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

Homebound?

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

husband

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 (www.ssristories.com) 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 bridges4kids.org!

Welcome to bridges4kids.org!
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.

Sincerely....

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.

Thursday, March 15, 2007

Woody Matters

Woody Matters
The nature of Woody’s death did not add up. It started a long journey with lots of endless nights without sleep, researching this issue. It is our goal to provide you with the research on and knowledge about these drugs. All in one place. No one should have to experience what his friends and family did. Be smart. Be informed.

March 14, 2007
Kim Witczak (Woody's widow) to testify at US Senate hearing on drug safety/FDA reform.Consumer's Union press release: http://www.consumersunion.org/pub/core_health_care/004312.html

Kim Witczak's written statement: http://www.consumersunion.org/KimWitczakWrittenStatement.pdf

WOODY'S Story
On August 6, 2003, Woody died of a Zoloft-induced suicide at age 37. He was not depressed, nor did he have any history of mental illness or depression. He died after taking the drug a total of 5 weeks with the dosage being doubled shortely before his death. He was given the antidepressant from his general physician for “insomnia.”Woody loved life and all that this world had to offer. He was a compassionate, loyal husband, son, brother, uncle, godfather and friend. He had endless energy, a constant smile and a laugh that could be heard a mile away. He truly cared for others.He had a successful career in sales. Plus, he was active in community, social and politics, always willing to fight for injustice and others less fortunate. Woody truly inspired others to be the best they could be. Woody went into his regular internist on June 30, 2003, because he was having trouble sleeping, in part because he had just started a new position as vice president of sales with a start up company about two months prior. He was excited about this dream opportunity to make his mark on the business world. Along with this excitement came some stress and difficulty sleeping. This was the first time he'd ever gone to a doctor for this sort of issue. Woody’s doctor gave him three weeks worth of Zoloft samples and told him to come back for a follow-up appointment after the samples were finished. Within a couple of days, he experienced every known side effect of Zoloft (e.g. night sweats, diarrhea from the time he got up in the morning, trembling hands, and anxiety worsened). Woody was extremely sensitive to foreign substances in his body- he didn’t even like to take over-the-counter medications (like Sudafed, Excedrin, or Nyquil), or to drink caffeine, or have more than one glass of wine or beer. One of the most significant side effects Woody was experiencing from Zoloft was an extremely uncomfortable feeling, called akathisia. Woody was acting out of character in terms of increased agitation and irritability. He was also very restless, which caused him not to sleep, as well as created a feeling that he always needed to keep moving.Shortly before his death, Woody came home crying after driving around all day. He sat in a fetal position on the kitchen floor with his hands pressing around his head like a vice saying, “Help me. Help me. I don’t know what’s happening to me. I am losing my mind. It’s like my head is outside my body looking in.” Over the course of the next week, in typical Woody fashion, he was looking for ways to “beat this feeling in my head.“ Two weeks later, a total of 5 weeks on the drug, Woody was found hanging from the rafters in the garage. Woody’s family and friends only wish we knew then what we know now. It wasn’t Woody’s head. It was the drug.

Wednesday, March 14, 2007

Letter from the doctor concerning 504/IEP

I wonder what I would want a letter from the doctor to say in regards to a 504 plan for Honey? I feel like I would have to "ghostwrite it" lol, because I still dont think health provider "gets it"- I know Honey has her support, but I dont know how much provider understands.
We just saw provider though, and she knows Honey is struggling. She knows that once this struggle is over (due to generic Zoloft), Honey will begin a slow taper off this crap.
Stephany, I just received your comment from the "bad night"post. I will look for the websites/books on the sidebar of your blog. So for the most part, is this something that I would start now to be implimented by next fall (start of next school year)?

IEP?

Stephany and anonymous mom, thanks for the insight and support.
On and off I think about some kind of 504 plan/IEP for Honey. I need to research it/figure out what having one could do for "Honey". She is a good student (last quarter managed 2 B+"s, 2A's and currently has 4 A's) and I think that does get in her way as far as reducing her stress (being a good/type A student. She has high expectations for herself. The B+'s last quarter really upset her.(she had been a straight A student up until those B's. That quarter (with the B's) was also the quarter when the withdrawals got unbearable/we didn't know at the time it was withdrawal- thought it was "depression", and that was also the quarter I filled for on Honey's behalf (and got) the restraining order on her icky x-asshole. It was a crazy time... and she pulled off 2 B's and 2 A's.
So I am thinking the school will think I am crazy and wonder what I am looking for (as far some relief for her.)
I also am hopeful for her future education and wonder if an IEP might affect college acceptance?
As far as help from school... I know that some relief as far as some flexibility with homework (I think she could still do it, but maybe not at the due date? There are just some nights when I dont know how she does it... and then falls apart when it is complete, doesn't sleep well (lots of dreams follow an evening of high stress) Another huge concern for me right now is attendance... she has missed 19 days so far, sometimes going to school when she can hardly stand the thought of it, just because I know she doesn't have much more time to miss before it turns into truancy. Any thoughts?

Tuesday, March 13, 2007

bad night

Honey had a bad night.
I think yesterday was overwhelming.
Going back to school after almost 2 weeks complete with her demons
Starting softball
A lot of homework due today
A lot of homework due at the end of the week.
Not sure what time it was, that she came into my room feeling "bad" and crawled into bed with me.
I dont think it was a bad dream. She said she was "just doing homework and I just started crying" (why she was still doing homework, I am not sure. When Superman (boyfriend) was going to stop over, I asked if her homework was done- "just about" and this sadness was a couple hours later.
We talked (she talked) a little. When she woke me up, it was out of a deep sleep, so I was really groggy.
I feel asleep pretty fast.
Not sure how long she stayed awake.
Just wanted to make note

Monday, March 12, 2007

Honey asked for prayer

As Honey was getting ready for school today she said "Pray for me mom." I asked if there was anything in specific, "No, just pray for my whole day."
So, I pray and will continue.
God knows, He knows what she needs.
It has been almost 2 weeks since she faced school and her demons there.
I remember being a child/youth and how hard it was to go back, especially after an extended break. How hard it must be for Honey-- to face evil in the eye at any given moment.
Last time she was at school, she was feeling symptoms of withdrawal, and it was harder than "Honey normal"
Hoping her day is going well.
Softball starts today as well.
I have many concerns about her playing.
I have not voiced any of them.
She will know if it is a good choice.
She will need to decide.

Zoloft dosage/form changes

wednesday 3/7 37.5mg sertraline greenstone (tablet form only) -bad day but noticed improvement in withdrawal symptoms
thursday 3/8 37.5mg sertraline greenstone (tablet form only) (day of disney on ice)- bad day/little improvement but did the disney thing- overstimulation
friday 3/9 37.5mg sertraline greenstone (tablet form only) better day- noticed improvement
Saturday 3/10 25mg sertraline greenstone (tablet form) and 12mg Zoloft oral concentrate better day- noticed improvement
Sunday 3/11 25mg sertraline greenstone (tablet form) and 12mg Zoloft oral concentrate better day- noticed improvement
Monday 3/12 25mg sertraline greenstone (tablet form) and 12mg Zoloft oral concentrate- current day. I need to remember to update, so we can look back and see changes over time.
Tues 3/13 25mg sertraline greenstone (tablet form) and 12mg Zoloft oral concentrate- current day good day
Wed 3/14 25mg sertraline greenstone (tablet form) and 12mg Zoloft oral concentrate- current day good day /basketball state tourney
Thur 3/15 25mg sertraline greenstone (tablet form) and 12mg Zoloft oral concentrate- current day good day/basketball state tourney
Frid 3/16 25mg sertraline greenstone (tablet form) and 12mg Zoloft oral concentrate- current day good day (girl scout sleep over thing that Honey helped with [didn't sleep over but was helping from 6pm until 12midnight- noisy, a little crazy and she seemed fine/tired])
Sat 3/17 25mg sertraline greenstone (tablet form) and 12mg Zoloft oral concentrate- current day good day /basketball state tourney
The plan (so far) is to make a form change on Monday 3/19. Will enter specifics in another post.

dosage remains unchanged through Wed 3/14/06
Honey seems to be tolerating the liquid Zoloft thus far (only 12mg/day)
I plan on making an increase in the liquid to 25mg ( with 12.5mg tablet- 1/2 25mg tablet) on Friday (3/16/07) but I will see how the next few days/nights go first. I am not going to be in any hurry. Will watch carefully for any problems?? Not sure what I would be looking for? or if there is anything to even be concerned about. According to health professional, there should not be a problem, but there should not have been a problem with the Teva form of sertraline, nor should Honey be having any problems at all because of something the doctor (trusted professional) prescribed, so obviously, I cant take most of what health care professional says with a whole lot of trust.

Sunday, March 11, 2007

Things are settling down...

Well, I do think things are starting to settle down a bit.
Honey appears and says that she is feeling much better
(since the withdrawal problem caused by the Teva form of sertraline).
She appears more grounded, less irritable and anxious. She continues to have muscle pain and her concentration might be a bit messed up? Sleep continues to be an issue, but I think it will be a huge issue until she is free from the Zoloft.
And I feel a sense of relief and a sense of peace, like I can let go of this a little bit (in a way)
I know now that she is on the right road.
She has what she needs as far as the right medication (read also as poison)
in the oral concentrate Zoloft.
She has her doctors understanding, backing and support.
She has gained some personal confidence in this journey.
She has gained some personal knowledge in her situation that she didn't have before.
We have started the transition to the liquid (from the tablet) in a slow process.
She will be off and running soon!
I know I need to start taking better care of me.
Doing more than existing to get her through another day of this mess.
I know that when I am feeling less than good, I am less than good to Honey, Tootsie and all the rest.
Stephany reminds me that this is my journey.
I may be walking alongside Honey in her journey, but I have a journey too.
I want to celebrate my journey

Saturday, March 10, 2007

walked

Today I walked, walked along with “tootsie” as she rode her bike through the spring puddles and slush.
The sun on my face.
We heard the birds too.
Not just the chickadee’s that stay around through the winter—they sounded like house finches.
The snow is melting fast- almost before your eyes.
The sound of the water going down the sewers echoed on the street.

Friday, March 9, 2007

More on the generic form of sertraline

Well, I cant just let this go-- let it be a lesson learned and move on.
I cant because I am sure it will be weeks before Honey is back to "Honey normal" again after this lesson, and it is really making me mad.

Found this interesting bit on Zoloft and the generic form written by Michael Craig Miller, M.D. Editor in Chief, Harvard Mental Health Letter

"The FDA requires that a generic drug be essentially similar to the brand-name version. It should contain the same amount of active drug. It must be taken by the same route (for example, by mouth). And at a given dose, it should deliver about the same amount of active ingredient into the bloodstream — anywhere from 20% less to 25% more than the brand-name drug.
It doesn't always deliver exactly the same amount because generic pills contain inactive substances that distinguish them from the original. In fact, the U.S. government actually requires this, to prevent fraudulent marketing. The otherwise inactive substances in a pill can affect how the active chemical is absorbed by the bloodstream, delivered to its target, and eliminated; for example, it may break up faster or more slowly in the gastrointestinal tract."

Should deliver "about the same"????
20% less to 25% more is about the same???

For the life of me, I can not understand why this is acceptable. With ANY drug, but specifically an SSRI.

Because, with an SSRI, it seems that the risk of suicide increases when the dosage of the SSRI is CHANGED (starting/stopping/dosage changes)

On the medication guide (that I just received for the FIRST TIME with Honey's script for Zoloft oral concentrate two days ago) tells me that I should be particularly watchful of Honey whenever an antidepressant is started or its dosage changed.

How could I know that her dosage was being changed, when it was changed without my knowledge or consent... all at the approval of the FDA?

Not like I needed another reason to distrust the FDA.

Missing Liver Enzyme- Peter Breggin

My first time reading through "The Antidepressant Fact Book" by Peter Breggin, I must have skipped over the discussion about liver enzymes. (pg 108- 110)
I caught it the second time, but didn't do a whole lot with the idea mentally, I was looking more closely at other issues.
The third time through the book, the idea caught me and I decided it would be worth looking into a little further.
Liver enzymes are required to metabolize and eliminate drugs.
On page 109-110 Breggin says that some people (an estimated 7 - 10% of Caucasians, 3% African Americans, and 1% Arabs and Asians) have a genetic makeup that lacks one or another of the key enzymes involved in metabolizing/breaking down specific SSRI's. "Therefore, the drug will stay in their bodies in higher concentrations for longer periods of times. Because blood levels are increased, the risk of toxicity of almost any kind, including psychosis or a serotonin syndrome, is increased."

"The missing enzyme is called P450 CYP2D and it plays the key role in breaking down many kinds of medications... People missing this enzyme have only one-ninth the ability of other people to degrade these drugs and eliminate them from the body. As a result, a routine dose of Prozac or almost any antidepressant can cause a very severe and potentially fatal reaction." Breggin

"This warning cannot be made too emphatic: A significant percentage of the population is genetically vulnerable to severe toxic reactions to antidepressants such as prozac and other psychiatric drugs-- but potential patients are rarely informed about this possibility before they take these drugs." Breggin

I wonder what is up with this?
and it makes me wonder if this could be some of the reason behind why some people taking psychotropic drugs fall apart and do worse, no matter what the drug/cocktail leading them into an absolute tailspin.
If I have some time today (?) I think I will look at what else is "out there" as far as information/research on this liver enzyme deal.
Honey is still sleeping/laying there, though she wanted to try to be up almost an hour ago.

Thursday, March 8, 2007

stable self?

Last night I wrote that Honey was "back to her stable self".
Maybe (?) I spoke too soon?
Not sure yet.
She does not feel well today, BUT...
we probably screwed up ( what's new )
We have had tickets F*O*R*E*V*E*R for "Disney's Princess' on Ice" (or whatever it was called)
A special treat for "Tootsie" since we were doing NOTHING for a vacation this year. It seemed a bad year for vacationing, Honey having a tough time and all. So instead, I figured we would take some fun local "trips" throughout the year.
I should have insisted that Honey stay home. I should have known (when, oh when will I learn!!) that it would be too much stimulation for her, especially right now!
A couple day ago, I would have made her stay home.
But yesterday, after getting a proper dosage of her poison (aka Zoloft), she seemed more grounded.
Well, she wants to come, doesn't want to miss it.
She seemed okay this morning, but tired and a little irritable.
The feelings seemed to increase on our way there (about an hour drive)
She was overwhelmed.
When we got there she was-
Overwhelmed by people,
overwhelmed by noise,
overwhelmed by the pure visual stimulation that makes up a "Disney on Ice" performance.
And of course, we forgot to bring the Aconitum Napellus (a homeopathic remedy that Honey has used with success for panic attacks.
She was uncomfortable, I could definitely tell, but she kept denying it.
When the show was over, we stayed in our seats until most everyone had cleared out and the custodial crews were cleaning up. I wanted to be sure that the area was pretty cleared out of people in the lobby area, escalators etc.
We practiced some deep, calming breathing-- tried to trick her body into thinking that she was not overwhelmed.
She slept on the way home.
She cancelled boyfriend plans for the evening.
I need to learn and remember this mistake.

Wednesday, March 7, 2007

yep, it was withdrawal, yep- got the script for liquid zoloft :) :)

Well, 7 hours after taking her 37.5mg dose of REAL zoloft, Honey is back to her stable self. Irritablity way down, anxiety way down. I cant wait to see how she sleeps tonight since for the past several days, dreams have been dramatic and vivid and waking her up frequently. For two weeks she has been in withdrawal and we just couldn't figure out what was wrong.

Sertraline under the Teva label should be investigated. This drug should not be used as an equal to Pfizer/Greenstone sertraline. It took me a visit to 3 different pharmacies before I found one that carried Greenstone (vs. Teva)

I was so proud of Honey today. We have been talking over (Honey and I) what the goals of the Dr. visit were, what we wanted to share, what we would share if necessary, what we would accept from the doctor and what we would refuse.
Honey presented "her case", presented a review of previous withdrawal (late Aug 06 - started back on sertraline Nov 06 and dosage bumped up Jan 07 (to help with symptoms that seemed to be withdrawal symptoms from previous Zoloft use of 50mg), presented a summary of WHY she wanted off the drug and presented our researched plan for tapering safely.
Honey ROCKED! She did all of this while she was basically "freaking out" due to withdrawal symptoms. She finally had to sit down/lay back on a bench in our final pharmacy. The pharmacist got a dose for Honey immediately. A literal few hours later and she was feeling so much better.

Dr. gave Honey a script for 2 weeks worth of tablets.
She also gave Honey the script for liquid Zoloft.
We decided that Honey would stabilize on the tablets for a couple days, then go to tablets and liquid and gradually go to just liquid. WHY? I dont know- I just feel like we should. Actually, I think I received a helpful, anonymous email from a dear helper who suggested not going straight to the liquid, but to make a gradual change. Who knows, but it seems safer to me and dr. had no problem with it.
Glad the day is over. I am so glad to have solved the withdrawal issue, so proud of Honey- being her own advocate today (I know it something she will be proud of for a while) and so glad we got the liquid :)

Teva Announces Launch of Generic Zoloft

Is Teva sertraline/generic sertraline equivelant to Pfizer Zoloft?

Well, this makes all the sense in the world (if it is true?- wonder how I find out?)
Honey has been on this Teva form of sertraline and I think she is having withdrawal symptoms... well, it is not our imagination and I am not going to blame my poor pill cutting skills anymore. The above link is to a message board - a conversation others are having on the difference between Teva sertraline, Greenstone sertraline (greenstone being a Pfizer subsidiary) and Pfizer Zoloft. There are 379 comments concerning this issue. Most of them in agreement that something is wrong with the generic form- that they are having symptoms of withdrawal (though many of them dont know what is happening to them)

I also found some interesting thoughts here
and here at crazymeds.org on generic vs. brand.

Well, I think I have resolved one issue- Honey is in withdrawal and it is because of the freaking drug (teva form of sertraline)
So now, wonder what I do?
Do I continue with 37.5mg doses?
I have no idea what she has been getting. But yes, she needs to get stable again.
This is my plan (if we get what we need from the doctor today):
(But wondering now if doctor can give me a mix of these two forms of zoloft?)

oral concentrate form of zoloft
I also plan to ask for a script for 25mg Zoloft tablets – hoping for a couple weeks worth. Honey would take 1.5 of these tablets. I know it is going to be a short wait for the liquid (if she gets it) since it is not stocked where I plan to go for her rx. (It wasn’t stocked regularly anywhere around here). I am done with Teva. So she will need tablets until the liquid is available for us. I thought about this-
Tablets until liquid is ready then:
1 tablet and 12.5mg of the liquid (.62ml- haven’t quite figured it out yet) for a couple days, then ½ tablet and 25mg of the liquid until I am out of tablets. I just feel like it should be a gradual shift from tablet to liquid.
But, what do I know… well, I guess I know I need to trust my gut.

Tuesday, March 6, 2007

Honey still irritable- withdrawal?

Honey has been really been different, though I am just now putting it all together.
She says she has felt this way for a couple weeks (which would be when I had to start cutting the Teva form of sertraline). It is just looking back at this time period that she realizes she has been “off”.
I have noticed it for about a week, but chalked it up to being housebound and then thinking she was getting sick.
Since I had many reasons to validate a change in her behavior and I am still not sure what its cause, I am just putting it together and seeing the big picture and I worry that it is somehow withdrawal symptoms?—could the dosage be that far off in my pill cutting to give honey withdrawal symptoms?
It seemed to escalate yesterday:
Irritable, irritable, irritable. Feeling sick (headache, body aches- no fever), feeling “down”, tired, tired, tired and affected more than normally by stimulation. (Example- Honey has been helping little sis with a computer game for a while (a month?) Honey wants to/likes to do this and they usually have fun. It is a game from lil sis’ school and lil sis runs into problems and Honey helps her figure out what to do. Honey helps for 15 minutes or so without any problem whatsoever. Yesterday, Honey helped and ten minutes later she was climbing the walls and had to lie down. I talked with her about it and we decided that it was too much stimulation- that activity like that would have to stop.)

We had been house-bound Wed- Saturday due to snow, lots of snow. Honey got outside just a few times for an hour or two at a time during that span. Without school and with slippery roads, Honey has been home much more than normally would.

Little sister has obviously been housebound with us. Little sister has been driving Honey crazy. Honey has had periods of absolute inability to tolerate lil sis. (and little sis isn’t really doing that much to irritate- it is just her being around??) She doesn’t want to be touched by lil sis or have her even get close. I am doing everything in my power to keep lil sis away from Honey. Have talked with lil sis and let her know it is important to just leave Honey alone. Let Honey come to her and then just talk quietly and gently with her. That when Honey is ready she will play again.

Maybe Honey is sick?
Maybe it with withdrawal symptoms?
Needed to make note of this

Sunday, March 4, 2007

Honey is feeling irritable

Well, after venting a bit I am feeling better. Stressed as ever, but feeling better.
We have been trapped in the house for a while. Honey did "get out" but only for a couple hours at a time, and has otherwise been trapped here with us. Tootsie (the younger sis) has been here 24/7. Bored out of her mind, though doesn't like any of my ideas. Her boots are at school (school is closed) so she cant get outside. Hoping that we can get in to school tomorrow and get them. The kids have the week off for "Spring" break. Spring is eons away. We are trapped under a fresh 40 inches of snow (most of it received within the past 10 days). So Honey and Tootsie are penned in here together and it is not going well for Honey. Tootsie is driving Honey a literal crazy.
I have noticed that the past few weeks have been more difficult for her (than normal-for-her difficult). Seems to be anxious, more dreams (not happy, fluffy kitty dreams either) and IrRiTaBLe as hell.
I've been cutting these damn pills with a razor and as I mentioned in an earlier post, it just is not working. I feel like I am doing an OK job-- not too far off-- but worried now that the doses have been off just enough to be causing Honey's symptoms. Wednesday's appointment will not get here soon enough.
Wednesdays appointment is keeping my mind so focused on this specific issue. (Getting nurse practitioner to give the rx for the liquid without a fight, without Honey getting upset/without giving Honey any ideas that "she needs this med" or "maybe try a different med" or "Let's increase the Zoloft and see if things get better" etc etc etc. ) I want to go in, present the case, get the script and get the hell out of there. I dont want to present my arsenal. I dont want to have to explain what I know and have her question me, have her question Honey. I dont want her to give excuses for why Honey feels the way she does/did. I dont want to get mad (even though I am p*ssed off). I dont want to say anything I will regret later.
I dont think I/we should have to beg. I dont want to feel like a little kid in there... I always feel like a little kid and the doctor is some wise, all knowing person, that I have to/should trust without question. I dont want this.
I just want this damn drug, so I can poison Honey some more with it.
This is crazy.

Honey went to pick up her prom dress today.
It is beautiful.
She is a beautiful girl.
I wonder if she feels beautiful on the inside anymore.
I dont think she does.
I think that icky ex-asshole of hers took that away.
I wonder if she feels beautiful at all any more.
I brushed her hair this morning.
I felt like I was stroking her soul.
Lately, she has been wanting to brush my hair.
Or play with my hair.
When I ask to do hers, she always has an excuse.
This morning, when I asked, she said, no- it's dirty.
I said, That's okay, mom's dont care about that...
and she let me brush it.
I felt like I was taking care of her again in such a basic way, but it meant more to both of us.

snow, weekend, school break

Personal vent--
We had a busload of snow Wed-Friday (actually into Saturday) no school for the kiddos (and thus no work for me on Thur or Friday-- which unfortunately means no $$ from clients -- will I really have to call them? beg for my $$... the $$ I earn feeding and caring for their kids?
Husband thinks I should let it go (not remind them that regardless of the snow storm, they still need to pay up NOW) and just make phone calls NEXT Sunday night letting them know that they will need to have child(ren) bring bag breakfast, lunch and snack- including beverage. Please also include toilet paper, cups, napkins, art supplies. Hey, food for us too since we haven't eaten in days! And then NEXT Friday, when they will all figure out that they have not yet paid me for this past week... I should actually do what I say I will do in my contract for late payment and add the 15.00/day late fee to their invoice. Ha. That might be fun. It might make starving worth it too. I will have to see. Of course, being me, being the spineless, loving daycare mom that I am, I wont do it. I wont call them all tomorrow and insist on being mailed a check- received no later than Wednesday... and I wont call next Sunday night to let them all know that bagged meals/supplies will be required by all children. And, I wont tack on the late fee (that I have right to per my contract that all families have signed) that would total 210.00/family. Doormat, yes, that is me when it comes to my job...
We really do have nothing worth eating... little tootsie just asked me what I was making for "dinner" I asked her if she wanted "Slim Fast" or Kraft mac & cheese made without milk. She is eating saltine crackers with ranch dressing- yum! lol
Suppose I will have to do something about this- it would be nice if hubby had a job, wouldn't it? Got a little in the checking account, but saving that in hopes that Honey will get the rx for Zoloft oral concentrate on Wednesday. Hate to dip into the savings. Shouldn't have to. Guess I will have to call for my money. Makes me feel like I am groveling. Like I am asking for a loan. It's my money- I have already earned it. THEY don't have to wait around til their employer feels like paying up.
I am crabby.

Wednesday, February 28, 2007

sertraline... trying to get an rx for liquid Zoloft

Well,
Refilled Honey's rx-- and the pharmacy switched something because the sertraline tablet is shaped differently... kind of oval with ends that are quite narrow (had been getting tablets that were oblong). I am finding this shape and tablet itself very hard to cut.
Since Honey is taking 37.5mg/day we had been cutting tablets and seemed to be doing a good job of it... not any longer.
So I decided to start titrating the drug in liquid and would measure accordingly. This dang drug does not dissolve in anything I have tried (though I have not tried alcohol yet- last resort, I guess) I have tried water- hot/cold, 7-up, tea, seltzer water... and I just get a cloudy mess- even after stirring and mixing several minutes, there is drug clinging to the sides of the measuring cup and it settles fairly quickly to the bottom.
We are going to march right in to the clinic and talk about getting an rx for Zoloft in a liquid form. In the end, if we succeed, it will make it much easier when Honey is ready to start reducing.
I hope we get through to the doctor - I hope she (doc) is open to my request and understands the need. It would relieve so much stress and I know would make this whole long process easier as far as dosages. Once Honey is ready, we will start with 5% reductions, not reducing again until she is grounded and feels just as stable as when we started. If we have to wait weeks/months for this to happen, so be it. Once school is out for the summer, I might try a 10% reduction and see how she tolerates it.
Glad to get this down.

world turned upside-down but set back a little straighter- Part 2

Well,
although my heart hurt and I felt and unbelievable rage, I kept it together for Honey. I was "unshocked" (as I have told to react to most anything she says) and I think she felt accepted and loved and she knew it was the right thing to tell me.
The next day, I found some most wonderful, caring, compasionate help for Honey. That very day a dear sweet woman sat with Honey and listened and listened and listened.
I think Honey lost 10 pounds of burden in those 2 hours.
Honey will meet with this great helper every week until Honey is ready to move on.
I KNOW Honey will heal.
I think she is on the right road now.
I know there will be ups and downs.
I know she is not out of the woods... but at least we can see the clearing.
It might be far away, but we can see the sun, the clearing is there.

Monday, February 26, 2007

world turned upside-down but set back a little straighter

wow, what a couple of weeks. A lot has happened. a lot of hard, good things.
Making a l o n g story a bit shorter, Honey and I had a great conversation and within the conversation my sweet, lovely Honey let me in on some horrors of her past year and a half. Let me know just what it was that led us to seek the Dr. help with symptoms of depression.
That horrid boy that she called a boyfriend last year raped her early in their relationship.
Then, she went to her "best friends" for help and support, kindness and a shoulder... and she got shut down, ignored, called a liar and worse.
So she went back to "Icky" as I like to call this creepy "boyfriend" who managed to use the fact that she now had no friends to brainwash her into thinking she "needed" him just as he "needed" her. That they were meant for each other, that he needed "help" and she was the only one who "understood" him and the only one who could help him. He knew all the right things to say and do to "keep" her and control her.
He continued to abuse and assault her. I had NO idea. She really didn't give any indication that SHE was unhappy with HIM (it was her friends that were causing the most pain, she would say, and HE was "helping" her through it) and everytime I tried to talk to her about their relationship she denied any problems, she never admitted to feeling that he was overbearing or controlling and couldn't stand the idea of "breaking up" with him. I spent most of the school year last year and a good deal of the summer trying to "wake" Honey up and get her out of his control.
Finally she saw the light (many people flipped the switch on and off, but it was something she had to "see" for herself, I guess).
Actually, late this summer/early part of the school year is when I finally filed for and was granted a restraining order on Honey's behalf.
Maybe the pain got too great? Maybe it was too much to try to bear alone? I know God intervened, stepped in. It became clear to me that Honey needed help with something. She finally shared it- at first just sharing the inital attack, then a few days later able to talk about how the assaults both sexual assaults and emotional abuse continued throughout the relationship.
That bastard.
Given the opportunity, I would make sure he would never hurt another living thing- ever.

Wednesday, February 14, 2007

soulful sepulcher: I took a walk; You have mental illness and medication , now what?

soulful sepulcher: I took a walk; You have mental illness and medication , now what?

Well, once again, Stephany seemed to have the right words for me today. I love the concept of "mindfulness" -- for myself and to share it with Honey.
More often than not, my mind is in the past or in the future and hardly has any idea what is currently going on. I do feel that "life is passing me by" and I am letting it. If I try, I know I can change the way I live and in practicing a more mindful existance, share it with my family as well.
I have so enjoyed reading (and putting into practice) Peace in Every Step (Thich Nhat Hanh)-- it all makes sense in a simple yet very spiritual way.
Focus on my breathing... such a simple thing- but it seems to make me ever so aware of ME and allows me to actually FEEL me and then I slowly feel some of the tension leave and fill those spots with a sort of calm or peace. lovely

Befrienders Worldwide

Befrienders Worldwide
I want to keep this handy:
Listening Skills
This is something I need to be sure I am practicing ALWAYS, I know I get caught up in my own thoughts and often while listening to someone else, instead of LISTENING, I find myself responding/reacting in my mind to what is being said -- instead of listening and THEN composing my response.
I have to remember as well, that not everything needs a response... sometimes I would be better to keep my mouth shut.

Monday, February 12, 2007

Husband "waking up"?

I think maybe my husband is waking up to the fact that we have a situation that he can't sleep through. He has agreed to "read" Breggin's "Your Drug May Be Your Problem". Most likely he will not read cover to cover but hopefully will read enough so he can realize that these issues are not all in "Honey's" mind... and maybe he will understand that his suggestion to just stop taking the Zoloft (cold turkey) would do more damage.
He carries on like this is all my problem since I was the one who initiated the first appointment to the doctor with Honey's sadness. I was the one who started it. Well, maybe I did, but it was out of concern and I had no idea that it would lead to all of this.
I hope he will gain something from reading so he will (Well, I guess I first hope he will take some time to READ and hear the message)
I hope he can finally help me and Honey by sharing the burden.

Stephany's Soulful Sepulcher

I have been reading (on the edge of my seat with copy and paste in full use), Stephany's "Soulful Sepulcher" blog. As sorry as I am that any of us have to go through this crap, I cant explain how good it feels to "interact" with another mom who is dealing with some of this same stuff (having a child on psychiatric meds/getting a child off/helping a child feel whole again). Her daughter took Zoloft once upon a time. Her road has been a long one. She has been a hope to me and an inspiration. She sounds so strong and wise. I think she gained a lot of it as she went through trials that came close to touching hell. I am so thankful she is willing to share.

We turned out a good weekend

Our weekend was good... calm, peaceful and together.
Honey was home with us on Saturday-- all day and evening too.
It was nice to just be together. Honey wanted to make dinner for us... she thought for a while and said "I think I will make 'Papa Murphy's' pizza" (a take and bake pizza)... a true home cooked meal, lol.
We had some nice conversations-- one about her friends (sweet girls) and how much they mean to Honey. Friends had been one of the issues that put Honey in her intial long bout of sadness (the ended her up on Zoloft to begin with) Now she has some true friends, the kind she was searching so desperately for over a year ago. I just hope she doesn't do or say something "zolofty" that cause these girls to back away. She is realizing (through help from me) that she does say and do "stupid" things without thought-- not terribly frequent, but enough to worry about. I dont think she knows it is coming nor do I think she has any control over it??? She never acted in these ways prior to Zoloft.
Girls can be so dang mean to each other-- I remember it. Honey was looking for friends that cared more about what they wore and the color of their nail polish, she was looking for friends that cared about *everyone*, who were not afraid to be who they really were and still accepted you if you sat next to "a loser" during lunch.

Honey had a quest going on Sunday that started after she realized the prom dress she planned to buy was "gone". She and Superman (Honey's boyfriend) had plans to go pick it up on Sunday after he was done with work. She spent a couple hours trying to track down another (same dress/size) at every imaginable store, with no luck. She survived. I was proud of myself for just letting go of it-- letting her handle it, make the calls and such that she felt she needed to do. I have been known to "do it for her" as a way to hope to reduce her stress, but in the end, she seemed no worse for the wear.
Superman came over on Sunday and once he was here, must have invited Honey over to his house to have dinner with his family. Honey declined but felt bad that she didn't want to go.
Superman's stepdad sounds like a creep (from the way Honey talks of him and Superman has mentioned a couple of incidents that let me know things are not all together healthy over there)
Honey and Superman have been dating seriously for 8 months. For some reason (maybe the reason being that step dad seems to want to control everyone and everything?) step dad dislikes Honey and does not approve of her. He will make comments that air these thoughts whenever he feels like it and Honey finds it hurtful (I find it abusive). Honey seems to feel that Superman's mom likes and approves of her just fine, but because of Mr. Control Freak (step dad) Honey is just not accepted.
I think we need to consider whether going over to Superman's house **at all** is a good place for Honey (she dislikes meals because mealtime is when she has to interact with step-dad, but does go over at other times).
I have been watching Superman closely over the months to be sure he doesn't act controlling or abusive in any way towards Honey (or anyone). He is supportive of Honey and she considers him to be one of her "safe people". I enjoy visiting with him and he seems geniune in his feeling for Honey.

Saturday, February 10, 2007

I love the weekend

I am glad for another weekend.
I hope it will be quiet.
and calm
and peaceful.
I hope for no drama, no tears or anger
I hope we can find some joy
and some time to be together.
I hope to gather the girls for a nice "Red Letter Bible Meeting" as they have affectionately called our time of Bible study and prayer. I think they like it. I know I do. I never would have imagined that "Tootsie" (what I will call the youngest as I blog) would enjoy it so much. I read all of Phillipians to her last night (NLT) and she sighed at the end and said "God will tell my heart what it meant"
I think that Honey and I will shop for a short bit today-- time alone and time to enjoy (I hope... it wasn't more than a few months ago, that she had a severe panic attack while shopping with me-- the mall/shops were so crowded and noisy with holiday shoppers and she really was so ungrounded to begin with at that point)
Honey was gone most of the day afterschool and evening, though I had a chance to visit with she and her boyfriend, "Superman" (what I will call Honey's boyfriend as I blog). I catch glimpses of the "real" Honey, from behind the Zoloft fog every so often. Yesterday was not one of those times. Yesterday, she seemed a bit manic Sometimes, I wonder if she puts on a "happy show" for my benefit- so that I wont worry. ((I have seen in Honey a couple of times, however, what seemed to be an actual manic state, when she was on 25mg of Zoloft (before we increased it to 37.5mg). I need to remember to document this here (I have it documented... but would like to have everything in one spot)). Maybe I question her too often about how her "heart" feels. Or ask her if she is being true to herself when she doesn't want to think about it. My use of "Are you being true to yourself" started about a month ago. I noticed with the eyes that are in the back of my head (actually they have grown to cover my head now... and they dont blink much anymore either) and my motherly insticts (might have also been the manic behavior Honey was displaying (that seemed to go hand in hand with impulsive behavior) that tipped me off??) that she was involved in another of her "impulsive/rumor causing situations" and sure enough, I was correct. We talked about it, she denied nothing, and seemed truly perplexed as to why she would act in such a way/"say" (actually instant message) the things she did (things that damage relationships and damage her reputation) It is almost like she has no conscious control over some of her actions? We talked about being true to ourselves. I told her I would be checking in with this aspect of her life by asking her if she was being "true to herself" and that she could also look over her actions on a daily basis as see if she were being true to the person she is... I am hoping that if she/we catch these situations early enough, I can help her steer clear of potentially damaging situations.
She (Honey) has problems with doing and saying impulsive things-- all started last year a couple months on Zoloft
In "The Antidepressant Solution" (Joseph Glenmullen MD) which I am reading now (just about done), Glenmullen talks about impulsivity (disinhibititon) as a side effect of SSRI's. Though I have very limited knowledge about SSRI's/their side effects/withdrawal, I am trying to educate myself best I can. Glenmullen's mentioning impulsivity and disinhibition as a side effect of SSRI's was when I first learned that Honey's impulsive behavior (frequent episodes) might just be related to the Zoloft. I felt so relieved that this behavior might be the drug and NOT Honey at all!! I ran this by our "helper" (the absolute saint who is helping Honey prepare for withdrawal and who I hope will also be "with" us once we actually begin to taper)-- are these "things" that Honey has done in the recent past related to the Zoloft? and she said, "Of course it's the drug. People cannot be themselves on these drugs. While this is all stunning to you, believe me, it is a story heard every day." (said by our "Helper")
This Zoloft really sucks... but I know that my real, true Honey will get through this and come out lovely and real on the other side of it.
Maybe someday, my thoughts will be less scattered. I am glad to be writing though, because I have so much I want to get down. Once I have all the words down that I have seemingly saved in my heart and mind, maybe writing will be easier for me to follow.
the writing feels good... like I am sharing it with someone-- sharing the burden in a way.