use their 1/2 hour of electronics for the week (which I had actually upped to 1 hour because they had been pretty good), they played outside for a long time with the hose, spraying each, without fighting a bit. 

When it came time for electronics, they weren’t sure what to do with their time because the time was so short.  They used the computer a bit, and shared some time watching a show on Netflix.   They didn’t whine or complain much when the time was over.

Later, we had the grandparents over unexpectedly for dinner, so we all rushed to straighten the house, and then they had a great rest of the evening.   They also watched an episode of a documentary show about birds (David Attenborough – The Life of Birds) while the grown-ups were talking.

Bedtime was easy with the assistance of the melatonin, and instead it was the older brother who kept coming out of his room with this excuse or another.   We realized that because of The Captain’s fiery tantrums and overall stress inducement, we often overlook the mild bad behavior of his brother, because it is a welcome relief.

Sunday went almost as well.   The Captain woke up early and washed dishes and otherwise cleaned happily, without being asked to.   I can’t tell if he really did it to be nice, or if he was trying to get some measure of electronics back.   After his morning risperdone nap, he got stuck in the mindset of whining “There’s nothing to do!” etc. etc.

We managed to keep busy the rest of the day with other distractions, and more documentaries, and actually watched a movie with them in the evening.   The Captain did not want to go to bed, but did not put up much of a fight.

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New Order

The Captain has been varying in mood and irritability.  We can definitely say he is better than he was before the risperdal, but he still has his moments, and quite a few of them.

On Tuesday, we discovered that he has been blackmailing his brother for an undetermined time (a while).   Apparently he would hold any slipped swearing or other indiscretions against him, promising to tell me about it unless his brother lied to me about the fact that they were both playing with a certain neighborhood kid they weren’t supposed to be around.

Both of them lost the privilege of independence – the ability to go to the park or convenience store, etc., by themselves.  For the blackmailing portion, I said we would talk to the psychiatrist since we had an appointment the next day anyway.

The Doctor prescribed a new regimen for discipline.   No more punishments!   Really, it was just a re-wording of discipline.  He said that they have the clothes on their back and three square meals a day, and everything else is a privilege they need to work for.   Also, no video games/TV/etc. during the week – only on Saturday (not Sunday), and only if they’ve earned enough points, and even then, only for a limited time.  He suggested a half hour.

Also, he said to lock up food treats, so we got a lock for the fridge and for one cabinet door.

The Captain took this surprisingly well.  Amazingly well.  I think it must be because it was coming from a higher authority source in his mind – The Doctor.  His brother made a scowly face, but accepted it well, too.

The part about points was a little vague, so we stayed up late last night trying to determine what gets points, and how many points they are worth, and how many points are needed for the electronics privileges on Saturday.

The Doctor also recommend a two-week reward and a four-week reward if the previous time was judged to be good… I’m not sure how that fits in with the point system exactly yet.

What The Doctor doesn’t realize, because it’s never come up, or we’ve avoided bringing it up, is that these boys are oversaturated in video games and computers and movies.  Up until this point, they’ve largely been unschooled, due to the problems we’ve had with The Captain trying to implement a true curriculum.

Today, they begin with a more regimented schedule, with Spectrum workbooks for math, science, writing, vocabulary, and geography, as well as multiplication and division flash cards, and U.S. state flash cards.   We also got a game that teaches about human anatomy.   This is not the ideal curriculum – this is the cheap curriculum to get them used to structure.

For fear of them literally not having anything to do, and rebelling from the whole system out of boredom, we also got them new lego sets and some playing cards.

Last night, The Captain spent the night at Grandma’s, who has been apprised of the situation, while The Explorer stayed home.   Each will have their chores and schoolwork separately, and perhaps that will help ease them into this transition.

Meanwhile, The Doctor added guanfacine back into The Captain’s regimen, starting a 1mg for the first week, followed by 2mg the next, 3mg the next, and finally 4mg.     Thus, he is now on 3mg of risperdal + 1mg of guanfacine, and 5mg of melatonin at night.

I’m at work, but look forward to hearing how their days went.

Weekend Review

A nice long weekend.   The Captain was mostly good, handling change / transitions / disruptions (not getting his way) well for the most part.   Sunday night he got the Melatonin about an hour before actual bedtime and for the first time in weeks, he went right to sleep without any tantrum or complaint.

Aha!  We had discovered the key.   Previously, we had given him the Melatonin about 20 minutes prior to bedtime (per the bottle’s instruction).   Perhaps he needed to be really tired before it would kick in so smoothly.

We tried this method again last night, but it failed.   It may have worked though, if he hadn’t received a call from Grandma last night, and wanted to spend the night at their house.  His tantrum last night was over not being able to go.   He blamed his brother because his brother didn’t want to go.

This morning, he woke up early again, before 5am, and quietly had breakfast, took a shower, and started being helpful, cleaning.  He’s a different person in the morning.

The Week in Review

Monday, May 24th – The Admiral said that The Captain had some issues today, mostly arguments over commands and transitions.  I witnessed a bit of the same when I got home.   The melatonin again knocked him out at bedtime.

Tuesday, May 25th – Again, still argumentative over things during the day.  Both boys skipped homeschool group.  The Captain knew he would not be able to handle himself there, and The Explorer feigned sickness to avoid it.   When I got home from work, The Captain was obviously heading into a mood, so we gave him an extra .5 mg of Risperdal.  The boys had avoided their chores, so I made them do them when I got home.   The Captain found new energy and mowed the back lawn and weedwacked in addition to normal chores.   Quiet time was good until it switched to Bed time, where The Captain threw a fit about going into his room (there’s nothing to do!) and kept coming out of his room, until eventually, the melatonin kicked in.

Wednesday, May 26th – The Captain woke early.  Had a semi-good day, with oppositional behavior to parental requests.   Met with his therapist, which went “Fine.”  Bedtime woes again, until he passed out.

Thursday, May 27th – Day behavior about the same.   Early wake ups all week.  Appointment with The Doctor in the evening.   Two developments… One:  he noted that aggression was gone, but oppositional behavior still existed.  He upped the dose from 2mg to 3mg.   Two:  he discussed apologizing to his brother, which I’ll cover in a separate post.

Friday, May 28th – Woke early again, in a good mood.  I am hopeful.

The Emergency Room Visit

A few weeks later, we still did not see improvements, and The Captain had a Very Bad Day.  He got into an argument with his brother and hit him in the back with a large piece of wood from the deck.  Afterward, he was uncontrollable as he banged his head into the floor and the wall and destroyed anything he could reach.  Our stress level was as high as it had ever been.

The Doctor had said in the event of him attempting to harm himself or others, we should go directly to the emergency room or call 911.   So, we did.

We managed to get him to the car with no issue.  He screamed and cried along the way but did not actually resist.  His crying fell to a whisper by the time we reached the hospital.

While in the waiting room, The Captain chewed his hospital wristband off.   After a short wait, we were brought in and he had his vitals checked.  We were escorted to a far away hallway in the emergency section with several rooms that had nothing in them but the hospital bed.  No sharp corners.

They handed us a gown and said he needed to change into it.  He did not like this at all and screamed and cried over it for quite a while before we were able to convince him that it was better if he undressed himself than if someone had to do it for him.

He lay on the hospital bed while The Admiral and I stood beside him, waiting.   The Explorer was left at home and we checked in about once an hour.

Overall, we were there for about 4 hours, with intermittent visits from nurses or doctors doing routine things like registration and blood/urine tests.   In the end, The Captain fell asleep in the bed, and we decided to leave.

The day after, we met with the therapist and psychiatrist.   He doubled his dosage of the guanfacine from 1mg to 2mg, actually giving him a meltaway 2mg in the office.  He had us wait there for 20-30 minutes to see how it would affect him.

He was remarkably more playful and less impatient in the waiting area, and this impressed the doctor.   He said we could dose him additionally as needed in .5 mg increments, 40 minutes apart.  We’ve done this once or twice since then and it may or may not have been effective.

Since then, he has seemed better during the day, though still very irritable, but bedtime is still a recurring problem.

The New Doctor

After leaving the in-patient program, we had an introductory session with his new local therapist, followed by an appointment with the new psychiatrist the next day.  The new diagnosis left off the anxiety disorder bit and focused more on the moods and the pervasive development disorder, thus his current diagnosis is ADHD, bipolar, and high-functioning autism.

The Doctor reviewed what the hospital had prescribed (prozac, focaline, guanfacine, and desmopressin) and could not believe it.  Apparently some of these medications could interact with each other in dangerous ways, and some would not show improvement for a month.   He took him off everything, and switched him to just use Abilify.

Within days, he was back to “normal” and the chaos had returned.   At one point, he actually asked for his old medicine back.  The Doctor had said we should start low and move up, though, and that the mood and autism needed to be treated before the ADHD.

The In-Patient Program

The Captain’s hormones finally kicked in full force this spring, when his days and nights became a constant struggle, and his rages became completely uncontrollable.   Up until then, we had been able to “handle” him.  He has been homeschooled/unschooled and unmedicated since second grade.

The current state of the home is unbelievable.    We could no longer let his older brother, The Explorer, share a room with him, because all of The Explorer’s possessions would become destroyed just like The Captain’s.   We moved The Explorer and his stuff into our bedroom, and The Admiral and I out into the living room.   That’s right, we now sleep in the living room.   We are working on renovations to the rest of the house to allow us to be in another space, but until then, we are at the mercy of the living room and its lack of privacy.

Still, his behavior persisted and his rages over any little thing escalated, and his violence towards his brother exploded.   He punched, hit, and slammed The Explorer’s head into a desk.   We were at our wit’s end.

Finally, we made an appointment and took him to a local (but not close by) hospital’s adolescent behavior wing.  Security guards nearly had to drag him in.  After some hours of waiting and little feedback, we had to wait a few days until they decided to accept him into the in-patient program.

For three weeks, he spent his days at the in-patient day program and his nights at home.     He never displayed his rages or aggressive behavior while at the hospital, but based on our reports, the psychiatrist still diagnosed him as having a mood disorder, though he would not specify.   In the end, he was diagnosed as having ADHD, a mood disorder, an anxiety disorder, and pervasive development disorder.

Immediately, they started him on Prozac (for the anxiety) along with Desmopressin (for his enuresis).   His hyperactivity was still in high gear, and perhaps worsened, so they added Focaline to the mix.  Doses were changed, timings of medications were changed, but nothing seemed to help.   Nights at home were better some nights but chaotic on others.

In the last week, they added Tenex (guanfacine) to the mix, and at last, this seemed to normalize him.   He was able to attend homeschool group without throwing tantrums or attacking other kids.  He was able to focus and seemed genuinely happy.  He also learned a few “coping techniques” that he talked about (mostly things to do with his hands when fidgety).  He even stopped wetting the bed some nights (but not every night).

He was good enough to come home, they decided, and we were to meet with a new, local psychiatrist and therapist duo in a few weeks.