Leukocytes and Depakote

We just got the last of Pajama Monster's blood test results back. The Depakote levels are in the low end of the therapeutic range, so based on behavior (he's for instance tearing the plastic covers off the toilet bolts and flushing them, slapping Daddy, etc.) we can increase now. All other readings look great EXCEPT the leukocyte count. It's very slightly below the normal range. The leukocyte count is a measure of white blood cell/immune system health. Essentially, there is a chance we're improving everything in our lives and Pajama Monster's life at the expense of his little immune system. The levels aren't dangerously low...yet. We're doing another blood test in 2 weeks to see if they're still low or if it was just a fluke caused by something else.

This is the best things have ever been and in 2 weeks we may be right back where we started from, trapped in a stinking house full of poo and urine soaked carpet with a son laughing hysterically as he carves up the drywall and attacks his sister. I don't want to stop the Depakote. I really, REALLY, don't want to. I want to increase it to the top of it's therapeutic/safe range and see if things can just be normal then. I don't want to move on to heavier duty/scarier meds and I don't want a complicated huge med cocktail, but above all I don't want to endanger my child. Sadly, that leaves me with only one choice if the Depakote is trashing his immune system. I suppose all I can do is try to enjoy things for the next 2 weeks and pray that the low leukocyte count is a red herring. Why can't anything ever be simple? At least we've had a few weeks. We went to the zoo and went out to eat and got coffee and it was wonderful! Sometimes we ended up boxing our food up and carrying a screaming, hitting Pajama Monster out of the restaurant because he was mad that his noodles won't stay on the fork, but that didn't happen every time. It used to be about a 90% chance that the evening would end that way, but now it's more like 20%, with about an additional 40% chance that we'll have a couple incidents that require removing Pajama Monster to let him calm down. That used to be a 100% chance. It's not perfect, but it's so much better and the fear of losing all this is killing me. If anyone out there is reading this, prayers for my little Pajama Monster and his immune system would be very much appreciated!

That Was Fast!

Pajama Monster had his blood draw yesterday and subsequent McDonald's trip. He again handled it better than I could have hoped. Even McDonald's went well till he randomly dipped a toy in ketchup from the trash can and wiped it on my face. Apart from flushing part of our toilet paper holder down the toilet, the evening wasn't as bad as usual either. The Depakote blood levels came back at 66 with a normal range of 50-100. I've e-mailed the psychiatrist with an update on Pajama Monster's behavior but she won't be available till Wednesday. I'm not sure if she'll want to increase the dose further or not. I think I'd be much more in favor of that than in adding any new med into the mix.

We seem to be ahead of schedule though. We should be heading into weeks of hell about now. Despite that, with no change or increase in the medication, Pajama Monster had a great day today. He got in trouble for a few minor things and calmed down rapidly. That seems to be the biggest difference we see on the Depakote. Even when it isn't stopping many of the negative behaviors as it hasn't been for the past week, it seems to allow him to recover and return to normal behavior MUCH more quickly. I'll find him in time out playing calmly on his floor after just a couple of minutes, which is what I would consider a normal time out. Before the medication it was normal for time out to basically just function as containment till he appeared safe to be out of his room without hurting anyone or destroying anything. That would sometimes be hours of screaming, poo smearing, throwing toys, kicking the walls, etc. Now he's sitting on the floor playing with blocks when I go in to check on him.

The other thing we're noticing is that while there still is obviously a cycle happening, it's not the same as before the Depakote. Normally there were many many swings in any given day. We'd have a number of very bad spells lasting weeks, and then onece or twice a year we'd have a good spell lasting a few days to a week. Now we've had several pretty good weeks with one week of moderately bad behavior and now seem to be improving again. It's impossible to say how this will play out again, but I was really expecting each day to be worse and worse followed by many weeks of truly horrible behavior.

Reading over my own blog, I sound bipolar. One post I'm full of hope, the next I'm beside myself, then optimistic again. That's what life is like with Pajama Monster. Each day brings something new and we simply have to take things as they come, reveling in the good times and gritting our teeth through the bad.