Monday, July 19, 2010

She did it! Honey is completely off the poison called sertraline!

Well, it took her years to get off... but slow and steady decreases to the antidepressant sertraline (Zoloft) and Honey is done with it. She was down to just a small crumb of a daily dosage (down from 50mg/day to last dose before discontinuing at about 1mg/day (estimate).
Her last dose of "poison" was over 2 weeks ago. No zaps, dizziness, nightmares. No anxiety, sleeplessness. She seems to feel her concentration has not changed negatively, no panic attacks. It is a feeling for me like she has escaped from something horrible.
Honey is now a 19 year old woman. Busy with a part time job and being a college student. Busy with friends and spending time doing things she enjoys. She is a great friend, a super student and looks forward to the rest of her life.

Monday, July 23, 2007

Honey's July update

Thank you so much for the concern and requests for updates- I appreciate it!
Honey is doing well (or "okay"). It is hard to say at the immediate moment how she is really doing- her current boyfriend (of one year) leaves on July 31 for Navy basic- will be gone between 6 and 8 weeks, only to leave again for South (?) Carolina soon after returning for 3 years of schooling/training and then on to serving another 3+ years with the Navy.
It is their mutual desire to "stay together"... at her young age of 16 years old, it is a ginormous commitment and we will see how they fair. But, I think/feel/believe that it is what she needs right now... some time to discover herself, some grounding time, some time away from the needs of another, some more time for friends and family, time for hobbies, down-time, more time for studies (without stressing out because she is being pulled in so many directions). Yes, they will remain in frequent contact... letters (yes, good old snail mail) during basic training, and then email/snail mail/phone/texting while he is in school, and the Navy (I guess) is a little more giving as far as leave goes... but that is down the road a bit.
She says she is doing okay with his upcoming leave- she says that she is almost looking forward to school starting and getting back into a routine. She is looking forward to not being pulled in so many directions (boyfriend, friends, school, athletics, family and time for herself) It is also an important school year for her (Junior year) as far as academics goes, she has some tough classes, a couple post secondary and really wants to do well and continue with her high class rank and super gpa.
I guess (???) I am waiting to do any reductions until boyfriend leaves and her period comes and goes... I have been advised to wait until just after her period for hormonal reasons before trying a reduction. We might wait until school has started and see how things are going? I was so hoping to get going with reductions this summer-- but she was against it- she really wanted to have an enjoyable, stress-free summer with boyfriend before he left.
We will be leaving for South Dakota a few days after boyfriend leaves- thought it would be an active spot to go (some sight-seeing, hiking, horses) and would be busy enough, to keep Honey's mind busy, but not overwhelming- we will see.
I am wondering something...
Any of you been pregnant and had a healthy baby while on an SSRI?
Honey is NOT pregnant... and hopefully will not be preg. anytime real soon- YEARS and YEARS!!, but at this point, it is my main concern.
off for now, thanks again, to those of you who sent well wishes and concern-- it means a lot!!
love, Amy

Monday, May 14, 2007

April/May update

Yeah, it's been awhile. I guess for a few reasons. First being that Honey is home now (not at school). I dont really want her to know about this (that I write here). I dont want her to be curious and want to read this stuff. I dont want her to realize I dont know what to freaking to next. I dont want her to know I am scared. I dont want her to realize that actually nobody is in control of what is going on and there really are no answers. So I stay off here.

Also, because there seem to be no real answers (I have searched)... theories/thoughts maybe, but no facts, I started to feel like I was digging myself into a trench... that all I could focus on was what the hell are we going to do. I have to push forward and I cant afford to let this consume me. So, by not writing everyday (or frequently) it has allowed me a space to breathe and not feel consumed. I was getting no where in that mode, except p*issed off, freaked out and very overwhelmed-- and I found there was nothing to do with those emotions in this situation- who the hell do I throw my anger at? Pfizer? Yeah, I think they care. Her doctor? That will work-- then how the hell do I get this damn drug, if doctor feels my fury?

Well, enough of that... my heart is racing again.
I needed to document this ordeal Honey went through so I can keep all of the pieces together.
She/we wanted to finally start reducing this poison. We decided to wait until prom was over (she was beautiful, by the way, her boyfriend was very handsome and they had a wonderful time!... wish I could post a picture, but then I mess with her privacy). The day after prom, we had decided to begin. Since she is not in school, we decided that a 10% cut would be okay. Actually a 10% would have been closer to 4mg and we cut 3mg. 3mg... I wish I would have saved a little morsel (or taken a picture) of what 3mg's of her dose looks like... it is pretty tiny.
Sunday April 29th:
am: Honey takes the reduced dosage (34.5 mg... probably more)
seems fine throughout the day
pm: taking a walk with boyfriend and suddenly feels like she is going to vomit. Can hardly get home. Finally home, white as a sheet and begins vomiting. Continues pretty frequently for 2+ hours. She is clammy and cold. Has a bad headache.
Monday April 30th
am: Feels like hell. We have not yet put the vomiting and headache together as a withdrawal reaction. body AND bones hurt. She does not want to be touched. It is too loud. Headache through the night remains. She takes a reduced dose of zoloft (34.5mg... prob. more) and some tylenol.
throughout the day/evening: Continues to feel nauseous. Ate some crackers with the zoloft. She is exhaused beyond comprehension. Does not even get up from couch... hardly even moves No vomiting. She is dizzy. Diarrhea in evening. She is sad (emotional) and upset. She is crying a lot. I know now that she is having withdrawal symptoms. These are much more severe than I expected at less than a 10% cut and so soon. I gave her 1/2 of the morning cut (1.5mg) in the early evening. Missed color guard practice ( there was no way she could have gone even if I thought it was safe for her to leave home-- she was not stable at all) Slept with me
Tuesday: May 1st
am: does not feel well (same symptoms continue) a lot more of the emotional symptoms now too. Is kind of in a zombie like state much of the time. Takes zoloft (minus a 1.5mg cut... we decided (I decided) that 3mgs was too much for her right now and went down to less than a 5% reduction with the 1.5mg cut).
mid afternoon... she has a meeting with her tutor today (part of being homebound from school) and she thinks she is okay to go (? or feels like she should?). Boyfriend comes afterschool (30 min before she needs to leave for tutor) Boyfriend comes upstairs to get me and says "You better come down, I think she needs you". She is CRYING uncontrollable on the couch. She is PURPLE and sweat is pouring off of her. I held her for a while and said that I thought we needed to stop this reduction. I went and got the little morsel (1.5mg... more like a flake) from that mornings cut and she took it. I called the tutor and cancelled. Boyfriend stayed with her until I was done with work for the day. She slept/cried for the rest of the day... I sat with her. She told me/showed me later what she had done to her bedroom door... put a hole/break in it with her open hand. She did it out of frustration/anger that she could not find a needed paper for her tutor. She is not an angry person and has never shown violence, especially like this. She said she felt out of control when it happened.
so, needless to say, stopping the reduction at that point was the only choice. It took her several days to get to a point where she felt okay physically. I dont know if she is even at baseline emotionally even now... sometimes I see her, but much of the time she seems blunted.

Has been seeing a new therapist (along with woman from the sexual assault center). She will also start group therapy at the assault center this tuesday.
I think she is getting close to filing a police report.
Since she is missing from school there are a lot of rumors of course... the two main ones are that Honey is preg or that she is insane. She didn't care for either of these. Her friends and boyfriend know the truth... She has had medication issues, yes, but I think the main issue for her was the repeated sightings of that assh*le at school. And that kid roams the halls like no tomorrow. Her boyfriend/friends wanted to know what they should/could say when others asked where Honey was (why isn't she in school?) Honey asked therapist what she should do about the rumors. Therapist said it was okay if Honey felt comfortable, to let people know the truth... if someone asked they didn't need details but there was no reason to continue protecting this creepy idiot who did this. So people beyond her safe circle know.
Now the creepy idiot has had the stupidity to go to the school liaison office and complain that no longer do people think Honey is insane or pregnant, but know the truth about what happened. I told Honey, that as soon as she feels up to it, she needs to get together a time-line type record of what happened. I feel like she might get pressured into a police report soon. She was hoping to wait until school was out for the summer (as she really wants to return to school for the last few weeks) but I am not sure if that is going to happen.

Tuesday, April 3, 2007

best day for Honey in a while

Today was the best weekday I have seen Honey in a long while. She seemed lighter and brighter. She was up early, exercised a bit and showered. She continues to keep up with homework- finished a paper today (due Thursday) and cleaned up her room. Met with "Dee", her counselor with the sexual assault center this afternoon and she went to colorguard practice tonight- off to pick her up now- cant wait to see how she did :)

Monday, April 2, 2007


Honey went to school today (after a long, anxious night) and ended up in the counselors office after her first class.
Though I hadn't spoke about it with Honey, I had decided that today (Monday) and Tuesday would be the "test". She has been home more than in school the past several weeks. When she is in school, it sounds like her whole day is a turmoil of emotions- I have to wonder if she is learning anything anyhow? and I have to wonder how healthy it is for her to try to face her "demon" without the tools to cope successfully? Since she spent most of yesterday worrying about school, got little or no quality sleep (up worrying) and made it through only 90 minutes of school, I think she will learn more and I think she will be better able to heal here at home. She will return to school... I dont know when, but I know she will learn some coping techniques and I know she will conquer this situation in time.
We have an appointment with someone who deals with PTSD and rape trauma in April (we had an appointment in mid-June- that was as early as we could get in... but I have called and left messages a couple times with her (let her know Honey really needed to get in asap) and the next time I called we got bumped up... so a couple weeks.
Now, I am just waiting for Honey's PCP to fax an okay/request to school for homebound status until the end of the current school year. We can always change it, if Honey feels she wants to go back sooner. She will also request that Honey be allowed to continue with extra curricular activities as tolerated. Honey's counselor is in the process of locating a homebound teacher. She is still pretty worked up from today, but I think once she relaxes, she will feel much less stress with the idea that she does not have to return to school until she is ready.

Wednesday, March 28, 2007

School's accomodations for Honey

At this point I am not going to push for a 504. I really feel like Honey has the backing of all of her teachers- all understand and are completely sympathetic. She has already proven herself at school- administrators see by her past grades that she is a hard worker and not using her current situation to to her benefit.
This is the current "plan"
  • All absences related to health are excused (already had that with doctors note)
  • Homework due dates are flexible. Homework can be completed on a "can do" basis without penalty. At this point, Honey will complete all assignments.
  • Testing can be done in a different location if Honey chooses
  • Testing time can be extended.
  • If Honey requests verbally or non verbally, she will be allowed without question to have a student "escort" if she needs to leave during class.
  • Honey may leave class without issue/question to go to counselors office. She will need a note from counselor/counselor secretary to return to class.
  • If she desires, she can leave one class early to arrive early at next class to avoid passing time- she does not like this one and says she will not use this one.
  • She can have lunch in counseling office with one friend. She does not like this one and says she will not use it.

I know, Stephany, I dont have a paper trail... but I have been assured that IF I want/when I want, all of Honey's teachers will agree to this in a 504 plan, and as long as I have their cooperation, and I am not asking for anything they wont offer or guarantee to provide.

We will see how this all goes. I feel confident that all will be okay for the remainder of the year with school accommodating. Over the summer, I will have time to consider whether a 504 plan should be lined up for next year. Since Principal/V.P. and Honey's counselor are all very supportive, I just dont think we are going to have a problem...

Also, when talking to Honey's doctor today, I asked if she would be willing to provide a note to school for temporary homebound status, she said anything we needed.

Okay, off to read to lil sis and play a game!

Hey, Stephany, thanks for the nomination... I haven't quite figured it out yet, but when I get some time I will be over- hoping Lindsay is doing well!

phone call from little sisters school

I received a phone call from little sister's school this morning (I cried 3 times on the phone just this morning)
It was from one of her teachers, Mrs. K.
Mrs K was concerned about lil sis. She seems to be losing her confidence. She has noticed it for a couple of weeks. She wanted me to know, wanted to know if I had noticed it. I shared with her (which I should have done weeks/months ago) that her big sis was having problems and she needed a lot of daily support/encouragement and private time with mom.
I felt so bad. Lil sis has told me a number of times in the past few weeks/month that school is "hard", doesn't "like" school anymore, is having trouble with friends... I listen, I do and comfort her and encourage her, but I really wrote it off. I thought maybe lil sis was in her own way, duplicating what she thought Honey might be saying to me when Honey and I talk alone.
This house has been crazy the past few (several?) weeks (months??). I know that lil sis has not had as much of me as she probably needs (and for sure wants). This is so damn overwhelming.
Work a full-time plus job in my home, try to keep the dust tumbleweeds at bay is a job on its own here... this place is overgrown and full of dust plants and stacks of crap all over... I keep piling it because there is no time to actually deal with anything.
So, lil sis is no doubt feeling very alone and I know is missing the old "us" and the old "me" Her teacher was very understanding and had a good deal of compassion for us/lil sis/Honey. She assured me that she would give her a lot of extra encouragement and love at school.
There is just not enough time or enough of me to give them equal me right now, but it is taking its toll on lil sis... my little baby. damn


A couple days ago, my husband freaked me out.
Honey decided to take softball one day at a time. Was not going to make a decision whether or not to play, just keep "playing" but if a day was too hard, she would not go to softball... if there were more days than not that she was unable to go to softball, maybe there would be her answer. Husband couldn't figure this out. Why wouldn't she play? Why should it be stressful? Honey explained to me, then I tried to explain to him, that it wasn't that softball was stressful, it was the TIME it took- practice til 6pm, games until 8pm or later, then home, get homework done, eat something quick, then go to bed, only to wake and do it all over again- fine for someone who can concentrate and focus, who isn't struggling with insomnia and lack of sleep, fine when you are feeling good to begin with, but she is not feeling "fine".
Honey left to visit with a girl friend for about 15 minutes. I took that time to hopefully open his damn eyes and get him to realize that he has to quit loving his kids based on WHAT THEY DO... but love them just because THEY ARE. I made him read a bit from the ssri stories site ( and told him (me in tears of course) that he needs to stop with the pressure and the stress and just be glad she is alive, be glad we are not reading about her story on that site. I think I made my point, I just hope it stays fresh in his mind.

Not really sure where we are...

I am not sure what is going on.
I am thinking now of the possibility that Honey is struggling with PTSD (post traumatic stress disorder). Her counselor/therapist suggested it. When I research it, it sure sounds like she could be dealing with it. Talked to doctor about it (as well as the fact that she is back on tablet form of sertraline only- no liquid) and we both agreed that since we are not seeking medication but are hopeful that counseling/therapy will be most helpful, that a formal diagnosis at this time would do nothing but add another label.
I am seeking couseling above what the sexual assault center is offering. The couselor she has there is GREAT but can only meet with Honey once a week for a half hour. I am thinking, that at least for the time being, until Honey is feeling more grounded and has more coping techniques that are working for her, that meeting with someone else who might be beneficial.
Honey is home from school again today.
She was at school Mon and Tues, but felt very anxious/nervous/overwhelmed there.
She has been talking frequently of seeing her "nightmare" at school often- she feels that any time she is out of class (restroom break/counselor visit/library visit) she had been seeing "him" loitering in the halls. I listened and talked about whether it just seemed like she aways saw him, just because she was so nervous about running into him.
Well, yesterday, I shared her "sightings" with her couselor on the phone, who agreed with Honey that yes, he is in the halls a whole bunch. He even made an inappropriate comment to her (counselor) who was on her way down to her husbands classroom (they both are on staff at Honey's school) - he made a comment like "Oh, I know where YOU are going... and on school hours too" like she was going to have some sexual contact with her husband. She has since reported his comment to the pricipal/vp. I sent an email to the vp today with concerns about this creep roaming the halls (like a predator) and cc'd it to Honey's couselor. I have been assured by both that the issue will be dealt with, that there is no reason this kid should have free reign at school, wandering around unsupervised. I mentioned in my email that I think she feels like he is looking to run into her. I think he probably gets a charge out of running into her, since he can be upsetting without violating the restraining order. I have been told time and again that there is no way they can enforce that he be required to be a certain number of feet away from Honey at school. They have made sure that they do not have lunch together, no classes together and lockers in different halls, that they will enforce that he is to have no contact with Honey, but beyond that there is nothing they can do. Well, I hope they can keep him in class. I guess he has a right to finish his education, but he is not getting that education loitering in the halls.
I will post more later about our agreements with school and other things

Saturday, March 24, 2007

Honey's dilemmas

Honey has so much to consider.
It is overwhelming for her.
She IS feeling somewhat-much better (now that she is back on tablets only- no liquid/zoloft)
She needs to consider if she wants to WAIT until summer to transition to liquid zoloft OR if she wants to take some time off of school and do it NOW, then once recovered work as a homebound student until she is caught up and ready to go back.
I dont feel it is my decision to make-- but I might have to step in and make it for her once I know a few things- first, HOW LONG might transitioning to zoloft take? Our helper, Catherine, has told me that we could do it "quickly" (transition at 25% increments) but I dont know yet how long we wait at each interval. I have an email out to her, and once we have her guesstimate, it will be easier to see the best option for Honey right now (in my opinion).
She also is considering softball. She is playing "just for fun" not worried about making varsity, not worrying about "starting" or any of that. But is concerned (as I have been) that it is "too much right now". She will have to make the decision. As I told her, if she really wants to play, play and if she finds it is TOO much, drop out, stay on as a manager or whatever.
Also, she is co-captain of her school's color guard group with the marching band (they perform with colorful flags with the marching band) Is this too much she wonders? For her, it is one of the truly joyful things she does.
so much to think about. Dilemmas

Thursday, March 22, 2007

Homeschooling or Can Honey stay home and keep up with assignments from school?

I need to research this. My books arrive today, there might be answers there?
I need to find out if Honey is able to stay home for the most part (maybe check in with teachers once a week?) and complete assigned school work at home. She could go to school (maybe afterschool??) for tests. Not sure how band would work? Maybe she could finish this quarter (a week (?) left) and drop it next?
I need to find out if this is possible or if she wants to stay home if somehow I can figure out how to homeschool her?????
holy cow

Wednesday, March 21, 2007

Honey Update/ Books ordered/blank copy of schools 504 plan

Well, I think it is definitly withdrawal. She is irritable and cant stand being around her sister- has been a repeating theme with Honey and withdrawal.
Tomorrow we go back to tablets only. Going to stay on tablets only until school is out.
She will stay home tomorrow.
I have ordered (will be delivered tomorrow) these books:
  • Not Once, Not Twice, but Three Times: Being an Advocate for Children's Hidden Disabilities and 504 Plans
  • Wrightslaw: From Emotions to Advocacy: The Special Education Survival Guide
  • Wrightslaw: Special Education Law, 2nd Edition

Somewhere in my chaotic days I will need to get some reading done!

When Honey's school counselor came to pick up her kiddo's she brought me a blank copy of the 504 plan the school uses to look over.

Honey's day and art therapy

Honey is home again today (yesterday as well). I cant help but feel that she was again in withdrawal (we are not ready for that yet!! Honey is still trying to get to a stable place- then we will be more ready to reduce the poison in a slow, precise manner-- withdrawal symptoms are not expected at this time, so it is frustrating and scary for Honey, and worrisome and scary for me ). It is the liquid, I am almost certain. I bumped her back to 31.25mg of the tablet (1 1/4 25mg tablet) and gave her 6.25mg of the liquid yesterday and today (by late in the day yesterday, she was still struggling, but seemed to be coming around, today, she appears more stable (no crying and doing more than just sitting there). She says she is still feeling "out of it", overwhelmed and tired. Our "helper" has just emailed me. She had shared that the liquid could/would be a problem and had I received her concerns prior to getting the script for the liquid/Honey starting the liquid, we would have been able to make a safer decision. Our "Helper" writes this:

"Yes, different pills have different "inactive" ingredients. In most cases, it is a difference in timing of release or amount being metabolized. The liquid contains no real fillers. I cannot say you will have less trouble in the switchover by doing it gradually. I've not seen a smooth transition no matter how it's done. My best advice is to not do this while she is in school. Regardless of her preferences, you are the one who needs to keep her safe. I would be concerned about her safety during a transition like this. If she cannot control other things (her actions and attitudes that are out-of-character), she certainly cannot control her reaction to possible akathisia or other difficult reactions while switching over."

So, starting tomorrow we will go back to all tablet at least until school is out. Tapering down/off will have to wait.
At this point, I may have to look into a compounding pharmacist. If liquid is going to cause these crazy withdrawal symptoms, I am not sure it is worth it. She was struggling with 12mg of liquid/25mg tablet.
Who knows, but for now, I wont worry about it too much (other than looking into a compounding pharmacist and checking on cost there, I will also let Honey's doctor know that we have put everything on hold (tablets only) until school is out. Will let her know what is up then, unless she wants to see Honey)
Honey spent about 4 hours today gathering some affirmations that spoke to her (posted below) and picked several to put up in her room and around the house. I will take a photo of them later. They are beautiful.
Yesterday she spent hours making "bead buddies"... that was weird. She even wanted to go in our very messy and unorganized storage/crawl space area to find her old "bead buddies" that she made maybe 8 years ago- when they were the thing to make. After she tired of bead buddies she made some of those deals where you put the plastic bead things on a grid like deal, then iron the beads so they melt and you can remove them from the grid deal- that was weird too. I did see though that these were soothing activities for her and she really jumped right in with making some affirmations she can display. I will have to take a look around this weekend at Michaels and see if I can find something that takes little thought that she might enjoy. Art therapy, I guess. Stephany will know. If she sees this I bet she will say something. I think she mentioned this once to me.
We were talking last night about her thoughts always going back to negative or upsetting thoughts. We talked about how our thoughts become who we are and how if we are able to change our thoughts, to turn negative thinking away by using affirmations, that maybe the negative/upsetting thoughts can be controlled more (instead of allowing them to control us.)
more later
also, Honey mentioned the possiblity of my homeschooling her for the remainder of the year.

~~~~~~Honey's Affirmations~~~~~~

I have the ability to handle this.
Nothing is worth losing my sanity over.
I am beautiful!
I love myself for who I am.
I am able to handle any problem I face.
I am a rich treasure ready to be found.
I am loved by many people.
I am smart.
There are interesting things happening in my life daily.
I am on the road to success.
I can handle all the changes that come my way.
I am strong.
God loves me.
God has a wonderful plan for me.
I am an interesting person.
I care about other people.
I make good decisions.
I am an excellent student.
I am a helpful person.
I am creative.

Tuesday, March 20, 2007

Welcome to!

Welcome to!
Wanted to hold on to this page. I have not had time to look more indepth at the site, came across it by accident.
Talks a bit about 504 and
IDEA and specifically IDEA for students with depression- might qualify under ED (emotionally disturbed) category. Does Honey?
Looking at this:

"IDEA v §504 Eligibility - One of the important differences between IDEA (a funding law) and §504 (a non-funded civil rights law) is that IDEA has very specific eligibility categories while §504 does not. Therefore a child diagnosed with long term depression could: (a) not qualify under either law, (b) qualify only under §504, or (c) could qualify under IDEA’s Emotionally Disturbed (ED) category (in which case the §504 rights automatically attach).
If the student qualifies under either IDEA or §504, the school must provide them with a free and appropriate public education – a FAPE although the standards differ somewhat between §504 and IDEA and private vs. public schools. Under §504 a school that is a recipient of federal funds needs to provide education services (regular and special education) and related aids and services that are designed to meet individual educational needs of handicapped persons as adequately as the needs of non-handicapped persons are met.
Student’s with Depression – as noted above students with depression could qualify under IDEA’s ED category IF they meet the following eligibility criteria (with my emphasis as to the issues that are generally subject to dispute):
IDEA Eligibility - 34 CFR 300.7 - Emotional Disturbance is defined as follows:
The term means a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a child's educational performance:
(My personal question: I wonder how long a "long period of time is"? and who determines "adversely affects a child's educational performance"?)

(A) An inability to learn that cannot be explained by intellectual, sensory, or health factors.
(B) An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.
(C) Inappropriate types of behavior or feelings under normal circumstances.
(D) A general pervasive mood of unhappiness or depression.
(E) A tendency to develop physical symptoms or fears associated with personal or school problems.
(F) The term includes schizophrenia. The term does not apply to children who are socially maladjusted, unless it is determined that they have an emotional disturbance.
Therefore, if a student exhibits long term depression of a marked degree that adversely affects educational performance, then the public school must provide them with a FAPE by creating an Individualized Educational Plan (IEP) that includes accommodations as well as direct and related special education services.

§504 Eligibility - A student with the medical condition of depression (or any other medical condition) may not meet the requirements of one of IDEA’s specific categories, yet they may still qualify as a handicapped person under §504 of the Rehabilitation Act of 1973 as the eligibility requirements are different than under IDEA. First, there are no specific eligibility categories. All that the law requires is stated at 29 U.S.C. 706(8) where it states a person is considered a handicapped person IF the person has a physical or mental impairment which substantially limits one or more of such person’s major life activities, or has a record of such impairments, or is regarded as having such an impairment. (Emphasis added). Life activities include such tasks as walking, breathing and learning.

Therefore, in the case of a depressed student, the question becomes if the impairment “substantially limits” the students learning. Again, the recognized method to answer that question is for a group of school persons who know and understand the student to meet with the parents and make a determination as to whether or not the student’s impairment “substantially limits” the life activity of learning. As this is a subjective decision, if the parent disputes the finding they can take their dispute before an impartial hearing officer.

If the student is found eligible under §504, a plan needs to be developed so that the student may be provided a FAPE. Using IDEA’s IEP format is one way of documenting the child’s plan and meeting §504’s procedural safeguards. At the same time it has been my experience as §504 is not a funding source, many school are not willing to include special education type services in their §504 plans.

Monday, March 19, 2007

New thought on liquid Zoloft

ok, bad day today.
Honey seems like there is no reason for it, she just feels bad/sad.
She seems lethargic.
I am thinking that if this continues, she is looking at withdrawal again :(
Though I cant be sure (no map, you know), I might have to assume it. Not sure how long to wait this one out? Oh, how I wish she would wake up feeling great tomorrow morning-- or even stay home but feel better/more stable as the day progressed and go to school feeling well on Wed. Well, if withdrawal is the case, I think what we could do is use no more than 6.25 mg of liquid at a time (the rest tablet- 1.25 of a tablet). We could taper the 6mg's of liquid and once she is done with that cycle (tapering the 6mg liquid- at 2 or less mg at a time) then she could drop another 6mg from her tablet dose and take it as liquid instead and then drop that 6mg's and repeat (and repeat and repeat...)
I will have to see how things go and how she feels- but that might be more successful, now that I think about it, then trying to get down to just 12.5mg in tablet and the rest liquid.
Redrawing the map... good thing we are using pencil.

Doctor note

Husband picked up new script for sertraline (more 25mg tablets) and note from PCP for school. She wrote just what I asked for:
To whom it may concern:

_______ was diagnosed with depression over a year ago. She is currently making some changes with medications. During this process, she may experience some physical and emotional symptoms. Please excuse her absences from school during this time.


When I let Honey read it, I could see some different emotions. Relief, yes, there was certainly relief, but also something else, almost like "I am different" or "there really is something wrong with me" not sure, but I will have to talk with her about it.

I am strongly considering beginning the steps toward a 504 plan meeting. I have contacted her counselor with my thoughts. I need to get back to her as she asked "what kinds of modifications were we thinking of? Sometimes, we do some simple accommodations without a 504 plan.
I am not sure yet what to ask for, except some homework deadline relief (work done, but handed in at her own pace, allowance for medically necessary absences (work made up) and...?? I will talk with Honey about it when she is feeling better and ask her counselor for some suggestions as well... research, research right now-- that will help me a lot.

bad day

Monday 3/19/07 Honey had a "bad" day. She isn't sure why. She saw "the devil" (her icky ex-asshole) this morning and since then has felt very sad. Seeing him at school is nothing new, she never enjoys it, but today, possibly it affected her more.
We still need to write down a couple notes on how she is feeling.
She is pretty vague.
Has already let me know that she needs to sleep next to me and is not planning on going to school tomorrow.
I cant tell if this is some kind of withdrawal symptoms?? (Due to the liquid)
We continue to create this "map" we are working on.
37.5mg sertraline (25mg tablet/12.5mg liquid)

Honey's supportive doctor

I talked with Honey's PCP a while ago on the phone.
I am always impressed with the time she gives Honey and I both on the phone and in the office. I never feel like I am wasting her time nor do I feel like she is thinking that I need to stop telling her (PCP) what I need.
I had a couple goals concerning our conversation.

First, I wanted to update her as to what is going on (that we had not started reducing, that Honey was still trying to transition from tablets to liquid (while maintaining "stability"), and wanted her to know that Honey is just now feeling completely "normal" since the TEVA form of sertraline experience. I told her that I thought "Honey must be pretty sensitive to this medication". I feel if I say this (instead of saying the drug/poison "sucks" and is killing people) that I will not put her on the defensive and still have her seeing that my ideas about tapering really slow and cautiously is best for "Honey".
That goal met.

Second goal was to express my concern over transitioning to the liquid and shared with her my "information" regarding the possibility that the liquid might also trigger withdrawal symptoms (like the TEVA did for Honey) and that I wanted to transition slowly (from tablet to liquid) as well as keep her on at least 12.5mg of the tablet while decreasing the liquid.
Goal met-- she probably thinks I am nuts, but she said she definitely was okay with that and would continue to write refills for both the liquid and tablets as long as needed- would I just keep her updated- I almost thought it sounded like she meant "Keep educating her on this process".

Third goal: Ask PCP if she would write a note for school to inform school of Honey's diagnosis and let them know that she was having medications adjusted and the adjustments might cause physical and psychological symptoms. This is what I asked her to write (or something along those lines)-- we will see what we get. I also asked if she would be willing to help out as needed as far as school goes and she said "Certainly".
third goal met (haven't seen the note yet, but anything at this point from her that informs school of her diagnosis and med changes and knowing that PCP will back us as needed is all I need to get things started with school.
I feel like I accomplished something.

Honey continues to do well. We have started daily documentation as far as dosage, Honey's moods and any physical symptoms- so we will have a good baseline to go by when we start reducing and making poison (med) changes as far as form (tablet to liquid). This is our plan for now:

Currently (for the past 10 days 3/10- 3/19) she is taking 37.5mg Zoloft - 12mg liquid (.6ml) and 25mg tablet.
Starting tomorrow 3/20 she will take ¾ of a 25mg tablet (18.75mg) and 19mg liquid (.95ml) She will continue this for 10 days (until 3/29) as long as there are no withdrawal symptoms.
At that point (on 3/30- Thursday) we will try ½ tablet (12.5mg) and 25mg liquid (1.25ml). After 10 days (starting 4/9) on this ratio of tablet to liquid, I would like to start reducing the liquid (as long as she is baseline). We will reduce at 5% (actually just a bit more) of the total dose of 37.5 (actually reducing 2mg/.1ml). We plan to have her stay at this dose until she feels baseline or better. (at least 2 weeks on this dosage) and will reduce from there as tolerated.
I plan to keep her on 12.5mg of the tablet (½ tablet) as she reduces the liquid. I will have to worry about making a transition with the remainder of the tablet later. (Once she has reduced a good deal of the liquid)

I have never felt this way before... like a pioneer? I feel like Honey and I are creating a map. We can talk to other pioneers, who have been this way before, but their map might be different or maybe they have not been "here" before. Weird. I dont like being here and I dont like being here without a proven map. Honey hates it. But in a way (?) it is actually empowering (?) (I am sure I will take this "empowering" thing back)
It is also weird trusting my gut to this degree. Trusting it over science and mainstream practice. I am proud of my intuition/gut and proud that I listened, as it knew to go slow with the liquid, even before I understood that there might actually be theory behind it (might bring about withdrawal symptoms??- theory/thought)

Uchenna Agu (as in Uchenna and Joyce from Amazing Race All-Stars (yes, I watch)) said something on last night's episode that I loved. I dont have his exact words but it went something like this: By not trusting your instinct/gut/intuition, you are basically telling God or the Universe that He (God) is wrong. Like I said, I got his exact words wrong, but I think I got the gist of it correct. I am going to look for his exact words, because they were great.

Saturday, March 17, 2007

Possible problems switching from Zoloft tablets to Zoloft liquid concentrate- I wonder if I could be any more confused?

I have some new concerns (what's new??)- this time with a potential problem switching from sertraline in tablet form to liquid form. I am learning that there is a possibility of moderate to severe withdrawal symptoms( something like what Honey experienced with the TEVA form of sertraline or worse). So, a couple of ideas/questions/plan of action that I am pondering.

First, being that Greenstone (pharmaceuticals) is a subsidiary of Pfizer, ***what are the chances of Greenstone sertraline being identical (inactive ingredients as well) to the Pfizer Zoloft tablet? I think they are identical, aside from the Greenstone version not having “Zoloft” printed on them. The colors and shape are the same for at least the 25 and 50mg tablets, I guess I have not seen a 100mg of either. (The U.S. government requires that the drug look different so it won't be mistaken for the original. This prevents fraud.)

***So, I have to imagine that the reason Honey had problems with the TEVA version of sertraline could have something to do with inactive ingredients?

***So then, I have to imagine that the reason she may have problems with Zoloft liquid could be the same issue? Different inactive ingredients?

***So, then, I have to wonder if her chances of being successful with the liquid (without serious withdrawal symptoms) might be increased if she remained on a bit of the tablet?
(Looking back at the TEVA experience, when she first started the TEVA setraline, Honey was taking ½ of a 50mg TEVA tablet and ¼ (12.5mg) of a 50mg Greenstone sertraline tablet, because I had a number of ¼ tablets remaining of the Greenstone. Once I ran out of the Greenstone ¼ tablets, she was taking just the TEVA, it was really then a matter of days (5?) before we noticed the withdrawal symptoms that continued to increase until back on the greenstone)

I guess I am going to continue on with going to liquid, but will keep her on at least 12.5mg of the tablet (using a slow change-over to get to that point). I will do this over time and see how she does and will in no way hesitate to go back to where she is now. At that point (going back to just tablets), I would wait until school was out for the summer and work it that way.
My plan at this time (actually in a few days/this coming Monday - going to give the current liquid/tablet ratio 10 days) is to go to ¾ 25mg tablet (18.75mg) and 18.75mg liquid (Honey is currently taking 25mg tablet and 12.5mg liquid) and she how she does and without hesitation, if withdrawal begins to look like the TEVA withdrawal, I will reinstate the previous setup (what she is taking now). IF all goes okay, (after several days (10) of feeling baseline) I will again try to take a ¼ tablet away and replace it with liquid. I am thinking if she can successfully get down to just a ½ 25mg tablet with the remainder being liquid, and is stable and ready, we will start reducing the liquid (and keep the ½ tablet (12.5mg) in place. Then, I can decide what to do later about the 12.5mg tablet.
I spent the entire night thinking this through. I did not sleep. This is all making me just about lose my mind
Honey continues to do well and she has noticed that her problems with concentration have decrease to just about “normal for her”.
I realize all of what I am talking about above are my own theories and could have nothing to do with fact. I know there is a strong possibility that I will be wrong. I know we could just as easily wait for school to be out to start this process- but Honey wants to press forward. I will try it as long as Honey is for the most part symptom free. (All the more reason to get myself together and get a note from PCP and talk with school counselor/possibly school Principal.