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.
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