Tuesday, July 20, 2010

A whirlwind day

M1 fell off his bike Sunday night. He crawled (no, actually crawled) into the house saying that his foot hurt and refused to walk on it for ages. He's prone to melodrama when it comes to wounds, so I told him if he couldn't walk on his foot, he wouldn't be allowed to go to the YMCA camp this week that he's been looking foward to all summer (that order has caused much parental guilt now). He hobbled around the rest of the evening and went to bed. He got up yesterday morning and told me that the pain was less (5/10 instead of 8/10), so I let him go to camp. He came home with a swollen foot, more pain, and a bruise coming up on the bottom of the foot. The pain was on the outer edge in a very specific spot. He was going to be devastated if I didn't send him to camp, but the mom in me had to take him to the doctor. I'd have taken him to urgent care except it's a bigger copay and he was already nervous about the x-rays.

This morning, then, I called the pediatrician's office and got told to bring him right in. The nurse practitioner who works with the pediatrician had an opening. I tossed the kids and breakfast into the car and hauled them in. X-rays were taken, and because the x-ray tech likes us, she always shows us the films once they're developed. It had been a long, long time since I'd seen an x-ray of M1's foot. When he was born, he had 12 toes - six per foot. (He also had 12 fingers but they weren't fully developed and were tied off just like the cord.) He had to have the two extra toes surgically removed because they would have hindered him developmentally and made shoes impossible to fit.

I digress.

Looking closely at two of the views, a chip fracture seemed pretty clearly visible to me, the tech, and the nurse in the room. The NP saw it as did another physician in the building. So while technically we have to wait for the official radiology report because foot fractures are notoriously hard to diagnose, we're treating it as a chip fracture.

That's the bad news. The good news is that because it's only a chip fracture and hasn't impacted any growth plates, he can walk on it as long as he's comfortable - no running - and so was able to go to camp! He took good care of his foot today, refusing to climb a rock wall or do running games. There's something to be said for the Independence of Aspergerdom. We elevated and iced it tonight, though he'll be at an away camp for the rest of the week. I worry, but I know he'll tell a counselor and have me called if it gets worse. We go back in three weeks to get it x-rayed again.

Anyway, so we left there, went back home, got his lunch and bag packed and hauled him to camp. M2 and I swung by her school and grabbed some clothes out of the uniform closet (yay free!!!) before going back home to finish off some chores and get lunch before...

We headed to her psychiatric appointment.

I like the guy. He's conservative when it comes to both diagnosing and medications. He didn't try to pressure M2 into talking but instead let her play with blocks almost the entire time and didn't react at all when she refused to look at him when he asked her to clean them up. That was good. Very good.

He said that the Intuniv that she's on right now is probably the safest med he can try since it's been studied in the short-acting form in kids as young as 3 and found to be safe (which I knew, but he didn't know I knew). It seems to make her sleepy and has cut WAY back on the tantrums at home already; the jury is still out on social situations. Anyway, he also refused to diagnose her with bipolar but said, "It's in my head..." for later. Her official diagnosis right now that he wrote down is: Generalized anxiety disorder, separation anxiety, rule out mood disorder/bipolar.

What does all that mean? Well, it means he doesn't think it's a sensory issue. She has a few but nothing major. Nothing worse than the rest of us! It means that he's not even considering bipolar medication right now, which is fine by me because of all the nasty side effects that come along with them, particularly in the weight arena. If we do decide that Intuniv isn't cutting the mustard, then he's going to try anxiety treatments first. We go back in a month, since school will be well and truly started by then and we should know how she reacts to all that. In the meantime, I'm going to see about getting M2 in with the psychologist that M1 has used in the past and who M2 knows and likes. Maybe we'll be able to get some help in dealing with the tantrums and figuring out triggers since I haven't been able to do that so far. And if we go through the anxiety treatments or her manic/depressive cycles escalate, then we can consider a mood disorder further. I have charts to fill out for mood changes over the next month to see how she's doing. I'm anal retentive enough to do it.

After all that, you'd think my day was over, right? I wish!!! I brought M2 home, and she had a blast the rest of the afternoon. She got permission to play with her gerbil in the bathtub because it can't escape. The cats kept following her into the bathroom, so I told her to shut the door. Which she did. And about that time I had a nap waylay me in the middle of a book and leave me stranded on the couch for 30 minutes. When I woke up, I realized that she hadn't come out of the bathroom at ALL during that time and that if I was going to pretend I was a good mom, I needed to find out what was going on in there.

It's never a good thing to contemplate.

She had the gerbil in the tub, as directed, and had lined the tub with Kleenex so as to collect the poop more easily when it was time to put him up. She had gotten into her drawer of "make-up" and hair clips and had pinned her hair in about six different places and decided to wear BLUE lipstick. I still maintain it was supposed to be eyeshadow, but it's fake make-up anyway, so I don't think it matters. Her lips were pretty much glowing blue. I put the gerbil back in his cage and she cleaned up the Kleenex mess, and then she wanted a dress to go with her hair and make-up, so I let her change into a dress.

Apparently just letting her have that half-hour in the bathroom caused this to be "the best day ever." When we got M1 from camp and brought him home to shower, elevate, ice, and eat pizza and salad in front of the TV with M2, she told him so. He said he'd had a great day at camp. More camp stories tomorrow while I'm pining for him since he'll be away for two nights with me basically unable to reach him. I know he won't miss me, but I'll miss him!

Guess I'll just have to keep busy. I'm sure M2 can find something for me to do.

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