Wednesday, August 06, 2014

A Collective Effort

Just like we do every other week, Thomas and I drove up to see Dr. N. I was in fighting mode once we got to the waiting room anticipating being told I needed to wait in the waiting room while Dr. N. talked to Thomas. It wasn't that I didn't want the two of them to have time together but I really wanted to speak to him and tell him what I had noticed as Thomas' mom. I hadn't seen Dr. N. myself for 6 or 8 weeks so I felt like this appointment was important.

When Dr. N. peeked around the corner to invite us back I made solid eye contact with him and asked him if I could come too so that we could all talk together. He easily agreed and I was relieved. Once back there he and Thomas went through the usual questions and then, just as I thought would happen, Thomas completely downplayed what had happened Saturday night and Sunday. This pretty much confirmed for me what had happened in the 6 or 8 weeks I had missed. Because Thomas' memory isn't the best, he doesn't give an accurate picture of his health. At any rate, after he said what little he said about Saturday, I put up my hand and got Dr. N's attention. I explained to him what REALLY happened and how Thomas was struggling that night and the next day and I saw that he was really listening to me. I also told him that I felt that there was some delusional thinking going on. He heard me.

We went on all of us together talking about Thomas' depression and how to solve it. The idea of adding in a different anti-depressant came up but was dropped in favor of other plans. I was glad about that because for some reason I felt bad that yet another pill would be thrown Thomas' direction. I don't know, there's just something about Thomas right now that I feel like I need to protect more than usual and adding another pill to the pill case just seems kind of cruel to me. It's very hard to sit in on appointments where we all decide what pharmaceutical concoction to throw at Thomas. I surmise that this comes from that little corner of my mind and heart that doesn't want Thomas to be sick after all.

Then the clozaril came up. Ah the clozaril. This is the med we've--or rather they--have been reducing for a while now. I can't say that I have been much of a fan of it from the start but once the Latuda was added in, clozaril (and Latuda) seemed to be the magic combination that saved Thomas. Clozaril is also the only one that has been messed with and it has been, after the reduction of it on several occasions, that Thomas had breakthrough symptoms. Now, because of all of that I felt that adding a little of it back in might help Thomas. It's what I personally believed wholeheartedly and it was what I was going to fight for.

I was pretty straightforward with Dr. N. letting him know that I felt that the COMBINATION of the two meds was what was keeping Thomas stable and he seemed to reluctantly agree that that was true. His plan had been to remove one of Thomas' meds (the clozaril) as fast as possible once he got stable. Contrary to his reputation that I heard about before Thomas ever saw him, he is not a doctor that wants to throw a pharmacy of meds at his patients and as such he wanted the clozaril out of the pill box.

In the end though, after listening to both Thomas and I, he doubled Thomas' clozaril dose. Doubled. Yeah, even I was a bit surprised. He must have heard me though and decided that Thomas needed it and Thomas agreed to it hoping that it would help his depression.

So, last night we were back to square one. A VERY sedated Thomas greeted me at his bedroom door when I came to say good night and my heart broke seeing him like that. That is one aspect of the treatment of schizophrenia I will never get used to. We said good night and we all went to bed.

Today is a new day. Today we start the march forward and we wait to see what the med change will do for Thomas. I fear that he will hate the sedation and will want to reduce it again. Right now all I want is his psychological suffering to be minimized though so the next few days are going to be ones of cooperation between Thomas and I as he gets used to and accepts this change.

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