One other thing

During my conversation with Toots' psychiatrist, she said, "I can't imagine how you ever coped with this at home."

"I don't need to be in the hospital"

I received a phone call from Toots' psychiatrist, Dr. S., at about 11:45 this morning. She filled in more of the story.

Seems Toots says she fell in the shower the other day. The staff didn't hear her fall, but they found her sitting on the floor of the shower stall complaining of back pain. (I let the doctor know that she has sat on the floors of showers for years, just letting the waterfall run over her for many minutes.) She was examined by the hospital pediatrician, who said she would be OK and offered her pain medicine. Toots didn't like that. As I have discussed before, her pattern for the last ten years is, with any pain real or not, to loudly and repeatedly insist on being taken to the nearest ER.

The most striking incidence of this behavior was five years ago, at my dad's wake. Toots claimed she had twisted her ankle running around outside, and was lying on a sofa moaning and groaning and insisting on an ER run. We have two doctors in the family - one a pediatric emergency specialist - and they both examined her and pronounced that she'd be fine with an ice pack and a little rest. Nothing doing for Toots. She kept complaining,louder and louder. Finally, Lew took her out for a ride in the car, which did not satisfy her but calmed her down a little.

Back to current events. Dr. S. observed that Toots seems to express her emotions through complaining about pain. True, doctor, we've been seeing that for a very long time. During the incident last evening, when she punched a staff member in the face, she was restrained manually. One of the people doing the hold had to twist her arm behind her back to get control. Today, she has been complaining about pain in her wrist. Again, she was examined by the pediatrician, who determined that it was not serious. She was offered ice and pain meds, which she refused. The pediatrician and the hospital's Medical Director agree that she does not need to go to the ER now, and on top of that, in her current mental state she is not safe to leave the hospital with staff.

Nevertheless, Toots kept insisting that the staff call me to take her to the ER. Dr. S. told her that she and Toots would call me at home together, during the lunch hour. I told Dr. S. that I absolutely would not take her, especially since they feel she is not safe.

This may be getting a mite confusing. Anyway, Toots and the doctor called me at about 12:30. I got an earful about "I don't need to be here, I need to go to the ER, I'm in a lot of pain, Mom, why don't you ever listen to me instead of to them?" She said that she bit the staffer because he had told her "Shut up." Hey, if that's the worst thing he said to her when she was raging, he has more strength of character than I do.

I tried to keep my voice as calm as possible and told her that it was NEVER okay to hit someone in the face. Since both doctors felt she didn't need to go, I was not taking her. (I didn't remind her, but I have vivid memories of Toots in a rage, attempting to grab the steering wheel, put the car into neutral, and run me off the road. Not gonna go there again.)

Her response was to hang up on me.

Oh, Toots. How can you think that you would be able to function in the outside world on your own?

Sigh

During my visit on Sunday, Toots kept insisting that she doesn't need to be in the hospital, she hates it, she knows what she has to do, etc. etc.

Last night at 9:30, we received a phone call from a nurse on her unit. Toots "had a bad day" yesterday, which means she balked at requests, spoke nastily to staff, picked arguments with other girls, refused to do her schoolwork, etc. etc. Her aggression escalated on the unit last evening. She scratched her arm, although she didn't have anything at hand to cut herself with. She also punched a staff member in the face. The nurse told us that the injured staffer has a cut on the lip, and that's all. Thank God. Toots had to be restrained (they use manual holds only) and given "stat" medication (quick-acting sedative). She was put back on one-to-one, with a staff member with her at all times. They had her sleep in the common area of the unit, rather than in her room, for monitoring purposes.

If she does get out into the "real world", how long would it take for her to hit someone and be arrested for assault? Worse, what if she hits a police officer (she's done it before, but no serious consequences because she's a minor and a psych patient)and gets Tasered or shot?

Keeps piling up

Last night, Toots punched a wall on her unit at Children's Hospital. She does this frequently, and has broken her right wrist several times. Not this time, thankfully. Just got a phone call. Today in school, she was having a verbal altercation with another girl. A male teacher stepped in and tried to break it up. Toots stabbed him in the side with a pencil.

Just broke the skin, fortunately.

I get so I don't even feel much at the announcement of new atrocities. It's just same old, same old with Toots, ten years' worth of it.

She thinks she is going to college when she finishes high school. We can't imagine how she would navigate a campus environment or make it through a class.

Short visit

Toots didn't like the Aveeno skin lotion I brought her last weekend, and she requested baby lotion. She didn't like the smell of the Aveeno. Why did I accede to her request? Because she gets very dry skin in winter, and needs to be using lotion. Now that she's decided against the Aveeno, she'd rather eat nails than use it. So I brought her baby lotion. After that, my visit this afternoon didn't go well. You see, when Lew was on the phone with her the other night, and she was talking about having assaulted a staff person, he said (as we have done before), "Toots, I can't continue this conversation when you're talking about having beaten someone up. Love ya, honey, good night." And hung up. Note that he did not slam the phone down abruptly. Today, Toots started in on how she feels very insulted and disrespected by that action of his. I tried to explain to her that we cannot accept her assaulting staff, and that it is in no way OK. She said that it wasn't her fault (it never is), she got mad when they tried to get into her room, and "I just blacked out and didn't know what I was doing. When I realized what I was doing, I stopped." It was further excused by the fact that she hasn't done anything like that in years. I corrected her memory; it's been just over a year since she assaulted a police officer. She said, "Well, many months." In the discussion somewhere was, "I'm not stupid, I'm not a little kid, don't you think I know better, I apologized." Sorry, Toots, I don't buy that. Up till now, you've gotten a bye because you're a psychiatric patient. In the outside world, if you assault someone, you will be arrested and go to jail. Her reaction, of course? "Well, I won't do that!" Famous last words. How many times has she said "I know how to behave, I'll just do it", and then gone blithely on to do exactly the opposite. Anyway, to make a long story short, I left 25 minutes into an hour-long visiting period.

Bad to worse

Well, she cut herself again today, using the piece of foil off a juice cup. I would have thought that foil was too soft to cut anything, but when Toots is determined, she's determined.

We don't have full information yet, but the unit had to "call a code" on her this evening. She got mad about something (who knows what), barricaded herself in her room, and wouldn't come out. I assume the staff tried to get her to open up, because she got madder and assaulted one of them.  Apparently the person is not badly hurt.

Oh, Toots. Where in the world can you be safely? Is there anywhere?