Thursday, October 26, 2006

Who am I?

B's class had an open house last week (known at his school as "Curriculum Night"). In keeping with the beginning of the year topic, the exploration of "mysteries", they made silhouettes of every child's head & then asked them to compose "Who Am I?" poems to superimpose on the silhouettes. I was so blown-away by B's poem that I thought I'd post it...

It really does range from the sublime to the silly :) It really does describe my boy very well, too. I'm amazed by how well he knows himself sometimes... (His scepticism made me think of Kev's wild & wacky post today about the recent Skeptic's Circle meeting- made me wonder how soon it'll be before my kid joins in the fun...)

We had a team meeting today at school, the first this year. Everybody was able to make it (except for C, but we didn't try to catch him because he & I had brainstormed ideas & I brought the notes), & it turned out to be the first time that B's OT & Speech therapist had met each other, although they both work for the city. Our main objective was to find some ways to help B cope with overwhelming tics at school so that he can participate more in what school has to offer. C & I had decided to suggest that B have a weekly or daily schedule with the activities clearly spelled-out, as well as the alternatives when appropriate. For example, B has been exempted from Spanish class because he's taking Japanese, & because he's really bored this year due to it being essentially a repeat of what he learned in 3rd grade Spanish. (One thing we all noted was that B's tics are given free range whenever he's not fully engaged with whatever's going on in class, so this is another good reason to skip Spanish this year...) So during the time he would be in Spanish he's been doing everything from having some "down time" to catching up on things that were covered in class earlier in the day (if he wasn't able to be in the room due to tics). Sometimes his agreed-upon plan for that time has been overrulled by another teacher, who misunderstood how B was using the time, which has really frustrated him. The team really liked the idea of a schedule, since it not only makes it very clear how B's time will be spent (to everyone involved) but also can help B learn the organisational skills he'll need as he gets older. The rest of his class has been learning to use an organiser for their homework, which B isn't doing these days, so he'll get the same benefit from doing the organising in a different way. We also talked about how B can be very motivated to participate in things when he can "earn" a reward. We have been using behavioural charting with B since he gave up the binky (pacifier) when he was 3 & we know it works for him, if the parameters are very clearly spelled-out. So we suggested that perhaps such a system could be set up to encourage his remaining in the classroom as much as possible. Everyone agreed that he's ready to do it, so Cherie (B's consultant teacher) said she'd think about how to go about it. A friend of B's gets to bake something on Friday if he accomplishes his weekly goals, so maybe he can join in the baking fun (there's a full kitchen there for the students to use...!).

The other things I updated everyone on were the new way of looking at the OCD (the pokemon trainer paradigm) & that we are slowly reducing B's dosage of zoloft, in the aftermath of his inability to tolerate the target dose for the OCD symptoms. We were trying to increase the zoloft to the point where it would treat the OCD anxiety so that we could finally wean B off the seroquel. It has become clear that B does not tolerate SSRI's (& in fact, the seroquel has been one of the medicines that has counteracted their tendency to rev him up) so it's time to either see how he does on a minimal dosage or switch him to a non-SSRI anti-depressant (assuming they even work in kids). We'll see his psychiatrist next week to try & sort this all out. Interestingly, in the wake of the zoloft reduction we have been able to reduce the seroquel as well, since it was having a sedative effect due to the lower dose of zoloft. There is a part of me that would love to toss every medicine out the window entirely... but I have lived with this kid without any help from medicines & the anxiety is just too overwhelming for him. He tried to commit suicide when he was 8 years old because he couldn't face the anxiety, so we are committed to finding something that works & allows him to enjoy his life.

The other person we updated today about the meds changes & new way of imagining the OCD was B's psychologist, Dr. M. He was really interested in the pokemon training idea, & very encouraging. He quizzed me a bit when B & I explained to him about my OCD/pokemon (a Pichu). B likes to talk about my Pichu, so Dr. M asked me if the Pichu had ever helped me out... & I told him what I'd told B about it helping me to live with my very unpredictable father when I was a child. Then Dr. M asked me if I find that it helps me now, & I told him how it helps me by making me very meticulous about details. I also described how I've had to overcome (train my Pichu) some of the perfectionist tendencies, too, so they wouldn't drive me crazy. This quizzing is a technique that Dr. M has used before, which allows B to pick up information in a non-direct manner by overhearing adults chat about things. What kid doesn't like to listen-in on adult conversation? B played with his new bionicle (earned just today with the current behavioural charting system) while he listened to us. He told Dr. M all about the "neh nasai" pun & made Skitty noises for him. I added that we were trying to put a more positive & manageable spin on things because B's image of fighting a parasite in his head seemed awfully scary (& Dr. M agreed). He added that the goal is not to fight the OCD but to come to live with it as peacefully as possible (hence his quizzing me about the positive affects of having under-control OCD). We acknowledged that B still has a lot of his training journey to go, & that it's hard sometimes & discouraging. Sometimes (like after school today) B will hate the OCD/unruly Skitty, but we were able to reinforce for B that these feelings aren't forever. That as he gets older he will learn ways to feel more in control. I left them to their "training" after about 15 minutes of our appointment, & when they came out they were talking about being on the same pokemon training team :)

B told me this evening that the OCD was also a bit like having InuYasha as a companion. It's rude & unpredictable, but can do positive things. I smiled to think that B is trying to find ways not only to express what he's feeling inside & talk about it, but to internalise the positive message as much as possible. Not to minimise his strong, unhappy, bad feelings... but I think that a positive outlook is a learned thing. He is willing to learn & that's a wonderful start.


At 10:38 PM, Blogger Zilari said...

That is the coolest poem ever!!! B definitely sounds like quite the scientist.

At 12:11 AM, Anonymous Tera said...

I agree with Zilari--B's poem *is* the coolest!

I also loved this:

"B told me this evening that the OCD was also a bit like having InuYasha as a companion. It's rude & unpredictable, but can do positive things."

B's attitude is awesome. (And if he's ever having a bad OCD day, tell him I said "SIT, BOY!")

At 12:55 PM, Anonymous Anonymous said...

Lisa, did you mean to use B's real name?

At 3:27 PM, Blogger Lisa/Jedi said...

Thanks very much for catching that, Anonymous! First time real-life & blog-life have gotten blurry edges...


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