VENT plus hoping for ideas - LOOOOONG

clanmcculloch

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Feb 20, 2009
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I'm getting towards the end of my rope and I need somebody I can just get all this out to. I love that none of you know me in real life so I can just unload on you without fear of hurting anybody I love with my unbelievable level of frustration right now.

DD13 has Asperger Syndrome. She's always obsessive compulsive tendencies associated with her AS but about 2 months before school let out they started to get worse, especially in the area of concern over cross contamination of food allergens and not knowing who last touched something and what might have been on their hands. By the last 2 weeks of school, she wouldn't even go to the bathroom at school unless she was at the point where was risking an accident at which point she'd go to the nurse's office and thank goodness the amazingly patient and wonderful nurse would actually clean the toilet for her. During this same time her aid was also having to clean her desk and chair for her in order for her to sit down because she was freaking out over what the previous person sitting there might have eaten and did they have crumbs on their hands, etc. I should mention that her allergies are not anaphylactic, they cause some GI issues and worstening autistic issues so it's not like she's had some kind of near death experience to traumatize her.

Well, since summer began, it's only gotten worse. Things have now gotten to the point where it's not just food but also germs. I'm the only person who is allowed to physically touch her and even then it's only when SHE initiates or else she goes into a panic where she just can't function because she doesn't feel clean. She's been washing her hands so often that she has sores. She can't put cream on her hands herself because no matter how many times I clean the jar it's not clean so I have to put it on for her but I'm at work all day. She can't turn the tap on and off herself unless she has what she deems to be a clean cloth (meaning nobody but her touched it and it hasn't touched the floor) so she constantly asks me to do it when I'm at home and her little sister (who is incidentally having totally understandable meltdowns of her own over the stress of all this) when I'm not there though she ends up generally yelling at her sister for not doing it right (too hot, too cold, too strong, not strong enough). She calls me at work with meltdowns all day long. She has to wash her hands if she touches her own feet, if she touches ANYTHING that she deems unclean (which is almost everything). Going to the bathroom is a whole production of its own. She can barely leave the house because anywhere she goes seems to be unclean. She has trouble getting to sleep at night because her mind won't turn off. She calls out to me every 10-15 minutes about some obsession or another until I end up yelling at her to stop calling to me unless she's bleeding or dying. Yes, I'm at the end of my rope and I hate doing that but I don't know what else to do.

DH can't help her at all because somehow he's become the focus of some of her obsessions and anything he touches is immediately considered unclean. It doesn't help that he's the kind of person who really isn't capable of seeing things from another person's point of view and doesn't understand what real obsessive compulsive issues are, despite his oldest have classic OCD (it was me who had to put my foot down and insist that she get help despite being the step-parent; bio parents just couldn't conceive of what a psychiatric problem really is). He ends up just yelling at her which of course just makes things worse. They barely speak to each other but I have to listen to each of them vent to me about each other. I tell them, beg them, to stop since it's just putting that much more stress on me and not actually accomplishing anything but it doesn't matter and they just don't stop.

She started with a therapist last week but I really don't know what a once a week appointment will do in the short term. Last week included me and was going over her history and explaining the problems that need adressing. Today will be basically raport building. I don't think I can cope with this until she gets to the point where she's actually dealing with this. I'm welling up in tears sitting here right now typing this because I'm so overwhelmed.

She says she absolutely refuses medication. I don't know why and can't get any kind of explaination out of her. I suspect it's part of the obsessive compulsive stuff that she just can't explain. Years ago when she was misdiagnosed with OCD (though now I'm wondering if she really does now have true OCD) she was medicated with Zoloft and became violent. Can you imagine a violent 3 year old? I've seen it, it's not pleasant. Anyway, the psychiatrist said she should never ever take SSRIs again after that. Not just Zoloft but any SSRI. Anyway, even if we did try medication, it takes a long time for it to kick in and get titered up to the right dose so again I don't know how I'll cope until that happens even if we do end up going that route.

We head to WDW in 15 days. Because of this I'm NOT starting any new medications that have the potential for side effects. I've told her that I'm really nervous about our trip because I'm worried that she won't be able to even leave the room. She looked at me like I had 2 heads and proclaimed that WDW is her happy place and it's clean so there shouldn't be any problems (that's my girl). Hopefully in that obsessive compulsive part of her brain she really does believe this but I'm still worried. Unbelievably worried. I'm actually holding off on booking flights for a February trip until I see how she does in a couple weeks. Luckily there is something about WDW that does seem to calm her but I can't even express how nervous I am about our upcoming trip. She can't even cope at home, how will she handly everything else? I'm mentally preparing for maybe renting a wheelchair to give her a buffer zone so nobody bumps her but I know DH is VERY opposed to this.

When we get home, school starts a few days later. How the heck will she function at school? When do I call the school to tell them what's going on and what do I even say?

Anyway, if you're still reading along, thank you for listening to me unload. If you have ANY suggestions, I'm all ears. If not, thanks again for just letting me get all this out.
 
I have absolutely no advice for you. Just wanted to let you know that someone was listening. And bless you for loving this child as is – for letting her be a little bit crazy, but still your wonderful daughter. I imagine your life must be incredibly hard. I hope you are able to relax a little and enjoy Disney.:hug:
 
I got teary eyed just reading this. You have so much on your plate.:hug:

The one thing I found really interesting, and maybe useful down the road is if she thinks WDW is "clean" then she is somewhat situational about her OCD. I'd never tell her it isn't clean...but it does make me think there's a way to crack open the window to other places that are "clean". Rationally, it doesn't make sense that WDW is any more "clean", right?

Does she have favorite fast food/restaurants? Or the YMCA? Or church, or a community center? I'm just trying to think of other favorites.

I don't know enough about psych meds to know if there are other options than SSRI's for her. But if she were my child, I'd ask. And I'd sneak them into her food or drink or whatever, given her fear of meds.
 
First :grouphug: I'm sorry you're all having such a hard time. I know that SSRIs can cause issues. DD takes zoloft but we can't increase the dose at all (she's been taking the same amount since she was 9 and she's 12) because it causes disinhibition and all her emotions are amplified.

when DD started her medicine one of her big fears was taking medicine so we got a liquid and told her she had to drink juice every morning. She took it for a couple of years without knowing- until she could handle it and understand that it helps her. Maybe there's something she could take in juice or soda? DD drinks Fresca now every morning because zoloft has to be in water, oj, or lemon lime soda.

I wish I had more ideas to help. Hang in there!
 

DS -- who is now 16 -- has classic OCD pretty much as you have described it when he is unmedicated and without therapy. He has NLD, which is similar to Aspergers, and his OCD presented when he was in 4th grade. I won't go through all the details because you've described them pretty accurately. However, he now takes fluvoxamine (Luvox) and goes to therapy every other week and functions fairly normally. (He makes straight A's in school and is beginning Advanced Placement classes this year.) He COULD NOT function without meds, though. OCD, as I imagine you know, is pretty much a neuro-chemical disorder. Meds are almost a necessity. Fluvoxamine is an SSRI, I think, but I know that there are lots of different treatments out there. When DS has a full-blown panic attack, we use 1/2 of a dose of Xanax to bring him down. (This happens about once a year, so you can see he is not in any danger of becoming addicted to Xanax.) This has really worked on the occasions when he is just completely out of control -- compulsion, compulsion, compulsion. (Like washing his hands until they bleed....) Cognitive behavioral therapy is generally more effective for people with OCD than talk therapy. (It's not comfortable because it gradually exposes the patient to things he or she obsesses about.) But it is very effective.

I am so sorry you are going through this. I cannot tell you how much I hate OCD. It is a scourge that fills our beautiful children with fear. Let me know if I can offer any words of encouragement.

Julie
 
Last thought on WDW -- It has always been our son's happy place. We ended up buying DVC the year after his OCD showed up because of this. It was the ONLY place we could go and just BE. So, maybe it will work out.

If not, don't push your daughter or make her feel bad about her inability to go out. If this really is OCD (and it sounds like it), she really can't control it. DS's therapist says OCD is almost as difficult to deal with as schizophrenia; we just don't recognize it because we tend to marginalize it by joking about it so much, "Oh he's so OCD," when someone is a neat freak.

Julie
 
:hug:

I am listening too!

Although I have not had to deal with this exactly here are just a few things I thought of that may help. (or may make things worse.... I am just putting them out there.)

What about plastic gloves? Like the ones for food prep or doctors use? This may help her need to wash her hands less, as the gloves protect her. maybe bring some of those disinfecting wipes, so that she can wipe down a chair, table, etc on her own. (while wearing said gloves).

These are not fixes, but just ways to try to lessen the load. gloves are easier than trying to be home to turn on a faucet. :confused3

and from what I am reading, for 'fixing' we shouldn't "Do not participate in your relative’s rituals. If you have helped with rituals in the past, it may take time and practice to change this pattern. In order for people with OCD to make progress, family and friends must resist helping with ritual behaviours. Supporting the rituals, including reassurance rituals, hinders progress."

http://www.camh.net/About_Addiction_Mental_Health/Mental_Health_Information/OCD/ocd_help.html

I don't know... I just know I read it and wish I could help some way. :grouphug::grouphug:
 
Thank you every sooooo much for all the wonderful words. You have no idea how much it means (actually I think you do which makes it mean even more). You're all so wonderful!!!!

Her therapist supposedly does use CBT but we've got a long road ahead of us. Yesterday was only her second appointment and it did not go well. Somebody about her set DD off and made her uncomfortable. It seems she didn't like being asked questions about herself. Uh, how else is she supposed to get to know you? Sigh..... She's got another appointment Friday and then the therapist is then on vacation until the Monday before our trip (we leave on the Wednesday). Obviously not a lot can be done in such a short time.

I've been trying to avoid letting her have rubber gloves because I was afraid that would be feeding the OCD monster but I'm starting to realize that it might be a good temporary measure to get her to maybe break the washing cycle and start doing activities she's stopped doing. I think I likely still have some in my kitchen (I need them for handling raw potatoes as I have a bad allergic reaction if I do so without rubber gloves; most times I just get DH to handle the raw ones so I haven't looked for them in a while). I'll have to look around and see if I can find them.

I really don't know what it is about WDW that she deems clean. I sure wish I did understand so I could maybe find some commonalities to other places. I suspect it's got to do with how accomodating they've always been of her plus how AMAZING the chefs are with allergies. She knows that restaurants are the safest we go to. That probably translates to WDW in general being safe.

There are a couple local restaurants where she loves to eat so we do go to these places on occasion but frankly it's not cheap because one's a steakhouse and one's a sushi place. There is a greek place that we recently discovered which is a lot cheaper but it still adds up. She's no longer willing to eat any fast food but frankly I can't blame her for that one since even foods that are supposed to be safe for her allergens seem to upset her stomache.

I plan to pick up some unscented baby wipes to carry in my purse for when we are out and she needs something.

When we get back from WDW, I probably will have to bring her to a psychiatrist to discuss possibly medicating her. I'll need to find somebody though who really understands autism as well because the doctor needs to be able to differentiate autistic obsessive compulsive issues from OCD. I wonder if she'd be better off with a neurologist? Neuropsychologists aren't medical doctors, are they? Hmmmm... I wonder if I can find a neuropsychiatrist?

I definitely can NOT sneak anything into her food. Right now she trusts me completely because she knows I never lie to her (I'm determined to have her trust) and she already has food trust issues because of her allergies and fears of cross contamination. She is willing to take medication in general as she takes a couple for GI issues and last night she was willing to take a decongestant. There's just something about psychiatric medication that she's opposed to. I don't know why. One of her closest friends who also has AS takes anxiety medication so it's not like there would be a stigma or anything. I'm kind of suspecting that her friend made some kind of negative comment about it but I really don't know for sure. If I pushed the issue she'd likely agree to take the medicine since she does take things when I insist. When we get home from WDW, it'll certainly be back on the table for discussion.

The point about doing things for her is not lost on me. I'm realizing that I am enabling her. Last night I lost it with her and ended up yelling at her. She ended up in her room crying for a good hour afterward, but while crying she also started taking some responsibility for picking up her own stuff and getting it put away (part of what I was yelling about since she was melting down over touching her stuff with her foot which is a big meltdown issue for her yet she leaves her stuff in piles in her room). I realized that I need to get back on a schedule of actually doing things. Even if it means meltdowns, she has to do things. I started thinking back over the past month and realized that when she does do stuff rather than just moping around the house, she seems to handle it ok as long as she has me there as a bit of a buffer. Around the house that doesn't seem to cut it but when she's active she can cope a bit better. I've been allowing her to do this which is something I need to stop for her sake as well as the rest of us around her. In addition to scheduling doing things around the house, I'm going to try getting her out of the house to some public places that she's enjoyed in the past just to break the routine and get her used to it again. It makes no sense but I'm hoping it'll work. I'm grasping at straws for ideas. Wish me luck!!

Thanks again everybody for just listening and for all the advice you offered. If you have any more ideas, I'm very open to them.
 
:grouphug: no real advice but wanted you to know I read your post and am sending you good thoughts and prayers.
 
Adding my well wishes and support to that of the others here! Only suggestion is that you use vinyl or fabric gloves for your DD. Latex (rubber) can leach thru the skin and cause irritation and eventually a life threatening allergy in some people (20yrs as an EMT taught me that!). vinyl gloves are cheap so you can just carry a box with you. BTW DS(19) sees WDW as a clean safe place as well, I think maybe we give them that impression because we tell them how wonderful it is, and anyplace that is so fun and happy cannot possibly be dirty, right? keep us updated on how things go.:goodvibes
 
:hug: OP, this sounds utterly exhausting for you AND for your daughter. I know you mentioned a therapist, but do you have a psychiatrist involved? If not, you should. They are experts on treating mental illness. And make no mistake, this IS a mental illness. :hug: This situation is waaaaaay beyond what a family doctor can manage. Your DD is very likely in need of medication, and there are many many meds other than SSRIs. Also, you might want to talk to the therapist about having sessions twice a week for a short period of time while your DD establishes a relationship with the therapist.

:grouphug: You have my total sympathy. I'm glad you found a safe place to vent.
 
I'm with Minky; this calls for a specialist medical intervention; the longer it is allowed to proceed unchecked the worse it is likely to get.

Honestly, given what you have described, I would not be surprised if short-term inpatient treatment were suggested for her; in which case you would want to get started right away so as to minimize time out of school.

I'm so sorry that your DD is suffering this way, and I hope that you can find a solution that helps her.
 
I just thought I'd share an update.

Counselling hasn't been going well. She told her therapist that she doesn't like her (very bluntly I might add). She was referred to another therapist but we haven't been able to see her yet as the first available appointment isn't until 9/15.

Her primary doctor and the mom of her best friend who is also an Aspie both recommended a psychiatrist whose specialty is autistic adolecenses which is great. The downside is that the first opening is 10/31 though she's been put on the wait list for cancellations. I'm not very hopeful about cancellations though as I've never actually seen that work with other doctors.

She managed WDW much better than I had expected but not nearly as well as she had expected. WDW really is pretty magical. I was shocked that she actually held Princess Tiana's hand and let Phineus and Ferb per an arm around her. She wouldn't acknowledge the characters are Cape May Cafe and these were the only other characters we met this trip but that was huge about those other characters. She did have some rough moments but overall she had a great time and the rest of us weren't in alert mode the whole trip and actually got to enjoy ourselves as well. WDW is truely magical.

School has been rough. On her first day she only made it to one class. By Friday she was at least in all of her classes but her case manager is very concerned and actually stated that as this point they're not sure if they can teach her but will definitely ensure her safety while at school. While this isn't acceptable, I do know that they're trying everything they can to help her and they did put together a packet of all her work from the week so she could work on it over the weekend and I did see that she definitely had absorbed the info she heard so she's doing better than what appears on the surface. Friday was by far her best day.

I am hopeful though. Here's why. She had her physical on Thursday. I had written up a list of questions, concerns and things I wanted her tested for. On this list I included testing certain vitamin levels (she has GI issues so she's prone to deficiencies and some of her problems could be made worse by certain deficiencies) and thyroid as well as also testing her for a UTI and strep. I know these last 2 sound weird but in the past she's had these infections without any symptoms other than worstening autistic issues and possibly some joint pain with strep. I figured it's better to test than to wonder. Boy am I glad I asked. She has strep. She's likely had strep for months without us knowing. She had no fever. She had no sore throat though the nurse to took the swab said her throat did look bad. She's been on antibiotics since Thursday evening and on Saturday morning she told me she's feeling much more like her old self and we've definitely seen a difference in what she's able to cope with. Can you believe all this time strep has been the root cause of this? We're still keeping the therapy and psychiatrist appointments since at this point I think some of this has become ingrained in her and she'll need professional help to get past this but we're definitely seeing light at the end of the tunnel.

So my PSA of the day is that autistic kids do not always present with symptoms for infections so keep this in the back of your mind when you're seeing increased perseverating or increased sensory issues. While this isn't necessarily common in autistic kids, it's not exactly uncommon either.
 
I would call the psyc's office every other day or so asking (politely;)) about cancellations. Become the scheduling person's best friend. I've been able to get my dd's appts moved up by months by doing that. Of course, you may have to drop everything and go at the last minute, but let them know that that is a possibility...if it is.
 
If your ped is willing, someone from his office can call and talk to the psych office. My ds needed a dermatologist badly. Couldn't get in for months. The dr's office called while we were being seen and got us in the next week. The nurse admitted to crying a bit but we got in.
 
Just out of curiosity, how much have you talked to her about the whole hormone change thing she is going through? DS is 15 but had some serious anxiety issues around her age. They don't really get the hormone changes that are happening like NT kids do. He is better about handling it but still has some anxiety. I am glad you have found a light at the end of the tunnel. It sounds to me like she was trying to control what she could when she couldn't control something else. DS does that sometimes. If you ever need to talk, feel free to PM me. There is nothing like talking to one who is right there with you.
 
I've asked her primary to see if there's anything she can do to stress the urgency with the psychiatrist to get her in earlier. The therapist is also in the same practice as the psychiatrist so I'll see if she can help too. I'll also make sure to phone periodically to see how we're doing on the list and to ask if there's any way to get bumped up.

We have discussed hormones and their impact on all of this with her. It is definitely a factor, a huge factor. Unfortunately, rationally understanding this doesn't actually change the emotions and anxieties when they're happening. Even pointing out when it's happening doesn't change that it's happening. If only it did. There's just such a huge gap between rationally understanding things and coping with that irrational feeling that comes with these kinds of anxieties. She understands how irrational some of these feelings are and can even tell us that but it doesn't change that feeling.

Yesterday in class she actively participated in a debate type of game in Social Studies and had fun doing so. YAY!!! In guitar class, she's holder her guitar and using it. In math and language arts she's now taking worksheets and completing them. We're definitely making progress. Baby steps.....
 












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