When A Door Opens, Does a Window Slam Shut?

Let me see, where did I leave off…oh yes. The Girl finished outpatient therapy, started meds, went through a month of forced primping, and was doing better with her moods, self-isolation, and distrust. It was bliss.

Then, on Mother’s Day, I asked her to help me move some things off our patio so we had room for a new freestanding fire pit.  She didn’t look thrilled about helping me, but agreed.  I wanted to move two awkward log holders that had had been on the patio for the winter, closer to the house, back to their summer spot behind the shed.  I suggested we each take a side and start walking it across the lawn, stopping as often as was needed to change our hold or just rest a minute.  We got about halfway across the yard when The Girl dropped her end and said she felt dizzy and nauseous.  After 10 minutes in the house she came out to try again, but as she lifted it her eyes rolled back in her head and we stumbled back towards the house.  It took another 20 minutes of me watching her to realize this was more than just dehydration, as she lost the ability to remember the alphabet, then couldn’t stay awake.

By the time I carried her in to the emergency room I was convinced it was a stroke.  Her face was locked in a grimace and she was in and out of consciousness.  By the evening she’d had blood tests, a CT, and MRI and a stroke, diabetes, and heart attack had all been ruled out.  She was admitted to the pediatric ICU ward where a doctor-in-training told us they had to treat it like and overdose for 12 hours, since she’s a teen and had been in an outpatient program less than 60 days before.  I told her we lock up all our medications and got that condescending smile most doctors don’t perfect until well into their forties.  “No one locks up all their medications,” she said.  “Have you ever treated a child who has a sibling with Schizophrenia?” I asked.  The doctor had to admit she hadn’t.  I gently told her that now she has and, trust me, we lock up everything.  I was badgered about not knowing any of The Girl’s family medical history, and had to explain that some kids in the real world are abandoned by their birth parents, who don’t leave medical records with the baby they dump in a homeless shelter. Seriously, I wonder why the class in bedside manner is an elective.  Obviously they aren’t required to take it for their degree.

She couldn't keep her eyes open.

Four days and an EEG later, we had a diagnosis.  Frontal Lobe, myotonic seizures.  Origin unknown, but apparently they could be genetic, even triggered by SSRIs, which The Girl had been taking for going on three months.  That’s my theory, anyway, after reading about it.  The neurologist and The Girl’s psychiatrist thought that was a long shot, but we decided to wean her off the SSRIs anyway, since four days after getting out of the hospital she had another seizure.  In the month since she’s been off them, she’s been seizure free.  But, full disclosure, she wasn’t at a therapeutic level of her anti-seizure meds then and she is now.

So now we play the waiting game.  Were the SSRIs really helping her mood? She was on a very low dose, I tell myself.  Maybe it’s an internal conversion, not the meds.  It’s summer now, a time of notorious self-isolation for The Girl, but we are sending her to visit family in California for most of July, where she’s unlikely to isolate herself from the beach, Sea World, and her six cousins.  Then it’s merely three weeks until school begins again in late August.  If the psychiatric meds were helping her mood, we probably won’t see any deterioration that is remarkable until the Fall.

Maybe I’m a fatalist, expecting the worst, always waiting for the other shoe to drop, and any other cliche about being a negative Nancy you can come up with.  Optimism doesn’t come too easily to me after life with my brood.  But I know enough about RAD to know that it’s not something you cure.  The window of recovery was open; now I feel it’s slammed shut by a seizure disorder.  I’m worried about trying a non-SSRI anti-depressant and what possible other genetic malady could be triggered.  We could go back to just CBT, but that alone didn’t do the trick for years before.  If you’ve got a RAD teen, I’d love to hear your thoughts.