The last several weeks have been rough. A little over a month ago Pajama Monster's blood draw showed that his Depakote levels had suddenly skyrocketed for no apparent reason. He was suddenly well above the therapeutic range. Naturally we reduced the dose and our doctor ordered another blood draw to see if the Depakote levels had dropped and to check on liver function. Two weeks later his Depakote was still high and his liver tests were showing overly high scores too. After more tests and reductions it became apparent that Pajama Monster's liver was just not going to keep playing nicely with the Depakote, so the Depakote had to go.
Our psychiatrist recommended Risperdal again and again we refused. Perhaps it would fix all the behavior problems we're having, but it would also make him feel a little sedated and increase his lifetime risk of tardive dyskinesia and diabetes. He's only six. He can't be sedated through his childhood. How will he learn and grow as he's supposed to? No. Just no.
The next and safest option appears to be Lithium. Now we had to decide when to start it. It took about a week and a half to wean Pajama Monster off the Depakote. We were given the green light to start the Lithium increase while we were doing the Depakote decrease, but I didn't want to do that. Pajama Monster has been medicated for a long time. Deep in my heart I kept hoping "What if he doesn't need the meds as much any more.? What it he's matured and can handle things better?" I wanted so much for that to be true. I felt that I owed it to Pajama Monster to at least see how things are off everything. I notified the school so that Pajama Monster's behavior wouldn't be held against him. As we tapered the Depakote his behavior kept getting worse. I kept hoping that we'd hit rock bottom, but that didn't seem to happen till about 1-2 days after we stopped the Depakote completely. We also stopped the Adderall right after the Depakote stopped so that we could start with a clean slate. Surprisingly, his appetite came back as we stopped the Depakote, not the Adderall. I kept hoping that maybe we just wouldn't start any new medication and he's be ok with just behavioral intervetions. By last Monday, a day before we finished the Depakote, we pulled Pajama Monster out of school. He was becoming increasingly violent, hitting teachers, having screaming meltdowns, and usually had to be removed from the class for the entire day starting at 9:15. School starts at 9:00.
I think we've finally hit rock bottom. We started the Lithium 2 days ago. Pajama Monster has been poking holes in his wall and scratching up his bed. He pooed on the floor and the urinated on his bed to make a "yellow Easter egg" stain while I was on my hands and knees scrubbing up the poo. He's urinated down his heat vent, urinated into various containers, even taken the plastic 3 ring sheet protectors out of his art binder to fill them with urine. He threatens to kill me and hits me. He steals and has started removing the pins from door hinges. He has screaming tantrums and can't calm or listen to reasoning or warnings. Much like before "Pajama Monster, please don't do that. No! Do not do that! You will lose your computer time. *Parent moving to stop him* Stop now!" has no impact whatsoever and he's surprised and furious when, after he does whatever it was we were telling him to stop, completely ignoring all directions, he then loses his computer time, or has whatever consequence he's been warned about. He has all the problems he did when we started the medication last time. I didn't want to medicate, but I don't see how he can have any kind of life like this. He can't go to play dates because of his violence. He can't function at school. I just pray this medication is the right choice. I don't know if anyone is out there reading this, or if it's just a place for me to vent, but if you do happen across this blog, and you're willing, prayers for my litle Pajama Monster would be truly welcome.
Friday, March 15, 2013
Monday, February 18, 2013
He knows everything
Pajama monster often believes he knows everything about everything. He probably wouldn't say it that way, but he does say that he doesn't think he should have to listen to his teacher since he knows so much more than she does, and no matter how great the danger or how firm the limit he's sure he can ignore the limits and danger because he has a smart plan to handle everything. Those plans are almost always pure fantasy and run along the lines of "but if I got a tank and drove it over and used a huge metal pair of tongs to..." He also believes he should be the boss, make the rules, control everyone's actions, and that he has the right to do pretty much whatever he wants whenever he's in that mindset. Grandiosity is a symptom of mania, but seems to be one that isn't talked about a lot in pediatric bipolar. Perhaps it's less common, or just less understood. Perhaps people just chalk it up to bossiness or brattiness, but if it only shows up in a manic episode, it isn't that the child is a brat, it's a symptom of the mania. Frustratingly, this is a chronic struggle with Pajama Monster.
The truth is, he is very bright, and his ideas are often very creative, great ideas, but when that becomes magnified into an inability to join play because he has to change the rules so everyone is following his directions, and an inability to function in Kindergarten without constantly being reminded to follow the rules, it's a problem.
The question is, what do I do about it. Mania doesn't respond to reason. It isn't that he's just not looking at the right set of facts and that's why he's thinking this way. His brain chemistry is making him feel like he's king of the world and so he's acting accordingly. There's no way to argue with that. I can point out the teacher's degree and age and experience, and point out the huge gaping holes in the logic of his plans, but they just don't register when he's manic. He's Superman and I'm just some citizen pointing out that he's wearing his undies on the outside of his costume. He doesn't care. He's Superman!! The only thing that seems to work is to increase the level of supervision till the phase seems to be passing. This is, of course, the very last thing he wants us to do when he's manic, so in some ways we're just causing him to fight against the rules more. The alternative it to let him get hurt though, so we're stuck increasing structure when he wants it the least.
The other thing that has helped some is explaining things from a "because you're awesome and should get what you want" perspective. On some level this is easy, because no matter how much I want to scream at him sometimes, he's my son and I do believe he's awesome and I do want him to get things to make him happy. One of our latest is my explanation on how to get kids to do what you want in play. Pajama Monster's standard MO is to walk up to a group of playing kids, announce some change in the play, then continue yelling, calling and trying to get the attention of the other children while doing everything in his power to get them to follow his new idea. This usually looks something like this: Group of kids are running in circles around a tree roaring and pretending to be dinosaurs. Pajama Monster runs over and announces that he's planting food for the dinosaurs, then tells them to all line up to get their food. The kids at this point are usually just continuing to roar and run in circles. Pajama monster starts calling more loudly, then warning that the food is going to go bad, then that they'll starve, etc. All this time the kids are running and roaring. If by some chance the kids do line up to get the pretend food, Pajama Monster will start micro managing every item of how they line up and what they say to get the food and which foods he will allow them to have, and what happens once they eat them and on and on. It always ends with the kids wandering off to play and Pajama Monster following after them still yelling rules, then being a sad little boy on my lap who doesn't understand why no one will let him play. The upshot of all this is my new "get people to listen to your great play ideas" technique. Step one: Notice EXACTLY what the group of kids are doing. Step two: Do EXACTLY that. Do not add rules or your own spin. Just join THEIR game. Step three: Wait for the kids to show they're playing with you through eye contact, smiling at you or talking with you. Step 4: Suggest (don't order) one of your great ideas Step 5: if they don't like it, wait a minute and try a different great idea, or, if they do like it remember to only decide what YOUR character/self can/can't do.
This is just one little piece. It doesn't fix the help myself to whatever I want and bully my sister and ignore limits issues, but at least maybe it will help him look at ways to get what he wants without just demanding over and over.
The truth is, he is very bright, and his ideas are often very creative, great ideas, but when that becomes magnified into an inability to join play because he has to change the rules so everyone is following his directions, and an inability to function in Kindergarten without constantly being reminded to follow the rules, it's a problem.
The question is, what do I do about it. Mania doesn't respond to reason. It isn't that he's just not looking at the right set of facts and that's why he's thinking this way. His brain chemistry is making him feel like he's king of the world and so he's acting accordingly. There's no way to argue with that. I can point out the teacher's degree and age and experience, and point out the huge gaping holes in the logic of his plans, but they just don't register when he's manic. He's Superman and I'm just some citizen pointing out that he's wearing his undies on the outside of his costume. He doesn't care. He's Superman!! The only thing that seems to work is to increase the level of supervision till the phase seems to be passing. This is, of course, the very last thing he wants us to do when he's manic, so in some ways we're just causing him to fight against the rules more. The alternative it to let him get hurt though, so we're stuck increasing structure when he wants it the least.
The other thing that has helped some is explaining things from a "because you're awesome and should get what you want" perspective. On some level this is easy, because no matter how much I want to scream at him sometimes, he's my son and I do believe he's awesome and I do want him to get things to make him happy. One of our latest is my explanation on how to get kids to do what you want in play. Pajama Monster's standard MO is to walk up to a group of playing kids, announce some change in the play, then continue yelling, calling and trying to get the attention of the other children while doing everything in his power to get them to follow his new idea. This usually looks something like this: Group of kids are running in circles around a tree roaring and pretending to be dinosaurs. Pajama Monster runs over and announces that he's planting food for the dinosaurs, then tells them to all line up to get their food. The kids at this point are usually just continuing to roar and run in circles. Pajama monster starts calling more loudly, then warning that the food is going to go bad, then that they'll starve, etc. All this time the kids are running and roaring. If by some chance the kids do line up to get the pretend food, Pajama Monster will start micro managing every item of how they line up and what they say to get the food and which foods he will allow them to have, and what happens once they eat them and on and on. It always ends with the kids wandering off to play and Pajama Monster following after them still yelling rules, then being a sad little boy on my lap who doesn't understand why no one will let him play. The upshot of all this is my new "get people to listen to your great play ideas" technique. Step one: Notice EXACTLY what the group of kids are doing. Step two: Do EXACTLY that. Do not add rules or your own spin. Just join THEIR game. Step three: Wait for the kids to show they're playing with you through eye contact, smiling at you or talking with you. Step 4: Suggest (don't order) one of your great ideas Step 5: if they don't like it, wait a minute and try a different great idea, or, if they do like it remember to only decide what YOUR character/self can/can't do.
This is just one little piece. It doesn't fix the help myself to whatever I want and bully my sister and ignore limits issues, but at least maybe it will help him look at ways to get what he wants without just demanding over and over.
Sunday, November 6, 2011
Not losing sight of hope
As you might expect, we've had a number of ups and downs since the last post. The increase dropped the leukocyte count which then stabilized into the normal range. Our last check showed the Depakote levels as at the top of the therapeutic range, so we're staying at this dose and keeping an eye on things month to month. Last Thursday we had a bit of an off day, followed by a rotten Friday and a bad Saturday and Sunday. On Friday he threatened to bring a gun to school and shoot his teachers. Yes, it was a bad day. Fortunately he's only 4 so he isn't being expelled as he might be if this had happened when he was older. The school called to do a safety check and were very nice about it. They seemed satisfied that Pajama Monster has NO access to guns EVER. I'm hoping that this will all be part of the newly emerging pattern we're seeing. It seems that he has a good stretch of time and then a warning day, several rotten days and then another rocky day and we're fine again. It's hard surfing these and remembering that he didn't pick this, that he isn't just deciding to be a malicious little jerk. Still, it's not as bad.
Even during his good phases he has "stuck" moments usually several times per day. He just gets fixated on something and can't let it go. For instance, he decides that he needs to help stir the treat the kids are making BEFORE he washes his hands. He can't accept any reasons for this not being the case and will just keep screaming about it or fighting to do it till he's removed or till I'm able to talk him down.
Our psychiatrist is considering either decreasing the Adderall or adding some Prozac to deal with his stuck moments which she sees as anxiety based. I had actually been asking that we try decreasing the Adderall after the holidays anyway, but I'm hoping we're not looking at adding anything else in. When he gets stuck he seems so panicked over it. During his bad phases he gets even more focused on controlling his sister too. Being two, her coping strategy is to scream when he does this, so that's tons of fun for Mommy.
All in all I just need to remember that things are better now, and even though they're not perfect, and perhaps we'll always have periods where I need to carry him out from the play date, they are better. He's been able to go across the hall after bedtime to use the potty, a huge step in trust. Previously this always ended in him literally destroying things in the bathroom and making huge messes. We haven't had a real poo or urine incident since Oktoberfest, and I chalk those up to being overtired and overstimulated. I just wish that every day didn't feel like waiting for the other shoe to drop. It's also lonely because most parents of disabled children that I know have children who are autistic or cognitively delayed. I don't know anyone with a bipolar child. It would be nice to have someone going through the same thing to go through this with. Thank God I have a husband who is invested in me, the children and the family. I don't know what I'd do without that support.
Even during his good phases he has "stuck" moments usually several times per day. He just gets fixated on something and can't let it go. For instance, he decides that he needs to help stir the treat the kids are making BEFORE he washes his hands. He can't accept any reasons for this not being the case and will just keep screaming about it or fighting to do it till he's removed or till I'm able to talk him down.
Our psychiatrist is considering either decreasing the Adderall or adding some Prozac to deal with his stuck moments which she sees as anxiety based. I had actually been asking that we try decreasing the Adderall after the holidays anyway, but I'm hoping we're not looking at adding anything else in. When he gets stuck he seems so panicked over it. During his bad phases he gets even more focused on controlling his sister too. Being two, her coping strategy is to scream when he does this, so that's tons of fun for Mommy.
All in all I just need to remember that things are better now, and even though they're not perfect, and perhaps we'll always have periods where I need to carry him out from the play date, they are better. He's been able to go across the hall after bedtime to use the potty, a huge step in trust. Previously this always ended in him literally destroying things in the bathroom and making huge messes. We haven't had a real poo or urine incident since Oktoberfest, and I chalk those up to being overtired and overstimulated. I just wish that every day didn't feel like waiting for the other shoe to drop. It's also lonely because most parents of disabled children that I know have children who are autistic or cognitively delayed. I don't know anyone with a bipolar child. It would be nice to have someone going through the same thing to go through this with. Thank God I have a husband who is invested in me, the children and the family. I don't know what I'd do without that support.
Tuesday, September 13, 2011
Praise and Thanks to God!!
I've been praying for Pajama Monster. I'm a Mommy and a Christian, so of course I've been praying for him. I prayed for his conception and pregnancy and birth, and now I pray every day for him to just be able to have a good life. Lately that's been centering around his medications and health. I believe that God answers every prayer, but sometimes the answer is "no." Today, however, the answer about the leukocyte counts was "yes." Apparently, according to our psychiatrist, in some cases the body can adjust to the Depakote and stabilize the white blood cells. From his latest, completely normal WBC of 8.2, that appears to be what happened. His depakote level is 75, smack in the middle of the range, so we're increasing the dose slightly to see if we can get him nearer the best end of the therapeutic range. It's possible that a month from now my little Pajama Monster could be functioning like any other very gifted little snuggle bug. He might be able to function in preschool without behavioral specialists and go to playdates without needing to leave because of his behavior. Even if we never make it all the way there, this is manageable. Praise be to God for all his help! Without Him we would be truly lost!
Friday, September 2, 2011
Not the Mommy I'd like to be...
I'm not the energetic, always ready to play Mommy that I'd always hoped I'd be. The truth is, I'm drained. It seems like Pajama Monster needs so much constant supervision that when he is sitting and wanting to play with Mommy, all I really want to do is go in the bedroom and hide from the chaos for a little bit. I want to drink a whole cup of tea, or eat a whole bagel without having to stop Pajama Monster from bullying 5 or 6 times and redirect him back to his task another 15 times and then stop him from various other defiant acts another dozen or so times. Breakfast alone generally requires this number of interventions. I'm not a super picky Mommy when it comes to breakfast either. I'm pretty happy if the kids stay at the table, eat something, and no one is screming.
That being said, I know I need to play with the kids but often struggle because I am so drained. It's the emotional exhaustion that comes from needing to intervene at least once a minute for hours and hours at a time. It's from never knowing when a mood swing will happen. It's the weariness that comes from people raising an eyebrow at me when Pajama Monster acts out, and also coming over to lecture me when I do intervene early to prevent the acting out because somehow that's wrong too. If I give him meds I'm an irresponsible unloving monster who wants my child to be a zombie, and if I don't then I'm a worthless incompetent mother who is clearly causing his behavior. If he is having a good day then I'm exagerating and "overprotective," but if he's having a bad day then I get lectured on his bratty/violent behavior. Last week a mom freaked out at a playdate because her child urinated behind a tree and my son was trying to play in it with a stick. I didn't ask why she thought it was reasonable for her son to be urinating with an audience in the first place. That's what I get for turning my back for a second to hear what Peep was asking me.
I feel silly and whiny saying that I don't have the energy to play legos and cars, but sometimes it just feels like I can't handle the strain of wondering when the next problem is going to start, or who is going to try to shove their unwanted judgements down my throat while I'm elbow deep in another Pajama Monster meltdown. When I'm not feeling worn down I can just ignore most of these, but some days it gets to me. I do find myself reading a book at the counter some days, or taking my laptop out to the kitchen and reading or surfing when I could be playing, then I feel guilty because I know Pajama Monster wants to play. I love him so much, but sometimes I wish he had a 10 minute pause button, just so I could catch my breath and collect my thoughts. I've tried many times to add in a little structured Mommy/kid exercise time or yoga time, but Pajama Monster just can't handle it. If I'm not playing his game his way with him in control of my every move then it doesn't count for him as being played with. I know that this just shows that he needs play time even more because he needs to build his play skills, but some days it's hard. I suppose that's just part of being a Mommy. It's just magnified with the bipolar.
I whined to my husband about feeling worthless because I'm so tired while other moms are out there baking fresh bread every day and chairing the PTA. My husband reminded me that on top of the parenting those moms don't have all the therapy appointments, psychiatry appointments, special ed. meetings, social skills meetups, support group meetings and also probably don't have to shampoo urine out of the carpet 4-5 times a week. That made me feel a little better. Maybe other moms aren't really doing more, but just doing different. Society spends so much time telling us that Bipolar isn't real and meds are unnecessary that some days I guess a part of my brain (albeit a dumb part) buys into it and wonders why my life feels so hard.
Wednesday, August 24, 2011
And the Saga Continues...
The last few months have been a long series of blood draws and "wait and see" pauses. Behavior in these last months has been better than ever before, but that doesn't mean we're anywhere near normal. Still, it's manageable. He often goes many days at a time without destroying anything or hurting anyone. Tantrums calm faster and we're able to do some activities as a family. We went to the renaissance faire and my little boy asked to go dance with everyone in the big circle. It was wonderful! He was so proud of himself! We went camping twice and things went really well.
We've never gotten the Depakote levels up beyond the low middle of the therapeutic range, and the Leukocyte count has stayed below the normal range, but just barely. We've discussed trying a different med, but the problem is that there are really only about 3 places to go from here. One it Lithium, which has a very thin window of efficacy and becomes toxic above that level. Below that level it does no good. At Pajama Monster's size that window is so tiny that moving into the toxic range is very probable, so that's a no-go. The second option has some potentially permanent side effects that increase in probability with exposure, so starting at age 4 means I'm likely signing him up for permanent side effects, even once the med is stopped...also not something I'm willing to do. The final option is to stay in the Depakote family. The Lamictal that sent him into a manic fork wielding attack on the baby is also in the Depakote family, so we might be back in for another episode like that, or we might have the same problem with low Leukocyte counts. That's our best and only option as I see it if the Depakote can't be made to work safely.
That brings us to our current situation. Pajama Monster's last blood tests showed his leukocyte count as barely back into the normal range, but his Depakote levels have dropped below the therapeutic range, despite the fact that we INCREASED the dose a month ago. The psychiatrist believes that Pajama Monster's liver has just gotten fantastic at munching up the Depakote and that's why the levels are dropping. This happens with some meds, especially some in the Depakote family. It sometimes takes several increases over the course of several months to get to a stable level.
My husband and I had been wondering why, despite the increase in dose, Pajama Monster's behavior had suddenly started getting worse. He's been encouraging Peep, who is now potty training, to poo in a bucket in the yard and then hoarding the bowel movements in his play house outside. He's also been playing in his urine and being more generally defiant and violent. I've also noticed that he's been wanting to pretend that he has bags of garbage, piles of garbage, a dump, etc again. This is an old game of his that had disappeared and seems to have come back. He essentially just stuffs toys, papers, etc into bags and carries them around and hides or dumps them places. I don't mind the game, but it is interesting that it shows up when he's having other problems and subsides as his behavior improves.
The final thing I've noticed is that he seems to be wanting to pray for forgiveness for things, was obsessed with idea of writing worries on paper at a wedding ceremony to give up fears, is anxious about things in general, needs to finish tasks, even if finishing is just picking up the thing I set down and setting it down himself, etc. For most parents these would probably be lost in the noise of Pajama Monster's other oddities, but I should probably mention at this point that I have confessional OCD, as do both of my siblings, and my mother. Her mother also had OCD, but I don't know the variety. Onset is usually around the start of puberty, but perhaps it's early for Pajama Monster. I don't want to throw another med into the mix. No one in my family has ever used meds for the OCD. It's just a living hell for a while and then with a lot of focus and practice it subsides into manageable hints of symptoms that we carry the rest of our lives. I think it's time to start pushing the Psychologist to begin addressing or at least considering more strongly the possibility of OCD.
For the moment we're increasing the Depakote again and blood testing again in a month. Wish us luck. Prayers for my Pajama Monster are always welcome.
We've never gotten the Depakote levels up beyond the low middle of the therapeutic range, and the Leukocyte count has stayed below the normal range, but just barely. We've discussed trying a different med, but the problem is that there are really only about 3 places to go from here. One it Lithium, which has a very thin window of efficacy and becomes toxic above that level. Below that level it does no good. At Pajama Monster's size that window is so tiny that moving into the toxic range is very probable, so that's a no-go. The second option has some potentially permanent side effects that increase in probability with exposure, so starting at age 4 means I'm likely signing him up for permanent side effects, even once the med is stopped...also not something I'm willing to do. The final option is to stay in the Depakote family. The Lamictal that sent him into a manic fork wielding attack on the baby is also in the Depakote family, so we might be back in for another episode like that, or we might have the same problem with low Leukocyte counts. That's our best and only option as I see it if the Depakote can't be made to work safely.
That brings us to our current situation. Pajama Monster's last blood tests showed his leukocyte count as barely back into the normal range, but his Depakote levels have dropped below the therapeutic range, despite the fact that we INCREASED the dose a month ago. The psychiatrist believes that Pajama Monster's liver has just gotten fantastic at munching up the Depakote and that's why the levels are dropping. This happens with some meds, especially some in the Depakote family. It sometimes takes several increases over the course of several months to get to a stable level.
My husband and I had been wondering why, despite the increase in dose, Pajama Monster's behavior had suddenly started getting worse. He's been encouraging Peep, who is now potty training, to poo in a bucket in the yard and then hoarding the bowel movements in his play house outside. He's also been playing in his urine and being more generally defiant and violent. I've also noticed that he's been wanting to pretend that he has bags of garbage, piles of garbage, a dump, etc again. This is an old game of his that had disappeared and seems to have come back. He essentially just stuffs toys, papers, etc into bags and carries them around and hides or dumps them places. I don't mind the game, but it is interesting that it shows up when he's having other problems and subsides as his behavior improves.
The final thing I've noticed is that he seems to be wanting to pray for forgiveness for things, was obsessed with idea of writing worries on paper at a wedding ceremony to give up fears, is anxious about things in general, needs to finish tasks, even if finishing is just picking up the thing I set down and setting it down himself, etc. For most parents these would probably be lost in the noise of Pajama Monster's other oddities, but I should probably mention at this point that I have confessional OCD, as do both of my siblings, and my mother. Her mother also had OCD, but I don't know the variety. Onset is usually around the start of puberty, but perhaps it's early for Pajama Monster. I don't want to throw another med into the mix. No one in my family has ever used meds for the OCD. It's just a living hell for a while and then with a lot of focus and practice it subsides into manageable hints of symptoms that we carry the rest of our lives. I think it's time to start pushing the Psychologist to begin addressing or at least considering more strongly the possibility of OCD.
For the moment we're increasing the Depakote again and blood testing again in a month. Wish us luck. Prayers for my Pajama Monster are always welcome.
Thursday, June 9, 2011
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!
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