Friday, April 15, 2016

And then there were two

I've been trying to write this for two weeks. I've written the main part of it in my head dozens of times, but when it came to actually putting down the words I've been unable to. I need to get it out, and I need it to be seen but I haven't been able to get it started. I mean, how do you start a post about having to commit your eldest son to residential behavioral care 1,2000 miles away for an undetermined period of time?

Oh. Like that, I suppose.

It's no secret that D has been struggling this year. It's not something unexpected, either; take the suckiness of 6th grade plus the start of puberty plus a crap-ton of acronyms (ASD, SPD, GAD, ODD, OPP, SOS, ETC) and I had expected this to be a tough year in some aspects. But there were a lot of good things about this year to help soften the blow; being in class with his best friend for the third year in a row, having a great para that he already knew and had worked with, familiar faces in class, and all around the school. He had been seeing the same therapist for about a year at that point, as well as a psychiatrist, therapy was going well-ish... We (the adults in his life) had high hopes for this year--realistic high hopes.

There were times when he met and exceeded any hopes we had for him. He was getting more comfortable in social situations, he was attending class more, his grades were good, and he seemed happy. Unfortunately, those times were outnumbered by the not-so-good times.

He had a somewhat predictable cycle of good to great to shittiest life ever to saddest kid back to shitty life then numb. And by predictable I don't mean the timing, I mean the parts of the cycle. The one thing this kid has always been consistent with is his inconsistencies.   And the cycle really wasn't anything new, the intensity was. He had always been self-injurious but this year he became more outwardly violent. He was hurting and he wanted others to hurt. There were weeks where he would spend all day in the Sensory room at school sleeping just to keep him and others safe.

Life at home wasn't much better. His meltdowns became aggressive and explosive to the point that I had to send A outside or to a neighbor's house to keep him out of the path of mayhem.  We addressed these things in therapy, had medication adjustments, worked with his case worker, we took advantage of crisis care, and respite care but they were just bandages. D was miserable. "Mom, I hate being like this. I hate being so angry and I don't know how to control it." A was miserable. "Mom, why does D have to threaten me? Does he know I love him? You can be scared of someone and love them, right?" I was miserable. The husband was miserable.

Towards the end of February after a particularly spectacular meltdown involving kicking me in the shins and cursing out his case manager, the subject of hospitalization came up. Now, he was hospitalized for a short time last April (three days after his birthday) as an acute situation. That means that he was in the hospital to diffuse the situation, and to ensure everyone was safe.  It was shitty, and it sucked, so when  his case manager Z mentioned it to me, my first thoughts were to last year's situation. And I did not like it.  But this would be a different situation, so the husband and I talked it over and I told him I would talk to D's shrink and get her thoughts on it.

I met with Dr. Awesome the next day and asked what she thought about residential hospitalization.  "I really don't know what else I can do from an outpatient standpoint."  We discussed his medication situation and that at this point the best thing to do would be to take him off all meds, clean out his system, and then start from scratch. "That is something that needs to be done away from home." Discussions were had, tears were cried, and decisions were made; He needs to be hospitalized.

My first goal was to talk to D and let him have some say in it. By that I mean the good ol' parental trick of letting him think it's his idea to go. He and I discussed it before bed and I told him that I knew he wasn't happy, and that we all want to help him, but we've run out of ways to do it here. I mentioned going to a residential center and assured him it would not be the same place he did acute care. He thought about it, and agreed.

Next step: finding a hospital. As I said, this was the end of February and I was hoping to find a 30 day program because his birthday is the middle of April, and we didn't want him to spend his 12th birthday in a hospital. Dr. Awesome put together a 131 page packet to send off to Tricare and to lots of residential hospitals. And then we waited. We got rejection letters from several places, we expanded our search and I started working with a woman whose job is to find beds for people who need help. While we waited we walked on eggshells at home. I knew it would be a temporary tiptoeing routine and to conserve what was left of my sanity, I let him get away with stuff I normally wouldn't. Nothing majorly terrible, but stuff that really wasn't worth a fight.

Once the decision was made, a huge weight seemed to be off of D's shoulders. He was looking forward to going as much as a kid can look forward to going to a behavioral hospital.  Patience was getting thin and the tunnel seemed to be closing up as more days passed without any good news.

And then it came. "D has a bed. The hospital is in Montana. His admission date is 30 March." That call came in the 24th of March.  We're really doing this. I'm sending my baby away. Holy shit, I am the worst person ever.

I knew on a cognitive level that this was the best decision, that D needed help that we just couldn't get him here, that this would end up being a good thing. Emotionally, I was a fucking wreck. When the boys were in school I would Ugly Cry for about 45 minutes straight up to three times a day. No exaggeration. If the tears I shed were pounds then I would be a skinny bitch right now.

This decision hurt. My heart hurt. My entire body hurt. I was going through my days like a zombie. I had to unenroll him from school, I had to find someone to watch A, I had to fill out pounds of paperwork, I had to comfort my son.  A knew something was going on, but we weren't sure when exactly to tell him. I had wanted to wait until closer to leaving but he overheard D and I talking about our flight. "You're going on a plane? Why? Where are you going?" I looked at D and the three of us sat on the couch. I asked him if he wanted me to tell A, or did he. D said, "No. I'll do it," and proceeded to be the most amazing kid in the world.

"Hey buddy, you know how I've been really angry lately, and being mean and trying to hurt you?"
"Yes. I don't like it."
"I know. I don't either. So I am going to a place to learn how to control my anger, and to be a better big brother."

Pay no attention to the sobbing mess of a woman on the end of the couch.  My boys hugged and snuggled and D kept whispering to A, "I love you so much," and I kept crying.

To be continued because I just can't right now.

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