Thursday, July 12, 2012

7/11 - Progress and new med


Chelsey did so well on Wednesday! She was calm and lucid for calls from Beth and for almost my entire 2-hour visit. She stayed grounded in reality, and I don’t think we did even one make-believe story. She said she was sad, though, “Because I’m starting to realize I may be just a normal person,” instead of a goddess. Realizing that Sam Flynn is just a movie character was also sad, because that means he can’t be her boyfriend. We talked about what it might look like to have a boyfriend in real life. We also talked a lot about coming home, and she’s very motivated to make that happen. She was happy at times.

She also seemed better equipped to deal with the other patients. She’s back in her stoic, calm mode. She says they don’t bother her, and she spends a lot of her time “doing my own thing.” She planned to ask for a book or watch TV when she went back on the unit.

One major downside is that her improvement may have been due primarily to a new medication, Risperdal, which was necessary because her disordered thoughts had been continuing. Risperdal is used for both bipolar and schizophrenia, and it’s often used for autistic patients. The fact that it was needed and has improved her thinking may suggest that she has schizophrenia, or mania with schizophrenic features. Or perhaps it was just a temporary psychotic break. I don’t know the nuances. Anyway, it’s bad news that she may have a relatively complex case of mania or something more than just mania. My impression is that Risperdal has a higher risk of worse side effects. I don’t know what that means for the long-term future.

The doctor called after the visit to discuss her progress and meds. We’re all thinking she might be able to come home next Monday or Tuesday if she stays on her current path. They still want to monitor the out-of-touch thoughts, suicidality, and daily living activities like going to the bathroom. She’s still in pull-ups and doing inappropriate behaviors at times, even though it’s improving. There’s some indication that she’ll try to just tell us what we want to hear about suicidal thinking in order to get home. It’s like she has a checklist of items she needs to convince us of to get home, and she’ll be working on it even if she feels otherwise.

Overall, progress. Bringing her home early next week is the new goal.

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