Tuesday, March 4, 2014

Just because you got the monkey off your back...

"Just cause you got the monkey off your back doesn't mean the circus has left town." ~ George Carlin

For the first two and a half days after he got home from crisis stabilization, Parrish didn't appear to have any thoughts at all. For two days, nothing. He had no energy. There was very little conversation and a whole lot of sitting and staring and absentmindedly stroking Honey’s back. I prepared his favorite home dishes but he wasn’t hungry. There was an eerie sense of inertia about him, an almost palpable ennui. There were no tears and no smiles. Maybe he was so overwhelmed by racing thoughts that he couldn’t do anything but sit and listen to them spin in his head, but if he was, there was no external manifestation of it. His heels were quiet on the floor, his hands relaxed in his lap. His speech gradually cleared and was almost normal by Thursday morning.

He woke up on Thursday in a state of muted mania, if there is such a thing. He was anxious about is first visit with his new psychiatrist. It was as though there were a monkey inside his brain that could jump out at any minute and start chattering and climbing trees and throwing up crazy all over the place.

We arrived fifteen minutes early for the appointment, The Doctor’s first of the day. The morning sun was hot on our backs as we waited on the sofa under the window of the tiny reception area. An inane radio program, just loud enough to interfere with quite conversation, emanated from a speaker under the end table. We both tried to read but it was impossible, so we sat with our hands in our laps and tried to tune it out.

We had been sitting in the waiting room with the radio piping blather into our brains for thirty-five minutes before The Doctor finally breezed into the office. A slender woman with a mass of blonde curls furled out behind her and a backpack slung over her shoulder, she looked to be about Parrish’s age. She disappeared behind a door and within thirty seconds, called P back into her office. I sat in the too hot and too loud waiting room and tried my book again, but there was not hope of escaping into it.

I addition to the nitwittery pouring from the radio, I could hear but not understand the voices from The Doctor’s office. Her door must have been open, and it occurred to me that the prattle pouring from the speaker was a sort of buffer. Why the hell couldn’t she just close her fucking door?

After twenty-five minutes, P was back in the waiting room, prescriptions in hand. The Doctor added Adderall and Restoril to the long list of things he is already taking. Yes, she prescribed an amphetamine to take every morning and a sleeping pill to take every night.

P started campaigning for medicine for his ADHD a couple of days before the appointment, reminding me about a dozen times that Ritalin got him through college. He said he needed something to control his racing thoughts, something to help him focus and stay on task. What tasks? He spent most of the first two days in bed, and when he did talk to me, he was focused only on the past, mainly the difficulties and not the good times. I tried unsuccessfully to bring him into the present, center him in the moment, but he continued to drift backward in time. He could not concentrate on a book. His television sat mute and dark. This man who loves music as much as I do wasn’t even interested in learning how to create a playlist on his iPad.

On the way home we dropped the prescriptions at CVS and went across the street to Starbucks for a coffee. For the first time since I picked him up at Gateway on Monday, P was animated, chatty but not loud, excited but controlled. I had been denying him caffeine at home, thinking that after being off of it for four weeks, there was no need for him to start back on what is, after all, another drug, but Dr. DaVanzo gave him permission to take it in moderation. 

I began to wonder about her. First, the prescription for amphetamines, then the caffeine thing. This woman saw P for less than half an hour and really knows nothing about him except what he told her. In the days leading up to their visit, he was confused about his recent history, and I am not yet convinced that he is an accurate and complete reporter of the events since January 10.

“What’s with the speed?” I thought to myself.

Parrish was in crisis stabilization for a month because of extreme mania and psychosis and is taking three antipsychotic meds. She's The Doctor, I know, but why not try weaning him off some of the downers instead of putting him on an stimulant? At her direction, P took an Adderall as soon as we got home, and within thirty minutes, he was talking and essentially did not shut his mouth until he went to bed. 

“Don’t you think I’m doing better? I used to think that if I took my medicine, all of my problems would disappear. Now I know I have to work on them. Aren’t you proud of me? I’m proud of me! Aren’t you glad The Doctor is sending me to see a therapist? I wonder what she will be like. I think this medication is what I’ve been needing all along, don’t you? I can’t tell you how happy I am to be here with you. I haven’t been happy in years. This sure beats living on the street. I am so grateful to you to putting up with me and my craziness. You will never know what I’ve been through. Daddy has our back, you know. He’s standing by for whatever we need. Isn’t it bizarre that he’s back in our lives? It feels strange to me. Don’t you think it’s strange? Don’t you think I’m doing better? I mean, really? What is the weather supposed to be like? Daddy is an expert on the weather, keeps track of it with NOAA radio. You know I can’t help being sick, don’t you? I didn’t ask to be this way! You do understand that I love you more than life, don’t you? What do you think my therapist will think when I tell her my story? I’m nervous about going to see her. You don’t blame me, do you? I’ve never been to a therapist before. I’m sure she will be shocked. I hope I like her. I hope she likes me.”

And on and on..

I exhausted myself trying to answer his questions, assuage his anxiety, assure him that his father and I both love him dearly, that we are proud of him, that there is no shame in being sick. I urged him not to question his father’s presence in his life, not to try to figure out why but instead accept it with gratitude. I turned on television and tuned to The History Channel, thinking he would get absorbed in a program. He could not concentrate and continued to make the same statements and ask the same questions repeatedly.  

I finally started playing solitaire on my iPad. He didn’t notice, and it didn’t slow down his constant stream of chatter, which continued until he took his sleeping pill and went to bed. An hour later, I was sitting with my laptop having little luck organizing my thoughts to work on a poem, and he came out of his room, fixed a bowl of cereal and came and sat in my corner of the room and started talking.

I said “good night” and went to bed.


Copyright 2014 cj Schlottman



3 comments:

Anonymous said...

Claudia, I am in agreement with your reaction to the out-pt doc's choices of meds for Parrish and am not sure of what information she based her decision!!!! I would want to call that in-pt doc if door of communication was left open, and get his opinion altho these docs often times don't want to "step on the toes" of their colleagues. Do you have any confidence in the home care professional ?nurse person? to discuss and who does that person report to for orders? I think the trial and error for finding a suitable drug regime is a difficult aspect of a chemical disorder because of the vast combinations and unknown outcomes!! As soon as Parrish can see a psychologist who I hope is suitable for his case, he should get relief as the layers of festering issues are pealed away like the relief that comes after the lancing of an enormous puss pocket!!!! I am wondering if Parrish has ever dabbled in water colors? Just slapping paints on a canvas on muddlement days and painting in the lines of a paint by number on focused days? Will close for now but will continue to keep you and Parrish close in heart and prayer day by day in loving friendship, Cecie

Judie said...

CJ, as his legal guardian, are you planning to sit down with this psychiatrist and go over Parrish's history with her? Just how medicated can one person be before his brain is totally fried?

Susan Anderson said...

I share your concern about the ritalin. It's hard to find a p-doc that doesn't overmedicate, and I don't think anyone prone to mania and psychosis should be on speed, period. I also agree with your wondering why they don't try to decrease some of the downer drugs rather than put a bandage on them with an upper. I think Judie has the right idea about talking to this new psychiatrist and giving her a full history, along with your own observations/thoughts as a nurse and mother.

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