Disturbing incident in triage .....

CO2emission · Jul 23, 2007

Ask a nurse or doctor from a "developing" country if the children there have bipolar disorder or ADHD. No.... they are still trying to get drugs for malaria. The pharmaceutical industry has a lot to answer for.....

Step 1... Make a drug

Step 2... Invent a disorder to go with the drug

Step 3... Convince society that the disorder is an epidemic

Step 4... Make another drug to "complement" the other drug

Step 5... Make another drug to treat the side effects of the other drugs. :uhoh3:

Some would call it the medicalization of society. What terminates a medical consultation? I think they call it a prescription.

crackerjack · Jul 23, 2007

I'm sorry this sort of incident was shocking for the OP and many here. I'm afraid there is much to learn and many who will reject the content. The fact is that while young brains are still forming, things can still go terribly wrong. How long did it take for Autism to become an accepted diagnosis...there are those who still reject it. There was a time I shared many of the opinions and shock that have been voiced on this thread, that is, until I had a child who went on to be diagnosed with bipolar disorder that is now, tragically, being ruled out in favor of one more appropriate, schizoaffective, and also more severe. Unfortunately, unless you've parented a child with one of these tragic disorders, you cannot possibly fathom how inadequate or misguided the suggestion of parenting or some of the others mentioned here really is. My son was diagnosed at 7yo then a short period later he was placed on lithium wherein he cried and thanked me repeatedly for his new med because for the first time in his life he no longer felt like killing himself. With the proper dose of an antipsychotic, originally given off-label for homicidal aggressions, it was learned that many of the things he had been reacting to were no longer present. He had, for as long as he could remember, suffered visual hallucinations. This was also the first time in his life he was able to sleep a normal, full night's sleep compared to his 2-4 hours nightly before. Bedtime routines, parenting, behavioral modifications, etc were of no value with this problem. I'm not one to try a new method or routine once or twice and declare it useless; I would remain fast with something for several weeks and longer to no avail. You cannot parent away a child's behavioral reactions to hallucinations, a child's reaction to being bombarded by emotions he cannot understand and lacks the ability to recognize it is abnormal to have such drastic turmoil in one's life or to not realize that some of what one sees is not even real.

Does mental illness run in the family, yes. Did I consider it as a possibility, no. I assumed I was not being a good parent, was not consistent enough, hadn't yet found what 'worked' for this child...all despite having two other children whom I'd successfully parented ahead of him without problems such as these. In the long run, I wish I had considered such a possibility much sooner and sought treatment at a much younger age.

Non-pharmaceutical treatments for bipolar have not been acceptable nor therapeutic for my son. Yes, he takes multiple psychiatric medications. For us, it is a simple choice. Without his medications he becomes symptomatic with return of hallucinations, lack of need for sleep, homicidal and suicidal ideation with plan and action....the full picture of bipolar with the unrelenting, as of yet, paranoia and perceptual distortions of schizophrenia. Yeah, I wish treatment had been sought and available at 3yo. Yes, there were symptoms that dated back well before he was 3 that I dismissed as him being a very peculiar child or outright denial or disbelief. He has been in therapy now more than half his life. He recognizes when his meds are working for him and, like most with severe mental illness, is unaware when things are gradually worsening. As he goes through puberty we are seeing pubertal changes, challenging boundaries, wanting to have full privileges of adulthood without the responsibility, and the typical teen transition issues that are not part of the disorder but are exacerbated by it. It is a difficult line to define when is something a symptom of the disorder worsening and when is it just a teenager being a teenager. It is not something he, his psychiatrist, psychologist, or I take lightly. Nor is it something we medicate before giving things time to percolate through counseling, time, situations and watched to determine if medications require changes at all. We've tried reducing medications gradually to determine if he can maintain at lower, safer doses but alas he became suicidally depressed. It just isn't a risk we can take.

I've rambled entirely too much and said so little. It is a complex disorder understood by few and experienced by few as well, thankfully. Nonetheless, the numbers of those diagnosed are increasing and I believe that in large part that is because people are becoming more aware and more accepting of mental illness diagnoses. The young Rebecca Riley case does not help things at all. It was recently in the news that family who were staying with the Riley's actually came forward and signed affidavits stating they had pilfered much of the clonidine that had been missing from RR's prescription to avoid having to fill their own medication prescriptions. I don't know the current belief of her cause of death with that in light but at last I read, the attorneys for her parents were planning to request the case be dismissed. Surprisingly, the other Riley children were also on complex medication regimens and despite being pulled and placed in foster care, remain on the same medication regimens as when they were with their parents.

crackerjack · Jul 23, 2007

That isn't the problem. The problem arises when a family is high middle class and still have outrageous bills because of a drastic medical condition. Basically in the case of my nephew, his father has insurance and makes too much according to the government or recieve financial help, but not enough to truly survive in the real world. My nephew is 19 and obviously can't work because of his condition, but can't gain in support either

At 19, your nephew can now apply for social security disability even though he lives with his parents. Once a child reaches adult age of 18 he can apply independently of his parents' income. If he is unable to manage funds on his own in a reasonable manner, a parent can be assigned to receive the funds and manage the account for the adult child. You must keep good records to account for what you're doing with the money for the recipient but it isn't something that can't be done. Be advised, it is a long hard road to gaining approval and for the most part the unwritten 'rule' is to deny all first time claims regardless of validity. This is where some hire a disability attorney, others choose to reapply/appeal on their own. Good luck!

Kidrn911 · Jul 23, 2007

At 19, your nephew can now apply for social security disability even though he lives with his parents. Once a child reaches adult age of 18 he can apply independently of his parents' income. If he is unable to manage funds on his own in a reasonable manner, a parent can be assigned to receive the funds and manage the account for the adult child. You must keep good records to account for what you're doing with the money for the recipient but it isn't something that can't be done. Be advised, it is a long hard road to gaining approval and for the most part the unwritten 'rule' is to deny all first time claims regardless of validity. This is where some hire a disability attorney, others choose to reapply/appeal on their own. Good luck!

You would think, but the state of Illinois don't know that yet, or at least the last 2 times he has applied.

debbiemonica · Jul 23, 2007

I don't understand why a child with supposed bipolar disorder is being prescribed antipsychotic medications?

teeituptom, BSN, RN · Jul 23, 2007

I may have to cross post this in the Psych Forum, if there is one ....
Last night, while doing time in Triage ...
I had a sweet 3 year old boy ...
I'm asking meds/allergies, etc. Turns out, the child was on Abilify and Risperdal. I give Mom the raised eyebrow ... "Why is he on these meds?"
She says, "Oh, he's bipolar...."
WHAT????
The child was 3 years old!!!!!!
Am I the only one who is FLOORED by these kinds of things?? How in the world could/would you diagnose a child that young with bi-polar disorder???
Dianna

I read all the posts

I am not floored by this at all. nothing floors me anymore

But if it wasnt for Pharmaceutical companies looking for new areas to market their drugs, thus making larger profits. Profits is what its all about to them.

If it wasnt for MD being in the pockets of pharmaceutical companies, and helping find areas to increase profits to the pharmaceutical companies. Profits are essential to the MDs also

If it wasnt for the TV companies selling Ad times to these companies for making a profit. Though TV stations do post disclaimers to protect themselves.

I see a common thread here " PROFITS' in the pockets only.

Barbie38 · Jul 24, 2007

I am currently a clinical instructress in Psychiatric Nursing here in our country, Philippines. This thread meant a lot. Thank you for bringing this up. This is really alarming. I wish to convey this message to the nurse...you are really concerned and I think you could help this child while you could.

I have been to a lot of psychiatric milieu centers here in our place and I feel so secure to know that most of the patients we had are on the ages...20 plus.

But maybe we could learn something from the parents of this 3 yr. old kid, if you would have time to ask them. .... and basing on the fact that U.S. physicians are looked up to by physicians of our country.... I think we need enlightenment here to erase any suspicions and doubt..

I hope to know the upcoming episode of this thread. It is educational.....I hope.

crackerjack · Jul 24, 2007

You would think, but the state of Illinois don't know that yet, or at least the last 2 times he has applied.

Are they applying for state assistance or Social Security Disability? With state assistance parental income is going to be considered -assuming the adult child still lives at home. Social Security Disability is federal however so I'm not sure what the state's opinion has to do with anything on that matter.

FranEMTnurse, CNA, LPN, EMT-I · Aug 25, 2007

I may have to cross post this in the Psych Forum, if there is one ....
Last night, while doing time in Triage ...
I had a sweet 3 year old boy ...
I'm asking meds/allergies, etc. Turns out, the child was on Abilify and Risperdal. I give Mom the raised eyebrow ... "Why is he on these meds?"
She says, "Oh, he's bipolar...."
WHAT????
The child was 3 years old!!!!!!
Am I the only one who is FLOORED by these kinds of things?? How in the world could/would you diagnose a child that young with bi-polar disorder???
Dianna

My personal thougt on this is, :nono:no child at that age is bipolar. He/she can get ad/hd if not trained properly, and then there are the occasional real cases, but no where near what is diagnosed. :angryfireI COMES FROM THE CHILD'S ENVIRONMENT. I hate it when the buck is passed off that way. Something, or many traumatic somethings had to have occurred in the child's environment to cause her/him to be that way. :oPoor little kids.

crackerjack · Aug 25, 2007

My personal thougt on this is, :nono:no child at that age is bipolar. He/she can get ad/hd if not trained properly, and then there are the occasional real cases, but no where near what is diagnosed. :angryfireI COMES FROM THE CHILD'S ENVIRONMENT. I hate it when the buck is passed off that way. Something, or many traumatic somethings had to have occurred in the child's environment to cause her/him to be that way. :oPoor little kids.

So I'm wondering, if it is all from the child's environment, what of the ongoing studies that are finding genetic markers for these disorders? Do genetic markers only count in adults? We readily accept genetic likelihood of diseases such as high cholesterol, heart disease, diabetes and oh so many others...why not psychiatric disorders? And if we're going to accept genetic predisposition to psychiatric disorders, why do we limit them to adults? Do children's genes not play a part in their medical makeup until they magically become adults? Is autism all about the child's environment as well? It is not a diagnosis of traditional 'medical' origin, it exists in the DSM, is a psychiatric diagnosis.

FranEMTnurse, CNA, LPN, EMT-I · Aug 26, 2007

So I'm wondering, if it is all from the child's environment, what of the ongoing studies that are finding genetic markers for these disorders? Do genetic markers only count in adults? We readily accept genetic likelihood of diseases such as high cholesterol, heart disease, diabetes and oh so many others...why not psychiatric disorders? And if we're going to accept genetic predisposition to psychiatric disorders, why do we limit them to adults? Do children's genes not play a part in their medical makeup until they magically become adults? Is autism all about the child's environment as well? It is not a diagnosis of traditional 'medical' origin, it exists in the DSM, is a psychiatric diagnosis.

If you read my earler message correctly, you will notice I did mention with exception. I was a school bus driver several years ago, where I dealt with children and their parents for 15 years. Most of the children I drove the past 5 hears were horrendously mixed up, would not listen to anything, I even heard the filthiest words I had ever heard from a 5 year old who just didn't care. I went to a conference with him and his stepfather twice, and the stepfather blamed the school and the school bus company's rules. Now, how about that. What I'm saying here, is numerous parents are negligent in their childrearing. Then when the child, who has had little to no training throws a fit, the parent, boyfriend, etc shakes slaps beats the child, or the children are witness to alcoholism, drug addiction by their parents, etc. the whold 9 yards.

I was married to one of the exceptional ones. He was a narcisistic, paranoid, scitzophrenic who felt everyone was going to listen on our conversations, due to implanted listening devices in our home, he wasn't capable of loving me or my children correctly. When we separated, He took the oldest daughter out on the west coast and asked his inlaws to raise her.

Laurel never forgot that. She now has very ambivilant memories of her father for keeping her away from me for so long.

We got back together a year later, and my hubby and I remained separated, with visiting rites on weekends during the day.

I had a mother who was spoiled growing up. She was given everything by my grandfather. So after she got married, she expected my father to get up in the middle of the night to buy her some icecream. He did it too. Then we were growing up, she was going to an old army doctor who pushed drugs. We had an elderly gentleman living with us as our babysitter. That doctor would prescribe Demeral to my mother on his social security insurance. It was done all the time. She became a drug addict, who eventually lost her life in a house fire because she was too high to get my grandfather out. And she taught my brother to become a druggie too. Now he's currently very ill, but still taking methadone which he loves.

Now, as you can see, I do know something about the subject.

dria · Aug 26, 2007

personal experience does not make one a subject matter expert. the research clearly indicates a genetic implication to mental health disorders. the research also clearly indicates a difference in the physical structure of the brain of those with mental illness. however, it remains unclear as yet which is the causative factor and which is the result.

environment may play a role in triggering those with a genetic predisposition, similar to some of the current theories related to carciongenesis.

it is true that some childen develop mental health disorders due to a traumatic home environment. however, i am curious to know why franmet decided that her ex-spouse was one of the "exceptions." obviously, she was not around during his childhood to know whether this was the result of his parents "poor training."

the point of all of this is that no one can judge the causative factors of any child's mental illness. at the end of the day, the cause of this illness is a moot point....why not get past any potential finger pointing and care for this child?