Leelo's fasting blood test came back negative, came back normal. So Risperdol isn't affecting his blood sugar or cholesterol levels to a problematic degree. That's good.
Still, the Risperdol isn't as effective as it used to be, with regards to self-control, aggression (self- and outward-directed), and maintaining a reasonable sleep cycle for his age. And his OCD-like behaviors (stomping, banging windows, doors; slamming toilet seats repetitively) remain on constant slow boil. Those are potentially manageable, behaviorally, with constant blocking and redirection so he doesn't get the reinforcing "high" of compulsion completion -- but the blocking and redirection not only require hypervigilance and proximity, but mean I'd be constantly pissing off a strong little boy who already deals with a hell of a lot more frustration than any kid should.
Supervisor M is going to talk about the OCD and meds possibility with Leelo's psychiatrist. We will discuss the matter at his team meeting on Wednesday.
I just want Leo to be happy in his skin, to have free and total access to the joy that sent him bounding across the field during Iz's recent soccer game* (the players were elsewhere; closing in on and stealthily throwing elbows near the goal). It wouldn't be worth the trade off to sedate him, or change his personality. But he's going to get bigger; the pounding and slamming is annoying now, but it could get destructive.
We will reach a decision in the next two weeks.
In the meantime, please send wishes for good health to Jennyalice, who is battling increasingly brutal pneumonia.
*Seymour is out of town at the opening of his brother's new restaurant (so exciting!); I think Leo's exuberance helped the other soccer parents figure out why I do not usually attend Iz's games.
This phrase just blew my mind: reinforcing "high" of compulsion completion.ReplyDelete
This is such a helpful frame for thinking about Ben's compulsions and rituals.
While they take a different form than Leo's (we MUST act out this scene from Robin Hood RIGHT NOW even though we are in the cereal isle of the grocery store!) there is something similar in terms of the function.
I never thought of it as "completion high" before but that makes a hell of a lot of sense.
I am glad about the bG levels. You are such a smart cookie and work hard. I admire you lovely lady. Leelo is a lucky dude. :-)ReplyDelete
Christa, that "high" concept is straight from Supervisor M. She told me that the more someone with OCD engages in their compulsions, the more they crave them. If you can block or redirect, they don't get a "hit" in the first place.ReplyDelete
Jen, we are glad too, thanks. Diabetes and autism are a really challenging combination in one person.