She's home

What an exhausting and frustrating day. After fighting so hard to get her in there, they made us sign a release against medical advise form. Now THEY think she needs to be there. Which incompetent am I to believe.

I actually talked to some empathetic and seemingly intelligent people today as they pleaded for us to keep her there. These people would not being seeing DD. Too little, too late. Turns out she would only have four 45 minute to one hour sessions a week! What is the point? Why is she living there for that? We can sedate her at home and get her four sessions a week. They UPPED her dosage TWICE without a call to us.

Now I need to run to parent orientation night at the High School. Tomorrow DD will go to Junior High like nothing happened. But I am sure she will tell everybody what happened. I can't save her from herself.

Is it worth it?

So, I called DD today to see how things are going.

Apparently she was throwing up all day Saturday--the day after they started medicating her. No medical staff there on weekends. No activities on weekends. Other than eating, the kids had no scheduled activities. How dangerous is it to have a bunch of troubled kids sitting around idle?

She sounded sedated--not quite slurring, but not her usual tone. I was told she would be given two meds, with an optional sleeping pill at night if she wanted. She said she gets a pill in the morning, afternoon, and two at night--one being the sleeping pill. Four pills. They are automatically giving her the sleeping pill that she was only to have if she asked for it, and perhaps one of the meds is given two times a day. I am not sure of anything, and I don't like it.

I called the therapist to confirm our Wednesday appointment and got her voicemail, where she states her name and her position. She is an intern. The intake biotch was also an intern. A nurse called me to tell me about the meds, but couldn't really tell me why these particular drugs were selected. I wonder when we get to talk to a doctor who is maybe more experienced in diagnosing and working with attachment disorder.

I am starting to hear from more and more people who tell me that these RTCs simply drug and release these kids--some coming home with new learned skills that you won't like, having been exposed to kids even more messed up than them. I'm hearing this from parents and teachers. I am losing faith that they will make any positive difference in her life and we are considering pulling her out as early as tomorrow. All I see happening now is that they drug her, then release her a week or two behind in school. Nothing beneficial.

She also said that she has been in several fights with her roommate who is supposedly bossing her around--probably is, but... So, even sedated she is having issues, and they are still talking about releasing her in a week. I just don't see any benefit to this farce. I am so drained by all of this. I am feeling a bit trapped and helpless. They bill my insurance $550 a day for what?!?!? You would think that $16-$17K a month would provide more qualified care with constant structure and observation and guidance. I think this is one of the biggest scams I have ever witnessed.

I am so stressed that I cannot sleep at night. I am having some kind of reaction around my eyes as well. I look like a bulldog from the extreme puffiness. I've taken tons of Benedryl, used Benedryl cream and antihistamine eye drops thinking maybe it is some weird allergy, but I think it is a combo of no sleep and some physical manifestation of the total anxiety created by interacting with this frustrating place.

DH sees how frazzled I am and is stepping up. He is going to call them tomorrow and tell them to prepare her to leave--pack her up and get their bloody forms ready. He is ready to get her out of there. We will not continue the drugs either. We will pursue yet another Psychiatrist here locally and wait out the 6 months for an opening and see what happens.

If I thought that they might make a difference and might really observe and examine her over time, then treat her for the months I think it will take to help her, I might be willing to overlook some of the unprofessional areas we've witnessed, and leave her there a little longer. But I get the clear message that they will keep her for a week, two at the most, and that is just a waste of the insurance money, of DDs school time, of our time and effort, and just the hassle of having these idiots dictate to us what we have to do with BOTH of our kids. Meanwhile, school started today without her and she is falling further and further behind there. She described her first day of school at the RTC (they started a week ago) and it sounded so minimal. Reading, playing, singing, catching a frog outside (not related to science). I find it hard to believe that this would keep her up to date with the 7th grade curriculum at home. I think they are doing more harm than good.

So - tomorrow will be an odd day. Not sure how it will all go down, but I suspect more drama is on the way.

On the bright side, I worked from home today so I could see Tony off for his first day of High School and pick him up after. Tony had a great first day of school. He saw some old friends, loves his classes--even the AP English he was dreading, and he liked the food in the cafeteria. He came home, organized his books, gave me papers to sign, then started on his homework. Then practiced for his piano lesson. On days like this I'm so grateful that he is so responsible and self-sufficient. He brought a huge smile to my face and a warm hug to my heart.

Kind of numb...

DD's therapist called me today at work, 20 minutes before I had to give a presentation in a meeting. After spending an hour with DD, she feels like she may be released in a week or so, since she is not a danger to herself or others. So hitting, fighting, biting, scratching, jumping on other kid's heads is apparently not a danger to others. She actually needs to pull a weapon. I don't know.

Then she tells me that DS must be a part of every family therapy session. I told her that there was no point in involving him initially--that first we, as the parents must establish a relationship with this child and that I will not put DS through anything further until we see some progress. She insists he must be part of it since he lives in the house. I told her again I would not do that to him. She asked how old he is and I told her that he turns 15 today! It is his birthday and I need to focus on HIM today. Then she starts lecturing me on the rough life DD has had and how through no fault of her own has developed these behaviors and that I need to understand...I cut her off completely. I was LIVID!!!

"Who do you think you are talking to? Do you think that I do not know all this already? Do you think I am some heartless bitch who doesn't understand all of this? I completely understand and my heart breaks for her, but I am telling you that I do not have the tools to help her. After six years of therapists, psychiatrists, counselors, powerful, frightening medications, parenting, guidance, love, support, rewards, punishments, warnings, threats, loss of priveledges, after all of that energy and effort towards supporting change in her that not one behavior has changed. She is doing the same things she did 6 years ago with no progress and that we need help."

I then reminded her that we have been trying for two years and she has known her for one hour and that I don't care if she thinks I am some over-reactive, uncaring beast, there are deeper problems here than we can handle and that she needs to hang out with her a little more before she starts lecturing me about this kids needs. I was shaking I was so angry, and then had to go lead a meeting and do a presentation. I was still shaking when the meeting started and I was flustered and just all over the place.

Even typing this I am getting very emotional. It took me over three months to get her in there. They want me to go and withdraw her from the Junior High here so they can transfer all her records and IEP/ARD papers there, and for what? A week!?!?!? I am just dumbfounded again.

Then a nurse calls me at home to say the psychiatrist saw her and wants to medicate her immediately. He is putting her on two extremely powerful and heavily regulated drugs. But there is no problem and she still might be released in a week. Tonight she is starting on Abilify and Depokote. She has been on both before with no results. They are both used basically as mood stabilizers.

I am totally deflated, but need to let go of this so I can enjoy my son's birthday tonight and try to enjoy whatever time we have without her. Our options are getting limited in what we can do to help her without sacrificing our family and our health any further.

We are scheduled for a family session on Wednesday at 4:30. DS will be in attendance as we are doing a conference call from home. If she stays long enough for a second session the following week, he will NOT attend as I am not going to pull him out of school to drive an hour north of here for a session that really hinges on her bonding with us first.

Tu Mama es LOCO!!!!

Ever see the movie, Terms of Endearment, with Shirley MacLaine and Debra Winger? There is a scene where Shirley MacLaine is trying to get the nurses to give her dying daughter (Winger) some pain medication and when they are moving too slow she goes a little psycho on them.

OK - I went "Terms of Endearment" on thay azzez.

Facility number one was driving me crazy. When I tried to call yesterday to confirm that they had all they needed from me or from our therapist or our doctor, their phones were not working for the second time in fives days!!! I don't know how you run a facility with 120 kids and not have functioning communication devices. It was maddening. And here we are 7 days since our initial contact and I still have not heard from them.

So, yesterday I called another facility and started all over again.

I cannot believe how difficult this process has been. I told my intake nemesis that she is ALREADY APPROVED and this biotch was almost yelling at that she is NOT APPROVED. I was going wiggy! I was just dumbfounded. This woman refused to make a 1-800 call that would take 5 minutes to verify. Instead she kept telling me that since DD has not been previously hospitalized, was not attempting suicide or threatening to kill us, that she did not qualify!! This is the battle I fought with the insurance company for two months and finally won. I kept asking why I had to wait until it got to that point before anyone would consider helping her.

This back and forth and her sassy attitude had me going a little psycho on the phone. I was saying things like:

"I know that this is not your typical approval and admission process. This case is a little unconventional, but if you will PLEASE just make the call. I am begging you. I'm sorry that she does not fit your little checklist but I am telling you that she is approved. Do you think I am making this up?!?! Do you think I am lying? Why would I do that? What would that get me? You would figure it out real quick and I would be stuck with a $17K bill for the month!! I am begging you to step out of the box a little and have a heart and help a mother out. This has gone on for months. I want to get her settled before school starts. I cannot believe this. I have a therapist, a psychiatrist and an insurance company all saying she needs this and it is approved--the money is in your bank as soon as you say yes--and you keep telling me that my insurance will not approve this! I am loosing my mind here. What is it going to take for you to listen to me, believe me, and take a little action beyond asking me a list of questions and dismissing me?"

She got real pissy and said, "Fine, you can come in for an assessment if you want, and when we submit the papers your insurance is going to deny coverage."

I said, "FINE! So when can we come in?"

"Tomorrow, if you want!"

"FINE! What time?"

"Can you be here at 11:00?"

"I can be there whenever you say!"

"So, then can you come in at 10:00?"

"Yes - Definitely. What do I need to bring?"

She starts going down a list of documents, thinking it would be overwhelming for me to pull all this stuff together. She really doesn't understand me. I have had her papers ready for months. Then she tells me to bring a suitcase with 5-7 changes of clothes. I said, "Wow! Tomorrow bring a suitcase? Do you really think it will happen that fast?"

And she says, "NO! I don't think it will happen at all, your insurance is not going to approve this, but as long as you are coming in you might as well."

So I asked, "Why will you not call them? What is so difficult about this? How hard would it be for you to dial them up?

She said, "I'm not going to call them because they are going to say the same thing to me that I am saying to you. She is not going to be approved!"

_ _ _ _ _ _

Maddening, I tell you.

_ _ _ _ _ _

So, I feel like she scheduled the assessment just to placate me. So I stayed up until 1:00 A.M. faxing them tons of papers. Pscyh evals. School assessments. Foster parent observations, letters from the therapist and psychiatrist both recommending RTC. Then this morning I went in with everything I have--a two-foot high stack of papers. I had everything on their checklist, which freaked them out. They said no one ever has everything; they usually have to fax something within 24 hours.

It was a long day, but eventually it all went through, and my nemesis had to come back into the room we were locked in all day and act excited when she told us, "OK- So she's been approved, as you know, and we are getting everything set up."

We then met with a doctor, two nurses, the school counselor, a cottage nurse, and got a quick tour of the place and said our goodbyes. DD was just giddy--she was so excited. Her treatments start tomorrow--as do her school classes.

The whole day was pretty surreal, and DD already called to say hi and ended with an "I love you, Momma." Which is such BS and all for show for whomever was watching her make the call. She also asked if we could write letters to each other. We must look so much more appealing to her from a distance. I am very curious to see how these 30 days go. At the end, will they recommend another 30, or will they release her? We have no idea. Insurance only approves 30 days at a time, which makes sense, but will cause a little anxiety at the end of each month.

However long they keep her, I just hope it has an impact.

Patience is a virtue...

...in which I am lacking.

No one seems to feel the same sense of urgency that I do to get DD enrolled before school starts. If there is to be any kind of smooth transition back into this community and into our home, she needs to start the RTC before August 27th--when school starts. Otherwise, she will start, disappear, then reappear before Christmas, leaving her open to even more questions to her where-abouts in the interim.

Hope is fading that she will be admitted this week. Maybe next week will work, or even the following week. I am letting go, since I cannot control this. On Monday, if I have not heard something more, I will begin to bug the facility again, but the message so far is pretty clear. We are supposedly moving at warp speed compared to other cases, and 2-3 months to get things set up is a quick turn-around.

Meanwhile, my intake contact is way too mellow for my tastes. He doesn't do anything until I call him at least twice, possibly three times. He constantly forgets what he said he would do, and even though he tells me all the things that I need to send to him, and I send it immediately, he doesn't bother to check the fax for days, to see if he received what he supposedly needs to take the next step. He doesn't know how to spell our name (it is all over the faxes he requested from me). He forgets that I already gave him some info, like insurance numbers, ss#, fax numbers. He forgets that he said he would send something--something that I need to take action on to move forward. When I call to remind he, he scolds me, misunderstanding what I am asking for, then realizes that HE is the one who said he would send this stuff to me so I can jump through yet another hoop. He is driving me nuts. I think he is stoned. And maybe you need to be stoned to deal with a facility full of aggressive, challenging kids. Maybe this is why he is there, and I am not.

So...we wait. She will start school on Monday, and make all kinds of decisions and plans as if she will be around long term (she announced in therapy yesteday that she will be in the Color Guard this year--news to me and again, somewhat delusional on her part), and then she will disappear from her classes without any explanation to the students. Not what I would call an ideal setting for a quiet return later, but apparently, nothing I can do about it now. We will just cross that bridge later.

They called ME!!!

The insurance company actually called ME at 5:45 PM!!! I didn't have to hunt them down, yet again! They got the fax from the therapist and called to approve Residential Treatment!!! They agreed to short-term, (4-6 weeks) with monthly telephonic reviews to assess if more time is needed, based on medical neccessity and recommendations of the RTC. I can definitely live with that!

The other good news she gave me was that while I thought we would be paying 20% of the cost, there is a maximum out-of-pocket that is a huge relief! So, first thing tomorrow I am on the phone trying to get something started as soon as possible. School starts August 27th, and I would prefer to have her not start then disappear. Cross your fingers.

Tonight is parent orientation night at the high school. I think I might be a little distracted... Tomorrow, DS has a half-day freshman camp to learn the lay of the campus and what to expect on day one. I can't believe my little boy is in High School.

Oh the DRAMA...

So, it WAS too good to be true. The insurance company now has new hoops for us to jump through.

So, when we saw the arrogant Psychiatrist in early July, (all of the other insurance approved Psychiatrists within a 50-mile radius were either not taking new patients or were booked for 6-months out and would not schedule anyone new at this point)we asked him for a letter or recommendation to get DD extra, more intensive help. At our second appointment he did - he sat and hand scribbled a letter on his letterhead (whatever!). So, now that the vacations are out of the way and I have all my ducks in a row, I pursue the facility that the insurance company suggested. The facility informed me that I did not have what they needed. I called a second facility--same response. So I called the insurance company wanting to talk to my assigned case manager. No one at the insurance company knows what I am talking about and they never heard of her or that role.

Deep breath.

I was transferred through five people spending over an hour on the phone, almost loosing it while hiding in a conference room for privacy at work. Turns out the letters won't work. Here is the criteria: She either needs to be in a psychotic rage and the police take her to the facility, or she needs to threaten to hurt herself or us. I call these the three deadly criteria. These are all behaviors that we have been warned WILL occur around age 15-16. No one denys that. Not even the insurance company. The only other option is to get her a current psych evaluation, which leads us back to the issue of no one being available in town but the ass that told us, in front of DD, that it was too late to help her, that she is too old at 12, and then told her that these facilities were like Prison. Nice, huh!?!? No wonder he had availability.

So, we now have an appointment in late September with a Psych in a small town about an hour north of here. That is the best we have so far. The fifth person I talked to at the insurance company thought that maybe having her current therapist and even the arrogant ass call the insurance company might help expedite approval for her to go to an RTC.

Meanwhile, DD is BRAGGING to everyone that she is going away to boarding school where she will get 3 hours of therapy everyday. Oy!

As for DD - we had an almost flawless vacation with my cousins except for the daily dramas that centered around DD. The dramas built with intensity over the week, culminating at the end with me requiring her to stay within two-feet of me for the last day and half. Much as I wouldn't allow a two-year old to play unsupervised, she needed supervision. It was painful, exasperating, and embarrassing. I felt like I had inflicted her on my family. Honestly, almost everything else was perfect! It really was a great vacation, but the intense outbursts, inappropriate behaviors, physical altercations, constant bickering and just overall hassle of managing her was a constant thorn in our sides.

School starts in three weeks. I really don't know how to prepare. So many questions about her future, but I guess I just need to go on as if the RTC were not an option and buy her all new clothes and school supplies. If she is later accepted to an RTC I know that they limit how much personal stuff you can take, but I just don't know exactly how limited.

Yesterday we attended an informal parent support group at a local fun park/arcade. The kids ran around playing with each other while the parents sat and shared and vented and supported each other. Much to my surprise, a woman that I have chatted with on Adoption.com and of whose work I read and copied from the site, was there. We had so much to talk about. She has two biological kids and adopted a half-brother/sister sibling group. The 14-year old son is currently in an RTC and the 12-year old daughter is giving them a real work-out. They didn't notice how pervasive her behaviors were when the son was at home, because his behaviors were so much more evident. The police were out to their house a couple of times, and the father was accused of abuse. The kids were taken, and an investigation showed that they were innocent and both kids were returned. We were constantly interrupted by someone's kid needing something, so it was frustrating trying to chat because I wanted to hear so much more. We swapped contact info and will be getting in touch soon. They don't live very far from us. Small world - considering that is an international site.